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. 2000 Aug;108(Suppl 4):743–750. doi: 10.1289/ehp.00108s4743

Outdoor air pollution and lung cancer.

A J Cohen 1
PMCID: PMC1637685  PMID: 10931793

Abstract

In the 1950s evidence of an ongoing epidemic of lung cancer in the United States and Western Europe led researchers to examine the role of outdoor air pollution, which was considered by some to be a likely cause. Although epidemiologic research quickly identified the central role of cigarette smoking in this epidemic, and despite progress in reducing outdoor air pollution in Western industrialized countries, concerns that ambient air pollution is causing lung cancer have persisted to the present day. This concern is based on the fact that known carcinogens continue to be released into outdoor air from industrial sources, power plants, and motor vehicles, and on a body of epidemiologic research that provides some evidence for an association between outdoor air pollution and lung cancer. This article reviews the epidemiologic evidence for this association and discusses the limitations of current studies for estimating the lung cancer risk in the general population. It also identifies research needs and suggests possible approaches to addressing outstanding questions.

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Selected References

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  1. Archer V. E. Air pollution and fatal lung disease in three Utah counties. Arch Environ Health. 1990 Nov-Dec;45(6):325–334. doi: 10.1080/00039896.1990.10118751. [DOI] [PubMed] [Google Scholar]
  2. Barbone F., Bovenzi M., Cavallieri F., Stanta G. Air pollution and lung cancer in Trieste, Italy. Am J Epidemiol. 1995 Jun 15;141(12):1161–1169. doi: 10.1093/oxfordjournals.aje.a117389. [DOI] [PubMed] [Google Scholar]
  3. Beeson W. L., Abbey D. E., Knutsen S. F. Long-term concentrations of ambient air pollutants and incident lung cancer in California adults: results from the AHSMOG study.Adventist Health Study on Smog. Environ Health Perspect. 1998 Dec;106(12):813–822. doi: 10.1289/ehp.106-1533247. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Birkett N. J. Effect of nondifferential misclassification on estimates of odds ratios with multiple levels of exposure. Am J Epidemiol. 1992 Aug 1;136(3):356–362. doi: 10.1093/oxfordjournals.aje.a116500. [DOI] [PubMed] [Google Scholar]
  5. Boffetta P., Jourenkova N., Gustavsson P. Cancer risk from occupational and environmental exposure to polycyclic aromatic hydrocarbons. Cancer Causes Control. 1997 May;8(3):444–472. doi: 10.1023/a:1018465507029. [DOI] [PubMed] [Google Scholar]
  6. Buffler P. A., Cooper S. P., Stinnett S., Contant C., Shirts S., Hardy R. J., Agu V., Gehan B., Burau K. Air pollution and lung cancer mortality in Harris County, Texas, 1979-1981. Am J Epidemiol. 1988 Oct;128(4):683–699. doi: 10.1093/oxfordjournals.aje.a115022. [DOI] [PubMed] [Google Scholar]
  7. Cohen A. J., Pope C. A., 3rd, Speizer F. E. Ambient air pollution as a risk factor for lung cancer. Salud Publica Mex. 1997 Jul-Aug;39(4):346–355. doi: 10.1590/s0036-36341997000400012. [DOI] [PubMed] [Google Scholar]
  8. DOLL R., HILL A. B. Smoking and carcinoma of the lung; preliminary report. Br Med J. 1950 Sep 30;2(4682):739–748. doi: 10.1136/bmj.2.4682.739. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Detels R., Tashkin D. P., Sayre J. W., Rokaw S. N., Massey F. J., Jr, Coulson A. H., Wegman D. H. The UCLA population studies of CORD: X. A cohort study of changes in respiratory function associated with chronic exposure to SOx, NOx, and hydrocarbons. Am J Public Health. 1991 Mar;81(3):350–359. doi: 10.2105/ajph.81.3.350. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Dockery D. W., Pope C. A., 3rd, Xu X., Spengler J. D., Ware J. H., Fay M. E., Ferris B. G., Jr, Speizer F. E. An association between air pollution and mortality in six U.S. cities. N Engl J Med. 1993 Dec 9;329(24):1753–1759. doi: 10.1056/NEJM199312093292401. [DOI] [PubMed] [Google Scholar]
