1
|
Bidoli E, Barbone F, Collarile P, Valent F, Zanier L, Daris F, Gini A, Birri S, Serraino D. Residence in Proximity of an Iron Foundry and Risk of Lung Cancer in the Municipality of Trieste, Italy, 1995-2009. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:9025-35. [PMID: 26264014 PMCID: PMC4555261 DOI: 10.3390/ijerph120809025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 07/24/2015] [Accepted: 07/27/2015] [Indexed: 11/16/2022]
Abstract
We assessed the risk of lung cancer in people living near the iron foundry located within the city of Trieste, Northeastern Italy. Between 1995 and 2009, all incident cases of lung cancer and corresponding population were considered. A deposition model of the foundry-specific emissions of SO2 defined: "nearby", "urban", and "outlying" areas. Rate ratios (RRs) and annual percent changes (APCs) were computed. Among nearby residents, significantly increased risks of lung cancer were noted in men below age 75 years (RR = 1.35 vs. urban area; 95% CI: 1.03-1.77). In women, and in men aged 75 years or older, no significant RRs were observed. Conversely, people living in the outlying area appeared to be at lower risk than residents in the urban area- in all age groups, in men (RR = 0.87; 95% CI: 0.78-0.98) and in women (RR = 0.74; 95% CI: 0.62-0.88). Negative statistically significant APC was recorded in men living in urban areas (-2.6%), whereas in women APC significantly increased among those living in the urban area (+2.3%). Multiple interpretations for this observation are plausible, since several factors might have modified and/or confounded the risk of lung cancer, including air pollution from other sources and road traffic, occupational and smoking patterns.
Collapse
Affiliation(s)
- Ettore Bidoli
- SOC Epidemiologia e Biostatistica, IRCCS Centro di Riferimento Oncologico di Aviano, 33081 Aviano (PN), Italy.
| | - Fabio Barbone
- Istituto di Igiene ed Epidemiologia clinica, DSMB Università degli Studi di Udine, 33100 Udine, Italy.
- DSM Università degli Studi di Trieste, 34100 Trieste, Italy.
- SOC Igiene ed Epidemiologia Clinica, Azienda Ospedaliero Universitaria di Udine, 33100 Udine, Italy.
| | - Paolo Collarile
- Agenzia Regionale Protezione Ambientale, Friuli Venezia Giulia, 33057 Palmanova (UD), Italy.
| | - Francesca Valent
- Direzione Centrale Salute, Friuli Venezia Giulia, Servizio Regionale di Epidemiologia, 33100 Udine, Italy.
| | - Loris Zanier
- Direzione Centrale Salute, Friuli Venezia Giulia, Servizio Regionale di Epidemiologia, 33100 Udine, Italy.
| | - Fulvio Daris
- Agenzia Regionale Protezione Ambientale, Friuli Venezia Giulia, 33057 Palmanova (UD), Italy.
| | - Andrea Gini
- SOC Epidemiologia e Biostatistica, IRCCS Centro di Riferimento Oncologico di Aviano, 33081 Aviano (PN), Italy.
| | - Silvia Birri
- SOC Epidemiologia e Biostatistica, IRCCS Centro di Riferimento Oncologico di Aviano, 33081 Aviano (PN), Italy.
| | - Diego Serraino
- SOC Epidemiologia e Biostatistica, IRCCS Centro di Riferimento Oncologico di Aviano, 33081 Aviano (PN), Italy.
