Air Pollution in England, 3 Countries Tied to Lung Cancer

TOPLINE:
Long-term residential exposure to fine particulate matter, nitrogen dioxide, and black carbon are positively linked to lung cancer incidence and mortality, with similar risks found across all four jurisdictions under study (England, Norway, Denmark, and Rome). A negative association was found for warm-season ozone.
METHODOLOGY:
This study, known as ELAPSE, analysed residential exposure to annual averages of four pollutants across four administrative cohorts in Denmark (2000-2015), England (2011-2017), Norway (2001-2016), and Rome, Italy (2001-2015).
Cohort-specific hazard ratios were calculated based on hospital admission records or cancer registries.
A meta-analysis across the four cohorts was also conducted.
TAKEAWAY:
Nearly 112,000 incident lung cancers occurred with more than 9.3 million person-years of follow-up.
All four jurisdictions showed similar risks.
The meta-analysis found a 14% increase in incident lung cancers for every 5 µg/m3 increase in particulate matter2.5, a 10% increase for every 10 µg/m3 increase in nitrogen dioxide, and an 8% increase for every 0.5 x 10−5/m increase in black carbon, whereas warm season ozone was negatively associated with the risk for lung cancer.
Risks for lung cancer incidence were identical to or slightly stronger than those for lung cancer mortality, most likely because of lung cancer’s high case fatality rate.
IN PRACTICE:
The authors concluded that, “Our study found positive associations between incident lung cancer and residential exposure…which persisted at pollution levels below the current EU limits. We estimated that up to 31.7% incident lung cancer cases can potentially be prevented by achieving the 2021 WHO [Air Quality Guidelines].”
SOURCE:
The lead and corresponding author is Jie Chen of Utrecht University, Utrecht, the Netherlands. The study appeared in Environmental Research.
LIMITATIONS:
Limitations included an observational study design and a lack of generalisability of results to high levels of exposure to air pollutants.
DISCLOSURES:
The authors declared no conflicts of interest. The study was funded by the Cancer Registry of Norway and other sources.
 
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