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  • 1
    Keywords: CANCER ; LUNG ; DIAGNOSIS ; FOLLOW-UP ; lung cancer ; LUNG-CANCER ; COHORT ; EXPOSURE ; MORTALITY ; RISK ; TIME ; AIR-POLLUTION ; ASSOCIATION ; AGE ; smoking ; COUNTRIES ; RECRUITMENT ; ADDUCTS ; case-control studies ; EPIC ; nutrition ; SMOKERS ; case-control study ; air pollution ; case control studies ; INTERVAL ; GENDER ; occupational exposures ; prospective study ; EXPOSURES ; SO2 ; AMBIENT ; POLLUTANTS
    Abstract: To estimate the relationship between air pollution and lung cancer, a nested case-control study was set up within EPIC (European Prospective Investigation on Cancer and Nutrition). Cases had newly diagnosed lung cancer, accrued after a median follow-up of 7 years among the EPIC exsmokers (since at least 10 years) and never smokers. Three controls per case were matched. Matching criteria were gender, age (+/- 5 years), smoking status, country of recruitment and time elapsed between recruitment and diagnosis. We studied residence in proximity of heavy traffic roads as an indicator of exposure to air pollution. In addition, exposure to air pollutants (NO2, PM10, SO2) was assessed using concentration data from monitoring stations in routine air quality monitoring networks. Cotinine was measured in plasma. We found a nonsignificant association between lung cancer and residence nearby heavy traffic roads (odds ratio = 1.46, 95% confidence interval, CI, 0.89-2.40). Exposure data for single pollutants were available for 197 cases and 556 matched controls. For NO2 we found an odds ratio of 1.14 (95% CI, 0.78-1.67) for each increment of 10 mu g/m(3), and an odds ratio of 1.30 (1.02-1.66) for concentrations greater than 30 mu g/m(3). The association with NO2 did not change after adjustment by cotinine and additional potential confounders, including occupational exposures. No clear association was found with other pollutants. (c) 2006 Wiley-Liss, Inc
    Type of Publication: Journal article published
    PubMed ID: 16463382
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  • 2
    Keywords: CANCER ; EXPRESSION ; LUNG ; FOLLOW-UP ; INFORMATION ; lung cancer ; LUNG-CANCER ; DISEASE ; EXPOSURE ; LONG-TERM ; POPULATION ; RISK ; RISKS ; QUALITY ; REDUCTION ; BIOMARKERS ; PARTICLES ; HEALTH ; DESIGN ; smoking ; COUNTRIES ; SWEDEN ; TOBACCO ; EUROPE ; HIGH-LEVEL ; HEAVY ; prospective studies ; bias ; LEVEL ; EPIDEMIOLOGIC EVIDENCE ; methods ; POWER ; prospective ; prospective study ; NEVER SMOKERS ; CANCERS ; ENGLAND ; EMISSION ; plant ; nonsmokers ; GASES ; discussion ; OUTDOOR
    Abstract: Background: Several countries are discussing new legislation on the ban of smoking in public places, and on the acceptable levels of traffic-related air pollutants. It is therefore useful to estimate the burden of disease associated with indoor and outdoor air pollution. Methods: We have estimated exposure to Environmental Tobacco Smoke (ETS) and to air pollution in never smokers and ex-smokers in a large prospective study in 10 European countries (European Prospective Investigation into Cancer and Nutrition)(N = 520,000). We report estimates of the proportion of lung cancers attributable to ETS and air pollution in this population. Results: The proportion of lung cancers in never-and ex-smokers attributable to ETS was estimated as between 16 and 24%, mainly due to the contribution of work-related exposure. We have also estimated that 5-7% of lung cancers in European never smokers and ex-smokers are attributable to high levels of air pollution, as expressed by NO2 or proximity to heavy traffic roads. NO2 is the expression of a mixture of combustion (traffic-related) particles and gases, and is also related to power plants and waste incinerator emissions. Discussion: We have estimated risks of lung cancer attributable to ETS and traffic-related air pollution in a large prospective study in Europe. Information bias can be ruled out due to the prospective design, and we have thoroughly controlled for potential confounders, including restriction to never smokers and long-term ex-smokers. Concerning traffic-related air pollution, the thresholds for indicators of exposure we have used are rather strict, i.e. they correspond to the high levels of exposure that characterize mainly Southern European countries (levels of NO2 in Denmark and Sweden are closer to 10-20 ug/m(3), whereas levels in Italy are around 30 or 40, or higher). Therefore, further reduction in exposure levels below 30 ug/m(3) would correspond to additional lung cancer cases prevented, and our estimate of 5-7% is likely to be an underestimate. Overall, our prospective study draws attention to the need for strict legislation concerning the quality of air in Europe
    Type of Publication: Journal article published
    PubMed ID: 17302981
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