{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T15:23:19Z","timestamp":1784042599033,"version":"3.55.0"},"reference-count":36,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,8,25]],"date-time":"2022-08-25T00:00:00Z","timestamp":1661385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Eulji University"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and objectives: Long-term exposure to air pollution has been associated with lung cancer. This study aimed to evaluate the relative risk (RR) and hazard ratio (HR) of lung cancers and the prognostic implication of outdoor particulate matter (PM) pollution using a meta-analysis. Materials and Methods: We performed the meta-analysis using 19 eligible studies and evaluated the PMs, dividing into PM smaller than 2.5 \u00b5m (PM2.5) and PM smaller than 10 \u00b5m (PM10). In addition, subgroup analyses, based on the increment of PM exposure, location, sex, smoking history, and tumor histology, were performed. Results: Lung cancer was significantly increased by exposure to PM2.5 (RR 1.172, 95% confidence interval (CI) 1.002\u20131.371), but not PM10 exposure. However, there was no significant correlation between PM10 exposure and the incidence of lung cancers (RR 1.062, 95% CI 0.932\u20131.210). The all-cause and lung-cancer-specific mortalities were significantly increased by PM2.5 exposure (HR 1.1.43, 95% CI 1.011\u20131.291 and HR 1.144, 95% CI 1.002\u20131.307, respectively). However, PM10 exposure significantly increased the all-cause mortality, but not the lung-cancer-specific mortality. The lung-cancer-specific mortality was significantly increased by PM10 per 12.1 \u03bcg\/m3 increment and in the Europe area. Conclusions: PM2.5 significantly increased lung cancer and the all-cause and lung-cancer-specific mortalities, whereas PM10 did not increase lung cancer or lung-cancer-specific mortality. However, PM10 increased the all-cause mortality and the PM10 per 12.1 \u03bcg\/m3 increment and PM10 in the Europe area may increase the lung-cancer-specific mortality.<\/jats:p>","DOI":"10.3390\/medicina58091159","type":"journal-article","created":{"date-parts":[[2022,8,26]],"date-time":"2022-08-26T02:04:32Z","timestamp":1661479472000},"page":"1159","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Impacts of Outdoor Particulate Matter Exposure on the Incidence of Lung Cancer and Mortality"],"prefix":"10.3390","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0320-8088","authenticated-orcid":false,"given":"Jung-Soo","family":"Pyo","sequence":"first","affiliation":[{"name":"Department of Pathology, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu-si 11759, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0461-6385","authenticated-orcid":false,"given":"Nae Yu","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu-si 11759, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4300-3469","authenticated-orcid":false,"given":"Dong-Wook","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Pathology, Chungnam National University Sejong Hospital, 20 Bodeum 7-ro, Sejong 30099, Korea"},{"name":"Department of Pathology, Chungnam National University School of Medicine, 266 Munhwa Street, Daejeon 35015, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"111618","DOI":"10.1016\/j.ecoenv.2020.111618","article-title":"Exposure to PM(2.5) is associated with malignant pleural effusion in lung cancer patients","volume":"208","author":"Bai","year":"2021","journal-title":"Ecotoxicol. Environ. Saf."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Moon, D.H., Kwon, S.O., Kim, S.Y., and Kim, W.J. (2020). Air Pollution and Incidence of Lung Cancer by Histological Type in Korean Adults: A Korean National Health Insurance Service Health Examinee Cohort Study. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17030915"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.1016\/S1470-2045(13)70487-X","article-title":"The carcinogenicity of outdoor air pollution","volume":"14","author":"Loomis","year":"2013","journal-title":"Lancet Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1080\/00039899709602881","article-title":"Air pollution, temperature, and regional differences in lung cancer mortality in Japan","volume":"52","author":"Choi","year":"1997","journal-title":"Arch. Environ. Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"140313","DOI":"10.1016\/j.scitotenv.2020.140313","article-title":"Burden of lung cancer attributable to ambient fine particles and potential benefits from air quality improvements in Beijing, China: A population-based study","volume":"738","author":"Yang","year":"2020","journal-title":"Sci. Total Environ."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Xing, D.F., Xu, C.D., Liao, X.Y., Xing, T.Y., Cheng, S.P., Hu, M.G., and Wang, J.X. (2019). Spatial association between outdoor air pollution and lung cancer incidence in China. BMC Public Health, 19.","DOI":"10.1186\/s12889-019-7740-y"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/1759-7714.12916","article-title":"Epidemiology of lung cancer in China","volume":"10","author":"Cao","year":"2019","journal-title":"Thorac. Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1164\/ajrccm.159.2.9806020","article-title":"Long-term inhalable particles and other air pollutants related to mortality in nonsmokers","volume":"159","author":"Abbey","year":"1999","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1056\/NEJM199312093292401","article-title":"An association between air pollution and mortality in six U.S. cities","volume":"329","author":"Dockery","year":"1993","journal-title":"N. Engl. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/S1470-2045(13)70279-1","article-title":"Air pollution and lung cancer incidence in 17 European cohorts: Prospective analyses from the European Study of Cohorts for Air Pollution Effects (ESCAPE)","volume":"14","author":"Andersen","year":"2013","journal-title":"Lancet Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"106249","DOI":"10.1016\/j.envint.2020.106249","article-title":"Long-term low-level ambient air pollution exposure and risk of lung cancer\u2014A pooled analysis of 7 European cohorts","volume":"146","author":"Hvidtfeldt","year":"2021","journal-title":"Environ. Int."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1289\/ehp.761641","article-title":"Deposition and clearance of inhaled particles","volume":"16","author":"Stuart","year":"1976","journal-title":"Environ. Health Perspect."