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Dahman L, Gauthier V, Camier A, Bigna JJ, Glowacki F, Amouyel P, Dauchet L, Hamroun A. Air pollution and kidney cancer risk: a systematic review and meta-analysis. J Nephrol 2024:10.1007/s40620-024-01984-x. [PMID: 38913266 DOI: 10.1007/s40620-024-01984-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 04/30/2024] [Indexed: 06/25/2024]
Abstract
BACKGROUND Although several risk factors of kidney cancer have already been well-addressed, many remain underappreciated, such as chronic exposure to air pollution. This systematic review and meta-analysis aims to assess the association between air pollutant exposure and the risk of kidney cancer. METHODS With an exhaustive search equation including keywords related to air pollution and kidney cancer on EMBASE, PubMed, Web of science, Cochrane Library and CINAHL database, we identified all relevant articles published before March 23rd, 2023 (Prospero registration number: CRD42020187956). Using random-effects meta-analysis, we present pooled hazard ratios (with their respective 95% confidence interval) associated with a 10 µg/m3 increase in each pollutant level. Heterogeneity was quantified by the I2 statistic. Risks of methodological and publication bias were also both assessed using appropriate tools. RESULTS Of the 1919 records identified, our review included 19 articles (13 cohort, 5 registry-based and 1 case-control studies), of which 9 were suitable for the meta-analysis. We found a significantly increased risk of kidney cancer incidence for a 10 μg/m3 elevation of both particulate matter of less than 10 µm (PM10) (HR = 1.29 [1.10; 1.51], I2 = 0%, p = 0.002) and nitrogen dioxide (NO2) (HR = 1.10 [1.03; 1.18], I2 = 20%, p = 0.004). Secondary analyses also suggest an increased risk of kidney cancer-related morbidity-mortality associated with PM10 exposure. CONCLUSIONS Overall, our findings suggest a potential association between exposure to increased levels of PM10 and NO2 and the risk of kidney cancer. These results should nonetheless be interpreted with caution due to the limited number of included studies and their significant risk of methodological bias.
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Affiliation(s)
- Lina Dahman
- Service de Santé Publique, Epidémiologie, Economie de la Santé et Prévention, CHU de Lille, Lille, France
- Faculté de Médecine, Université Catholique de Lille, Lille, France
| | - Victoria Gauthier
- Service de Santé Publique, Epidémiologie, Economie de la Santé Et Prévention, CHU de Lille, Lille, France
- UMR1167 RID-AGE, Institut Pasteur de Lille, Inserm, Univ Lille, CHU Lille, Lille, France
| | | | - Jean Joel Bigna
- Département de Santé Publique, Epidémiologie, Institut Pasteur du Cameroun, Yaoundé, Cameroun
| | | | - Philippe Amouyel
- Service de Santé Publique, Epidémiologie, Economie de la Santé Et Prévention, CHU de Lille, Lille, France
- UMR1167 RID-AGE, Institut Pasteur de Lille, Inserm, Univ Lille, CHU Lille, Lille, France
| | - Luc Dauchet
- Service de Santé Publique, Epidémiologie, Economie de la Santé Et Prévention, CHU de Lille, Lille, France
- UMR1167 RID-AGE, Institut Pasteur de Lille, Inserm, Univ Lille, CHU Lille, Lille, France
| | - Aghiles Hamroun
- Service de Santé Publique, Epidémiologie, Economie de la Santé Et Prévention, CHU de Lille, Lille, France.
- UMR1167 RID-AGE, Institut Pasteur de Lille, Inserm, Univ Lille, CHU Lille, Lille, France.
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Badaloni C, De Sario M, Caranci N, De' Donato F, Bolignano A, Davoli M, Leccese L, Michelozzi P, Leone M. A spatial indicator of environmental and climatic vulnerability in Rome. ENVIRONMENT INTERNATIONAL 2023; 176:107970. [PMID: 37224679 DOI: 10.1016/j.envint.2023.107970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/14/2023] [Accepted: 05/08/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND Urban areas are disproportionately affected by multiple pressures from overbuilding, traffic, air pollution, and heat waves that often interact and are interconnected in producing health effects. A new synthetic tool to summarize environmental and climatic vulnerability has been introduced for the city of Rome, Italy, to provide the basis for environmental and health policies. METHODS From a literature overview and based on the availability of data, several macro-dimensions were identified on 1,461 grid cells with a width of 1 km2 in Rome: land use, roads and traffic-related exposure, green space data, soil sealing, air pollution (PM2.5, PM10, NO2, C6H6, SO2), urban heat island intensity. The Geographically Weighted Principal Component Analysis (GWPCA) method was performed to produce a composite spatial indicator to describe and interpret each spatial feature by integrating all environmental dimensions. The method of natural breaks was used to define the risk classes. A bivariate map of environmental and social vulnerability was described. RESULTS The first three components explained most of the variation in the data structure with an average of 78.2% of the total percentage of variance (PTV) explained by the GWPCA, with air pollution and soil sealing contributing most in the first component; green space in the second component; road and traffic density and SO2 in the third component. 56% of the population lives in areas with high or very high levels of environmental and climatic vulnerability, showing a periphery-centre trend, inverse to the deprivation index. CONCLUSIONS A new environmental and climatic vulnerability indicator for the city of Rome was able to identify the areas and population at risk in the city, and can be integrated with other vulnerability dimensions, such as social deprivation, providing the basis for risk stratification of the population and for the design of policies to address environmental, climatic and social injustice.
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Affiliation(s)
- Chiara Badaloni
- Department of Epidemiology of the Lazio Regional Health Service, ASL Roma 1, Rome, Italy.
| | - Manuela De Sario
- Department of Epidemiology of the Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Nicola Caranci
- Regional Health and Social Care Agency, Emilia-Romagna Region, Bologna, Italy
| | - Francesca De' Donato
- Department of Epidemiology of the Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | | | - Marina Davoli
- Department of Epidemiology of the Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Letizia Leccese
- Department of Epidemiology of the Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Paola Michelozzi
- Department of Epidemiology of the Lazio Regional Health Service, ASL Roma 1, Rome, Italy
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Debrah JK, Dinis MAP. Chemical characteristics of bottom ash from biomedical waste incinerators in Ghana. ENVIRONMENTAL MONITORING AND ASSESSMENT 2023; 195:568. [PMID: 37058242 PMCID: PMC10102684 DOI: 10.1007/s10661-023-11132-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 03/12/2023] [Indexed: 05/19/2023]
Abstract
Biomedical waste (BMW) incineration is the most used alternative disposal method in developing countries, such as Ghana. The improper disposal of incinerator-generated bottom ash (BA) is a significant concern due to the hazardous nature of waste. A study was conducted at Tema Hospital (TGH) and Asuogyaman Hospital (VRAH) incinerator sites. The BA samples were sent to the Council for Scientific and Industrial Research, Institute of Industrial Research, Ghana. The BA samples were weighed with fisher analytical balance, ground, and sieved with standard grade meshes of 120, 100, and 80 to determine the BA particle size distribution. The chemical composition and heavy metals were analysed using X-ray fluorescence spectrometry (XRF) and atomic absorption spectroscopy (AAS) techniques. The results indicated the chemical composition of the analysed BA samples was CaCO3 (49.90%), CaO (27.96%) and MgCO3 (6.02%) for TGH and CaCO3 (48.30%), CaO (27.07%), and SiO2 (6.10%) for VRAH, respectively. The mean concentration (M) (kg m-3) and standard deviation (SD) for TGH in the BA were 7.082 ± 0.478 (Ti), 4.657 ± 0.127 (Zn) and 4.271 ± 1.263 (Fe), while that of VRAH consisted of 10.469 ± 1.588 (Ti), 7.896 ± 2.154 (Fe) and 4.389 ± 0.371 (Zn). Therefore, the heavy metals' mean concentration at the BA is above the WHO permissible limits of soil, i.e., 0.056 kg m-3 (Ti), 0.085 kg m-3 (Pb), 0.100 kg m-3 (Cr) and 0.036 kg m-3 (Cu). Furthermore, the heavy metal mean concentrations of TGH and VRAH present in the BA analysed samples were ranked in descending order: Ti > Zn > Fe and Ti > Fe > Zn, respectively. It is therefore recommended that BA must be properly disposed of because of the hazardous nature of heavy metals present in the analysed samples, which are able to cause environmental and public health issues.
