Environmental exposure to cadmium and risk of cancer: a prospective population-based study
Environmental exposure to cadmium and risk of cancer: a prospective population-based study
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DOI：
10.1016/s1470-2045(06)70545-9
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发表时间：
2006-02-01
期刊：
影响因子：
51.1
通讯作者：
Staessen, JA
中科院分区：
文献类型：
--
作者：
Nawrot, T;Plusquin, M;Staessen, JA
背景镉是一种普遍存在的环境污染物，它在人体内积累，因此24小时尿液排泄物是终生接触的生物标志物。我们的目的是评估镉环境暴露与癌症之间的关联。方法我们从靠近三个锌冶炼厂的地区招募了随机人群样本（n = 994），并从镉暴露量较低的地区招募了参考人群。在基线 (1985-89)，我们测量了 24 小时内获得的尿液样本和参与者花园土壤中的镉，并跟踪癌症的发病率直至 2004 年 6 月 30 日。我们使用 Cox 回归来计算与内部（即尿液）和外部（即土壤）镉暴露相关的癌症风险比，同时调整协变量。结果土壤中的镉浓度 范围为 0.8 毫克/公斤至 17.0 毫克/公斤。在基线时，高暴露区域人群的几何平均尿镉排泄量为 12.3 nmol/天，而参考（即低暴露区域）人群的几何平均尿镉排泄量为 7.7 nmol/天（p < 0.0001）。在随访期间（中位时间 17.2 年 [范围 0.6-18.8]），发生了 50 例致命癌症和 20 例非致命癌症，其中分别为 18 例和 1 例肺癌。总体癌症风险与 24 小时镉排泄量加倍显着相关（风险比 1.3）[95% CI 1.03-1.65]，p=0.026。在高暴露区域，肺癌的人群归因风险为 67% (95% CI 33-101)，而吸烟的人群归因风险为 73% (38-108)。对于肺癌，24 小时尿镉排泄量翻倍的调整后风险比为 1.70 (1.13-2.57，p=0.011)，居住在高暴露区域与低暴露区域的调整后风险比为 4.17 (1.21-14.4，p=0.024)，居住在低暴露区域的调整后风险比为 1.57 (1.11-2.24，p=0.024)。 p=0.012) 中镉浓度加倍 土壤。解读 有色金属冶炼厂的历史污染继续对健康造成严重危害，因此需要采取有针对性的预防措施。
Background Cadmium is a ubiquitous environmental pollutant, which accumulates in the human body such that 24-h urinary excretion is a biomarker of lifetime exposure. We aimed to assess the association between environmental exposure to cadmium and cancer.Methods We recruited a random population sample (n=994) from an area close to three zinc smelters and a reference population from an area with low exposure to cadmium. At baseline (1985-89), we measured cadmium in urine samples obtained over 24 h and in the soil of participants' gardens, and followed the incidence of cancer until June 30, 2004. We used Cox regression to calculate hazard ratios for cancer in relation to internal (ie, urinary) and external (ie, soil) exposure to cadmium, while adjusting for covariables.Findings Cadmium concentration in soil ranged from 0.8 mg/kg to 17.0 mg/kg. At baseline, geometric mean urinary cadmium excretion was 12.3 nmol/day for people in the high-exposure area, compared with 7.7 nmol/day for those in the reference (ie, low-exposure) area (p < 0.0001). During follow-up (median 17.2 years [range 0.6-18.8]), 50 fatal cancers and 20 non-fatal cancers occurred, of which 18 and one, respectively, were lung cancers. Overall cancer risk was significantly associated with a doubling of 24-h cadmium excretion (hazard ratio 1.3) [95% CI 1.03-1.65], p=0.026. Population-attributable risk of lung cancer was 67% (95% CI 33-101) in the high-exposure area, compared with that of 73% (38-108) for smoking. For lung cancer, adjusted hazard ratio was 1.70 (1.13-2.57, p=0.011) for a doubling of 24-h urinary cadmium excretion, 4.17 (1.21-14.4, p=0.024) for residence in the high-exposure area versus the low-exposure area, and 1.57 (1.11-2.24, p=0.012) for a doubling of cadmium concentration in soil.Interpretation Historical pollution from non-ferrous smelters continues to present a serious health hazard, necessitating targeted preventive measures.