Radon in Underground Mines

Radon, a radioactive noble gas, is a decay product of uranium found in varying concentrations in all soils and rocks in the earth crust. It is colorless, odorless, tasteless, and a leading cause of lung cancer death in the USA. A study of underground miners shows that 40% of lung cancer deaths may be due to radon progeny exposure. In underground mines, radon monitoring and exposure standards help in limiting miners’ exposure to radioactivity. Radon mitigation techniques play an important role in keeping its concentration levels under permissible limits. This chapter presents a review of the radon sources and monitoring standards followed for underground mines in the USA. Also, the different radon prediction and measurement techniques employed in the underground mines and potential mitigation techniques for underground mining operations are discussed.

Lung Cancer Death Attributable to Long-Term Ambient Particulate Matter (PM2.5) Exposure in East Asian Countries During 1990–2019

Background: Ambient particulate matter is a public health concern in East Asia as it contributes to a growing number of all-cause and cancer deaths. This study aimed to estimate lung cancer death attributable to ambient particulate matter (PM) < 2.5 μm (PM2.5) in East Asia countries.Methods: The attributable death rates of lung cancer were estimated based on the calculation of population attributable fraction. We performed joinpoint regression analysis and age-period-cohort (APC) model to estimate temporal trends of the attributable death to PM2.5.Results: In 2019, PM2.5 was estimated to have caused 42.2% (nearly 0.13 million) of lung cancer deaths in East Asia men. During 1990–2019, the increase in age-standardized death rates of lung cancer attributable to PM2.5 was highest in China, which increased by 3.50% in males and 3.71% in females. The death rate caused by PM2.5 also significantly increased in the Democratic People's Republic of Korea (2.16% in males; 3.06% in females). Joinpoint analysis showed that the rates generally increased in younger and older people in both the Democratic People's Republic of Korea and Mongolia, while it only increased in elderly people in other countries'. Age effect from APC analysis demonstrated the risk of lung cancer death attributable to PM2.5 generally increased from young to old age. Period effect indicated that from 1994–1998 to 2019–2023 period risk continuously increased by 1.77, 1.68, and 1.72 times in China, the Democratic People's Republic of Korea, and Japan, respectively. The period risk decreased from 1999 to 2009 and subsequently increased from 2009 to 2019 in both the Republic of Korea and Mongolia.Conclusions: The death rate of lung cancer attributable to PM2.5 is increasing in the Democratic People's Republic of Korea, Mongolia, and China. In East Asia, China is facing the highest attributable death rate in recent decades. The period effect suggested a remarkably increased risk of lung cancer death caused by PM2.5 in China, the Democratic People's Republic of Korea, and Japan during the long-term period. It is recommended that the governments of these countries should continuously concentrate on particulate matter pollution governance and improvement.

Development and validation of a prognostic model for non-lung cancer death in elderly patients treated with stereotactic body radiotherapy for non-small cell lung cancer

This study sought to develop and validate a prognostic model for non-lung cancer death (NLCD) in elderly patients with non-small cell lung cancer (NSCLC) treated with stereotactic body radiotherapy (SBRT). Patients aged ≥65 diagnosed with NSCLC (Tis-4N0M0), tumor diameter ≤5 cm and SBRT between 1998 and 2015 were retrospectively registered from two independent institutions. One institution was used for model development (arm D, 353 patients) and the other for validation (arm V, 401 patients). To identify risk factors for NLCD, multiple regression analysis on age, sex, performance status (PS), body mass index (BMI), Charlson comorbidity index (CCI), tumor diameter, histology and T-stage was performed on arm D. A score calculated using the regression coefficient was assigned to each factor and three risk groups were defined based on total score. Scores of 1.0 (BMI ≤18.4), 1.5 (age ≥ 5), 1.5 (PS ≥2), 2.5 (CCI 1 or 2) and 3 (CCI ≥3) were assigned, and risk groups were designated as low (total ≤ 3), intermediate (3.5 or 4) and high (≥4.5). The cumulative incidences of NLCD at 5 years in the low, intermediate and high-risk groups were 6.8, 23 and 40% in arm D, and 23, 19 and 44% in arm V, respectively. The AUC index at 5 years was 0.705 (arm D) and 0.632 (arm V). The proposed scoring system showed usefulness in predicting a high risk of NLCD in elderly patients treated with SBRT for NSCLC.

