Transcript Association of lung cancer and mould in the flat in an environmental

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,
4Nomogram
Budapest
Ltd., Budapest
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
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
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
ISEE/CEEC Meeting,
Budapest, Hungary, 9–11 June 2005
Features of >35 year olds
Nyergesújfalu, 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
Lung cancer cases and prevalences
by gender, age and smoking
Nyergesújfalu, Hungary, 1998
4
%
3
2
1
3
8
2
2
3
4
4
7
N
0
Women Men 35+ 45+ 55+ 65+ ys Non-/Smokers
(2-sided Fisher exact test: not significant at p<0.05)
ISEE/CEEC Meeting,
Budapest, Hungary, 9–11 June 2005
Associations of gender, age and smoking
with lung cancer
Nyergesújfalu, 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
Lung cancer cases and prevalences
by workplace dustiness and mould in the flat
%
Nyergesújfalu, Hungary, 1998
10
9
8
7
6
5
4
3
2
1
0
*
7
*
3
7
4
+
+
Dusty workplace, Persistent mould
>20 ys
in the flat
(2-sided Fisher exact test: *p<0.05)
N
ISEE/CEEC Meeting,
Budapest, Hungary, 9–11 June 2005
Associations of dusty workplace and mould
with lung cancer
Nyergesújfalu, 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
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
ISEE/CEEC Meeting,
Budapest, Hungary, 9–11 June 2005
Thank you for your attention!
E-mail: [email protected]
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:
95% CI=0.25–4.46
mOR=1.06,
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!!!)