Preeyagamone Khan

Country: Thailand


This study aims to answer a question on what aspects of air pollution can be linked to lung cancer in Bangkok residents. In this study, case-control and direct measurement of air pollution were applied. In the case-control design, a sample of 132 lung cancer cases and 296 members of the general population who lived in Bangkok more than 10 years were collected during March – August 2001. The collected information consisted of residential history, occupational exposure, smoking habits and other factors such as transport mode and commuting pattern. Direct measurement of air pollution was carried out using personal pump monitors in order to measure the air particulate level. Volunteers imitated the commuting pattern of 20 lung cancer patients and 20 members of the general population. The other source on air pollution was from the Pollution Control Department, an analysis of carcinogenic markers such as carbon black and benzo [a] pyrene. In this study, the method of statistical analysis used was the Cox proportional hazard regression. The average age of lung cancer patients and members of the general population was 62 and 61 years with the average years of residence for both groups of 47 years. 47 per cent of the lung cancer patients had lived very close to the main road compared to 8 per cent of general public members. 75 per cent of the male lung cancer cases were or had been heavy smokers compared to 32 per cent of the male general population. While a majority of the female patients were non smokers (86 per cent) compared to 84 per cent of the female general population. 15 per cent of the lung cancer cases worked as factory workers compared to 5 per cent of the control. 26 and 25 per cent of the lung cancer cases were exposed to smoke and dust compared to 22 and 17 per cent of general population, of which the most exposed groups were bus drivers, traffic police and road sweepers. The results from the darkest filters of the direct measurement of air pollution revealed that 60 per cent of lung cancer cases traveled by normal bus and motorcycle as a main transport mode compared to 40 per cent of the control. 50 per cent of the lung cancer cases spent time commuting in urban traffic more than 3 hours compared to 35 per cent of the general public members. Consistently, lung cancer cases were more likely to be exposed to higher concentrations of carbon black than the control (p < 0.05). Commuting, in a particular mode and time spent in urban traffic was a contributor to lung cancer risk among Bangkok residents. Furthermore, living close to a primary source such as a main road with congested traffic plays a crucial role as well as smoking. Whilst the social factor of occupation was associated with the risk of lung cancer. The risk increased among factory and transport workers. The recommendation is to reduce risk of lung cancer by reducing emissions from vehicles, in particular public buses and motorcycles on the road. Prospective research should focus on fine particulate matter related to lung cancer and the influence of enclosed compartments such as air-conditioned bus, cars and other modes of commuting.


Doctor of Philosophy in Demography (International Program)
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