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 all-
cause mortality is related to low vitamin D levels.

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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, 1·12-
1·27), 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.

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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 spatio-
temporal 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.

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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
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
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