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Affiliation(s)
- Justice Kofi Debrah
- Faculty of Science and Technology, University Fernando Pessoa (UFP), Praça 9 de Abril 349, 4249-004, Porto, Portugal.
| | - Maria Alzira Pimenta Dinis
- UFP Energy, Environment and Health Research Unit (FP-ENAS), University Fernando Pessoa (UFP), Praça 9 de Abril 349, 4249-004, Porto, Portugal.
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Boonhat H, Lin RT, Lin JT. Association between residential exposure to petrochemical industrial complexes and pancreatic cancer: a systematic review and meta-analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2023; 33:116-127. [PMID: 34930088 DOI: 10.1080/09603123.2021.2007226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/11/2021] [Indexed: 06/14/2023]
Abstract
Increased in the global demand-expansion of the petrochemical industry is a possible environmental risk factor pancreatic cancer among residents living close to petrochemical complexes. This meta-analysis aimed to estimate the pooled risk of pancreatic cancer among residents living near petrochemical industrial complexes. We systematically searched and reviewed published studies in six databases based on the inclusion criteria derived from the population, exposure, comparator, and outcomes framework (population: general population; exposure: residence near petrochemical industrial complexes/living in cities with petrochemical industrial complexes; comparators: residents living farther away from petrochemical industrial complexes/living in cities without petrochemical industrial complexes; outcome: pancreatic cancer). We identified seven studies, covering 1,605,568 residents. Pooled analysis showed a significantly higher risk of pancreatic cancer among residents living near petrochemical industrial complexes (relative risk [RR] = 1.31, 95% confidence interval [CI] = 1.21-1.42) than those living farther away from petrochemical industrial complexes. Such effect was higher in female residents (RR = 1.34, 95% CI = 1.18-1.53) than in male residents (RR = 1.26, 95% CI = 1.12-1.41). This study suggests that exposure to petrochemical industry-related activities should be recognized as a risk factor for pancreatic cancer among residents living near petrochemical industrial complexes.
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Affiliation(s)
- Hathaichon Boonhat
- Graduate Institute of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Ro-Ting Lin
- Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung Taiwan
| | - Jaw-Town Lin
- Department of Internal Medicine, Digestive Medicine Center, China Medical University Hospital, Taichung Taiwan
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Baek K, Park JT, Kwak K. Systematic review and meta-analysis of cancer risks in relation to environmental waste incinerator emissions: a meta-analysis of case-control and cohort studies. Epidemiol Health 2022; 44:e2022070. [PMID: 36097807 PMCID: PMC9849852 DOI: 10.4178/epih.e2022070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/01/2022] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES Various toxic substances can be generated from incinerators, exposing nearby residents, and epidemiological studies have shown wide variations in risk estimates for cancer risk in populations living close to incinerators. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a literature search and systematic review were conducted to identify studies conducted on general populations exposed to environmental incinerator emissions and cancer outcomes. Meta-analysis was performed according to the cancer types for which 2 or more studies were reported. Subgroup analysis was done for sex, the exposure estimation method, the study period, and the type of outcome. RESULTS Eleven studies were found for the qualitative review and meta-analysis. Seven studies had a case-control design, and 4 had a cohort design. The pooled effect size was not significant for breast, colorectal, liver, lung, lymphohematopoietic, stomach, bladder, central nervous system, and laryngeal cancers, non-Hodgkin lymphoma, sarcoma, leukemia, and all cancers. In the subgroup analysis, the pooled effect size of laryngeal cancer in females was 1.82 (95% confidence interval, 1.10 to 3.01), although only 2 studies were identified. CONCLUSIONS The meta-analysis did not provide evidence of an increased risk for any cancer among populations living near waste incinerators, except for laryngeal cancer in females. However, since relatively few studies were reviewed and some cancer types showed significant increases in individual studies, this evidence needs to be updated regularly.
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Affiliation(s)
- Kiook Baek
- Department of Occupational and Environmental Medicine, Yeungnam University Hospital, Daegu, Korea
| | - Jong-Tae Park
- Department of Occupational and Environmental Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Kyeongmin Kwak
- Department of Occupational and Environmental Medicine, Korea University Ansan Hospital, Ansan, Korea,Correspondence: Kyeongmin Kwak Department of Occupational and Environmental Medicine, Korea University Ansan Hospital, 123 Jeokgeum-ro, Danwon-gu, Ansan 15355, Korea E-mail:
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Domingo JL, Marquès M, Nadal M, Schuhmacher M. Health risks for the population living near petrochemical industrial complexes. 1. Cancer risks: A review of the scientific literature. ENVIRONMENTAL RESEARCH 2020; 186:109495. [PMID: 32283337 DOI: 10.1016/j.envres.2020.109495] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/05/2020] [Accepted: 04/05/2020] [Indexed: 06/11/2023]
Abstract
Petrochemical complexes and oil refineries are well known sources of a wide range of environmental pollutants. Consequently, the potential harmful health effects of living near these facilities is a topic of concern among the population living in the neighborhood. Anyhow, the number of studies carried out on this issue is rather limited and, in some cases, results are even slightly contradictory. The present Review was aimed at assessing whether living in the vicinity of petrochemical industries and oil refineries is associated with a higher incidence of cancer and cancer mortality. In this sense, up to 23 investigations were found in PubMed and Scopus databases. According to the type of cancer, leukemia and other hematological malignancies were reported as the main types of cancer for populations living in the neighborhood of petrochemical industries. This was concluded based on studies performed in Taiwan, Spain, United Kingdom, Italy and Nigeria. In contrast, no association was found in 4 different investigations conducted in Sweden, Finland and USA with the same purpose. Other scientific studies reported a high incidence of lung and bladder cancer in Taiwan, Italy and USA, as well as an excess mortality of bone, brain, liver, pleural, larynx and pancreas cancers in individuals living near petrochemical complexes from Taiwan, Spain, Italy, United Kingdom and USA. Thus, human exposure to certain carcinogenic pollutants emitted from petrochemical industries might increase the incidence of some cancers and cancer mortality. Anyway, since the limited number of investigations conducted until now, further studies are required in order to corroborate -in a more generalized way-this conclusion.
