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Association of lung cancer and mould in the flat in an environmental epidemiological survey

ISEE/CEEC Meeting, Budapest, Hungary, 9–11 June 2005. Association of lung cancer and mould in the flat in an environmental epidemiological survey Mihály János VARRÓ 1 , Mária POSGAY 2 , György UNGVÁRY 3 , Zsolt LANG 4

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Association of lung cancer and mould in the flat in an environmental epidemiological survey

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  1. ISEE/CEEC Meeting, Budapest, Hungary, 9–11 June 2005 Association of lung cancer and mould in the flat in an environmental epidemiological survey Mihály János VARRÓ1, Mária POSGAY2, György UNGVÁRY3, Zsolt LANG4 1National Institute of Environmental Health, “Fodor József” National Center for Public Health (NCPH), Budapest 2National Institute of Occupational Health, NCPH, Budapest 3NCPH, Budapest 4Nomogram Ltd., Budapest

  2. ISEE/CEEC Meeting, Budapest, Hungary, 9–11 June 2005 Introduction A survey – To evaluate the health impact of environmental asbestos exposure – Lung cancer & mould in the flat Objective • To assess associations • between mould in the flat and lung cancer • in an adult town population

  3. ISEE/CEEC Meeting, Budapest, Hungary, 9–11 June 2005 Methods 1. • Questionnaire study • – Interviewers • – 2007 standardized questionnaires • – Nyergesújfalu, Hungary • (asbestos cement factory) • – >35 years • – Both genders

  4. ISEE/CEEC Meeting, Budapest, Hungary, 9–11 June 2005 Methods 2. • Data processing • – Data entry: Epi Info 6.04d • – Analysis: Stata 7.0 • – Occupationally exposed to asbestos: excluded • – Crude odds ratios (cORs) / adjusted ORs (aORs) • (gender, age groups of 10 years, smoking behaviour) • – 95% confidence intervals (95% CI) • – 1470 subjects

  5. ISEE/CEEC Meeting, Budapest, Hungary, 9–11 June 2005 Features of >35 year oldsNyergesújfalu, Hungary, 1998 – 630 (of 1465, 43.0%) male and 835 (57.0%) female – Median age: 53 years (interquartile range=44–63 years) – 745 (of 1466, 50.8%) smoked (currently or formerly) – 11 (of 1450, 0.8%) lung cancer – 92 (of 1354, 6.8%) worked >20 years in a dusty workplace – 132 (of 1437, 9.2%) persistent mould in the flat

  6. 3 8 2 2 3 4 4 7 N Women Men 35+ 45+ 55+ 65+ ys Non-/Smokers (2-sided Fisher exact test: not significant at p<0.05) Lung cancer cases and prevalences by gender, age and smokingNyergesújfalu, Hungary, 1998

  7. ISEE/CEEC Meeting, Budapest, Hungary, 9–11 June 2005 Associations of gender, age and smoking with lung cancerNyergesújfalu, Hungary, 1998 Gender (male) – cOR=3.51, 95% CI=0.94–13.48 – aOR=3.28, 95% CI=0.79–13.70 Age (+10 years) – cOR=1.40, 95% CI=0.81–2.41 – aOR=1.43, 95% CI=0.81–2.52 Smoking (current or past) – cOR=1.69, 95% CI=0.49–5.79 – aOR=1.25, 95% CI=0.33–4.77 Goodness-of-fit p=0,73

  8. Lung cancer cases and prevalences by workplace dustiness and mould in the flatNyergesújfalu, Hungary, 1998 0 * * 7 3 7 4 N - + - + Dusty workplace, Persistent mould>20 ys in the flat (2-sided Fisher exact test: *p<0.05)

  9. ISEE/CEEC Meeting, Budapest, Hungary, 9–11 June 2005 Associations of dusty workplace and mould with lung cancerNyergesújfalu, Hungary, 1998 Dusty workplace for >20 years – cOR=6.10**, 95% CI=1.55–23.99 – aOR=4.17*, 95% CI=1.02–16.88 Goodness-of-fit p=0,92 Persistent mould in the flat – cOR=5.76**, 95% CI=1.66–19.96 – aOR=6.13**, 95% CI=1.73–21.67 Goodness-of-fit p=0,81 *p<0.05; **p<0.01

  10. ISEE/CEEC Meeting, Budapest, Hungary, 9–11 June 2005 Conclusions A strong assocation (even if adjusted) – mould in the flat & lung cancer E. g.: aflatoxin B1 – IARC Class 1 human carcinogen – It is to consider: the possible carcinogenic role of airborne mycotoxins – The number of lung cancer cases: few – The association: highly significant – Further literature and field research is needed

  11. ISEE/CEEC Meeting, Budapest, Hungary, 9–11 June 2005 Thank you for your attention! E-mail: varromj@okk.antsz.hu

  12. ISEE/CEEC Meeting, Budapest, Hungary, 9–11 June 2005 A model for lung cancer Nyergesújfalu, Hungary, 1998 Gender (male): mOR=3.18, 95% CI=0.69–14.72 Age (+10 years): mOR=1.49, 95% CI=0.79–2.81 Smoking: mOR=1.06, 95% CI=0.25–4.46 Dusty w. >20 ys: mOR=3.67, 95% CI=0.89–15.08 Mould in the flat: mOR=6.67**, 95% CI=1.77–25.18 Goodness-of-fit p=0,94 **p<0.01 (Statistical validation: not possible!!!)

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