- Registro Tumori del Friuli Venezia Giulia, 33081 Aviano (PN), Italy.
| |
Collapse
|
2
|
Lung cancer risk and past exposure to emissions from a large steel plant. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2013; 2013:684035. [PMID: 24324501 PMCID: PMC3845394 DOI: 10.1155/2013/684035] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 09/16/2013] [Accepted: 10/08/2013] [Indexed: 11/22/2022]
Abstract
We studied the spatial distribution of cancer incidence rates around a large steel plant and its association with historical exposure. The study population was close to 600,000. The incidence data was collected for 1995–2006. From historical emission data the air pollution concentrations for polycyclic aromatic hydrocarbons (PAH) and metals were modelled. Data were analyzed using Bayesian hierarchical Poisson regression models. The standardized incidence ratio (SIR) for lung cancer was up to 40% higher than average in postcodes located in two municipalities adjacent to the industrial area. Increased incidence rates could partly be explained by differences in socioeconomic status (SES). In the highest exposure category (approximately 45,000 inhabitants) a statistically significant increased relative risk (RR) of 1.21 (1.01–1.43) was found after adjustment for SES. The elevated RRs were similar for men and women. Additional analyses in a subsample of the population with personal smoking data from a recent survey suggested that the observed association between lung cancer and plant emission, after adjustment for SES, could still be caused by residual confounding. Therefore, we cannot indisputably conclude that past emissions from the steel plant have contributed to the increased risk of lung cancer.
Collapse
|
3
|
Kim TW, Koh DH, Park CY. Decision tree of occupational lung cancer using classification and regression analysis. Saf Health Work 2010; 1:140-8. [PMID: 22953174 PMCID: PMC3430888 DOI: 10.5491/shaw.2010.1.2.140] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2010] [Accepted: 09/16/2010] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Determining the work-relatedness of lung cancer developed through occupational exposures is very difficult. Aims of the present study are to develop a decision tree of occupational lung cancer. METHODS 153 cases of lung cancer surveyed by the Occupational Safety and Health Research Institute (OSHRI) from 1992-2007 were included. The target variable was whether the case was approved as work-related lung cancer, and independent variables were age, sex, pack-years of smoking, histological type, type of industry, latency, working period and exposure material in the workplace. The Classification and Regression Test (CART) model was used in searching for predictors of occupational lung cancer. RESULTS In the CART model, the best predictor was exposure to known lung carcinogens. The second best predictor was 8.6 years or higher latency and the third best predictor was smoking history of less than 11.25 pack-years. The CART model must be used sparingly in deciding the work-relatedness of lung cancer because it is not absolute. CONCLUSION We found that exposure to lung carcinogens, latency and smoking history were predictive factors of approval for occupational lung cancer. Further studies for work-relatedness of occupational disease are needed.
Collapse
Affiliation(s)
- Tae-Woo Kim
- Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Incheon, Korea
| | | | | |
Collapse
|
4
|
Richardson EA, Mitchell RJ, Shortt NK, Pearce J, Dawson TP. Evidence-based selection of environmental factors and datasets for measuring multiple environmental deprivation in epidemiological research. Environ Health 2009; 8 Suppl 1:S18. [PMID: 20102585 PMCID: PMC2796496 DOI: 10.1186/1476-069x-8-s1-s18] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
This Environment and Human Health project aims to develop a health-based summary measure of multiple physical environmental deprivation for the UK, akin to the measures of multiple socioeconomic deprivation that are widely used in epidemiology. Here we describe the first stage of the project, in which we aimed to identify health-relevant dimensions of physical environmental deprivation and acquire suitable environmental datasets to represent population exposure to these dimensions at the small-area level. We present the results of this process: an evidence-based list of environmental dimensions with population health relevance for the UK, and the spatial datasets we obtained and processed to represent these dimensions. This stage laid the foundations for the rest of the project, which will be reported elsewhere.