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Affiliation(s)
- José L Domingo
- Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira I Virgili, Sant Llorens 21, 43201, Reus, Catalonia, Spain.
| | - Montse Marquès
- Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira I Virgili, Sant Llorens 21, 43201, Reus, Catalonia, Spain
| | - Martí Nadal
- Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira I Virgili, Sant Llorens 21, 43201, Reus, Catalonia, Spain
| | - Marta Schuhmacher
- Departament d'Enginyeria Química, Universitat Rovira I Virgili, Avd. Països Catalans 26, 43007, Tarragona, Catalonia, Spain
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Negri E, Bravi F, Catalani S, Guercio V, Metruccio F, Moretto A, La Vecchia C, Apostoli P. Health effects of living near an incinerator: A systematic review of epidemiological studies, with focus on last generation plants. ENVIRONMENTAL RESEARCH 2020; 184:109305. [PMID: 32135359 DOI: 10.1016/j.envres.2020.109305] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 02/07/2020] [Accepted: 02/24/2020] [Indexed: 06/10/2023]
Abstract
Huge reductions in incinerators' emissions occurred over time, and results of older studies cannot be directly generalized to modern plants. We conducted a systematic review of the epidemiologic evidence of the health effects of incinerators, classifying plants in three generations, according to emission limits. A systematic search identified 63 epidemiologic studies, published in English, investigating health effects of incinerators on humans. We focused on cancer, cardio-cerebrovascular diseases (CVD) and respiratory diseases, pregnancy outcomes and congenital anomalies. Only six studies in the general population were on third generation incinerators providing data on pregnancy outcomes and congenital anomalies. Given the heterogeneity of methods, the abundance of ecological/semi-ecological studies and the lack of reliable quantitative measures of exposure in several studies we did not perform any meta-analysis. No excesses emerged concerning all cancers and lung cancer. An excess of non-Hodgkin lymphoma was reported in some earlier studies, but not for second generation plants. Possible excesses of soft tissue sarcomas were confined to earlier incinerators and the areas closer to the plants. No clear association emerged for CVD and diseases of the respiratory system. Several different pregnancy outcomes were considered, and no consistent association emerged, in spite of a few positive results. Studies were negative for congenital anomalies as a whole. Sporadic excesses were reported in a few studies for specific types of anomalies, but no consistent pattern emerged. Evaluation of the evidence was hindered by heterogeneity in reporting and classification of outcomes across studies. Direct evidence from third generation plants is scarce. Methodological issues in study design (mainly related to exposure assessment, confounding and ecological design) and analysis make interpretation of results complex. In spite of this, the overall evidence suggests that, if there were any excesses at all for older incinerators, they were modest at most. Additional monitoring of third generation plants needs to overcome methodological weaknesses.
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Affiliation(s)
- Eva Negri
- Dipartimento di Scienze Biomediche e Cliniche, Università degli Studi di Milano, Milan, Italy
| | - Francesca Bravi
- Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, Milan, Italy
| | - Simona Catalani
- Dipartimento, Specialità Medico-Chirurgiche, Scienze Radiologiche e Sanità Pubblica, Università degli Studi di Brescia, Brescia, Italy
| | - Valentina Guercio
- Dipartimento di Scienze Biomediche e Cliniche, Università degli Studi di Milano, Milan, Italy
| | - Francesca Metruccio
- ICPS, International Centre for Pesticides and Health Risk Prevention, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Angelo Moretto
- Dipartimento di Scienze Biomediche e Cliniche, Università degli Studi di Milano, Milan, Italy; ICPS, International Centre for Pesticides and Health Risk Prevention, ASST Fatebenefratelli Sacco, Milan, Italy.
| | - Carlo La Vecchia
- Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, Milan, Italy
| | - Pietro Apostoli
- Dipartimento, Specialità Medico-Chirurgiche, Scienze Radiologiche e Sanità Pubblica, Università degli Studi di Brescia, Brescia, Italy
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Di Ciaula A, Gentilini P, Diella G, Lopuzzo M, Ridolfi R. Biomonitoring of Metals in Children Living in an Urban Area and Close to Waste Incinerators. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061919. [PMID: 32187971 PMCID: PMC7143875 DOI: 10.3390/ijerph17061919] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/06/2020] [Accepted: 03/10/2020] [Indexed: 02/07/2023]
Abstract
The impact of waste incinerators is usually examined by measuring environmental pollutants. Biomonitoring has been limited, until now, to few metals and to adults. We explored accumulation of a comprehensive panel of metals in children free-living in an urban area hosting two waste incinerators. Children were divided by georeferentiation in exposed and control groups, and toenail concentrations of 23 metals were thereafter assessed. The percentage of children having toenail metal concentrations above the limit of detection was higher in exposed children than in controls for Al, Ba, Mn, Cu, and V. Exposed children had higher absolute concentrations of Ba, Mn, Cu, and V, as compared with those living in the reference area. The Tobit regression identified living in the exposed area as a significant predictor of Ba, Ni, Cu, Mn, and V concentrations, after adjusting for covariates. The concentrations of Ba, Mn, Ni, and Cu correlated with each other, suggesting a possible common source of emission. Exposure to emissions derived from waste incinerators in an urban setting can lead to body accumulation of specific metals in children. Toenail metal concentration should be considered a noninvasive and adequate biomonitoring tool and an early warning indicator which should integrate the environmental monitoring of pollutants.
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Affiliation(s)
- Agostino Di Ciaula
- Division of Internal Medicine, Hospital of Bisceglie (ASL BAT), 76011 Bisceglie, Italy
- International Society of Doctors for Environment (ISDE), 52100 Arezzo, Italy; (P.G.); (R.R.)
- Clinica Medica “A. Murri”, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy
- Correspondence:
| | - Patrizia Gentilini
- International Society of Doctors for Environment (ISDE), 52100 Arezzo, Italy; (P.G.); (R.R.)
| | - Giusy Diella
- Department of Biomedical Science and Human Oncology, University of Study of Bari “Aldo Moro”, 70124 Bari, Italy; (G.D.); (M.L.)
| | - Marco Lopuzzo
- Department of Biomedical Science and Human Oncology, University of Study of Bari “Aldo Moro”, 70124 Bari, Italy; (G.D.); (M.L.)
| | - Ruggero Ridolfi
- International Society of Doctors for Environment (ISDE), 52100 Arezzo, Italy; (P.G.); (R.R.)
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Cancer Mortality and Deprivation in the Proximity of Polluting Industrial Facilities in an Industrial Region of Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061860. [PMID: 32183043 PMCID: PMC7142953 DOI: 10.3390/ijerph17061860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/07/2020] [Accepted: 03/09/2020] [Indexed: 11/17/2022]
Abstract
Residential proximity to industrial facilities that release pollutants is a source of exposure to a high number of toxics, many of them known or suspected carcinogens. The objective of the study was to analyze the association between lung, larynx, bladder, and kidney cancer mortality and deprivation in areas proximate to polluting industrial facilities in Cadiz, a highly industrialized province in Spain. An ecological study at census tract level was carried out to estimate the mortality rates associated with deprivation and proximity to polluting industrial facilities (1–5 km) using the Besag–York–Mollié model. The results show a negative social gradient for lung and larynx cancers in males and greater risk of lung cancer was observed in the least deprived areas in females. These associations were found regardless the distance to industrial facilities. Increasing excess risk (relative risk; 95% credibility interval) of lung cancer for males (1.09; 1.02–1.16 at 5 km vs 1.24; 1.08–1.41 at 1 km) and bladder cancer for males (1.11; 1.01–1.22 at 5 km vs 1.32; 1.08–1.60 at 1 km) and females (1.32; 1.04–1.69 at 4 km vs 1.91; 1.28–2.86 at 1 km) was found as proximity to polluting industrial facilities increased. For kidney cancer, high risks were observed near such facilities for both sexes. Knowing the possible influence of industrial pollution and social inequalities over cancer risk allows the definition of policies aimed at reducing the risk.
