In-home coal and wood use and lung cancer risk: a pooled analysis of the International Lung Cancer Consortium.
BACKGROUND
Domestic fuel combustion from cooking and heating is an important public health issue because roughly 3 billion people are exposed worldwide. Recently, the International Agency for Research on Cancer classified indoor emissions from household coal combustion as a human carcinogen (group 1) and from biomass fuel (primarily wood) as a probable human carcinogen (group 2A).


OBJECTIVE
We pooled seven studies from the International Lung Cancer Consortium (5,105 cases and 6,535 controls) to provide further epidemiological evaluation of the association between in-home solid-fuel use, particularly wood, and lung cancer risk.


METHODS
Using questionnaire data, we classified subjects as predominant solid-fuel users (e.g., coal, wood) or nonsolid-fuel users (e.g., oil, gas, electricity). Unconditional logistic regression was used to estimate the odds ratios (ORs) and to compute 95% confidence intervals (CIs), adjusting for age, sex, education, smoking status, race/ethnicity, and study center.


RESULTS
Compared with nonsolid-fuel users, predominant coal users (OR = 1.64; 95% CI, 1.49-1.81), particularly coal users in Asia (OR = 4.93; 95% CI, 3.73-6.52), and predominant wood users in North American and European countries (OR = 1.21; 95% CI, 1.06-1.38) experienced higher risk of lung cancer. The results were similar in never-smoking women and other subgroups.


CONCLUSIONS
Our results are consistent with previous observations pertaining to in-home coal use and lung cancer risk, support the hypothesis of a carcinogenic potential of in-home wood use, and point to the need for more detailed study of factors affecting these associations.
Hosgood
H Dean
HD
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland 20892-7240, USA. hosgoodd@mail.nih.gov
Boffetta
Paolo
P
Greenland
Sander
S
Lee
Yuan-Chin Amy
YC
McLaughlin
John
J
Seow
Adeline
A
Duell
Eric J
EJ
Andrew
Angeline S
AS
Zaridze
David
D
Szeszenia-Dabrowska
Neonila
N
Rudnai
Peter
P
Lissowska
Jolanta
J
Fabiánová
Eleonóra
E
Mates
Dana
D
Bencko
Vladimir
V
Foretova
Lenka
L
Janout
Vladimir
V
Morgenstern
Hal
H
Rothman
Nathaniel
N
Hung
Rayjean J
RJ
Brennan
Paul
P
Lan
Qing
Q
D000368:Aged; D016902:Air Pollution, Indoor / Q000706:statistics & numerical data*; D003031:Coal; D003296:Cooking; D005260:Female; D006361:Heating; D006801:Humans; D007390:International Agencies; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014934:Wood
D003031:Coal