Air-polluted environmental heavy metal exposure increase lung cancer incidence and mortality: A population-based longitudinal cohort study

• Published in: The Science of the total environment Vol. 810; p. 152186
• Main Authors: Lee, Nian-Wei, Wang, Hsin-Yi, Du, Chung-Li, Yuan, Tzu-Hsuen, Chen, Chung-Yu, Yu, Chong-Jen, Chan, Chang-Chuan
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.03.2022
• Subjects: air; Air pollution; Cadmium; Cohort Studies; environment; Environmental Exposure - analysis; Environmental Monitoring; hazard ratio; Heavy metals; Humans; Incidence; lifestyle; Longitudinal Studies; Lung cancer; lung neoplasms; Lung Neoplasms - chemically induced; Lung Neoplasms - epidemiology; Metals, Heavy; mortality; prognosis; questionnaires; risk; tobacco; urine; Cadmium; Air pollution; Lung cancer; Heavy metals
• ISSN: 0048-9697; 1879-1026; 1879-1026
• DOI: 10.1016/j.scitotenv.2021.152186

An increased risk of lung cancer has been observed due to exposure to certain environmental heavy metals. This study elucidated the role of air-polluted heavy metals in the development of lung cancer. A longitudinal cohort study involving the general population was conducted to compare heavy metal content among lung cancer patients. The urine concentrations of heavy metals were measured. Questionnaire surveys were designed to collect exposure-related demographic and lifestyle data of the study subjects. Participants residing near the petrochemical industrial area with higher air Cd concentration had relatively higher urinary concentration of Cd. After adjusting for sociodemographic and behavioral factors, tobacco smoking and air pollution remained as potential sources of Cd exposure. An increased prevalence of lung cancer was observed in the highly polluted zone. The risk of lung cancer incidence increased 1.25-fold for each 1 μg/g-creatinine increase in urine Cd level. Patients with lung cancer had significantly higher urinary Cd concentrations. Lung cancer patients with higher urinary Cd level had significantly poor survival (urine Cd level ≥ 1.58 vs <1.58 μg/g-creatinine; survival, medium, 192.0 vs 342.5 days, p < 0.001). At the longitudinal follow-up, participants with higher urinary Cd level had a higher risk of lung cancer incidence (urine Cd level ≥ 1.58 vs <1.58 μg/g-creatinine: 3.91% v.s. 0.87%, hazard ratio: 4.65, p < 0.001). Accumulation of Cd could be a risk of lung cancer occurrence. High exposure to Cd may result in poor prognosis in lung cancer patients. [Display omitted] •Cadmium exposure is a risk factor both for lung cancer occurrence and mortality.•Cigarettes smoking and polluted air were the major source of Cadmium exposure.•High urinary Cadmium level is an indicator for lung cancer screening.