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Pizzo AM, Chellini E, Costantini AS. Lung Cancer Risk and Residence in the Neighborhood of a Sewage Plant in Italy. A Case-Control Study. TUMORI JOURNAL 2018; 97:9-13. [DOI: 10.1177/030089161109700102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and background Environmental pollution originating in sewage and industrial plants can be associated with lung cancer risk, as ecological and case-control studies have indicated. In the present study, the association between lung cancer occurrence and residence near a sewage plant in Prato (Italy) was investigated. A previous geographic study in the same area had shown an increasing trend of lung cancer mortality and incidence with propinquity to the plant. Methods A case-control study was carried out in the male population of Prato. Incident cases in the period 1987–1997 were identified from the Tuscan Cancer Registry (no. 918). Controls were randomly extracted from the Registry Office of the Municipality of Prato (no. 1852). For all subjects, the residential history was reconstructed. A weighted average distance from the plant was computed and used as a proxy variable of exposure. Two analyses were performed: on the whole data set and on a subset of subjects for whom information on tobacco exposure and education was obtained through a postal questionnaire (response rate, 41.1%). Logistic regression models were applied to estimate odds ratios and 95% CI. Results Both analyses showed a significantly elevated lung cancer risk for subjects living within 1.5 km (ORwhole = 1.56, 1.06–2.28; ORsubset = 2.28, 1.06–4.86) and suggested a risk increase with a decrease of weighted average distance from the plant. Conclusions The findings highlight a possible role, in lung cancer occurrence, for environmental pollution spread from the plant. Due to drawbacks of the study, further analyses are needed to evidence a noncontroversial etiological conclusion. When environmental data are not available, results of epidemiological studies using residential histories may be useful in preventive policies regarding point source emissions. Free full text available at www.tumorionline.it
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Affiliation(s)
- Anna Maria Pizzo
- Environmental and Occupational Epidemiology Unit, ISPO Cancer Prevention and Research Institute, Florence, Italy
| | - Elisabetta Chellini
- Environmental and Occupational Epidemiology Unit, ISPO Cancer Prevention and Research Institute, Florence, Italy
| | - Adele Seniori Costantini
- Environmental and Occupational Epidemiology Unit, ISPO Cancer Prevention and Research Institute, Florence, Italy
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Lin CK, Hung HY, Christiani DC, Forastiere F, Lin RT. Lung cancer mortality of residents living near petrochemical industrial complexes: a meta-analysis. Environ Health 2017; 16:101. [PMID: 28950871 PMCID: PMC5615452 DOI: 10.1186/s12940-017-0309-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 09/21/2017] [Indexed: 05/23/2023]
Abstract
BACKGROUND Lung cancer, as the leading cause of cancer mortality worldwide, has been linked to environmental factors, such as air pollution. Residential exposure to petrochemicals is considered a possible cause of lung cancer for the nearby population, but results are inconsistent across previous studies. Therefore, we performed a meta-analysis to estimate the pooled risk and to identify possible factors leading to the heterogeneity among studies. METHODS The standard process of selecting studies followed the Cochrane meta-analysis guideline of identification, screening, eligibility, and inclusion. We assessed the quality of selected studies using the Newcastle-Ottawa scale. Reported point estimates and 95% confidence intervals were extracted or calculated to estimate the pooled risk. Air quality standards were summarized and treated as a surrogate of exposure to air pollution in the studied countries. Funnel plots, Begg's test and Egger's test were conducted to diagnose publication bias. Meta-regressions were performed to identify explanatory variables of heterogeneity across studies. RESULTS A total of 2,017,365 people living nearby petrochemical industrial complexes (PICs) from 13 independent studied population were included in the analysis. The pooled risk of lung cancer mortality for residents living nearby PICs was 1.03-fold higher than people living in non-PIC areas (95% CI = 0.98-1.09), with a low heterogeneity among studies (I 2 = 25.3%). Such effect was stronger by a factor of 12.6% for the year of follow-up started 1 year earlier (p-value = 0.034). CONCLUSIONS Our meta-analysis gathering current evidence suggests only a slightly higher risk of lung cancer mortality among residents living nearby PICs, albeit such association didn't receive statistically significance. Reasons for higher risks of early residential exposure to PICs might be attributable to the lack of or less stringent air pollution regulations.
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Affiliation(s)
- Cheng-Kuan Lin
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Building 1, Room 1401, Boston, MA 02115 USA
| | - Huei-Yang Hung
- Department of General Medicine, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Road, Kaohsiung, 807 Taiwan
| | - David C. Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Building 1, Room 1401, Boston, MA 02115 USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Building 1, Room 1401, Boston, MA 02115 USA
| | - Francesco Forastiere
- Department of Epidemiology Lazio Regional Health Service, Via Cristoforo Colombo, 112 Rome, Italy
| | - Ro-Ting Lin
- Department of Occupational Safety and Health, College of Public Health, China Medical University, 91 Hsueh-Shih Road, Taichung, 40402 Taiwan
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Pedersen M, Andersen ZJ, Stafoggia M, Weinmayr G, Galassi C, Sørensen M, Eriksen KT, Tjønneland A, Loft S, Jaensch A, Nagel G, Concin H, Tsai MY, Grioni S, Marcon A, Krogh V, Ricceri F, Sacerdote C, Ranzi A, Sokhi R, Vermeulen R, Hoogh KD, Wang M, Beelen R, Vineis P, Brunekreef B, Hoek G, Raaschou-Nielsen O. Ambient air pollution and primary liver cancer incidence in four European cohorts within the ESCAPE project. ENVIRONMENTAL RESEARCH 2017; 154:226-233. [PMID: 28107740 DOI: 10.1016/j.envres.2017.01.006] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 12/19/2016] [Accepted: 01/05/2017] [Indexed: 05/21/2023]
Abstract
BACKGROUND Tobacco smoke exposure increases the risk of cancer in the liver, but little is known about the possible risk associated with exposure to ambient air pollution. OBJECTIVES We evaluated the association between residential exposure to air pollution and primary liver cancer incidence. METHODS We obtained data from four cohorts with enrolment during 1985-2005 in Denmark, Austria and Italy. Exposure to nitrogen oxides (NO2 and NOX), particulate matter (PM) with diameter of less than 10µm (PM10), less than 2.5µm (PM2.5), between 2.5 and 10µm (PM2.5-10) and PM2.5 absorbance (soot) at baseline home addresses were estimated using land-use regression models from the ESCAPE project. We also investigated traffic density on the nearest road. We used Cox proportional-hazards models with adjustment for potential confounders for cohort-specific analyses and random-effects meta-analyses to estimate summary hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS Out of 174,770 included participants, 279 liver cancer cases were diagnosed during a mean follow-up of 17 years. In each cohort, HRs above one were observed for all exposures with exception of PM2.5 absorbance and traffic density. In the meta-analysis, all exposures were associated with elevated HRs, but none of the associations reached statistical significance. The summary HR associated with a 10-μg/m3 increase in NO2 was 1.10 (95% confidence interval (CI): 0.93, 1.30) and 1.34 (95% CI: 0.76, 2.35) for a 5-μg/m3 increase in PM2.5. CONCLUSIONS The results provide suggestive evidence that ambient air pollution may increase the risk of liver cancer. Confidence intervals for associations with NO2 and NOX were narrower than for the other exposures.
