Cancer Risk from Exposure to Particulate Matter and Ozone According to Obesity and Health-Related Behaviors: A Nationwide Population-Based Cross-Sectional Study

Background: There is little evidence of an association between cancer risk and long-term exposure to ambient particulate matter 10 ) and ozone (O 3 ), according to obesity and health-related behaviors. Methods: In the 2012 Korean Community Health Survey, survey data on socioeconomic characteristics, health-related behaviors, and previous cancer history were collected from 100,867 participants. Daily average concentrations of PM 10 and O 3 (2003–2012) were obtained from the Korean Air Pollutants Emission Service. The cancer risks for interquartile increases in PM 10 and O 3 were evaluated using multiple logistic regression and were stratified by age, sex, obesity, and health-related behaviors. Results: Increased cancer risk was found among obese subjects aged ≥50 years after adjusting for confounding factors [PM 10 : ≥60 years: OR 1.34, 95% confidence interval (CI) 1.03–1.74; 50–60 years: OR 1.40, CI 1.01–1.96; O 3 : ≥60 years: OR 1.12, CI 1.04–1.20; 50–60 years: OR 1.20, CI 1.08–1.33]. However, we did not observe similar trends in the nonobese subjects. Among obese subjects aged ≥50 who had been exposed to PM 10 , men, ever smokers, and inactive subjects were at increased cancer risk. Regarding O 3 , the cancer risk was significantly higher among obese adults >50 years old, regardless of sex or health-related behaviors. Conclusions: Long-term exposure to PM 10 and O 3 was found to increase cancer risk. In particular, the risk differed according to obesity status, age, sex, and health-related behaviors. Impact: The effect of air pollution on cancer risk was compounded by obesity, smoking, and physical inactivity among subjects over 50 years old.