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The effects of air pollution on the lung cancer mortality in rural areas of eastern China: a multi-region study

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Abstract

Recently, the burden of lung cancer (LC) has attracted global attention. Meanwhile, LC has become the leading cause of death in China. Many studies found a strong link between air pollutants and the risk of LC mortality in some large cities, but the results have been inconsistent, and most studies have only focused on the daily effects of six pollutants in large cities, ignoring their potential cumulative effects. This study was to investigate the weekly effects of six air pollutants (CO, NO2, O3, PM2.5, PM10, and SO2) on LC mortality in rural areas of eastern China and to further clarify which population groups were susceptible to air pollution and seasonal trends. First, a generalized additive model was combined with a distributed lag nonlinear model to evaluate the individual impact of air pollution on LC deaths in each area. The random-effect model was then used to pool the associations between air pollutants and LC mortality risk in ten counties or districts. The results showed that six air pollutants had a statistically significant effect on the risk of LC mortality at different lag weeks. The effects of NO2, PM10, and CO on weekly LC mortality were strongest at a cumulative lag of 1, 0, and 1 week, respectively, the maximum cumulative risk ratio (RR) of 1.37 (95%CI: 1.23 to 1.52), 1.30 (95%CI: 1.15 to 1.46), and 1.30 (95%CI: 1.17 to 1.43), with interquartile concentrations increasing. In summary, air pollution was an important factor in LC mortality, and the effect was stronger on males, the elderly, and during cold season. It was suggested that relevant departments should formulate air pollution management measures for the elderly, males, and in different seasons in rural areas and reduce the burden of lung cancer caused by air pollution.

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Data availability

The datasets analyzed during the current study are available from the corresponding author on reasonable request.

References

  • Bauwelinck M, Chen J, de Hoogh K, Katsouyanni K, Rodopoulou S, Samoli E, Andersen ZJ, Atkinson R, Casas L, Deboosere P, Demoury C, Janssen N, Klompmaker JO, Lefebvre W, Mehta AJ, Nawrot TS, Oftedal B, Renzi M, Stafoggia M, Strak M, Vandenheede H, Vanpoucke C, Van Nieuwenhuyse A, Vienneau D, Brunekreef B, Hoek G (2021) Variability in the association between long-term exposure to ambient air pollution and mortality by exposure assessment method and covariate adjustment: a census-based country-wide cohort study. Sci Total Environ. 804:150091. https://doi.org/10.1016/j.scitotenv.2021.150091

    Article  CAS  Google Scholar 

  • Chen R, Peng RD, Meng X, Zhou Z, Chen B, Kan H (2013) Seasonal variation in the acute effect of particulate air pollution on mortality in the China air pollution and health effects study (CAPES). Sci Total Environ. 450–451:259–65. https://doi.org/10.1016/j.scitotenv.2013.02.040

    Article  CAS  Google Scholar 

  • Chen R, Yin P, Meng X, Wang L, Liu C, Niu Y, Liu Y, Liu J, Qi J, You J, Kan H, Zhou M (2019) Associations between coarse particulate matter air pollution and cause-specific mortality: a nationwide analysis in 272 Chinese cities. Environmental Health Perspectives. 127:017008. https://doi.org/10.1289/ehp2711

    Article  CAS  Google Scholar 

  • Chung CY, Yang J, He J, Yang X, Hubbard R, Ji D (2021) An investigation into the impact of variations of ambient air pollution and meteorological factors on lung cancer mortality in Yangtze River Delta. Sci Total Environ. 779:146427. https://doi.org/10.1016/j.scitotenv.2021.146427

    Article  CAS  Google Scholar 

  • Dominici F, Peng RD, Bell ML, Pham L, McDermott A, Zeger SL, Samet JM (2006) Fine particulate air pollution and hospital admission for cardiovascular and respiratory diseases. JAMA: the journal of the American Medical Association. 295, 1127-1134. https://doi.org/10.1001/jama.295.10.1127

  • GBD 2019 Respiratory Tract Cancers Collaborators (2021) Global, regional, and national burden of respiratory tract cancers and associated risk factors from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet Respiratory Medicine. 9, 1030-1049.https://doi.org/10.1016/s2213-2600(21)00164-8

