Traffic air pollution and lung cancer in females in Taiwan: petrol station density as an indicator of disease development

Risk of death from liver cancer in relation to long-term exposure to fine particulate air pollution in Taiwan

According to the International Agency for Research on Cancer (IARC), airborne fine particulate matter (PM_2.5), which is categorized as a Group I carcinogen, was found to lead to predominantly lung as well as other cancer types in humans. Hepatocellular carcinoma (HCC) is endemic in Taiwan where it is the second and fourth foremost cause of cancer deaths in men and women, respectively. Taiwan's mortality rates for liver cancer vary considerably from one region to another, suggesting that the environment may exert some influence on deaths attributed to liver cancer. The aim of this investigation was to perform an ecologic study to examine the possible link between ambient PM_2.5 levels and risk of liver cancer in 66 in Taiwan municipalities. To undertake this investigation, annual PM_2.5 levels and age-standardized liver cancer mortality rates were calculated for male and female residents of these areas from 2010 to 2019. Data were tested using weighted-multiple regression analyses to compute adjusted risk ratio (RR) controlling for urbanization level and physician density. Annual PM_2.5 levels of each municipality were divided into tertiles. The adjusted RRs for males residing in those areas with intermediate tertile levels (21.85 to 28.21 ug/m³) and the highest tertiles levels (28.22-31.23 ug/m³) of PM_2.5 were 1.29 (95% CI = 1.25-1.46) and 1.41 (95% CI = 1.36-1.46), respectively. Women in these locations shared a similar risk, 1.32 (1.25-1.4) and 1.41 (1.34-1.49), respectively. Evidence indicated that PM_2.5 increased risk of mortality rates attributed to liver cancer in both men and women in Taiwan.

Deciphering the impact of urban built environment density on respiratory health using a quasi-cohort analysis of 5495 non-smoking lung cancer cases

INTRODUCTION

Lung cancer is a major health concern and is influenced by air pollution, which can be affected by the density of urban built environment. The spatiotemporal impact of urban density on lung cancer incidence remains unclear, especially at the sub-city level. We aimed to determine cumulative effect of community-level density attributes of the built environment on lung cancer incidence in high-density urban areas.

METHODS

We selected 78 communities in the central city of Shanghai, China as the study site; communities included in the analysis had an averaged population density of 313 residents per hectare. Using data from the city cancer surveillance system, an age-period-cohort analysis of lung cancer incidence was performed over a five-year period (2009-2013), with a total of 5495 non-smoking/non-secondhand smoking exposure lung cancer cases. Community-level density measures included the density of road network, facilities, buildings, green spaces, and land use mixture.

RESULTS

In multivariate models, built environment density and the exposure time duration had an interactive effect on lung cancer incidence. Lung cancer incidence of birth cohorts was associated with road density and building coverage across communities, with a relative risk of 1·142 (95 % CI: 1·056-1·234, P = 0·001) and 1·090 (95 % CI: 1·053-1·128, P < 0·001) at the baseline year (2009), respectively. The relative risk increased exponentially with the exposure time duration. As for the change in lung cancer incidence over the five-year period, lung cancer incidence of birth cohorts tended to increase faster in communities with a higher road density and building coverage.

CONCLUSION

Urban planning policies that improve road network design and building layout could be important strategies to reduce lung cancer incidence in high-density urban areas.

Association between fine particulate air pollution and the risk of death from lung cancer in Taiwan

Airborne fine particulate matter (PM_2.5) has been classified as a Group I carcinogen leading to lung cancer in humans by the International Agency for Research on Cancer (IARC). In Taiwan, where there is a growing incidence of this disease, lung cancer is currently the leading cause of cancer-associated deaths in women and second leading cause of deaths in men. Because tobacco use is rare in Taiwan, especially amongst women, the high incidence of this type of cancer was suggested to be attributed to the other external contaminants, including airborne PM₂ pollution. In this ecologic study, a possible association between ambient air PM_2.5 exposure and likelihood of death attributed to lung cancer was examined in Taiwan in 66 municipalities. Annual PM_2.5 levels and age-standardized lung cancer mortality rates for male and female residents were calculated for years 2010 to 2019. Weighted-multiple regression was applied to analyze our data, adjusting for level of urbanization and physician density. For males, the adjusted risk ratios (RRs) for lung cancer mortality were 1.01 for municipalities with PM_2.5 levels 21.85-28.21 ug/m3 and 1.07 for municipalities with 28.22-31.23 ug/m3, compared to those with the lowest PM_2.5 levels. For females, these adjusted RRs were 0.99 and 1.06, respectively. Data demonstrated an association between chronic exposure to high levels of PM_2.5 and increased likelihood of death attributed to lung cancer for both men and women in Taiwan. Further studies are needed to explore the relationship between PM_2.5 air pollution exposure and risk of lung cancer histologic subtype.

