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Household use of biomass and lung cancers. INTERIM RESULTS Imran Choudhury, Dan Pope, Mukesh Dherani , Nigel Bruce University of Liverpool & Amir Sapkota University of Maryland. Search strategy.

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household use of biomass and lung cancers

Household use of biomass and lung cancers

INTERIM RESULTS

Imran Choudhury, Dan Pope, MukeshDherani, Nigel Bruce

University of Liverpool

&

Amir Sapkota

University of Maryland

search strategy
Search strategy
  • (Lung OR pulmonary OR bronchogenic OR bronchial OR “respiratory tract” OR bronch* OR trachea* OR “lower respiratory tract” )
  • Cancer OR cancers OR carcinoma OR carcinomata OR neoplasm OR neoplasms OR tumor OR tumors OR tumour OR tumours OR “*small-cell”)
  • "IAP" OR "Indoor air" OR "pollution" OR "pollutant" OR "fuel" OR "fuels" OR "dung" OR "agricultural waste" OR "crop waste" OR "crop residue" OR "charcoal" OR "coal" OR "biomass" OR "wood" OR "stove" OR "stoves" OR "chula" OR "chulla" OR "oven" OR "ovens" OR "smoke" OR "smoky" OR heat* OR cook* OR light* OR burn*
databases
Databases
  • PubMed (Medline)
  • Embase (Scopus & Ovid)
  • Cochrane Controlled Trials Register
  • CINAHL (Ovid)
  • Global Health (Ovid)
  • DARE (Database of Abstracts of Reviews of Effects) – for reviews
  • LILACS (Latin American and Caribbean literature)
  • Scielo
  • Index Medicus Africanus
  • Chinese databases CNKI – by Ray Liu @UCB
search results english
Search results (English)
  • 19,833 search results
  • 137 papers: full papers (English) or foreign language paper abstracts with solid fuel data
  • 60 potentially relevant for biomass review
    • 25 Chinese abstracts/full papers for Ray
    • 4 on request /awaiting translation
    • 17 papers with some form relevant data
search results
Search Results
  • Of the 17 papers which have data
  • All case control studies
    • 6 combine biomass with another fuel
    • 11 papers with estimates for meta-analysis
    • 1/11 later excluded
publication bias
Publication bias
  • Begg's Test
  • adj. Kendall's Score (P-Q) = 22
  • Std. Dev. of Score = 24.28
  • Number of Studies = 17
  • z = 0.91
  • Pr > |z| = 0.365
  • z = 0.87 (continuity corrected)
  • Pr > |z| = 0.387 (continuity corrected)
  • Egger's test
  • ------------------------------------------------------------------------------
  • Std_Eff | Coef. Std. Err. t P>|t| [95% Conf. Interval]
  • -------------+----------------------------------------------------------
  • -------------+------
  • slope | .0722589 .173642 0.42 0.683 -.2978503 .442368
  • bias | .4820188 .6609868 0.73 0.477 -.9268412 1.890879
key assumptions issues
Key assumptions/issues
  • Unclear reference categories
    • Ever wood vs. never wood
  • Cooking as exposure when most of subjects are men
  • Studies with very low population prevalence of biomass use
  • Is there a separate pathway for adenocarcinoma?
issues
Issues
  • Comparable - probably
  • Valid – a lot of quality issues even before considering ventilation, behaviour etc
  • External validity might help??
  • Heterogeneity
  • Meta-analysis does not give clear answer
  • Probably need better data?
  • Await Chinese studies