Indoor Air Pollution Increases the Risk of Lung Cancer

Abstract

(1) Background: Cooking and burning incense are important sources of indoor air pollutants. No studies have provided biological evidence of air pollutants in the lungs to support this association. Analysis of pleural fluid may be used to measure the internal exposure dose of air pollutants in the lung. The objective of this study was to provide biological evidence of indoor air pollutants and estimate their risk of lung cancer. (2) Methods: We analyzed 14 common air pollutants in the pleural fluid of 39 cases of lung adenocarcinoma and 40 nonmalignant controls by gas chromatography-mass spectrometry. (3) Results: When we excluded the current smokers and adjusted for age, the adjusted odds ratios (ORs) were 2.22 (95% confidence interval CI = 0.77–6.44) for habitual cooking at home and 3.05 (95% CI = 1.06–8.84) for indoor incense burning. In females, the adjusted ORs were 5.39 (95% CI = 1.11–26.20) for habitual cooking at home and 6.01 (95% CI = 1.14–31.66) for indoor incense burning. In pleural fluid, the most important exposure biomarkers for lung cancer were naphthalene, ethylbenzene, and o-xylene. (4) Conclusions: Habitual cooking and indoor incense burning increased the risk of lung adenocarcinoma.

Non‐small cell lung cancer in China

“…In China, the rate of lung cancer among females who have never smoked might be related closely to the use of unhealthy cooking methods and unventilated kitchens. By means of gas chromatography-mass spectrometry, Chen et al [50] found that habitual cooking was an important risk factor for lung cancer among Chinese non-smoking females, with odds ratios (ORs) of 5.39. In a Chinese cohort of 71,320 never-smoking females, the researchers demonstrated that inadequate ventilation in kitchens increased the lung cancer risk, with a hazard ratio (HR) of 1.49 [54].…”

“…Air pollution is responsible for about 5% of lung cancer‐related deaths [ 49 , 50 , 51 , 52 ]. According to the Global Burden of Disease Study, in China, the mortality of lung cancer attributable to air pollution in 2017 was 9.4/100,000 [ 53 ].…”

“…In a Chinese cohort, the age‐standardized mortality of lung cancer attributable to ambient air pollution was higher than for indoor air pollution (7.4/100,000 vs. 2.0/100,000) [ 53 ]. Common indoor air pollution sources include harmful volatiles from decorating materials and cooking oil fumes [ 50 ]. In China, the rate of lung cancer among females who have never smoked might be related closely to the use of unhealthy cooking methods and unventilated kitchens.…”

The Epidemiology of Lung Cancer- How Much Have We Discovered?

“…The primary factors of lung cancer in never smokers are linked to exposure to carcinogens including radon gas, second-hand smoke, and other indoor air pollutants such as incense burning [53,54].…”

“…In five studies, investigators explored indoor contact to smoke from wood, straw, and further solid fuel and lung cancer risk amongst never smoking women [54]. In a multicenter casecontrol study that was conducted during 1998-2001, Lissowska et al found a similar association of solid fuel use for heating and cooking with lung cancer risk, where the odds ratio of lung cancer in lifetime users of solid fuel was 1.80 and switching to nonsolid fuels resulted in a lowered risk [55].…”