Collapse
Affiliation(s)
- Elizabeth A Richardson
- School of GeoSciences, The University of Edinburgh, Drummond Street, Edinburgh EH8 9XP, UK
| | - Richard J Mitchell
- Section of Public Health and Health Policy, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UK
| | - Niamh K Shortt
- School of GeoSciences, The University of Edinburgh, Drummond Street, Edinburgh EH8 9XP, UK
| | - Jamie Pearce
- School of GeoSciences, The University of Edinburgh, Drummond Street, Edinburgh EH8 9XP, UK
| | - Terence P Dawson
- School of Geography, University of Southampton, Highfield, Southampton SO17 1BJ, UK
| |
Collapse
|
5
|
Abstract
Environmental carcinogens, in a strict sense, include outdoor and indoor air pollutants, as well as soil and drinking water contaminants. An increased risk of mesothelioma has consistently been detected among individuals experiencing residential exposure to asbestos, while results for lung cancer are less consistent. Several good-quality studies have investigated lung cancer risk from outdoor air pollution based on measurement of specific agents. Their results tend to show an increased risk in the categories at highest exposure, with relative risks in the range 1.5. A causal association has been established between exposure to environmental tobacco smoke and lung cancer, with a relative risk in the order of 1.2. Radon is another carcinogen present in indoor air, with a relative risk in the order of 1.06 for exposure at 100 Bq/m3. In several Asian populations, an increased risk of lung cancer results among women from indoor pollution from cooking and heating. There is strong evidence of an increased risk of bladder, skin and lung cancers following consumption of water with high arsenic contamination; results for other drinking water contaminants, including chlorination by-products, are inconclusive. A total of 29 occupational agents are established human carcinogens, and another 30 agents are suspected carcinogens. In addition, at least 12 exposure circumstances entail exposure to carcinogens. Exposure is still widespread for many important occupational carcinogens, such as asbestos, coal tar, arsenic and silica, in particular in developing countries. Although estimates of the global burden of occupational and environmental cancer result in figures in the order of 2% and less than 1%, respectively, these cancers concentrate in subgroups of the population; furthermore, exposure is involuntary and can, to a large extent, be avoided.
Collapse
Affiliation(s)
- Paolo Boffetta
- International Agency for Research on Cancer, 150 cours Albert-Thomas, 69008 Lyon, France.
| |
Collapse
|
6
|
Abstract
Environmental carcinogens, in a strict sense, include outdoor and indoor air pollutants, as well as soil and drinking water contaminants. An increased risk of mesothelioma has consistently been detected among individuals experiencing residential exposure to asbestos, whereas results for lung cancer are less consistent. At least 14 good-quality studies have investigated lung cancer risk from outdoor air pollution based on measurement of specific agents. Their results tend to show an increased risk in the categories at highest exposure, with relative risks in the range 1.5-2.0, which is not attributable to confounders. Results for other cancers are sparse. A causal association has been established between exposure to environmental tobacco smoke and lung cancer, with a relative risk in the order of 1.2. Radon is another carcinogen present in indoor air which may be responsible for 1% of all lung cancers. In several Asian populations, an increased risk of lung cancer is present in women from indoor pollution from cooking and heating. There is strong evidence of an increased risk of bladder, skin and lung cancers following consumption of water with high arsenic contamination; results for other drinking water contaminants, including chlorination by-products, are inconclusive. A precise quantification of the burden of human cancer attributable to environmental exposure is problematic. However, despite the relatively small relative risks of cancer following exposure to environmental carcinogens, the number of cases that might be caused, assuming a causal relationship, is relatively large, as a result of the high prevalence of exposure.
Collapse
Affiliation(s)
- Paolo Boffetta
- International Agency for Research on Cancer, Lyon, France.
