Household coal use and lung cancer: systematic review and meta-analysis of case-control studies, with an emphasis on geographic variation
| Autor: | Hu Wei, Imran Choudhury, Qing Lan, Kirk R. Smith, Nigel Bruce, H. Dean Hosgood, Nathaniel Rothman, Amir Sapkota |
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| Rok vydání: | 2011 |
| Předmět: |
Mainland China
Male China Asia Lung Neoplasms Epidemiology Population Taiwan complex mixtures Risk Assessment Heating Environmental health otorhinolaryngologic diseases Confidence Intervals Odds Ratio Prevalence Medicine Humans Cooking education Developing Countries Cancer Geographic difference education.field_of_study Family Characteristics business.industry technology industry and agriculture Case-control study General Medicine Publication bias Odds ratio respiratory system respiratory tract diseases Coal Meta-analysis Air Pollution Indoor Case-Control Studies Female Public Health Risk assessment business Needs Assessment |
| Zdroj: | International journal of epidemiology. 40(3) |
| ISSN: | 1464-3685 |
| Popis: | Background Emissions from household coal combustion associated with cooking and heating are an important public health issue, particularly in China where hundreds of millions of people are exposed. Although coal emissions are a known human carcinogen, there is still uncertainty about the level of risk for lung and other cancers. Methods We performed a meta-analysis on 25 case–control studies (10 142 cases and 13 416 controls) to summarize the association between household coal use and lung cancer risk, and to explore the effect modification of this association by geographical location. Results Using random-effects models, household coal use was found to be associated with lung cancer risk among all studies throughout the world [odds ratio (OR) = 2.15; 95% confidence interval (CI) = 1.61–2.89, Nstudies = 25], and particularly among those studies carried out in mainland China and Taiwan (OR = 2.27; 95% CI = 1.65–3.12, Nstudies = 20). Stratification by regions of mainland China and Taiwan found a variation in effects across the regions, with south/southeastern (OR = 3.27; 95% CI = 1.27–8.42, Nstudies = 3) and southwestern China (OR = 2.98; 95% CI = 1.18–7.53, Nstudies = 3) experiencing the highest risk. The elevated risk associated with coal use throughout Asia was also observed when stratifying studies by gender, smoking status, sample size, design (population vs hospital case–control) and publication language. No significant publication bias was found (pBegg’s = 0.15). Conclusions Our results provide evidence that although the carcinogenic effect of coal use varies by location, coals from many locations exhibit elevated lung cancer risks. |
| Databáze: | OpenAIRE |
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