Bulletin électronique de veille Cancer Environnement

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Bulletin électronique de veille Cancer Environnement
N° 3 du 07/ 11/ 2013
Ce bulletin de veille signale mensuellement une sélection de documents identifiés dans le cadre de la
veille cancer environnement. La méthodologie mise en œuvre est présentée dans la fiche du site cancer
environnement : http://www.cancer-environnement.fr/334-Veille-scientifique.ce.aspx
Publications récentes
Questionnaire-based second-hand smoke assessment in adults
Évaluation du tabagisme passif chez les adultes à partir de questionnaires
Pérez-Ríos M, Eur J Public Health. 2013 Oct
Numerous studies have assessed second-hand smoke (SHS) exposure but a gold standard remains to be
established. This study aimed to review how SHS exposure has been assessed in adults in questionnaire-based
epidemiological studies.
METHODS: A literature search of original papers in English, French, Italian or Spanish published from January
2000 to May 2011 was performed using PubMed. The variables recorded for each study included target
population, sample size, validation of the SHS questions, study design and phrasing of every question used to
assess SHS exposure. For each item, information such as the setting where exposure was assessed or the
indicator used to ascertain SHS exposure was extracted.
RESULTS: We retrieved 977 articles, of which 335 matched the inclusion criteria. The main objective of 75.8%
of the studies was to assess SHS exposure.The proportion of validated questions aiming to ascertain SHS
exposure was 17.9%. Most studies collected data only for one (40.3%) or two settings (33.4%), most frequently
the home (83.9%) and workplace (57%). The most commonly used indicator to ascertain exposure was the
presence of smokers and 68.9% of the studies included an item to assess the intensity of SHS exposure.
CONCLUSIONS: The variability in the indicators and items used to ascertain SHS exposure is very high,
whereas the use of items derived from validated studies remains low. Identifying the diverse settings where SHS
exposure may occur is essential to accurately assess exposure over time. A standard set of items to identify SHS
exposure in distinct settings is needed.

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Tanning bed use is not associated with internal cancer risk: Evidence from a large
cohortstudy.
L’utilisation de banc solaire n'est pas associée au risque de cancer d’ organes internes : Résultats d’une
vaste étude de cohorte
Zhand M, Cancer Epidemiol Biomarkers Prev. 2013 Oct
Background: Increased risk of skin cancer by indoor tanning has drawn public attention. However, there are
arguments that tanning bed use increases vitamin D production, which may therefore prevent internal cancers.
Methods: We follow 73,358 female nurses for 20 years (1989-2009) in the Nurses' Health Study II and
investigated the frequency of tanning bed use during high school/college and at ages 25-35 in relation to the
incidence of total cancers (excluding skin cancers). We used multivariate Cox proportional hazards models to
estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of total cancers and each individual major
cancer with more than 100 cases.
Results: During follow-up, a total of 4,271 internal cancer cases were diagnosed. No association was found
between tanning bed use and risk of total cancers (multivariable-adjusted HR, 0.99; 95% CI, 0.95-1.04 for every
4 times/year use on average during high school/college and at ages 25-35). In addition, no association was found
for the risk of any individual major cancers, such as breast cancer, thyroid cancer, colorectal cancer, non-
Hodgkin lymphoma, or endometrial cancer.
Conclusions: Our data do not suggest any association between the use of tanning beds and risk of internal
cancers. Impact: Based on the strong evidence of increase in skin cancer risk and no evidence of reduction in
internal cancer risk by tanning bed use, it is important to warn the public against indoor tanning.
Ambient air pollution and low birthweight: a European cohort study (ESCAPE)
Pollution de l'air ambiant et faible poids de naissance : une étude de cohorte européenne (ESCAPE)
Pedersen M, The Lancet Respiratory Medecine. 2013 Oct
Ambient air pollution has been associated with restricted fetal growth, which is linked with adverse respiratory
health in childhood. We assessed the effect of maternal exposure to low concentrations of ambient air pollution
on birthweight.
Methods : We pooled data from 14 population-based mother—child cohort studies in 12 European countries.
Overall, the study population included 74 178 women who had singleton deliveries between Feb 11, 1994, and
June 2, 2011, and for whom information about infant birthweight, gestational age, and sex was available. The
primary outcome of interest was low birthweight at term (weight <2500 g at birth after 37 weeks of gestation).
Mean concentrations of particulate matter with an aerodynamic diameter of less than 2·5 μm (PM2·5), less than
10 μm (PM10), and between 2·5 μm and 10 μm during pregnancy were estimated at maternal home addresses
with temporally adjusted land-use regression models, as was PM2·5 absorbance and concentrations of nitrogen
dioxide (NO2) and nitrogen oxides. We also investigated traffic density on the nearest road and total traffic load.
We calculated pooled effect estimates with random-effects models.
Findings : A 5 μg/m3 increase in concentration of PM2·5 during pregnancy was associated with an increased risk
of low birthweight at term (adjusted odds ratio [OR] 1·18, 95% CI 1·06—1·33). An increased risk was also
recorded for pregnancy concentrations lower than the present European Union annual PM2·5 limit of 25 μg/m3
(OR for 5 μg/m3 increase in participants exposed to concentrations of less than 20 μg/m3 1·41, 95% CI 1·20—
1·65). PM10 (OR for 10 μg/m3 increase 1·16, 95% CI 1·00—1·35), NO2 (OR for 10 μg/m3 increase 1·09,
1·00—1·19), and traffic density on nearest street (OR for increase of 5000 vehicles per day 1·06, 1·01—1·11)
were also associated with increased risk of low birthweight at term. The population attributable risk estimated for
a reduction in PM2·5 concentration to 10 μg/m3 during pregnancy corresponded to a decrease of 22% (95% CI
8—33%) in cases of low birthweight at term. Interpretation : Exposure to ambient air pollutants and traffic
during pregnancy is associated with restricted fetal growth. A substantial proportion of cases of low birthweight
at term could be prevented in Europe if urban air pollution was reduced.