| | | |
Collapse
|
7
|
Hobbesland A, Kjuus H, Thelle DS. Study of cancer incidence among 6363 male workers in four Norwegian ferromanganese and silicomanganese producing plants. Occup Environ Med 1999; 56:618-24. [PMID: 10615295 PMCID: PMC1757793 DOI: 10.1136/oem.56.9.618] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Little has been known about the risk of cancer associated with occupational exposure to manganese. The objective of this study was therefore to examine the associations between duration of specific work and cancer incidence among employees in four Norwegian ferromanganese and silicomanganese producing plants. METHODS Among men first employed in 1933-91 and with at least 6 months in these plants, the incident cases of cancer during 1953-91 were obtained from The Cancer Registry of Norway. The numbers of various cancers were compared with expected figures calculated from age and calendar time specific rates for Norwegian men during the same period. Internal comparisons of rates were performed with Poisson regression analysis. The final cohort comprised 6363 men. RESULTS A total of 607 cases of cancer were observed against 596 cases expected (standardised incidence ratio (SIR) 1.02). Internal comparisons of rates showed a positive trend between the rate of all cancers and duration of furnace work. A slightly weaker trend was also found for duration of blue collar non-furnace work when lags of 25 or 30 years were applied in the analyses. However, several results indicated that the incidence of all cancers among the non-furnace workers decreased during the period of active employment. CONCLUSIONS Furnace and non-furnace workers may have exposures that increase the incidence of several cancers. The low incidence of cancer among non-furnace workers during the period of ongoing exposure cannot be explained. As this study cannot identify any causal factors, the role of exposure to manganese remains unclear.
Collapse
Affiliation(s)
- A Hobbesland
- Telemark Central Hospital, Department of Occupational and Environmental Medicine, Skien, Norway
| | | | | |
Collapse
|
8
|
Chau N, Benamghar L, Pham QT, Teculescu D, Rebstock E, Mur JM. Mortality of iron miners in Lorraine (France): relations between lung function and respiratory symptoms and subsequent mortality. BRITISH JOURNAL OF INDUSTRIAL MEDICINE 1993; 50:1017-31. [PMID: 8280627 PMCID: PMC1035537 DOI: 10.1136/oem.50.11.1017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
An increased mortality from lung and stomach cancer was found in previous studies on Lorraine iron miners. A detailed analysis, however, was not possible due to the lack of data for survivors. In this study the cohort included 1178 workers selected at random from all the 5300 working miners aged between 35 and 55 at the start of the follow up period, which ranged from 1975 to 1985. Occupational exposures and tobacco consumption, lung function tests, and respiratory symptoms were assessed for each subject in 1975, 1980, and 1985. This study confirmed the excess of lung cancer (standardised mortality ratio (SMR) = 389, p < 0.001) and of stomach cancer (SMR = 273, p < 0.05). There was no excess of lung cancer in non-smokers and moderate smokers (< 20 pack-years) or the miners who worked only at the surface or underground for less than 20 years. A significant excess (SMR = 349, p < 0.001) was found in moderate smokers when they worked underground for between 20 and 29 years. Heavy smokers (over 30 pack-years) or subjects who worked underground for more than 30 years experienced a high risk: SMR = 478 (p < 0.001) for moderate smokers who worked underground for over 30 years; 588 (p < 0.001) for heavy smokers who worked underground for between 20 and 29 years; and 877 (p < 0.001) for heavy smokers who worked underground for over 30 years. This showed an interaction between smoking and occupational exposure. The excess mortality from lung cancer was because there were some subjects who died young (from 45 years old). Comparison with the results of a previous study showed that additional hazards produced by diesel engines and explosives increased the mortality from lung cancer. The SMR was higher than 400 (p < 0.001) from 45 years old instead of from 56 years. A relation was found between a decrease in vital capacity (VC), forced expiratory volume in one second (FEV1) and of FEV1/VC and mortality from all causes and from lung cancer in heavy smokers or men who had worked underground for more than 20 years. Respiratory symptoms were related to mortality from lung cancer among smokers (moderate and heavy) who worked underground for more than 20 years. It is considered that the risk of lung cancer in the Lorraine iron miners was mainly due to dust, diesel engines, and explosives although the role of low exposure to radon daughters could not be totally excluded.
Collapse
Affiliation(s)
- N Chau
- INSERM U115 Santé an Travail et Santé Publique: Méthodes et Applications, Faculte de Médecine, Vandoseuvre-lis-Nancy, France
| | | | | | | | | | | |
Collapse
|