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Amadou A, Giampiccolo C, Bibi Ngaleu F, Praud D, Coudon T, Grassot L, Faure E, Couvidat F, Frenoy P, Severi G, Romana Mancini F, Roy P, Fervers B. Multiple xenoestrogen air pollutants and breast cancer risk: Statistical approaches to investigate combined exposures effect. Environ Pollut 2024; 351:124043. [PMID: 38679129 DOI: 10.1016/j.envpol.2024.124043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 02/10/2024] [Accepted: 04/23/2024] [Indexed: 05/01/2024]
Abstract
Studies suggested that exposure to air pollutants, with endocrine disrupting (ED) properties, have a key role in breast cancer (BC) development. Although the population is exposed simultaneously to a mixture of multiple pollutants and ED pollutants may act via common biological mechanisms leading to synergic effects, epidemiological studies generally evaluate the effect of each pollutant separately. We aimed to assess the complex effect of exposure to a mixture of four xenoestrogen air pollutants (benzo-[a]-pyrene (BaP), cadmium, dioxin (2,3,7,8-Tétrachlorodibenzo-p-dioxin TCDD)), and polychlorinated biphenyl 153 (PCB153)) on the risk of BC, using three recent statistical methods, namely weighted quantile sum (WQS), quantile g-computation (QGC) and Bayesian kernel machine regression (BKMR). The study was conducted on 5222 cases and 5222 matched controls nested within the French prospective E3N cohort initiated in 1990. Annual average exposure estimates to the pollutants were assessed using a chemistry transport model, at the participants' residence address between 1990 and 2011. We found a positive association between the WQS index of the joint effect and the risk of overall BC (adjusted odds ratio (OR) = 1.10, 95% confidence intervals (CI): 1.03-1.19). Similar results were found for QGC (OR = 1.11, 95%CI: 1.03-1.19). Despite the association did not reach statistical significance in the BKMR model, we observed an increasing trend between the joint effect of the four pollutants and the risk of BC, when fixing other chemicals at their median concentrations. BaP, cadmium and PCB153 also showed positive trends in the multi-pollutant mixture, while dioxin showed a modest inverse trend. Despite we found a clear evidence of a positive association between the joint exposure to pollutants and BC risk only from WQS and QGC regression, we observed a similar suggestive trend using BKMR. This study makes a major contribution to the understanding of the joint effects of air pollution.
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Affiliation(s)
- Amina Amadou
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France.
| | - Camille Giampiccolo
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Université Claude Bernard Lyon 1, Lyon, France; Service de Biostatistique-Bioinformatique, Pole Sante Publique, Hospices Civils de Lyon, Lyon, France; Laboratoire de Biometrie Et Biologie Evolutive, CNRS UMR 5558, Villeurbanne, France
| | - Fabiola Bibi Ngaleu
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France; Université Claude Bernard Lyon 1, Lyon, France
| | - Delphine Praud
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France
| | - Thomas Coudon
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France
| | - Lény Grassot
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France
| | - Elodie Faure
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France
| | - Florian Couvidat
- National Institute for industrial Environment and Risks (INERIS), Verneuil-en-Halatte, France
| | - Pauline Frenoy
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France
| | - Gianluca Severi
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France; Department of Statistics, Computer Science and Applications (DISIA), University of Florence, Italy
| | - Francesca Romana Mancini
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France.
| | - Pascal Roy
- Université Claude Bernard Lyon 1, Lyon, France; Service de Biostatistique-Bioinformatique, Pole Sante Publique, Hospices Civils de Lyon, Lyon, France; Laboratoire de Biometrie Et Biologie Evolutive, CNRS UMR 5558, Villeurbanne, France
| | - Béatrice Fervers
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France.
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Dessemon J, Perol O, Chauvel C, Noelle H, Coudon T, Grassot L, Foray N, Belladame E, Fayette J, Fournie F, Swalduz A, Neidhart EM, Saintigny P, Tabutin M, Boussageon M, Gomez F, Avrillon V, Perol M, Charbotel B, Fervers B. Survival of bronchopulmonary cancers according to radon exposure. Front Public Health 2024; 11:1306455. [PMID: 38328545 PMCID: PMC10847230 DOI: 10.3389/fpubh.2023.1306455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/18/2023] [Indexed: 02/09/2024] Open
Abstract
Introduction Residential exposure is estimated to be responsible for nearly 10% of lung cancers in 2015 in France, making it the second leading cause, after tobacco. The Auvergne-Rhône-Alpes region, in the southwest of France, is particularly affected by this exposure as 30% of the population lives in areas with medium or high radon potential. This study aimed to investigate the impact of radon exposure on the survival of lung cancer patients. Methods In this single-center study, patients with a histologically confirmed diagnosis of lung cancer, and newly managed, were prospectively included between 2014 and 2020. Univariate and multivariate survival analyses were carried out using a non-proportional risk survival model to consider variations in risk over time. Results A total of 1,477 patients were included in the analysis. In the multivariate analysis and after adjustment for covariates, radon exposure was not statistically associated with survival of bronchopulmonary cancers (HR = 0.82 [0.54-1.23], HR = 0.92 [0.72-1.18], HR = 0.95 [0.76-1.19] at 1, 3, and 5 years, respectively, for patients residing in category 2 municipalities; HR = 0.87 [0.66-1.16], HR = 0.92 [0.76-1.10], and HR = 0.89 [0.75-1.06] at 1, 3, and 5 years, respectively, for patients residing in category 3 municipalities). Discussion Although radon exposure is known to increase the risk of lung cancer, in the present study, no significant association was found between radon exposure and survival of bronchopulmonary cancers.
