摘要
目的揭示淮河流域关键污染物的空间聚集模式,并基于污染分级进一步量化非消化道癌症风险和癌症负担,为淮河流域水污染的深化治理提供靶目标和数据支持。方法选取淮河流域2021年地表水质及2019年肿瘤登记年报的7种癌症发病数据,采用随机森林-SHapley加性解释分析筛选关键污染物,基于空间分析划分污染分级,并计算其癌症风险和人群归因分数。结果筛选出5个关键污染物,分别为总磷、总氮、化学需氧量、5日生化需氧量及砷,并将其联合效应划分为3个污染分级,结果显示与低污染地区相比,高污染地区的5种癌症发病风险显著增加,包括肺癌(RR=1.26,95%CI=1.06~1.50)、乳腺癌(女性)(RR=1.46,95%CI=1.21~1.77)、胰腺癌(RR=1.46,95%CI=1.06~2.01)、脑癌(RR=1.44,95%CI=1.05~1.98)和胆囊癌(RR=1.60,95%CI=1.03~2.50),且人群归因分数几乎均超过5%。结论地表水污染的潜在癌症风险和负担不容忽视,唯有各行业密切合作,通过进一步制定政策法规、加强环境治理和进行公众健康干预,才能从根本上应对这一挑战。
Objective To reveal the spatial distribution patterns of key pollutants in the Huaihe River Basin and quantify the risks and burdens of non-gastrointestinal cancers by the grade of pollution,providing targets and data support for enhanced management of water pollution in the Huaihe River Basin.Methods Surface water quality data of the Huaihe River Basin were obtained from the National Surface Water Environmental Quality Monitoring Network(2021).Incidence data of seven cancers were extracted from the 2019 Annual Report of the China Cancer Registry.Random forest and SHapley Additive exPlanations were employed to select key pollutants,and pollution was graded based on the spatial analysis of the Huaihe River Basin.The cancer risks and population attributable fractions were calculated under pollution grades.Results Five key pollutants linked to cancers were identified,including total nitrogen,total phosphorus,chemical oxygen demand,biochemical oxygen demand after 5 days,and arsenic.Pollution was graded into three levels regarding the combined effects of pollutants.Compared with the low pollution areas,high pollution areas showed increased risks of lung cancer(RR=1.26,95%CI:1.06-1.50),breast cancer(female)(RR=1.46,95%CI:1.21-1.77),pancreatic cancer(RR=1.46,95%CI:1.06-2.01),brain cancer(RR=1.44,95%CI:1.05-1.98),and gallbladder cancer(RR=1.60,95%CI:1.03-2.50).The grade of pollution contributed to more than 5%of cases for most cancers above.Conclusions The potential cancer risks and burdens attributed to surface water pollution cannot be overlooked.Addressing this challenge necessitates close collaboration of various stakeholders to strengthen policy development,enhance environmental governance,and implement public health interventions.
作者
赵婧
韩伟
郭晓波
张璐雯
薛芳
姜晶梅
ZHAO Jing;HAN Wei;GUO Xiaobo;ZHANG Luwen;XUE Fang;JIANG Jingmei(Institute of Basic Medical Sciences,Chinese Academy of Medical Sciences,Department of Epidemiology and Biostatistics,School of Basic Medicine,Peking Union Medical College,Beijing 100005,China;Centre of Environmental and Health Sciences,CAMS and PUMC,Beijing 100005,China)
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2024年第6期849-861,共13页
Acta Academiae Medicinae Sinicae
基金
中国医学科学院医学与健康科技创新工程项目(2021-I2M-1-022)。
关键词
淮河流域
地表水污染
空间分布模式
污染分级
癌症
Huaihe River basin
surface water pollution
spatial distribution patterns
pollution grading
cancer
