A cohort study of air pollution, lung cancer, and COPD in Los Angeles County

项目摘要/摘要 虽然过去几十年空气质量有所改善，但空气污染无处不在，空气污染的绝对数量 受影响的人是一个主要的公共卫生问题。2013年，国际癌症研究机构 将室外空气污染和颗粒物(PM)列为对人类致癌和导致肺部疾病的物质 癌症。这种最近的分类要求立即采取行动，解决流行病学文献中关于 空气污染在增加肺癌和慢性阻塞性肺疾病风险中的作用 慢性阻塞性肺病(COPD)是美国四大死因中的两个。因此，我们设计了以下目标， 利用丰富的环境、生活方式、社区、分子和监控数据 常备多民族队列(MEC)研究。我们在目标1中建议量化和描述这些关联 112,023人中估计暴露于空气颗粒物(PM2.5，PM10)与肺癌风险之间的关系 加州(CA)MEC参与者有3057例肺癌病例。在目标2中，我们将量化和描述 有医疗保险数据的46,000名CA MEC参与者中PM2.5、PM10与COPD风险之间的关系 包括11,508例慢性阻塞性肺疾病患者。在目标3中，我们将研究PM2.5、PM10和血清之间的关系 在7566名CA MEC参与者中，已经可以获得炎症标志物C反应蛋白的水平。在每一个中 在这些目标中，我们还将评估这些PM关联被共同污染物改变的程度 (例如，NO2和NOx交通标志)、个人级别(例如，种族/民族、性别、吸烟状况)以及 邻里层面的因素(例如，社会经济地位、种族飞地)。这项建议的优点包括： (1)这是首批预期的空气污染与肺癌和慢性阻塞性肺病的研究之一，其中包括相当大的 非洲人和拉丁美洲人的人数(n=80,489)；(2)它通过以下方式处理空气污染评估的复杂性 评估具有不同优势和功能的三种不同的空气污染物估算指标； (3)它利用同一时期内的多种风险敞口衡量标准，提供更深入的 了解暴露模式及其与风险的关联；以及(4)结合了分子流行病学 组件。通过这项工作，我们希望增加对肺癌负担的了解，并 与空气污染暴露相关的慢性阻塞性肺病，并找出重要的 子组。

PROJECT SUMMARY/ABSTRACT While air quality has improved over the past decades, air pollution is ubiquitous and the absolute number of people affected is a major public health concern. In 2013, the International Agency for Research on Cancer classified outdoor air pollution and particulate matter (PM) as carcinogenic to humans and a cause of lung cancer. This recent classification calls for prompt action to address the gaps in the epidemiologic literature on the role of air pollution in increasing the risks for lung cancer and chronic obstructive pulmonary disease (COPD), two of the top four causes of death in the United States. Thus, we designed the following aims, leveraging the rich environmental, lifestyle, neighborhood, molecular, and surveillance data of the long- standing Multiethnic Cohort (MEC) Study. We propose in Aim 1 to quantify and characterize the associations between estimated exposure to airborne particulate matter (PM2.5, PM10) and lung cancer risk among 112,023 California (CA) MEC participants with 3,057 lung cancer cases. In Aim 2 we will quantify and characterize the associations between PM2.5, PM10, and risk of COPD among 46,000 CA MEC participants with Medicare data, including 11,508 COPD cases. In Aim 3 we will investigate the relationships between PM2.5, PM10, and serum levels of the inflammatory marker, C-reactive protein, already available in 7,566 CA MEC participants. In each of these aims, we will also assess the extent to which these PM-associations are modified by co-pollutants (e.g., NO2 and NOx traffic markers), individual-level (e.g., race/ethnicity, gender, smoking status), and neighborhood-level (e.g., socioeconomic status, ethnic enclave) factors. The strengths of this proposal include: (1) it represents one of the first prospective air pollution and lung cancer and COPD study to include sizeable numbers of Africans and Latinos (n=80,489); (2) it addresses the complexity of air pollution assessment by evaluating three separate measures of estimated air pollutants having different advantages and functionalities; (3) it leverages multiple measures of exposures over the same periods to provide a greater depth in understanding exposure patterns and associations with risk; and (4) it incorporates a molecular epidemiology component. Through this work, we expect to increase our understanding of the burdens of lung cancer and COPD associated with air pollution exposure and to identify differences in associations among important subgroups.