Biological and Statistical Approaches for Modeling Exposure to Specific Trihalomethanes and Bladder Cancer Risk
Biological and Statistical Approaches for Modeling Exposure to Specific Trihalomethanes and Bladder Cancer Risk
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DOI：
10.1093/aje/kwt009
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发表时间：
2013-08-15
影响因子：
5
通讯作者：
Villanueva, Cristina M.
中科院分区：
文献类型：
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作者：
Salas, Lucas A.;Cantor, Kenneth P.;Villanueva, Cristina M.
终生暴露于三卤甲烷（THM）与膀胱癌风险增加有关。我们探讨了膀胱癌的风险分析方法与4 THM（氯仿，溴二氯甲烷，二溴氯甲烷，溴仿）作为替代消毒副产品（DBP）的混合物在西班牙的病例对照研究（1998-2001年）。计算了686例膀胱癌患者和750例匹配的医院对照者家庭中THM的终生平均浓度。通过条件Logistic回归对几个暴露指标进行建模，包括以下分析：总THM（μ g/L），总THM的细胞毒性加权总和（pmol/L），4个THM在单独的模型中，4个THM在1个模型中，氯仿和溴化THM的总和在1个模型中，以及主成分分析。THM的组成，浓度和相关性各不相同的地区。总THM的模型是稳定的，并显示出增加的剂量反应趋势。单独THM的模型提供了不稳定的估计和不一致的剂量-反应关系。特定THM的风险估计受到混合物的不同组成、物种之间的相关性和历史估计的不精确性的阻碍。总THM（μ g/L）提供了DBP的替代指标，与膀胱癌风险产生最强的剂量反应关系。在其他情况下，应使用各种指标和统计方法来评估这种关联。
Lifetime exposure to trihalomethanes (THM) has been associated with increased risk of bladder cancer. We explored methods of analyzing bladder cancer risk associated with 4 THM (chloroform, bromodichloromethane, dibromochloromethane, and bromoform) as surrogates for disinfection by-product (DBP) mixtures in a case-control study in Spain (1998-2001). Lifetime average concentrations of THM in the households of 686 incident bladder cancer cases and 750 matched hospital-based controls were calculated. Several exposure metrics were modeled through conditional logistic regression, including the following analyses: total THM (mu g/L), cytotoxicity-weighted sum of total THM (pmol/L), 4 THM in separate models, 4 THM in 1 model, chloroform and the sum of brominated THM in 1 model, and a principal-components analysis. THM composition, concentrations, and correlations varied between areas. The model for total THM was stable and showed increasing dose-response trends. Models for separate THM provided unstable estimates and inconsistent dose-response relationships. Risk estimation for specific THM is hampered by the varying composition of the mixture, correlation between species, and imprecision of historical estimates. Total THM (mu g/L) provided a proxy measure of DBPs that yielded the strongest dose-response relationship with bladder cancer risk. A variety of metrics and statistical approaches should be used to evaluate this association in other settings.