Ecological analysis of digestive cancer mortality related to contamination by diarrhetic shellfish poisoning toxins along the coasts of France
Ecological analysis of digestive cancer mortality related to contamination by diarrhetic shellfish poisoning toxins along the coasts of France
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DOI：
10.1006/enrs.2000.4103
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发表时间：
2000-10-01
影响因子：
8.3
通讯作者：
Belin, C
中科院分区：
文献类型：
--
作者：
Cordier, S;Monfort, C;Belin, C
贝类消费者面临着腹泻的风险，其中包括产生腹泻性贝类中毒（DSP）毒素的藻类，如Dinophysis spp.自1984年以来，这些疾病已经有效地预防了，当时在法国沿海建立了藻毒素监测网络。尽管如此，人们还是担心残留的冈田酸可能会增加经常食用贝类的人患癌症的风险。冈田酸是一种已知的肿瘤促进剂，是法国沿海水域中存在的主要毒素。为了验证这一假设，我们在59个沿海地区进行了一项生态研究，将消化道癌症死亡率与DSP毒素污染的替代措施联系起来。观察到的死亡人数和预期死亡人数（以国家死亡率为参考）按性别、死亡原因和地区计算了1984-1988年和1989-1993年两个时期的死亡人数。每个区域的污染水平是通过监测开始以来因DSP毒素污染而停产的总周数来估计的。通过泊松回归和对四种暴露类别标准化死亡率趋势的检验，我们发现了一些与几种消化道癌部位（男性食道癌、胃癌、结肠癌、肝癌和全消化道癌；女性胃癌和胰腺癌）相关的证据。在男性中，考虑到饮酒可能造成的混杂因素后，唯一有统计学意义的结果是结肠癌。这种分析所提供的结论是非常试探性的；它们需要根据关于DSP毒素潜在长期影响的额外信息进行复制和解释。在缺乏人体数据的情况下，它们提供了暴露于DSP毒素和消化系统癌症之间可能存在关联的一些迹象。(C) 2000年学术出版社。
Shellfish consumers are exposed to the risk of diarrhea from, among other contaminants, algae that produce diarrhetic shellfish poisoning (DSP) toxins, such as Dinophysis spp. These illnesses have been effectively prevented since 1984, when a phycotoxin monitoring network was set up along the coasts of France. There is nonetheless concern that residual levels of okadaic acid, a known tumor promoter that is the main toxin present in French coastal waters, might increase the risk of cancer among regular shellfish consumers. To test this hypothesis, we conducted an ecological study linking digestive cancer mortality rates with a proxy measure of contamination by DSP toxins in 59 coastal areas. Observed and expected numbers of deaths (using national rates as the reference) were computed by sex, cause of death, and area for two time periods: 1984-1988 and 1989-1993. The level of contamination in each area was estimated by the total number of weeks since monitoring began that production was shut down because of DSP toxin contamination. Using both Poisson regressions and test for trends of standardized mortality ratios across four exposure categories, we found some evidence of associations for several digestive cancer sites (esophagus, stomach, colon, liver, and total digestive cancers for men; stomach and pancreatic cancers for women). Among men, the only statistically significant result that remained after taking possible confounding by alcohol use into account involved colon cancer. The conclusions provided by this analysis are very tentative; they need to be reproduced and interpreted in the light of additional information on the potential long-term effects of DSP toxins. In the absence of human data, they provide some indication of a possible association between exposure to DSP toxins and digestive cancers. (C) 2000 Academic Press.