RESIDENTIAL RADON EXPOSURE AND LUNG-CANCER AMONG NONSMOKING WOMEN
RESIDENTIAL RADON EXPOSURE AND LUNG-CANCER AMONG NONSMOKING WOMEN
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DOI：
10.1093/jnci/86.24.1829
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发表时间：
1994-12-21
期刊：
影响因子：
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通讯作者：
BOICE, JD
中科院分区：
文献类型：
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作者：
ALAVANJA, MCR;BROWNSON, RC;BOICE, JD
背景：已知在足够高的浓度下，氡会在地下矿工和实验动物中引起肺癌。目的：我们的目的是确定室内氡水平是否与可检测到的肺癌增加有关。不吸烟的女性之所以被选中，是因为她们提供了检测与氡相关的风险的最佳机会，同时将吸烟和职业的潜在混杂影响降至最低。方法：在密苏里州开展了一项以人群为基础的肺癌发病病例对照研究。共有538名在1986至1992年间被诊断患有肺癌的非吸烟白人女性和1183名年龄匹配的对照受试者分别从密苏里州癌症登记处以及驾照和医疗保险名单中被确认。通过电话访谈获得有关肺癌危险因素的信息。对过去5-30年居住的每个住宅进行了长达一年的氡测量。结果：氡测量覆盖了相关居住期的78%，据报道，女性在此期间有84%的时间待在室内。病例组和对照组的时间加权平均氡浓度完全相同(空气的1.82pCI/L[pCI L(-1)])。有6.5%的病例组和6.8%的对照组经历过的氡水平大于4pci L(-1)。综合所有数据，几乎没有证据表明肺癌有随着氡浓度增加而增加的趋势(双尾趋势检验，P=0.99连续数据分析；P=0.19分类数据分析)。在腺癌细胞类型和直接受访的妇女中，有一个积极的剂量-反应趋势(双尾趋势检验；P=.31连续数据分析；P=0.04分类数据分析)，但对于其他组织学或在接受代孕访谈的妇女中没有。结论：在这项研究中，通过(A)包括大量不吸烟且室内占有率高的女性，(B)在诊断癌症时进行大量的氡测量，以及(C)控制已知的肺癌病因，最大限度地提高了检测室内氡风险的可能性。然而，没有令人信服的证据表明肺癌与暴露在国内水平的氡之间存在联系。含义：美国住宅中常见的氡水平导致肺癌的风险似乎很低。
Background: Radon at sufficiently high concentrations is known to cause lung cancer among underground miners and in experimental laboratory animals. Purpose: Our aim was to determine whether indoor levels of radon are associated with a detectable increase in lung cancer. Nonsmoking women were selected because they offer the best opportunity to detect radon-related risk while minimizing the potentially confounding influences of cigarette smoking and occupation. Methods: A population-based, case-control study of incident lung cancer was conducted in Missouri. A total of 538 nonsmoking white women diagnosed with lung cancer between 1986 and 1992 and 1183 age-matched control subjects were identified from the Missouri Cancer Registry and from driver's license and Medicare listings, respectively. Information on lung cancer risk factors was obtained by telephone interview. Year-long radon measurements were sought in every dwelling occupied for the previous 5-30 years. Results: Radon measurements covered 78% of the relevant residential period, and women reported being indoors for 84% of this time. The time-weighted average radon concentrations were exactly the same for case subjects and control subjects (1.82 pCi/L of air [pCi L(-1)]). Radon levels greater than 4 pCi L(-1) were experienced by 6.5% of the case subjects and 6.8% of the control subjects. For all data combined, there was little evidence for a trend of lung cancer with increasing radon concentrations (two-tailed trend test, P = .99 continuous data analysis; P = .19 categorical data analysis). A positive dose-response trend was suggested for the adenocarcinoma cell type and among directly interviewed women (two-tailed trend test; P = .31 continuous data analysis; P = .04 categorical data analysis), but not for other histologies or among those who had surrogate interviews. Conclusions: The possibility of detecting a risk from indoor radon in this study was maximized by (a) including a large number of nonsmoking women with high indoor occupancy, (b) conducting a large number of radon measurements near the time of the diagnosis of cancer, and (c) controlling for known causes of lung cancer. However, an association between lung cancer and the exposure to domestic levels of radon was not convincingly demonstrated. Implications: The magnitude of the lung cancer risk from radon levels commonly found in U.S. dwellings appears low.