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Portable stove use is associated with lower lung cancer mortality risk in lifetime smoky coal users.

Hosgood HD, Chapman R, Shen M, Blair A, Chen E, Zheng T, Lee KM, He X, Lan Q - Br. J. Cancer (2008)

Bottom Line: Both men (P<0.0001) and women (P<0.0001) who changed to portable stoves had a significantly increased probability of survival compared with those who did not change.Portable stoves were associated with decreased risk of lung cancer mortality in male participants (hazard ratio (HR)=0.62, 95% confidence interval (CI)=0.46-0.82) and female participants (HR=0.41, 95% CI=0.29-0.57).Portable stove use is associated with reduced lung cancer mortality risk, highlighting a cost-effective intervention that could substantially benefit health in developing countries.

View Article: PubMed Central - PubMed

Affiliation: Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-7240, USA. hosgoodd@mail.nih.gov

ABSTRACT
Domestic fuel combustion from cooking and heating, to which about 3 billion people worldwide are exposed, is associated with increased lung cancer risk. Lung cancer incidence in Xuanwei is the highest in China, and the attributable risk of lung cancer from unvented smoky coal burning is greater than 90%. To evaluate any lung cancer mortality reduction after changing from unvented stoves to portable stoves, we used lifetime smoky coal users in a retrospective cohort of all farmers born during 1917-1951 and residing in Xuanwei in 1976. Of the 42,422 enrolled farmers, 4054 lifetime smoky coal users changed to portable stoves, 4364 did not change, and 1074 died of lung cancer. Lung cancer morality associated with stove change was assessed by product-limit survival curves and multivariate Cox regression models. Both men (P<0.0001) and women (P<0.0001) who changed to portable stoves had a significantly increased probability of survival compared with those who did not change. Portable stoves were associated with decreased risk of lung cancer mortality in male participants (hazard ratio (HR)=0.62, 95% confidence interval (CI)=0.46-0.82) and female participants (HR=0.41, 95% CI=0.29-0.57). Portable stove use is associated with reduced lung cancer mortality risk, highlighting a cost-effective intervention that could substantially benefit health in developing countries.

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Product-limit survival curves for probability of lung cancer mortality for those who changed to a portable stove compared with those with no change.
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fig1: Product-limit survival curves for probability of lung cancer mortality for those who changed to a portable stove compared with those with no change.

Mentions: In product-limit analysis, for both men (P<0.0001) and women (P<0.0001), the probability of dying from lung cancer was significantly lower in subjects who underwent stove change compared with those who did not (Figure 1). In both men and women, stove change was associated with a decreased risk of lung cancer mortality in lifetime smoky coal users (Table 2). Further, tons of smoky coal used annually increased risk of lung cancer mortality in a dose-dependent fashion. History of lung cancer in a spouse was also significantly associated with an increased risk of lung cancer mortality in men and women. In men, ever working as a coal miner and years of cigarette smoking were associated with an increased risk of lung cancer mortality, whereas literacy and time spending ⩾7 h per day indoors were not associated with risk of lung cancer mortality. On the contrary, in women, spending 7 or more hours indoors per day until they were 20 years old had an increased risk of lung cancer mortality, and years of cooking was associated with a nonsignificant increased risk. When restricted to only cooking years before stove change, however, the risk of lung cancer mortality associated with cooking was significantly increased in women (10–20 years: HR=3.29, 95% CI=1.58–6.83; ⩾20 years: HR=1.12, 95% CI=0.67–1.88).


Portable stove use is associated with lower lung cancer mortality risk in lifetime smoky coal users.

Hosgood HD, Chapman R, Shen M, Blair A, Chen E, Zheng T, Lee KM, He X, Lan Q - Br. J. Cancer (2008)

Product-limit survival curves for probability of lung cancer mortality for those who changed to a portable stove compared with those with no change.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2600700&req=5

fig1: Product-limit survival curves for probability of lung cancer mortality for those who changed to a portable stove compared with those with no change.
Mentions: In product-limit analysis, for both men (P<0.0001) and women (P<0.0001), the probability of dying from lung cancer was significantly lower in subjects who underwent stove change compared with those who did not (Figure 1). In both men and women, stove change was associated with a decreased risk of lung cancer mortality in lifetime smoky coal users (Table 2). Further, tons of smoky coal used annually increased risk of lung cancer mortality in a dose-dependent fashion. History of lung cancer in a spouse was also significantly associated with an increased risk of lung cancer mortality in men and women. In men, ever working as a coal miner and years of cigarette smoking were associated with an increased risk of lung cancer mortality, whereas literacy and time spending ⩾7 h per day indoors were not associated with risk of lung cancer mortality. On the contrary, in women, spending 7 or more hours indoors per day until they were 20 years old had an increased risk of lung cancer mortality, and years of cooking was associated with a nonsignificant increased risk. When restricted to only cooking years before stove change, however, the risk of lung cancer mortality associated with cooking was significantly increased in women (10–20 years: HR=3.29, 95% CI=1.58–6.83; ⩾20 years: HR=1.12, 95% CI=0.67–1.88).

Bottom Line: Both men (P<0.0001) and women (P<0.0001) who changed to portable stoves had a significantly increased probability of survival compared with those who did not change.Portable stoves were associated with decreased risk of lung cancer mortality in male participants (hazard ratio (HR)=0.62, 95% confidence interval (CI)=0.46-0.82) and female participants (HR=0.41, 95% CI=0.29-0.57).Portable stove use is associated with reduced lung cancer mortality risk, highlighting a cost-effective intervention that could substantially benefit health in developing countries.

View Article: PubMed Central - PubMed

Affiliation: Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-7240, USA. hosgoodd@mail.nih.gov

ABSTRACT
Domestic fuel combustion from cooking and heating, to which about 3 billion people worldwide are exposed, is associated with increased lung cancer risk. Lung cancer incidence in Xuanwei is the highest in China, and the attributable risk of lung cancer from unvented smoky coal burning is greater than 90%. To evaluate any lung cancer mortality reduction after changing from unvented stoves to portable stoves, we used lifetime smoky coal users in a retrospective cohort of all farmers born during 1917-1951 and residing in Xuanwei in 1976. Of the 42,422 enrolled farmers, 4054 lifetime smoky coal users changed to portable stoves, 4364 did not change, and 1074 died of lung cancer. Lung cancer morality associated with stove change was assessed by product-limit survival curves and multivariate Cox regression models. Both men (P<0.0001) and women (P<0.0001) who changed to portable stoves had a significantly increased probability of survival compared with those who did not change. Portable stoves were associated with decreased risk of lung cancer mortality in male participants (hazard ratio (HR)=0.62, 95% confidence interval (CI)=0.46-0.82) and female participants (HR=0.41, 95% CI=0.29-0.57). Portable stove use is associated with reduced lung cancer mortality risk, highlighting a cost-effective intervention that could substantially benefit health in developing countries.

Show MeSH
Related in: MedlinePlus