Review Advance Publication
Outdoor Particulate Matter Exposure and Lung Cancer: A Systematic Review and Meta-Analysis
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Citation: Hamra GB, Guha N, Cohen A, Laden F, Raaschou-Nielsen O, Samet JM, Vineis P, Forastiere F, Saldiva P, Yorifuji T, Loomis D. Outdoor Particulate Matter Exposure and Lung Cancer: A Systematic Review and Meta-Analysis. Environ Health Perspect; http://dx.doi.org/10.1289/ehp.1408092.
Received: 6 January 2014
Accepted: 3 June 2014
Advance Publication: 6 June 2014
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Background: Particulate matter (PM) in outdoor air pollution was recently designated a Group I carcinogen by the International Agency for Research on Cancer (IARC). This determination was based on the evidence regarding the relationship of PM2.5 and PM10 to lung cancer risk; however, the IARC evaluation did not include a quantitative summary of the evidence.
Objective: To provide a systematic review and quantitative summary of the evidence regarding the relationship between PM and lung cancer.
Methods: We conducted meta-analyses of studies examining the relationship of exposure to PM2.5 and PM10 with lung cancer incidence and mortality. In total, 18 studies met inclusion criteria and provided the information necessary to estimate the change in lung cancer risk per 10-μg/m3 increase in exposure to PM. We used random effects analyses to allow between study variability to contribute to meta-estimates.
Results: The meta-relative risk (95% CI) for lung cancer associated with PM2.5 was 1.09 (95% CI: 1.04, 1.14). The meta-relative risk of lung cancer associated with PM10 was similar, but less precise: 1.08 (95% CI: 1.00, 1.17). Estimates were robust to restriction to studies that considered potential confounders, as well as sub-analyses by exposure assessment method. Analyses by smoking status showed that lung cancer risk associated with PM2.5 was greatest for former smokers, 1.44 (95% CI: 1.04, 1.22) followed by never smokers, 1.18 (95% CI: 1.00, 1.39), and then current smokers, 1.06 (95% CI: 0.97, 1.15). In addition, meta-estimates for adenocarcinoma associated with PM2.5 and PM10 were 1.40 (95% CI: 1.07, 1.83) and 1.29 (95% CI: 1.02, 1.63), respectively.
Conclusion: The results of these analyses, and the decision of the IARC working group to classify PM and outdoor air pollution as carcinogenic (Group 1), further justify efforts to reduce exposures to air pollutants that can arise from many sources.
CEHN July 2014 Article of the Month
“Outdoor Formaldehyde and NO2 Exposures and Markers of Genotoxicity in Children Living Near Chipboard Industries” (Environ Health Perspect; DOI:10.1289/ehp.1307259) has been selected by the Children’s Environmental Health Network (CEHN) as its July 2014 Article of the Month. These CEHN summaries discuss the potential policy implications of current children’s environmental health research.
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