Indoor wood-burning from stoves and fireplaces and incident lung cancer among Sister Study participants

Background and aim: Epidemiological studies conducted mostly in low- and middle-income countries have found a positive association between household combustion of wood and lung cancer. However, most studies have been retrospective, and few have been conducted in the United States where indoor wood-b...

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Main Authors: Suril S. Mehta, M. Elizabeth Hodgson, Ruth M. Lunn, Claire E. Ashley, Whitney D. Arroyave, Dale P. Sandler, Alexandra J. White
Format: Article
Language:English
Published: Elsevier 2023-08-01
Series:Environment International
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S0160412023004014
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author Suril S. Mehta
M. Elizabeth Hodgson
Ruth M. Lunn
Claire E. Ashley
Whitney D. Arroyave
Dale P. Sandler
Alexandra J. White
author_facet Suril S. Mehta
M. Elizabeth Hodgson
Ruth M. Lunn
Claire E. Ashley
Whitney D. Arroyave
Dale P. Sandler
Alexandra J. White
author_sort Suril S. Mehta
collection DOAJ
description Background and aim: Epidemiological studies conducted mostly in low- and middle-income countries have found a positive association between household combustion of wood and lung cancer. However, most studies have been retrospective, and few have been conducted in the United States where indoor wood-burning usage patterns differ. We examined the association of exposure to indoor wood smoke from fireplaces and stoves with incident lung cancer in a U.S.-wide cohort of women. Methods: We included 50,226 women without prior lung cancer participating in the U.S.-based prospective Sister Study. At enrollment (2003–2009), women reported frequency of use of wood-burning stoves and/or fireplaces in their longest-lived adult residence. Cox regression was used to estimate adjusted hazard ratios (HRadj) and 95 % confidence intervals (CI) for the association between indoor wood-burning fireplace/stove use and incident lung cancer. Lung cancer was self-reported and confirmed with medical records. Results: During an average 11.3 years of follow-up, 347 medically confirmed lung cancer cases accrued. Overall, 62.3 % of the study population reported the presence of an indoor wood-burning fireplace/stove at their longest-lived adult residence and 20.6 % reported annual usage of ≥30 days/year. Compared to those without a wood-burning fireplace/stove, women who used their wood-burning fireplace/stove ≥30 days/year had an elevated rate of lung cancer (HRadj = 1.68; 95 % CI = 1.27, 2.20). In never smokers, positive associations were seen for use 1–29 days/year (HRadj = 1.64; 95 % CI = 0.87, 3.10) and ≥30 days/year (HRadj = 1.99; 95 % CI = 1.02, 3.89). Associations were also elevated across all income groups, in Northeastern, Western or Midwestern U.S. regions, and among those who lived in urban or rural/small town settings. Conclusions: Our prospective analysis of a cohort of U.S. women found that increasing frequency of wood-burning indoor fireplace/stove usage was associated with incident lung cancer, even among never smokers.
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spelling doaj.art-9b41b3ac9a26480f9a7e10816fceeb9d2023-08-16T04:26:31ZengElsevierEnvironment International0160-41202023-08-01178108128Indoor wood-burning from stoves and fireplaces and incident lung cancer among Sister Study participantsSuril S. Mehta0M. Elizabeth Hodgson1Ruth M. Lunn2Claire E. Ashley3Whitney D. Arroyave4Dale P. Sandler5Alexandra J. White6Integrative Health Assessments Branch, Division of Translational Toxicology, National Institute of Environmental Health Sciences, Research Triangle Park, NC, United States; Corresponding author at: Report on Carcinogens Group, Integrative Health Assessments Branch, Division of Translational Toxicology, National Institute of Environmental Health Sciences, 111 TW Alexander Drive, P.O. Box 12233, Mail Drop K2-14, Research Triangle Park, NC 27709, United States.Integrated Laboratory Systems, LLC an Inotiv Company, Morrisville, NC, United StatesIntegrative Health Assessments Branch, Division of Translational Toxicology, National Institute of Environmental Health Sciences, Research Triangle Park, NC, United StatesGillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, United StatesIntegrated Laboratory Systems, LLC an Inotiv Company, Morrisville, NC, United StatesEpidemiology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, Research Triangle Park, NC, United StatesEpidemiology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, Research Triangle Park, NC, United StatesBackground and aim: Epidemiological studies conducted mostly in low- and middle-income countries have found a positive association between household combustion of wood and lung cancer. However, most studies have been retrospective, and few have been conducted in the United States where indoor wood-burning usage patterns differ. We examined the association of exposure to indoor wood smoke from fireplaces and stoves with incident lung cancer in a U.S.-wide cohort of women. Methods: We included 50,226 women without prior lung cancer participating in the U.S.-based prospective Sister Study. At enrollment (2003–2009), women reported frequency of use of wood-burning stoves and/or fireplaces in their longest-lived adult residence. Cox regression was used to estimate adjusted hazard ratios (HRadj) and 95 % confidence intervals (CI) for the association between indoor wood-burning fireplace/stove use and incident lung cancer. Lung cancer was self-reported and confirmed with medical records. Results: During an average 11.3 years of follow-up, 347 medically confirmed lung cancer cases accrued. Overall, 62.3 % of the study population reported the presence of an indoor wood-burning fireplace/stove at their longest-lived adult residence and 20.6 % reported annual usage of ≥30 days/year. Compared to those without a wood-burning fireplace/stove, women who used their wood-burning fireplace/stove ≥30 days/year had an elevated rate of lung cancer (HRadj = 1.68; 95 % CI = 1.27, 2.20). In never smokers, positive associations were seen for use 1–29 days/year (HRadj = 1.64; 95 % CI = 0.87, 3.10) and ≥30 days/year (HRadj = 1.99; 95 % CI = 1.02, 3.89). Associations were also elevated across all income groups, in Northeastern, Western or Midwestern U.S. regions, and among those who lived in urban or rural/small town settings. Conclusions: Our prospective analysis of a cohort of U.S. women found that increasing frequency of wood-burning indoor fireplace/stove usage was associated with incident lung cancer, even among never smokers.http://www.sciencedirect.com/science/article/pii/S0160412023004014Wood smokeHeatingCookingLung cancerWomen
spellingShingle Suril S. Mehta
M. Elizabeth Hodgson
Ruth M. Lunn
Claire E. Ashley
Whitney D. Arroyave
Dale P. Sandler
Alexandra J. White
Indoor wood-burning from stoves and fireplaces and incident lung cancer among Sister Study participants
Environment International
Wood smoke
Heating
Cooking
Lung cancer
Women
title Indoor wood-burning from stoves and fireplaces and incident lung cancer among Sister Study participants
title_full Indoor wood-burning from stoves and fireplaces and incident lung cancer among Sister Study participants
title_fullStr Indoor wood-burning from stoves and fireplaces and incident lung cancer among Sister Study participants
title_full_unstemmed Indoor wood-burning from stoves and fireplaces and incident lung cancer among Sister Study participants
title_short Indoor wood-burning from stoves and fireplaces and incident lung cancer among Sister Study participants
title_sort indoor wood burning from stoves and fireplaces and incident lung cancer among sister study participants
topic Wood smoke
Heating
Cooking
Lung cancer
Women
url http://www.sciencedirect.com/science/article/pii/S0160412023004014
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