Modeling Air Pollution Health Risk for Environmental Management of an Internationally Important Site: The Salt Range (Kallar Kahar), Pakistan

This study aimed to assess the health effects of emissions released by cement industries and allied activities, such as mining and transportation, in the salt range area of district Chakwal, Pakistan. DISPER was used to estimate dispersion and contribution of source emission by cement industries and allied activities to surface accumulation of selected pollutants (PM2.5, PM10, NOx, and O3). To assess the long-term effects of pollutants on human health within the radius of 500 m to 3 km, Air Q+ software was used, which was designed by the World Health Organization (WHO). One-year average monitoring data of selected pollutants, coordinates, health data, and population data were used as input data for the model. Data was collected on lung cancer mortality among different age groups (25+ and 30+), infant post-neonatal mortality, mortality due to respiratory disease, and all-cause mortality due to PM2.5 and NO2. Results showed that PM2.5 with the year-long concentration of 27.3 ug/m3 contributes a 9.9% attributable proportion (AP) to lung cancer mortality in adults aged 25+, and 13.8% AP in adults age 30+. Baseline incidence is 44.25% per 100,000 population. PM10 with the year-long concentration of 57.4 ug/m3 contributes 16.96% AP to infant post-neonatal mortality and baseline incidence is 53.86% per 1000 live births in the country. NO2 with the year-long concentration of 14.33 ug/m3 contributes 1.73% AP to all-cause mortality. Results obtained by a simulated 10% reduction in pollutant concentration showed that proper mitigation measures for reduction of pollutants’ concentration should be applied to decrease the rate of mortalities and morbidities. Furthermore, the study showed that PM2.5 and PM10 are significantly impacting the human health in the nearby villages, even after mitigation measures were taken by the selected cement industries. The study provides a roadmap to policymakers and stakeholders for environmental and health risk management in the area.

Lung cancer incidence and mortality trends in the Republic of Belarus (1990-2019)

favorable malignant diseases globally. In the Republic of Belarus, it ranks third (8.2%) in the cancer incidence structure and first (21.5%) in the cancer mortality structure. The object of the study were the lung cancer incidence and mortality trends in the Republic of Kazakhstan in 1990-2019. Methods: The present study included all patients - residents of Belarus, registered in the national cancer registry from 1990 to 2019 with a diagnosis of lung cancer (ICD-10 code: C33-C34). Demographic variables included gender, age, and area of residence (urban or rural). The number of PD cases is presented as absolute values and rough intensity indicators per 100,000 population. Standardized morbidity and mortality rates are calculated using the world standard (World) and are indicated per 100,000 population. Results: In the study period, the standardized incidence rate decreased from 27.5 to 25.6 per 100 000 population (– 7.1%, p<0.01). In males, it decreased from 62.1 to 54.6 per 100 000 males (– 12.1%, p<0.001); in females, it increased from 5.3 to 6.4 per 100 000 females (+20.7%, p<0.05). The standardized lung cancer mortality rate has decreased over the study period from 23.0 to 18.3 per 100 000 population (– 20.4%, p<0.001). In males, it went down from 53.6 to 40.7 (– 24.1%, p<0.001), and in women it changed slightly from 3.6 to 3.7 (+2.8%, p>0.05) per 100 000 of the relevant sex. The average annual increase in standardized mortality decreased eight times faster than the growth in standardized incidence. Conclusion: In the Republic of Belarus, lung cancer incidence is increasing in males and decreasing in females. At that, lung cancer mortality is decreasing. Quality specialized cancer care creates conditions for quicker negative growth of lung cancer standardized mortality vs. incidence

Exploration of Social-economic and Environmental Impacts on Lung Cancer Mortality in 94 Countries With Artificial Neural Network and Random Decision Tree Analysis

BackgroundSince lung cancer is the biggest killer in cancer families, extremely threatening to human health, an understanding of social-economic and environmental impacts on lung cancer mortality (LCM) is imperative to improve patient psychological health and potentially mitigate lung cancer incidences and multimorbidity. Figuring out key indicators in social-economic and environment impacts which are sensitive to LCM on spatial-temporal scales contributes to preclinical control and systemic treatments for lung cancer with standard chemotherapy agents are still relatively ineffective. MethodsBased on lung cancer mortalities in 94 countries within a decade (2006-2016), this research appropriately dissects social-economic, demographic, and environmental independent variable effects using Artificial Neural Network (ANN) and CRT Random Decision Tree algorithms (CRT-CRT-RDF).ResultsWith the two methods comparison, the similarity is that education and carbon emission were two etiologies. Education in low and middle countries of lung cancer was related with total ecological footprint and total population. Carbon emission in extreme countries was linked to ecological forestland footprint. Spatial-temporal analysis postulated China and the U.S were the two largest countries whereas China and India were the two fastest countries of LCM growth. Both models have a high precision of prediction (96.1% of CRT-CRT-RDF and 98.4% of ANN).ConclusionsThis research will facilitate preventive lung cancer services, prioritize the geographical allocation of lung cancer investment for WHO, and provide evidence for shrinking carbon emission and deforestation.