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Affiliation(s)
- Marie Pedersen
- The Danish Cancer Society Research Center, Copenhagen, Denmark; Centre for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Zorana J Andersen
- Centre for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service, Local Health Unit ASL RM1, Rome, Italy; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Claudia Galassi
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Mette Sørensen
- The Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | - Anne Tjønneland
- The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Steffen Loft
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Andrea Jaensch
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany; Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Hans Concin
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Ming-Yi Tsai
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Sara Grioni
- Epidemiology and Prevention Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alessandro Marcon
- Unit of Epidemiology & Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Fulvio Ricceri
- Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco, Italy; Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Andrea Ranzi
- Environmental Health Reference Centre, Regional Agency for Prevention, Environment and Energy of Emilia-Romagna, Modena, Italy
| | - Ranjeet Sokhi
- Centre for Atmospheric and Instrumentation Research, University of Hertfordshire, College Lane, Hatfield, United Kingdom
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands; School of Public Health, Imperial College, London, United Kingdom
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Meng Wang
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Rob Beelen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; National Institute for Public Health (RIVM), Bilthoven, The Netherlands
| | - Paolo Vineis
- School of Public Health, Imperial College, London, United Kingdom; Molecular end Epidemiology Unit, HuGeF, Human Genetics Foundation, Torino, Italy
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Ole Raaschou-Nielsen
- The Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Roskilde, Denmark
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Ruiz-Rudolph P, Arias N, Pardo S, Meyer M, Mesías S, Galleguillos C, Schiattino I, Gutiérrez L. Impact of large industrial emission sources on mortality and morbidity in Chile: A small-areas study. ENVIRONMENT INTERNATIONAL 2016; 92-93:130-138. [PMID: 27104670 DOI: 10.1016/j.envint.2016.03.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 03/19/2016] [Accepted: 03/29/2016] [Indexed: 06/05/2023]
Abstract
Chile suffers significant pollution from large industrial emitters associated with the mining, metal processing, paper production, and energy industries. The aim of this research was to determine whether the presence of large industrial facilities (i.e. coal- and oil-fired power plants, pulp and paper mills, mining facilities, and smelters) affects mortality and morbidity rates in Chile. For this, we conducted an ecological study that used Chilean communes as small-area observation units to assess mortality and morbidity. Public databases provided information on large pollution sources relevant to Chile. The large sources studied were oil- and coal-fired power plants, copper smelters, pulp and paper mills, and large mining facilities. Large sources were filtered by first year of production, type of process, and size. Mortality and morbidity data were acquired from public national databases, with morbidity being estimated from hospitalization records. Cause-specific rates were calculated for the main outcomes: cardiovascular, respiratory, cancer; and other more specific health outcomes. The impact of the large pollution sources was estimated using Bayesian models that included spatial correlation, overdispersion, and other covariates. Large and significant increases in health risks (around 20%-100%) were found for communes with power plants and smelters for total, cardiovascular, respiratory, all-cancer, and lung cancer mortality. Higher hospitalization rates for cardiovascular disease, respiratory disease, cancer, and pneumonia (20-100%) were also found for communes with power plants and smelters. The impacts were larger for men than women in terms of both mortality and hospitalizations. The impacts were also larger when the sources were analyzed as continuous (production volume) rather than dichotomous (presence/absence) variables. In conclusion, significantly higher rates of total cardiovascular, respiratory, all-cancer and lung cancer mortality and cardiovascular, respiratory, cancer and pneumonia hospitalizations were observed in communes with power plants and smelters.
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Affiliation(s)
- Pablo Ruiz-Rudolph
- Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Independencia 939, Independencia, Santiago, Chile.
| | - Nelson Arias
- Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Independencia 939, Independencia, Santiago, Chile; Departamento de Salud Pública, Universidad de Caldas, Carrera 25 N° 48-56, Manizales, Colombia
| | - Sandra Pardo
- Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Independencia 939, Independencia, Santiago, Chile; Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Pedro de Valdivia 641, Providencia, Santiago, Chile
| | - Marianne Meyer
- Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Independencia 939, Independencia, Santiago, Chile
| | - Stephanie Mesías
- Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Independencia 939, Independencia, Santiago, Chile
| | - Claudio Galleguillos
- Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Independencia 939, Independencia, Santiago, Chile
| | - Irene Schiattino
- Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Independencia 939, Independencia, Santiago, Chile
| | - Luis Gutiérrez
- Instituto de Salud Poblacional, Facultad de Medicina, Universidad de Chile, Independencia 939, Independencia, Santiago, Chile
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14
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Mataloni F, Badaloni C, Golini MN, Bolignano A, Bucci S, Sozzi R, Forastiere F, Davoli M, Ancona C. Morbidity and mortality of people who live close to municipal waste landfills: a multisite cohort study. Int J Epidemiol 2016; 45:806-15. [PMID: 27222499 PMCID: PMC5005946 DOI: 10.1093/ije/dyw052] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2016] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The evidence on the health effects related to residing close to landfills is controversial. Nine landfills for municipal waste have been operating in the Lazio region (Central Italy) for several decades. We evaluated the potential health effects associated with contamination from landfills using the estimated concentration of hydrogen sulphide (H2S) as exposure. METHODS A cohort of residents within 5 km of landfills was enrolled (subjects resident on 1 January 1996 and those who subsequently moved into the areas until 2008) and followed for mortality and hospitalizations until 31 December 2012. Assessment of exposure to the landfill (H2S as a tracer) was performed for each subject at enrolment, using a Lagrangian dispersion model. Information on several confounders was available (gender, age, socioeconomic position, outdoor PM10 concentration, and distance from busy roads and industries). Cox regression analysis was performed [Hazard Ratios (HRs), 95% confidence intervals (CIs)]. RESULTS The cohort included 242 409 individuals. H2S exposure was associated with mortality from lung cancer and respiratory diseases (e.g. HR for increment of 1 ng/m(3) H2S: 1.10, 95% CI 1.02-1.19; HR 1.09, 95% CI 1.00-1.19, respectively). There were also associations between H2S and hospitalization for respiratory diseases (HR = 1.02, 95% CI 1.00-1.03), especially acute respiratory infections among children (0-14 years) (HR = 1.06, 95% CI 1.02-1.11). CONCLUSIONS Exposure to H2S, a tracer of airborne contamination from landfills, was associated with lung cancer mortality as well as with mortality and morbidity for respiratory diseases. The link with respiratory disease is plausible and coherent with previous studies, whereas the association with lung cancer deserves confirmation.
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Affiliation(s)
| | - Chiara Badaloni
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | | | - Simone Bucci
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | | | - Marina Davoli
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Carla Ancona
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
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15
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Winters N, Goldberg MS, Hystad P, Villeneuve PJ, Johnson KC. Exposure to ambient air pollution in Canada and the risk of adult leukemia. THE SCIENCE OF THE TOTAL ENVIRONMENT 2015; 526:153-176. [PMID: 25955692 DOI: 10.1016/j.scitotenv.2015.03.149] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 03/13/2015] [Accepted: 03/23/2015] [Indexed: 06/04/2023]
Abstract
There is a paucity of studies investigating adult leukemia and air pollution. To address this gap, we analyzed data from a Canadian population-based case-control study conducted in 1994-1997. Cases were 1064 adults with incident leukemia and controls were 5039 healthy adults. We used data from satellites and fixed-site monitoring stations to estimate residential concentrations of NO2 and fine particulate matter (PM2.5) for the period prior to diagnosis, starting in 1975 and ending in 1994. We modeled the average annual exposure of each subject. Odds ratios (OR) and their 95% confidence intervals (CI) were estimated using logistic regression, adjusted for age, gender, province, smoking, education, body mass index, income, and self-reported exposures to ionizing radiation and benzene. We found an 'n-shaped' response function between exposure to NO2 and all forms of leukemia: from the tenth percentile to the median (4.51 to 14.66 ppb), the OR was 1.20; 95% CI: 0.97-1.48 and from the 75th percentile to the 90th (22.75 to 29.7 ppb), the OR was 0.79; 95% CI 0.68-0.93. For PM2.5 we found a response function consistent with a linear model, with an OR per 10 μg/m(3) of 0.97 (95% CI 0.75-1.26). For chronic lymphocytic leukemia we found response functions that were consistent with a simple linear model, with an OR per 5 ppb of NO2 of 0.93 (95% CI 0.86-1.00) and an OR per 10 μg/m(3) of PM2.5 of 0.62 (95% CI 0.42-0.93). In summary, for chronic lymphocytic leukemia we found no evidence of an association with air pollution and with all forms of leukemia we found weak evidence of an association only at low concentrations of NO2. It is possible that these inconsistent results may have arisen because of unaccounted urban/rural differences or possibly from a selection effect, especially among controls.
