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Association of traffic-related hazardous air pollutants and cervical dysplasia in an urban multiethnic population: a cross-sectional study.

ABSTRACT: Human papillomavirus (HPV) infection is a necessary cause in the development of cervical cancer; however, not all women infected with HPV develop cervical cancer indicating that other risk factors are involved. Our objective was to determine the association between exposure to ambient levels of common traffic-related air toxics and cervical dysplasia, a precursor lesion for cervical cancer.The study sample consisted of women enrolled in a Phase II clinical trial to evaluate diagnostic techniques for cervical disease in Houston, Texas. The current assessment is a secondary data analysis in which cases were defined as women diagnosed with cervical dysplasia, while those without cervical dysplasia served as controls. Residential census tract-level estimates of ambient benzene, diesel particulate matter (DPM), and polycyclic aromatic hydrocarbons (PAHs) were used to assess exposure. Census tract-level pollutant estimates were obtained from the United States Environmental Protection Agency. Multivariable logistic regression was used to estimate prevalence odds ratios (aOR) and 95% confidence intervals (CI) adjusted for age, race/ethnicity, education, smoking status, and HPV status.Women in the highest residential exposure categories for benzene and DPM had an increased prevalence of cervical dysplasia compared to the lowest exposure category (Benzene: aOR [95% CI] for high exposure?=?1.97[1.07-3.62], very high exposure?=?2.30[1.19-4.46]. DPM: aOR [95% CI] for high exposure?=?2.83[1.55-5.16], very high exposure?=?2.10[1.07-4.11]). Similarly, women with high residential exposure to PAHs had an increased prevalence of cervical dysplasia (aOR [95% CI]?=?2.46[1.35-4.48]). The highest PAH exposure category was also positively associated with cervical dysplasia prevalence but was not statistically significant. Assessment of the combined effect of HAP exposure indicates that exposure to high levels of more than one HAP is positively associated with cervical dysplasia prevalence (p for trend?=?0.004).Traffic-related HAPs, such as benzene, DPM, and PAHs, are not as well-regulated and monitored as criteria air pollutants (e.g., ozone), underscoring the need for studies evaluating the role of these toxicants on disease risk. Our results suggest that exposure to traffic-related air toxics may increase cervical dysplasia prevalence.

SUBMITTER: Scheurer ME

PROVIDER: S-EPMC4063240 | biostudies-literature | 2014 Jun

REPOSITORIES: biostudies-literature

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Association of traffic-related hazardous air pollutants and cervical dysplasia in an urban multiethnic population: a cross-sectional study.

Scheurer Michael E ME Danysh Heather E HE Follen Michele M Lupo Philip J PJ

Environmental health : a global access science source 20140613 1

<h4>Background</h4>Human papillomavirus (HPV) infection is a necessary cause in the development of cervical cancer; however, not all women infected with HPV develop cervical cancer indicating that other risk factors are involved. Our objective was to determine the association between exposure to ambient levels of common traffic-related air toxics and cervical dysplasia, a precursor lesion for cervical cancer.<h4>Methods</h4>The study sample consisted of women enrolled in a Phase II clinical tria ...[more]

PMID: 24924773

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Project description:BackgroundStudies suggest that higher breast cancer rates in urban areas persist after accounting for the prevalence of known risk factors, leading to speculation that urban environmental exposures, such as air pollution, may play a role in the etiology of breast cancer. Combining modeled ambient air concentrations with data from a large prospective cohort of California women with over 15 years of follow-up, we examined the relationship between breast cancer incidence and modeled concentrations of air pollutants shown to be mammary gland carcinogens (MGCs).MethodsThe study population of 112,378 California Teachers Study participants included 5,676 women diagnosed with invasive breast cancer. Modeled annual average ambient air concentrations of 24 MGCs from the U.S. Environmental Protection Agency were linked to participants' addresses. Cox proportional hazards models were used to estimate hazard rate ratios and 95% confidence intervals associated with residential MGC levels. MGCs were examined individually and as a combined summary variable for all participants, in selected subsets, and by tumor hormone responsiveness.ResultsInitial models yielded some evidence for increased risk for several compounds, including acrylamide, carbon tetrachloride, chloroprene, 4,4'-methylene bis(2-chloroaniline), propylene oxide, and vinyl chloride, but after adjustment for multiple comparisons, only results for propylene oxide and vinyl chloride remained statistically significant. In subset analyses, estrogen-receptor positive or progesterone-receptor positive (ER+/PR+) tumors were associated with higher ambient levels of acrylamide, benzidine, carbon tetrachloride, ethylidene dichloride, and vinyl chloride, while ER-/PR- tumors were associated with higher ambient levels of benzene. Interesting results for different compounds were observed within certain subsets of the population.ConclusionWhile our initial models yielded several elevated risk estimates, after adjusting for multiple comparisons and breast cancer risk factors, most hazard ratios were no longer statistically significant. Our subset analyses, however, suggest that elevated risk may be associated with some compounds for certain subgroups of interest. A summary variable for all 24 MGCs did not offer any advantage over the models for individual compounds. Results must be interpreted cautiously, as estimated exposure was limited to modeled annual average ambient air concentrations, and could not account for other sources or routes other than inhalation.

Project description:BACKGROUND:Children are especially vulnerable to pneumonia and the effects of air pollution. However, little is known about the impacts of air pollutants on pediatric admissions for Mycoplasma pneumonia. This study was conducted to investigate the impacts of air pollutants on pediatric hospital admissions for Mycoplasma pneumonia in Shanghai, China. METHODS:A cross-sectional design was applied to explore the association between pediatric hospital admissions and levels of air pollutants (fine particulate matter, particulate matter, ozone, sulfur dioxide, nitrogen dioxide, and carbon monoxide). Data on hospital admissions for pneumonia and levels of ambient air pollutants were obtained for the period of 2015 to 2018. Associations between pediatric admissions for Mycoplasma pneumonia and ambient air pollutants were calculated using logistic regression and described by the odds ratio and relevant 95% confidence interval. The hysteresis effects of air pollutants from the day of hospital admission to the previous 7?days were evaluated in single-pollutant models and multi-pollutant models with adjustments for weather variables and seasonality. Lag 0 was defined as the day of hospital admission, lag 1 was defined as the day before hospital admission, and so forth. RESULTS:In the single-pollutant models (without adjustment for other pollutants), pediatric hospital admissions for pneumonia were positively associated with elevated concentrations of nitrogen dioxide and fine particulate matter. A 0.5% increase in daily admissions per 10-?g/m3 increase in the nitrogen dioxide level occurred at lag 1 and lag 2, and a 0.3% increase in daily admissions per 10-?g/m3 increase in fine particulate matter occurred at lag 1. In the multi-pollutant models, nitrogen dioxide and fine particulate matter remained significant after inclusion of particulate matter, ozone, sulfur dioxide, and carbon monoxide. CONCLUSIONS:This study illustrated that higher levels of nitrogen dioxide and fine particulate matter increase the risk of pediatric hospitalization for Mycoplasma pneumonia in Shanghai, China. These findings imply that the high incidence of Mycoplasma pneumonia in children in Asia might be attributed to the high concentration of specific air pollutants in Asia.

Dataset Information

Association of traffic-related hazardous air pollutants and cervical dysplasia in an urban multiethnic population: a cross-sectional study.

Publications

Association of traffic-related hazardous air pollutants and cervical dysplasia in an urban multiethnic population: a cross-sectional study.

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