Servicio Clínico de Neumología Oncológica, Instituto Nacional de Enfermedades Respiratorias.
División de Posgrado, Facultad de Medicina, Universidad Nacional Autónoma de México.
Eur J Cancer Prev. 2021 Nov 1;30(6):462-468. doi: 10.1097/CEJ.0000000000000644.
Exposure to biomass combustion products, particularly firewood, has been considered as a potential carcinogen for developing lung cancer. In this regard, current evidence is widely heterogeneous; besides, in most studies, wood smoke exposure is not appropriately quantified, which further complicates the analysis of wood smoke as a potential carcinogen. The aim of the present study was to estimate the risk of developing lung cancer according to the degree of exposure to wood smoke in patients who use firewood for cooking.
We performed a case-control study that included 482 patients with lung cancer (cases) and 592 hospital controls. Exposure to wood smoke was evaluated as a dichotomous variable (i.e. yes or no); in patients with prior wood smoke exposure, an index of exposure in hours per year was calculated (WSEI). Using bivariate and multivariate logistic regression analyses, the odds ratio (OR) between wood smoke exposure and lung cancer were calculated.
The ORs for developing lung cancer (raw and adjusted) for a WSEI > 100 h/year were OR 1.55 [95% confidence interval (CI), 1.06-2.26) and OR 2.26 (95% CI, 1.50-3.40), respectively; the ORs (raw and adjusted) for WSEI >300 h/year were OR 1.76 (95% CI, 1.06-2.91) and OR 3.19 (95% CI, 1.83-5.55), respectively.
Exposure to wood smoke is a risk factor for lung cancer; furthermore, this effect maintains a dose-response relationship which has a multiplicative effect with smoking.
接触生物质燃烧产物，尤其是薪柴，已被认为是导致肺癌的潜在致癌物。在这方面，目前的证据差异很大；此外，在大多数研究中，木材烟雾暴露并没有得到适当的量化，这进一步增加了分析木材烟雾作为潜在致癌物的复杂性。本研究的目的是根据使用薪柴做饭的患者接触木柴烟雾的程度，估计患肺癌的风险。
我们进行了一项病例对照研究，包括 482 名肺癌患者（病例）和 592 名医院对照。暴露于木柴烟雾被评估为二分类变量（即是或否）；在有既往木柴烟雾暴露的患者中，计算了每年暴露小时数的指数（WSEI）。使用双变量和多变量逻辑回归分析，计算了木柴烟雾暴露与肺癌之间的比值比（OR）。
WSEI > 100 小时/年的肺癌发病比值比（原始和调整）分别为 OR 1.55 [95%置信区间（CI），1.06-2.26] 和 OR 2.26（95% CI，1.50-3.40）；WSEI > 300 小时/年的肺癌发病比值比（原始和调整）分别为 OR 1.76（95% CI，1.06-2.91）和 OR 3.19（95% CI，1.83-5.55）。
接触木柴烟雾是肺癌的一个危险因素；此外，这种效应保持着剂量-反应关系，与吸烟有乘法效应。
