title: Household air pollution and lung cancer in China: a review of studies in Xuanwei.
abstract: Over half of the world's population is exposed to household air pollution from the burning of solid fuels at home. Household air pollution from solid fuel use is a leading risk factor for global disease and remains a major public health problem, especially in low- and mid-income countries. This is a particularly serious problem in China, where many people in rural areas still use coal for household heating and cooking. This review focuses on several decades of research carried out in Xuanwei County, Yunnan Province, where household coal use is a major source of household air pollution and where studies have linked household air pollution exposure to high rates of lung cancer. We conducted a series of case-control and cohort studies in Xuanwei to characterize the lung cancer risk in this population and the factors associated with it. We found lung cancer risk to vary substantially between different coal types, with a higher risk associated with smoky (i.e., bituminous) coal use compared to smokeless (i.e., anthracite) coal use. The installation of a chimney in homes resulted in a substantial reduction in lung cancer incidence and mortality. Overall, our research underscores the need among existing coal users to improve ventilation, use the least toxic fuel, and eventually move toward the use of cleaner fuels, such as gas and electricity.
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, USA. weijie.seow2@nih.gov.
authors.forename: Wei Jie
authors.initials: WJ
authors.lastname: Seow
authors.forename: Wei
authors.initials: W
authors.lastname: Hu
authors.forename: Roel
authors.initials: R
authors.lastname: Vermeulen
authors.forename: H Dean
authors.initials: HD
authors.lastname: Hosgood Iii
authors.forename: George S
authors.initials: GS
authors.lastname: Downward
authors.forename: Robert S
authors.initials: RS
authors.lastname: Chapman
authors.forename: Xingzhou
authors.initials: X
authors.lastname: He
authors.forename: Bryan A
authors.initials: BA
authors.lastname: Bassig
authors.forename: Christopher
authors.initials: C
authors.lastname: Kim
authors.forename: Cuiju
authors.initials: C
authors.lastname: Wen
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Rothman
authors.forename: Qing
authors.initials: Q
authors.lastname: Lan
mesh_terms: D016902:Air Pollution, Indoor / Q000009:adverse effects*; D002681:China; D003031:Coal / Q000009:adverse effects* / Q000145:classification; D015331:Cohort Studies; D003296:Cooking; D005579:Fossil Fuels; D006361:Heating; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000209:etiology* / Q000401:mortality*; D012307:Risk Factors; D012906:Smoke / Q000009:adverse effects*; D012907:Smoking
chemical_list: D003031:Coal; D005579:Fossil Fuels; D012906:Smoke