Abstract
Purpose
To investigate indoor particulate matter (PM) level and various indoor air pollution exposure, and to examine their relationships with risk of lung cancer in an urban Chinese population, with a focus on non-smoking women.
Methods
We conducted a case–control study in Taiyuan, China, consisting of 399 lung cancer cases and 466 controls, of which 164 cases and 218 controls were female non-smokers. Indoor PM concentrations, including PM1, PM2.5, PM7, PM10, and TSP, were measured using a particle mass monitor. Unconditional logistic regression models were used to calculate odds ratios (ORs) and 95 % confidence intervals after adjusting for age, education, annual income, and smoking.
Results
Among non-smoking women, lung cancer was strongly associated with multiple sources of indoor air pollution 10 years ago, including heavy exposure to environmental tobacco smoke at work (aOR = 3.65), high frequency of cooking (aOR = 3.30), and solid fuel usage for cooking (aOR = 4.08) and heating (aORcoal stove = 2.00). Housing characteristics related to poor ventilation, including single-story, less window area, no separate kitchen, no ventilator, and rarely having windows open, are associated with lung cancer. Indoor medium PM2.5 concentration was 68 μg/m3, and PM10 was 230 μg/m3. PM levels in winter are strongly correlated with solid fuel usage for cooking, heating, and ventilators. PM1 levels in cases are more than 3 times higher than that in controls. Every 10 μg/m3 increase in PM1 is associated with 45 % increased risk of lung cancer.
Conclusions
Indoor air pollution plays an important role in the development of lung cancer among non-smoking Chinese women.
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Abbreviations
- PM:
-
Particulate matter
- ETS:
-
Environmental tobacco smoke
- OR:
-
Odds ratio
- aOR:
-
Adjusted OR
- 95 % CI:
-
95 % confidence interval
- IAP:
-
Indoor air pollution
- PAH:
-
Polycyclic aromatic hydrocarbons
References
IARC (2008) Cancer incidence, mortality and prevalence worldwide in 2008. Globocan 2008
Wang JB, Jiang Y, Wei WQ, Yang GH, Qiao YL, Boffetta P (2010) Estimation of cancer incidence and mortality attributable to smoking in China. Cancer Causes Control 21(6):959–965
Franchini M, Mannucci PM (2007) Short-term effects of air pollution on cardiovascular diseases: outcomes and mechanisms. J Thromb Haemost 5(11):2169–2174
Mannino DM, Buist AS (2007) Global burden of COPD: risk factors, prevalence, and future trends. Lancet 370(9589):765–773
Boffetta P (2006) Human cancer from environmental pollutants: the epidemiological evidence. Mutat Res 608(2):157–162
Yang G, Fan L, Tan J, Qi G, Zhang Y, Samet JM, Taylor CE, Becker K, Xu J (1999) Smoking in China: findings of the 1996 national prevalence survey. JAMA 282(13):1247–1253
Wakai K, Inoue M, Mizoue T, Tanaka K, Tsuji I, Nagata C, Tsugane S (2006) Tobacco smoking and lung cancer risk: an evaluation based on a systematic review of epidemiological evidence among the Japanese population. Jpn J Clin Oncol 36(5):309–324
Alberg AJ, Ford JG, Samet JM (2007) Epidemiology of lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest 132(3 Suppl):29S–55S
Ellickson PL, Orlando M, Tucker JS, Klein DJ (2004) From adolescence to young adulthood: racial/ethnic disparities in smoking. Am J Public Health 94(2):293–299
Services UDoHaH (1987) Smoking and health: a national status report. In: US Government Printing Office, Washington, DC
Peto R (1985) Control of tobacco-related disease. Ciba Found Symp 110:126–142
