Pollution de l’air provenant de véhicules
Transcript of Pollution de l’air provenant de véhicules
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Pollution de l’air provenant de véhicules
et cancer de la prostate à Montréal, Canada
Colloque de l’IRSPUM, octobre 2013 Marie-Élise Parent, PhD
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Collaborateurs
Mark S Goldberg ̶ Dept. of Medicine, McGill University, Montréal
Dan L Crouse ̶ Statistics Canada, Ottawa
Nancy A Ross ̶ Dept. of Geography, McGill University
Hong Chen ̶ Public Health Ontario,Toronto
Alexandre Liautaud ̶ School of Population and Public Health, University of British Columbia
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Prostate cancer (PCa)
• Most frequent cancer among men
• Etiology poorly understood
• Established risk factors: age, family history of PCa,
ancestry / geography
• Evidence from migrant studies suggests that risk is
influenced by the environment
Role for the environment?
Prostate is under hormone regulation. Could
environmental factors modulating androgens & estrogens
play an etiological role? Still not substantiated
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A few studies have reported associations between
traffic-related air pollution and cancer risk
• Breast cancer (2010, Montréal)
• Cervical cancer (2012, Denmark)
• Brain cancer (2012, Denmark)
• Childhood cancers (2013, California)
• Lung cancer (2013, Europe)
Prostate cancer
• Positive associations in ecological mortality
studies (1960s, New York and Tennessee)
• No association (2012, Denmark)
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Traffic-related air pollution
• Local vehicular traffic is the primary contributor to air
pollution in urban areas
• Vehicular emissions include gases, particles, volatile
organic compounds, some of which are potential
carcinogens
• Polycyclic aromatic hydrocarbons and
benzo(a)pyrene have hormone-modulating properties
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Our question
Is traffic-related air pollution associated with prostate
cancer risk?
A largely unexplored territory…
Parent et al., Occup Environ Med 2013;70:511-8.
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PROtEuS:
The Prostate cancer and Environment Study
• Study base: Greater Montreal
• Case-control
• Age less 76 yrs
• 2,000 cases and 2,000 controls
This analysis (restricted to residents of Island of Montreal):
• 803 incident prostate cancers, histologically confirmed
across French Montreal hospitals (2005-2007)
• 969 population controls from French electoral list, age –
matched (± 5 yrs)
• Response rates: 86% and 63% for cases and controls
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PROtEuS
Data collection
• Face-to-face interviews
• Questionnaires eliciting
- Socio-demographics (including current address)
- Lifestyle factors
- Detailed work history
• Biological specimens
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Characteristics of the 803 cases and 969 controls
Cases Controls
Mean age (yrs) 64 65
Ancestry (%)
French 71 52
African 9 5
Asian 1 3
Other 18 38
Completed ≥ high school (%) 73 78
Mean BMI 27 27
Family history of PCa (%) 20 11
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Assessment of exposure to traffic-related
air pollution
NO2 used as marker of traffic-related air pollution
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Montreal survey of NO2 levels
• Estimated by measuring 2-week integrated
concentrations of nitrogen dioxide (NO2) using Ogawa
samplers at 129 locations at 3 times in 2005 and 2006
• Based on land use, road, and traffic data, a
regression model was developed to predict
concentrations of NO2 at all points in the city
• Using historical data from fixed-site monitors, the land
use regression model was extrapolated backward to
1996 and 1985
Crouse D et al., Atmospheric Environment, 2009
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Montreal survey of NO2 levels
• NO2 levels estimated by measuring 2-week integrated
concentrations of nitrogen dioxide (NO2) using Ogawa
samplers at 129 locations at 3 times in 2005 and 2006
• Based on land use, road, and traffic data, a
regression model was developed to predict
concentrations of NO2 at all points in the city
• Using historical data from fixed-site monitors, the land
use regression model was extrapolated backward to
1996 and 1985
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Pictures (1)
Anjou, Boul. Metropolitain Park-Extension
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ISEE August 2009 15
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Montreal survey of NO2 levels
• Estimated by measuring 2-week integrated
concentrations of nitrogen dioxide (NO2) using Ogawa
samplers at 129 locations at 3 times in 2005 and 2006
• Based on land use, road, and traffic data, a
regression model was developed to predict
concentrations of NO2 at all points in the city
• Using historical data from fixed-site monitors, the land
use regression model was extrapolated backward to
1996 and 1985
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Selected
predictor
variables
• Distance from nearest highway
• Traffic count on nearest
highway
• Length of major roads within
100m
• Area of industrial space within
500m
• Population density within
1000m
Model R2 = .80
Land use regression
model to predict annual
concentrations of NO2 at
a resolution of
5 m X 5 m
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ISEE August 2009 18
Park Mont Royal
Downtown
Land Use Regression Map Averaged over three Seasons
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Montreal survey of NO2 levels
• Estimated by measuring 2-week integrated
concentrations of nitrogen dioxide (NO2) using Ogawa
samplers at 129 locations at 3 times in 2005 and 2006
• Based on land use, road, and traffic data, a
regression model was developed to predict
concentrations of NO2 at all points in the city
• Using historical data from fixed-site monitors, the land
use regression model was extrapolated backward to
1996 and 1985
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Distribution of estimates of exposure to
NO2 (ppb)
Minimum Mean Maximum
2006 4.3 11.3 37.4
1996 5.9 15.7 44.5
1985 7.9 20.1 66.8
Hong Chen et al., Atmos Environ 2010
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Assigning NO2 exposures to our case-
control series of prostate cancer
1st step: geocoded current addresses
- GeoPinpoint V6.4 (DMTI Spatial, Markham, ON)
- ArcGIS 9.3 geographic information system (GIS)
(ESRI, Redlands, CA)
2nd step: linked current addresses to NO2 exposure
estimates
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Results
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23
OR for prostate cancer per increase of 5ppb of NO2
Age adjusted Fully adjusted*
Years of estimate of
exposure OR 95%CI OR 95%CI
2005-2006 1.47 1.24-1.75 1.44 1.21-1.73
1996 1.45 1.28-1.65 1.41 1.24-1.62
*Age, ancestry, education, family history of prostate cancer
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OR for prostate cancer per increase
of 5ppb of NO2
excluding controls not screened for PC
Fully adjusted*
Years of estimate of
exposure OR 95%CI
2005-2006 1.43 1.18-1.72
1996 1.41 1.22-1.62
*Age, ancestry, education, family history of prostate cancer
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Conclusion
NO2, used as a marker of traffic related air pollution,
was associated with prostate cancer risk
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Discussion
• Surprising…
• Findings due to chance?
• Confounding? All known risk factors already
accounted for in model
• Bias?
Next step:
Expand NO2 levels to lifetime addresses
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The future
• Air pollution and cancer research – still embryonic
• Spatially-referenced data may be particularly useful
for studying the etiology of cancers showing
geographic variations
• Need to further develop (and use!) spatially-
referenced databases
• Associations observed with geographic patterns
can help generate new hypotheses