地域性农村水环境降级对居民恶性肿瘤的影响  

Influence of Regional Water Environmental Degradation to Rural Residents' Cancer

作　　者：韩方岸[1] 将兆峰 柯士鸣 王苏华[2] 杨生 陆荣柱[2] 

机构地区：[1]江苏省镇江市疾病预防控制中心,江苏镇江212003 [2]江苏大学医学院 [3]镇江市卫生监督所

出　　处：《实用预防医学》2010年第9期1726-1730,共5页Practical Preventive Medicine

基　　金：江苏省预防医学基金项目(Y200718);镇江市社会发展基金项目(SH2007045)

摘　　要：目的探讨农村村民肿瘤高发与水生态环境变化的关联,了解肿瘤病因,为采取预防措施提供依据。方法应用生态流行病学方法,对比分析不同生存环境及环境变化前后农村村民的肿瘤发病状况。应用村民生活用水有机混合提取物进行Ames试验。定量检测农村水中有机污染物。结果研究区村民肿瘤标化发病率高于对照区(χ2=63.51,P<0.01)。地理环境相似,饮用河塘水的村民肿瘤标化发病率高于饮用自来水的村民(χ2=63.51,P<0.01);通过改水干预后村民肿瘤发病率显著降低(χ2=15.08,P<0.01)。多因素Logistic回归分析结果饮用水、喜食腌菜、家族史、生气为肿瘤危险因素,喜食水果、饮茶为保护因素。Ames试验验证,肿瘤高发村河水、浅井水、自来水对TA98、TA97、TA100致突变结果,MR>2。水硝酸盐、亚硝酸盐、乐果、阿特拉津检测结果高于对照村水,并检测出内分泌干扰物五氯酚。结论水环境有机污染物的联合作用是地域性肿瘤发病率上升的危险因素,改水可降低肿瘤发病率。Objective To discuss the correlation between the high incidence of cancer and the changes of water ecological environment in rural residents,to investigate the cancer etiology,and to provide the evidence for taking preventive measures to control cancer. Methods With the ecological-epidemiological method,the ecological environmental condition of the villages and the different incidence rates of cancers were comparatively studied.The mixture of VOCs and SVOCs extract from the surface water and villagers＇ drinking water was used to conduct Ames test.The VOCs and SVOCs in the surface water and villagers＇ drinking water were quantitatively detected. Results The standardized incidence rate of cancer in villagers of the three research villages was higher than that of three control villages,（χ2=63.51,P0.01）.In the similar geographical environment,the standardized incidence rate of cancer in villagers using pond waters or river waters for drinking was higher than that of villagers using tap water for drinking（χ2=63.51,P0.01）.The incidence rate of cancer in the villagers was significantly declined after water-improvement and intervention（χ2=15.08,P0.01）.The multivariate Logistic regression analysis results showed that drinking water,eating pickles,family history,and angry were the risk factors for cancers,while eating fruit and drinking green tea were the protective factors.Ames test results verified that the mixture of VOCs and SVOCs extract from river waters,shallow well water,and tap water in high cancer incidence villages showed mutagenic to TA98,TA97,and TA100,with MR2.Nitrate,nitrite,dimethoate,and atrazine in the river waters,shallow well water,and tap water in high cancer incidence villages were higher than those in the water from control villages,and pentachlorophenol was detected in the research villages. Conclusions The coalescence effect of mixture of organic pollutants in living water is the risk factor for cancer incidence among the villagers.The improvement of drinking water can reduce the

关 键 词：肿瘤 地域性 生态环境 饮用水 有机物 危险因素 

分 类 号：R730[医药卫生—肿瘤]