Maya Spaur, Lauren M Hurwitz, Danielle N Medgyesi, Alexander P Keil, Laura E Beane Freeman, Jared A Fisher, Jessica M Madrigal, Samantha Ammons, Emma S Spielfogel, Komal Bangia, Paul S Albert, Tiffany R Sanchez, James V Lacey, Rena R Jones, Mary H Ward
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引用次数: 0
Abstract
Background: Several drinking water contaminants are known or suspected carcinogens; however, there are only a few investigations of drinking water exposures and ovarian cancer. We evaluated associations between regulated contaminants in community water systems (CWS) and ovarian cancer risk in the California Teachers Study, a prospective cohort of female California educators.
Methods: Participants were cancer-free, without bilateral oophorectomy, living in California at baseline (1995-1996) with geocoded addresses linked to a CWS (N=91,127, 92%), with follow-up through 2020 (mean=19.0 years). Among participants with a residential duration at enrollment of at least 10 years, we computed 15-year (1990-2005) averages of log2-transformed arsenic, nitrate, total trihalomethanes (TTHM) (N=59,881), and uranium concentrations (N=56,314). We estimated hazard ratios (HRs, 95% CIs) for all epithelial ovarian cancers (n=424) and the high-grade serous histotype (n=203), using Cox proportional hazards regression, adjusting for age, body mass index, menopause status, oral contraceptive use, and parity. We evaluated the mixture effect (per IQR in log2 concentrations), using quantile-based g-computation.
Results: Almost all women (>99%) had average exposures below regulatory limits for all contaminants. In single contaminant analyses, a doubling in average uranium concentrations was associated with all ovarian cancer (HRperlog2=1.09, CI 1.02-1.16), whereas a doubling in nitrate was associated with the high-grade serous histotype (HRperlog2=1.09, CI 1.02-1.17). Findings were similar in models adjusted for other contaminants. We observed positive but imprecise associations for arsenic and TTHM in single-contaminant and contaminant-adjusted analyses. HRs per increase in the mixture were 1.39 (1.00, 1.94) and 1.75 (1.09, 2.83), for all ovarian cancer and the high-grade serous histotype, respectively. Uranium was the largest contributor (55%) to the mixture effect for all ovarian cancer, and nitrate was the largest contributor (46%) for the high-grade serous histotype.
Conclusions: Novel associations between drinking water contaminants and ovarian cancer risk at levels below regulatory limits warrant further investigation. https://doi.org/10.1289/EHP16582.
背景:几种饮用水污染物是已知或可疑的致癌物;然而,关于饮用水暴露和卵巢癌的调查很少。我们在加州教师研究中评估了社区供水系统(CWS)中受管制污染物与卵巢癌风险之间的关系,这是一项加州女性教育工作者的前瞻性队列研究。方法:参与者无癌症,未进行双侧卵巢切除术,基线(1995-1996年)居住在加利福尼亚州,地理编码地址与CWS相关(N=91,127, 92%),随访至2020年(平均=19.0年)。在居住时间至少为10年的参与者中,我们计算了15年(1990-2005)log2转化砷、硝酸盐、总三卤甲烷(TTHM) (N=59,881)和铀浓度(N=56,314)的平均值。我们使用Cox比例风险回归,调整年龄、体重指数、绝经状态、口服避孕药使用和胎次,估计了所有上皮性卵巢癌(n=424)和高级别浆液组织型(n=203)的风险比(hr, 95% CIs)。我们使用基于分位数的g计算来评估混合效应(每IQR在log2浓度下)。结果:几乎所有妇女(约99%)的平均暴露量低于所有污染物的规定限值。在单一污染物分析中,平均铀浓度加倍与所有卵巢癌相关(HRperlog2=1.09, CI 1.02-1.16),而硝酸盐浓度加倍与高级别浆液组织型相关(HRperlog2=1.09, CI 1.02-1.17)。在对其他污染物进行调整后的模型中,结果也类似。我们观察到在单一污染物和污染物调整分析中,砷和TTHM呈正但不精确的关联。在所有卵巢癌和高级别浆液组织型中,每增加1倍的hr分别为1.39(1.00,1.94)和1.75(1.09,2.83)。铀是所有卵巢癌混合效应的最大贡献者(55%),硝酸盐是高级别浆液组织型的最大贡献者(46%)。结论:饮用水污染物与卵巢癌风险之间的新联系在低于法规限制的水平值得进一步调查。https://doi.org/10.1289/EHP16582。
期刊介绍:
Environmental Health Perspectives (EHP) is a monthly peer-reviewed journal supported by the National Institute of Environmental Health Sciences, part of the National Institutes of Health under the U.S. Department of Health and Human Services. Its mission is to facilitate discussions on the connections between the environment and human health by publishing top-notch research and news. EHP ranks third in Public, Environmental, and Occupational Health, fourth in Toxicology, and fifth in Environmental Sciences.