Objective: To document associations between environmental risk factors and benign prostate hyperplasia (BPH) among Hong Kong men using a case-control study. Methods: We recruited 431 newly diagnosed prostate cancer cases and 402 age-matched controls from Prince of Wales Hospital in Hong Kong. We further consecutively recruited 855 BPH cases from the urological outpatients who were confirmed by biopsy to be non-malignancy. We adopted a standardized questionnaire to obtain each participant's information on shift work, diets, habits of using food and water containers, household detergents and pesticide usage, etc. We applied a new assessment tool of environmental bisphenol A exposure (BPA) developed in our previous publication on BPA and prostate cancer to each BPH case to calculate a novel cumulative BPA exposure index (CBPAI). Compared with the distribution of exposures among controls, we estimated odds ratio (OR) and 95% confidence interval (95% CI) for BPH using multiple logistic regression analysis. Results: Shift work was more common among BPH cases (12.9%) than the controls (7.5%), showing an adjusted OR of 1.90 (95%CI: 1.23-2.94). Weekly consumption of deep fried food and pickle vegetables was positively associated BPH with OR of 2.25 (95%CI: 1.49-3.38) and 1.85 (95%CI: 1.12-3.05), respectively. Habitually drinking green tea had benefits (OR=0.6$195%CI: 0.41-0.92) but habitual coffee consumption showed harmful (OR=1.59,95%CI: 1.17-2.15). A significant positive gradient between exposure to CBPAI and risk of BPH was observed. Conclusions: This study identified weekly consumption of deep fried/persevered foods, habitual coffee drinking and frequent use food/water containers are risk factors of BPH, but habitual green tea drinking is protective. This study is the first to provide an integrated picture on the etiology of BPH. [Acknowledgement: Health and Medical Research Fund (HMRF), Project No.: 11121091; correspondence: shelly@cuhk.edu.hk]
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