RT Journal Article
SR Electronic
T1 Does household use of biomass fuel cause lung cancer? A systematic review and evaluation of the evidence for the GBD 2010 study
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 433
OP 441
DO 10.1136/thoraxjnl-2014-206625
VO 70
IS 5
A1 Nigel Bruce
A1 Mukesh Dherani
A1 Rui Liu
A1 H Dean Hosgood III
A1 Amir Sapkota
A1 Kirk R Smith
A1 Kurt Straif
A1 Qing Lan
A1 Daniel Pope
YR 2015
UL http://thorax.bmj.com/content/70/5/433.abstract
AB Background Around 2.4 billion people use traditional biomass fuels for household cooking or heating. In 2006, the International Agency for Research on Cancer (IARC) concluded emissions from household coal combustion are a Group 1 carcinogen, while those from biomass were categorised as 2A due to epidemiologic limitations. This review updates the epidemiologic evidence and provides risk estimates for the 2010 Global Burden of Disease study. Methods Searches were conducted of 10 databases to July 2012 for studies of clinically diagnosed or pathologically confirmed lung cancer associated with household biomass use for cooking and/or heating. Findings Fourteen eligible studies of biomass cooking or heating were identified: 13 had independent estimates (12 cooking only), all were case-control designs and provided 8221 cases and 11 342 controls. The ORs for lung cancer risk with biomass for cooking and/or heating were OR 1.17 (95% CI 1.01 to 1.37) overall, and 1.15 (95% CI 0.97 to 1.37) for cooking only. Publication bias was not detected, but more than half the studies did not explicitly describe a clean reference category. Sensitivity analyses restricted to studies with adequate adjustment and a clean reference category found ORs of 1.21 (95% CI 1.05 to 1.39) for men (two reports, compiling five studies) and 1.95 (95% CI 1.16 to 3.27) for women (five reports, compiling eight studies). Exposure–response evidence was seen for men, and higher risk for women in developing compared with developed countries, consistent with higher exposures in the former. Conclusions There is now stronger evidence for biomass fuel use causing lung cancer, but future studies need better exposure assessment to strengthen exposure–response evidence.