Lung cancer risk and pollution in an industrial region of Northern Spain: a hospital-based case-control study.
BACKGROUND
Asturias, an Autonomous Region in Northern Spain with a large industrial area, registers high lung cancer incidence and mortality. While this excess risk of lung cancer might be partially attributable to smoking habit and occupational exposure, the role of industrial and urban pollution also needs to be assessed. The objective was to ascertain the possible effect of air pollution, both urban and industrial, on lung cancer risk in Asturias.


METHODS
This was a hospital-based case-control study covering 626 lung cancer patients and 626 controls recruited in Asturias and matched by ethnicity, hospital, age, and sex. Distances from the respective participants' residential locations to industrial facilities and city centers were computed. Using logistic regression, odds ratios (ORs) and 95% confidence intervals (95%CIs) for categories of distance to urban and industrial pollution sources were calculated, with adjustment for sex, age, hospital area, tobacco consumption, family history of cancer, and occupation.


RESULTS
Whereas individuals living near industries displayed an excess risk of lung cancer (OR = 1.49; 95%CI = 0.93-2.39), which attained statistical significance for small cell carcinomas (OR = 2.23; 95%CI = 1.01-4.92), residents in urban areas showed a statistically significant increased risk for adenocarcinoma (OR = 1.92; 95%CI = 1.09-3.38). In the Gijon health area, residents in the urban area registered a statistically significant increased risk of lung cancer (OR = 2.17; 95%CI = 1.25-3.76), whereas in the Aviles health area, no differences in risk were found by area of exposure.


CONCLUSIONS
This study provides further evidence that air pollution is a moderate risk factor for lung cancer.
Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avda, Monforte de Lemos, 5, 28029 Madrid, Spain. flcina@isciii.es
María Felicitas
MF
López-Cima
Javier
J
García-Pérez
Beatriz
B
Pérez-Gómez
Nuria
N
Aragonés
Gonzalo
G
López-Abente
Adonina
A
Tardón
Marina
M
Pollán
D000368:Aged; D000397:Air Pollution / Q000009:adverse effects*; D016022:Case-Control Studies; D016001:Confidence Intervals; D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D005843:Geography; D006801:Humans; D007221:Industry / Q000706:statistics & numerical data*; D016015:Logistic Models; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012042:Registries; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data*
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