Household Stove Improvement and Risk of Lung Cancer in Xuanwei, China

Lan, Qing; Chapman, Robert S.; Schreinemachers, Dina M.; Tian, Linwei; He, Xingzhou

doi:10.1093/jnci/94.11.826

Cited by 227 publications

(210 citation statements)

References 34 publications

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“…The remaining 42 422 consenting farmers were entered into the cohort, of which 12 952 subjects underwent a stove change to portable stove (251 858.9 person-years) and 6629 did not (94 727.7 personyears). The remaining subjects underwent a stove change to a stove with chimney, which has been previously reported (Lan et al, 2002), or did not permanently change their stove type. Lifetime smoky coal users accounted for 4054 subjects who underwent a stove change to portable stove (78 195.9 person-years) and 4364 who did not undergo a stove change (60 322.8 person-years).…”

Section: Methodsmentioning

confidence: 95%

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Portable stove use is associated with lower lung cancer mortality risk in lifetime smoky coal users

et al. 2008

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Domestic fuel combustion from cooking and heating, to which about 3 billion people worldwide are exposed, is associated with increased lung cancer risk. Lung cancer incidence in Xuanwei is the highest in China, and the attributable risk of lung cancer from unvented smoky coal burning is greater than 90%. To evaluate any lung cancer mortality reduction after changing from unvented stoves to portable stoves, we used lifetime smoky coal users in a retrospective cohort of all farmers born during 1917 -1951 and residing in Xuanwei in 1976. Of the 42 422 enrolled farmers, 4054 lifetime smoky coal users changed to portable stoves, 4364 did not change, and 1074 died of lung cancer. Lung cancer morality associated with stove change was assessed by product-limit survival curves and multivariate Cox regression models. Both men (Po0.0001) and women (Po0.0001) who changed to portable stoves had a significantly increased probability of survival compared with those who did not change. Portable stoves were associated with decreased risk of lung cancer mortality in male participants (hazard ratio (HR) ¼ 0.62, 95% confidence interval (CI) ¼ 0.46 -0.82) and female participants (HR ¼ 0.41, 95% CI ¼ 0.29 -0.57). Portable stove use is associated with reduced lung cancer mortality risk, highlighting a cost-effective intervention that could substantially benefit health in developing countries.

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Section: Methodsmentioning

confidence: 95%

“…Previous reports have assessed the long-term health benefits of converting from unvented stoves to stoves with chimneys in Xuanwei smoky coal users (Lan et al, 2002). The benefits of portable stove use, however, have not been reported.…”

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confidence: 99%

Portable stove use is associated with lower lung cancer mortality risk in lifetime smoky coal users

et al. 2008

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“…In the early 1980s, the world's largest publicly financed initiativesthe National Improved Stove Program (NISP)swas launched, aimed at providing rural households with more efficient biomass cookers, later the coal stoves for both cooking and heating (3). As a result, significant health benefits have been observed, including a declined lung cancer rate in Xuanwei County (4). In addition, the Chinese government has supported clean coal technology (CCT) through the use of coal briquettes to reduce air pollution and improve energy efficiency (5).…”

Section: Introductionmentioning

confidence: 99%

Deployment of Coal Briquettes and Improved Stoves: Possibly an Option for both Environment and Climate

Zhi

Peng

Chen

et al. 2009

Environ. Sci. Technol.

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The use of coal briquettes and improved stoves by Chinese households has been encouraged by the government as a means of reducing air pollution and health impacts. In this study we have shown that these two improvements also relate to climate change. Our experimental measurements indicate that, if all coal were burned as briquettes in improved stoves, particulate matter (PM), organic carbon (OC), and black carbon (BC) could be annually reduced by 63 ( 12%, 61 ( 10%, and 98 ( 1.7%, respectively. Also, the ratio of BC to OC (BC/OC) could be reduced by about 97%, from 0.49 to 0.016, which would make the primary emissions of household coal combustion more optically scattering. Therefore, it is suggested that the government consider the possibility of: (i) phasing out direct burning of bituminous raw-coal-chunks in households; (ii) phasing out simple stoves in households; and, (iii) financially supporting the research, production, and popularization of improved stoves and efficient coal briquettes. These actions may have considerable environmental benefits by reducing emissions and mitigating some of the impacts of household coal burning on the climate. International cooperation is required both technologically and financially to accelerate the emission reduction in the world.

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“…In 1970s, the government encouraged and supported local residents to improve their stoves, and this stove improvement project was completed in the late 1980s. According to previous studies, indoor exposure to Benzopyrene and particulate matter, as well as the risk of lung cancer decreased after stove improvement [9,10]. However, the mortality rate due to lung cancer did not decline as expected [11,12].…”

Section: Introductionmentioning

confidence: 76%

“…The stove improvement project conducted in Xuanwei was effective [9,10] targeting the indoor air pollution. In a cohort study conducted in Xuanwei by Barone-Adesi, et al , 73.3% of all participants were lifelong users of smoky coal and 87.3% of them have ever improved their stoves [5].…”

Section: Discussionmentioning

confidence: 99%

The mortality patterns of lung cancer between 1990 and 2013 in Xuanwei, China

et al. 2015

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a b s t r a c tObjectives: To explore the variations in the mortality trends, especially death due to lung cancer, from 1990 to 2013 in Xuanwei City. Materials and methods: Mortality data were collected in Xuanwei during the 2nd and 3rd National Retrospective Sampling Survey on Mortality and Routine Death Registration System (DRS) during 2011-2013. According to the result of the survey on under-reported deaths, mortality data from DRS during 2011-2013 were adjusted. Disease specific mortality rate, age-standardized mortality rate (ASMR) and 45Q15 were calculated in Xuanwei and compared with those in rural areas of China. Results: During three periods, 1990-1992, 2004-2005 and 2011-2013, lung cancer contributed to 56.86%, 58.45% and 63.03% of deaths from all cancers respectively with a much higher proportion than rural areas nationally. The ASMR of lung cancer for males surged from 41.43/10 5 to 88.17/10 5 during 1990-2005 and it surged from 37.70/10 5 to 74.45/10 5 for females. Although they declined slightly during 2011-2013 (82.53/10 5 and 62.62/10 5 for males and females respectively), the ASMR of lung cancer among males in Xuanwei was three times of that in rural areas in China, and it was six times higher among females. The 45Q15 of lung cancer for males in Xuanwei was 3-5 times of that in rural areas of China and for females it was 7-9 times. The high-mortality areas of lung cancer were still located in Laibin, Longchang, Wanshui and Shuanglong Communities. High-mortality areas of lung cancer expanded to their surrounding areas and those in southeast. Conclusions: Although indoor air pollution caused by smoky coal has been fairly well controlled, patterns of death due to lung cancer have not obviously changed. The mortality rate of lung cancer among females was similar to that among males. Therefore, further studies should be conducted to comprehensively explore the risk factors of lung cancer in Xuanwei.

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Household Stove Improvement and Risk of Lung Cancer in Xuanwei, China

Abstract: Changing from unvented to vented stoves appears to benefit the health of people in China and may do so in other developing countries as well.

Cited by 227 publications

References 34 publications

Portable stove use is associated with lower lung cancer mortality risk in lifetime smoky coal users

Portable stove use is associated with lower lung cancer mortality risk in lifetime smoky coal users

Deployment of Coal Briquettes and Improved Stoves: Possibly an Option for both Environment and Climate

The mortality patterns of lung cancer between 1990 and 2013 in Xuanwei, China

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