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Age and the effect of physical activity on breast cancer survival: A systematic review.
L’âge et l’effet de l’activité physique sur la survie après cancer du sein : Une revue systématique
Fontein DB, Cancer Treat Rev. 2013 Dec;39(8):958-65
The effect of physical activity (PA) on cancer survival is still the topic of debate in oncology research focusing
on survivorship, and has been investigated retrospectively in several large clinical trials. PA has been shown to
improve quality of life, fitness and strength, and to reduce depression and fatigue. At present, there is a growing
body of evidence on the effects of PA interventions for cancer survivors on health outcomes. PA and functional
limitations are interrelated in the elderly. However the relationship between breast cancer survival and PA in
older breast cancer patients has not yet been fully investigated. Our systematic review of the existing literature
on this topic yielded seventeen studies. Most reports demonstrated an improved overall and breast cancer-
specific survival. Furthermore, in studies that compared younger women with older or postmenopausal women,
it was suggested that the beneficial effect of PA may be even greater in older women. Understanding the
interaction between physical functioning and cancer survival in older breast cancer patients is key, and may
contribute to successful treatment and survival. In this population of cancer survivors it is therefore imperative to
embark on research focused on improving physical functioning in the context of comorbidities and functional
limitations.

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Actualités et lettres d’information des acteurs Santé Environnement
Région Rhône-Alpes
National
Agence Régionale de Santé Rhône-Alpes
Agence nationale de sécurité sanitaire, de
l’alimentation, de l’environnement et du
travail
Air Rhône-Alpes
Bulletin de veille bibliographique Nota Bene
Cancer de l’Institut National du Cancer
(INCa)
Lettre d’information de l’INCa
Espace Régional de Santé Publique Rhône-
Alpes
Institut national de recherche en sciences et
technologies pour l’environnement et
l’agriculture
Fédération Rhône-Alpes de Protection de la
Nature
Lettre d’information de l’Institut National de
Recherche et de Sécurité pour la prévention
des accidents du travail et des maladies
professionnelles
Institut de Recherche en Santé Publique
Lettre d’information “Ademe et vous”
Lettre Santé-Environnement Rhône-Alpes de
l’ORS Rhône-Alpes
La lettre de la Société Française de Santé
Environnement
Société Française de Santé Publique Bulletin
Flash e-mail SFSP
Société Française de Médecine du Travail
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