Lung Cancer and Indoor Air Pollution Arising from Chinese-Style Cooking among Nonsmoking Women Living in Shanghai, China

Associations between indoor air pollution from Chinese-style cooking and lung cancer have been found in several investigations. To provide more detailed estimates of the associations while accounting for key confounding factors, we conducted a population-based, case-control study of lung cancer among nonsmoking women living in Shanghai, the People's Republic of China. Five hundred four incident, primary lung cancer cases diagnosed from February 1992 through January 1994 were identified through the population-based Shanghai Cancer Registry. A control group of 601 nonsmoking women was selected randomly from the Shanghai Residential Registry, and they were frequency-matched to the expected age distribution of the cases. Exposure to indoor air pollutants from Chinese-style cooking was ascertained through in-person interviews. We estimated adjusted odds ratios (OR) and 95% confidence intervals (CI) by unconditional logistic regression. There were similar patterns of excess risk for exposure to indoor air pollutants from Chinese-style cooking across different histological types of lung cancer. Women who did not have a separate kitchen experienced a 28% increased risk of lung cancer (OR = 1.28; 95% CI = 0.98–1.68). We found little association with area of the windows of the apartment where subjects had lived for the longest period of time. Heating cooking oils to high temperatures was associated with a 1.64-fold increased risk of lung cancer (95% CI = 1.24–2.17). An 84% excess risk was found among women who most often cooked with rape-seed oil (OR = 1.84; 95% CI = 1.12–3.02). Lung cancer risks were also related to “considerable” smokiness of the kitchen during cooking (OR = 2.38; 95% CI = 1.58–3.57), frequent eye irritation during cooking (OR = 1.68; 95% CI = 1.02–2.78), to a more than weekly use of frying (OR = 2.09; 95% CI = 1.14–3.84) and deep-frying (OR = 1.88; 95% CI = 1.06–3.32). This population-based case-control study confirmed that exposure to indoor air pollution from Chinese-style cooking, especially cooking unrefined rapeseed oil at high temperatures in woks, may increase the risk of lung cancer.