Bulletin électronique de veille Cancer Environnement N°11 du 17/09/2014
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Bulletin électronique de veille Cancer Environnement N°11 du 17/09/2014 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 Household and occupational exposure to pesticides and risk of breast cancer. Exposition domestique et professionnelle aux pesticides et le risque de cancer du sein. El-Zaemey S et al, Int J Environ Health Res. 2014 Apr The association between breast cancer in women and the use of household or occupational pesticides was examined in a population-based case-control study. This study was conducted in Western Australia in 2009-2011 and included 1,789 controls and 1,205 cases. Information on household pesticide exposure was collected from questionnaires. For occupational pesticide exposure, job-specific modules (JSMs) were used. To evaluate potential recall bias, we stratified the analysis by belief about whether pesticides contribute to breast cancer. Unconditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Women's exposures to pesticides in households and workplaces were not related to increased risk of breast cancer (OR = 1.10; CI: 0.86-1.37) and (OR = 0.77; CI: 0.45-1.32), respectively. The prevalence of occupational exposure to pesticides among women in our study was low. In the stratified analyses, the odd ratios associated with household pesticide use were similar among participants who believed pesticides increased breast cancer risk and those who did not. The results of our study did not show associations between breast cancer and household or occupational exposure to pesticides. Avoidance of sun exposure is a risk factor for all-cause mortality: results from the Melanoma in Southern Sweden cohort. La prévention de l'exposition au soleil est un facteur de risque de mortalité toutes causes confondues: résultats de la cohorte Mélanome dans le sud de la Suède Lindgvist PG et al, J Intern Med. 2014 Jul BACKGROUND: Sunlight exposure and fair skin are major determinants of human vitamin D production, but they are also risk factors for cutaneous malignant melanoma (MM). There is epidemiological evidence that allcause mortality is related to low vitamin D levels. 1 METHODS: We assessed the avoidance of sun exposure as a risk factor for all-cause mortality for 29 518 Swedish women in a prospective 20-year follow-up of the Melanoma in Southern Sweden (MISS) cohort. Women were recruited from 1990 to 1992 and were aged 25 to 64 years at the start of the study. We obtained detailed information at baseline on their sun exposure habits and potential confounders. Multivariable flexible parametric survival analysis was applied to the data. RESULTS: There were 2545 deaths amongst the 29 518 women who responded to the initial questionnaire. We found that all-cause mortality was inversely related to sun exposure habits. The mortality rate amongst avoiders of sun exposure was approximately twofold higher compared with the highest sun exposure group, resulting in excess mortality with a population attributable risk of 3%. CONCLUSION: The results of this study provide observational evidence that avoiding sun exposure is a risk factor for all-cause mortality. Following sun exposure advice that is very restrictive in countries with low solar intensity might in fact be harmful to women's health. Body-mass index and risk of 22 specific cancers: a population-based cohort study of 5·24 million UK adults. Index de masse corporelle et risque de 22 cancers spécifiques: une étude de cohorte basée sur la population de 5,24 millions d'adultes au Royaume-Uni. Bhaskaran K et al, Lancet. 2014 Aug BACKGROUND: High body-mass index (BMI) predisposes to several site-specific cancers, but a large-scale systematic and detailed characterisation of patterns of risk across all common cancers adjusted for potential confounders has not previously been undertaken. We aimed to investigate the links between BMI and the most common site-specific cancers. METHODS: With primary care data from individuals in the Clinical Practice Research Datalink with BMI data, we fitted Cox models to investigate associations between BMI and 22 of the most common cancers, adjusting for potential confounders. We fitted linear then non-linear (spline) models; investigated effect modification by sex, menopausal status, smoking, and age; and calculated population effects. FINDINGS: 5·24 million individuals were included; 166,955 developed cancers of interest. BMI was associated with 17 of 22 cancers, but effects varied substantially by site. Each 5 kg/m(2) increase in BMI was roughly linearly associated with cancers of the uterus (hazard ratio [HR] 1·62, 99% CI 1·56-1·69; p<0·0001), gallbladder (1·31, 1·12-1·52; p<0·0001), kidney (1·25, 1·17-1·33; p<0·0001), cervix (1·10, 1·03-1·17; p=0·00035), thyroid (1·09, 1·00-1·19; p=0·0088), and leukaemia (1·09, 1·05-1·13; p≤0·0001). BMI was positively associated with liver (1·19, 1·121·27), colon (1·10, 1·07-1·13), ovarian (1·09, 1.04-1.14), and postmenopausal breast cancers (1·05, 1·03-1·07) overall (all p<0·0001), but these effects varied by underlying BMI or individual-level characteristics. We estimated inverse associations with prostate and premenopausal breast cancer risk, both overall (prostate 0·98, 0·95-1·00; premenopausal breast cancer 0·89, 0·86-0·92) and in never-smokers (prostate 0·96, 0·93-0·99; premenopausal breast cancer 0·89, 0·85-0·94). By contrast, for lung and oral cavity cancer, we observed no association in never smokers (lung 0·99, 0·93-1·05; oral cavity 1·07, 0·91-1·26): inverse associations overall were driven by current smokers and ex-smokers, probably because of residual confounding by smoking amount. Assuming causality, 41% of uterine and 10% or more of gallbladder, kidney, liver, and colon cancers could be attributable to excess weight. We estimated that a 1 kg/m(2) population-wide increase in BMI would result in 3790 additional annual UK patients developing one of the ten cancers positively associated with BMI. INTERPRETATION: BMI is associated with cancer risk, with substantial population-level effects. The heterogeneity in the effects suggests that different mechanisms are associated with different cancer sites and different patient subgroups. 