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Household Fuel Use and the Risk of Gastrointestinal Cancers: The Golestan Cohort Study.

Published version
Peer-reviewed

Type

Article

Change log

Authors

Sheikh, Mahdi 
Poustchi, Hossein 
Pourshams, Akram 
Khoshnia, Masoud 
Gharavi, Abdolsamad 

Abstract

BACKGROUND: Three billion people burn nonclean fuels for household purposes. Limited evidence suggests a link between household fuel use and gastrointestinal (GI) cancers. OBJECTIVES: We investigated the relationship between indoor burning of biomass, kerosene, and natural gas with the subsequent risk of GI cancers. METHODS: During the period 2004-2008, a total of 50,045 Iranian individuals 40-75 years of age were recruited to this prospective population-based cohort. Upon enrollment, validated data were collected on demographics, lifestyle, and exposures, including detailed data on lifetime household use of different fuels and stoves. The participants were followed through August 2018 with

                        <
                        1
                        %
                    
                 loss. RESULTS: During the follow-up, 962 participants developed GI cancers. In comparison with using predominantly gas in the recent 20-y period, using predominantly biomass was associated with higher risks of esophageal [hazard ratio (HR): 1.89; 95% confidence interval (CI): 1.02, 3.50], and gastric HR: 1.83; 95% CI: 1.01, 3.31) cancers, whereas using predominantly kerosene was associated with higher risk of esophageal cancer (HR: 1.84; 95% CI: 1.10, 3.10). Lifetime duration of biomass burning for both cooking and house heating (exclusive biomass usage) using heating-stoves without chimney was associated with higher risk of GI cancers combined (10-y HR: 1.14; 95% CI: 1.07, 1.21), esophageal (10-y HR: 1.19; 95% CI: 1.08, 1.30), gastric (10-y HR: 1.11; 95% CI: 1.00, 1.23), and colon (10-y HR: 1.26; 95% CI: 1.03, 1.54) cancers. The risks of GI cancers combined, esophageal cancer, and gastric cancer were lower when biomass was burned using chimney-equipped heating-stoves (strata difference 
                    
                        p
                        -values
                        =
                        0.001
                    
                , 0.003, and 0.094, respectively). Duration of exclusive kerosene burning using heating-stoves without chimney was associated with higher risk of GI cancers combined (10-y HR: 1.05; 95% CI: 1.00, 1.11), and esophageal cancer (10-y HR: 1.14; 95% CI: 1.04, 1.26). DISCUSSION: Household burning of biomass or kerosene, especially without a chimney, was associated with higher risk of some digestive cancers. Using chimney-equipped stoves and replacing these fuels with natural gas may be useful interventions to reduce the burden of GI cancers worldwide. https://doi.org/10.1289/EHP5907.

Description

Keywords

Adult, Aged, Air Pollution, Indoor, Biomass, Cohort Studies, Cooking, Environmental Exposure, Family Characteristics, Female, Gastrointestinal Neoplasms, Heating, Household Articles, Humans, Iran, Kerosene, Male, Middle Aged, Natural Gas, Prospective Studies, Risk Factors, Wood

Journal Title

Environmental Health Perspectives

Conference Name

Journal ISSN

0091-6765
1552-9924

Volume Title

128

Publisher

The National Institute of Environmental Health Sciences (NIEHS)

Rights

All rights reserved
Sponsorship
Cancer Research Uk (None)
Cancer Research Uk (None)