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1016\/S0045-6535(00)00550-6","article-title":"Urban airborne particulate: Genotoxicity evaluation of different size fractions by mutagenesis tests on microorganisms and comet assay","volume":"44","author":"Buschini","year":"2001","journal-title":"Chemosphere"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"015004","DOI":"10.1088\/2515-7620\/ab06e9","article-title":"Ambient PM2.5 exposure and risk of lung cancer incidence in North America and Europe","volume":"1","author":"Ghazipura","year":"2019","journal-title":"Environ. Res. Commun."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1289\/ehp\/1408092","article-title":"Outdoor particulate matter exposure and lung cancer: A systematic review and meta-analysis","volume":"122","author":"Hamra","year":"2014","journal-title":"Environ. Health Perspect."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/0378-4274(77)90023-6","article-title":"Mutagenic activity of airborne particulate organic pollutants","volume":"1","author":"Pitts","year":"1997","journal-title":"Toxicol. Lett."},{"key":"ref_17","first-page":"339","article-title":"Airborne particulate matter and human health: Toxicological assessment and importance of size and composition of particles for oxidative damage and carcinogenic mechanisms","volume":"26","author":"Valavanidis","year":"2008","journal-title":"J. Environ. Sci. Health"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1164\/rccm.201210-1758OC","article-title":"Mortality associations with long-term exposure to outdoor air pollution in a national English cohort","volume":"187","author":"Carey","year":"2013","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1289\/ehp.1205862","article-title":"Long-term exposure to urban air pollution and mortality in a cohort of more than a million adults in Rome","volume":"121","author":"Cesaroni","year":"2013","journal-title":"Environ. Health Perspect."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1136\/thoraxjnl-2015-207927","article-title":"Air pollution affects lung cancer survival","volume":"71","author":"Eckel","year":"2016","journal-title":"Thorax"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1186\/s12940-017-0268-7","article-title":"The association between ambient fine particulate matter and incident adenocarcinoma subtype of lung cancer","volume":"16","author":"Gharibvand","year":"2017","journal-title":"Environ. Health"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e076","DOI":"10.1097\/EE9.0000000000000076","article-title":"Ambient air pollution and lung cancer risk among never-smokers in the Women\u2019s Health Initiative","volume":"3","author":"Gowda","year":"2019","journal-title":"Environ. Epidemiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1164\/rccm.200912-1903OC","article-title":"Long-term ambient multipollutant exposures and mortality","volume":"183","author":"Hart","year":"2011","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1136\/oemed-2012-100876","article-title":"Long-term exposure to NO2 and PM10 and all-cause and cause-specific mortality in a prospective cohort of women","volume":"70","author":"Heinrich","year":"2013","journal-title":"Occup. Environ. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1097\/EDE.0b013e3182949ae7","article-title":"Long-term residential exposure to air pollution and lung cancer risk","volume":"24","author":"Hystad","year":"2013","journal-title":"Epidemiology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1164\/rccm.201303-0609OC","article-title":"Spatial analysis of air pollution and mortality in California","volume":"188","author":"Jerrett","year":"2013","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"132","DOI":"10.2188\/jea.JE20100098","article-title":"An association between long-term exposure to ambient air pollution and mortality from lung cancer and respiratory diseases in Japan","volume":"21","author":"Katanoda","year":"2011","journal-title":"J. Epidemiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.3349\/ymj.2017.58.6.1111","article-title":"Lung Cancer Risk and Residential Exposure to Air Pollution: A Korean Population-Based Case-Control Study","volume":"58","author":"Lamichhane","year":"2017","journal-title":"Yonsei Med. J."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1289\/ehp.1104660","article-title":"Chronic exposure to fine particles and mortality: An extended follow-up of the Harvard Six Cities study from 1974 to 2009","volume":"120","author":"Lepeule","year":"2012","journal-title":"Environ. Health Perspect."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1164\/rccm.201012-2082OC","article-title":"Long-term exposure to air pollution and cardiorespiratory disease in the California teachers study cohort","volume":"184","author":"Lipsett","year":"2011","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1038\/sj.jea.7500095","article-title":"Relationships of mortality with the fine and coarse fractions of long-term ambient PM10 concentrations in nonsmokers","volume":"10","author":"McDonnell","year":"2000","journal-title":"J. Expo. Anal. Environ. Epidemiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1001\/jama.287.9.1132","article-title":"Lung cancer, cardiopulmonary mortality, and long-term exposure to fine particulate air pollution","volume":"287","author":"Pope","year":"2002","journal-title":"JAMA"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1289\/ehp.1307490","article-title":"Particulate matter air pollution exposure, distance to road, and incident lung cancer in the nurses\u2019 health study cohort","volume":"122","author":"Puett","year":"2014","journal-title":"Environ. Health Perspect."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1958","DOI":"10.1002\/ijc.30255","article-title":"Long-term exposure to fine particulate matter air pollution and the risk of lung cancer among participants of the Canadian National Breast Screening Study","volume":"139","author":"Tomczak","year":"2016","journal-title":"Int. J. Cancer"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1136\/thorax.58.12.1071","article-title":"Lung cancer and air pollution: A 27 year follow up of 16 209 Norwegian men","volume":"58","author":"Nafstad","year":"2003","journal-title":"Thorax"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"5626","DOI":"10.1158\/1078-0432.CCR-09-0376","article-title":"Lung cancer in never smokers: Clinical epidemiology and environmental risk factors","volume":"15","author":"Samet","year":"2009","journal-title":"Clin. Cancer Res."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/9\/1159\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:15:24Z","timestamp":1760141724000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/9\/1159"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,25]]},"references-count":36,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["medicina58091159"],"URL":"https:\/\/doi.org\/10.3390\/medicina58091159","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,25]]}}}