2 Prenatal exposure to phenols and growth in boys. Exposition prénatale aux phénols et croissance chez les garçons. Philippat C et al, Epidemiology 2014 Sep BACKGROUND: Phenols interact with nuclear receptors implicated in growth and adipogenesis regulation. Only a few studies have explored their effects on growth in humans. OBJECTIVES: We studied the associations of maternal exposure to phenols during pregnancy with prenatal and postnatal growth of male newborns. METHODS: Within a cohort of women recruited during pregnancy, we selected 520 mother-son pairs and quantified 9 phenols in spot urine samples collected during pregnancy. We used ultrasonography during pregnancy, together with birth measurements, to assess fetal growth. We modeled individual postnatal growth trajectories from repeated measures of weight and height in the first 3 years of life. RESULTS: Triclosan concentration was negatively associated with growth parameters measured at the third ultrasound examination but not earlier in pregnancy. At birth, this phenol tended to be negatively associated with head circumference (-1.2 mm for an interquartile range [IQR] increase in ln-transformed triclosan concentration [95% confidence interval = -2.6 to 0.3]) but not with weight or height. Parabens were positively associated with weight at birth. This positive association remained for 3 years for methylparaben (β = 193 g [-4 to 389]) for an IQR increase in ln-transformed concentrations. CONCLUSION: We relied on only 1 spot urine sample to assess exposure; because of the high variability in phenol urinary concentrations reported during pregnancy, using only 1 sample may result in exposure misclassification, in particular for bisphenol A. Our study suggested associations between prenatal exposure to parabens and triclosan and prenatal or early postnatal growth. Air quality and social deprivation in four French metropolitan areas—A localized spatiotemporal environmental inequality analysis Qualité de l'air et précarité sociale dans quatre villes de France- Une analyse spatio-temporelle des inégalités environnementales. Padilla CM et al, Environ Res.2014 Sep Several studies have documented that more deprived populations tend to live in areas characterized by higher levels of environmental pollution. Yet, time trends and geographic patterns of this disproportionate distribution of environmental burden remain poorly assessed, especially in Europe. We investigated the spatial and temporal relationship between ambient air nitrogen dioxide (NO2) concentrations and socioeconomic and demographic data in four French metropolitan areas (Lille in the North, Lyon in the center, Marseille in the South, and Paris) during two different time periods. The geographical unit used was the census block. The dependent variable was the NO2 annual average concentration (μg/m3) per census block, and the explanatory variables were a neighborhood deprivation index and socioeconomic and demographic data derived from the national census. Generalized additive models were used to account for spatial autocorrelation. We found that the strength and direction of the association between deprivation and NO2 estimates varied between cities. In Paris, census blocks with the higher social categories are exposed to higher mean concentrations of NO2. However, in Lille and Marseille, the most deprived census blocks are the most exposed to NO2. In Lyon, the census blocks in the middle social categories were more likely to have higher concentrations than in the lower social categories. Despite a general reduction in NO2 concentrations over the study period in the four metropolitan areas, we found contrasting results in the temporal trend of environmental inequalities. There is clear evidence of city-specific spatial and temporal environmental inequalities that relate to the historical socioeconomic make-up of the cities and its evolution. Hence, general statements about environmental and social inequalities can be made. 3 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 RhôneAlpes 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 Lettre d’information de l’IReSP 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 Nos partenaires Avec soutien de : Pour tout abonnement/désabonnement à cet e-bulletin ou pour nous faire part d'informations à diffuser dans les prochains numéros, n’hésitez pas à nous écrire à l'adresse suivante : [email protected] Afin de respecter la législation sur la propriété intellectuelle, le bulletin de veille électronique renvoie l’internaute à la source d’origine de chacune des ressources répertoriées. Il propose systématiquement des liens vers d’autres sites qui ne relèvent pas de son autorité. Il est à noter qu’il n’est pas responsable du contenu de ces sites, des liens qui y sont suggérés et des changements ou mises à jour qu’ils subissent. « La relecture et sélection des publications de ce bulletin électronique est réalisée par des membres du comité éditorial du portail cancer-environnement.fr avec la participation des professionnels de santé du Centre Léon Bérard et ses partenaires, sur la base de leur pertinence dans le champ ‘cancer, environnement et nutrition’. Dans la mesure où le contenu des sources et des informations recensées dans ce e-bulletin n’engagent que leurs auteurs, il appartient au lecteur d’en évaluer la qualité. » E-Bulletin réalisé par le Comité Editorial du portail http://www.cancer-environnement.fr/48-Qui-sommes-nous.ce.aspx 4
