title: Exposure to fogger trucks and breast cancer incidence in the Long Island Breast Cancer Study Project: a case-control study.
abstract: BACKGROUND
  Few studies have supported an association between breast cancer and DDT, usually assessed with biomarkers that cannot discern timing of exposure, or differentiate between the accumulation of chronic low-dose versus acute high-dose exposures in the past. Previous studies suggest that an association may be evident only among women exposed to DDT during biologically susceptible windows, or among those diagnosed with estrogen receptor/progesterone receptor-positive (ER+PR+) breast cancer subtypes. Self-reported acute exposure to a fogger truck, which sprayed DDT prior to 1972, was hypothesized to increase the risk of breast cancer, particularly among women exposed at a young age or diagnosed with ER+PR+ breast cancer.
  
  
  METHODS
  We examined these possibilities in the Long Island Breast Cancer Study Project (LIBCSP) (1,508 cases, 1,556 controls), which included exposure assessment by structured questionnaire and serum samples collected between 1996-1998, using adjusted logistic and polytomous regression to estimate ORs and 95% CIs.
  
  
  RESULTS
  Women with ER+PR+ breast cancer had a 44% increased odds of ever seeing a pre-1972 fogger truck compared to other subtypes (OR = 1.44; 95% CI 1.08-1.93). However, there was little variation in the observed increase in breast cancer risk when considering all women who reported seeing a pre-1972 fogger truck at their residence (OR = 1.16; 95% CI 0.98, 1.37), or during hypothesized susceptible windows. Self-reported acute exposure was not correlated with serum concentrations, a biomarker of long-term exposure.
  
  
  CONCLUSIONS
  These findings support the hypothesis that seeing a fogger truck, a proxy measure for acute DDT exposure, may be associated with ER+PR+ tumors, the most commonly diagnosed breast cancer subtype among American women.
authors.affiliation: Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA. whitea@unc.edu
authors.forename: Alexandra J
authors.initials: AJ
authors.lastname: White
authors.forename: Susan L
authors.initials: SL
authors.lastname: Teitelbaum
authors.forename: Mary S
authors.initials: MS
authors.lastname: Wolff
authors.forename: Steven D
authors.initials: SD
authors.lastname: Stellman
authors.forename: Alfred I
authors.initials: AI
authors.lastname: Neugut
authors.forename: Marilie D
authors.initials: MD
authors.lastname: Gammon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000393:Air Pollutants / Q000032:analysis / Q000633:toxicity*; D001943:Breast Neoplasms / Q000139:chemically induced / Q000453:epidemiology*; D016022:Case-Control Studies; D002648:Child; D003634:DDT / Q000032:analysis / Q000633:toxicity*; D004781:Environmental Exposure; D004784:Environmental Monitoring; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009518:New York; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000393:Air Pollutants; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D003634:DDT