Modifiable Risk Factors Branch, Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland 20892, USA.
Environ Health Perspect. 2012 Nov;120(11):1495-8. doi: 10.1289/ehp.1204962. Epub 2012 Jul 30.
Indoor air pollution (IAP) derived largely from the use of solid fuels for cooking and heating affects about 3 billion people worldwide, resulting in substantial adverse health outcomes, including cancer. Women and children from developing countries are the most exposed populations. A workshop was held in Arlington, Virginia, 9-11 May 2011, to better understand women's and children's potential health effects from IAP in developing countries. Workshop participants included international scientists, manufacturers, policy and regulatory officials, community leaders, and advocates who held extensive discussions to help identify future research needs.
Our objective was to identify research opportunities regarding IAP and cancer, including research questions that could be incorporated into studies of interventions to reduce IAP exposure. In this commentary, we describe the state of the science in understanding IAP and its associations with cancer and suggest research opportunities for improving our understanding of the issues.
Opportunities for research on IAP and cancer include studies of the effect of IAP on cancers other than lung cancer; studies of genetic factors that modify susceptibility; studies to determine whether the effects of IAP are mediated via germline, somatic, and/or epigenetic changes; and studies of the effects of IAP exposure via dermal and/or oral routes.
IAP from indoor coal use increases the risk of lung cancer. Installing chimneys can reduce risk, and some genotypes, including GSTM1-null, can increase risk. Additional research is needed regarding the effects of IAP on other cancers and the effects of different types of solid fuels, oral and dermal routes of IAP exposure, genetic and epigenetic mechanisms, and genetic susceptibility.
室内空气污染（IAP）主要源于烹饪和取暖用固体燃料的使用，影响着全球约 30 亿人，导致了严重的不良健康后果，包括癌症。发展中国家的妇女和儿童是受影响最严重的人群。2011 年 5 月 9 日至 11 日，在弗吉尼亚州阿灵顿举行了一次研讨会，以更好地了解发展中国家室内空气污染对妇女和儿童健康的潜在影响。研讨会参与者包括国际科学家、制造商、政策和监管官员、社区领袖和倡导者，他们进行了广泛的讨论，以帮助确定未来的研究需求。
我们的目标是确定与室内空气污染和癌症相关的研究机会，包括可以纳入减少室内空气污染暴露干预措施研究的研究问题。在这篇评论中，我们描述了理解室内空气污染及其与癌症关联的科学现状，并提出了改善我们对这些问题理解的研究机会。
室内空气污染和癌症研究的机会包括研究室内空气污染对除肺癌以外的癌症的影响；研究遗传因素对易感性的影响；研究确定室内空气污染的影响是否通过种系、体细胞和/或表观遗传变化介导；以及研究通过皮肤和/或口腔途径暴露于室内空气污染的影响。
室内燃煤引起的室内空气污染增加了患肺癌的风险。安装烟囱可以降低风险，某些基因型，包括 GSTM1 缺失型，会增加风险。需要进一步研究室内空气污染对其他癌症的影响，以及不同类型的固体燃料、口腔和皮肤途径暴露于室内空气污染、遗传和表观遗传机制以及遗传易感性的影响。