Characterizing Trends in Lung Cancer Mortality Attributable to Airborne Environmental Carcinogens

Tracheal, bronchus, and lung (TBL) cancer is the leading cause of cancer death globally, but trends in TBL mortality attributable to tobacco, ambient particulate matter pollution (APMP), and household air pollution (HAP) were unequally distributed within global population subgroups over the last three decades. We used data from the Global Burden of Disease 2019 study to quantify the impact of sex, time, sociodemographic development index (SDI), and age for each exposure from 1990–2019. During that interval, tobacco dominated the TBL cancer mortality landscape, with its minimum global age-adjusted death rate of 16.71 deaths/100,000 (95% Uncertainty Interval (UI): 15.27–18.13) outstripping maximums of 3.85 deaths/100,000 (UI: 2.82–4.83) and 2.54 deaths/100,000 (UI: 1.69–3.54) for APMP and HAP, respectively. In 2019, tobacco male TBL death rates exceeded female rates by a factor of 4.4:1. Ratios of 1.9:1 for APMP and 2.1:1 for HAP were seen. Our analysis indicates that both-sex middle SDI and female low, low-middle, and high-middle SDI populations are suffering increasing tobacco TBL burden. Efforts producing successful global reductions in HAP-associated TBL mortality should continue, with attention to low SDI female death rate increases. Finally, except for high SDI populations, global APMP-attributable TBL cancer burden is increasing and represents a major health concern.

Safety and Effectiveness of Lung Cancer Screening Using Low-dose Computed Tomography Scan in High-risk Individuals: A Comprehensive Review

Context: Lung cancer is the most important cause of cancer mortality. Given the incidence and mortality of this disease, the implementation of preventive interventions is necessary. Objectives: The present study investigated the effectiveness of one of the most important interventions of lung cancer screening with lowdose computed tomography (LDCT) in high-risk individuals. Evidence Acquisition: The present study was an applied study performed as a comprehensive review. For the assessment of safety, studies on the technical specifications of computed tomography scans and issues related to the safety of applying this device were searched using keywords in medical databases. For the evaluation of clinical effectiveness, a comprehensive review of health technology assessment studies, systematic review studies, and screening guidelines was performed. Results: Based on 15 studies extracted for the safety issue, the diagnosis of harmless tumors, false positives cases and Unnecessary invasive complementary interventions, and possible negative effects of radiation exposure are discussable safety issues. Based on the synthesis of 16 studies on effectiveness, lung cancer screening intervention using LDCT was determined to reduce lung cancer mortality by 15 - 20% and mortality from other causes by 0 - 6%. Additionally, the incidence of this disease in its upper stages decreases significantly. Conclusions: Lung cancer screening using LDCT does not threaten the health of individuals seriously and, in comparison to nonintervention is more clinically effective and will lead to a statistically significant reduction in lung cancer mortality and increase in the timely diagnosis of this disease.

Smoking-dependent expression alterations in nasal epithelium reveal immune impairment linked to germline variation and lung cancer risk

Lung cancer is the leading cause of cancer-related death in the world. In contrast to many other cancers, a direct connection to lifestyle risk in the form of cigarette smoke has long been established. More than 50% of all smoking-related lung cancers occur in former smokers, often many years after smoking cessation. Despite extensive research, the molecular processes for persistent lung cancer risk are unclear. CT screening of current and former smokers has been shown to reduce lung cancer mortality by up to 26%. To examine whether clinical risk stratification can be improved upon by the addition of genetic data, and to explore the mechanisms of the persisting risk in former smokers, we have analyzed transcriptomic data from accessible airway tissues of 487 subjects. We developed a model to assess smoking associated gene expression changes and their reversibility after smoking is stopped, in both healthy subjects and clinic patients. We find persistent smoking-associated immune alterations to be a hallmark of the clinic patients. Integrating previous GWAS data using a transcriptional network approach, we demonstrate that the same immune and interferon related pathways are strongly enriched for genes linked to known genetic risk factors, demonstrating a causal relationship between immune alteration and lung cancer risk. Finally, we used accessible airway transcriptomic data to derive a non-invasive lung cancer risk classifier. Our results provide initial evidence for germline-mediated personalised smoke injury response and risk in the general population, with potential implications for managing long-term lung cancer incidence and mortality.