Case-control study about magnitude of exposure to wood smoke and risk of developing lung cancer

Exposure to biomass combustion products, particularly firewood, has been considered as a potential carcinogen for developing lung cancer. In this regard, current evidence is widely heterogeneous; besides, in most studies, wood smoke exposure is not appropriately quantified, which further complicates the analysis of wood smoke as a potential carcinogen. The aim of the present study was to estimate the risk of developing lung cancer according to the degree of exposure to wood smoke in patients who use firewood for cooking.

We performed a case-control study that included 482 patients with lung cancer (cases) and 592 hospital controls. Exposure to wood smoke was evaluated as a dichotomous variable (i.e. yes or no); in patients with prior wood smoke exposure, an index of exposure in hours per year was calculated (WSEI). Using bivariate and multivariate logistic regression analyses, the odds ratio (OR) between wood smoke exposure and lung cancer were calculated.

The ORs for developing lung cancer (raw and adjusted) for a WSEI > 100 h/year were OR 1.55 [95% confidence interval (CI), 1.06-2.26) and OR 2.26 (95% CI, 1.50-3.40), respectively; the ORs (raw and adjusted) for WSEI >300 h/year were OR 1.76 (95% CI, 1.06-2.91) and OR 3.19 (95% CI, 1.83-5.55), respectively.

Exposure to wood smoke is a risk factor for lung cancer; furthermore, this effect maintains a dose-response relationship which has a multiplicative effect with smoking.