Mortality in Yusho patients exposed to polychlorinated biphenyls and polychlorinated dibenzofurans: a 50-year retrospective cohort study
Tóm tắt
In 1968, the Yusho incident resulted in accidental exposure to polychlorinated biphenyls (PCBs), polychlorinated dibenzofurans (PCDFs), and related compounds in Japan. This study updated the risk of mortality in Yusho patients.
We obtained updated cohort data for all Yusho patients for the period 1968–2017. We calculated standardized mortality ratios (SMRs) for all-cause and cause-specific mortality over a 50-year follow-up period compared with the general population in Japan.
A total of 1664 Yusho patients with 63,566 person-years of follow up were included in the analysis. Among males, excess mortality was observed for all cancers (SMR: 1.22, 95% confidence interval [CI]: 1.02 to 1.45) and lung cancer (SMR: 1.59, 95% CI: 1.12 to 2.19). Among females, increased mortality was observed for liver cancer (SMR: 2.05, 95% CI: 1.02 to 3.67). No significant increase was seen in non-cancer-related mortality compared with the general population.
Carcinogenic risk in humans after exposure to PCBs and PCDFs remains higher among Yusho patients. Our findings suggest the importance of care engagement and optimum management to deal with the burden of Yusho disease.
Từ khóa
Tài liệu tham khảo
Kuratsune M, Yoshimura T, Matsuzaka J, Yamaguchi A. Epidemiologic study on Yusho, a poisoning caused by ingestion of Rice oil contaminated with a commercial brand of polychlorinated biphenyls. Environ Health Perspect. 1972;1:119–28.
Mitoma C, Uchi H, Tsukimori K, Yamada H, Akahane M, Imamura T, et al. Yusho and its latest findings-a review in studies conducted by the Yusho group. Environ Int. 2015;82:41–8.
Mitoma C, Uchi H, Tsukimori K, Todaka T, Kajiwara J, Shimose T, et al. Current state of yusho and prospects for therapeutic strategies. Environ Sci Pollut Res Int. 2018;25(17):16472–80.
Urabe H, Asahi M. Past and current dermatological status of yusho patients. Environ Health Perspect. 1985;59:11–5.
Ikeda M. Comparison of clinical picture between Yusho/Yucheng cases and occupational PCB poisoning cases. Chemosphere. 1996;32(3):559–66.
Chen PH, Chang KT, Lu YD. Polychlorinated biphenyls and polychlorinated dibenzofurans in the toxic rice-bran oil that caused PCB poisoning in Taichung. Bull Environ Contam Toxicol. 1981;26(4):489–95.
Steele G, Stehr-Green P, Welty E. Estimates of the biologic half-life of polychlorinated biphenyls in human serum. N Engl J Med. 1986;314(14):926–7.
Phillips DL, Smith AB, Burse VW, Steele GK, Needham LL, Hannon WH. Half-life of polychlorinated biphenyls in occupationally exposed workers. Arch Environ Health. 1989;44(6):351–4.
Hopf NB, Ruder AM, Waters MA, Succop P. Concentration-dependent half-lives of polychlorinated biphenyl in sera from an occupational cohort. Chemosphere. 2013;91(2):172–8.
Van den Berg M, De Jongh J, Poiger H, Olson JR. The toxicokinetics and metabolism of polychlorinated dibenzo-p-dioxins (PCDDs) and dibenzofurans (PCDFs) and their relevance for toxicity. Crit Rev Toxicol. 1994;24(1):1–74.
Onozuka D, Yoshimura T, Kaneko S, Furue M. Mortality after exposure to polychlorinated biphenyls and polychlorinated dibenzofurans: a 40-year follow-up study of Yusho patients. Am J Epidemiol. 2009;169(1):86–95.
Li MC, Chen PC, Tsai PC, Furue M, Onozuka D, Hagihara A, et al. Mortality after exposure to polychlorinated biphenyls and polychlorinated dibenzofurans: a meta-analysis of two highly exposed cohorts. Int J Cancer. 2015;137(6):1427–32.
Onozuka D, Hirata T, Furue M. Relative survival after exposure to polychlorinated biphenyls and dioxins: a follow-up of Japanese patients affected in the Yusho incident. Sci Total Environ. 2011;409(12):2361–5.
Onozuka D, Hirata T, Furue M. Net survival after exposure to polychlorinated biphenyls and dioxins: the Yusho study. Environ Int. 2014;73:28–32.