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Affiliation(s)
- Juliette Dessemon
- Département Prévention Cancer Environnement, Center Léon Bérard, Lyon, France
- Faculté de Médecine Lyon Est, Université de Lyon, Lyon, France
| | - Olivia Perol
- Département Prévention Cancer Environnement, Center Léon Bérard, Lyon, France
- Inserm UMR1296, “Radiation: Defense, Health Environment,” Center Léon Bérard, Lyon, France
| | - Cécile Chauvel
- Center of Excellence in Respiratory Pathogens (CERP), Hospices Civils de Lyon, Lyon, France
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, CNRS UMR5308, ENS de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Hugo Noelle
- Département Prévention Cancer Environnement, Center Léon Bérard, Lyon, France
- Faculté de Médecine Lyon Est, Université de Lyon, Lyon, France
| | - Thomas Coudon
- Département Prévention Cancer Environnement, Center Léon Bérard, Lyon, France
- Inserm UMR1296, “Radiation: Defense, Health Environment,” Center Léon Bérard, Lyon, France
| | - Lény Grassot
- Département Prévention Cancer Environnement, Center Léon Bérard, Lyon, France
- Inserm UMR1296, “Radiation: Defense, Health Environment,” Center Léon Bérard, Lyon, France
| | - Nicolas Foray
- Inserm UMR1296, “Radiation: Defense, Health Environment,” Center Léon Bérard, Lyon, France
| | - Elodie Belladame
- Département Prévention Cancer Environnement, Center Léon Bérard, Lyon, France
- Inserm UMR1296, “Radiation: Defense, Health Environment,” Center Léon Bérard, Lyon, France
| | - Jérôme Fayette
- Département de Cancérologie Médicale, Center Léon Bérard, Lyon, France
| | - Françoise Fournie
- Département Interdisciplinaire de Soins de Support du Patient en Oncologie, Center Léon Bérard, Lyon, France
| | - Aurélie Swalduz
- Département de Cancérologie Médicale, Center Léon Bérard, Lyon, France
| | | | - Pierre Saintigny
- Département de Cancérologie Médicale, Center Léon Bérard, Lyon, France
| | - Mayeul Tabutin
- Département de Chirurgie Cancérologique, Center Léon Bérard, Lyon, France
| | - Maxime Boussageon
- Inserm UMR1296, “Radiation: Defense, Health Environment,” Center Léon Bérard, Lyon, France
| | - Frédéric Gomez
- Département de Santé Publique, Center Léon Bérard, Lyon, France
| | - Virginie Avrillon
- Département de Cancérologie Médicale, Center Léon Bérard, Lyon, France
| | - Maurice Perol
- Département de Cancérologie Médicale, Center Léon Bérard, Lyon, France
| | - Barbara Charbotel
- Université de Lyon, Université Lyon 1, Université Gustave Eiffel-Ifsttar, Umrestte, UMR, Lyon, France
- CRPPE-Lyon, Center Régional de Pathologies Professionnelles et Environnementales de Lyon, Center Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Béatrice Fervers
- Département Prévention Cancer Environnement, Center Léon Bérard, Lyon, France
- Inserm UMR1296, “Radiation: Defense, Health Environment,” Center Léon Bérard, Lyon, France
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Gaspard E, Frenoy P, Praud D, Coudon T, Grassot L, Assi AA, Fervers B, Gelot A, Mancini FR, Severi G, Besson C, Faure E. Association between cumulative airborne dioxin exposure and non-Hodgkin's lymphoma risk in a nested case-control study within the French E3N cohort. Sci Total Environ 2024; 906:167330. [PMID: 37778544 DOI: 10.1016/j.scitotenv.2023.167330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/20/2023] [Accepted: 09/22/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Dioxins are a family of chemical molecules that are chlorinated, lipophilic, and bio-accumulative. They are thought to enhance the risk of non-lymphoma Hodgkin's due to their known carcinogenic properties (NHL). This is the first epidemiological research to investigate the relationship between repeated emissions of airborne dioxin exposure and the risk of NHL. OBJECTIVE A case-control study nested within the French E3N cohort of 98,995 women covered by the health insurance provider of the national education system evaluated the association between cumulative airborne dioxin exposure and NHL risk. MATERIALS AND METHODS NHL incident cases (368) and controls (368) were compared. Over the duration of the study, participants' residential histories and the locations of industrial sites were gathered (1990-2008). Using a Geographic Information System (GIS)-based exposure index, the cumulative exposure to airborne dioxins for each participant was calculated at the individual address level. The odds ratios (OR) and 95 % confidence intervals (CI) were calculated using multivariable conditional logistic regression models (CI). RESULTS The log-transformed continuous cumulative dioxin exposure index was substantially correlated with the risk of NHL (OR1.2 (95 % CI 1.0,1.4) for an increase in log-TEQ/m2 of 4.4, or one standard deviation). The combined chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) subtype was significantly associated with NHL histological subtypes (OR 1.6 (95 % CI 1.1,2.3)). CONCLUSION The findings of this study demonstrate a significant positive correlation between cumulative airborne dioxin exposure and the risk of NHL in women, and more specifically, a significant positive association for the CLL & SLL subtype. These results help to support the attempts to reduce the exposure to dioxins in the air.
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Affiliation(s)
- Elizabeth Gaspard
- Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, 94805 Villejuif, France
| | - Pauline Frenoy
- Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, 94805 Villejuif, France
| | - Delphine Praud
- Département Cancer Environnement, Centre Léon Bérard, 28 rue Laënnec, 69373 Lyon Cedex 08, France; INSERM, U1296 Unit, "Radiation: Defense, Health and Environment", Centre Léon Bérard, 28 rue Laënnec, 69073 Lyon cedex 8, France; Inserm U1052, Centre de Recherche en Cancérologie de Lyon, 28 rue Laënnec, 69373 Lyon Cedex 08, France
| | - Thomas Coudon
- Département Cancer Environnement, Centre Léon Bérard, 28 rue Laënnec, 69373 Lyon Cedex 08, France; INSERM, U1296 Unit, "Radiation: Defense, Health and Environment", Centre Léon Bérard, 28 rue Laënnec, 69073 Lyon cedex 8, France; Inserm U1052, Centre de Recherche en Cancérologie de Lyon, 28 rue Laënnec, 69373 Lyon Cedex 08, France
| | - Lény Grassot
- Département Cancer Environnement, Centre Léon Bérard, 28 rue Laënnec, 69373 Lyon Cedex 08, France; INSERM, U1296 Unit, "Radiation: Defense, Health and Environment", Centre Léon Bérard, 28 rue Laënnec, 69073 Lyon cedex 8, France; Inserm U1052, Centre de Recherche en Cancérologie de Lyon, 28 rue Laënnec, 69373 Lyon Cedex 08, France
| | - Aline Abou Assi
- Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, 94805 Villejuif, France; Centre de Recherche en Épidémiologie et StatistiqueS (CRESS Inserm U1153), INRAE, Université Paris Cité, Paris, France
| | - Béatrice Fervers
- Département Cancer Environnement, Centre Léon Bérard, 28 rue Laënnec, 69373 Lyon Cedex 08, France; INSERM, U1296 Unit, "Radiation: Defense, Health and Environment", Centre Léon Bérard, 28 rue Laënnec, 69073 Lyon cedex 8, France; Inserm U1052, Centre de Recherche en Cancérologie de Lyon, 28 rue Laënnec, 69373 Lyon Cedex 08, France
| | - Amandine Gelot
- Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, 94805 Villejuif, France
| | | | - Gianluca Severi
- Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, 94805 Villejuif, France; Department of Statistics, Computer Science, Applications "G. Parenti", University of Florence, 50134 Florence, Italy
| | - Caroline Besson
- Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, 94805 Villejuif, France; Centre Hospitalier de Versailles, 78150 Le Chesnay, France
| | - Elodie Faure
- Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, CESP, 94805 Villejuif, France.
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Praud D, Deygas F, Amadou A, Bouilly M, Turati F, Bravi F, Xu T, Grassot L, Coudon T, Fervers B. Traffic-Related Air Pollution and Breast Cancer Risk: A Systematic Review and Meta-Analysis of Observational Studies. Cancers (Basel) 2023; 15:cancers15030927. [PMID: 36765887 PMCID: PMC9913524 DOI: 10.3390/cancers15030927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/24/2023] [Accepted: 01/27/2023] [Indexed: 02/05/2023] Open
Abstract
Current evidence of an association of breast cancer (BC) risk with air pollution exposure, in particular from traffic exhaust, remains inconclusive, and the exposure assessment methodologies are heterogeneous. This study aimed to conduct a systematic review and meta-analysis on the association between traffic-related air pollution (TRAP) and BC incidence (PROSPERO CRD42021286774). We systematically reviewed observational studies assessing exposure to TRAP and BC risk published until June 2022, available on Medline/PubMed and Web of Science databases. Studies using models for assessing exposure to traffic-related air pollutants or using exposure proxies (including traffic density, distance to road, etc.) were eligible for inclusion. A random-effects meta-analysis of studies investigating the association between NO2/NOx exposure and BC risk was conducted. Overall, 21 studies meeting the inclusion criteria were included (seven case-control, one nested case-control, 13 cohort studies); 13 studies (five case-control, eight cohort) provided data for inclusion in the meta-analyses. Individual studies provided little evidence of an association between TRAP and BC risk; exposure assessment methods and time periods of traffic emissions were different. The meta-estimate on NO2 exposure indicated a positive association (pooled relative risk per 10 µg/m3 of NO2: 1.015; 95% confidence interval, CI: 1.003; 1.028). No association between NOx exposure and BC was found (three studies). Although there was limited evidence of an association for TRAP estimated with proxies, the meta-analysis showed a significant association between NO2 exposure, a common TRAP pollutant marker, and BC risk, yet with a small effect size. Our findings provide additional support for air pollution carcinogenicity.
