While smoking remains the leading cause of lung cancer, air pollution has emerged as a significant environmental risk factor. Recent studies have highlighted a concerning link between air pollution and an increased risk of lung cancer. Air pollution consists of a complex mix of harmful substances, including carcinogens like benzene, formaldehyde, and heavy metals. Long-term exposure to these pollutants, even at low levels, has been associated with a heightened risk of lung cancer. According to the World Health Organization (WHO), air pollution is now classified as a Group 1 carcinogen, putting it in the same category as tobacco smoke and asbestos. The WHO estimates that air pollution contributes to hundreds of thousands of lung cancer deaths globally each year.

We got in touch with Dr Vikas Goswami, Director - Medical Oncology, Max Hospital Vaishali who shares how air pollution can increase the risk of lung cancer. Lung cancer is significantly increased by air pollution, especially in areas like Delhi NCR. Elevated concentrations of PM2.5, or tiny particulate matter smaller than 2.5 micrometres, can cause lung cancer and other health problems by deeply penetrating the lungs and entering the bloodstream.

The International Agency for Research on Cancer (IARC) has categorized PM2.5 in the same group as tobacco smoke—Group 1 carcinogens. Delhi's PM2.5 levels frequently surpass the permissible limits set by the World Health Organization, even on its "cleanest" days. This is in stark contrast to European cities, where air quality regulations are closely followed and substantially higher.

Who Is At Risk?

As per reports, people living in urban areas with high levels of traffic and industrial emissions, as well as those exposed to indoor pollutants such as cooking fumes and second-hand smoke are at risk. Vulnerable populations, including children, the elderly, and those with pre-existing respiratory conditions, face an even greater risk.

Other Factors That May Lead To Lung Cancer

Dr Vikas Goswami explains although it is often acknowledged that direct smoking is a significant risk factor, additional tobacco use significantly raises the possibility of developing lung cancer. Particularly among the younger urban population, the usage of e-cigarettes and vaping devices, as well as chewing tobacco, is growing in popularity. “A lot of young people think vaping is less dangerous than smoking. But the dangerous chemicals and carcinogens included in e-cigarettes can injure lung tissue and raise the risk of cancer,” he said.

Sick Building Syndrome (SBS) is an additional complication. This condition arises when building inhabitants have acute health problems associated with their time there, but no particular ailment or cause can be determined. Dr Vikas Goswami shares SBS can be caused by inadequate ventilation, biological contaminants like mould and bacteria, and chemical contaminants from indoor sources including adhesives, carpeting, and upholstery. Although there is little direct evidence connecting SBS to lung cancer, long-term exposure to these conditions can cause respiratory issues that raise the risk of the disease.

Lung cancer is mostly caused by the colourless and odourless gas radon. It infiltrates buildings through gaps and fissures as it naturally originates from rocks and dirt. The risk of developing lung cancer is greatly increased by prolonged exposure to high radon levels, particularly in areas with inadequate ventilation. Dr Vikas Goswami explains that many Indians are ignorant of their potential exposure because there is a dearth of thorough radon gas mapping of the country's cities, which is in contrast to Western nations, where it is standard practice. By doing radon tests and implementing preventative measures, this silent threat can be lessened.

Another significant risk is asbestos, formerly widely used in insulation, building, and other sectors. Dr Vikas Goswami explains both lung cancer and mesothelioma, a rare kind of cancer, can be contracted by inhaling asbestos fibres. Even with today's strict regulations, there are still dangers associated with exposure in older buildings and some industries. For people who might be in danger, awareness and appropriate safety precautions are essential.

The susceptibility to lung cancer is also influenced by genetics. Regardless of smoking status, an individual's risk may be elevated by a family history of lung cancer. Dr Vikas Goswami explains genetic mutations can predispose cells to develop cancer, whether they are inherited or acquired. Understanding one's family medical history and talking with medical professionals about genetic testing might offer important information and chances for early detection.

Lung cancer risk is increased in some occupations, especially those that include exposure to carcinogens like silica, diesel exhaust, and other chemicals. Dr Vikas Goswami shares that minimizing these dangers for workers requires protective measures and regulations related to occupational safety.