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The relationship of indoor coal use and environmental tobacco smoke exposure with lung cancer in China: A meta-analysis


1 Department of Health Service, Institute of Military Health Management, CPLA, College of Health Service, Second Military Medical University, Shanghai 200433, China
2 Department of Environmental Art Design, Fashion and Art Design Institute, Donghua University, Shanghai 200051, China

Correspondence Address:
Lulu Zhang,
Institute of Military Health Management, CPLA, College of Health Service, Second Military Medical University, 800 Xiangyin Road, Shanghai 200433
China
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Source of Support: None, Conflict of Interest: None

Objective: To assess the association between long-term exposures to smoky coal, environmental tobacco smoke (ETS) and lung cancer incidence in China. Methods: A meta-analysis was performed on literature searched through Web of Science, Chinese National Knowledge Infrastructure, Weipu, and Wanfang databases. Odds ratio (OR) with 95% confidence intervals (CIs) was used to assess the strength of association between air pollution and lung cancer in China. Results: Twenty-eight studies were included in the meta-analysis. Stratification by ETS exposure source, amount, and gender found a variation in effect. The pooled OR (95% CI) for exposure to spousal, parents, and work ETS was 1.153 (1.000-1.329), 2.117 (1.626-2.755), and 1.454 (1.307-1.618), respectively. The OR (95% CI) values related to childhood exposure was 1.297 (1.142-1.473), adulthood exposure 1.102 (0.937-1.296), exposure lower than 20 cigarette/day 1.088 (0.809-1.464), higher than 20 cigarette/day 1.776 (1.392-2.267), male 1.555 (1.304-1.855), female 1.487 (1.265-1.748), and coal use 1.490 (1.330-1.669). Conclusion: The meta-analysis provided evidence that indoor coal use and ETS were significantly associated with lung cancer in China.


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