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Affiliation(s)
- Delphine Praud
- Prevention Cancer Environment Department, Centre Léon Bérard, 28 rue Laënnec, 69008 Lyon, France
- Inserm, U1296 Unit, “Radiation: Defense, Health and Environment”, Centre Léon Bérard, 28 rue Laënnec, 69008 Lyon, France
- Correspondence:
| | - Floriane Deygas
- Prevention Cancer Environment Department, Centre Léon Bérard, 28 rue Laënnec, 69008 Lyon, France
- Inserm, U1296 Unit, “Radiation: Defense, Health and Environment”, Centre Léon Bérard, 28 rue Laënnec, 69008 Lyon, France
| | - Amina Amadou
- Prevention Cancer Environment Department, Centre Léon Bérard, 28 rue Laënnec, 69008 Lyon, France
- Inserm, U1296 Unit, “Radiation: Defense, Health and Environment”, Centre Léon Bérard, 28 rue Laënnec, 69008 Lyon, France
| | - Maryline Bouilly
- Prevention Cancer Environment Department, Centre Léon Bérard, 28 rue Laënnec, 69008 Lyon, France
- Inserm, U1296 Unit, “Radiation: Defense, Health and Environment”, Centre Léon Bérard, 28 rue Laënnec, 69008 Lyon, France
| | - Federica Turati
- Department of Clinical Sciences and Community Health, University of Milan, Via A. Vanzetti 5, 20133 Milan, Italy
| | - Francesca Bravi
- Department of Clinical Sciences and Community Health, University of Milan, Via A. Vanzetti 5, 20133 Milan, Italy
| | - Tingting Xu
- Prevention Cancer Environment Department, Centre Léon Bérard, 28 rue Laënnec, 69008 Lyon, France
| | - Lény Grassot
- Prevention Cancer Environment Department, Centre Léon Bérard, 28 rue Laënnec, 69008 Lyon, France
- Inserm, U1296 Unit, “Radiation: Defense, Health and Environment”, Centre Léon Bérard, 28 rue Laënnec, 69008 Lyon, France
| | - Thomas Coudon
- Prevention Cancer Environment Department, Centre Léon Bérard, 28 rue Laënnec, 69008 Lyon, France
- Inserm, U1296 Unit, “Radiation: Defense, Health and Environment”, Centre Léon Bérard, 28 rue Laënnec, 69008 Lyon, France
| | - Béatrice Fervers
- Prevention Cancer Environment Department, Centre Léon Bérard, 28 rue Laënnec, 69008 Lyon, France
- Inserm, U1296 Unit, “Radiation: Defense, Health and Environment”, Centre Léon Bérard, 28 rue Laënnec, 69008 Lyon, France
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5
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Amadou A, Praud D, Coudon T, Deygas F, Grassot L, Dubuis M, Faure E, Couvidat F, Caudeville J, Bessagnet B, Salizzoni P, Leffondré K, Gulliver J, Severi G, Mancini FR, Fervers B. Long-term exposure to nitrogen dioxide air pollution and breast cancer risk: A nested case-control within the French E3N cohort study. Environ Pollut 2023; 317:120719. [PMID: 36435283 DOI: 10.1016/j.envpol.2022.120719] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 11/17/2022] [Accepted: 11/20/2022] [Indexed: 06/16/2023]
Abstract
Nitrogen dioxide (NO2) is an important air pollutant due to its adverse effects on human health. Yet, current evidence on the association between NO2 and the risk of breast cancer lacks consistency. In this study, we investigated the association between long-term exposure to NO2 and breast cancer risk in the French E3N cohort study. Association of breast cancer risk with NO2 exposure was assessed in a nested case-control study within the French E3N cohort including 5222 breast cancer cases identified over the 1990-2011 follow-up period and 5222 matched controls. Annual mean concentrations of NO2 at participants' residential addresses for each year from recruitment 1990 through 2011, were estimated using a land use regression (LUR) model. Multivariable conditional logistic regression models were used to compute odds ratios (ORs) and their 95% confidence intervals (CIs). Additional analyses were performed using NO2 concentrations estimated by CHIMERE, a chemistry transport model. Overall, the mean NO2 exposure was associated with an increased risk of breast cancer. In all women, for each interquartile range (IQR) increase in NO2 levels (LUR: 17.8 μg/m3), the OR of the model adjusted for confounders was 1.09 (95% CI: 1.01-1.18). The corresponding OR in the fully adjusted model (additionally adjusted for established breast cancer risk factors) was 1.07 (95% CI: 0.98-1.15). By menopausal status, results for postmenopausal women were comparable to those for all women, while no association was observed among premenopausal women. By hormone receptor status, the OR of estrogen receptor positive breast cancer = 1.07 (95% CI: 0.97-1.19) in the fully adjusted model. Additional analyses using the CHIMERE model showed slight differences in ORs estimates. The results of this study indicate an increased risk of breast cancer associated with long-term exposure to NO2 air pollution. Observing comparable effects of NO2 exposure estimated by two different models, reinforces these findings.
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Affiliation(s)
- Amina Amadou
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations, Défense, Santé, Environnement, Lyon, France
| | - Delphine Praud
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations, Défense, Santé, Environnement, Lyon, France.
