Short-term effects of indoor and outdoor air pollution on the lung cancer morbidity in Henan Province, Central China

Lung cancer is one of the most common cancer types and a major cause of death. The relationship between lung cancer morbidity and exposure to air pollutants is of particular concern. However, the relationship and difference in lung cancer morbidity between indoor and outdoor air pollution effects remain unclear. In this paper, the aim was to comprehensively investigate the spatial relationships between the lung cancer morbidity and indoor-outdoor air pollution in Henan based on the standard deviation ellipse, spatial autocorrelation analysis and GeoDetector. The results indicated that (1) the spatial distribution of lung cancer morbidity was related to the geomorphology, while high-morbidity areas were concentrated in the plains and basins of Central, Eastern and Southern Henan. (2) Among the selected outdoor air pollutants, PM2.5, NO2, SO2, O-3 and CO were significantly correlated with the lung cancer morbidity. The degree of indoor air pollution was measured by the use of heating energy, and the proportions of coal-heating households, households with coal/biomass stoves and households with heated kangs were highly decisive in regard to the lung cancer morbidity. (3) The interaction between two factors was more notable than a single factor in explaining the lung cancer morbidity. Moreover, the interaction type was mainly nonlinear enhancement, and the proportion of households with coal/biomass stoves imposed the strongest interaction effect on the other factors.

Automated summary

This study investigated the spatial relationships between lung cancer morbidity and indoor-outdoor air pollution in Henan. The results showed a correlation between lung cancer morbidity and geomorphology, significant associations between outdoor air pollutants and morbidity, and the impact of indoor air pollution on lung cancer morbidity. interactions between factors played a significant role in explaining lung cancer morbidity, with non-linear enhancement effects observed.