美国海军陆战队勒让营基地受污染饮用水暴露的海军陆战队员、海军人员和文职工作人员的死亡率评估:一项队列研究。

IF 5.3 2区 环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES
Frank J Bove, April Greek, Ruth Gatiba, Rona C Boehm, Marcie M Mohnsen
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引用次数: 0

摘要

背景:1953 年至 1985 年期间,北卡罗来纳州勒让恩营美国海军陆战队基地 (MCB) 的饮用水受到三氯乙烯和其他工业溶剂的污染:对 1975 年至 1985 年期间开始服役并驻扎在勒让恩营(人数 = 159,128 人)或加利福尼亚州 MCB 彭德尔顿营(人数 = 168,406 人)的海军陆战队/海军人员,以及 1972 年 10 月至 1985 年 12 月期间受雇于勒让恩营(人数 = 7,332 人)或彭德尔顿营(人数 = 6,677 人)的文职工作人员进行了队列死亡率研究。彭德尔顿营地的饮用水未受到工业溶剂污染。死亡率跟踪时间为 1979 年至 2018 年。采用比例危险回归法计算调整后的危险比 (aHR),比较勒让讷营地和彭德尔顿营地队列之间的死亡率。95% 置信区间 (CI) 上限和下限的比值或 CIR 用于评估 aHRs 的精确度。研究的重点是aHR≥1.20和CIR≤3的基本死因:勒让恩营和彭德尔顿营海军陆战队/海军陆战队人员的死亡人数分别为 19,250 人和 21,134 人。勒让恩营和彭德尔顿营文职人员的死亡人数分别为 3,055 人和 3,280 人。与彭德尔顿营的海军陆战队/海军人员相比,勒让营的肾癌(aHR = 1.21,95% CI:0.95,1.54)、食道癌(aHR = 1.24,95% CI:1.00,1.54)和女性乳腺癌(aHR = 1.20,95% CI:0.73,1.98)的aHR≥1.20,CIR≤3。aHR≥1.20且CIR>3的死因包括帕金森病、骨髓增生异常综合症以及睾丸癌、宫颈癌和卵巢癌。与彭德尔顿营的文职人员相比,勒让营的慢性肾病(aHR = 1.88,95% CI:1.13,3.11)和帕金森病(aHR = 1.21,95% CI:0.72,2.04)的aHR≥1.20,CIR≤3。女性乳腺癌的 aHR 为 1.19(95% CI:0.76,1.88),肾癌和咽癌、黑色素瘤、霍奇金淋巴瘤和慢性粒细胞白血病的 aHR ≥ 1.20,CIR>3。定量偏倚分析表明,吸烟和饮酒造成的混杂不会对研究结果产生明显影响:与彭德尔顿营相比,可能暴露于勒让营受污染饮用水的海军陆战队/海军陆战队人员和文职工作人员的几种死因的危险比增加了。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of mortality among Marines, Navy personnel, and civilian workers exposed to contaminated drinking water at USMC base Camp Lejeune: a cohort study.

Background: Drinking water at U.S. Marine Corps Base (MCB) Camp Lejeune, North Carolina was contaminated with trichloroethylene and other industrial solvents from 1953 to 1985.

Methods: A cohort mortality study was conducted of Marines/Navy personnel who, between 1975 and 1985, began service and were stationed at Camp Lejeune (N = 159,128) or MCB Camp Pendleton, California (N = 168,406), and civilian workers employed at Camp Lejeune (N = 7,332) or Camp Pendleton (N = 6,677) between October 1972 and December 1985. Camp Pendleton's drinking water was not contaminated with industrial solvents. Mortality follow-up was between 1979 and 2018. Proportional hazards regression was used to calculate adjusted hazard ratios (aHRs) comparing mortality rates between Camp Lejeune and Camp Pendleton cohorts. The ratio of upper and lower 95% confidence interval (CI) limits, or CIR, was used to evaluate the precision of aHRs. The study focused on underlying causes of death with aHRs ≥ 1.20 and CIRs ≤ 3.

Results: Deaths among Camp Lejeune and Camp Pendleton Marines/Navy personnel totaled 19,250 and 21,134, respectively. Deaths among Camp Lejeune and Camp Pendleton civilian workers totaled 3,055 and 3,280, respectively. Compared to Camp Pendleton Marines/Navy personnel, Camp Lejeune had aHRs ≥ 1.20 with CIRs ≤ 3 for cancers of the kidney (aHR = 1.21, 95% CI: 0.95, 1.54), esophagus (aHR = 1.24, 95% CI: 1.00, 1.54) and female breast (aHR = 1.20, 95% CI: 0.73, 1.98). Causes of death with aHRs ≥ 1.20 and CIR > 3, included Parkinson disease, myelodysplastic syndrome and cancers of the testes, cervix and ovary. Compared to Camp Pendleton civilian workers, Camp Lejeune had aHRs ≥ 1.20 with CIRs ≤ 3 for chronic kidney disease (aHR = 1.88, 95% CI: 1.13, 3.11) and Parkinson disease (aHR = 1.21, 95% CI: 0.72, 2.04). Female breast cancer had an aHR of 1.19 (95% CI: 0.76, 1.88), and aHRs ≥ 1.20 with CIRs > 3 were observed for kidney and pharyngeal cancers, melanoma, Hodgkin lymphoma, and chronic myeloid leukemia. Quantitative bias analyses indicated that confounding due to smoking and alcohol consumption would not appreciably impact the findings.

Conclusion: Marines/Navy personnel and civilian workers likely exposed to contaminated drinking water at Camp Lejeune had increased hazard ratios for several causes of death compared to Camp Pendleton.

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来源期刊
Environmental Health
Environmental Health 环境科学-公共卫生、环境卫生与职业卫生
CiteScore
10.10
自引率
1.70%
发文量
115
审稿时长
3.0 months
期刊介绍: Environmental Health publishes manuscripts on all aspects of environmental and occupational medicine and related studies in toxicology and epidemiology. Environmental Health is aimed at scientists and practitioners in all areas of environmental science where human health and well-being are involved, either directly or indirectly. Environmental Health is a public health journal serving the public health community and scientists working on matters of public health interest and importance pertaining to the environment.
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