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Table 2 Multivariable adjusted associations of increasing quartiles of each estrogen disruptor HAP exposure on risk of incident invasive overall, estrogen-receptor positive (ER+) or estrogen-receptor negative (ER-) breast cancer 1989–2011 among 109,239 members of the Nurses’ Health Study II cohort

From: Exposure to hazardous air pollutants and risk of incident breast cancer in the Nurses’ Health Study II

  

Quartile 1

Quartile 2

Quartile 3

Quartile 4

 

Hazardous air pollutant

Outcome

Cases

HR (95% CI)

Cases

HR (95% CI)

Cases

HR (95% CI)

Cases

HR (95% CI)

P-value for trend

Diesel engine emissionsa

Overall

795

Ref

828

1.03 (0.93, 1.14)

828

1.02 (0.92, 1.13)

870

1.10 (0.99, 1.22)

0.096

ER+

518

Ref

530

1.02 (0.90, 1.15)

540

1.03 (0.91, 1.17)

572

1.11 (0.97, 1.27)

0.099

ER-

139

Ref

152

1.07 (0.84, 1.35)

146

1.02 (0.80, 1.32)

121

0.91 (0.70, 1.19)

0.401

Arsenic compounds (Inorganic)

Overall

812

Ref

855

0.99 (0.90, 1.10)

846

0.97 (0.88, 1.07)

808

0.96 (0.86, 1.06)

0.321

ER+

529

Ref

533

0.95 (0.84, 1.08)

560

0.99 (0.87, 1.13)

538

0.97 (0.86, 1.10)

0.837

ER-

146

Ref

152

1.01 (0.80, 1.28)

128

0.88 (0.68, 1.13)

132

0.91 (0.71, 1.16)

0.319

Biphenyl

Overall

801

Ref

859

1.06 (0.96, 1.17)

857

1.07 (0.97, 1.18)

804

0.99 (0.89, 1.09)

0.293

ER+

522

Ref

567

1.09 (0.96, 1.23)

541

1.05 (0.93, 1.19)

530

1.01 (0.89, 1.15)

0.640

ER-

140

Ref

137

0.98 (0.77, 1.25)

161

1.18 (0.94, 1.50)

120

0.93 (0.71, 1.21)

0.418

Bis(2-Ethylhexyl)Phthalate (Dehp)

Overall

833

Ref

809

0.99 (0.90, 1.10)

867

1.06 (0.96, 1.17)

812

1.01 (0.92, 1.12)

0.756

ER+

565

Ref

516

0.96 (0.84, 1.09)

559

1.03 (0.91, 1.16)

520

0.98 (0.87, 1.11)

0.897

ER-

131

Ref

145

1.09 (0.85, 1.39)

137

1.06 (0.82, 1.36)

145

1.22 (0.96, 1.56)

0.110

Dibutulphthalate

Overall

797

Ref

790

0.96 (0.87, 1.06)

902

1.13 (1.02, 1.25)*

832

1.06 (0.96, 1.17)

0.414

ER+

525

Ref

530

0.99 (0.87, 1.12)

571

1.10 (0.97, 1.24)

534

1.05 (0.93, 1.19)

0.600

ER-

143

Ref

135

0.95 (0.74, 1.21)

146

1.12 (0.87, 1.43)

134

0.98 (0.76, 1.24)

0.716

Dimethyl formamide

Overall

814

Ref

813

1.01 (0.91, 1.12)

867

1.08 (0.97, 1.19)

827

1.08 (0.97, 1.20)

0.105

ER+

531

Ref

521

1.00 (0.88, 1.13)

579

1.13 (0.99, 1.28)

529

1.09 (0.95, 1.24)

0.145

ER-

149

Ref

138

0.94 (0.74, 1.19)

144

0.97 (0.76, 1.24)

127

0.93 (0.72, 1.20)

0.683

4-Nitrophenol

Overall

798

Ref

836

1.01 (0.91, 1.12)

832

1.01 (0.91, 1.12)

855

1.07 (0.96, 1.19)

0.179

ER+

510

Ref

563

1.07 (0.95, 1.22)

544

1.04 (0.92, 1.19)

543

1.06 (0.92, 1.21)

0.655

ER-

144

Ref

130

0.90 (0.70, 1.15)

150

1.07 (0.84, 1.36)

134

1.02 (0.79, 1.32)

0.610

Selenium compounds

Overall

802

Ref

837

1.04 (0.94, 1.14)

882

1.06 (0.96, 1.17)

800

0.96 (0.86, 1.07)

0.283

ER+

516

Ref

546

1.06 (0.94, 1.20)

578

1.08 (0.95, 1.22)

520

0.95 (0.83, 1.09)

0.230

ER-

150

Ref

141

0.97 (0.77, 1.22)

146

1.00 (0.79, 1.27)

121

0.84 (0.64, 1.11)

0.222

Styrenea

Overall

1050

Ref

632

0.97 (0.88, 1.07)

753

0.94 (0.85, 1.03)

886

0.97 (0.89, 1.06)

0.676

ER+

681

Ref

400

0.96 (0.85, 1.09)

495

0.97 (0.86, 1.09)

584

1.01 (0.90, 1.13)

0.744

ER-

176

Ref

113

1.05 (0.83, 1.34)

131

0.99 (0.78, 1.24)

138

0.92 (0.73, 1.15)

0.341

  1. Note: All models adjusted for age, calendar period, race, family history of breast cancer, history of aspiration or biopsy confirmed benign breast disease, age at menarche, parity and age at first birth, menopausal status and postmenopausal hormone use, oral contraception use, recent mammogram, height, BMI at age 18, difference between current BMI and BMI at age 18, smoking status, physical activity, overall diet quality (including alcohol consumption), alcohol consumption at age 15 and age 18, shift work, individual-level SES (marital status, living arrangements, household income), area-level SES (Census tract median home value and median income), and Census region of residence
  2. aDiesel exhaust and Styrene are both potential estrogen disruptors and mammary carcinogens
  3. *indicates p-values< 0.05
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Environmental Health

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