Environment and Breast Cancer: Science Review

Evidence From Humans
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Exposure to fogger trucks and breast cancer incidence in the Long Island Breast Cancer Study Project: a case-control study
White, A. J., Teitelbaum, S. L., Wolff, M. S., Stellman, S. D., Neugut, A. I., Gammon, M. D. Environ Health. 2013. 12:1, 24.
Topic area
Environmental pollutant - Organochlorine pesticide DDT
Study design
Population based case-control
Funding agency
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
Stratified analysis based on menopausal status
Number of Controls
Controls: 1,556
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
Female residents of Nassau and Suffolk Counties (Long Island), NY, participating in the Long Island Breast Cancer Study Project, age 20 or older, English-speaking, newly diagnosed with in situ or invasive breast cancer in 1996-1997. Cases identified by regional hospital pathology laboratories. Controls had no breast cancer history and were matched by 5-year age group, identified by random-digit-dialing or Medicare records (for women 65 and older).
Exposure Investigated
Exposures investigated
Self-report of ever seeing a fogger truck at personal residence on Long Island.
How exposure was measured
Questionnaire Biological
Exposure assessment comment
Seeing a fogger truck is used as a proxy measure for acute DDT exposure. Participants were also asked about whether they chased fogger trucks as a child, but this data was not included in the analysis because of few positive responses.
Early life exposures considered
Yes. Exposure at ≤14 and ≤20 years of age.
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.
Based on causal diagram: Change in weight from age 20 to diagnosis, menopausal status, breastfeeding history, and family history of breast cancer.
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
Compared to women who never reported seeing a fogger truck at residence:
Born <1926; saw fogger truck <1972 OR 1.35 (0.95-1.89)
Born 1926-1945; saw fogger truck <1972 OR 1.29 (1.10-1.52)
Born 1946-1972; saw fogger truck <1972 OR 0.87 (0.72-1.04)
Ever saw fogger truck < 1972, ER+/PR+ OR 1.44 (1.08-1.93)
Ever saw fogger truck < 1972 at age ≤ 20, ER+/PR+ OR 1.50 (0.97-2.32)
Ever saw fogger truck < 1972 at age ≤ 14, ER+/PR+ OR 1.15 (0.99-1.33)

Postmenopausal women:
Ever saw fogger truck <1972: OR 1.24 (95% CI 1.02-1.51)

Premenopausal women:
Ever saw fogger truck <1972: OR 0.97 (95% CI 0.70-1.35)
Results Comments
Seeing a fogger truck did not predict serum levels of p,p'-DDE or p,p'-DDT measured in a random sample of cases and controls (643 cases/427 controls for p,p’-DDE; 633 cases/418 controls for p,p’-DDT) who donated blood near the time of diagnosis/reference.
Reviewers Comments
The same number of cases and controls reported seeing a fogger truck after the ban on DDT; however, this does not necessarily indicate that recall bias is nondifferential between cases and controls.