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Lung cancer risk and pollution in an industrial region of Northern Spain: a hospital-based case-control study

María Felicitas López-Cima123*, Javier García-Pérez12, Beatriz Pérez-Gómez12, Nuria Aragonés12, Gonzalo López-Abente12, Adonina Tardón23 and Marina Pollán12

  • * Corresponding author: María F López-Cima flcina@isciii.es

  • † Equal contributors

Author Affiliations

1 Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain

2 CIBER en Epidemiología y Salud Pública (CIBERESP), Spain

3 Molecular Epidemiology of Cancer Unit, University Institute of Oncology, University of Oviedo, C/Fernando Bongera, s/n, 33006 Oviedo, Spain

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International Journal of Health Geographics 2011, 10:10  doi:10.1186/1476-072X-10-10

Published: 25 January 2011

Abstract

Background

Asturias, an Autonomous Region in Northern Spain with a large industrial area, registers high lung cancer incidence and mortality. While this excess risk of lung cancer might be partially attributable to smoking habit and occupational exposure, the role of industrial and urban pollution also needs to be assessed. The objective was to ascertain the possible effect of air pollution, both urban and industrial, on lung cancer risk in Asturias.

Methods

This was a hospital-based case-control study covering 626 lung cancer patients and 626 controls recruited in Asturias and matched by ethnicity, hospital, age, and sex. Distances from the respective participants' residential locations to industrial facilities and city centers were computed. Using logistic regression, odds ratios (ORs) and 95% confidence intervals (95%CIs) for categories of distance to urban and industrial pollution sources were calculated, with adjustment for sex, age, hospital area, tobacco consumption, family history of cancer, and occupation.

Results

Whereas individuals living near industries displayed an excess risk of lung cancer (OR = 1.49; 95%CI = 0.93-2.39), which attained statistical significance for small cell carcinomas (OR = 2.23; 95%CI = 1.01-4.92), residents in urban areas showed a statistically significant increased risk for adenocarcinoma (OR = 1.92; 95%CI = 1.09-3.38). In the Gijon health area, residents in the urban area registered a statistically significant increased risk of lung cancer (OR = 2.17; 95%CI = 1.25-3.76), whereas in the Aviles health area, no differences in risk were found by area of exposure.

Conclusions

This study provides further evidence that air pollution is a moderate risk factor for lung cancer.