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Does air pollution contribute to urban–rural disparity in male lung cancer diseases in China?

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Abstract

It remains unknown whether exposure to ambient air pollution can be a mediator linking socioeconomic indicator to health outcome. The present study aims to examine the mediation effect of PM2.5 air pollution on the association between urban–rural division and the incidence (mortality) rate of male lung cancer. We performed a nationwide analysis in 353 counties (districts) of China between 2006 and 2015. A structural equation model was developed to determine the mediation effect of exposure to PM2.5. We also tested whether the findings of the mediation effect of exposure to PM2.5 are sensitive to the controls of smoking factors and additional air pollutant, and PM2.5 exposures with different lag structures. According to the results, we found that exposure to PM2.5 significantly mediated the association between urban–rural division and the incidence rate of male lung cancer. Specifically, there were significant associations between urban–rural division, exposure to PM2.5, and the incidence rate of male lung cancer, with PM2.5 exposure accounting for 29.80% of total urban–rural difference in incidence rates of male lung cancer. A similar pattern of results was observed for the mortality rate of male lung cancer. That is, there was a significant mediation effect by PM2.5 on the association of the mortality rate with urban–rural division. The findings of exposure to PM2.5 as a mediator were robust in the three sensitivity analyses. In conclusion, urban–rural difference in exposures to PM2.5 may be a potential factor that contributes to urban–rural disparity in male lung cancer diseases in China. The findings inform that air pollution management and control may be effective measures to alleviate the great difference in male lung cancer diseases between urban and rural areas in China.

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Data availability

The datasets analyzed during the current study available from the corresponding author on reasonable request.

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Funding

This work was supported by the Start-up Foundation of Fuzhou University (511034), Shenzhen Fundamental Research Program (GXWD20201231165807007-20200816003026001), 2021 Guangdong Natural Science Fund - General Programme (2021A1515012571) and Guangdong - Hong Kong - Macau Joint Laboratory Program of the 2020 Guangdong New Innovative Strategic Research Fund, Guangdong Science and Technology Department (2020B1212030009).

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Authors and Affiliations

  1. School of Architecture and Urban-Rural Planning, Fuzhou University, Fuzhou, 350108, China

    Huagui Guo

  2. Department of Urban Planning and Design, The University of Hong Kong, Hong Kong, China

    Weifeng Li & Hung Chak Ho

  3. Shenzhen Institute of Research and Innovation, The University of Hong Kong, Shenzhen, 518057, China

    Weifeng Li

  4. Key Laboratory for Urban Habitat Environmental Science and Technology, Shenzhen Graduate School, Peking University, Shenzhen, 518055, China

    Jiansheng Wu

  5. Key Laboratory for Earth Surface Processes, Ministry of Education, College of Urban and Environmental Sciences, Peking University, Bei**g, 100871, China

    Jiansheng Wu

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  1. Huagui Guo
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  2. Weifeng Li
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Contributions

Dr. Huagui Guo conducted research design, data analysis and manuscript writing and revision. Dr. Weifeng Li and Prof. Jiansheng Wu performed data collection and manuscript revision. Dr. Hung Chak Ho contributed to research design and manuscript revision. All authors read and approved the final version of the manuscript.

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Correspondence to Hung Chak Ho.

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Guo, H., Li, W., Wu, J. et al. Does air pollution contribute to urban–rural disparity in male lung cancer diseases in China?. Environ Sci Pollut Res 29, 23905–23918 (2022). https://doi.org/10.1007/s11356-021-17406-5

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