Household stove improvement and risk of lung cancer in Xuanwei, China
Household stove improvement and risk of lung cancer in Xuanwei, China
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DOI：
10.1093/jnci/94.11.826
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发表时间：
2002-06-05
期刊：
影响因子：
--
通讯作者：
He, XZ
中科院分区：
文献类型：
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作者：
Lan, Q;Chapman, RS;He, XZ
背景：云南省宣威县农村肺癌发病率居全国前列。居民们传统上在没有通风口的室内火坑里燃烧“冒烟”的煤，产生非常高的空气污染。从20世纪70年代开始，大多数居民都从火坑变成了带烟囱的炉子。这项研究评估了这种炉子改进后肺癌发病率是否下降。方法：21232名农民，出生于1917年至1951年，从1976年至1992年进行了回顾性随访。所有受试者都是生在有未通风的火坑的家庭中的煤烟使用者。在他们的一生中，17184名受试者（80.9%）永久改变了烟囱炉灶。在随访期间，医院记录检索检测到1384例肺癌病例（6.5%）。用积限图和多变量考克斯模型分析炉灶改进与肺癌发病率的关系。1995年，在宣威市的家庭中，在有烟囱的炉子和不通风的炉子或火坑中燃烧冒烟的煤时，室内空气中的颗粒物和苯并[a]芘的浓度进行了比较。结果：炉灶改进后，肺癌发病率长期下降。在考克斯模型中，炉灶改进后肺癌的风险比（RR）男性为0.59（95%置信区间[CI] = 0.49至0.71），女性为0.54（95% CI = 0.44至0.65）（两者均为P
Background: Lung cancer rates in rural Xuanwei County, Yunnan Province, are among the highest in China. Residents traditionally burned "smoky" coal in unvented indoor firepits that generated very high levels of air pollution. Since the 1970s, most residents have changed from firepits to stoves with chimneys. This study assessed whether lung cancer incidence decreased after this stove improvement. Methods: A cohort of 21232 farmers, born from 1917 through 1951, was followed retrospectively from 1976 through 1992. All subjects were users of smoky coal who had been born into homes with unvented firepits. During their lifetime, 17184 subjects (80.9%) changed permanently to stoves with chimneys. A hospital record search detected 1384 cases of lung cancer (6.5%) during follow-up. Associations of stove improvement with lung cancer incidence were analyzed with product-limit plots and multivariable Cox models. In 1995, indoor concentrations of airborne particles and benzo[a]pyrene were compared in Xuanwei homes during smoky coal burning in stoves with chimneys and in unvented stoves or firepits. Results: A long-term reduction in lung cancer incidence was noted after stove improvement. In Cox models, risk ratios (RRs) for lung cancer after stove improvement were 0.59 (95% confidence interval [CI] = 0.49 to 0.71) in men and 0.54 (95% CI = 0.44 to 0.65) in women (for both, P