Abstract 3629: Household ventilation, cooking fuels and oils, and lung cancer risk in a prospective cohort of non-smoking Chinese women.
Authors: Kim Christopher , Gao Yutang , Xiang Yongbing , Barone-Adesi Francesco , Zhang Yawei , Hosgood H. Dean , Ma Shuangge , Shu Xiao-ou , Ji Bu-Tian , Chow Wong-Ho , Cai Qiuyin , Zheng Wei , Rothman Nathaniel , Lan Qing 
Published: August 2014

Lung cancer incidence has been on the rise in less-developed countries. Indoor air pollution caused by poor ventilation, burning of solid fuels, and cooking oils has been associated with lung cancer risk in developing poor and rural countries in many retrospective case-control studies. However, few studies have been conducted in more urban and more economically developed populations, even less in prospective studies. To assess the relationship of indoor air quality and risk of lung cancer in a modern population, a prospective cohort study was conducted in the Shanghai Women's Health Study. 73,442 women were followed through December 2009. A total of 469 lung cancer patients were diagnosed during the follow-up period, but after excluding ever smokers, 71,320 women in the cohort and 429 women with lung cancer were included in this analysis. Standardized and structured questionnaires were used to collect information on all household living and cooking practices: past three residences lived, cooking fuel utilized, cooking oil utilized, ventilation conditions, smoking patterns of family at home, and coworker smoking at work. Effect estimates for household ventilation conditions, cooking fuels, and cooking oils use for the risk of lung cancer are presented as hazard ratios (HR) with 95% confidence intervals (95% CI) from Cox proportional hazards regression. Ever having poor household ventilation was associated with a 61% increase in lung cancer risk (HR: 1.61; 95% CI: 1.19-2.18), and more than 20 years was associated with a 100% increase in risk (HR: 2.00; 95% CI: 1.32-3.01) compared to always having good ventilation. Ever use of coal with poor ventilation was associated with a 71% increased risk of lung cancer (HR: 1.71; 95% CI: 1.19-2.46), and more than 20 years of using coal with poor ventilation was associated with an 83% increase (HR: 1.83; 95% CI: 1.16-2.89) compared to gas users with good ventilation. There was some suggestion of lung cancer risk with vegetable oil use compared to soybean oil use, although the number of lung cancer cases was few and not statistically stable. In summary, this prospective cohort study of non-smoking Chinese women suggests that exposure to poor ventilation and poorly vented cooking coal increases the risk of lung cancer. These findings were consistent with past retrospective case-control studies and suggesting that past exposure to coal use with poorly ventilated conditions pose a health risk. These results suggest that current modern day cooking conditions, particularly in poorly ventilated homes, is still a public health issue.

Citation Format: Christopher Kim, Yutang Gao, Yongbing Xiang, Francesco Barone-Adesi, Yawei Zhang, H. Dean Hosgood, Shuangge Ma, Xiao-ou Shu, Bu-Tian Ji, Wong-Ho Chow, Qiuyin Cai, Wei Zheng, Nathaniel Rothman, Qing Lan. Household ventilation, cooking fuels and oils, and lung cancer risk in a prospective cohort of non-smoking Chinese women. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 3629. doi:10.1158/1538-7445.AM2013-3629