  11. Dosemeci M., Wacholder S., Lubin J. H. Does nondifferential misclassification of exposure always bias a true effect toward the null value? Am J Epidemiol. 1990 Oct;132(4):746–748. doi: 10.1093/oxfordjournals.aje.a115716. [DOI] [PubMed] [Google Scholar]
  12. Elliott P., Shaddick G., Kleinschmidt I., Jolley D., Walls P., Beresford J., Grundy C. Cancer incidence near municipal solid waste incinerators in Great Britain. Br J Cancer. 1996 Mar;73(5):702–710. doi: 10.1038/bjc.1996.122. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Garcia-Closas M., Rothman N., Lubin J. Misclassification in case-control studies of gene-environment interactions: assessment of bias and sample size. Cancer Epidemiol Biomarkers Prev. 1999 Dec;8(12):1043–1050. [PubMed] [Google Scholar]
  14. Greenland S., Robins J. Invited commentary: ecologic studies--biases, misconceptions, and counterexamples. Am J Epidemiol. 1994 Apr 15;139(8):747–760. doi: 10.1093/oxfordjournals.aje.a117069. [DOI] [PubMed] [Google Scholar]
  15. Greenland S. The effect of misclassification in the presence of covariates. Am J Epidemiol. 1980 Oct;112(4):564–569. doi: 10.1093/oxfordjournals.aje.a113025. [DOI] [PubMed] [Google Scholar]
  16. Hatch M., Thomas D. Measurement issues in environmental epidemiology. Environ Health Perspect. 1993 Dec;101 (Suppl 4):49–57. doi: 10.1289/ehp.93101s449. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Hemminki K., Dickey C., Karlsson S., Bell D., Hsu Y., Tsai W. Y., Mooney L. A., Savela K., Perera F. P. Aromatic DNA adducts in foundry workers in relation to exposure, life style and CYP1A1 and glutathione transferase M1 genotype. Carcinogenesis. 1997 Feb;18(2):345–350. doi: 10.1093/carcin/18.2.345. [DOI] [PubMed] [Google Scholar]
  18. Henderson B. E., Gordon R. J., Menck H., Soohoo J., Martin S. P., Pike M. C. Lung cancer and air pollution in southcentral Los Angeles County. Am J Epidemiol. 1975 Jun;101(6):477–488. doi: 10.1093/oxfordjournals.aje.a112118. [DOI] [PubMed] [Google Scholar]
  19. Jedrychowski W., Becher H., Wahrendorf J., Basa-Cierpialek Z. A case-control study of lung cancer with special reference to the effect of air pollution in Poland. J Epidemiol Community Health. 1990 Jun;44(2):114–120. doi: 10.1136/jech.44.2.114. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Kafadar K., Freedman L. S., Goodall C. R., Tukey J. W. Urbanicity-related trends in lung cancer mortality in US counties: white females and white males, 1970-1987. Int J Epidemiol. 1996 Oct;25(5):918–932. doi: 10.1093/ije/25.5.918. [DOI] [PubMed] [Google Scholar]
  21. Katsouyanni K., Karakatsani A., Messari I., Touloumi G., Hatzakis A., Kalandidi A., Trichopoulos D. Air pollution and cause specific mortality in Athens. J Epidemiol Community Health. 1990 Dec;44(4):321–324. doi: 10.1136/jech.44.4.321. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Künzli N., Lurmann F., Segal M., Ngo L., Balmes J., Tager I. B. Association between lifetime ambient ozone exposure and pulmonary function in college freshmen--results of a pilot study. Environ Res. 1997 Jan;72(1):8–23. doi: 10.1006/enrs.1996.3687. [DOI] [PubMed] [Google Scholar]
  23. Lipsett M., Campleman S. Occupational exposure to diesel exhaust and lung cancer: a meta-analysis. Am J Public Health. 1999 Jul;89(7):1009–1017. doi: 10.2105/ajph.89.7.1009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Lubin J. H., Gail M. H. On power and sample size for studying features of the relative odds of disease. Am J Epidemiol. 1990 Mar;131(3):552–566. doi: 10.1093/oxfordjournals.aje.a115530. [DOI] [PubMed] [Google Scholar]
  25. Lubin J. H., Samet J. M., Weinberg C. Design issues in epidemiologic studies of indoor exposure to Rn and risk of lung cancer. Health Phys. 1990 Dec;59(6):807–817. doi: 10.1097/00004032-199012000-00004. [DOI] [PubMed] [Google Scholar]
  26. Merlo F., Andreassen A., Weston A., Pan C. F., Haugen A., Valerio F., Reggiardo G., Fontana V., Garte S., Puntoni R. Urinary excretion of 1-hydroxypyrene as a marker for exposure to urban air levels of polycyclic aromatic hydrocarbons. Cancer Epidemiol Biomarkers Prev. 1998 Feb;7(2):147–155. [PubMed] [Google Scholar]
