我们之前的研究表明，暴露于5-甲基蒽（5MC）和其他甲基多环芳烃（PAHs）最能够解释中国使用烟煤的非吸烟妇女肺癌风险的病例对照研究。时间因素（如暴露时的年龄）和非线性关系没有被探究。我们使用大型回顾性队列研究了煤炭来源的空气污染物和肺癌死亡率之间的关系。参与者来自宣威的四个公社的42,420名烟煤（焦炭）或不含烟煤（无烟煤）用户队列，随访周期从1976年至2011年，期间有4,827名因肺癌死亡。预测了43种不同污染物的暴露情况，使用层次聚类法确定了暴露集群。使用Cox回归评估了5MC的暴露反应关系，而通过暴露集群原型研究了暴露时年龄的效应修饰。在嵌套病例对照样本上拟合贝叶斯惩罚多污染物模型，使用更受限制的模型来研究非线性暴露反应关系。我们确认了5MC的强暴露反应关系（危险比[95％置信区间]=2.5 [2.4, 2.6]每个标准差（SD））。我们确定了四个污染物聚类，除了两种PAHs外，所有污染物都在单个聚类中。处于大聚类中的PAHs暴露与更高的肺癌死亡率相关（HR [95％CI] = 2.4 [2.2, 2.6]每个SD），而18岁之前的暴露似乎比成年暴露更为重要。多污染物模型的结果确定了蒽醌（ANT）和苯并（a）蒽（BaC）作为危险因素。在包括ANT和BaC以及苯并[a]芘（BaP）的模型中，5MC仍然与肺癌强相关。我们确认了烟煤用户暴露于PAHs和肺癌之间的联系，并发现18岁之前的暴露特别重要。我们发现了一些关于致癌物质5MC以及非致癌物质ANT和BaC的证据。版权所有 © 2023 The Authors. Elsevier Ltd. 保留所有权利。

We previously showed that exposure to 5-methylchrysene (5MC) and other methylated polycyclic aromatic hydrocarbons (PAHs) best explains lung cancer risks in a case-control study among non-smoking women using smoky coal in China. Time-related factors (e.g., age at exposure) and non-linear relations were not explored.We investigated the relation between coal-derived air pollutants and lung cancer mortality using data from a large retrospective cohort.Participants were smoky (bituminous) or smokeless (anthracite) coal users from a cohort of 42,420 subjects from four communes in XuanWei. Follow-up was from 1976 to 2011, during which 4,827 deaths from lung-cancer occurred. Exposures were predicted for 43 different pollutants. Exposure clusters were identified using hierarchical clustering. Cox regression was used to estimate exposure-response relations for 5MC, while effect modification by age at exposure was investigated for cluster prototypes. A Bayesian penalized multi-pollutant model was fitted on a nested case-control sample, with more restricted models fitted to investigate non-linear exposure-response relations.We confirmed the strong exposure-response relation for 5MC (Hazard Ratio [95% Confidence Interval] = 2.5 [2.4, 2.6] per standard-deviation (SD)). We identified four pollutant clusters, with all but two PAHs in a single cluster. Exposure to PAHs in the large cluster was associated with a higher lung cancer mortality rate (HR [95%CI] = 2.4 [2.2, 2.6] per SD), while exposure accrued before 18 years of age appeared more important than adulthood exposures. Results from the multi-pollutant model identified anthanthrene (ANT) and benzo(a)chrysene (BaC) as risk factors. 5MC remained strongly associated with lung cancer in models that included ANT and BaC and also benzo(a)pyrene (BaP).We confirmed the link between PAH exposures and lung cancer in smoky coal users and found exposures before age 18 to be especially important. We found some evidence for the carcinogen 5MC and non-carcinogens ANT and BaC.Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.