Fang Fang, Zhou Jin-Yi, Kim Claire H, Jin Zi-Yi, Liu Xing, Li Liming, Mu Lina, Wu Ming, Zhao Jin-Kou, Zhang Zuo-Feng
Department of Epidemiology, Fielding School of Public Health, University of California at Los Angeles (UCLA), Los Angeles, California, USA.
Department of Non-Communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China.
Indoor Air. 2025;2025. doi: 10.1155/ina/9937960. Epub 2025 Feb 27.
Though indoor air pollution (IAP) is associated with elevated lung cancer risk, an integrated measure is imperative to thoroughly investigate this association. The interplay between sex and IAP on lung cancer remains unclear. We conducted a population-based case-control study in Jiangsu Province, China, from 2003 to 2010, with 2871 lung cancer cases and 8019 controls. Exposures and covariates information were collected via in-person interviews using a standardized questionnaire. An integrated weighted risk score (WRS), accounting for the effect sizes of each source of IAP, was introduced. Unconditional logistic regression was employed to estimate adjusted odds ratios (aORs) and their 95% confidence intervals (CIs). Interactions between sex and IAP by tobacco smoking status were evaluated. Environmental tobacco smoking (ETS) (aOR = 1.54, 95% CI: 1.40, 1.69), poor ventilation (aOR = 1.18, 95% CI: 1.07, 1.30), and coal used for cooking (aOR = 1.27, 95% CI: 1.15, 1.41) were associated with lung cancer. Dose-response relationships between lung cancer and WRS were observed, with for trend less than 0.001. aOR for individuals at the highest quartile of the WRS of IAP was 1.74 (95% CI: 1.52, 2.00) compared to the lowest quartile. The associations were more profound among never-smokers than ever-smokers. Females tended to be more vulnerable to IAP, and sex interacted with IAP beyond multiplicativity on the odds scale. IAP is associated with lung cancer, with a stronger impact among never-smokers. An interaction between IAP and sex was observed. These results underscore the importance of controlling IAP, especially ETS in order to reduce the risk of lung cancer.
尽管室内空气污染（IAP）与肺癌风险升高有关，但必须采取综合措施来全面调查这种关联。性别与IAP在肺癌发生中的相互作用仍不清楚。我们于2003年至2010年在中国江苏省进行了一项基于人群的病例对照研究，共纳入2871例肺癌病例和8019例对照。通过使用标准化问卷进行面对面访谈收集暴露因素和协变量信息。引入了一个综合加权风险评分（WRS），该评分考虑了IAP各来源的效应大小。采用无条件逻辑回归来估计调整后的比值比（aORs）及其95%置信区间（CIs）。评估了性别与IAP在吸烟状况方面的相互作用。环境烟草烟雾暴露（ETS）（aOR = 1.54，95% CI：1.40，1.69）、通风不良（aOR = 1.18，95% CI：1.07，1.30）以及用于烹饪的煤炭（aOR = 1.27，95% CI：1.15，1.41）与肺癌有关。观察到肺癌与WRS之间存在剂量反应关系，趋势检验P值小于0.001。与IAP的WRS最低四分位数相比，处于最高四分位数的个体的aOR为1.74（95% CI：1.52，2.00）。从不吸烟者中的关联比曾经吸烟者更为显著。女性往往更容易受到IAP的影响，并且在比值比尺度上，性别与IAP的相互作用超出了相乘性。IAP与肺癌有关，对从不吸烟者的影响更强。观察到IAP与性别之间存在相互作用。这些结果强调了控制IAP，尤其是ETS以降低肺癌风险的重要性。