| | - Thomas Coudon
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations, Défense, Santé, Environnement, Lyon, France; Ecole Centrale de Lyon, INSA Lyon, Université Claude Bernard Lyon 1, Ecully, France
| | - Floriane Deygas
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations, Défense, Santé, Environnement, Lyon, France
| | - Lény Grassot
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations, Défense, Santé, Environnement, Lyon, France
| | - Mathieu Dubuis
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations, Défense, Santé, Environnement, Lyon, France
| | - Elodie Faure
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Université Paris-Saclay, UVSQ, Inserm U1018, CESP, "Exposome Heredity, Cancer and Health", Gustave Roussy, Villejuif, France
| | - Florian Couvidat
- National Institute for Industrial Environment and Risks (INERIS), Verneuil-en-Halatte, France
| | - Julien Caudeville
- National Institute for Industrial Environment and Risks (INERIS), Verneuil-en-Halatte, France
| | - Bertrand Bessagnet
- National Institute for Industrial Environment and Risks (INERIS), Verneuil-en-Halatte, France; Citepa, Technical Reference Center for Air Pollution and Climate Change, Paris, France
| | - Pietro Salizzoni
- Ecole Centrale de Lyon, INSA Lyon, Université Claude Bernard Lyon 1, Ecully, France
| | - Karen Leffondré
- Univ Bordeaux, ISPED, INSERM, Bordeaux Population Health Research Center, UMR1219, Bordeaux, France
| | - John Gulliver
- Centre for Environmental Health and Sustainability, School of Geography, Geology and the Environment, University of Leicester, United Kingdom
| | - Gianluca Severi
- Université Paris-Saclay, UVSQ, Inserm U1018, CESP, "Exposome Heredity, Cancer and Health", Gustave Roussy, Villejuif, France; Department of Statistics, Computer Science and Applications (DISIA), University of Florence, Italy
| | - Francesca Romana Mancini
- Université Paris-Saclay, UVSQ, Inserm U1018, CESP, "Exposome Heredity, Cancer and Health", Gustave Roussy, Villejuif, France
| | - Béatrice Fervers
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations, Défense, Santé, Environnement, Lyon, France
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Zhai Y, Amadou A, Mercier C, Praud D, Faure E, Iwaz J, Severi G, Mancini FR, Coudon T, Fervers B, Roy P. The impact of left truncation of exposure in environmental case-control studies: evidence from breast cancer risk associated with airborne dioxin. Eur J Epidemiol 2021; 37:79-93. [PMID: 34254231 DOI: 10.1007/s10654-021-00776-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 06/15/2021] [Indexed: 12/24/2022]
Abstract
In epidemiology, left-truncated data may bias exposure effect estimates. We analyzed the bias induced by left truncation in estimating breast cancer risk associated with exposure to airborne dioxins. Simulations were run with exposure estimates from a Geographic Information System (GIS)-based metric and considered two hypotheses for historical exposure, three scenarios for intra-individual correlation of annual exposures, and three exposure-effect models. For each correlation/model combination, 500 nested matched case-control studies were simulated and data fitted using a conditional logistic regression model. Bias magnitude was assessed by estimated odds-ratios (ORs) versus theoretical relative risks (TRRs) comparisons. With strong intra-individual correlation and continuous exposure, left truncation overestimated the Beta parameter associated with cumulative dioxin exposure. Versus a theoretical Beta of 4.17, the estimated mean Beta (5%; 95%) was 73.2 (67.7; 78.8) with left-truncated exposure and 4.37 (4.05; 4.66) with lifetime exposure. With exposure categorized in quintiles, the TRR was 2.0, the estimated ORQ5 vs. Q1 2.19 (2.04; 2.33) with truncated exposure versus 2.17 (2.02; 2.32) with lifetime exposure. However, the difference in exposure between Q5 and Q1 was 18× smaller with truncated data, indicating an important overestimation of the dose effect. No intra-individual correlation resulted in effect dilution and statistical power loss. Left truncation induced substantial bias in estimating breast cancer risk associated with exposure with continuous and categorical models. With strong intra-individual exposure correlation, both models detected associations, but categorical models provided better estimates of effect trends. This calls for careful consideration of left truncation-induced bias in interpreting environmental epidemiological data.
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Affiliation(s)
- Yue Zhai
- Département Prévention Cancer Environnement, Centre Léon Bérard, Lyon, France.,Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.,Laboratoire de Biométrie Et Biologie Évolutive, CNRS UMR 5558, Villeurbanne, France.,Université Claude Bernard Lyon 1, Lyon, France
| | - Amina Amadou
- Département Prévention Cancer Environnement, Centre Léon Bérard, Lyon, France.,Inserm U1296 Radiations: Défense, Santé, Environnement, 28 Rue Laënnec, 69373, Lyon Cedex 08, France
| | - Catherine Mercier
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.,Laboratoire de Biométrie Et Biologie Évolutive, CNRS UMR 5558, Villeurbanne, France.,Université Claude Bernard Lyon 1, Lyon, France
| | - Delphine Praud
- Département Prévention Cancer Environnement, Centre Léon Bérard, Lyon, France.,Inserm U1296 Radiations: Défense, Santé, Environnement, 28 Rue Laënnec, 69373, Lyon Cedex 08, France
| | - Elodie Faure
- Centre de Recherche en Epidémiologie Et Santé Des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France
| | - Jean Iwaz
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.,Laboratoire de Biométrie Et Biologie Évolutive, CNRS UMR 5558, Villeurbanne, France.,Université Claude Bernard Lyon 1, Lyon, France
| | - Gianluca Severi
- Centre de Recherche en Epidémiologie Et Santé Des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France.,Department of Statistics, Computer Science and Applications (DISIA), University of Florence, Florence, Italy
| | - Francesca Romana Mancini
- Centre de Recherche en Epidémiologie Et Santé Des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France
| | - Thomas Coudon
- Département Prévention Cancer Environnement, Centre Léon Bérard, Lyon, France.,Inserm U1296 Radiations: Défense, Santé, Environnement, 28 Rue Laënnec, 69373, Lyon Cedex 08, France
| | - Béatrice Fervers
- Département Prévention Cancer Environnement, Centre Léon Bérard, Lyon, France. .,Inserm U1296 Radiations: Défense, Santé, Environnement, 28 Rue Laënnec, 69373, Lyon Cedex 08, France.
| | - Pascal Roy
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.,Laboratoire de Biométrie Et Biologie Évolutive, CNRS UMR 5558, Villeurbanne, France.,Université Claude Bernard Lyon 1, Lyon, France
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7
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Deygas F, Amadou A, Coudon T, Grassot L, Couvidat F, Bessagnet B, Faure E, Salizzoni P, Gulliver J, Caudeville J, Severi G, Mancini FR, Leffondré K, Fervers B, Praud D. Long-term atmospheric exposure to PCB153 and breast cancer risk in a case-control study nested in the French E3N cohort from 1990 to 2011. Environ Res 2021; 195:110743. [PMID: 33450235 DOI: 10.1016/j.envres.2021.110743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 12/18/2020] [Accepted: 01/08/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Although the genetic and hormonal risk factors of breast cancer are well identified, they cannot fully explain the occurrence of all cases. Epidemiological and experimental studies have suggested that exposure to environmental pollutants, especially those with potential estrogenic properties, as polychlorinated biphenyls (PCBs) may have a role in breast cancer development. Being the most abundantly detected in human tissues and in the environment, congener 153 (PCB153) is widely used in epidemiological studies as indicator for total PCBs exposure. OBJECTIVES We aimed to estimate the association between cumulative atmospheric exposure to PCB153 and breast cancer risk. METHODS We conducted a case-control study of 5222 cases and 5222 matched controls nested within the French E3N cohort from 1990 to 2011. Annual atmospheric PCB153 concentrations were simulated with the deterministic chemistry-transport model (CHIMERE) and were assigned to women using their geocoded residential history. Their cumulative PCB153 exposure was calculated for each woman from their cohort inclusion to their index date. Breast cancer odds ratios (ORs) associated with cumulative PCB153 exposure and their 95% confidence intervals (95% CIs) were estimated using multivariate conditional logistic regression models. RESULTS Overall, our results showed a statistically significant linear increase in breast cancer risk related to cumulative atmospheric exposure to PCB153 as a continuous variable (adjusted OR = 1.19; 95% CI: 1.08-1.31, for an increment of one standard deviation among controls (55 pg/m3)). Among women who became postmenopausal during follow-up, the association remained statistically significant (adjusted OR = 1.23; 95% CI: 1.09-1.39). In analyses by hormone receptors status, the positive association remained significant only for ER-positive breast cancer (adjusted OR = 1.18; 95% CI: 1.05-1.33). DISCUSSION This study is the first to have estimated the impact of atmospheric exposure to PCB153 on breast cancer risk. Our results showed a statistically significant increase in breast cancer risk, which may be limited to ER-positive breast cancer. These results warrant confirmation in further independent studies but raise the possibility that exposure to PCB153 increase breast cancer risk.
