Environment and Breast Cancer: Science Review

Evidence From Humans
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Association between hospital discharge rate for female breast cancer and residence in a zip code containing hazardous waste sites
Lu, X., Lessner, L., Carpenter, D. O. Environ Res. 2014. 134C, 375-381.
Topic area
Environmental pollutant
Study design
Funding agency
Institute for Health and the Environment of the Un
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
No analyses based on menopausal status
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
Breast cancer diagnoses among African American and White women over age 30 living in one of 1,373 zip codes in New York State (not including New York City). Zip codes in analysis restricted to those with median household income between 10th-90th percentile of mean values over 16 years. Cases identified from state-regulated hospital discharge data from 1993-2008.
Comment about participation selection
The data available from the NY Department of Health did not include individual information on breast cancer risk factors such as family history, age of menarche, childbearing, use of hormone replacement therapy, or residential history. Discharges did not specify primary or secondary diagnosis.
Exposure Investigated
Exposures investigated
Zip code of residence at time of hospital discharge classified by number and type of hazardous waste sites (HWS) in the zip code from US EPA Toxic Release Inventory (TRI) 1993-2008. Categories of hazardous waste included POPs, VOCs, or other (includes met
How exposure was measured
Geographic location
Exposure assessment comment
957 zip codes did not have a HWS, and served as the reference group. The study does not include residential history.
Breast cancer outcome investigated
Primary incident breast cancer
Ethnic groups with separate analysis
If this study provided a separate analysis by ethnic or racial group, the groups are listed here.
Predominantly white; separate analysis with African American women
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.
Age, median household income, ethnicity, urbanicity
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 lived in zip codes with no HWS:
Women who lived in zip codes with 1 HWS: IRR 1.06 (95% CI 1.02-1.09)
Women who lived in zip codes with 4 or more HWS: IRR 1.09 (95% CI 1.04-1.15)
Women who lived in zip codes with at least one VOC HWS: IRR 1.06 (95% CI 1.01-1.13)
Women who lived in zip codes with at least one POP HWS: IRR 1.01 (95% CI 0.97-1.06)

White women who lived in highly urban, low income zip codes with 4 or more HWS: IRR 1.29 (95% CI 1.08-1.55)
African American women who lived in highly urban, low income zip codes with 4 or more HWS: IRR 1.59 (95% CI 1.31-1.94)
Results Comments
Hospital discharge rates among African American women were significantly elevated at all levels of urbanicity and median household income in the sub-analysis of high HWS zip codes.
Author address
Laboratory for Earth Surface Processes, College of Urban and Environmental Sciences, Peking University, Beijing, China; Institute for Health and the Environment, University at Albany, 5 University Place, A217, Rensselaer, New York 12144, USA. Electronic a
Reviewers Comments
Measurements of contaminants at the HWS were not available, so the level of pollution from any given site was not characterized. There are other sources of pollutants that may affect breast cancer risk in more urban areas.