Expanded PAH analysis of household air pollution in a rural region of China with high lung cancer incidence

The domestic combustion of locally sourced smoky (bituminous) coal in Xuanwei and Fuyuan counties, China, is responsible for some of the highest lung cancer rates in the world. Recent research has pointed to methylated PAHs (mPAHs), particularly 5-methylchrysene (5MC), within coal combustion products as a driving factor. Here we describe measurements of mPAHs in Xuanwei and Fuyuan derived from controlled burnings (i.e., water boiling tests, WBT, n = 27) representing exposures during stove use, and an exposure assessment (EA) study (n = 116) representing 24 h weighted exposures. Using smoky coal has led to significantly higher concentrations of known and likely human carcinogens than using smokeless coal, including 5MC (3.7 ng/m³ vs. 1.0 ng/m³ for EA samples and 100.8 ng/m³ vs. 2.2 ng/m³ for WBT samples), benzo[a]pyrene (38.0 ng/m³ vs. 7.9 ng/m³ for EA samples and 455.3 ng/m³ vs. 12.0 ng/m³ for WBT samples) and 7,12-dimethylbenz[a]anthracene (1.9 ng/m³ vs. 0.2 ng/m³ for EA samples and 47.7 ng/m³ vs. 0.6 ng/m³ for WBT samples). Mixed effect models for both EA samples and WBT samples revealed clear variation in mPAHs concentrations depending on smoky coal source while stove ventilation was consistently found to reduce measured concentrations (by up to nine fold and 65 fold for EA and WBT samples respectively when using smoky coal). Fuel type had a larger influence on mPAHs concentrations than stove type. These findings indicate that users of smoky coal experience exposure to many PAHs, including known and suspected human carcinogens (especially during cooking activities), many of which are not routinely tested for. Collectively, this provides insights into the potential etiologies of lung cancer in the region and further highlights the importance of targeting clean fuel transitions and stove refinements as the final goal for reducing household air pollution and its associated health risks.