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Affiliation(s)
- Floriane Deygas
- Department of Prevention, Cancer and Environment, Centre Léon Bérard, Lyon, France; Inserm U1296, "Radiation: Defense, Health and Environment", Centre Léon Bérard, Lyon, France
| | - Amina Amadou
- Department of Prevention, Cancer and Environment, Centre Léon Bérard, Lyon, France; Inserm U1296, "Radiation: Defense, Health and Environment", Centre Léon Bérard, Lyon, France
| | - Thomas Coudon
- Department of Prevention, Cancer and Environment, Centre Léon Bérard, Lyon, France; Inserm U1296, "Radiation: Defense, Health and Environment", Centre Léon Bérard, Lyon, France; Ecole Centrale de Lyon, University Claude Bernard Lyon 1, Ecully, France
| | - Lény Grassot
- Department of Prevention, Cancer and Environment, Centre Léon Bérard, Lyon, France; Inserm U1296, "Radiation: Defense, Health and Environment", Centre Léon Bérard, Lyon, France
| | - Florian Couvidat
- National Institute for Industrial Environment and Risks (INERIS), Verneuil-en-Halatte, France
| | - Bertrand Bessagnet
- National Institute for Industrial Environment and Risks (INERIS), Verneuil-en-Halatte, France; Citepa, Technical Reference Center for Air Pollution and Climate Change, Paris, France
| | - Elodie Faure
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), Team "Exposome and Heredity", Gustave Roussy, Villejuif, France
| | - Pietro Salizzoni
- Ecole Centrale de Lyon, University Claude Bernard Lyon 1, Ecully, France
| | - John Gulliver
- Centre for Environmental Health and Sustainability, School of Geography, Geology and the Environment, University of Leicester, Leicester, United Kingdom
| | - Julien Caudeville
- National Institute for Industrial Environment and Risks (INERIS), Verneuil-en-Halatte, France
| | - Gianluca Severi
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), Team "Exposome and Heredity", Gustave Roussy, Villejuif, France; Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Italy
| | - Francesca Romana Mancini
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), Team "Exposome and Heredity", Gustave Roussy, Villejuif, France.
| | - Karen Leffondré
- University of Bordeaux, ISPED, Inserm U1219, Bordeaux Population Health Center, Bordeaux, France
| | - Béatrice Fervers
- Department of Prevention, Cancer and Environment, Centre Léon Bérard, Lyon, France; Inserm U1296, "Radiation: Defense, Health and Environment", Centre Léon Bérard, Lyon, France.
| | - Delphine Praud
- Department of Prevention, Cancer and Environment, Centre Léon Bérard, Lyon, France; Inserm U1296, "Radiation: Defense, Health and Environment", Centre Léon Bérard, Lyon, France
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8
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Amadou A, Praud D, Coudon T, Deygas F, Grassot L, Faure E, Couvidat F, Caudeville J, Bessagnet B, Salizzoni P, Gulliver J, Leffondré K, Severi G, Mancini FR, Fervers B. Risk of breast cancer associated with long-term exposure to benzo[a]pyrene (BaP) air pollution: Evidence from the French E3N cohort study. Environ Int 2021; 149:106399. [PMID: 33503556 DOI: 10.1016/j.envint.2021.106399] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Benzo[a]pyrene (BaP) is an endocrine-disrupting pollutant formed during incomplete combustion of organic materials. It has been recognized as a reproductive and developmental toxicant, however epidemiological evidence of the long-term effect of ambient air BaP on breast cancer (BC) is limited. Thus we evaluated associations between ambient air BaP exposure and risk of BC, overall and according to menopausal status and molecular subtypes (estrogen receptor negative/positive (ER-/ER+) and progesterone receptor negative/positive (PR-/PR+)), stage and grade of differentiation of BC in the French E3N cohort study. METHODS Within a nested case-control study of 5222 incident BC cases and 5222 matched controls, annual BaP exposure was estimated using a chemistry-transport model (CHIMERE) and was assigned to the geocoded residential addresses of participants for each year during the 1990-2011 follow-up period. Multivariable conditional logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Overall, cumulative airborne BaP exposure was significantly associated with the overall risk of BC, for each 1 interquartile range (IQR) increase in the concentration levels of BaP (1.42 ng/m3), the OR = 1.15 (95% CI: 1.04-1.27). However, by menopausal status, the significant positive association remained only in women who underwent menopausal transition (i.e. premenopausal women at inclusion who became postmenopausal at diagnosis), OR per 1 IQR = 1.20 (95% CI: 1.03-1.40). By hormone receptor status, positive associations were observed for ER+, PR + and ER + PR + BC, with ORs = 1.17 (95% CI: 1.04-1.32), 1.16 (95% CI: 1.01-1.33), and 1.17 (95% CI: 1.01-1.36) per 1 IQR, respectively. There was also a borderline positive association between BaP and grade 3 BC (OR per 1 IQR = 1.15 (95% CI: 0.99-1.34). CONCLUSIONS We provide evidence of increased risk of BC associated with cumulative BaP exposure, which varied according to menopausal status, hormone receptor status, and grade of differentiation of BC. Our results add further epidemiological evidence to the previous experimental studies suggesting the adverse effects of BaP.
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Affiliation(s)
- Amina Amadou
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm UMR 1296 Radiations : Défense, Santé, Environnement, Lyon, France
| | - Delphine Praud
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm UMR 1296 Radiations : Défense, Santé, Environnement, Lyon, France
| | - Thomas Coudon
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm UMR 1296 Radiations : Défense, Santé, Environnement, Lyon, France; Ecole Centrale de Lyon, INSA Lyon, Université Claude Bernard Lyon 1, Ecully, France
| | - Floriane Deygas
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm UMR 1296 Radiations : Défense, Santé, Environnement, Lyon, France
| | - Leny Grassot
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm UMR 1296 Radiations : Défense, Santé, Environnement, Lyon, France
| | - Elodie Faure
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France
| | - Florian Couvidat
- National Institute for Industrial Environment and Risks (INERIS), Verneuil-en-Halatte, France
| | - Julien Caudeville
- National Institute for Industrial Environment and Risks (INERIS), Verneuil-en-Halatte, France
| | - Bertrand Bessagnet
- National Institute for Industrial Environment and Risks (INERIS), Verneuil-en-Halatte, France; Citepa, Technical Reference Center for Air Pollution and Climate Change, Paris, France
| | - Pietro Salizzoni
- Ecole Centrale de Lyon, INSA Lyon, Université Claude Bernard Lyon 1, Ecully, France
| | - John Gulliver
- Centre for Environmental Health and Sustainability, School of Geography, Geology and the Environment, University of Leicester, United Kingdom
| | - Karen Leffondré
- Université de Bordeaux, ISPED, Inserm U1219, Bordeaux Population Health Center, Bordeaux, France
| | - Gianluca Severi
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France; Departement of Statistics, Computer Science and Applications (DISIA), University of Florence, Italy
| | - Francesca Romana Mancini
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France.
| | - Béatrice Fervers
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm UMR 1296 Radiations : Défense, Santé, Environnement, Lyon, France.
