Abstract
The association between fine particulate matter < 2.5 µm (PM2.5) and oral neoplasm has barely been addressed. The purpose of this study is to elucidate the association between PM2.5 and oral neoplasm, including oral potentially malignant disorder (OPMD) and oral cancer (OC), taking into account the geographical heterogeneity. Data for analysis were derived from nationwide OC screening program, targeting Taiwanese cigarette smokers and/or betel quid chewers, and the Taiwan Air Quality Monitoring Network between 2006 and 2016. Totally 3,864,045 smokers and/or betel quids chewers were enrolled in this study. Among them, 154,030 OPMD cases and 23,286 oral cancers were found during the study period. Information on age, gender, living area, personal oral habits, and monthly PM2.5 concentration in average were collected. We used the Bayesian random-effect logistic regression model to assess the association between PM2.5 and OPMD/OC. After adjusting for sex, age, and behavior of betel quid chewing and cigarette smoking, we found that subjects from areas of higher levels of PM2.5 (≥ 35 µg m–3) had an increased risk of OPMD/OC and OC by 11% (aRR = 1.11; 95% CI: 1.09–1.13) and 55% (aRR = 1.55; 95% CI: 1.49–1.60) respectively, compared to those from areas of lower PM2.5 (< 35 µg m–3). Such effect was further demonstrated in a concentration-dependent manner. Subjects from areas of higher PM2.5 levels were found to have greater risk of OPMD/OC in Taiwan. Future studies are warranted to investigate the effect of personal PM2.5 exposure on OPMD/OC risk.
Highlights
It is inevitable that air pollution has become environmental burden worldwide
Men who had the habit of cigarette smoking and betel quid chewing were dominant in both oral potentially malignant disorder (OPMD) and Oral cancer (OC) groups
There are still numerous variables related to OPMD/OC risk such as genetic, family history of OC, history of chronic diseases and other potential carcinogenic compounds, which we haven’t considered in this study. This is the first study to investigate the association between PM2.5 and OPMD/OC at nationwide level
Summary
It is inevitable that air pollution has become environmental burden worldwide. Among all air pollutants, fine particulate matters (particulate matter with an aerodynamic diameter ≤ 2.5 μm; PM2.5) are thought to be the most important toxicants in urban air (Kaiser 2005). In 2016, World Health Organization (WHO) reported that approximately 92% of the world’s population were residing in places where level of the PM2.5 exceeds WHO air quality guideline (AQG), an annual average concentration of 10 μg m–3 (WHO, 2006). In order to prevent the disease onset and to cure or slow the disease progression, the Taiwanese government has implemented the biennial nationwide OC screening focusing on Aerosol and Air Quality Research | https://aaqr.org adults at a higher risk (betel quid chewers or smokers) since 2004 to detect oral potentially malignant disorder (OPMD) and OC (Chuang et al, 2017). The betel quid chewing rate among male adults over 18 has been declined from 2007 to 2018 by 59.2% in Taiwan (Health Promotion Administration, 2019). Age-standardized OC incidence rate increased continuously in both sexes before 2009, it has become flatten since (Siewchaisakul et al, 2020a)
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