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, N(studies) = 25], and particularly among those studies carried out in mainland China and Taiwan (OR = 2.27; 95% CI = 1.65-3.12, N(studies) = 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, N(studies) = 3) and southwestern China (OR = 2.98; 95% CI = 1.18-7.53, N(studies) = 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 (p(Begg'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.
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, N(studies) = 25], and particularly among those studies carried out in mainland China and Taiwan (OR = 2.27; 95% CI = 1.65-3.12, N(studies) = 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, N(studies) = 3) and southwestern China (OR = 2.98; 95% CI = 1.18-7.53, N(studies) = 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 (p(Begg'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.
Authors: Stella Manchun Tsai; Junfeng Jim Zhang; Kirk R Smith; Yuqing Ma; R A Rasmussen; M A K Khalil Journal: Environ Sci Technol Date: 2003-07-01 Impact factor: 9.028
Authors: A H Wu-Williams; X D Dai; W Blot; Z Y Xu; X W Sun; H P Xiao; B J Stone; S F Yu; Y P Feng; A G Ershow Journal: Br J Cancer Date: 1990-12 Impact factor: 7.640
Authors: H Dean Hosgood; Roel Vermeulen; Hu Wei; Boris Reiss; Joseph Coble; Fusheng Wei; Xu Jun; Guoping Wu; Nat Rothman; Qing Lan Journal: Int J Environ Health Res Date: 2012-05-28 Impact factor: 3.411
Authors: H Dean HosgoodIII; Robert S Chapman; Xingzhou He; Wei Hu; Linwei Tian; Larry Z Liu; Hong Lai; Wei Chen; Nathaniel Rothman; Qing Lan Journal: Lung Cancer Date: 2013-07-25 Impact factor: 5.705
Authors: H Dean Hosgood; Amy R Sapkota; Nathaniel Rothman; Thomas Rohan; Wei Hu; Jun Xu; Roel Vermeulen; Xingzhou He; James Robert White; Guoping Wu; Fusheng Wei; Emmanuel F Mongodin; Qing Lan Journal: Environ Mol Mutagen Date: 2014-06-03 Impact factor: 3.216