  • Espin-Perez A, Krauskopf J, Chadeau-Hyam M, van Veldhoven K, Chung F, Cullinan P, Piepers J, van Herwijnen M, Kubesch N, Carrasco-Turigas G, Nieuwenhuijsen M, Vineis P, Kleinjans JCS, de Kok TMCM (2018) Short-term transcriptome and microRNAs responses to exposure to different air pollutants in two population studies. Environ Pollut. 242:182–190. https://doi.org/10.1016/j.envpol.2018.06.051

    Article  CAS  Google Scholar 

  • Ethan CJ, Mokoena KK, Yu Y, Shale K, Fan Y, Rong J, Liu F (2020) Association between PM2.5 and mortality of stomach and colorectal cancer in Xi’an: a time-series study. Environ Sci Pollut Res Int. 27:22353–22363. https://doi.org/10.1007/s11356-020-08628-0

    Article  CAS  Google Scholar 

  • Ghio AJ (2014) Particle exposures and infections. Infection. 42:459–67. https://doi.org/10.1007/s15010-014-0592-6

    Article  CAS  Google Scholar 

  • Guo H, Chang Z, Wu J, Li W (2019) Air pollution and lung cancer incidence in China: who are faced with a greater effect? Environ Int. 132:105077. https://doi.org/10.1016/j.envint.2019.105077

    Article  CAS  Google Scholar 

  • He S, Li H, Cao M, Sun D, Lei L, Li N, Peng J, Chen W (2020) Trends and risk factors of lung cancer in China. Chin J Cancer Res. 32, 683-694. https://doi.org/10.21147/j.issn.1000-9604.2020.06.02

  • Huang K, Ding K, Yang XJ, Hu CY, Jiang W, Hua XG, Liu J, Cao JY, Zhang T, Kan XH, Zhang XJ (2020) Association between short-term exposure to ambient air pollutants and the risk of tuberculosis outpatient visits: a time-series study in Hefei. China. Environ Res. 184:109343. https://doi.org/10.1016/j.envres.2020.109343

    Article  CAS  Google Scholar 

  • Huang Y, Zhu M, Ji M, Fan J, Xie J, Wei X, Jiang X, Xu J, Chen L, Yin R, Wang Y, Dai J, Jin G, Xu L, Hu Z, Ma H, Shen H (2021) Air pollution, genetic factors and the risk of lung cancer: a prospective study in the UK Biobank. Am J Respir Crit Care Med. https://doi.org/10.1164/rccm.202011-4063oc

    Article  Google Scholar 

  • Jiang Y, Niu Y, Xia Y, Liu C, Lin Z, Wang W, Ge Y, Lei X, Wang C, Cai J, Chen R, Kan H (2019) Effects of personal nitrogen dioxide exposure on airway inflammation and lung function. Environ Res. 177:108620. https://doi.org/10.1016/j.envres.2019.108620

    Article  CAS  Google Scholar 

  • Li G, Wu H, Zhong Q, He J, Yang W, Zhu J, Zhao H, Zhang H, Zhu Z, Huang F (2021) Six air pollutants and cause-specific mortality: a multi-area study in nine counties or districts of Anhui Province, China. Environ Sci Pollut Res Int. https://doi.org/10.1007/s11356-021-15730-4

  • Liu C, Yin P, Chen R, Meng X, Wang L, Niu Y, Lin Z, Liu Y, Liu J, Qi J, You J, Kan H, Zhou M (2018) Ambient carbon monoxide and cardiovascular mortality: a nationwide time-series analysis in 272 cities in China. Lancet Planet Health. 2:e12–e18. https://doi.org/10.1016/s2542-5196(17)30181-x

    Article  Google Scholar 

  • Nilsson Sommar J, Andersson EM, Andersson N, Sallsten G, Stockfelt L, Ljungman PL, Segersson D, Eneroth K, Gidhagen L, Molnar P, Wennberg P, Rosengren A, Rizzuto D, Leander K, Lager A, Magnusson PK, Johansson C, Barregard L, Bellander T, Pershagen G, Forsberg B (2021) Long-term exposure to particulate air pollution and black carbon in relation to natural and cause-specific mortality: a multicohort study in Sweden. BMJ Open. 11:e046040. https://doi.org/10.1136/bmjopen-2020-046040

