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Rezaei N, Sharafkhah M, Farahmand Y, Sepanlou SG, Dalvand S, Poustchi H, Sajadi A, Masoudi S, Roshandel G, Khoshnia M, Eslami L, Akhlaghi M, Delavari A. Population attributable fractions of cancer mortality related to indoor air pollution, animal contact, and water source as environmental risk factors: Findings from the Golestan Cohort Study. PLoS One 2024; 19:e0304828. [PMID: 38857263 PMCID: PMC11164345 DOI: 10.1371/journal.pone.0304828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 05/15/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Environmental risk factors are significant contributors to cancer mortality, which are neglected. PURPOSE This study aimed to estimate the population attributable fraction of cancer mortality due to the environmental risk factors. METHODS Golestan cohort study is a population-base cohort on 50045 participants between 40-75 with about 18 years of follow up. We detected 2,196 cancer mortality and applied a multiple Cox model to compute the hazard ratio of environmental risk factor on all cancer and cancer-specific mortality. The population attributable fraction was calculated, accordingly. RESULTS Biomass fuels for cooking, as an indoor air pollution, increased the risk of colorectal, esophageal, gastric cancer, and all-cancer mortality by 84%, 66%, 37%, and 17% respectively. Using gas for cooking, particularly in rural areas, could save 6% [Population Attributable Fraction: 6.36(95%CI: 1.82, 10.70)] of esophageal cancer, 3% [Population Attributable Fraction: 3.43 (0, 7.33)] of gastric cancer, and 6% [Population Attributable Fraction: 6.25 (1.76, 13.63)] of colorectal cancer mortality. Using a healthy tap water source could save 5% [Population Attributable Fraction:5.50(0, 10.93)] of esophageal cancer mortality, particularly in rural areas. There was no significant association between indoor air pollution for heating purposes and animal contact with cancer mortality. CONCLUSION Considering the results of this study, eliminating solid fuel for most daily usage, among the population with specific cancer types, is required to successfully reduce cancer related mortality. Adopting appropriate strategies and interventions by policymakers such as educating the population, allocating resources for improving the healthy environment of the community, and cancer screening policies among susceptible populations could reduce cancer related mortalities.
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Affiliation(s)
- Negar Rezaei
- Digestive Disease Research Center (DDRC), Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Sharafkhah
- Digestive Disease Research Center (DDRC), Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Yalda Farahmand
- School of Medicine, Terhan University of Medical Sciences, Tehran, Iran
| | - Sadaf G. Sepanlou
- Digestive Disease Research Center (DDRC), Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Dalvand
- Digestive Disease Research Center (DDRC), Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreatobiliary Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Sajadi
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Masoudi
- Digestive Disease Research Center (DDRC), Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Masoud Khoshnia
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Layli Eslami
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahboube Akhlaghi
- Digestive Disease Research Center (DDRC), Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Delavari
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Sabde YD, Trushna T, Mandal UK, Yadav V, Sarma DK, Aher SB, Singh S, Tiwari RR, Diwan V. Evaluation of health impacts of the improved housing conditions on under-five children in the socioeconomically underprivileged families in central India: A 1-year follow-up study protocol. Front Public Health 2022; 10:973721. [PMID: 36187626 PMCID: PMC9523261 DOI: 10.3389/fpubh.2022.973721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/12/2022] [Indexed: 01/21/2023] Open
Abstract
Unacceptable housing conditions prevalent in Indian urban slums adversely affect the health of residents. The Government of India initiated the Basic Services to the Urban Poor (BSUP) as a sub-mission under the Jawaharlal Nehru National Urban Renewal Mission (JNNURM), to provide basic services to the urban poor. As per the available scientific literature, the health effects of such improved housing schemes for the poor have not been studied so far in India, especially in under-five children (0-5 years old) who spend most of their time indoors. The present paper describes the protocol for a follow-up research study proposed to fill this gap. This study, funded by the Indian Council of Medical Research (Sanction No. 5/8-4/9/Env/2020-NCD-II dated 21.09.2021), will be conducted in Bhopal in the central Indian province of Madhya Pradesh for over 2 years. We will recruit 320 under-five children each from Group 1 (Beneficiary families residing in the houses constructed under BSUP) and Group 2 (Slum dwelling families eligible for improved housing but who did not avail of benefit). Eligible children will be recruited in the first household visit. During the same visit, we will record clinical history, examination findings and take anthropometric measurements of participants. We will also collect data regarding socio-economic-environmental parameters of the house. During subsequent monthly follow-up visits, we will collect primary data on morbidity profile, anthropometric details and medical history over 1 year. Approval for the study was obtained from the Institutional Ethics Committee of the National Institute for Research in Environmental Health (No: NIREH/BPL/IEC/2020-21/198, dated 22/06/2020). This study will evaluate the impact of different housing conditions on the health of under-five children. Finding of this research will be beneficial in guiding future housing-related policy decisions in low- and middle-income countries.
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Affiliation(s)
- Yogesh Damodar Sabde
- Department of Environmental Health and Epidemiology, ICMR-National Institute for Research in Environmental Health, Bhopal, Madhya Pradesh, India,*Correspondence: Yogesh Damodar Sabde
| | - Tanwi Trushna
- Department of Environmental Health and Epidemiology, ICMR-National Institute for Research in Environmental Health, Bhopal, Madhya Pradesh, India,Tanwi Trushna
| | - Uday Kumar Mandal
- Department of Environmental Health and Epidemiology, ICMR-National Institute for Research in Environmental Health, Bhopal, Madhya Pradesh, India
| | - Vikas Yadav
- Department of Environmental Health and Epidemiology, ICMR-National Institute for Research in Environmental Health, Bhopal, Madhya Pradesh, India
| | - Devojit Kumar Sarma
- Department of Molecular Biology, ICMR-National Institute for Research in Environmental Health, Bhopal, Madhya Pradesh, India
| | - Satish Bhagwatrao Aher
- Department of Environmental Monitoring and Exposure Assessment (Air), ICMR-National Institute for Research in Environmental Health, Bhopal, Madhya Pradesh, India
| | - Surya Singh
- Department of Environmental Monitoring and Exposure Assessment (Water and Soil), ICMR-National Institute for Research in Environmental Health, Bhopal, Madhya Pradesh, India
| | - Rajnarayan R. Tiwari
- ICMR-National Institute for Research in Environmental Health, Bhopal, Madhya Pradesh, India
| | - Vishal Diwan
- Department of Environmental Monitoring and Exposure Assessment (Water and Soil), ICMR-National Institute for Research in Environmental Health, Bhopal, Madhya Pradesh, India
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