Abstract
BACKGROUND: Ambient polycyclic aromatic hydrocarbons (PAHs) are a class of toxicologically important and understudied air pollutants. Epidemiologic evidence suggests that chronic exposure to PAHs increases breast cancer risk; however, there are few studies in nonoccupational settings that focus on early-onset diagnoses. METHODS: The relationship between residentially-based ambient PAH concentrations and female breast cancer, among those 18-45 years of age, was characterized in the Ontario Environment and Health Study (OEHS). The OEHS was a population-based case-control study undertaken in Ontario, Canada between 2013 and 2015. Primary incident breast cancers were identified within 3 months of diagnosis, and a population-based series of controls were recruited. Concentrations of ambient PAHs, using fluoranthene as a surrogate, were derived using a chemical transport model at a 2.5 km spatial resolution. These estimates were assigned to participants' residences at the time of the interview and 5 years prior. Logistic regression was used to estimate odds ratios (ORs) and their 95% confidence intervals (CIs) based on a quartile categorization of fluoranthene exposure while adjusting for a series of individual- and area-level risk factors. The shape of the exposure-response trend was evaluated using cubic splines. RESULTS: Median fluoranthene exposure for cases and controls was 0.0017 µg/m(3) and 0.0014 µg/m(3), respectively. In models adjusted for a parsimonious set of risk factors, the highest quartile of exposure was associated with an increased risk of breast cancer (OR = 2.16; 95% CI = 1.22, 3.84). Restricted spline analyses revealed nonlinear dose-response patterns. CONCLUSIONS: These findings support the hypothesis that ambient PAH exposures increases the risk of early-onset breast cancer.