臺灣地區空氣污染與癌症死亡率間關係的研究

Effects of air pollution on cancer mortality in Taiwan

劉家嘉(Chia-Chia Liu)

指導教授 ： 楊俊毓

高雄醫學大學/健康科學院/職業安全衛生研究所/博士(2009年)

摘要

本研究主要目的是想分析與瞭解臺灣地區空氣污染物質與三種癌症–肺癌、腦癌及膀胱癌的死亡率間是否有相關性。研究女性肺癌發生的對象是收錄自西元1995年到2005年，臺灣地區50到69歲女性因肺癌而死亡者為病例組，對照組則是取經配對及排除掉因癌症或呼吸道疾病而致死的病人，做了依不同程度(濃度)的五種空氣要件污染物與女性肺癌死亡率風險勝算比之間關係的研究，其它針對石化空氣污染與腦癌死亡率、空氣要件污染物與膀胱癌死亡率間的關係，也以類似的方法去作研究。
結果發現：一、研究女性肺癌方面：發現最高度空氣污染暴露比上最低度者(二氧化氮加上一氧化碳來看)，女性死於肺癌發生的風險勝算比是 1.46 (95% C.I.: 1.18 - 1.81)；中度污染比上最低度時，女性死於肺癌肺癌發生的風險勝算比是 1.24 (95% C.I.: 1.03 - 1.50 )，表示空氣污染程度與女性肺癌死亡率的發生風險是正相關的。二、腦癌的研究方面：發現最高度石化工業空氣污染暴露指標比上最低度者，在調整過干擾因子後，發生罹患腦癌(≦29歲)的風險勝算比是1.65(95% C.I.: 1.00 - 2.73 )，表示石化工業空氣污染與居民腦癌死亡率間存在有意義的關係性。三、研究膀胱癌方面：發現最高度空氣污染暴露比上最低度者(二氧化氮加上二氧化硫來看)，調整過後膀胱癌死亡率風險的勝算比是1.98 (95% C.I.: 1.36 - 2.88)；中度空氣污染暴露比上最低度污染者，在調整過干擾因子後，膀胱癌死亡率發生的勝算比是1.37 (95% C.I.: 1.03 - 1.82 )，表示空氣污染程度與膀胱癌死亡率的發生是正相關的。
本研究提供了一次室外空氣污染與三種癌症–腦癌、膀胱癌及女性肺癌死亡率之間存在著相關性的結果，由於是種生態性病例對照法的研究結果，當然還需要有更多的研究進一步去佐證，希望本次的研究能對臺灣的公共衛生政策有所貢獻。

關鍵字

空氣污染 ； 空氣要件污染物 ； 肺癌 ； 腦癌 ； 膀胱癌

並列摘要

The purpose of this study was to investigate the relationships between air pollution and lung cancer, brain cancer or bladder cancer. At first, we conducted a matched case-control study about female lung cancer using deaths that occurred in Taiwan from 1995 through 2005. Data on eligible female lung cancer deaths were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. The control group consisted of women who died from causes other than cancer or diseases associated with respiratory problems. The controls were pair - matched to the cases by sex, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each case. Classification of exposure to municipality air pollution was based on the measured levels of nitrogen dioxide and carbon monoxide. The other two studies were conducted with similar methods.
The results of our first study showed that there was a significant positive association between the levels of air pollution and female lung cancer mortality. The adjusted odds ratios (95% confidence interval) were 1.24 (1.03–1.50) for the group with medium air pollution level and 1.46 (1.18–1.81) for the group with high air pollution level when compared to the group with the low air pollution level. Trend analyses showed statistically significant trend in risk of female lung cancer with increasing air pollution level.
Our second study is to investigate the relationship between petrochemical air pollution and brain cancer (29 year of age or younger). The proportion of a municipality’s total population employed in the petrochemical industry in a municipality was used as an indicator of a resident’s exposure to air emissions from the petrochemical industry. The subjects were divided into tertiles according to the levels of the index just described. Subjects who lived in the group of municipalities characterized by the highest levels of petrochemical air pollution had a statistically significant higher risk of developing brain cancer than the group that lived in municipalities with the lowest petrochemical air pollution levels after controlling for possible confounders (OR=1.65, 95% C.I. = 1.00 - 2.73 ).
The results of our third study showed that there was a significant positive association between the levels of air pollution and bladder cancer mortality. The adjusted odds ratios (95% confidence interval) were 1.37 ( 1.03 – 1.82 ) for the group with medium air pollution level and 1.98 ( 1.36 – 2.88 ) for the group with high air pollution level when compared to the group with the low air pollution level. Trend analyses showed statistically significant trend in risk of death from bladder cancer with increasing air pollution level.
The findings of these studies warrant further investigation of the roles of air pollutants in the etiology of brain, bladder and female lung cancer. We hope this can offer help to public health policy in Taiwan.

並列關鍵字

air pollution ； criteria air pollutants ； lung cancer ； brain cancer ； bladder cancer

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