Department of Epidemiology and Public Health, National University of Singapore, Singapore.
Environ Health Perspect. 2010 Sep;118(9):1257-60. doi: 10.1289/ehp.0901587. Epub 2010 May 14.
Epidemiologic data suggest that Chinese women have a high incidence of lung cancer in relation to their smoking prevalence. In addition to active tobacco smoke exposure, other sources of fumes and airborne particles in the indoor environment, such as cooking and burning of incense and mosquito coils, have been considered potential risk factors for lung cancer.
We used a case-control study to explore effects of inhalants from combustion sources common in the domestic environment on lung cancer and their modification by active tobacco smoking.
We analyzed 703 primary lung cancer cases and 1,578 controls. Data on demographic background and relevant exposures were obtained by face-to-face interviews in the hospital.
We observed a positive relationship with daily exposure to incense or mosquito coils and to cooking fumes only among smokers, and no association among lifetime nonsmokers. Interactions between smoking and frequency of cooking, or exposure to incense or mosquito coils were statistically significant and consistent with synergistic effects on lung cancer. The odds ratio (OR) comparing smokers without daily incense or mosquito coil exposure with nonsmokers without daily exposure was 2.80 [95% confidence interval (CI), 1.86-4.21], whereas the OR comparing smokers with daily exposure to the same referent group was 4.61 (95% CI, 3.41-6.24). In contrast, daily exposure to incense or mosquito coils was not associated with lung cancer among nonsmokers (OR = 0.91; 95% CI, 0.72-1.16). We observed the same pattern of associations for smokers without (OR = 2.31; 95% CI, 1.52-3.51) and with (OR = 4.50; 95% CI, 3.21-6.30) daily cooking exposure compared with nonsmokers, with no evidence of an association with daily cooking exposure among nonsmokers.
Our results suggest that active tobacco smoking not only is an important risk factor for development of lung cancer, but also may cause smokers to be more susceptible to the risk-enhancing effects of other inhalants.
流行病学数据表明，与吸烟流行相比，中国女性肺癌发病率较高。除了主动吸烟暴露外，室内环境中其他来源的烟雾和气载颗粒，如烹饪和燃烧香和蚊香，被认为是肺癌的潜在危险因素。
我们使用病例对照研究来探讨常见于家庭环境中的燃烧源吸入物对肺癌的影响及其与主动吸烟的相互作用。
我们分析了 703 例原发性肺癌病例和 1578 例对照。通过在医院进行面对面访谈获得人口统计学背景和相关暴露的数据。
我们观察到，只有吸烟者与每天暴露于香或蚊香以及烹饪烟雾之间存在正相关关系，而在终身不吸烟者中则没有关联。吸烟与烹饪频率或暴露于香或蚊香之间的相互作用具有统计学意义，并且与肺癌的协同作用一致。与不每天暴露于香或蚊香的非吸烟者相比，不每天暴露于香或蚊香的吸烟者的比值比（OR）为 2.80（95%置信区间[CI]，1.86-4.21），而与同一参照组每天暴露于香或蚊香的吸烟者的 OR 为 4.61（95% CI，3.41-6.24）。相比之下，不吸烟者每天暴露于香或蚊香与肺癌无关（OR=0.91；95%CI，0.72-1.16）。对于不吸烟者（OR=2.31；95%CI，1.52-3.51）和有（OR=4.50；95%CI，3.21-6.30）每日烹饪暴露的吸烟者，我们观察到了相同的关联模式，而在不吸烟者中，没有证据表明与每日烹饪暴露有关。
我们的研究结果表明，主动吸烟不仅是肺癌发生的一个重要危险因素，而且可能使吸烟者更容易受到其他吸入物的风险增强作用的影响。
