Lung cancer rates in Xuanwei County have been among the highest in China for both males and females and have been causally associated with exposure to indoor smoky (bituminous) coal emissions that contain very high levels of polycyclic aromatic hydrocarbons. There are numerous coal mines across the County. Although lung cancer risk is strongly associated with the use of smoky coal as a whole, variation in risk by smoky coal subtype has not been characterized as yet. We conducted a population-based case-control study of 498 lung cancer cases and 498 controls, individually matched to case subjects on age (62 years) and sex to examine risk by coal subtype. Odds ratios (ORs) and 95% confidence intervals (CIs) for coal subtype were calculated by conditional logistic regression, adjusting for potential confounders. Overall, smoky coal use was positively and statistically significantly associated with lung cancer risk, when compared with the use of smokeless coal or wood (OR 5 7.7, 95% CI 5 4.5-13.3). Furthermore, there was a marked heterogeneity in risk estimates for specific subtypes of smoky coal (test for heterogeneity: p 5 5.17 3 10 210 ). Estimates were highest for coal of the Laibin (OR 5 24.8, 95% CI 5 12.4-49.6) and Longtan (OR 5 11.6, 95% CI 5 5.0-27.2) coal types and lower for coal from other subtypes. These findings strongly suggest that in Xuanwei and elsewhere, the carcinogenic potential of coal combustion products can exhibit substantial local variation by specific coal source.

BackgroundThis study describes 17 families with 38 lung injury patients (14 males, 24 females; 22 preschool-age children less than six years of age and 16 individuals of 13–50 years) who used disinfectant added to humidifiers in the home.MethodsClinical examination and humidifier disinfectant-use histories were taken, and a thorough home investigation was performed to assess exposure to humidifier disinfectant.ResultsNine of the patients (three pregnant females, six preschool-age children) died soon after they first developed lung damage. Six (16%) were pregnant females and 22 (58%) were preschool-aged children younger than six years. The patients used humidifier disinfectant products containing either polyhexamethylene guanidine phosphate (PHMG, n = 36) or oligo(2-(2-ethoxy)ethoxyethyl guanidinium chloride (PGH, n = 2). Twenty-six patients (68%) used the brand "Oxy"®, which contains PHMG. Of the ten patients with fatal lung injury, nine were found to have used PHMG.ConclusionsOur findings suggest that the use of humidifier disinfectant products containing either PGH or PHMG can cause lung injury, especially in preschool-age children younger than six years and pregnant women.

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Background: Although the clinical relevance of molecular subtypes of breast cancer has been examined, little is known about risk factors for different tumor subtypes, especially the HER2-overexpressing and triple-negative subtypes. Previous epidemiologic findings imply these subtypes may also vary with respect to risk factor profiles; however, these results were based mainly on older or younger cases in western countries. Our objective was to determine the different risk factors by breast cancer subtypes in Korean. Methods: In this study, cases were diagnosed with breast cancer and underwent curative surgery at two teaching hospitals located in Seoul, Korea, between 2000 and 2007. Control subjects were selected from two sources: records of the hospital based case-control study and community based health examination in the same duration. Total 2,473 cases and matched controls were eligible to analysis further study. Information was collected using a standardized questionnaire and breast tumours were tested by immunohistochemistry. Odds ratios (OR) and 95% confidence intervals (CI) of risk of molecular subtypes of breast cancer were calculated using a multivariate polytomous regression model, adjusting age at diagnosis. Results: In our study, 1,590 (65.6%) tumors were considered luminal (ER+ and/or PR+), 327 (13.5%) HER-2 overexpressing (ER-, PR-, HER-2+), and 505 (20.9%) triple negative (ER-, PR-, and HER-2-). We observed statistically strong significant differences in means or frequencies by tumor subtypes for age at diagnosis, education level, menopausal status, a family history of breast cancer and tumor size (p<0.0001). In a multivariate model, relative risks differed by molecular subtypes, comparing controls, for age at diagnosis, education level. In pre-menopausal women, higher body mass index (BMI) was associated with increased risk of triple negative tumors (OR=1.6, 95% CI 1.1-2.3), whereas higher BMI was inversely associated with risk of HER-2 overexpressing (3 tertile vs. 1st tertile: OR=0.6, 95% CI 0.3-0.9). In post-menopausal women, reduced risk associated with triple negative tumours (3rd tertile vs. 1st tertile: OR=0.5, 95% CI 0.3-0.8) was examined. And compared to luminal tumors, late age at menarche was significantly strongly associated with HER2-overexpressing (>=15 vs. <15: OR=2.1, 95% CI 1.4-3.2). On the other hand, reduced risk associated with higher age at diagnosis was stronger for triple-negative (> 50 vs. < 40: OR=0.5, 95% CI 0.3-0.8, p-trend <.0001) which was consistent with previous results. Conclusion: Our findings suggest that risk profiles may be different by molecular subtypes, especially body mass index in stratified analysis by menopausal status. However, underlying mechanisms need to be investigated in further study. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 5704.