OCCUPATIONAL EXPOSURES AND RISK OF BREAST CANCER

最近的估计表明，只有大约40%的乳腺癌 病例可以用公认的和怀疑的危险因素来解释。 女性在工作场所暴露于化学和物理制剂有 没有得到充分的研究。因此，本议定书的目的是 是为了确定职业暴露于选定的化学物质和 物理代理与前和后风险相关 绝经后乳腺癌。一项以人群为基础的病例对照研究 40岁女性绝经前和绝经后乳腺癌发病率 到79年间在纽约州西部进行的一项调查 1991年。只有新的、经组织学证实的原发恶性肿瘤病例 来自该地区所有主要医院的乳腺癌患者入选(301 绝经前和绝经后439人)。以人群为基础的对照组 被招募，并与案件受试者在年龄和 居住的县。训练有素的护士进行面对面的面谈- 进行了面谈，并提供了一系列关于 获得了可接受的和潜在的危险因素。标准化寿命 还获得了职业史，其中包括详细信息 关于就业地点、职责和与以下方面有关的活动 每一份工作。对于所有1,550名受试者，工作历史将被发送到 该研究所的专业工业卫生师和化学家团队 Armand-Frappier，然后将把暴露给大约300名特工 使用了西米亚特基和他的同事开发的方法。这支队伍有 在编码这些类型的工作历史和意志方面有相当丰富的经验 与水牛城的卫生员合作。职业信息 在工作描述中出现的内容足够详细，足以捕捉到 每个人的工作特点；因此，该系统将最小化 曝光错误分类。统计分析，包括逻辑分析 将采用回归和广义加法建模技术 评估职业暴露的作用，重点放在 多环芳烃、特定有机溶剂和 电磁场。分析将分别针对 绝经前和绝经后分组，并将酌情合并。 识别其暴露可经修改的制剂 可能允许采取新的公共卫生举措来降低风险。这来得正是时候 调查应该为我们有限的 了解乳腺癌的职业危险因素。

Recent estimates indicate that only about 40 percent of breast cancer cases can be explained by accepted and suspected risk factors. Exposures to chemical and physical agents in the workplace of women have not been studied adequately. Thus, the object of the present protocol is to determine whether occupational exposures to selected chemical and physical agents is associated with increased risks of pre- and postmenopausal breast cancer. A population-based, case-control study of pre-and postmenopausal breast cancer incidence among women aged 40 to 79 years was conducted in western New York State between 1986 and 1991. Only new, histologically-confirmed primary cases of malignant breast cancer from all major hospitals in the region were enrolled (301 premenopausal and 439 postmenopausal). A population-based control group was recruited and was frequency-matched to case subjects on age and county of residence. Face-to-face interviews by trained nurse- interviewers were carried out and information on a wide array of accepted and potential risk factors was obtained. Standardized lifetime occupational histories were also obtained and these included details regarding place of employment, duties and activities associated with each job. For all 1,550 subjects, the job histories will be sent to a team of expert industrial hygienists and chemists at the Institut Armand-Frappier who will then attribute exposure to about 300 agents using a method developed by Siemiatycki and colleagues. The team has considerable experience in coding these types of job histories and will collaborate with hygienists in Buffalo. The occupational information present in the job descriptions is sufficiently detailed to capture the idiosyncracies of each person's job; thus, this system will minimize exposure misclassification. Statistical analyses, including logistic regression and generalized additive modeling techniques, will be carried out to assess the role of occupational exposures with a focus on polycyclic aromatic hydrocarbons, specific organic solvents and electromagnetic fields. Analyses will be conducted separately for the pre- and postmenopausal groups and will be combined where appropriate. Identification of agents whose exposures are amenable to modification may allow for new public health initiatives to reduce risk. This timely investigation should make an important contribution to our limited understanding of occupational risk factors for breast cancer.