Adverse Health Complaints of Adults Exposed to Benzene After a Flaring Disaster at the BP Refinery Facility in Texas City, Texas

OBJECTIVE

The objective of this study was to assess the adverse health symptoms experienced by adult subjects who were exposed to benzene after a flaring disaster at the BP refinery in Texas City, Texas.

METHODS

A total of 2162 adults aged 18 years or older and exposed to benzene were included. Using the patients' medical charts, we collected and analyzed data on health complaints as well as the patients' serum levels of beta-2-microglobulin and urinary excretion of phenol.

RESULTS

A total of 11,368 health symptom complaints were reported in 2162 adults exposed to benzene. Neurological symptoms occurred most frequently (174%), followed upper respiratory symptoms (115%), cough (31%), painful joints (30%), cardiac symptoms (28%), dermatological symptoms (28%), gastrointestinal symptoms (27%), diarrhea (25%), vision symptoms (21%), and nausea/vomiting (19%). Logistic regression analysis indicated that urinary symptoms (R2=0.65) and painful joints (R2=0.44) were positively associated with increasing age in benzene-exposed subjects.

CONCLUSION

Adult subjects exposed to benzene experience a range of adverse health symptoms and an altered profile of urinary phenol, thus indicating they are at high risk of developing serious future health complications. (Disaster Med Public Health Preparedness. 2018;12:232-240).

Exposure to chemical hazards in petrol pumps stations in Ahvaz City, Iran

The objective of this study was to assess the level of exposure to BTEX (benzene, toluene, ethylbenzene, xylenes) in petrol pump stations in Ahvaz City. Two of the biggest fuelling stations were selected randomly among total 12 fuel stations of Ahvaz City, Iran, during September 2013. Thirty air samples were taken from different positions in the fuelling stations and 15 samples were taken from the personal breathing zone of operators and of customers in fuelling stations. Measuring the ambient concentration of benzene, toluene, ethylbenzene, and xylenes was done according to the method advised by National Institute for Occupational Safety and Health (NIOSH) 1501. This study showed that the concentration of benzene was very high (compared with the Iranian occupational exposure limit [OEL] standard) in ambient air of petrol stations in Ahvaz, which is considered as a high risk to the health of workers. Controlling the level of benzene in petrol stations is necessary. A new designed petrol nozzle was proposed for this purpose.

Effects of diesel exhaust particles on microRNA-21 in human bronchial epithelial cells and potential carcinogenic mechanisms

Air pollution plays a role in cancer risk, particularly in lung cancer, which is the leading cause of cancer-related mortality worldwide. Diesel exhaust particles (DEPs), a component of diesel exhaust products, is a complex mixture of particle compounds that include a large number of known and suspected human carcinogens. Historically, lung cancer, which is associated with DEPs, has been the focus of attention as a health risk in human and animal studies. However, the mechanism by which DEPs cause lung cancer remains unclear. The present study reports that DEPs increased miR-21 expression and then activated the PTEN/PI3K/AKT pathway in human bronchial epithelial (HBE) cells, which may serve as an important carcinogenic mechanism. However, the data revealed that short-term exposure to a high DEP concentration did not cause evident cell carcinogenesis in HBE cells.

Biology of diesel exhaust effects on allergic pulmonary inflammation

Although the adverse health effects of diesel exhaust particles (DEP) have been proposed and are being clarified, their facilitating effects on preexisting pathological conditions (pathological conditions) have not been fully identified. On the other hand, there exist hypersensitive subjects against particulate matters. In this review, we provide insights into the immunotoxicity of DEP as an aggravating factor in hypersusceptible subjects, especially those with allergic pulmonary diseases using our in vivo experimental model. In brief, we examined the effects of DEP on allergic asthma in vivo, and showed that repetitive pulmonary exposure to DEP has promoting effects on allergic airway inflammation, including adjuvanticity on Th2-milieu. Further, we propose a causal machinery regarding the adverse impacts, i.e., via inappropriate activation of antigen-presenting cells such as dendritic cells.

Occupational exposure to diesel and gasoline emissions and lung cancer in Canadian men

The International Agency for Research on Cancer classifies diesel exhaust as a probable human carcinogen; this decision is based largely from lung cancer evidence. Gasoline exhaust is classified as a possible carcinogen. Epidemiological studies are needed that improve upon some of the limitations of previous research with respect to the characterization of exposure, and the control for the potential confounding influence of smoking and other occupational exposures. Our objective was to investigate associations between occupational exposure to diesel and gasoline engine emissions and lung cancer. We used a case-control study design that involved men 40 years of age and older at the time of interview. Analyses are based on 1681 incident cases of lung cancer and 2,053 population controls. A self-reported questionnaire elicited a lifetime occupational history, including general tasks, and information on other potential risk factors. Occupational exposures to diesel and gasoline emissions, crystalline silica, and asbestos were assigned to each job held by study subjects by industrial hygienists who were blind to case-control status. Exposure metrics for diesel and gasoline emissions that were modeled included: ever exposure, cumulative exposure, and concentration of exposure. We found a dose-response relationship between cumulative occupational exposure to diesel engine emissions and lung cancer. This association was more pronounced for the squamous and large cell subtypes with adjusted odds ratios across the three increasing tertiles of cumulative lifetime exposure relative to those with no exposure of 0.99, 1.25, and 1.32 (p=0.04) for squamous cell carcinoma, and 1.06, 1.19, 1.68 (p=0.02) for large cell carcinoma. While the association with cumulative exposure to gasoline was weakly positive, it was not statistically significant. Our findings suggest that exposure to diesel engine emissions increases the risk of lung cancer particularly for squamous and large cell carcinoma subtypes.

