Survival of bronchopulmonary cancers according to radon exposure

IntroductionResidential 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.MethodsIn 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.ResultsA 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).DiscussionAlthough 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

Exposure to airborne cadmium and breast cancer stage, grade and histology at diagnosis: findings from the E3N cohort study

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

JMIR Res Protoc

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

Développement et application de méthodologies d'évaluation des expositions atmosphériques chroniques aux dioxines et au cadmium dans le cadre d'études épidémiologiques

A number of studies have examined the link between breast cancer and exposure to air pollution, including dioxins and cadmium. However, the results of these studies are inconclusive and present a number of methodological limitations. The main objective of this thesis was to develop a spatial indicator to assess chronic atmospheric exposure to dioxins and cadmium of women from the E3N cohort in France between 1990 and 2008. We first performed an inventory and created a database of 2620 dioxins and 2700 cadmium emitting sources in France between 1990 and 2008 and estimated and geolocated their annual emissions. The location of the sources and their estimated emissions were used as the basis for the construction of the indicator. Combination of additional spatial parameters, allowed us to obtain a "substantial" agreement between the dioxin and cadmium exposure classifications of the E3N subjects geolocalised at their residential address, using the estimated bythe indicator and exposures estimates derived from the Gaussian model. We also evaluated the spatial-temporal variability of dioxin and cadmium concentrations over nearly two decades in the Lyon metropolitan area, taking into account a wide variety of source types. This is the first study comparing concentrations predicted by a dispersion model to dioxin concentrations measured in ambient air. The exposure indicator was used in a case-control study within the E3N cohort to estimate the risk of breast cancer associated with atmospheric exposure to dioxins. It is currently being used in another study on cadmium exposure and breast cancer risk and may be applied in future studies on other pollutants or pathologiesUn certain nombre d'études ont étudié le lien entre cancer du sein et exposition aux dioxines et au cadmium. Toutefois, les résultats de ces études ne sont pas concluants et présentent des limites méthodologiques. L'objectif principal de cette thèse était de développer un indicateur spatial permettant d'estimer les expositions atmosphériques chroniques aux dioxines et au cadmium des femmes issues de la cohorte E3N en France, entre 1990 et 2008. Nous avons créé une base de données de 2620 sources de dioxines et 2700 sources de cadmium et estimé et géolocalisé leurs émissions. L'estimation des émissions à la source et leur localisation ont servi de base pour la construction de l'indicateur spatial. Nous avons identifié une sélection de paramètres permettant d'obtenir un accord « substantiel » entre les classifications des expositions des femmes de la cohorte E3N, localisées à l'adresse de résidence, estimées avec l'indicateur, et avec le modèle gaussien SIRANE. En utilisant le modèle SIRANE, nous avons également étudié la variabilité spatio-temporelle (1990-2008) des concentrations de dioxines et de cadmium sur la métropole de Lyon. Pour la première fois des concentrations modélisées ont été comparées à des mesures de concentrations de dioxines en air ambiant. L'indicateur développé dans cette thèse a été utilisé pour estimer le risque de cancer du sein associé à l'exposition atmosphérique aux dioxines dans une étude cas-témoins niché au sein de la cohorte E3N. Il est utilisé actuellement dans une étude sur le lien entre exposition au cadmium et risque de cancer du sein, et pourra être appliqué dans de futures études portant sur d'autres polluants ou d'autres pathologie

Development and application of assessment methodologies for chronic airborne dioxin and cadmium exposures to be used in epidemiological studies

