Environment and Breast Cancer: Science Review

Evidence From Humans
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Environment and health in contaminated sites: the case of Taranto, Italy
Pirastu, R., Comba, P., Iavarone, I., Zona, A., Conti, S., Minelli, G., Manno, V., Mincuzzi, A., Minerba, S., Forastiere, F., Mataloni, F., Biggeri, A. J Environ Public Health. 2013. 2013, 753719.
Topic area
Environmental pollutant - Air pollution
Study design
Funding agency
Italian Ministry of Health Ministry of Health's Pr
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
No analysis based on menopausal status
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
The study population consisted of residents living near sites with documented contamination and associated potential health impacts, named National Priority Contaminated Sites (NPCSs) by the National Environmental Remediation programme in Taranto, Italy. Cancer incidence for Taranto NPCSs and non-NPCS districts were based on data for the years 2006-2007. Incidence rates for the Italian South and Islands Cancer Registries macroarea were from 2005-2007. Mortality and morbidity for the years 1998-2008 and 1998-2010, respectively, were estimated for a cohort of residents living in specific districts close to the industrial sites, identified from the municipal register. The cohort included women aged 0-99 years who resided in Taranto, Massafa, and Statte at some point between, 1998-2010. Information on mortality and morbidity was obtained from Regional Health Databases.
Exposure Investigated
Exposures investigated
Residence near National Priority Contaminated Sites as a proxy for exposure to industrial sources of air pollution
Exposure assessment comment
Approximately half of the study's participants had a residence duration of 10 or more years.
Breast cancer outcome investigated
Primary incident breast cancer
Confounders considered
Other breast cancer risk factors, such as family history, age at first birth, and hormone replacement therapy use, that were taken into account in the study.
Mortality/morbidity analyses considered age, area-based SES, calendar period
Genetic characterization included
If the study analyzed relationships between environmental factors and inherited genetic variations, this field will be marked “Yes.” “No”, if not.
Strength of associations reported
Female breast cancer incidence in Taranto NPCSs vs South & Islands macroarea:
SIR 130 (90% CI 118-143)

Female breast cancer incidence in Taranto NPCSs vs other districts in Taranto:
SIR 124 (90% CI 113-136)

Association between district and breast cancer mortality between 1998-2008, compared to Taranto districts distant from industrial areas of interest:
Tamburi: aHR 0.92 (90% CI 0.69-1.22)
Borgo: aHR 1.18 (90% CI 0.96-1.44)
Paolo VI: aHR 1.29 (90% CI 0.93-1.79)
Slatte: aHR 1.04 (90% CI 0.72-1.49)

Association between district and breast cancer-specific hospitalizations between 1998-2010, compared to Taranto districts distant from industrial areas of interest:
Tamburi: aHR 1.03 (90% CI 0.87-1.21)
Borgo: aHR 0.98 (90% CI 0.86-1.12)
Paolo VI: aHR 1.33 (90% CI 1.11-1.59)
Statte: aHR 0.89 (90% CI 0.72-1.11)
Author address
Department of Biology and Biotechnologies Charles Darwin, Sapienza Rome University, Piazzale Aldo Moro 5, 00185 Rome, Italy. Department of Environment and Primary Prevention, National Health Institute, Viale Regina Elena 299, 00161 Rome, Italy. Unit of St
Reviewers Comments
Previous studies in Taranto demonstrated significant air pollution mainly from the steel industry (particulate matter, heavy metals, PAHs, and organ-halogenated compounds).