Hendryx Michael, O'Donnell Kathryn, Horn Kimberly
Department of Community Medicine, West Virginia University, Morgantown, WV 26506, United States.
Lung Cancer. 2008 Oct;62(1):1-7. doi: 10.1016/j.lungcan.2008.02.004. Epub 2008 Mar 18.
Previous research has documented increased lung cancer incidence and mortality in Appalachia. The current study tests whether residence in coal-mining areas of Appalachia is a contributing factor. We conducted a national county-level analysis to identify contributions of smoking rates, socioeconomic variables, coal-mining intensity and other variables to age-adjusted lung cancer mortality. Results demonstrate that lung cancer mortality for the years 2000-2004 is higher in areas of heavy Appalachian coal mining after adjustments for smoking, poverty, education, age, sex, race and other covariates. Higher mortality may be the result of exposure to environmental contaminates associated with the coal-mining industry, although smoking and poverty are also contributing factors. The knowledge of the geographic areas within Appalachia where lung cancer mortality is higher can be used to target programmatic and policy interventions. The set of socioeconomic and health inequalities characteristic of coal-mining areas of Appalachia highlights the need to develop more diverse, alternative local economies.
先前的研究记录了阿巴拉契亚地区肺癌发病率和死亡率的上升。当前的研究检验了居住在阿巴拉契亚的煤矿区是否是一个促成因素。我们进行了一项全国县级分析，以确定吸烟率、社会经济变量、煤矿开采强度及其他变量对年龄调整后的肺癌死亡率的影响。结果表明，在对吸烟、贫困、教育程度、年龄、性别、种族及其他协变量进行调整后，2000年至2004年期间，阿巴拉契亚煤矿密集地区的肺癌死亡率更高。尽管吸烟和贫困也是促成因素，但更高的死亡率可能是由于接触与煤矿行业相关的环境污染物所致。了解阿巴拉契亚地区肺癌死亡率较高的地理区域，可用于确定规划和政策干预的目标。阿巴拉契亚煤矿区特有的一系列社会经济和健康不平等现象凸显了发展更多样化的替代性地方经济的必要性。
