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Nanoquartz in Late Permian C1 coal and the high incidence of female lung cancer in the Pearl River Origin area: a retrospective cohort study

Linwei Tian1*, Shifeng Dai2, Jianfang Wang3, Yunchao Huang4, Suzanne C Ho1, Yiping Zhou5, Donald Lucas6 and Catherine P Koshland78

Author Affiliations

1 School of Public Health, Chinese University of Hong Kong, Hong Kong SAR, PR China

2 State Key Laboratory of Coal Resources & Safe Mining, Chinese University of Mining and Technology, Beijing 100083, PR China

3 Department of Physics, Chinese University of Hong Kong, Hong Kong SAR, PR China

4 Yunnan Province Tumor Hospital and The Third Affiliated Hospital of Kunming Medical University, Kunming 650106, PR China

5 Yunnan Institute of Coal Geology Prospection, Kunming 650218, PR China

6 Lawrence Berkeley National Laboratory, University of California, Berkeley, CA 94720, USA

7 School of Public Health, University of California, Berkeley, CA 94720, USA

8 Energy and Resources Group, University of California, Berkeley, CA 94720, USA

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BMC Public Health 2008, 8:398  doi:10.1186/1471-2458-8-398

Published: 2 December 2008



The Pearl River Origin area, Qujing District of Yunnan Province, has one of the highest female lung cancer mortality rates in China. Smoking was excluded as a cause of the lung cancer excess because almost all women were non-smokers. Crystalline silica embedded in the soot emissions from coal combustion was found to be associated with the lung cancer risk in a geographical correlation study. Lung cancer rates tend to be higher in places where the Late Permian C1 coal is produced. Therefore, we have hypothesized the two processes: C1 coal combustion --> nanoquartz in ambient air --> lung cancer excess in non-smoking women.


We propose to conduct a retrospective cohort study to test the hypothesis above. We will search historical records and compile an inventory of the coal mines in operation during 1930–2009. To estimate the study subjects' retrospective exposure, we will reconstruct the historical exposure scenario by burning the coal samples, collected from operating or deserted coal mines by coal geologists, in a traditional firepit of an old house. Indoor air particulate samples will be collected for nanoquartz and polycyclic aromatic hydrocarbons (PAHs) analyses. Bulk quartz content will be quantified by X-ray diffraction analysis. Size distribution of quartz will be examined by electron microscopes and by centrifugation techniques. Lifetime cumulative exposure to nanoquartz will be estimated for each subject. Using the epidemiology data, we will examine whether the use of C1 coal and the cumulative exposure to nanoquartz are associated with an elevated risk of lung cancer.


The high incidence rate of lung cancer in Xuan Wei, one of the counties in the current study area, was once attributed to high indoor air concentrations of PAHs. The research results have been cited for qualitative and quantitative cancer risk assessment of PAHs by the World Health Organization and other agencies. If nanoquartz is found to be the main underlying cause of the lung cancer epidemic in the study area, cancer potency estimates for PAHs by the international agencies based on the lung cancer data in this study setting should then be updated.