Household Ventilation May Reduce Effects of Indoor Air Pollutants for Prevention of Lung Cancer: A Case-Control Study in a Chinese Population

BACKGROUND: Although the International Agency for Research on Cancer (IARC) has classified various indoor air pollutants as carcinogenic to humans, few studies evaluated the role of household ventilation in reducing the impact of indoor air pollutants on lung cancer risk. OBJECTIVES: To explore the association between household ventilation and lung cancer. METHODS: A population-based case-control study was conducted in a Chinese population from 2003 to 2010. Epidemiologic and household ventilation data were collected using a standardized questionnaire. Unconditional logistic regression was employed to estimate adjusted odds ratios (OR(adj)) and their 95% confidence intervals (CI). RESULTS: Among 1,424 lung cancer cases and 4,543 healthy controls, inverse associations were observed for good ventilation in the kitchen (OR(adj) = 0.86, 95% CI: 0.75, 0.98), bedroom (OR(adj) = 0.90, 95% CI: 0.79, 1.03), and both kitchen and bedroom (OR(adj) = 0.87, 95% CI: 0.75, 1.00). Stratified analyses showed lung cancer inversely associated with good ventilation among active smokers (OR(adj) = 0.85, 95% CI: 0.72, 1.00), secondhand smokers at home (OR(adj) = 0.77, 95% CI: 0.63, 0.94), and those exposed to high-temperature cooking oil fumes (OR(adj) = 0.82, 95% CI: 0.68, 0.99). Additive interactions were found between household ventilation and secondhand smoke at home as well as number of household pollutant sources. CONCLUSIONS: A protective association was observed between good ventilation of households and lung cancer, most likely through the reduction of exposure to indoor air pollutants, indicating ventilation may serve as one of the preventive measures for lung cancer, in addition to tobacco cessation.