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9
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Amadou A, Coudon T, Praud D, Salizzoni P, Leffondre K, Lévêque E, Boutron-Ruault MC, Danjou AMN, Morelli X, Le Cornet C, Perrier L, Couvidat F, Bessagnet B, Caudeville J, Faure E, Mancini FR, Gulliver J, Severi G, Fervers B. Chronic Low-Dose Exposure to Xenoestrogen Ambient Air Pollutants and Breast Cancer Risk: XENAIR Protocol for a Case-Control Study Nested Within the French E3N Cohort. JMIR Res Protoc 2020; 9:e15167. [PMID: 32930673 PMCID: PMC7525465 DOI: 10.2196/15167] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 01/14/2020] [Accepted: 01/22/2020] [Indexed: 12/24/2022] Open
Abstract
Background Breast cancer is the most frequent cancer in women in industrialized countries. Lifestyle and environmental factors, particularly endocrine-disrupting pollutants, have been suggested to play a role in breast cancer risk. Current epidemiological studies, although not fully consistent, suggest a positive association of breast cancer risk with exposure to several International Agency for Research on Cancer Group 1 air-pollutant carcinogens, such as particulate matter, polychlorinated biphenyls (PCB), dioxins, Benzo[a]pyrene (BaP), and cadmium. However, epidemiological studies remain scarce and inconsistent. It has been proposed that the menopausal status could modify the relationship between pollutants and breast cancer and that the association varies with hormone receptor status. Objective The XENAIR project will investigate the association of breast cancer risk (overall and by hormone receptor status) with chronic exposure to selected air pollutants, including particulate matter, nitrogen dioxide (NO2), ozone (O3), BaP, dioxins, PCB-153, and cadmium. Methods Our research is based on a case-control study nested within the French national E3N cohort of 5222 invasive breast cancer cases identified during follow-up from 1990 to 2011, and 5222 matched controls. A questionnaire was sent to all participants to collect their lifetime residential addresses and information on indoor pollution. We will assess these exposures using complementary models of land-use regression, atmospheric dispersion, and regional chemistry-transport (CHIMERE) models, via a Geographic Information System. Associations with breast cancer risk will be modeled using conditional logistic regression models. We will also study the impact of exposure on DNA methylation and interactions with genetic polymorphisms. Appropriate statistical methods, including Bayesian modeling, principal component analysis, and cluster analysis, will be used to assess the impact of multipollutant exposure. The fraction of breast cancer cases attributable to air pollution will be estimated. Results The XENAIR project will contribute to current knowledge on the health effects of air pollution and identify and understand environmental modifiable risk factors related to breast cancer risk. Conclusions The results will provide relevant evidence to governments and policy-makers to improve effective public health prevention strategies on air pollution. The XENAIR dataset can be used in future efforts to study the effects of exposure to air pollution associated with other chronic conditions. International Registered Report Identifier (IRRID) DERR1-10.2196/15167
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Affiliation(s)
- Amina Amadou
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France.,Inserm UA 08 Radiations: Défense, Santé, Environnement, Lyon, France
| | - Thomas Coudon
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France.,Ecole Centrale de Lyon, INSA, Université Claude Bernard Lyon 1, Ecully, France
| | - Delphine Praud
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France.,Inserm UA 08 Radiations: Défense, Santé, Environnement, Lyon, France
| | - Pietro Salizzoni
- Ecole Centrale de Lyon, INSA, Université Claude Bernard Lyon 1, Ecully, France
| | - Karen Leffondre
- ISPED, Inserm U1219, Bordeaux Population Health Center, Université de Bordeaux, Bordeaux, France
| | - Emilie Lévêque
- ISPED, Inserm U1219, Bordeaux Population Health Center, Université de Bordeaux, Bordeaux, France
| | - Marie-Christine Boutron-Ruault
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Faculté de Médecine, Université Paris-Saclay, Villejuif, France
| | - Aurélie M N Danjou
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France
| | - Xavier Morelli
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France
| | - Charlotte Le Cornet
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France.,Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Lionel Perrier
- Univ Lyon, Centre Léon Bérard, GATE L-SE UMR 5824, Lyon, France
| | - Florian Couvidat
- National Institute for industrial Environment and Risks (INERIS), Verneuil-en-Halatte, France
| | - Bertrand Bessagnet
- National Institute for industrial Environment and Risks (INERIS), Verneuil-en-Halatte, France
| | - Julien Caudeville
- National Institute for industrial Environment and Risks (INERIS), Verneuil-en-Halatte, France
| | - Elodie Faure
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France
| | - Francesca Romana Mancini
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Faculté de Médecine, Université Paris-Saclay, Villejuif, France
| | - John Gulliver
- Centre for Environmental Health and Sustainability, School of Geography, Geology and the Environment, University of Leicester, Leicester, United Kingdom
| | - Gianluca Severi
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Faculté de Médecine, Université Paris-Saclay, Villejuif, France
| | - Béatrice Fervers
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France.,Inserm UA 08 Radiations: Défense, Santé, Environnement, Lyon, France
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10
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Amadou A, Praud D, Coudon T, Danjou AMN, Faure E, Leffondré K, Le Romancer M, Severi G, Salizzoni P, Mancini FR, Fervers B. Chronic long-term exposure to cadmium air pollution and breast cancer risk in the French E3N cohort. Int J Cancer 2020; 146:341-351. [PMID: 30851122 DOI: 10.1002/ijc.32257] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 02/18/2019] [Indexed: 12/26/2022]
Abstract
Cadmium, due to its estrogen-like activity, has been suspected to increase the risk of breast cancer; however, epidemiological studies have reported inconsistent findings. We conducted a case-control study (4,059 cases and 4,059 matched controls) nested within the E3N French cohort study to estimate the risk of breast cancer associated with long-term exposure to airborne cadmium pollution, and its effect according to molecular subtype of breast cancer (estrogen receptor negative/positive [ER-/ER+] and progesterone receptor negative/positive [PR-/PR+]). Atmospheric exposure to cadmium was assessed using a Geographic Information System-based metric, which included subject's residence-to-cadmium source distance, wind direction, exposure duration and stack height. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated using conditional logistic regression. Overall, there was no significant association between cumulative dose of airborne cadmium exposure and the risk of overall, premenopausal and postmenopausal breast cancer. However, by ER and PR status, inverse associations were observed for ER- (ORQ5 vs. Q1 = 0.63; 95% CI: 0.41-0.95, ptrend = 0.043) and for ER-/PR- breast tumors (ORQ4 vs. Q1 = 0.62; 95% CI: 0.40-0.95, ORQ5 vs. Q1 = 0.68; 95% CI: 0.42-1.07, ptrend = 0.088). Our study provides no evidence of an association between exposure to cadmium and risk of breast cancer overall but suggests that cadmium might be related to a decreased risk of ER- and ER-/PR- breast tumors. These observations and other possible effects linked to hormone receptor status warrant further investigations.
