American Journal of Epidemiology Advance Access originally published online on July 13, 2005
American Journal of Epidemiology 2005 162(4):326-333; doi:10.1093/aje/kwi204
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ORIGINAL CONTRIBUTIONS |
Lung Cancer and Indoor Pollution from Heating and Cooking with Solid Fuels
The IARC International Multicentre Case-Control Study in Eastern/Central Europe and the United Kingdom
1 Department of Epidemiology and Cancer Prevention, Cancer Center and M. Sklodowska-Curie Institute of Oncology, Warsaw, Poland
2 International Agency for Research on Cancer, Lyon, France
3 Public and Environmental Health Research Unit, London Scool of Hygiene and Tropical Medicine, London, United Kingdom
4 Institute of Carcinogenesis, Cancer Research Center, Moscow, Russia
5 Department of Epidemiology, The Nofer Institute of Occupational Medicine, Lodz, Poland
6 National Institute of Environmental Health, Budapest, Hungary
7 Department of Occupational Health, Specialized State Health Institute, Banska Bystrica, Slovakia
8 Roy Castle Lung Cancer Research Programme, University of Liverpool, Liverpool, United Kingdom
9 Institute of Hygiene, Public Health, Health Services, and Management, Bucharest, Romania
10 Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
11 Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Brno, Czech Republic
12 Department of Preventive Medicine, Palacky University of Medicine, Olomouc, Czech Republic
13 Current affiliation: Centre for Public Health Research, Massey University, Wellington, New Zealand
Correspondence to Dr. Jolanta Lissowska, Department of Epidemiology and Cancer Prevention, Cancer Center and M. Sklodowska-Curie Institute of Oncology, WH Roentgena 5, 00-782 Warsaw, Poland (e-mail: lissowsj{at}coi.waw.pl).
Exposure to fuel from cooking and heating has not been studied in Europe, where lung cancer rates are high and many residents have had a long tradition of burning coal and unprocessed biomass. Study subjects included 2,861 cases and 3,118 controls recruited during 1998–2002 in the Czech Republic, Hungary, Poland, Romania, Russia, Slovakia, and the United Kingdom. The odds ratio of lung cancer associated with solid fuel use was 1.22 (95% confidence interval (CI): 1.04, 1.44) for cooking or heating, 1.37 (95% CI: 0.90, 2.09) for solid fuel only for cooking, and 1.24 (95% CI: 1.05, 1.47) for solid fuels used for both cooking and heating. Risk increased relative to the percentage of time that solid fuel was used for cooking (ptrend < 0.0001), while no risk increase was detected for solid fuel used for heating. The odds ratio of lung cancer in whole-life users of solid cooking fuel was 1.80 (95% CI: 1.35, 2.40). Switching to nonsolid fuels resulted in a decrease in risk. The odds ratio for the longest duration of time since switching was 0.76 (95% CI: 0.63, 0.92). The data suggest a modest increased risk of lung cancer related to solid-fuel use for cooking rather than heating.
air pollution, indoor; case-control studies; cookery; Europe; fossil fuels; heating; lung neoplasms
Abbreviations: CI, confidence interval; OR, odds ratio
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