Wasi N, Flaaen A. Record linkage using Stata: preprocessing, linking, and reviewing utilities. Stata J. 2015;15(3):672–97.
Li MC, Tsai PC, Chen PC, Hsieh CJ, Leon Guo YL, Rogan WJ. Mortality after exposure to polychlorinated biphenyls and dibenzofurans: 30 years after the “Yucheng accident”. Environ Res. 2013;120:71–5.
Ruder AM, Hein MJ, Hopf NB, Waters MA. Mortality among 24,865 workers exposed to polychlorinated biphenyls (PCBs) in three electrical capacitor manufacturing plants: a ten-year update. Int J Hyg Environ Health. 2014;217(2–3):176–87.
Kimbrough RD, Krouskas CA, Xu W, Shields PG. Mortality among capacitor workers exposed to polychlorinated biphenyls (PCBs), a long-term update. Int Arch Occup Environ Health. 2015;88(1):85–101.
Checkoway H, Lees PSJ, Dell LD, Gentry PR, Mundt KA. Peak exposures in epidemiologic studies and cancer risks: considerations for regulatory risk assessment. Risk Anal. 2019;39(7):1441–64.
Lauby-Secretan B, Loomis D, Grosse Y, El Ghissassi F, Bouvard V, Benbrahim-Tallaa L, et al. Carcinogenicity of polychlorinated biphenyls and polybrominated biphenyls. Lancet Oncol. 2013;14(4):287–8.
Lauby-Secretan B, Loomis D, Baan R, El Ghissassi F, Bouvard V, Benbrahim-Tallaa L, et al. Use of mechanistic data in the IARC evaluations of the carcinogenicity of polychlorinated biphenyls and related compounds. Environ Sci Pollut Res Int. 2016;23(3):2220–9.
Scelo G, Boffetta P, Autier P, Hemminki K, Pukkala E, Olsen JH, et al. Associations between ocular melanoma and other primary cancers: an international population-based study. Int J Cancer. 2007;120(1):152–9.
Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359–86.
Kudo M, Izumi N, Ichida T, Ku Y, Kokudo N, Sakamoto M, et al. Report of the 19th follow-up survey of primary liver cancer in Japan. Hepatol Res. 2016;46(5):372–90.
Kudo M, Izumi N, Kubo S, Kokudo N, Sakamoto M, Shiina S, et al. Report of the 20th Nationwide follow-up survey of primary liver cancer in Japan. Hepatol Res. 2020;50(1):15–46.
Ukawa S, Okada E, Nakamura K, Hirata M, Nagai A, Matsuda K, et al. Characteristics of patients with liver cancer in the BioBank Japan project. J Epidemiol. 2017;27(3S):S43–8.
Goh GB, Chang PE, Tan CK. Changing epidemiology of hepatocellular carcinoma in Asia. Best Pract Res Clin Gastroenterol. 2015;29(6):919–28.
Global Burden of Disease Liver Cancer C. The burden of primary liver cancer and underlying etiologies from 1990 to 2015 at the global, regional, and National Level: results from the global burden of disease study 2015. JAMA Oncol. 2017;3(12):1683–91.
Uchida S, Satake M, Kurisu A, Sugiyama A, Ko K, Akita T, et al. Incidence rates of hepatitis C virus infection among blood donors in Japan: a nationwide retrospective cohort study. Transfusion. 2018;58(12):2880–5.
Kociba RJ, Keyes DG, Beyer JE, Carreon RM, Wade CE, Dittenber DA, et al. Results of a two-year chronic toxicity and oncogenicity study of 2,3,7,8-tetrachlorodibenzo-p-dioxin in rats. Toxicol Appl Pharmacol. 1978;46(2):279–303.
Hashmi MZ, Zhang J, Li B, Su X, Tariq M, Ahmad N, et al. Effects of structurally different noncoplanar and coplanar PCBs on HELF cell proliferation, cell cycle, and potential molecular mechanisms. Environ Toxicol. 2017;32(4):1183–90.
Wielsoe M, Kern P, Bonefeld-Jorgensen EC. Serum levels of environmental pollutants is a risk factor for breast cancer in Inuit: a case control study. Environ Health. 2017;16(1):56.
Huang W, He Y, Xiao J, Huang Y, Li A, He M, et al. Risk of breast cancer and adipose tissue concentrations of polychlorinated biphenyls and organochlorine pesticides: a hospital-based case-control study in Chinese women. Environ Sci Pollut Res Int. 2019;26(31):32128–36.