Tang N, Wu Y, Zhou B, Wang B, Yu R (2009) Green tea, black tea consumption and risk of lung cancer: a meta-analysis. Lung Cancer 65(3):274–283
Boehm K, Borrelli F, Ernst E, Habacher G, Hung SK, Milazzo S, Horneber M (2009) Green tea (Camellia sinensis) for the prevention of cancer. Cochrane Database Syst Rev (3):CD005004
Li Y, Chang SC, Goldstein BY, Scheider WL, Cai L, You NC, Tarleton HP, Ding B, Zhao J, Wu M et al (2011) Green tea consumption, inflammation and the risk of primary hepatocellular carcinoma in a Chinese population. Cancer Epidemiol 35(4):362–368
Wu M, Liu AM, Kampman E, Zhang ZF, Van’t Veer P, Wu DL, Wang PH, Yang J, Qin Y, Mu LN (2009) Green tea drinking, high tea temperature and esophageal cancer in high- and low-risk areas of Jiangsu Province, China: a population-based case-control study. Int J Cancer 124(8):1907–1913
Mu LN, Lu QY, Yu SZ, Jiang QW, Cao W, You NC, Setiawan VW, Zhou XF, Ding BG, Wang RH et al (2005) Green tea drinking and multigenetic index on the risk of stomach cancer in a Chinese population. Int J Cancer 116(6):972–983
Wang N, Chen WQ, Zhu WX, Xing XM, Lu AP, Yang L (2011) Incidence trends and pathological characteristics of lung cancer in urban Beijing during period of 1998–2007. Zhonghua Yu Fang Yi Xue Za Zhi 45(3):249–254
Wang X, Qin Y, Gu J, Wang F, Jia P, Wang H, Yao Q, Zhu S (2011) Systematic review of studies of workplace exposure to environmental tobacco smoke and lung cancer risk. Zhongguo Fei Ai Za Zhi 14(4):345–350
Eisner MD (2010) Secondhand smoke at work. Curr Opin Allergy Clin Immunol 10(2):121–126
Zhao H, Gu J, Xu H, Yang B, Han Y, Li L, Liu S, Yao H (2010) Meta-analysis of the relationship between passive smoking population in China and lung cancer. Zhongguo Fei Ai Za Zhi 13(6):617–623
Wen W, Shu XO, Gao YT, Yang G, Li Q, Li H, Zheng W (2006) Environmental tobacco smoke and mortality in Chinese women who have never smoked: prospective cohort study. BMJ 333(7564):376
Trichopoulos D, Kalandidi A, Sparros L, MacMahon B (1981) Lung cancer and passive smoking. Int J Cancer 27(1):1–4
Boffetta P (2002) Involuntary smoking and lung cancer. Scand J Work Environ Health 28(Suppl 2):30–40
Boffetta P, Agudo A, Ahrens W, Benhamou E, Benhamou S, Darby SC, Ferro G, Fortes C, Gonzalez CA, Jockel KH et al (1998) Multicenter case-control study of exposure to environmental tobacco smoke and lung cancer in Europe. J Natl Cancer Inst 90(19):1440–1450
Zhong L, Goldberg MS, Parent ME, Hanley JA (2000) Exposure to environmental tobacco smoke and the risk of lung cancer: a meta-analysis. Lung Cancer 27(1):3–18
Taylor R, Najafi F, Dobson A (2007) Meta-analysis of studies of passive smoking and lung cancer: effects of study type and continent. Int J Epidemiol 36(5):1048–1059
Mohtashamipur E, Mohtashamipur A, Germann PG, Ernst H, Norpoth K, Mohr U (1990) Comparative carcinogenicity of cigarette mainstream and sidestream smoke condensates on the mouse skin. J Cancer Res Clin Oncol 116(6):604–608
Denissenko MF, Pao A, Tang M, Pfeifer GP (1996) Preferential formation of benzo[a]pyrene adducts at lung cancer mutational hotspots in P53. Science 274(5286):430–432
Hoh E, Hunt RN, Quintana PJ, Zakarian JM, Chatfield D, Wittry BC, Rodriguez E, Matt GE (2012) Environmental tobacco smoke as a source of polycyclic aromatic hydrocarbons in settled household dust. Environ Sci Technol 46(7):4174–4183
Oberg M, Jaakkola MS, Woodward A, Peruga A, Pruss-Ustun A (2011) Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. Lancet 377(9760):139–146