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Affiliation(s)
- Amina Amadou
- Department of Cancer and Environment, Centre Léon Bérard, Lyon, France
- Inserm UA 08 Radiations: Défense, Santé, Environnement, 69008 Lyon, France
| | - Delphine Praud
- Department of Cancer and Environment, Centre Léon Bérard, Lyon, France
- Inserm U1052, CNRS UMR5286, Université Claude Bernard Lyon 1, Cancer Research Center of Lyon, Lyon, France
| | - Thomas Coudon
- Department of Cancer and Environment, Centre Léon Bérard, Lyon, France
- Ecole Centrale de Lyon, INSA Lyon, Université Claude Bernard Lyon 1, Ecully, France
| | - Aurélie M N Danjou
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC), Lyon, France
| | - Elodie Faure
- Department of Cancer and Environment, Centre Léon Bérard, Lyon, France
| | - Karen Leffondré
- Université de Bordeaux, ISPED, Centre Inserm U1219 Bordeaux Population Health, Bordeaux, France
| | - Muriel Le Romancer
- Inserm U1052, CNRS UMR5286, Université Claude Bernard Lyon 1, Cancer Research Center of Lyon, Lyon, France
| | - Gianluca Severi
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France
| | - Pietro Salizzoni
- Ecole Centrale de Lyon, INSA Lyon, Université Claude Bernard Lyon 1, Ecully, France
| | - Francesca Romana Mancini
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France
| | - Béatrice Fervers
- Department of Cancer and Environment, Centre Léon Bérard, Lyon, France
- Inserm UA 08 Radiations: Défense, Santé, Environnement, 69008 Lyon, France
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11
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Danjou AMN, Coudon T, Praud D, Lévêque E, Faure E, Salizzoni P, Le Romancer M, Severi G, Mancini FR, Leffondré K, Dossus L, Fervers B. Long-term airborne dioxin exposure and breast cancer risk in a case-control study nested within the French E3N prospective cohort. Environ Int 2019; 124:236-248. [PMID: 30658268 DOI: 10.1016/j.envint.2019.01.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 12/21/2018] [Accepted: 01/02/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Dioxins, Group 1 carcinogens, are emitted by industrial chlorinated combustion processes and suspected to increase breast cancer risk through receptor-mediated pathways. OBJECTIVES We estimated breast cancer risk associated with airborne dioxin exposure, using geographic information system (GIS) methods and historical exposure data. METHODS We designed a case-control study (429 breast cancer cases diagnosed between 1990 and 2008, matched to 716 controls) nested within the E3N (Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l'Education Nationale) cohort. Airborne dioxin exposure was assessed using a GIS-based metric including participants' residential history, technical characteristics of 222 dioxin sources, residential proximity to dioxin sources, exposure duration and wind direction. Odds ratios (OR) and 95% confidence intervals (CI) associated with quintiles of cumulative exposure were estimated using multivariate logistic regression models. RESULTS We observed no increased risk of breast cancer for higher dioxin exposure levels overall and according to hormone-receptor status. We however observed a statistically significant OR for Q2 versus Q1 overall (1.612, 95% CI: 1.042-2.493) and for estrogen-receptor (ER) positive breast cancer (1.843, 95% CI: 1.033-3.292). CONCLUSIONS Overall, as well as according to hormone-receptor status, no increased risk was observed for higher airborne dioxin exposure. The increased risk for low exposure levels might be compatible with non-monotonic dose-response relationship. Confirmation of our findings is required. Our GIS-based metric may provide an alternative in absence of ambient dioxin monitoring and may allow assessing exposure to other pollutants.
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Affiliation(s)
- Aurélie Marcelle Nicole Danjou
- Département Cancer Environnement, Centre Léon Bérard, 28 rue Laënnec, 69373 Lyon Cedex 08, France; Université de Lyon, Université Claude Bernard Lyon 1, 43 Boulevard du 11 Novembre 1918, 69100 Villeurbanne, France.
| | - Thomas Coudon
- Département Cancer Environnement, Centre Léon Bérard, 28 rue Laënnec, 69373 Lyon Cedex 08, France; Université de Lyon, Université Claude Bernard Lyon 1, 43 Boulevard du 11 Novembre 1918, 69100 Villeurbanne, France.
| | - Delphine Praud
- Département Cancer Environnement, Centre Léon Bérard, 28 rue Laënnec, 69373 Lyon Cedex 08, France; Inserm U1052, Centre de Recherche en Cancérologie de Lyon, 28 rue Laënnec, 69373 Lyon Cedex 08, France.
| | - Emilie Lévêque
- Université de Bordeaux, Institut de Santé Publique, d'Épidémiologie et de Développement, Centre Inserm U1219 Epidemiology and Biostatistics, 146 rue Léo Saignat, 33076 Bordeaux, France.
| | - Elodie Faure
- Département Cancer Environnement, Centre Léon Bérard, 28 rue Laënnec, 69373 Lyon Cedex 08, France.
| | - Pietro Salizzoni
- Laboratoire de Mécanique des Fluides et d'Acoustique, UMR CNRS 5509, Université de Lyon, Ecole Centrale de Lyon, INSA Lyon, Université Claude Bernard Lyon 1, 36 avenue Guy de Collongue, 69134 Ecully Cedex, France.
| | - Muriel Le Romancer
- Université de Lyon, Université Claude Bernard Lyon 1, 43 Boulevard du 11 Novembre 1918, 69100 Villeurbanne, France; Inserm U1052, Centre de Recherche en Cancérologie de Lyon, 28 rue Laënnec, 69373 Lyon Cedex 08, France; CNRS UMR5286, Centre de Recherche en Cancérologie de Lyon, 28 rue Laënnec, 69373 Lyon Cedex 08, France.
| | - Gianluca Severi
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, 114 rue Edouard-Vaillant, 94805 Villejuif Cedex, France.
| | - Francesca Romana Mancini
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, 114 rue Edouard-Vaillant, 94805 Villejuif Cedex, France.
| | - Karen Leffondré
- Université de Bordeaux, Institut de Santé Publique, d'Épidémiologie et de Développement, Centre Inserm U1219 Epidemiology and Biostatistics, 146 rue Léo Saignat, 33076 Bordeaux, France.
| | - Laure Dossus
- Département Cancer Environnement, Centre Léon Bérard, 28 rue Laënnec, 69373 Lyon Cedex 08, France; Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, 114 rue Edouard-Vaillant, 94805 Villejuif Cedex, France.
| | - Béatrice Fervers
- Département Cancer Environnement, Centre Léon Bérard, 28 rue Laënnec, 69373 Lyon Cedex 08, France; Université de Lyon, Université Claude Bernard Lyon 1, 43 Boulevard du 11 Novembre 1918, 69100 Villeurbanne, France; Inserm U1052, Centre de Recherche en Cancérologie de Lyon, 28 rue Laënnec, 69373 Lyon Cedex 08, France; CNRS UMR5286, Centre de Recherche en Cancérologie de Lyon, 28 rue Laënnec, 69373 Lyon Cedex 08, France.
