Xu Z Y, Blot W J, Li G, Fraumeni J F, Zhao D Z, Stone B J, Yin Q, Wu A, Henderson B E, Guan B P
Liaoning Public Health and Anti-epidemic Station, Shenyang, China.
IARC Sci Publ. 1991(105):460-5.
To investigate determinants of the high rates of lung cancer in Shenyang, an industrial city in north-eastern China, a case-control study was conducted. Interviews with 1249 lung cancer patients and 1345 population-based controls revealed that cigarette smoking was the main cause of lung cancer. Smoking accounted for 55% of the lung tumours in men and 37% in women. In addition, air pollution from coal-burning heating and cooking devices was significantly linked to lung cancer, with risks rising in proportion to duration of exposure to indoor pollutants. Measurement of benzo[a]pyrene revealed average wintertime levels in air that were nearly 60 times the recommended upper limit for US cities, with even higher concentrations indoors in traditional single-storey homes using coal-burning kang (stoves). Occupational factors were also involved, the risk being elevated by three fold among smelter workers. Soil levels of arsenic and other metals rose with increasing proximity to the Shenyang copper smelter, and elevated risks of lung cancer were found among men, but not women, living within 1 km of its central stacks. Prior nonmalignant lung disease was common and was reported more often among the lung cancer patients than among controls. The findings suggest that cigarette smoking and environmental pollutants combine to account for most of the excess risk of lung cancer in this population.
为调查中国东北工业城市沈阳肺癌高发病率的决定因素，开展了一项病例对照研究。对1249名肺癌患者和1345名基于人群的对照者进行访谈后发现，吸烟是肺癌的主要病因。吸烟导致男性肺癌病例的55%，女性肺癌病例的37%。此外，燃煤取暖和烹饪设备造成的空气污染与肺癌显著相关，风险随着接触室内污染物时间的延长而增加。苯并[a]芘的测量结果显示，冬季空气中的平均含量几乎是美国城市推荐上限的60倍，在使用燃煤炕（炉灶）的传统单层住宅中，室内浓度更高。职业因素也有影响，冶炼工人的患病风险提高了两倍。砷和其他金属的土壤含量随着与沈阳铜冶炼厂距离的缩短而升高，在距离冶炼厂中心烟囱1公里范围内居住的男性中发现肺癌风险升高，但女性未出现这种情况。既往非恶性肺部疾病很常见，肺癌患者中报告有该疾病的情况比对照者更频繁。研究结果表明，吸烟和环境污染物共同导致了该人群中大部分额外的肺癌风险。
