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INDOOR BURNING COAL AIR POLLUTION AND LUNG CANCER -- A CASE-CONTROL STUDY IN FUZHOU, CHINA Ren-Xia Luol, Bin WuZ, Ying-Nan Yi2, and Ru-Tao Lin2 'Fuzhou Senior Medical School, 6, Meifeng Rd., Fuzhou, 350003, P.R. China. 2Fujian Medical College, Fuzhou, 350004, P.R. China A case-control study on risk factors for lung cancer was carried out in Fuzhou, China. One hundred and two newly-diagnosed primary lung cancer cases in urban Fuzhou (78 male and 24 female cases) were matched with 306 population-based controls. The primary histological types were adenocarcinomas (57 cases, 55.9%) and squamous cell carcinomas (39 cases, 38.2%). Controls were obtained from the general population by random, stratified sampling and consisted of non-cancer cases matched for sex, ethnicity and age. Cases and controls were interviewed by trained professionals using a standardized questionnaire. Information was obtained on: smoking habit, living conditions, history of respiratory diseases, air pollution, and forty other variables. The data were evaluated by conditional logistic regression analysis. The major risk factors for lung adenocarcinoma were: indoor air pollution from burning coal, chronic bronchitis, and high economic income. These conclusions were based on the following model, which was derived from unconditional logistic regression analysis:

Ln Px/Qx = 1.7923 X1 + 1.4122 X15 + 0.9263 Xt:indoor burning coal air pollution X15:chronic bronchitis X17:high economic income X17 where When the same analysis was applied to lung squamous cell carcinoma, the following results were obtained. Ln Px/Qx = 2.6486 X1 + 1.1160 X3 + 1.9647 X6 + 1.5104 X8 + 1.5678 X17 where Xt:indoor burning coal air pollution X3:amount of cigarettes per day X6:deep smoking XB:passive smoking history before 20 years of age X17:high economic income Thus, risk factors for lung squamous cell carcinomas were: amount of cigarettes smoked per day, deep smoking, passive smoking history before 20 years of age, burning coal indoors, and high economic income. The results showed that the major risk factors for lung cancer in Fuzhou were: burning coal indoors, smoking, passive smoking history before 20 years of age, chronic bronchitis, and high economic income. Cigarette smoking significantly increased the risk: of lung squamous cell carcinoma, but it had no significant association with the risk of lung adenocarcinoma. In summary, our research supports the hypothesis that smoking and indoor air pollution are the major risk factors for lung cancer - 2 -

in Fuzhou. Burning coal indoors and smoking were associated with lung cancer mortality in a major city in southern China.

Key Words: LUNG CANCER CASE-CONTROL STUDY LOGISTIC REGRESSION ANALYSIS INDOOR BURNING COAL AIR POLLUTION