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Affiliation(s)
- Nicholas Winters
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Mark S Goldberg
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Division of Clinical Epidemiology, McGill University Health Centre, 687 Pine Ave. W., R4.29, Montreal, Quebec H3A 1A1, Canada.
| | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Paul J Villeneuve
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
| | - Kenneth C Johnson
- Science Integration Division, Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada, Ottawa, Ontario, Canada
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16
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Ancona C, Badaloni C, Mataloni F, Bolignano A, Bucci S, Cesaroni G, Sozzi R, Davoli M, Forastiere F. Mortality and morbidity in a population exposed to multiple sources of air pollution: A retrospective cohort study using air dispersion models. ENVIRONMENTAL RESEARCH 2015; 137:467-74. [PMID: 25701728 DOI: 10.1016/j.envres.2014.10.036] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 10/15/2014] [Accepted: 10/29/2014] [Indexed: 05/23/2023]
Abstract
BACKGROUND AND AIMS A landfill, an incinerator, and a refinery plant have been operating since the early 1960s in a contaminated site located in the suburb of Rome (Italy). To evaluate their potential health effects, a population-based retrospective cohort study was conducted using dispersion modeling for exposure assessment. METHODS A fixed cohort was enrolled in the Rome Longitudinal Study in 2001, mortality and hospitalizations were followed-up until 2010. Exposure assessments to the landfill (H2S), the incinerator (PM10), and the refinery plant (SOX) were performed for each subject using a Lagrangian dispersion model. Individual and small-area variables were available (including exposures levels to NO2 from traffic and diesel trucks). Cox regression analysis was performed (hazard ratios, HRs, 95% CI) using linear terms for the exposures (5th-95th percentiles difference). Single and bi-pollutant models were run. RESULTS The cohort included 85,559 individuals. The estimated annual average exposures levels were correlated. H2S from the landfill was associated with cardiovascular hospital admissions in both genders (HR 1.04 95% CI 1.00-1.09 in women); PM10 from the incinerator was associated with pancreatic cancer mortality in both genders (HR 1.40 95% CI 1.03-1.90 in men, HR 1.47 95% CI 1.12-1.93 in women) and with breast morbidity in women (HR 1.13 95% CI 1.00-1.27). SOx from the refinery was associated with laryngeal cancer mortality in women (HR 4.99 95% CI 1.64-15.9) and respiratory hospital admissions (HR 1.13 95% CI 1.01-1.27). CONCLUSIONS We found an association of the pollution sources with some cancer forms and cardio-respiratory diseases. Although there was a high correlation between the estimated exposures, an indication of specific effects from the different sources emerged.
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Affiliation(s)
- Carla Ancona
- Department of Epidemiology, Lazio Regional Health Service, Via Santa Costanza 53, 00198 Rome, Italy.
| | - Chiara Badaloni
- Department of Epidemiology, Lazio Regional Health Service, Via Santa Costanza 53, 00198 Rome, Italy
| | - Francesca Mataloni
- Department of Epidemiology, Lazio Regional Health Service, Via Santa Costanza 53, 00198 Rome, Italy
| | - Andrea Bolignano
- Lazio Environmental Protection Agency, Via Boncompagni 101, 00187 Rome, Italy
| | - Simone Bucci
- Department of Epidemiology, Lazio Regional Health Service, Via Santa Costanza 53, 00198 Rome, Italy
| | - Giulia Cesaroni
- Department of Epidemiology, Lazio Regional Health Service, Via Santa Costanza 53, 00198 Rome, Italy
| | - Roberto Sozzi
- Lazio Environmental Protection Agency, Via Boncompagni 101, 00187 Rome, Italy
| | - Marina Davoli
- Department of Epidemiology, Lazio Regional Health Service, Via Santa Costanza 53, 00198 Rome, Italy
| | - Francesco Forastiere
- Department of Epidemiology, Lazio Regional Health Service, Via Santa Costanza 53, 00198 Rome, Italy
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17
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Health effects associated with the disposal of solid waste in landfills and incinerators in populations living in surrounding areas: a systematic review. Int J Public Health 2013; 58:725-35. [PMID: 23887611 DOI: 10.1007/s00038-013-0496-8] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 06/26/2013] [Accepted: 07/10/2013] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVES Potential health hazards for the environment and people living nearby landfills and incinerators are claimed to be related to several methods of waste management. Independent systematic review of the scientific literature is a key procedure to support the lay public and policy makers to achieve informed decisions. METHODS The study design and potential biases of papers retrieved in this comprehensive literature search were analyzed. RESULTS The most consistent result is that the risks of congenital anomalies and hospitalization due to respiratory disease are likely to be real nearby special waste landfills. From the very little information on exclusively urban waste depots it is reasonable to say that correct management of landfill does not increase the risk of these health effects. It is confirmed that historically incinerators are an important source of pollution and harm for the health of populations living nearby; however, changes in technology are producing more reassuring results. CONCLUSIONS A moderate level of confidence is possible in limited areas of knowledge, implying the need to overcome the limitations of current studies about exposure assessment and to control confounders at the individual level.
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Cordioli M, Ranzi A, De Leo GA, Lauriola P. A review of exposure assessment methods in epidemiological studies on incinerators. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2013; 2013:129470. [PMID: 23840228 PMCID: PMC3694556 DOI: 10.1155/2013/129470] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Accepted: 05/23/2013] [Indexed: 11/18/2022]
Abstract
Incineration is a common technology for waste disposal, and there is public concern for the health impact deriving from incinerators. Poor exposure assessment has been claimed as one of the main causes of inconsistency in the epidemiological literature. We reviewed 41 studies on incinerators published between 1984 and January 2013 and classified them on the basis of exposure assessment approach. Moreover, we performed a simulation study to explore how the different exposure metrics may influence the exposure levels used in epidemiological studies. 19 studies used linear distance as a measure of exposure to incinerators, 11 studies atmospheric dispersion models, and the remaining 11 studies a qualitative variable such as presence/absence of the source. All reviewed studies utilized residence as a proxy for population exposure, although residence location was evaluated with different precision (e.g., municipality, census block, or exact address). Only one study reconstructed temporal variability in exposure. Our simulation study showed a notable degree of exposure misclassification caused by the use of distance compared to dispersion modelling. We suggest that future studies (i) make full use of pollution dispersion models; (ii) localize population on a fine-scale; and (iii) explicitly account for the presence of potential environmental and socioeconomic confounding.
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Affiliation(s)
- Michele Cordioli
- Department of Bio-Sciences, University of Parma, Parco Area delle Scienze 11/a, 43124 Parma, Italy.
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19
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Pascal M, Pascal L, Bidondo ML, Cochet A, Sarter H, Stempfelet M, Wagner V. A review of the epidemiological methods used to investigate the health impacts of air pollution around major industrial areas. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2013; 2013:737926. [PMID: 23818910 PMCID: PMC3684125 DOI: 10.1155/2013/737926] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Revised: 03/19/2013] [Accepted: 04/18/2013] [Indexed: 11/17/2022]
Abstract
We performed a literature review to investigate how epidemiological studies have been used to assess the health consequences of living in the vicinity of industries. 77 papers on the chronic effects of air pollution around major industrial areas were reviewed. Major health themes were cancers (27 studies), morbidity (25 studies), mortality (7 studies), and birth outcome (7 studies). Only 3 studies investigated mental health. While studies were available from many different countries, a majority of papers came from the United Kingdom, Italy, and Spain. Several studies were motivated by concerns from the population or by previous observations of an overincidence of cases. Geographical ecological designs were largely used for studying cancer and mortality, including statistical designs to quantify a relationship between health indicators and exposure. Morbidity was frequently investigated through cross-sectional surveys on the respiratory health of children. Few multicenter studies were performed. In a majority of papers, exposed areas were defined based on the distance to the industry and were located from <2 km to >20 km from the plants. Improving the exposure assessment would be an asset to future studies. Criteria to include industries in multicenter studies should be defined.
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Affiliation(s)
- Mathilde Pascal
- French Institute for Public Health Surveillance, 12 Rue du Val d'Osne, 94415 Staint-Maurice, France.