He TT, Zuo AJ, Wang JG, Zhao P. Organochlorine pesticides accumulation and breast cancer: a hospital-based case-control study. Tumour Biol. 2017;39(5):1010428317699114.
Donat-Vargas C, Akesson A, Berglund M, Glynn A, Wolk A, Kippler M. Dietary exposure to polychlorinated biphenyls and risk of breast, endometrial and ovarian cancer in a prospective cohort. Br J Cancer. 2016;115(9):1113–21.
Parada H Jr, Wolff MS, Engel LS, Eng SM, Khankari NK, Neugut AI, et al. Polychlorinated biphenyls and their association with survival following breast cancer. Eur J Cancer. 2016;56:21–30.
Leng L, Li J, Luo XM, Kim JY, Li YM, Guo XM, et al. Polychlorinated biphenyls and breast cancer: a congener-specific meta-analysis. Environ Int. 2016;88:133–41.
Zhang J, Huang Y, Wang X, Lin K, Wu K. Environmental polychlorinated biphenyl exposure and breast cancer risk: a meta-analysis of observational studies. PLoS One. 2015;10(11):e0142513.
Cao J, Fan T, Li W, Xiao S. Association study between plasma levels of polychlorinated biphenyls and risk of cutaneous malignant melanoma. Environ Int. 2019;126:298–301.
Pesatori AC, Grillo P, Consonni D, Caironi M, Sampietro G, Olivari L, et al. Update of the mortality study of workers exposed to polychlorinated biphenyls (Pcbs) in two Italian capacitor manufacturing plants. Med Lav. 2013;104(2):107–14.
Magoni M, Apostoli P, Donato F, Manganoni A, Comba P, Fazzo L, et al. Plasma levels of polychlorinated biphenyls and risk of cutaneous malignant melanoma: a hospital-based case-control study. Environ Int. 2018;113:20–5.
Boffetta P, Catalani S, Tomasi C, Pira E, Apostoli P. Occupational exposure to polychlorinated biphenyls and risk of cutaneous melanoma: a meta-analysis. Eur J Cancer Prev. 2018;27(1):62–9.
Zani C, Ceretti E, Covolo L, Donato F. Do polychlorinated biphenyls cause cancer? A systematic review and meta-analysis of epidemiological studies on risk of cutaneous melanoma and non-Hodgkin lymphoma. Chemosphere. 2017;183:97–106.
Georgiadis P, Gavriil M, Rantakokko P, Ladoukakis E, Botsivali M, Kelly RS, et al. DNA methylation profiling implicates exposure to PCBs in the pathogenesis of B-cell chronic lymphocytic leukemia. Environ Int. 2019;126:24–36.
Humblet O, Birnbaum L, Rimm E, Mittleman MA, Hauser R. Dioxins and cardiovascular disease mortality. Environ Health Perspect. 2008;116(11):1443–8.
Carpenter DO. Exposure to and health effects of volatile PCBs. Rev Environ Health. 2015;30(2):81–92.
Bergkvist C, Berglund M, Glynn A, Wolk A, Akesson A. Dietary exposure to polychlorinated biphenyls and risk of myocardial infarction - a population-based prospective cohort study. Int J Cardiol. 2015;183:242–8.
Bergkvist C, Berglund M, Glynn A, Julin B, Wolk A, Akesson A. Dietary exposure to polychlorinated biphenyls and risk of myocardial infarction in men - a population-based prospective cohort study. Environ Int. 2016;88:9–14.
Akesson A, Donat-Vargas C, Berglund M, Glynn A, Wolk A, Kippler M. Dietary exposure to polychlorinated biphenyls and risk of heart failure - a population-based prospective cohort study. Environ Int. 2019;126:1–6.
Bergkvist C, Kippler M, Larsson SC, Berglund M, Glynn A, Wolk A, et al. Dietary exposure to polychlorinated biphenyls is associated with increased risk of stroke in women. J Intern Med. 2014;276(3):248–59.
Tsai PC, Ko YC, Huang W, Liu HS, Guo YL. Increased liver and lupus mortalities in 24-year follow-up of the Taiwanese people highly exposed to polychlorinated biphenyls and dibenzofurans. Sci Total Environ. 2007;374(2–3):216–22.
Shimizu K, Ogawa F, Thiele JJ, Lee JB, Bae S, Sato S. Increased levels of urinary nitrite and nitrotyrosine in Yusho victims 40 years after accidental poisoning with polychlorinated biphenyls in Nagasaki, Japan. J Appl Toxicol. 2008;28(8):1040–4.