    Article  Google Scholar 

  • Riva DR, Magalhães CB, Lopes AA, Lanças T, Mauad T, Malm O, Valença SS, Saldiva PH, Faffe DS, Zin WA (2011) Low dose of fine particulate matter (PM2.5) can induce acute oxidative stress, inflammation and pulmonary impairment in healthy mice. Inhal Toxicol. 23:257–67. https://doi.org/10.3109/08958378.2011.566290

    Article  CAS  Google Scholar 

  • Rodrigues SD, Ueda RM, Barreto AC, Zanini RR, Souza AM (2021) How atmospheric pollutants impact the development of chronic obstructive pulmonary disease and lung cancer: a var-based model. Environ Pollut. 275:116622. https://doi.org/10.1016/j.envpol.2021.116622

    Article  CAS  Google Scholar 

  • Simkhovich BZ, Kleinman MT, Kloner RA (2008) Air pollution and cardiovascular injury epidemiology, toxicology, and mechanisms. J Am Coll Cardiol. 52:719–26. https://doi.org/10.1016/j.jacc.2008.05.029

    Article  CAS  Google Scholar 

  • So R, Chen J, Mehta AJ, Liu S, Strak M, Wolf K, Hvidtfeldt UA, Rodopoulou S, Stafoggia M, Klompmaker JO, Samoli E, Raaschou-Nielsen O, Atkinson R, Bauwelinck M, Bellander T, Boutron-Ruault MC, Brandt J, Brunekreef B, Cesaroni G, Concin H, Forastiere F, van Gils CH, Gulliver J, Hertel O, Hoffmann B, de Hoogh K, Janssen N, Lim YH, Westendorp R, Jørgensen JT, Katsouyanni K, Ketzel M, Lager A, Lang A, Ljungman PL, Magnusson PKE, Nagel G, Simonsen MK, Pershagen G, Peter RS, Peters A, Renzi M, Rizzuto D, Sigsgaard T, Vienneau D, Weinmayr G, Severi G, Fecht D, Tjønneland A, Leander K, Hoek G, Andersen ZJ (2021) Long-term exposure to air pollution and liver cancer incidence in six European cohorts. Int J Cancer. 149:1887–1897. https://doi.org/10.1016/j.jacc.2008.05.029

    Article  CAS  Google Scholar 

  • Sun X, Xu X, Wang Y, Hou B, Luo T, Meng D, Wang S, Ning F (2021) Incidence and mortality rates of lung cancer in Qingdao, China (2013–2017). Asia Pac J Clin Oncol. https://doi.org/10.1111/ajco.13559

    Article  Google Scholar 

  • Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F (2021) Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 71:209–249. https://doi.org/10.3322/caac.21660

    Article  Google Scholar 

  • Tian F, Qi J, Wang L, Yin P, Qian ZM, Ruan Z, Liu J, Liu Y, McMillin SE, Wang C, Lin H, Zhou M (2020) Differentiating the effects of ambient fine and coarse particles on mortality from cardiopulmonary diseases: a nationwide multicity study. Environ Int. 145:106096. https://doi.org/10.1016/j.envint.2020.106096

    Article  CAS  Google Scholar 

  • Valavanidis A, Vlachogianni T, Fiotakis K, Loridas S (2013) Pulmonary oxidative stress, inflammation and cancer: respirable particulate matter, fibrous dusts and ozone as major causes of lung carcinogenesis through reactive oxygen species mechanisms. Int J Environ Res Public Health. 10:3886–907. https://doi.org/10.3390/ijerph10093886

    Article  CAS  Google Scholar 

  • Viechtbauer W (2010) Conducting meta-analyses in R with the metafor package. Journal of Statistical Software, 36(3), 1–48. https://doi.org/10.18637/jss.v036.i03

