Major Factors Affecting Incidence of Childhood Thyroid Cancer in Belarus after the Chernobyl Accident: Do Nitrates in Drinking Water Play a Role?
Major Factors Affecting Incidence of Childhood Thyroid Cancer in Belarus after the Chernobyl Accident: Do Nitrates in Drinking Water Play a Role?
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DOI：
10.1371/journal.pone.0137226
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Reiners C
中科院分区：
文献类型：
--
作者：
Drozd VM;Saenko VA;Brenner AV;Drozdovitch V;Pashkevich VI;Kudelsky AV;Demidchik YE;Branovan I;Shiglik N;Rogounovitch TI;Yamashita S;Biko J;Reiners C
1986 年切尔诺贝利核电站事故造成的主要健康后果之一是事故发生时 18 岁以下人群的甲状腺癌发病率急剧上升。多项分析流行病学研究表明，这种增加与事故中甲状腺摄入的碘 131 (131I) 剂量直接相关。然而，对于改变 131I 相关风险的因素的了解仍然有限。我们重点关注白俄罗斯切尔诺贝利事故后的儿童甲状腺癌，回顾了辐射、甲状腺筛查和碘缺乏对甲状腺癌发病率区域差异影响的证据。我们还回顾了有关地下水中硝酸盐含量和甲状腺癌风险的现有证据，引起人们对白俄罗斯戈梅利和布列斯特等几个受污染地区的露天井水中硝酸盐含量高的关注，这与氮肥的使用有关。在这项假设生成研究中，基于生态数据和生物学合理性，我们认为硝酸盐污染可能会改变与辐射相关的甲状腺癌风险，从而导致白俄罗斯儿童甲状腺癌发病率存在区域差异。旨在评估地下水中硝酸盐含量和辐射的联合影响的分析流行病学研究提供了一条有前途的研究途径，并可能为甲状腺癌的病因学提供有用的见解。
One of the major health consequences of the Chernobyl Nuclear Power Plant accident in 1986 was a dramatic increase in incidence of thyroid cancer among those who were aged less than 18 years at the time of the accident. This increase has been directly linked in several analytic epidemiological studies to iodine-131 (131I) thyroid doses received from the accident. However, there remains limited understanding of factors that modify the 131I-related risk. Focusing on post-Chernobyl pediatric thyroid cancer in Belarus, we reviewed evidence of the effects of radiation, thyroid screening, and iodine deficiency on regional differences in incidence rates of thyroid cancer. We also reviewed current evidence on content of nitrate in groundwater and thyroid cancer risk drawing attention to high levels of nitrates in open well water in several contaminated regions of Belarus, i.e. Gomel and Brest, related to the usage of nitrogen fertilizers. In this hypothesis generating study, based on ecological data and biological plausibility, we suggest that nitrate pollution may modify the radiation-related risk of thyroid cancer contributing to regional differences in rates of pediatric thyroid cancer in Belarus. Analytic epidemiological studies designed to evaluate joint effect of nitrate content in groundwater and radiation present a promising avenue of research and may provide useful insights into etiology of thyroid cancer.