Relationship between Air Pollutant Exposure and Gynecologic Cancer Risk

Abstract

Exposure to air pollution has been suggested to be associated with an increased risk of women's health disorders. However, it remains unknown to what extent changes in ambient air pollution affect gynecological cancer. In our case-control study, the logistic regression model was combined with the restricted cubic spline to examine the association of short-term exposure to air pollution with gynecological cancer events using the clinical data of 35,989 women in Beijing from December 2008 to December 2017. We assessed the women's exposure to air pollutants using the monitor located nearest to each woman's residence and working places, adjusting for age, occupation, ambient temperature, and ambient humidity. The adjusted odds ratios (ORs) were examined to evaluate gynecologic cancer risk in six time windows (Phase 1-Phase 6) of women's exposure to air pollutants (PM_2.5, CO, O₃, and SO₂) and the highest ORs were found in Phase 4 (240 days). Then, the higher adjusted ORs were found associated with the increased concentrations of each pollutant (PM_2.5, CO, O₃, and SO₂) in Phase 4. For instance, the adjusted OR of gynecological cancer risk for a 1.0-mg m^-3 increase in CO exposures was 1.010 (95% CI: 0.881-1.139) below 0.8 mg m^-3, 1.032 (95% CI: 0.871-1.194) at 0.8-1.0 mg m^-3, 1.059 (95% CI: 0.973-1.145) at 1.0-1.4 mg m^-3, and 1.120 (95% CI: 0.993-1.246) above 1.4 mg m^-3. The ORs calculated in different air pollution levels accessed us to identify the nonlinear association between women's exposure to air pollutants (PM_2.5, CO, O₃, and SO₂) and the gynecological cancer risk. This study supports that the gynecologic risks associated with air pollution should be considered in improved public health preventive measures and policymaking to minimize the dangerous effects of air pollution.

Keywords: air pollutant exposure; association; gynecologic cancer risk.

Figure 1

Spatial distribution of 35,989 patients’ residence and 34 air quality monitoring stations.

Figure 2

The relationship between the concentrations of four air pollutants and the gynecological cancer in six exposure phases. (a) The OR and 95% CI of gynecological cancer with a 1.0 μg/m³ increase in PM_2.5 concentration; (b) the OR and 95% CI of gynecological cancer with a 1.0-mg/m³ increase in CO concentration; (c) the OR and 95% CI of gynecological cancer with a 1.0-μg/m³ increase in O₃ concentration; (d) the OR and 95% CI of gynecological cancer with a 1.0-μg/m³ increase in SO₂ concentration.

Figure 3

Exposure–response curve between air pollutant exposure and the risk of gynecological cancer. (a–d), Exposure–response curve of gynecological cancer risk with respect to PM_2.5 (a), CO (b), O₃ (c), and SO₂ (d) exposure. The red line represents the OR value, and the black line denotes the 95% confidence intervals. The histogram shows the distribution of the corresponding pollutant concentration. Here we controlled confounders.

Figure 4

Influence of the four air pollutants on the risk of gynecological cancer in different ranges in Phase 4. (a–d), The OR of gynecological cancer with respect to PM_2.5 (a), CO (b), O₃ (c), and SO₂ (d) exposure. The ORs of gynecological cancer with respect to PM_2.5, CO, SO₂, and O₃ exposure. Here we controlled confounders.

Figure 5

Relationship between air pollution and gynecological cancer with different social and demographic characteristics. The risks of four air pollutants on the risk of gynecological cancers is evaluated in each subgroup with PM_2.5, O₃, and SO₂ increase by 1.0 μg/m³ and CO increase by 1.0 mg/m³.