The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #63416

Peggy Reynolds, PhD¹, Debbie Goldberg, MS², Susan Hurley, MPH², Andrew Hertz³, and Robert B. Gunier, MPH¹. (1) Environmental Health Investigations Branch, California Department of Health Services, 1515 Clay Street, Suite 1700, Oakland, CA 94612, 510-622-4417, preynold@dhs.ca.gov, (2) Environmental Health Investigations Branch, Public Health Institute, 1515 Clay Street, Suite 1700, Oakland, CA 94612, (3) California Dept Health Services, Environmental Health Investigations Branch, 1515 Clay, Suite 1700, Oakland, CA 94612

The objective of this study was to examine the association between residential proximity to golf courses and the incidence of breast cancer among members of the California Teachers Study (CTS) cohort. Created in 1995-1996, the CTS cohort was established from the 133,479 respondents to a mailed questionnaire sent to all female professional school employees in the Statewide Teachers Retirement System. Residential address at the time of entry in the cohort was geocoded for 115,611 of the teachers with no prior history of breast cancer and 1,993 cases of invasive breast cancer were prospectively identified among the geocoded CTS members for 1995-2000. Residential proximity within a quarter-mile of a golf course boundary among each subject was determined using a Geographical Information System (GIS). Cox Proportional Hazard models were used to generate hazard ratios (HR) for golf course proximity, adjusting for age and race and census block group measures of socioeconomic status and urbanization. Our analyses revealed a non-significant increased incidence of breast cancer among women living within a quarter-mile of a golf course (HR=1.15, 95% CI=0.99-1.35). Further adjusting the models for SES and urbanization attenuated but did not substantially affect the risk estimates. Stratifying by menopausal status (at baseline) resulted in a statistically significant HR among the postmenopausal group when adjusting for age and race (HR=1.21, 95% CI=1.01-1.44). The HR remained elevated, but not statistically significant when the model was further adjusted for SES and urbanization.

Learning Objectives:

• Participants will acquire information regarding:
• • the public health reasons for exploring residential proximity to golf courses in relation to breast cancer
• • the California Teachers Cohort, the largest prospective breast cancer study to date
• • methods used to geocode a location using a Geographical Information System.
• As a result of this educational experience, participants can be expected to:
• • articulate the public health concern regarding residential proximity to golf courses in relation to breast cancer
• • describe the methods used to explore the association between residential proximity to golf courses and invasive breast cancer in the California Teachers Cohort study.
• At the conclusion of the session, the participant will be able to
• • discuss the public health concern residential proximity to golf courses and the incidence of breast cancer
• • describe the methods and results of the California Teachers Cohort study examining residential proximity to golf courses and invasive breast cancer
• • identify areas for future research with regards to breast cancer and proximity to golf courses.

Keywords: Breast Cancer, Environment

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.