Archives of Toxicology

, Volume 93, Issue 3, pp 573–583 | Cite as

Bituminous coal combustion and Xuan Wei Lung cancer: a review of the epidemiology, intervention, carcinogens, and carcinogenesis

  • Jinhui Li
  • Jinjun Ran
  • Lung-chi Chen
  • Max Costa
  • Yunchao Huang
  • Xiao Chen
  • Linwei TianEmail author
Review Article


Indoor air pollution from bituminous coal combustion has been linked to the extremely high lung cancer rates of nonsmoking women in Xuan Wei County, Yunnan Province, China. Venting the smoke outdoors by installing chimneys was found to be effective at reducing the lung cancer risk in a cohort study of 21,232 farmers in central Xuan Wei. However, the lung cancer mortality rates in all 1.2 million residents of Xuan Wei have been increasing dramatically over the last four decades. It was higher than that in Yunnan Province and China overall, with significant heterogeneities in the geographic patterns of Xuan Wei. Intervention measures targeting certain types of coal or certain carcinogenic components in coal smoke need to be explored. To inform targeted intervention policies, it is essential to pinpoint the specific substance (particulate matter, organic extract, PAHs, free radicals, crystalline silica, and inorganic matter) that might account for the carcinogenicity of bituminous coal smoke. Exploring the underlying carcinogenesis mechanisms would also contribute to the intervention and control of the lung cancer epidemic in Xuan Wei, China. Here we review the suspected carcinogens and carcinogenesis mechanisms and discuss future research directions towards a better understanding of the etiology of lung cancer in Xuan Wei, China.


Xuan Wei Lung cancer Bituminous coal smoke Particulate matter 


Compliance with ethical standards

Conflict of interest

The authors have no conflicts or financial disclosures to make.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Jinhui Li
    • 1
    • 2
  • Jinjun Ran
    • 1
  • Lung-chi Chen
    • 2
  • Max Costa
    • 2
  • Yunchao Huang
    • 3
  • Xiao Chen
    • 3
  • Linwei Tian
    • 1
    Email author
  1. 1.Li Ka Shing Faculty of Medicine, School of Public HealthThe University of Hong KongHong Kong SARChina
  2. 2.Department of Environmental MedicineNew York UniversityNew YorkUSA
  3. 3.Cancer Research Institute of Yunnan ProvinceThe Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital)KunmingPeople’s Republic of China

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