Un certain nombre d'études ont étudié le lien entre cancer du sein et exposition aux dioxines et au cadmium. Toutefois, les résultats de ces études ne sont pas concluants et présentent des limites méthodologiques. L'objectif principal de cette thèse était de développer un indicateur spatial permettant d'estimer les expositions atmosphériques chroniques aux dioxines et au cadmium des femmes issues de la cohorte E3N en France, entre 1990 et 2008. Nous avons créé une base de données de 2620 sources de dioxines et 2700 sources de cadmium et estimé et géolocalisé leurs émissions. L'estimation des émissions à la source et leur localisation ont servi de base pour la construction de l'indicateur spatial. Nous avons identifié une sélection de paramètres permettant d'obtenir un accord « substantiel » entre les classifications des expositions des femmes de la cohorte E3N, localisées à l'adresse de résidence, estimées avec l'indicateur, et avec le modèle gaussien SIRANE. En utilisant le modèle SIRANE, nous avons également étudié la variabilité spatio-temporelle (1990-2008) des concentrations de dioxines et de cadmium sur la métropole de Lyon. Pour la première fois des concentrations modélisées ont été comparées à des mesures de concentrations de dioxines en air ambiant. L'indicateur développé dans cette thèse a été utilisé pour estimer le risque de cancer du sein associé à l'exposition atmosphérique aux dioxines dans une étude cas-témoins niché au sein de la cohorte E3N. Il est utilisé actuellement dans une étude sur le lien entre exposition au cadmium et risque de cancer du sein, et pourra être appliqué dans de futures études portant sur d'autres polluants ou d'autres pathologiesA number of studies have examined the link between breast cancer and exposure to air pollution, including dioxins and cadmium. However, the results of these studies are inconclusive and present a number of methodological limitations. The main objective of this thesis was to develop a spatial indicator to assess chronic atmospheric exposure to dioxins and cadmium of women from the E3N cohort in France between 1990 and 2008. We first performed an inventory and created a database of 2620 dioxins and 2700 cadmium emitting sources in France between 1990 and 2008 and estimated and geolocated their annual emissions. The location of the sources and their estimated emissions were used as the basis for the construction of the indicator. Combination of additional spatial parameters, allowed us to obtain a "substantial" agreement between the dioxin and cadmium exposure classifications of the E3N subjects geolocalised at their residential address, using the estimated bythe indicator and exposures estimates derived from the Gaussian model. We also evaluated the spatial-temporal variability of dioxin and cadmium concentrations over nearly two decades in the Lyon metropolitan area, taking into account a wide variety of source types. This is the first study comparing concentrations predicted by a dispersion model to dioxin concentrations measured in ambient air. The exposure indicator was used in a case-control study within the E3N cohort to estimate the risk of breast cancer associated with atmospheric exposure to dioxins. It is currently being used in another study on cadmium exposure and breast cancer risk and may be applied in future studies on other pollutants or pathologie

National scale LUR model over France for PM10, PM2.5, NO2 and O3: development, validation and back-extrapolation from 2010 to 1990

International audienceBACKGROUND AND AIM: In the context of a case-control study nested in a French cohort of about 10400 subjects, on air pollution exposures and breast cancer risk, we reconstructed subjects' exposures to four pollutants (PM10, PM2.5, NO2 and O3) between 1990 and 2010, using land use regression models. METHODS: We used databases of ambient air measurements, a large number of geographical variables and background pollution data provided by a country-wide chemistry-transport model (CTM) with an 8x8km resolution. We first built baseline models for the most recent year of the study period (2010) and validated them via cross-validation (pooling of predictions from leave-20%-out). In a second step, we extrapolated the baseline models to 1990. For each pollutant, we tried multiple backextrapolation approach (trends established with concentrations measured from remote location or simulated by the CTM). We selected the best method, based on the performance compared to the measurement data available between 1990 and 2009 (and non-used for the backextrapolation). RESULTS:The cross-validation of the baseline models showed robust results (CV-R²; CV-RMSE): NO2 (0.67; 7.5), PM10 (0.64; 3.3), PM2.5 (0.51; 2.6) and O3 (0.60; 6.2). Based on the baseline models, we produced high spatial resolution maps of the French territory (50x50m). The extrapolation of the baseline models to 1990 seems to produce better results if based on trends established at the local scale (8x8km) with the CTM data. For NO2 and O3, the statistical indicators remain fairly stable over the period. For PM10 and PM2.5, we observe a drop in performance over the period 1990-1998. This can partly be explained by the very low number of PM10 and PM2.5 measurement data available in France before 2000, which limits extensive comparisons. CONCLUSIONS:This work shows that it is possible to accurately reconstruct exposures over very large territories and long periods thanks to the input of simulated background pollution data

A national inventory of historical dioxin air emissions sources in France

International audienceno abstrac

Long-term atmospheric exposure to PM2.5 and PM10 and breast cancer risk in a case-control study nested in the French E3N cohort from 1990 to 2011

International audienc

Assessment of long-term exposure to airborne dioxin and cadmium concentrations in the Lyon metropolitan area (France)

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Development and performance evaluation of a GIS-based metric to assess exposure to airborne pollutant emissions from industrial sources

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