ABSTRACT
Epidemiological studies on health effects of air pollution usually estimate exposure at the residential address. However, ignoring daily mobility patterns may lead to biased exposure estimates, as documented in previous exposure studies. To improve the reliable integration of exposure related to mobility patterns into epidemiological studies, we conducted a systematic review of studies across all continents that measured air pollution concentrations in various modes of transport using portable sensors. To compare personal exposure across different transport modes, specifically active versus motorized modes, we estimated pairwise exposure ratios using a Bayesian random-effects meta-analysis. Overall, we included measurements of six air pollutants (black carbon (BC), carbon monoxide (CO), nitrogen dioxide (NO2), particulate matter (PM10, PM2.5) and ultrafine particles (UFP)) for seven modes of transport (i.e., walking, cycling, bus, car, motorcycle, overground, underground) from 52 published studies. Compared to active modes, users of motorized modes were consistently the most exposed to gaseous pollutants (CO and NO2). Cycling and walking were the most exposed to UFP compared to other modes. Active vs passive mode contrasts were mostly inconsistent for other particle metrics. Compared to active modes, bus users were consistently more exposed to PM10 and PM2.5, while car users, on average, were less exposed than pedestrians. Rail modes experienced both some lower exposures (compared to cyclists for PM10 and pedestrians for UFP) and higher exposures (compared to cyclist for PM2.5 and BC). Ratios calculated for motorcycles should be considered carefully due to the small number of studies, mostly conducted in Asia. Computing exposure ratios overcomes the heterogeneity in pollutant levels that may exist between continents and countries. However, formulating ratios on a global scale remains challenging owing to the disparities in available data between countries.
Subject(s)
Air Pollutants , Air Pollution , Bayes Theorem , Environmental Exposure , Particulate Matter , Humans , Air Pollution/analysis , Air Pollution/adverse effects , Air Pollutants/analysis , Environmental Exposure/analysis , Particulate Matter/analysis , Carbon Monoxide/analysisABSTRACT
Outdoor exposure to particulate matter (PM2.5 and PM10) in urban areas can vary considerably depending on the mode of transport. This study aims to quantify this difference in exposure during daily travel, by carrying out a micro-sensor measurement campaign. The pollutant exposure was assessed simultaneously over predefined routes in order to allow comparison between different transport modes having the same starting and ending points. During the six-week measurement campaign, the average reference values for PM background concentrations were 13.72 and 17.92µg/m3 for the PM2.5 and PM10, respectively. The results revealed that the mode with the highest exposure to PM2.5 adjusted to background concentration (PM2.5Norm) was the bus (1.65) followed by metro (1.51), walking (1.33), tramway (1.31), car (1.09) and finally the bike (1.06). For PM10Norm, the tramway had the highest exposure (1.86), followed by walking (1.68), metro (1.65), bus (1.61), bike (1.43) and finally the car (1.39). The level of urbanization around the route and the presence of preferential lanes for public transportation influenced the concentration to which commuters were exposed. For the active modes (bike and walking), we observed frequent variations in concentrations during the trip, characterized by punctual peaks in concentration, depending on the local characteristics of road traffic and urban morphology. Fluctuations in particulate matter inside public transport vehicles were partly explained by the opening and closing of doors during stops, as well as the passenger flows, influencing the re-suspension of particles. The car was one of the least exposed modes overall, with the lowest concentration variability, although these concentrations can vary greatly depending on the ventilation parameters used. These results encourage measures to move the most exposed users away from road traffic, by developing a network of lanes entirely dedicated to cycling and walking, particularly in densely populated areas, as well as encouraging the renewal of motorized vehicles to use less polluting fuels with efficient ventilation systems.
Subject(s)
Air Pollutants , Environmental Monitoring , Particulate Matter , Transportation , Particulate Matter/analysis , Air Pollutants/analysis , Environmental Monitoring/methods , France , Vehicle Emissions/analysis , Humans , Air Pollution/analysisABSTRACT
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.
Subject(s)
Breast Neoplasms , Polychlorinated Biphenyls , Breast/chemistry , Breast Neoplasms/chemically induced , Breast Neoplasms/epidemiology , Case-Control Studies , Cohort Studies , Female , Humans , Polychlorinated Biphenyls/analysis , Polychlorinated Biphenyls/toxicity , Risk FactorsABSTRACT
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.
Subject(s)
Air Pollutants/adverse effects , Air Pollution/adverse effects , Breast Neoplasms/epidemiology , Cadmium/adverse effects , Adult , Aged , Air Pollution/statistics & numerical data , Breast/pathology , Breast Neoplasms/chemically induced , Breast Neoplasms/pathology , Case-Control Studies , Female , Follow-Up Studies , France/epidemiology , Humans , Incidence , Middle Aged , Postmenopause , Premenopause , Prospective Studies , Receptors, Estrogen/metabolism , Receptors, Progesterone/metabolism , Risk FactorsABSTRACT
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.
