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Indoor Air Pollution, Environmental Tobacco Smoking, and Lung Cancer

The 5th International Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, Sichuan, P.R. China April 7-10, 2010 . Indoor Air Pollution, Environmental Tobacco Smoking, and Lung Cancer. Zuo-Feng Zhang, MD, PhD Professor, Department of Epidemiology

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Indoor Air Pollution, Environmental Tobacco Smoking, and Lung Cancer

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  1. The 5th International Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, Sichuan, P.R. China April 7-10, 2010 Indoor Air Pollution, Environmental Tobacco Smoking, and Lung Cancer Zuo-Feng Zhang, MD, PhD Professor, Department of Epidemiology UCLA School of Public Health UCLA Center for Environmental Genomics

  2. Source: Peto J, 2001

  3. Age Standardized Incidence Rates (/100,000) Source: GLOBOCAN 2002

  4. Age-standardized Incidence Rates For Lung Cancer Source: Figure 5: Parkin DM, et al. CA Cancer J Clin [2005]; 55: 74-108

  5. Risk Factors for Lung Cancer Tobacco smoking Second hand smoking (passive smoking) Asbestos Radon exposure Occupational exposures Air pollution Other radiation Recurring inflammation Family history of cancer Insufficient diet and poor nutritional factors

  6. China-UCLA Lung Cancer Consortium Taiyuan, Air Pollution and Lung Cancer: 400 cases/ 400 controls Jiangsu: Epidemiology of Top 4 Cancers (Lung, esophagus, liver and stomach) Fuzhou, Air Pollution and DNA Repair Genes and Lung Cancer: 600 cases and 600 controls

  7. Specific Aims of the China-UCLA Lung Cancer Consortium • To identify novel environmental risk and protective factors • To evaluate genetic susceptibility • To assess potential environment-gene interactions

  8. Indoor Air Pollution in China, Preliminary Results

  9. TaiYuan Project Cases: 396 newly diagnosed patients with lung cancer from major cancer hospitals in this city between 2006-2007; Control: 465 healthy control from the same source population; Epidemiological data were collected by in-person interview using a standard questionnaire;

  10. Second Hand Smoking (SHS) and Lung Cancer Risk among Non-Smokers (Taiyuan)

  11. Household Second Hand Smoking Exposure and Lung Cancer Risk among Non-smokers

  12. Indoor Air pollution Index and Lung Cancer Risk Index: Sum of Indoor Air Pollution Exposure Cooking fuel(0,1), heating (0,1,2), Ventilation(0,1,2), Fry cooking(0,1), SHS (0,1)

  13. Indoor Particle Exposure Measurement A Particle Mass Monitor PM1, PM2.5, PM 7, PM10, TSP Indoor: Living room, bed room, kitchen; --Twice for each room Outdoor Two season: Heating season/non-heating season

  14. mg/m3 0.12 PM1 Case 0.1 PM1 Control 0.08 0.06 0.04 0.02 0 Living Bed room Kitchen Living Bed room Kitchen room room Winter Summer PM1 comparison among cases and controls Correlation between Indoor Air pollution Index and PM1 Concentration

  15. Indoor PM1 and Lung Cancer Risk * : PM1: High (>50%) vs Low (<50%)

  16. Conclusion • Indoor Air pollution, SHS, solid fuel exposure, cooking, poor ventilation may be associated with lung cancer • Indoor PM1 concentration may be associated with lung cancer • Potential gene-environmental exposure interaction.

  17. Second Hand Smoking and Lung Cancer Among Non-smokers, International Lung Cancer Consortium (ILCCO)

  18. Second hand smoking and lung cancer among 7,170 cases and 9,186 controls, ILCCO

  19. ETS and lung cancer among non-smokers, 2,218 cases and 6,243 controls, ILCCO

  20. SNPs Associated with Lung Cancer among Non-Smokers • OGG1 S326C • XRCC1 R194W • XPD D312N

  21. Theoretical model of gene-environmental interaction pathway for lung cancer susceptibility Tobacco/alcohol infection Environmental Carcinogens / Procarcinogens Exposures Ile105Val  Ala114Val Null  Diet and nutritional factors GSTP1 GSTM1 CYP2E1 Nitrosemins, Xenobiotics, Diet/nutrient Detoxified carcinogens Active carcinogens Tyr113His His139Arg Pro187Ser Tyr113His His139Arg mEH mEH NQO1 Normal cell DNA Damage XRCC3 M G1 G2 P53 P16 Arg72Pro Ala146Thr S Cyclin D1 G870A Programmed cell death Carcinogenesis Diet/nutrient Free radicals Oxidative Stress DNA damage repaired Defected DNA repair gene If DNA damage not repaired G0 If loose cell cycle control

  22. DNA repair Risk of Lung Cancer Associated with Low DRC 6 In Vitro Adduct Assay (genomic DNA) 5 Trend test : P < 0.001 4 3 Odds Ratio 2 1 0 Ist 2nd 3rd 4th DRC (%) by Quartile High Low Li et al, Cancer Res., 2001 Friedberg, Nature Reviews Cancer 2001; 1: 22-33

  23. Indoor Air Pollution, XRCC1 194 Polymorphism and Lung Cancer 100 OR 10 1 0.1 Arg/Arg Any Trp Arg/Arg Any Trp Arg/Arg Any Trp Indoor(-) Indoor(+) Indoor(++)

  24. Acknowledgements Fudan University Lina Mu Shunzhang Yu Qingwu Jiang Fuzhou Medical University Lin Cai Taiyuan CDC Li Liu Jianping Shi Baoxing Zhao UCLA Shun-Chun Chuang Yifang Zhu Jiangsu CDC Jinkou Zhao Hua Wang Shanxi Tumor hospital Ruigui Niu XiaoYou Han The study was supported in Part by National Natural Science Foundation of China

  25. Acknowledgements • T32 CA09142 (PI: Zhang), NIH/NCI, Cancer Epidemiology Training Program • P50 CA90833 (Project PI: Zhang),NIH NCI. Molecular Epidemiology of Lung Cancer • D43 TW000013-21S2 (Co-PIs: Zhang/ Detels) NIH/Fogarty. UCLA Fogarty AITRP: Molecular Epidemiology of HIV-AIDS-related Malignancies in China • D43 TW000013-20S (Co-PIs: Zhang/Detels). NIH Fogarty: International Training in Epidemiology Related to AIDS: HIV-AIDS-related Cancer in China

  26. UCLA is the largest comprehensive university in West Coast with shortest distance to China UCLA

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