Hosgood HD III, Boffetta P, Greenland S, Lee YC, McLaughlin J, Seow A, Duell EJ, Andrew AS, Zaridze D, Szeszenia-Dabrowska N et al (2010) In-home coal and wood use and lung cancer risk: a pooled analysis of the international lung cancer consortium. Environ Health Perspect 118(12):1743–1747
Galeone C, Pelucchi C, La Vecchia C, Negri E, Bosetti C, Hu J (2008) Indoor air pollution from solid fuel use, chronic lung diseases and lung cancer in Harbin, Northeast China. Eur J Cancer Prev 17(5):473–478
Lan Q, He X, Costa DJ, Tian L, Rothman N, Hu G, Mumford JL (2000) Indoor coal combustion emissions, GSTM1 and GSTT1 genotypes, and lung cancer risk: a case-control study in Xuan Wei, China. Cancer Epidemiol Biomarkers Prev 9(6):605–608
Xu ZY, Blot WJ, Li G, Fraumeni JF Jr, Zhao DZ, Stone BJ, Yin Q, Wu A, Henderson BE, Guan BP (1991) Environmental determinants of lung cancer in Shenyang, China. IARC Sci Publ 105:460–465
Zhang JJ, Smith KR (2007) Household air pollution from coal and biomass fuels in China: measurements, health impacts, and interventions. Environ Health Perspect 115(6):848–855
Dai XD, Lin CY, Sun XW, Shi YB, Lin YJ (1996) The etiology of lung cancer in nonsmoking females in Harbin, China. Lung Cancer 14(Suppl 1):S85–S91
Luo RX, Wu B, Yi YN, Huang ZW, Lin RT (1996) Indoor burning coal air pollution and lung cancer—a case-control study in Fuzhou, China. Lung Cancer 14(Suppl 1):S113–S119
Sun X, Dai X, Shi Y, Lin Y (2002) A case-control study on the relationship among indoor air pollution, depression and oncogenesis of lung cancer. Zhongguo Fei Ai Za Zhi 5(2):101–103
Kleinerman RA, Wang Z, Wang L, Metayer C, Zhang S, Brenner AV, Xia Y, Shang B, Lubin JH (2002) Lung cancer and indoor exposure to coal and biomass in rural China. J Occup Environ Med 44(4):338–344
Zhao Y, Wang S, Aunan K, Seip HM, Hao J (2006) Air pollution and lung cancer risks in China—a meta-analysis. Sci Total Environ 366(2–3):500–513
Zhang J, Smith KR, Ma Y, Ye S, Jiang F, Qi W, Liu P, Khalil MAK, Rasmussen RA, Thorneloe SA (2000) Greenhouse gases and other airborne pollutants from household stoves in China: a database for emission factors. Atmos Environ 34(26):4537–4549
Zhang J, Smith KR (1996) Hydrocarbon emissions and health risks from cookstoves in developing countries. J Expo Anal Environ Epidemiol 6(2):147–161
Chen H, Goldberg MS, Villeneuve PJ (2008) A systematic review of the relation between long-term exposure to ambient air pollution and chronic diseases. Rev Environ Health 23(4):243–297
Turner MC, Krewski D, Pope CA III, Chen Y, Gapstur SM, Thun MJ (2011) Long-term ambient fine particulate matter air pollution and lung cancer in a large cohort of never-smokers. Am J Respir Crit Care Med 184(12):1374–1381
Heidi Elizabeth Satff Medtl JF (2003) Air quality estimate in Taiyuan, Shanxi Province, China. In: CICERO report
Xie RK, Seip HM, Liu L, Zhang DS (2009) Characterization of individual airborne particles in Taiyuan City, China. Air Qual Atmos Health 2(3):123–131
Tseng CY, Huang YC, Su SY, Huang JY, Lai CH, Lung CC, Ho CC, Liaw YP (2012) Cell type specificity of female lung cancer associated with sulfur dioxide from air pollutants in Taiwan: an ecological study. BMC Public Health 12:4
Lin HH, Murray M, Cohen T, Colijn C, Ezzati M (2008) Effects of smoking and solid-fuel use on COPD, lung cancer, and tuberculosis in China: a time-based, multiple risk factor, modelling study. Lancet 372(9648):1473–1483
Wang XR, Chiu YL, Qiu H, Au JS, Yu IT (2009) The roles of smoking and cooking emissions in lung cancer risk among Chinese women in Hong Kong. Ann Oncol 20(4):746–751
Lee CH, Yang SF, Peng CY, Li RN, Chen YC, Chan TF, Tsai EM, Kuo FC, Huang JJ, Tsai HT et al (2010) The precancerous effect of emitted cooking oil fumes on precursor lesions of cervical cancer. Int J Cancer 127(4):932–941
