Research Opportunities for Cancer Associated with Indoor Air Pollution from Solid-Fuel Combustion

Britt C. Reid,¹ Armen A. Ghazarian,¹ David M. DeMarini,² Amir Sapkota,³ Darby Jack,⁴ Qing Lan,⁵ Deborah M. Winn,¹ and Linda S. Birnbaum^6,7

¹Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Department of Health and Human Services (NIH, DHHS), Bethesda, Maryland, USA; ²Integrated Systems Toxicology Division, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina, USA; ³Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, Maryland, USA; ⁴Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA; ⁵Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland, USA; ⁶National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle Park, North Carolina, USA; ⁷National Cancer Institute, NIH, DHHS, Research Triangle Park, North Carolina, USA


Abstract

Background: Indoor air pollution (IAP) derived largely from the use of solid fuels for cooking and heating affects about 3 billion people worldwide, resulting in substantial adverse health outcomes, including cancer. Women and children from developing countries are the most exposed populations. A workshop was held in Arlington, Virginia, 9–11 May 2011, to better understand women’s and children’s potential health effects from IAP in developing countries. Workshop participants included international scientists, manufacturers, policy and regulatory officials, community leaders, and advocates who held extensive discussions to help identify future research needs.


Objectives: Our objective was to identify research opportunities regarding IAP and cancer, including research questions that could be incorporated into studies of interventions to reduce IAP exposure. In this commentary, we describe the state of the science in understanding IAP and its associations with cancer and suggest research opportunities for improving our understanding of the issues.


Discussion: Opportunities for research on IAP and cancer include studies of the effect of IAP on cancers other than lung cancer; studies of genetic factors that modify susceptibility; studies to determine whether the effects of IAP are mediated via germline, somatic, and/or epigenetic changes; and studies of the effects of IAP exposure via dermal and/or oral routes.


Conclusions: IAP from indoor coal use increases the risk of lung cancer. Installing chimneys can reduce risk, and some genotypes, including GSTM1-null, can increase risk. Additional research is needed regarding the effects of IAP on other cancers and the effects of different types of solid fuels, oral and dermal routes of IAP exposure, genetic and epigenetic mechanisms, and genetic susceptibility.


Key words: cancer, environmental exposures, environmental health risks, epidemiology, household air pollution, indoor air pollution, public health, solid-fuel combustion.

Environ Health Perspect 120:1495–1498 (2012). http://dx.doi.org/10.1289/ehp.1204962 [Online 30 July 2012]


Address correspondence to B.C. Reid, Modifiable Risk Factors Branch, Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 6130 Executive Blvd., Room 5134, Bethesda, MD 20892 USA. Telephone: (301) 435-4914. Fax: (301) 435-6609. E-mail: reidbr@mail.nih.gov


We acknowledge B. Martin and J. Balbus for organizing the workshop on the “Health Burden of Indoor Air Pollution on Women and Children in Developing Countries,” 9–11 May 2011, which prompted this report.


This article includes the work of an employee of the National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH); however, the statements, opinions, or conclusions contained herein do not necessarily represent the statements, opinions, or conclusions of the NIEHS, NIH, or the U.S. government. This manuscript has been reviewed by the National Health and Environmental Effects Research Laboratory, U.S. Environmental Protection Agency, and approved for publication. Approval does not signify that the contents reflect the views of the agency, nor does mention of trade names or commercial products constitute endorsement or recommendation for use.


The authors declare they have no actual or potential competing financial interests.


Received 12 January 2012; Accepted 30 July 2012; Online 30 July 2012.