  • Wang N, Mengersen K, Tong S, Kimlin M, Zhou M, Wang L, Yin P, Xu Z, Cheng J, Zhang Y, Hu W (2019) Short-term association between ambient air pollution and lung cancer mortality. Environ Res. 179:108748. https://doi.org/10.1016/j.envres.2019.108748

    Article  CAS  Google Scholar 

  • Wang YQ, Li HZ, Gong WW, Chen YY, Zhu C, Wang L, Zhong JM, Du LB (2021) Cancer incidence and mortality in Zhejiang Province, Southeast China, 2016: a population-based study. Chin Med J (Engl). 134:1959–1966. https://doi.org/10.1097/cm9.0000000000001666

    Article  Google Scholar 

  • Wu X, Zhu B, Zhou J, Bi Y, Xu S, Zhou B (2021) The epidemiological trends in the burden of lung cancer attributable to PM2.5 exposure in China. BMC Public Health 21:737 https://doi.org/10.1186/s12889-021-10765-1

  • Xue X, Chen J, Sun B, Zhou B, Li X (2018) Temporal trends in respiratory mortality and short-term effects of air pollutants in Shenyang, China. Environ Sci Pollut Res Int. 25:11468–11479. https://doi.org/10.1007/s11356-018-1270-5

    Article  CAS  Google Scholar 

  • Yin P, Chen R, Wang L, Meng X, Liu C, Niu Y, Lin Z, Liu Y, Liu J, Qi J, You J, Zhou M, Kan H (2017) Ambient ozone pollution and daily mortality: a nationwide study in 272 Chinese cities. Environ Health Perspect. 125:117006. https://doi.org/10.1289/ehp1849

    Article  Google Scholar 

  • Zhou Y, Xiang ZS, Ma JY, Lin YT, Chen YP, Jiang HJ, Wu LR, Chen CB (2021) Survival of cancer patients in Fujian, Southeast China: a population-based cancer registry study. Neoplasma. 68:892–898. https://doi.org/10.4149/neo_2021_210203n168

    Article  Google Scholar 

  • Zhu F, Ding R, Lei R, Cheng H, Liu J, Shen C, Zhang C, Xu Y, Xiao C, Li X, Zhang J, Cao J (2019) The short-term effects of air pollution on respiratory diseases and lung cancer mortality in Hefei: a time-series analysis. Respir Med. 146:57–65. https://doi.org/10.1016/j.rmed.2018.11.019

    Article  Google Scholar 

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Acknowledgements

We would like to thank all the subjects who participated in this research.

Funding

This work was funded by the National Natural Science Foundation of China (grant number: 71804002) and Special Foundation for Science and Technology Development of Central Government Guiding Locals (contract number: 202007d07050008).

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Authors and Affiliations

  1. Anhui Provincial Center for Disease Control and Prevention, Anhui, China

    Zhenqiu Zha, Yili Lv, Wei Xu, Dan Dai & Zhirong Liu

  2. Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China

    Guoao Li, Lingli Liu, Jialiu He & Fen Huang

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  1. Zhenqiu Zha
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  2. Guoao Li
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  4. Lingli Liu
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Contributions

Zhenqiu Zha, Guoao Li, Zhirong Liu, and Fen Huang collaboratively designed the study, both making substantial intellectual contributions. Zhenqiu Zha analyzed the data and drafted the manuscript together with Guoao Li. Yili Lv, Zhirong Liu, and Fen Huang revised the manuscript. Lingli Liu, Jialiu He, and Wei Xu contributed to collecting the data. Dan Dai and Jialiu He contributed in interpreting the data. Zhenqiu Zha and Guoao Li contributed equally. All authors read and approved the final manuscript.

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Correspondence to Zhirong Liu or Fen Huang.

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Zhenqiu Zha and Guoao Li contributed equally to this work and should be considered as co-first authors.

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Zha, Z., Li, G., Lv, Y. et al. The effects of air pollution on the lung cancer mortality in rural areas of eastern China: a multi-region study. Environ Sci Pollut Res 29, 45716–45729 (2022). https://doi.org/10.1007/s11356-022-19027-y

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