Associations between petrol-station density and manganese and lead in the cord blood of newborns living in Taiwan

Although the anti-knocking agents used in Taiwan do not contain manganese, there are relatively high concentrations of the element in diesel fuel. As such, there have been many concerns about the impact of exposure to diesel fuels on health. This study was conducted in Taiwan to investigate the relationship between the concentration of manganese in cord blood of Taiwanese newborns and the geographic density of petrol stations as a surrogate for determining manganese emissions from vehicular traffic. A total of 1526 full-term newborns without major congenital malformations were consecutively recruited from various medical facilities from May 2004 to July 2005. Questionnaires were completed by the newborns' mothers after delivery to collect information on demographic characteristics, medical history, living environment, and other factors. Cord blood samples were collected at birth and analyzed for manganese and lead using inductively coupled plasma mass spectrometry. The geographic density of petrol stations within a 10 km zone around each newborn's residence was calculated for 1343 newborns using the Arc9 Geographic Information System. The geometric means of cord blood manganese and lead concentrations were 47.0 μg/L (GSD=1.42) and 12.6 μg/L (GSD=1.76), respectively. After adjusting for potential confounding factors, including maternal age, and maternal education, the results of a multiple linear regression model indicated that the concentration of cord blood manganese increased monotonically with an increasing density of petrol stations. However, no such association was found for levels of lead in cord blood. Further smoothing spline model analysis indicated that a ten unit increment in petrol station density made cord blood manganese and lead levels change by factors of 1.0092 (95% CI: 1.0058, 1.0127) and 0.9994 (95% CI: 0.9890, 0.9998), respectively. This finding suggests that exposure to manganese-containing fuel from motor vehicles may result in elevated manganese levels in the fetus. Further research is warranted to explore the relationship between traffic-related manganese exposure and potential adverse effects on fetal development.

Traffic air pollution and risk of death from gastric cancer in Taiwan: petrol station density as an indicator of air pollutant exposure

To investigate the relationship between air pollution and risk of death attributed to gastric cancer, a matched cancer case-control study was conducted using deaths that occurred in Taiwan from 2004 through 2008. Data for all eligible gastric cancer deaths were obtained and compared to a control group consisting of individuals who died from causes other than neoplasms and diseases that were associated with gastrointestinal (GIT) disorders. The controls were pair-matched to the cancer cases by gender, year of birth, and year of death. Each matched control was randomly selected from the set of possible controls for each cancer case. Data for the number of petrol stations in study municipalities were collected from two major petroleum supply companies. The petrol station density (per square kilometer) (PSD) for study municipalities was used as an indicator of a subject's exposure to benzene and other hydrocarbons present in ambient evaporative losses of petrol or to air emissions from motor vehicles. The exposed individuals were subdivided into three categories (≤25th percentile; 25th-75th percentile; >75th percentile) according to PSD in the residential municipality. Results showed that individuals who resided in municipalities with the highest PSD were at an increased risk of death attributed to gastric cancer compared to those subjects living in municipalities with the lowest PSD. The findings of this study warrant further investigation of the role of traffic air pollution exposure in the etiology of gastric cancer.

Traffic air pollution and risk of death from bladder cancer in Taiwan using petrol station density as a pollutant indicator

To investigate the relationship between air pollution and risk of death from bladder cancer, a matched cancer case-control study was conducted using deaths that occurred in Taiwan from 1997 through 2006. Data for all eligible bladder cancer deaths were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. The control group consisted of individuals who died from causes other than cancer or diseases associated with genitourinary problems. The controls were pair matched to the cases by gender, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each case. Data for the number of petrol stations in study municipalities were collected from the two major petroleum supply companies, Chinese Petroleum Corporation (CPC) and Formosa Petrochemical Corporation (FPCC). The petrol station density (per square kilometer) (PSD) for study municipalities was used as an indicator of a subject's exposure to benzene and other hydrocarbons present in ambient evaporative losses of petrol or to air emissions from motor vehicles. The subjects were divided into tertiles according to PSD in their residential municipality. The present study showed that individuals who resided in municipalities with high PSD levels were at an increased risk of death from bladder cancer compared to subjects living in municipalities with a low PSD level; however, the differences are not statistically significant. The findings of this study warrant further investigation of the role of vehicular air pollutant emissions in the etiology of bladder cancer development.