Impact of Chronic Obstruction Pulmonary Disease with Acute Exacerbation on Survival in Current-Smoking Patients with Advanced stages Lung Squamous Cell Carcinoma undergoing Concurrent Chemoradiotherapy

BACKGROUNDTo date, no data are available regarding the effect of chronic obstruction pulmonary disease (COPD) and COPD with acute exacerbation (COPDAE) on survival in patients with lung squamous cell carcinoma (SCC) receiving definitive concurrent chemoradiotherapy (CCRT).PATIENTS AND METHODSCurrent-smoking patients with clinical stage IIIA-IIIB, lung SCC who had received standard definitive CCRT and categorized them into two groups based on their COPD status to compare overall survival outcomes. We also examined the effects of COPD severity (0, 1, or ≥2 hospitalizations for COPDA within 1 year before CCRT). The aHRs (95% CIs) of lung cancer death for 1 and ≥2 hospitalizations for COPDAE within 1 year before CCRT were 1.21 (1.09, 1.39) and 1.63 (1.34, 1.97), respectively, compared with no hospitalization for COPDAE.RESULTSIn the inverse probability of treatment weighting (IPTW)-adjusted model, the adjusted hazard ratio (aHR) (95% confidence interval [CI]) of all-cause death for COPD was 1.06 (1.07, 1.71) compared with the non-COPD group. Moreover, in the IPTW-adjusted model, the aHRs (95% CIs) of 1 and ≥2 hospitalizations for COPDAE within 1 year before CCRT were 1.29 (1.16, 1.43) and 1.77 (1.41, 2.13), respectively, compared with no hospitalization for COPDAE.CONCLUSIONCOPD and its severity are significant independent risk factors for all-cause death in patients with stage IIIA-IIIB lung SCC receiving definitive CCRT. Hospitalization for COPDAE within 1 year before CCRT is the significant independent risk factors for lung cancer death in the patients with stages IIIA-IIIB lung SCC receiving definitive CCRT.

Distance to Highway and Factory Density Related to Lung Cancer Death and Associated Spatial Heterogeneity in Effects in Jiading District, Shanghai

Objective This study aimed to explore distance to highway and factory density related to lung cancer (LC) death and their spatial heterogeneity in effect. Methods We conducted a retrospective cohort study by using the data of registered LC patients in Jiading District from 2002 to 2012. Standard parametric model with weibull distribution was used to explore factors related to LC death and the spatial effect of environmental factors were detected by using spatial survival analysis. Results Shorter distance to highway (aOR = 1.15, 95% CI:1.03–1.30) and higher factory density (aOR = 1.20, 95% CI:1.05–1.37) were significantly associated with increased risks of LC death, and the associations showed spatial differences in northern and southern areas of Jiading District, respectively. High-risk areas were mainly distributed in the suburbs with a low population density, while low-risk areas were primarily located in the urban areas. Conclusion Traffic and factory-related pollution was significantly associated with increased risk of LC death with an obvious spatial heterogeneity.

Disease Prediction by Machine Learning Over Big Data Lung Cancer

Lung Cancer is one of the deadly diseases in the world today. Lung Cancer is caused because of some genetic factors and/or environmental factors and/or today’s modern lifestyle. Lung cancer has become the primary reason of death in developed countries. The majority effective way to decrease lung cancer death is to detect it earlier. The in advance detection of cancer is not easier method but if it is detecte it is curable. Various works have been done in predicting lung cancer different data mining approach and algorithm were adopt by different people. All work has some limits such as lack of intelligent prediction, and incompetent in structure that forced to take up this problem and to implement the Data mining based cancer prediction System (DMBCPS). This has proposed the Lung cancer prediction system based on data mining. This system is validated by comparing its predicted results with patient’s prior medical information and it was analyzed by using weka tool system. We analyzed the lung cancer prediction using classification algorithm such as Naive Bayes, SVM and Random forest algorithm. The dataset have 782 instances and 31 attributes. The main aim of this paper is to provide the earlier warning to the users and the performance analysis of the classification algorithms.

Smoking-attributable mortality at an infra-national level: regional estimates in France in 2015

Background Tobacco smoking is a major leading preventable cause of mortality. The Peto-Lopez method and its variants are commonly used for estimating smoking-attributable mortality in population in high-income countries. The method assumes the average cumulative exposure of tobacco smoking in the population can be approximated using lung cancer death rates. However, providing estimates at an infra-national level is often much more challenging because the observed number of deaths for lung cancer are generally too low to use directly the method. The aim of this study was to estimate the number of deaths attributable to smoking at the regional level in France in 2015. Methods Population attributable fractions were computed using the Peto-Lopez method modified by Parkin which combines mortality statistics, lung cancer death rates and adjusted relative risks of deaths associated with smoking. To estimate the proxy for smoking prevalence in regional level by sex and age group, we pooled lung cancer mortality on several years according to the size of the regional populations and we smoothed the non-linear relationship of age with the estimates of the proxy. The attributable fractions were estimated for the 13 metropolitan regions and 4 French overseas regions. Results In whole France, we estimated that 19% of deaths among men and 7% among women were attributable to smoking in 2015. Deaths attributable to smoking ranged across metropolitan regions from 17% to 23% among men and from 5.5% to 8.7% among women. In overseas territories, estimates presented much more variability with a range from 6% to 18% for men and from 1.2% to 4.3% for women. Conclusions We highlighted disparities in regional mortality attributable to smoking. Producing estimates of the burden of smoking at an infra-national level is a tool offering many perspectives for better analyzing territorial inequalities and ultimately to further guide more effective localized interventions to reduce tobacco consumptions. Key messages We provide a straightforward solution to estimate the infra-national burden attributable to tobacco from a usual method. Our results highlight the disparities in mortality attributable to smoking across regions in France in 2015.