Abstract：
Epstein-Barr virus (EBV) is one of the risk factors of nasopharyngeal carcinoma (NPC), and understanding the modifiable risk factors of EBV activation is crucial in the prevention of NPC. In this study, we aimed to investigate the association between solid fuel use and EBV seropositivity in a high-risk area of NPC. Our study was based on the baseline findings from an ongoing population-based prospective cohort in Sihui county in Southern China. We explored the association between current use of solid fuel in cooking and EBV seropositivity, and NPC-related EBV activation, using logistic regression models. Stratification analyses were further conducted to assess potential effect modifiers. We also examined the impact of frequency and duration of solid fuel use, and switch in fuel types, on EBV seropositivity among ever users. Of the 12,579 participants included in our analysis, 4088 (32.5%) were EBV seropositive and 421 (3.3%) were high risk for NPC-related EBV activation. Solid fuel use was associated with a higher risk of EBV seropositivity and NPC-related EBV activation, with odds ratios (ORs) of 1.33 (95%CI: 1.01, 1.76) and 1.81 (95%CI: 1.03, 3.18), respectively. Higher risk of EBV seropositivity was observed for those who did not use ventilation apparatus and those who consumed salted food. Among ever users, OR was highest for participants with more than 40 years of solid fuel exposure (1.17, 95%CI: 1.00-1.37) and who have been constantly using solid fuel (1.30, 95%CI: 0.96-1.75). We did not find a statistically significant impact of cooking frequency on EBV seropositivity. The identification of solid fuel as a risk factor for EBV activation is of great value for understanding the etiology of NPC. Our findings also have important public health implications given the fact that a third of the global population still lack access to clean cooking, especially in low resource settings.
摘要：
EB病毒(EBV)是鼻咽癌的危险因素之一,了解EBV激活的可改变的危险因素对预防NPC至关重要。在这项研究中,我们旨在调查NPC高危地区固体燃料使用与EBV血清阳性之间的关联.我们的研究基于中国南方四汇县正在进行的基于人群的前瞻性队列的基线发现。我们探讨了目前在烹饪中使用固体燃料与EBV血清阳性之间的关系，和NPC相关的EBV激活，使用逻辑回归模型。进一步进行分层分析以评估潜在的效应改性剂。我们还检查了固体燃料使用的频率和持续时间的影响，并切换燃料类型，在所有用户中的EBV血清阳性。在我们分析的12,579名参与者中，4088（32.5％）为EBV血清阳性，421（3.3％）为NPC相关EBV激活的高风险。固体燃料的使用与EBV血清阳性和NPC相关的EBV激活的风险较高相关，赔率比（ORs）为1.33（95CI：1.01，1.76）和1.81（95CI：1.03，3.18），分别。对于不使用通风设备和食用盐渍食物的人，观察到较高的EBV血清阳性风险。在任何用户中，对于固体燃料暴露超过40年（1.17，95CI：1.00-1.37）且一直使用固体燃料（1.30，95CI：0.96-1.75）的参与者，OR最高。我们没有发现烹饪频率对EBV血清阳性有统计学意义的影响。确定固体燃料是EBV激活的危险因素，对于了解NPC的病因具有重要价值。鉴于全球三分之一的人口仍然无法获得清洁烹饪，我们的发现也具有重要的公共卫生意义。特别是在低资源设置。