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20
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Raaschou-Nielsen O, Andersen ZJ, Hvidberg M, Jensen SS, Ketzel M, Sørensen M, Hansen J, Loft S, Overvad K, Tjønneland A. Air pollution from traffic and cancer incidence: a Danish cohort study. Environ Health 2011; 10:67. [PMID: 21771295 PMCID: PMC3157417 DOI: 10.1186/1476-069x-10-67] [Citation(s) in RCA: 120] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Accepted: 07/19/2011] [Indexed: 04/14/2023]
Abstract
BACKGROUND Vehicle engine exhaust includes ultrafine particles with a large surface area and containing absorbed polycyclic aromatic hydrocarbons, transition metals and other substances. Ultrafine particles and soluble chemicals can be transported from the airways to other organs, such as the liver, kidneys, and brain. Our aim was to investigate whether air pollution from traffic is associated with risk for other cancers than lung cancer. METHODS We followed up 54,304 participants in the Danish Diet Cancer and Health cohort for 20 selected cancers in the Danish Cancer Registry, from enrolment in 1993-1997 until 2006, and traced their residential addresses from 1971 onwards in the Central Population Registry. We used modeled concentration of nitrogen oxides (NO(x)) and amount of traffic at the residence as indicators of traffic-related air pollution and used Cox models to estimate incidence rate ratios (IRRs) after adjustment for potential confounders. RESULTS NO(x) at the residence was significantly associated with risks for cervical cancer (IRR, 2.45; 95% confidence interval [CI], 1.01;5.93, per 100 μg/m(3) NO(x)) and brain cancer (IRR, 2.28; 95% CI, 1.25;4.19, per 100 μg/m(3) NO(x)). CONCLUSIONS This hypothesis-generating study indicates that traffic-related air pollution might increase the risks for cervical and brain cancer, which should be tested in future studies.
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Affiliation(s)
- Ole Raaschou-Nielsen
- Institute of Cancer Epidemiology, Danish Cancer Society, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Zorana J Andersen
- Institute of Cancer Epidemiology, Danish Cancer Society, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Martin Hvidberg
- Department for Atmospheric Environment, National Environmental Research Institute, Aarhus University, Denmark
| | - Steen S Jensen
- Department for Atmospheric Environment, National Environmental Research Institute, Aarhus University, Denmark
| | - Matthias Ketzel
- Department for Atmospheric Environment, National Environmental Research Institute, Aarhus University, Denmark
| | - Mette Sørensen
- Institute of Cancer Epidemiology, Danish Cancer Society, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Johnni Hansen
- Institute of Cancer Epidemiology, Danish Cancer Society, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Steffen Loft
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Denmark
| | - Kim Overvad
- Department of Epidemiology, Institute of Public Health, Aarhus University, Denmark
| | - Anne Tjønneland
- Institute of Cancer Epidemiology, Danish Cancer Society, Strandboulevarden 49, 2100 Copenhagen, Denmark
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Ramis R, Diggle P, Cambra K, López-Abente G. Prostate cancer and industrial pollution Risk around putative focus in a multi-source scenario. ENVIRONMENT INTERNATIONAL 2011; 37:577-85. [PMID: 21216467 DOI: 10.1016/j.envint.2010.12.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Revised: 11/22/2010] [Accepted: 12/03/2010] [Indexed: 05/07/2023]
Abstract
BACKGROUND Prostate cancer is the second most common type of cancer among men but its aetiology is still largely unknown. Different studies have proposed several risk factors such as ethnic origin, age, genetic factors, hormonal factors, diet and insulin-like growth factor, but the spatial distribution of the disease suggests that other environmental factors are involved. This paper studies the spatial distribution of prostate cancer mortality in an industrialized area using distances from each of a number of industrial facilities as indirect measures of exposure to industrial pollution. MATERIALS AND METHODS We studied the Gran Bilbao area (Spain) with a population of 791,519 inhabitants distributed in 657 census tracts. There were 20 industrial facilities within the area, 8 of them in the central axis of the region. We analysed prostate cancer mortality during the period 1996-2003. There were 883 deaths giving a crude rate of 14 per 100,000 inhabitants. We extended the standard Poisson regression model by the inclusion of a multiplicative non-linear function to model the effect of distance from an industrial facility. The function's shape combined an elevated risk close to the source with a neutral effect at large distance. We also included socio-demographic covariates in the model to control potential confounding. RESULTS We aggregated the industrial facilities by sector: metal, mineral, chemical and other activities. Results relating to metal industries showed a significantly elevated risk by a factor of approximately 1.4 in the immediate vicinity, decaying with distance to a value of 1.08 at 12km. The remaining sectors did not show a statistically significant excess of risk at the source. DISCUSSION Notwithstanding the limitations of this kind of study, we found evidence of association between the spatial distribution of prostate cancer mortality aggregated by census tracts and proximity to metal industrial facilities located within the area, after adjusting for socio-demographic characteristics at municipality level.
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Affiliation(s)
- Rebeca Ramis
- Department of Environmental Epidemiology and Cancer, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
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Gouveia N, Prado RRD. [Spatial analysis of the health risks associated with solid waste incineration: a preliminary analysis]. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2011; 13:3-10. [PMID: 20683550 DOI: 10.1590/s1415-790x2010000100001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2009] [Accepted: 02/24/2010] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to examine if emissions from the Vergueiro solid waste incinerator are associated with an increased risk of cancer in the population in its vicinity. METHODS the area under influence of this incinerator was delimited by a 7 km radius from its geocoded centroid. Deaths of city residents in administrative districts inside this area due to cancer of lung, liver, larynx, non-Hodgkin's lymphoma in adults, leukemia, and all sites combined in children, in the 1998 to 2002 period, were selected and geocoded. The studied area was divided into 7 concentric rings delimited by a radius of 1 to 7 km from the incinerator. The analysis of the relationship between residential proximity to the incinerator and mortality due to cancer was based on the comparison of observed and expected cases, using the Stone test for decline in risk with distance from the incinerator. RESULTS the area studied comprised 1,599,532 inhabitants, of which 92,894 were children less than 5 years old and 634,993 were adults over 40 years old. No spatial gradient in risk was observed for any outcome in relation to distance from the incinerator. CONCLUSION although no excess risk for the selected cancers were observed, emissions of incinerators still operating and their possible health effects should be monitored. The study of the spatial distribution of health events in areas around point sources of air pollution can become a methodological option for surveillance activities.
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Affiliation(s)
- Nelson Gouveia
- Departamento de Medicina Preventiva, Universidade de São Paulo, Sao Paulo, Brazil.
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Federico M, Pirani M, Rashid I, Caranci N, Cirilli C. Cancer incidence in people with residential exposure to a municipal waste incinerator: an ecological study in Modena (Italy), 1991-2005. WASTE MANAGEMENT (NEW YORK, N.Y.) 2010; 30:1362-1370. [PMID: 19744847 DOI: 10.1016/j.wasman.2009.06.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2009] [Revised: 06/26/2009] [Accepted: 06/30/2009] [Indexed: 05/28/2023]
Abstract
We conducted a retrospective ecological study to assess cancer incidence during the period 1991-2005 in proximity of a municipal waste incinerator (MWI) in Modena (Italy). We identified three bands of increasing distance from the MWI, up to a radius of 5 km and used the residence as surrogate marker of the exposure. Residential history for Modena's population was reconstructed and residents were associated to the most appropriate census unit. Age-standardized incidence ratios (ASR) and standardized incidence ratios (SIR) were estimated for all cancers and selected sites. Variations in cancer incidence were investigated using space and space-time scan statistic. Deprivation index was taken into account as potential confounding factor. During the 15-year study period, 16,443 new cases of cancer were diagnosed among residents in Modena. The space-time clustering test identified three significant clusters but their shapes were not associable to the MWI exposition. The purely spatial analysis not showed statistically significant clusters. The SIR computed for all cancers and selected sites did not show any excess of risk in the area closest to the plant. Higher SIR for leukaemia was found in the second band from MWI (2-3.5 km) for females (SIR, age and DI adjusted: 1.35, 95%CI: 1.01-1.79) and for both sexes (SIR, age and DI adjusted: 1.28, 95%CI: 1.03-1.57), but not a spatial trend was observed, thus excluding a possible link with MWI. In conclusion, bearing in mind the intrinsic limits of the study, the results suggest that there is no detectable increase of cancer risk for people living in proximity to the Modena MWI.
