Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avda, Monforte de Lemos, 5, 28029 Madrid, Spain.
Int J Health Geogr. 2011 Jan 25;10:10. doi: 10.1186/1476-072X-10-10.
Asturias, an Autonomous Region in Northern Spain with a large industrial area, registers high lung cancer incidence and mortality. While this excess risk of lung cancer might be partially attributable to smoking habit and occupational exposure, the role of industrial and urban pollution also needs to be assessed. The objective was to ascertain the possible effect of air pollution, both urban and industrial, on lung cancer risk in Asturias.
This was a hospital-based case-control study covering 626 lung cancer patients and 626 controls recruited in Asturias and matched by ethnicity, hospital, age, and sex. Distances from the respective participants' residential locations to industrial facilities and city centers were computed. Using logistic regression, odds ratios (ORs) and 95% confidence intervals (95%CIs) for categories of distance to urban and industrial pollution sources were calculated, with adjustment for sex, age, hospital area, tobacco consumption, family history of cancer, and occupation.
Whereas individuals living near industries displayed an excess risk of lung cancer (OR = 1.49; 95%CI = 0.93-2.39), which attained statistical significance for small cell carcinomas (OR = 2.23; 95%CI = 1.01-4.92), residents in urban areas showed a statistically significant increased risk for adenocarcinoma (OR = 1.92; 95%CI = 1.09-3.38). In the Gijon health area, residents in the urban area registered a statistically significant increased risk of lung cancer (OR = 2.17; 95%CI = 1.25-3.76), whereas in the Aviles health area, no differences in risk were found by area of exposure.
This study provides further evidence that air pollution is a moderate risk factor for lung cancer.
西班牙北部的阿斯图里亚斯自治区拥有一个大型工业区，其肺癌发病率和死亡率都很高。虽然这种肺癌的超额风险可能部分归因于吸烟习惯和职业暴露，但工业和城市污染的作用也需要评估。目的是确定阿斯图里亚斯的空气污染（包括城市和工业污染）对肺癌风险的可能影响。
这是一项基于医院的病例对照研究，涵盖了在阿斯图里亚斯招募的 626 名肺癌患者和 626 名对照者，他们按种族、医院、年龄和性别进行匹配。计算了每位参与者居住地点到工业设施和市中心的距离。使用逻辑回归，计算了按距离城市和工业污染源分类的比值比（OR）和 95%置信区间（95%CI），并调整了性别、年龄、医院区域、吸烟情况、癌症家族史和职业因素。
居住在工业附近的个体患有肺癌的风险增加（OR=1.49；95%CI=0.93-2.39），其中小细胞癌达到统计学意义（OR=2.23；95%CI=1.01-4.92），而居住在城市地区的个体患有腺癌的风险增加（OR=1.92；95%CI=1.09-3.38）。在希洪卫生区，居住在城市地区的个体肺癌风险增加具有统计学意义（OR=2.17；95%CI=1.25-3.76），而在阿维莱斯卫生区，按暴露区域划分，风险无差异。
本研究进一步提供了证据表明，空气污染是肺癌的一个中度危险因素。
