Skip to main content

Risk of lung cancer associated with domestic use of different types of coal in Xuanwei, China

Tuesday, October 25, 2011 — Poster Session II

Noon – 2:00 p.m.

Natcher Conference Center



* FARE Award Winner


  • F Barone-Adesi
  • R Chapman
  • X He
  • W Hu
  • R Vermeulen
  • N Rothman
  • Q Lan


Lung cancer rates in Xuanwei County, Yunnan Province, are among the highest in China, and have been causally associated with exposure to indoor coal emissions. This study evaluated the effect of lifelong use of two different types of coal, “smoky coal” (bituminous) and “smokeless coal” (anthracite), on lung cancer mortality. A cohort of 37,753 farmers was followed retrospectively from 1976 through 1996. Association of type of coal used with lung cancer mortality was analyzed with nonparametric survival analysis and multivariable Cox models. After adjusting for the presence of competing risks of death, the probabilities of death from lung cancer before 80 years of age for men and women using smoky coal were 18% and 20%, respectively, compared with less than 0.5% among smokeless coal users of both sexes. Cox regression showed an increased risk of lung cancer among smoky coal users compared with smokeless coal users (men: Hazard Ratio [HR], 37; 95% Confidence Interval [CI], 22–51; women: HR, 121; 95% CI, 50–293). These findings suggest that the carcinogenic potential of household coal combustion products exhibits substantial variation by specific coal type. Use of less carcinogenic types of coal can translate to a substantial reduction of lung cancer risk.

back to top