Short-term association between ambient air pollution and lung cancer mortality. - GreenMedInfo Summary
Short-term association between ambient air pollution and lung cancer mortality.
Environ Res. 2019 Dec ;179(Pt A):108748. Epub 2019 Sep 17. PMID: 31561053
RATIONALE: Long-term exposure to air pollution has been associated with increased lung cancer incidence and mortality. However, the short-term association between air pollution and lung cancer mortality (LCM) remains largely unknown.
METHODS: We collected daily data on particulate matter with diameter<2.5 μm (PM), particulate matter with diameter < 10 μm (PM), sulfur dioxide (SO), and ozone (O), and LCM in three of the biggest cities in China, i.e. Beijing, Chongqing, and Guangzhou, from 2013 to 2015. We first estimated city-specific relationships between air pollutants and LCM using time-series generalized linear models, adjusting for potential confounders. A classification and regression tree (CART) model was used to stratify LCM risk based on combinations of air pollutants and meteorological factors in each city. Then we pooled the city-specific associations using random-effects meta-analysis. Meta regression was used to explore if city-specific characteristics modified the air pollution-LCM association. Finally, we stratified the analyses by season, age, and sex.
RESULTS: Over the entire period, the current-day concentrations of PMand PMin Chongqing and PM, PM, and SOin Guangzhou were positively associated with LCM (Excess risk ranged from 0.72% (95% CI 0.27%-1.17%) to 6.06% (95% CI 0.76%-11.64%) with each 10 μg/mincrement in different pollutants), but the association between current-day air pollution and LCM in Beijing was not significant (P > 0.05). When considering the environmental and weather factors simultaneously, current-day PM, relative humidity, and PMwere the most important factors associated with LCM in Beijing, Chongqing, and Guangzhou, respectively. LCM risk related with daily PM, PM, and SOsignificantly increased with the increasing annual mean temperature and humidity of the city, while LCM risk related with daily Osignificantly increased with the increases of latitude, annual mean Oconcentration, and socioeconomic level. After stratification, the current-day PM, PM, and Oduring the warm season in Beijing and PM, PM, and SOduring the cool season in Chongqing and Guangzhou were positively associated with LCM (Excess risk ranged from 0.93% (95% CI 0.42%-1.45%) to 7.16% (95% CI 0.64%-14.09%) with each 10 μg/mincrement in different pollutants). Male and the elderly lung cancer patients were more sensitive to the short-term effect of air pollution.
CONCLUSIONS: Lung cancer patients should enhance protection measures against air pollution. More attentions should be paid for the high PM, PM, and Oduring the warm season in Beijing, and high PM, PM, and SOduring the cool season in Chongqing and Guangzhou.