title: Indoor air pollution exposure from use of indoor stoves and fireplaces in association with breast cancer: a case-control study.
abstract: BACKGROUND
  Previous studies suggest that polycyclic aromatic hydrocarbons (PAHs) may adversely affect breast cancer risk. Indoor air pollution from use of indoor stoves and/or fireplaces is an important source of ambient PAH exposure. However, the association between indoor stove/fireplace use and breast cancer risk is unknown. We hypothesized that indoor stove/fireplace use in a Long Island, New York study population would be positively associated with breast cancer and differ by material burned, and the duration and timing of exposure. We also hypothesized that the association would vary by breast cancer subtype defined by p53 mutation status, and interact with glutathione S-transferases GSTM1, T1, A1 and P1 polymorphisms.
  
  
  METHODS
  Population-based, case-control resources (1,508 cases/1,556 controls) were used to conduct unconditional logistic regression to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI).
  
  
  RESULTS
  Breast cancer risk was increased among women reporting ever burning synthetic logs (which may also contain wood) in their homes (OR = 1.42, 95% CI 1.11, 1.84), but not for ever burning wood alone (OR = 0.93, 95% CI 0.77, 1.12). For synthetic log use, longer duration >7 years, older age at exposure (>20 years; OR = 1.65, 95% CI 1.02, 2.67) and 2 or more variants in GSTM1, T1, A1 or P1 (OR = 1.71, 95% CI 1.09, 2.69) were associated with increased risk.
  
  
  CONCLUSIONS
  Burning wood or synthetic logs are both indoor PAH exposure sources; however, positive associations were only observed for burning synthetic logs, which was stronger for longer exposures, adult exposures, and those with multiple GST variant genotypes. Therefore, our results should be interpreted with care and require replication.
authors.affiliation: Department of Epidemiology, University of North Carolina, CB#7435, McGavran-Greenberg Hall, Chapel Hill, NC 27599-7435, USA. whitea@unc.edu.
authors.forename: Alexandra J
authors.initials: AJ
authors.lastname: White
authors.forename: Susan L
authors.initials: SL
authors.lastname: Teitelbaum
authors.forename: Steven D
authors.initials: SD
authors.lastname: Stellman
authors.forename: Jan
authors.initials: J
authors.lastname: Beyea
authors.forename: Susan E
authors.initials: SE
authors.lastname: Steck
authors.forename: Irina
authors.initials: I
authors.lastname: Mordukhovich
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: McCarty
authors.forename: Jiyoung
authors.initials: J
authors.lastname: Ahn
authors.forename: Pavel
authors.initials: P
authors.lastname: Rossner
authors.forename: Regina M
authors.initials: RM
authors.lastname: Santella
authors.forename: Marilie D
authors.initials: MD
authors.lastname: Gammon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016902:Air Pollution, Indoor / Q000032:analysis*; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000235:genetics / Q000378:metabolism; D016022:Case-Control Studies; D003031:Coal; D003296:Cooking; D004781:Environmental Exposure / Q000032:analysis; D005260:Female; D005982:Glutathione Transferase / Q000235:genetics*; D006801:Humans; D008875:Middle Aged; D009154:Mutation; D059206:Natural Gas; D009518:New York / Q000453:epidemiology; D016017:Odds Ratio; D011110:Polymorphism, Genetic; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D016159:Tumor Suppressor Protein p53 / Q000235:genetics; D014934:Wood; D055815:Young Adult
chemical_list: D003031:Coal; D059206:Natural Gas; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D016159:Tumor Suppressor Protein p53; D005982:Glutathione Transferase