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In-home coal and wood use and lung cancer risk: a pooled analysis of the International Lung Cancer Consortium.

  • Author(s): Hosgood, H Dean
  • Boffetta, Paolo
  • Greenland, Sander
  • Lee, Yuan-Chin Amy
  • McLaughlin, John
  • Seow, Adeline
  • Duell, Eric J
  • Andrew, Angeline S
  • Zaridze, David
  • Szeszenia-Dabrowska, Neonila
  • Rudnai, Peter
  • Lissowska, Jolanta
  • Fabiánová, Eleonóra
  • Mates, Dana
  • Bencko, Vladimir
  • Foretova, Lenka
  • Janout, Vladimir
  • Morgenstern, Hal
  • Rothman, Nathaniel
  • Hung, Rayjean J
  • Brennan, Paul
  • Lan, Qing
  • et al.
Abstract

BACKGROUND:Domestic fuel combustion from cooking and heating is an important public health issue because roughly 3 billion people are exposed worldwide. Recently, the International Agency for Research on Cancer classified indoor emissions from household coal combustion as a human carcinogen (group 1) and from biomass fuel (primarily wood) as a probable human carcinogen (group 2A). OBJECTIVES:We pooled seven studies from the International Lung Cancer Consortium (5,105 cases and 6,535 controls) to provide further epidemiological evaluation of the association between in-home solid-fuel use, particularly wood, and lung cancer risk. METHODS:Using questionnaire data, we classified subjects as predominant solid-fuel users (e.g., coal, wood) or nonsolid-fuel users (e.g., oil, gas, electricity). Unconditional logistic regression was used to estimate the odds ratios (ORs) and to compute 95% confidence intervals (CIs), adjusting for age, sex, education, smoking status, race/ethnicity, and study center. RESULTS:Compared with nonsolid-fuel users, predominant coal users (OR = 1.64; 95% CI, 1.49-1.81), particularly coal users in Asia (OR = 4.93; 95% CI, 3.73-6.52), and predominant wood users in North American and European countries (OR = 1.21; 95% CI, 1.06-1.38) experienced higher risk of lung cancer. The results were similar in never-smoking women and other subgroups. CONCLUSIONS:Our results are consistent with previous observations pertaining to in-home coal use and lung cancer risk, support the hypothesis of a carcinogenic potential of in-home wood use, and point to the need for more detailed study of factors affecting these associations.

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