摘要
Objective:Ozone(O_(3))is recognized as a predominant and increasingly prevalent gaseous pollutant contributing to the Global Burden of Disease.However,its effect on the development of lung cancer has not been adequately acknowledged.Methods:Based on Health Evaluation And risk Reduction through nationwide Teamwork(ChinaHEART),a nationwide,population-based cohort study,2,006,878 participants living in 20,159 communities or villages were passively followed for the incidence of lung cancer through a linkage of data with the National Central Cancer Registry.The average O_(3) levels over ten years from the year of enrolment in their respective localities were determined based on geographic coordinates.We conducted Cox proportional-hazards regression models to assess the independent hazard ratios(HRs)associated with O_(3) exposure and the development of lung cancer.Results:During the follow-up of 4.93 million person-years,4555 new cases of lung cancer were identified.After adjusting for participant characteristics and other environmental factors,we observed a significant positive association between ambient O_(3) exposure and lung cancer.Compared with participants in the quartile 1 of O_(3),HRs and 95%confidence intervals(CI)for the other three quartiles were 1.09(95%CI:1.00-1.17),1.17(95%CI:1.06-1.29)and 1.42(95%CI:1.26-1.59),respectively.Conclusions:Long-term exposure to ambient O_(3) is associated with a substantially higher risk of lung cancer.Further studies are needed to explore its pathogenic mechanisms,as well as to evaluate measures for exposure protection or harm mitigation at the individual or population level.
基金
supported by the CAMS Innovation Fund for Med-ical Science(grant number:2021-1-I2M-011)
National High Level Hospital Clinical Research Funding(grant number:2022-GSP-GG-4)
Ministry of Finance of China and National Health Commission of China,the 111 Project from the Ministry of Education of China(grant number:B16005)。