Subject(s)
Air Pollutants/analysis , Cadmium/analysis , Dioxins/analysis , Environmental Monitoring/methods , Geographic Information Systems , Industry , Air Pollution/analysis , Breast Neoplasms/epidemiology , Case-Control Studies , Female , France/epidemiology , HumansABSTRACT
BACKGROUND: An increasing evidence links air pollution to breast cancer (BC) risk. Yet, pollutant exposure estimates at the workplace location in pollution exposure assessment have not been considered. OBJECTIVES: This study investigates the association between particulate matters (PM2·5, PM10) and nitrogen dioxide (NO2) atmospheric concentrations (1990-2011), at the women's residential and workplace locations, and BC risk. METHODS: This case-control study of 2419 BC cases and 2984 controls, was nested in the French prospective E3N cohort. The annual mean PM2·5, PM10 and NO2 concentrations were estimated using a Land Use Regression model (50 m x 50 m resolution) and assigned to the women's geocoded residential and workplace locations, from cohort recruitment to their index date (date of case diagnosis). Odds ratios (OR) and 95 % confidence intervals (CI) were estimated using multivariate logistic regression models. RESULTS: An increased BC risk was observed for a 10 µg/m3 increase of the 1990-2011 average PM2·5 concentration estimates (OR=1·28; CI 1·00, 1·63). An increased risk was suggested for a 10 µg/m3 increase for PM10 (OR=1·09; CI 0·92, 1·30) and NO2 (OR=1·05; CI 0·97, 1·13). No effect modification by menopausal status, nor difference by hormone receptor status were observed. DISCUSSION: This study is the first to estimate BC risk and long-term air pollutant exposure from both, residential and workplace location histories. Results suggest that residential PM2·5, PM10 and NO2 concentrations are strongly correlated with workplace ones, indicating that residential data may serve as proxy for overall exposure. Future studies should consider exposure during commuting.
Subject(s)
Air Pollution , Breast Neoplasms , Environmental Exposure , Particulate Matter , Workplace , Humans , Female , Breast Neoplasms/epidemiology , Breast Neoplasms/etiology , Breast Neoplasms/chemically induced , Case-Control Studies , Middle Aged , France/epidemiology , Aged , Environmental Exposure/adverse effects , Particulate Matter/analysis , Particulate Matter/adverse effects , Air Pollution/adverse effects , Air Pollution/analysis , Prospective Studies , Risk Factors , Nitrogen Dioxide/analysis , Nitrogen Dioxide/adverse effects , Adult , Air Pollutants/analysis , Air Pollutants/adverse effects , Time FactorsABSTRACT
Due to its importance in airborne disease transmission, especially because of the COVID-19 pandemic, much attention has recently been devoted by the scientific community to the analysis of dispersion of particle-laden air clouds ejected by humans during different respiratory activities. In spite of that, a lack of knowledge is still present particularly with regard to the velocity of the emitted particles, which could differ considerably from that of the air phase. The velocity of the particles is also expected to vary with their size. In this work, simultaneous measurements of size and velocity of particles emitted by humans while speaking have been performed by means of Interferometric Laser Imaging Droplet Sizing (ILIDS). This technique allowed us to detect emitted particles with size down to 2 µm as well as to quantify all three components of the velocity vector and the particle concentration. The outcomes of this work may be used as boundary conditions for numerical simulations of infected respiratory cloud transmission.
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.
Subject(s)
Air Pollutants , Air Pollution , Breast Neoplasms , Humans , Female , Nitrogen Dioxide/analysis , Cohort Studies , Breast Neoplasms/chemically induced , Breast Neoplasms/epidemiology , Case-Control Studies , Environmental Exposure/adverse effects , Environmental Exposure/analysis , Air Pollution/adverse effects , Air Pollution/analysis , Air Pollutants/analysis , Particulate Matter/analysisABSTRACT
The incidental or malicious release of toxic gases in the atmosphere is one of the most critical scenarios for cities. The impact of these releases varies with the ventilation potential of the urban environment. To disentangle this crucial aspect, vulnerability to airborne releases is here traced back to essential properties of the urban fabric. To this aim, pollutant dispersion is disassembled in its fundamental bricks and the main drivers of the process are captured. The analysis is based on four cities with emblematic architectures: Paris, Firenze, Lyon and New York. Results show that vulnerability is driven by the topology of the city and by its interaction with the approaching wind. In this sense, fragility to toxic releases is written in the layout of the urban fabric and results from its historical evolution. This study paves the way to the assessment of air pollution-related issues from a morphological point of view.
ABSTRACT
Molecular studies suggest that cadmium due to its estrogenic properties, might play a role in breast cancer (BC) progression. However epidemiological evidence is limited. This study explored the association between long-term exposure to airborne cadmium and risk of BC by stage, grade of differentiation, and histological types at diagnosis. A nested case-control study of 4401 cases and 4401 matched controls was conducted within the French E3N cohort. A Geographic Information System (GIS)-based metric demonstrated to reliably characterize long-term environmental exposures was employed to evaluate airborne exposure to cadmium. Multivariable adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated using conditional logistic regression models. There was no relationship between cadmium exposure and stage of BC. Also, no association between cadmium exposure and grade of differentiation of BC was observed. However, further analyses by histological type suggested a positive association between cadmium and risk of invasive tubular carcinoma (ITC) BC [ORQ5 vs Q1 = 3.4 (95% CI 1.1-10.7)]. The restricted cubic spline assessment suggested a dose-response relationship between cadmium and ITC BC subtype. Our results do not support the hypothesis that airborne cadmium exposure may play a role in advanced BC risk, but suggest that cadmium may be associated with an increased risk of ITC.
