空氣污染曝露與攝護腺癌發生之相關性

目的：探討長期戶外空氣污染對於攝護腺癌發生之相關性。方法：利用我國全民健康保險研究資料庫，擷取出2007－2009年攝護腺癌之新發生個案（簡稱為病例組,n=14,342），以及年齡與診斷年做為匹配條件，擷取出其對應之對照組（1比4匹配,n=57,366），並且利用地理統計模型－分位數貝氏最大熵模型，來估算病例組與對照組個案其從1998年至發病日期此期間之平均空氣污染曝露濃度。利用多變量羅吉斯迴歸分析，計算每四分位差污染物濃度之增加，其攝護腺癌症發生之相對勝算比之估計值（Odds ratio, OR）及其95%信賴區間（confidence interval, CI），統計模型中控制潛在干擾因子包含有：年齡、診斷年、共病情形、是否有慢性阻塞性肺病、平均投保薪資等級、以及投保所在鄉鎮市區之都市化程度。結果：大氣中氮氧化物每增加一個四分位差之平均曝露濃度，攝護腺癌的發生風險則增加1.19倍（95% CI=1.15－1.23）；一氧化碳每增加一個四分位差之平均曝露濃度，攝護腺癌的發生風險則增加1.11倍（95% CI=1.08－1.15）。長期曝露於大氣中二氧化硫與懸浮微粒與減少攝護腺癌發生之風險有關，而臭氧的曝露則與攝護腺癌的發生無相關。結論：本研究發現交通污染物如氮氧化物與一氧化碳的長期曝露與攝護腺癌發生的風險有關。期望本研究結果能提供空氣污染制定相關單位以及潛在高危險族群之參考。

關鍵字

空氣污染；攝護腺癌；環境流行病學

並列摘要

Purposes: To investigate the association between ambient air pollution and prostate cancer in a nationwide population-based case-control study in Taiwan. Methods: We identified 14,342 incident prostate cancer patients between 2007 and 2009 from the Taiwanese National Health Insurance Research. Database (NHIRD) and selected 57,366 age-matched and diagnosis-year-matched population controls from the NHIRD. The average ambient pollutant exposure concentrations from 1998 through the onset of prostate cancer were estimated using quantile-based Bayesian Maximum Entropy models. We estimated, based on logistic regression models, the odds ratios (ORs) and 95% confidence intervals (CIs) of ambient pollutant exposures and prostate cancer risk, adjusting for age, year of diagnosis, co-morbidities, chronic obstructive pulmonary disease, insurance premium, and urbanization. Results: We observed positive associations between NO_x, CO exposures, and prostate cancer. In multi-pollutant models, per interquartile range (IQR) increased in NO_x and CO, the ORs of prostate cancer were 1.19 (95% CI=1.15-1.23) and 1.11 (95% CI=1.08-1.15), respectively. We also observed negative associations between SO_2, PM_(10) and prostate cancer; though no association between O_3 and prostate cancer was observed. Conclusions: Our study suggests that ambient air pollution exposure, especially from traffic-related pollutants, such as NO_x and CO, increases prostate cancer risk. Our results may provide information in support of public health policy and air pollution regulation to eliminate environmental toxins and prevent cancer risk in the population.

並列關鍵字

ambient air pollution ； prostate cancer ； environmental epidemiology

參考文獻

張章堂、沈百淳、李承志、余佳蘋、駱勇全、李雅文。(2009)。結合可見光光觸媒單元與活性碳單元處理車內VOCs之研究。國立宜蘭大學工程學刊，(5)，115-130。doi:10.6176/BCE.2009.05.18

Brook, R. D., Franklin, B., Cascio, W., Hong, Y., Howard, G., Lipsett, M.,…Tager, I. (2004). Air pollution and cardiovascular disease: a statement for healthcare professionals from the Expert Panel on Population and Prevention Science of the American Heart Association. Circulation, 109 (21), 2655-2671. doi:10.1161/01.CIR.0000128587.30041.C8

Beelen, R., Hoek, G., van den Brandt, P. A., Goldbohm, R. A., Fischer, P., Schouten, L. J., …Brunekreef, B. (2007). Long-term effects of traffic-related air pollution on mortality in a Dutch cohort (NLCS-AIR study). Environment Health Perspective, 116 (2), 196-202. doi:10.1289/ehp.10767

Brawley, O.W. (2012). Prostate cancer epidemiology in the United States. World Journal of Urology, 30(2), 195-200. doi:10.1007/s00345-012-0824-2

Bashir, M. N., Ahmad, M. R., & Malik, A. (2015). Risk Factors of Prostate Cancer: a Case-control Study in Faisalabad, Pakistan. Asian Pacific Journal of Cancer Prevention, 15 (23), 10237-10240. doi:10.7314/APJCP.2014.15.23.10237

國際替代計量

空氣污染曝露與攝護腺癌發生之相關性

全文下載

主題瀏覽