  27. Motykiewicz G., Perera F. P., Santella R. M., Hemminki K., Seemayer N. H., Chorazy M. Assessment of cancer hazard from environmental pollution in Silesia. Toxicol Lett. 1996 Nov;88(1-3):169–173. doi: 10.1016/0378-4274(96)03734-4. [DOI] [PubMed] [Google Scholar]
  28. Natusch D. F. Potentially carcinogenic species emitted to the atmosphere by fossil-fueled power plants. Environ Health Perspect. 1978 Feb;22:79–90. doi: 10.1289/ehp.782279. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Nielsen P. S., de Pater N., Okkels H., Autrup H. Environmental air pollution and DNA adducts in Copenhagen bus drivers--effect of GSTM1 and NAT2 genotypes on adduct levels. Carcinogenesis. 1996 May;17(5):1021–1027. doi: 10.1093/carcin/17.5.1021. [DOI] [PubMed] [Google Scholar]
  30. Perera F. P., Hemminki K., Gryzbowska E., Motykiewicz G., Michalska J., Santella R. M., Young T. L., Dickey C., Brandt-Rauf P., De Vivo I. Molecular and genetic damage in humans from environmental pollution in Poland. Nature. 1992 Nov 19;360(6401):256–258. doi: 10.1038/360256a0. [DOI] [PubMed] [Google Scholar]
  31. Perera F. P., Mooney L. A., Dickey C. P., Santella R. M., Bell D., Blaner W., Tang D., Whyatt R. M. Molecular epidemiology in environmental carcinogenesis. Environ Health Perspect. 1996 May;104 (Suppl 3):441–443. doi: 10.1289/ehp.96104s3441. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Pershagen G., Elinder C. G., Bolander A. M. Mortality in a region surrounding an arsenic emitting plant. Environ Health Perspect. 1977 Aug;19:133–137. doi: 10.1289/ehp.7719133. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Peters J. M., Avol E., Gauderman W. J., Linn W. S., Navidi W., London S. J., Margolis H., Rappaport E., Vora H., Gong H., Jr A study of twelve Southern California communities with differing levels and types of air pollution. II. Effects on pulmonary function. Am J Respir Crit Care Med. 1999 Mar;159(3):768–775. doi: 10.1164/ajrccm.159.3.9804144. [DOI] [PubMed] [Google Scholar]
  34. Peters J. M., Avol E., Navidi W., London S. J., Gauderman W. J., Lurmann F., Linn W. S., Margolis H., Rappaport E., Gong H. A study of twelve Southern California communities with differing levels and types of air pollution. I. Prevalence of respiratory morbidity. Am J Respir Crit Care Med. 1999 Mar;159(3):760–767. doi: 10.1164/ajrccm.159.3.9804143. [DOI] [PubMed] [Google Scholar]
  35. Pope C. A., 3rd, Thun M. J., Namboodiri M. M., Dockery D. W., Evans J. S., Speizer F. E., Heath C. W., Jr Particulate air pollution as a predictor of mortality in a prospective study of U.S. adults. Am J Respir Crit Care Med. 1995 Mar;151(3 Pt 1):669–674. doi: 10.1164/ajrccm/151.3_Pt_1.669. [DOI] [PubMed] [Google Scholar]
  36. Raizenne M., Neas L. M., Damokosh A. I., Dockery D. W., Spengler J. D., Koutrakis P., Ware J. H., Speizer F. E. Health effects of acid aerosols on North American children: pulmonary function. Environ Health Perspect. 1996 May;104(5):506–514. doi: 10.1289/ehp.96104506. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Redmond C. K. Cancer mortality among coke oven workers. Environ Health Perspect. 1983 Oct;52:67–73. doi: 10.1289/ehp.835267. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Vena J. E. Air pollution as a risk factor in lung cancer. Am J Epidemiol. 1982 Jul;116(1):42–56. doi: 10.1093/oxfordjournals.aje.a113401. [DOI] [PubMed] [Google Scholar]
  39. White C. Research on smoking and lung cancer: a landmark in the history of chronic disease epidemiology. Yale J Biol Med. 1990 Jan-Feb;63(1):29–46. [PMC free article] [PubMed] [Google Scholar]
  40. Xu Z. Y., Blot W. J., Xiao H. P., Wu A., Feng Y. P., Stone B. J., Sun J., Ershow A. G., Henderson B. E., Fraumeni J. F., Jr Smoking, air pollution, and the high rates of lung cancer in Shenyang, China. J Natl Cancer Inst. 1989 Dec 6;81(23):1800–1806. doi: 10.1093/jnci/81.23.1800. [DOI] [PubMed] [Google Scholar]
  41. van der Lende R., Kok T. J., Reig R. P., Quanjer P. H., Schouten J. P., Orie N. G. Decreases in VC and FEV1 with time: indicators for effects of smoking and air pollution. Bull Eur Physiopathol Respir. 1981;17(5):775–792. [PubMed] [Google Scholar]

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