Subject(s)
Air Pollutants/adverse effects , Breast Neoplasms/etiology , Cadmium/adverse effects , Adult , Aged , Alcohol Drinking , Breast Neoplasms/diagnosis , Breast Neoplasms/epidemiology , Carcinoma, Ductal, Breast/diagnosis , Carcinoma, Ductal, Breast/epidemiology , Carcinoma, Ductal, Breast/etiology , Case-Control Studies , Cell Differentiation , Dose-Response Relationship, Drug , Environmental Exposure , Female , Geographic Information Systems , Humans , Middle Aged , Multivariate Analysis , Neoplasm Metastasis , Neoplasm Staging , Odds Ratio , Risk , Risk FactorsABSTRACT
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.
Subject(s)
Air Pollution , Breast Neoplasms , Air Pollution/adverse effects , Benzo(a)pyrene/toxicity , Breast Neoplasms/chemically induced , Breast Neoplasms/epidemiology , Case-Control Studies , Cohort Studies , Female , Humans , Risk FactorsABSTRACT
The dispersion of airborne pollutants in the urban atmosphere is a complex, canopy-driven process. The intricate structure of the city, the high number of potential sources, and the large spatial domain make it difficult to predict dispersion patterns, to simulate a great number of scenarios, and to identify the high-impact emission areas. Here we show that these complex transport dynamics can be efficiently characterized by adopting a complex network approach. The urban canopy layer is represented as a complex network. Street canyons and their intersections shape the spatial structure of the network. The direction and the transport capacity of the flow in the streets define the direction and the weight of the links. Within this perspective, pollutant contamination from a source is modeled as a spreading process on a network, and the most dangerous areas in a city are identified as the best spreading nodes. To this aim, we derive a centrality metric tailored to mass transport in flow networks. By means of the proposed approach, vulnerability maps of cities are rapidly depicted, revealing the nontrivial relation between urban topology, transport capacity of the street canyons, and forcing of the external wind. The network formalism provides promising insight in the comprehensive analysis of the fragility of cities to air pollution.
ABSTRACT
We review the efforts made by the scientific community in more than seventy years to elucidate the behaviour of concentration fluctuations arising from localized atmospheric releases of dynamically passive and non-reactive scalars. Concentration fluctuations are relevant in many fields including the evaluation of toxicity, flammability, and odour nuisance. Characterizing concentration fluctuations requires not just the mean concentration but also at least the variance of the concentration in the location of interest. However, for most purposes the characterization of the concentration fluctuations requires knowledge of the concentration probability density function (PDF) in the point of interest and even the time evolution of the concentration. We firstly review the experimental works made both in the field and in the laboratory, and cover both point sources and line sources. Regarding modelling approaches, we cover analytical, semi-analytical, and numerical methods. For clarity of presentation we subdivide the models in two groups, models linked to a transport equation, which usually require a numerical resolution, and models mainly based on phenomenological aspects of dispersion, often providing analytical or semi-analytical relations. The former group includes: large-eddy simulations, Reynolds-averaged Navier-Stokes methods, two-particle Lagrangian stochastic models, PDF transport equation methods, and heuristic Lagrangian single-particle methods. The latter group includes: fluctuating plume models, semi-empirical models for the concentration moments, analytical models for the concentration PDF, and concentration time-series models. We close the review with a brief discussion highlighting possible useful additions to experiments and improvements to models.
ABSTRACT
The objective of this research project was the design and development of an integrated model for odor emission estimation in wastewater treatment plants. The SMAT's plant, the largest wastewater treatment facility in Italy, was used as a case study. This article reports the results of the characterization phase that led to the definition and design of the proposed conceptual model for odor emission estimation. In this phase, concentrations of odor chemical tracers (VOC, H2S, NH3) and odor concentrations were monitored repeatedly. VOC screening with GC-MS analysis was also performed. VOC concentrations showed significant variability in space and magnitude. NH3 and H2S were also detected at considerable concentrations. Results were elaborated to define a spatially variable linear relationship between the sum of odor activity values (SOAV) and odor concentrations. Based on the results, a conceptual operational model was presented and discussed. The proposed system is composed by a network of continuous measurement stations, a set of algorithms for data elaboration and synchronization, and emission dispersion modeling with the application of Lagrangian atmospheric models.
Subject(s)
Air Pollutants , Odorants , Wastewater/analysis , Air Pollutants/chemistry , Gas Chromatography-Mass Spectrometry , Italy , Models, Theoretical , Wastewater/chemistryABSTRACT
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.
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.