Tobacco Documents Online

a I I I I I I I I I I I I I I I LIFESTYLE, ENVIRONMENTAL POLLUTION AND LUNG CANCER IN CITIES OF LIAONING IN NORTHEASTERN CHINA Xu Zhao-vi*, Linda Brown,**, Pan Guo-wei*, Li Guang* and Feng Yi-ping* * Liaoning Public Health and Antiepidemic Station, Shenyang, China ** National Cancer Institute, Biostatistics Branch, Rockville, Maryland, USA Several studies were conducted in cities of Liaoning Province, one of the heavy industrial concentrated areas of China, to examine the effects of life-style factors and environmental pollutants on lung cancer causation. A case-control study involving 1249 lung cancer patients and 1345 population-based controls was conducted in 1985-1988 in Shenyang, the capital of Liaoning. Cigarette smoking was found to be the principal cause of lung cancer, accounting for 55% of the attributable fraction in males and 37% in females in this population. There was also a significant increase in lung cancer risk associated with an overall index of indoor air pollution due to coal-burning emissions. The population attributable risk (PAR) of indoor air pollution was 13 % for males and 17 % for females. Risks significantly increased for some occupations including workers in non-ferrous smelters (OR=2.6), chemical drug manufacturers (OR=3.0), glass and pottery industry (OR= 1.6). Studies in the Anshan iron-steel complex showed a significant excess of lung cancer for workers exposed to a variety of dusts. A standardized proportional mortality ratio (SPMR) study of 8887 deaths during 1980-1989 among male workers of the iron steel complex showed a 37% increase in lung cancer (1.37; 95% CI 1.28-1.45) compared to citizens of the city. A nested case-control study was then conducted in that complex. Six hundred and ten cases of lung cancer diagnosed during 1987-1993 and 959 randonily selected controls from 196,993 active and retired employees of the complex were interviewed. Records on monitors for dust and benz(a)pyrene from 1956-1992 were collected to calculate cumulative exposure for each person. Results suggest that all "dusty occupations" (exposure to metal or mineral dusts) increased the risk for lung cancer; the highest risk was among coke oven workers (OR=3.5) and fire resistant brick makers (OR=2.9). Significant dose-response patterns between cumulative total dust particles, cumulative total BaP, and lung cancer risk were observed. These findings suggest that smoking and environmental pollution account for elevated rates of lung cancer in cities of northeastern China. t N O tb i -4 ' co W i co M I