LUNG CANCER IN NEPAL: THE ROLE OF TRADITIONAL TOBACCO PRODUCTS AND COMBUSTION RELATED HOUSEHOLD AIR POLLUTION

The burden of chronic diseases such as cancer is increasing in low and middle income countries around the globe. Nepal, one of the world’s poorest countries, is no exception to this trend, with lung cancer as the leading causes of cancer deaths. Despite this, limited data is available on the environmental and behavioral risk factors that contribute to the lung cancer etiology in Nepal. The objectives of this dissertation are to: 1) investigate the ethnic differences in consumption of local tobacco products and their role in lung cancer risk in Nepal; 2) evaluate urinary metabolite of 1,3-butadiene as a biomarker of exposure to combustion related household air pollution (CRHAP); 3) investigate the association between CRHAP exposure and lung cancer risk using urinary metabolite of 1,3-butadiene as a biomarker of exposure; 4) investigate the association between CRHAP exposure and lung cancer risk using questionnaire based measure of exposure. Lung cancer cases (n=606) and frequency matched controls (N=606) were recruited from B.P. Koirala Memorial Cancer Hospital. We obtained biological samples and information on lifestyles including cooking habits and type of fuels used. We used liquid chromatograph tandem mass spectrometer (LC-MS/MS) to quantify urinary metabolites of 1,3-butadiene in urine samples. We employed a combination of logistic and linear regression models to detect any exposure-disease associations while controlling for known confounding variables. Overall, we found that ethnic groups in Nepal use different tobacco products that have different differing cancer potency -we observed the highest odds ratios for the traditional tobacco products. The biomarker analysis showed strong evidence that monohydroxybutyl mercapturic acid is associated with biomass fuel use among participants. However, we did not find significant association between urinary MHMBA and lung cancer risk. When we used questionnaire based measure of exposure to household air pollution, we observed significant, dose-response associations between CRHAP exposure and lung cancer risk, particularly among never-smokers. Our results show that important role of local tobacco products in lung cancer risk in Nepal. Furthermore, we demonstrate that CRHAP exposure is a risk factor for lung cancer risk, independent of tobacco smoking.

Interaction of Acoustic Waves with a Laminar Line-Flame

A systematic study was conducted to elucidate the effects of acoustic perturbations on laminar diffusion line-flames and the conditions required to cause acoustically-driven extinction. Flames were produced from the fuels n-pentane, n-hexane, n-heptane, n-octane, and JP-8, using fuel-laden wicks. The wicks were housed inside of a burner whose geometry produced flames that approximated a two dimensional flame sheet. The acoustics utilized ranged in frequency between 30-50 Hz and acoustic pressures between 5-50 Pa. The unperturbed mass loss rate and flame height of the alkanes were studied, and they were found to scale in a linear manner consistent with Burke-Schumann. The mass loss rate of hexane-fueled flames experiencing acoustic perturbations was then studied. It was found that the strongest influence on the mass loss rate was the magnitude of oscillatory air movement experienced by the flame. Finally, acoustic perturbations were imposed on flames using all fuels to determine acoustic extinction criterion. Using the data collected, a model was developed which characterized the acoustic conditions required to cause flame extinction. The model was based on the ratio of an acoustic Nusselt Number to the Spalding B Number of the fuel, and it was found that at the minimum speaker power required to cause extinction this ratio was a constant. Furthermore, it was found that at conditions where the ratio was below this constant, a flame could still exist; at conditions where the ratio was greater than or equal to this constant, flame extinction always occurred.