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Coudon T, Danjou AMN, Faure E, Praud D, Severi G, Mancini FR, Salizzoni P, Fervers B. Development and performance evaluation of a GIS-based metric to assess exposure to airborne pollutant emissions from industrial sources. Environ Health 2019; 18:8. [PMID: 30683108 PMCID: PMC6347831 DOI: 10.1186/s12940-019-0446-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 01/03/2019] [Indexed: 06/01/2023]
Abstract
BACKGROUND Dioxins are environmental and persistent organic carcinogens with endocrine disrupting properties. A positive association with several cancers, including risk of breast cancer has been suggested. OBJECTIVES This study aimed to develop and assess performances of an exposure metric based on a Geographic Information System (GIS) through comparison with a validated dispersion model to estimate historical industrial dioxin exposure for its use in a case-control study nested within a prospective cohort. METHODS Industrial dioxin sources were inventoried over the whole French territory (n > 2500) and annual average releases were estimated between 1990 and 2008. In three selected areas (rural, urban and urban-costal), dioxin dispersion was modelled using SIRANE, an urban Gaussian model and exposure of the French E3N cohort participants was estimated. The GIS-based metric was developed, calibrated and compared to SIRANE results using a set of parameters (local meteorological data, characteristics of industrial sources, e.g. emission intensity and stack height), by calculating weighted kappa statistics (wκ) and coefficient of determination (R2). Furthermore, as performance evaluation, the final GIS-based metric was tested to assess atmospheric exposure to cadmium. RESULTS The concordance between the GIS-based metric and the dispersion model for dioxin exposure estimate was strong (wκ median = 0.78 (1st quintile = 0.72, 3rd quintile =0.82) and R2 median = 0.82 (1st quintile = 0.71, 3rd quintile = 0.87)). We observed similar performance for cadmium. CONCLUSIONS Our study demonstrated the ability of the GIS-based metric to reliably characterize long-term environmental dioxin and cadmium exposures as well as the pertinence of using dispersion modelling to construct and calibrate the GIS-based metric.
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Affiliation(s)
- Thomas Coudon
- Département Cancer & Environnement, Centre Léon Bérard, 69008 Lyon, France
- Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
| | - Aurélie Marcelle Nicole Danjou
- Département Cancer & Environnement, Centre Léon Bérard, 69008 Lyon, France
- Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
| | - Elodie Faure
- Département Cancer & Environnement, Centre Léon Bérard, 69008 Lyon, France
| | - Delphine Praud
- Département Cancer & Environnement, Centre Léon Bérard, 69008 Lyon, France
- INSERM 1052, CNRS 5286, Centre de Recherche en Cancérologie de Lyon, 69373 Lyon, France
| | - Gianluca Severi
- Centre de Recherche en Épidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS, UVSQ, Gustave Roussy, Villejuif, France
| | - Francesca Romana Mancini
- Centre de Recherche en Épidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS, UVSQ, Gustave Roussy, Villejuif, France
| | - Pietro Salizzoni
- Laboratoire de Mécanique des Fluides et d’Acoustique, UMR CNRS 5509, University of Lyon, Ecole Centrale de Lyon, INSA Lyon, Université Claude Bernard Lyon I, 36, avenue Guy de Collongue, 69134 Ecully, France
| | - Béatrice Fervers
- Département Cancer & Environnement, Centre Léon Bérard, 69008 Lyon, France
- Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
- INSERM 1052, CNRS 5286, Centre de Recherche en Cancérologie de Lyon, 69373 Lyon, France
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Coudon T, Danjou A, Faure E, Praud D, Salizzoni P, Fervers B. Development and performance evaluation of a GIS-based metric to assess exposure to airborne pollutant emissions from industrial sources. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.05.549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Coudon T, Hourani H, Nguyen C, Faure E, Mancini FR, Fervers B, Salizzoni P. Assessment of long-term exposure to airborne dioxin and cadmium concentrations in the Lyon metropolitan area (France). Environ Int 2018; 111:177-190. [PMID: 29220728 DOI: 10.1016/j.envint.2017.11.027] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 11/28/2017] [Accepted: 11/28/2017] [Indexed: 06/07/2023]
Abstract
Identifying the long-term effects of airborne pollutants requires the computation of the spatial and temporal variability of their concentration in air to estimate the exposure of the population. To estimate exposure levels of individuals in a breast cancer case control study nested in a national prospective cohort, we determine here the differential impact of a variety of cadmium and dioxin sources on urban air over a large urban area and over a period of almost 20years. To that end, we couple an emission model, to estimate dioxin and cadmium atmospheric annual releases, with an urban dispersion model in order to compute pollutant concentration fields at a fine temporal (1h) and spatial (25m) resolution. The reliability of the modelling chain is compared to two types of measurement: i) localized industrial emissions and ii) dioxin and cadmium air monitoring data (from 2007 to 2008), collected at a fixed station, placed in the city centre, as well as at three mobile short-term dioxin monitoring stations, located in the suburbs (the latter providing dioxin data, only). Comparisons between measured and estimated emissions show non-negligible difference, with a correlations for dioxin (rs=0.42) and cadmium (rs=0.41). Despite this, mean values between estimated emissions and emission measurements are close to each other, in particular for cadmium. Weekly average modelled concentrations show an overall good agreement with weekly average measured concentrations in spring and summer but are generally lower than monitored data in winter due to peak concentrations from diffuse sources representing an important proportion of emissions in 2007/2008. The model provides better results for cadmium than for dioxin. Despite the relevant errors in the model predictions, the model meets the validation criteria, defined by Chang and Hanna for an urban dispersion model. Simulation scenarios of air pollutant concentrations, reconstructed over the last 20years, show the effects of the variability of the pollutant sources over time with decreasing levels of dioxin and cadmium concentrations in air. This is primarily due to the reduction in localized industrial releases, which results in a general trend of homogenization of the exposure of the population. The model further allows us to dissociate the contribution of different types of pollutant sources on the population exposure. The impact on local concentrations due to industrial emissions, which were originally responsible for the major impact on air quality, is shown to drop over the years by 99% and 92% for dioxin and cadmium, respectively. Today, the major contributions are due to diffuse miscellaneous sources in the case of dioxin and to traffic-related emissions for cadmium. Average modelled concentrations at the study subjects' residential locations range from 10.2 to 82.1fg-TEQ/m3 for dioxin and 0.10 to 1.6ng/m3 for cadmium and are comparable with data from the literature. The study results will be essential to increase the accuracy of the assessment of long-term airborne dioxin and cadmium exposure and improve the results of epidemiological studies.
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Affiliation(s)
- T Coudon
- Département Cancer & Environnement, Centre Léon Bérard, Lyon 69008, France; Université Claude Bernard Lyon 1, Villeurbanne 69100, France.
| | - H Hourani
- Département Cancer & Environnement, Centre Léon Bérard, Lyon 69008, France
| | - C Nguyen
- Laboratory of Fluid Mechanics and Acoustics, Ecole Centrale de Lyon, Ecully 69134, France
| | - E Faure
- Département Cancer & Environnement, Centre Léon Bérard, Lyon 69008, France
| | - F R Mancini
- Centre de Recherche en Épidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Medicine, Université Paris-Saclay, UPS, UVSQ, Gustave Roussy, Villejuif, France
| | - B Fervers
- Département Cancer & Environnement, Centre Léon Bérard, Lyon 69008, France; Université Claude Bernard Lyon 1, Villeurbanne 69100, France; INSERM 1052, CNRS 5286, Centre de Recherche en Cancérologie de Lyon, Lyon, 69373, France
| | - P Salizzoni
- Laboratory of Fluid Mechanics and Acoustics, Ecole Centrale de Lyon, Ecully 69134, France
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