Mei-Sheng Ku1, Pallop Siewchaisakul2,3, Amy Ming-Fang Yen2, Chen-Yu Liu This email address is being protected from spambots. You need JavaScript enabled to view it.1

1 Institute of Environmental and Occupational Health Science, College of Public Health, National Taiwan University, Taipei, Taiwan
2 School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
Faculty of Public Health, Chiang Mai University, Thailand

Received: March 21, 2021
Revised: June 29, 2021
Accepted: July 23, 2021

 Copyright The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are cited.

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Ku, M.S., Siewhcaisakul, P., Yen, A.M.F., Liu, C.Y. (2021). The Association between Ambient Fine Particulate Matter and Oral Neoplasm among Smokers and Betel Quids Chewers. Aerosol Air Qual. Res. 21, 210060.


  • We examined the effects of PM2.5 on OPMD/OC using the nationwide screening data.
  • An increased risk of OPMD/OC and OC was noted in the areas of higher PM2.5 levels.
  • We observed a concentration-dependent relationship between PM2.5 and OC risk.


The association between fine particulate matter < 2.5 µm (PM2.5) and oral neoplasm has barely been addressed. The purpose of this study is to elucidate the association between PM2.5 and oral neoplasm, including oral potentially malignant disorder (OPMD) and oral cancer (OC), taking into account the geographical heterogeneity. Data for analysis were derived from nationwide OC screening program, targeting Taiwanese cigarette smokers and/or betel quid chewers, and the Taiwan Air Quality Monitoring Network between 2006 and 2016. Totally 3,864,045 smokers and/or betel quids chewers were enrolled in this study. Among them, 154,030 OPMD cases and 23,286 oral cancers were found during the study period. Information on age, gender, living area, personal oral habits, and monthly PM2.5 concentration in average were collected. We used the Bayesian random-effect logistic regression model to assess the association between PM2.5 and OPMD/OC. After adjusting for sex, age, and behavior of betel quid chewing and cigarette smoking, we found that subjects from areas of higher levels of PM2.5 (≥ 35 µg m3) had an increased risk of OPMD/OC and OC by 11% (aRR = 1.11; 95% CI: 1.09–1.13) and 55% (aRR = 1.55; 95% CI: 1.49–1.60) respectively, compared to those from areas of lower PM2.5 (< 35 µg m3). Such effect was further demonstrated in a concentration-dependent manner. Subjects from areas of higher PM2.5 levels were found to have greater risk of OPMD/OC in Taiwan. Future studies are warranted to investigate the effect of personal PM2.5 exposure on OPMD/OC risk.

Keywords: Particulate matter, Oral cancer, Nationwide screening program, Taiwan

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