Li M, Yin Z, Guan P, Li X, Cui Z, Zhang J, Bai W, He Q, Zhou B (2008) XRCC1 polymorphisms, cooking oil fume and lung cancer in Chinese women nonsmokers. Lung Cancer 62(2):145–151
Yu IT, Chiu YL, Au JS, Wong TW, Tang JL (2006) Dose-response relationship between cooking fumes exposures and lung cancer among Chinese nonsmoking women. Cancer Res 66(9):4961–4967
Metayer C, Wang Z, Kleinerman RA, Wang L, Brenner AV, Cui H, Cao J, Lubin JH (2002) Cooking oil fumes and risk of lung cancer in women in rural Gansu, China. Lung Cancer 35(2):111–117
Ko YC, Cheng LS, Lee CH, Huang JJ, Huang MS, Kao EL, Wang HZ, Lin HJ (2000) Chinese food cooking and lung cancer in women nonsmokers. Am J Epidemiol 151(2):140–147
Zhong L, Goldberg MS, Parent ME, Hanley JA (1999) Risk of developing lung cancer in relation to exposure to fumes from Chinese-style cooking. Scand J Work Environ Health 25(4):309–316
Straif K, Baan R, Grosse Y, Secretan B, El Ghissassi F, Cogliano V (2006) Carcinogenicity of household solid fuel combustion and of high-temperature frying. Lancet Oncol 7(12):977–978
Hecht SS, Seow A, Wang M, Wang R, Meng L, Koh WP, Carmella SG, Chen M, Han S, Yu MC et al (2010) Elevated levels of volatile organic carcinogen and toxicant biomarkers in Chinese women who regularly cook at home. Cancer Epidemiol Biomarkers Prev 19(5):1185–1192
Pan CH, Chan CC, Wu KY (2008) Effects on Chinese restaurant workers of exposure to cooking oil fumes: a cautionary note on urinary 8-hydroxy-2′-deoxyguanosine. Cancer Epidemiol Biomarkers Prev 17(12):3351–3357
Tao F, Gonzalez-Flecha B, Kobzik L (2003) Reactive oxygen species in pulmonary inflammation by ambient particulates. Free Radic Biol Med 35(4):327–340
Brauer M, Avila-Casado C, Fortoul TI, Vedal S, Stevens B, Churg A (2001) Air pollution and retained particles in the lung. Environ Health Perspect 109(10):1039–1043
Lippmann M, Yeates DB, Albert RE (1980) Deposition, retention, and clearance of inhaled particles. Br J Ind Med 37(4):337–362
Squadrito GL, Cueto R, Dellinger B, Pryor WA (2001) Quinoid redox cycling as a mechanism for sustained free radical generation by inhaled airborne particulate matter. Free Radic Biol Med 31(9):1132–1138
Moller P, Folkmann JK, Forchhammer L, Brauner EV, Danielsen PH, Risom L, Loft S (2008) Air pollution, oxidative damage to DNA, and carcinogenesis. Cancer Lett 266(1):84–97
Scapellato ML, Lotti M (2007) Short-term effects of particulate matter: an inflammatory mechanism? Crit Rev Toxicol 37(6):461–487
Lewtas J (2007) Air pollution combustion emissions: characterization of causative agents and mechanisms associated with cancer, reproductive, and cardiovascular effects. Mutat Res 636(1–3):95–133 (Epub 2007 Aug 2017)
Acknowledgments
This work was supported in part by the National Nature Science Foundation of China grant award to Dr. Lina Mu (NSFC-30500417). The work is also partially supported by NIH grants (ES06718, CA09142, DA11386) and the Alper Research Center for Environmental Genomics of the UCLA Jonsson Comprehensive Cancer Center.
Conflict of interest
We have no financial relationship with the organizations that sponsored the research.
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Mu, L., Liu, L., Niu, R. et al. Indoor air pollution and risk of lung cancer among Chinese female non-smokers. Cancer Causes Control 24, 439–450 (2013). https://doi.org/10.1007/s10552-012-0130-8
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DOI: https://doi.org/10.1007/s10552-012-0130-8