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Affiliation(s)
- Massimo Federico
- Medical Oncology II, University of Modena and Reggio Emilia, Via del Pozzo 71, Modena, Italy.
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24
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Porta D, Milani S, Lazzarino AI, Perucci CA, Forastiere F. Systematic review of epidemiological studies on health effects associated with management of solid waste. Environ Health 2009; 8:60. [PMID: 20030820 PMCID: PMC2805622 DOI: 10.1186/1476-069x-8-60] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2009] [Accepted: 12/23/2009] [Indexed: 05/19/2023]
Abstract
BACKGROUND Management of solid waste (mainly landfills and incineration) releases a number of toxic substances, most in small quantities and at extremely low levels. Because of the wide range of pollutants, the different pathways of exposure, long-term low-level exposure, and the potential for synergism among the pollutants, concerns remain about potential health effects but there are many uncertainties involved in the assessment. Our aim was to systematically review the available epidemiological literature on the health effects in the vicinity of landfills and incinerators and among workers at waste processing plants to derive usable excess risk estimates for health impact assessment. METHODS We examined the published, peer-reviewed literature addressing health effects of waste management between 1983 and 2008. For each paper, we examined the study design and assessed potential biases in the effect estimates. We evaluated the overall evidence and graded the associated uncertainties. RESULTS In most cases the overall evidence was inadequate to establish a relationship between a specific waste process and health effects; the evidence from occupational studies was not sufficient to make an overall assessment. For community studies, at least for some processes, there was limited evidence of a causal relationship and a few studies were selected for a quantitative evaluation. In particular, for populations living within two kilometres of landfills there was limited evidence of congenital anomalies and low birth weight with excess risk of 2 percent and 6 percent, respectively. The excess risk tended to be higher when sites dealing with toxic wastes were considered. For populations living within three kilometres of old incinerators, there was limited evidence of an increased risk of cancer, with an estimated excess risk of 3.5 percent. The confidence in the evaluation and in the estimated excess risk tended to be higher for specific cancer forms such as non-Hodgkin's lymphoma and soft tissue sarcoma than for other cancers. CONCLUSIONS The studies we have reviewed suffer from many limitations due to poor exposure assessment, ecological level of analysis, and lack of information on relevant confounders. With a moderate level confidence, however, we have derived some effect estimates that could be used for health impact assessment of old landfill and incineration plants. The uncertainties surrounding these numbers should be considered carefully when health effects are estimated. It is clear that future research into the health risks of waste management needs to overcome current limitations.
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Affiliation(s)
- Daniela Porta
- Department of Epidemiology, Regional Health Service Lazio Region, Rome, Italy
| | - Simona Milani
- Department of Epidemiology, Regional Health Service Lazio Region, Rome, Italy
| | - Antonio I Lazzarino
- Department of Epidemiology, Regional Health Service Lazio Region, Rome, Italy
- Division of Epidemiology, Public Health and Primary Care, Imperial College, London, UK
| | - Carlo A Perucci
- Department of Epidemiology, Regional Health Service Lazio Region, Rome, Italy
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Maier W, Mielck A. „Environmental justice“ (Umweltgerechtigkeit). PRÄVENTION UND GESUNDHEITSFÖRDERUNG 2009. [DOI: 10.1007/s11553-009-0200-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Karakis I, Bolotin A, Kordysh E, Belmaker I, Sarov B. Mortality in the bedouin population and proximity to a regional industrial complex. ENVIRONMENTAL HEALTH INSIGHTS 2008; 1:21-29. [PMID: 21572844 PMCID: PMC3091347 DOI: 10.4137/ehi.s891] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND The study was initiated by public concern about exposure to an industrial park (IP) emission. The study examined whether mortality in the Bedouin population in the southern part of Israel is associated with the residential distance to the IP. MATERIAL AND METHODS Ecological study during 1995-2001 included the entire Bedouin population. Mortality data was obtained from the Central Bureau of Statistics. As an indirect measurement of exposure we used residential distance to the IP (with 20 km radius as a cut-of-point) based on residents' complaints about odor related to the IP. Differences in mortality rates by distance were assessed by the Mantel-Haenszel relative risk (M-H RR) within the 95% CI. The country Arab population served as a reference for calculation of the age-adjusted standardized mortality ratio (SMR). RESULTS Increased mortality rates due to symptoms/ill-defined conditions and non-external causes were observed in the Bedouin population of both sexes, residing up to 20 km from the IP, compared to those living in more remote areas. Corresponding M-H RR (plus 95% CI) were 1.66 (1.17-2.36), 1.24 (1.06-1.44) in females, and 1.55 (1.15-2.10), 1.32 (1.15-1.52) in males. CONCLUSIONS The study results suggest an association between residential proximity to the regional IP and increased mortality rates in the Negev Bedouin population. These findings have been accepted by the authorities as an issue for community health protection.
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Affiliation(s)
- Isabella Karakis
- Department of Epidemiology and Health Services Evaluation, Ben-Gurion University of the Negev, Beersheba, Israel
- School of Public Health, Haifa University, Haifa, Israel
| | - Arkady Bolotin
- Department of Epidemiology and Health Services Evaluation, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Ella Kordysh
- Department of Epidemiology and Health Services Evaluation, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Ilana Belmaker
- Southern Regional Health Department of the Israeli Ministry of Health, Beersheba, Israel
| | - Batia Sarov
- Department of Epidemiology and Health Services Evaluation, Ben-Gurion University of the Negev, Beersheba, Israel
- Department of Epidemiology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, U.S.A
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Chirpaz E, Colonna M, Viel JF. L’analyse de cluster en épidémiologie géographique : utilisation de plusieurs méthodes statistiques et comparaison de leurs résultats. Rev Epidemiol Sante Publique 2004; 52:139-49. [PMID: 15138393 DOI: 10.1016/s0398-7620(04)99035-9] [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: 10/22/2022] Open
Abstract
BACKGROUND The increasing interest in environmental epidemiology has been followed by the development of many statistical tests for detecting disease clustering near a point source. The objectives of this study were to compare several tests to detect disease clustering, among which modelisation using Markov Chain Monte Carlo methods. METHODS We compared six statistical methods for detecting disease clustering of bladder cancer around an industrial centre of Isère (France) for the period 1983-1997: Stone's test, score test, and two log-linear modelisations (with and without corrections for extra-Poisson variations) using two ways of parameters estimation (maximum likelihood and Markov Chain Monte Carlo methods). RESULTS The results of the Stone test and the score test are not in favour of a higher risk of bladder cancer around the considered point source. The conclusions brought by the log linear modelisations are the same, but the results obtained using the Markov Chain Monte Carlo Method are very dependant of prior distributions determined for the different parameters. CONCLUSION Markov Chain Monte Carlo methods, which allow taking into account complex geographical effects, seem well adapted to cluster analysis in geographical epidemiology. However, they remain difficult to implement.
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Affiliation(s)
- E Chirpaz
- Registre des Cancers de l'Isère, 21, chemin des Sources, 38240 Meylan.
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Wight R, Paleri V, Arullendran P. Current theories for the development of nonsmoking and nondrinking laryngeal carcinoma. Curr Opin Otolaryngol Head Neck Surg 2003; 11:73-7. [PMID: 14515082 DOI: 10.1097/00020840-200304000-00002] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The pivotal risk of smoking and alcohol in laryngeal cancer has meant that evidence for alternate cofactors has been indicative to date. A number of case series, however, contain a few patients who are life-long nondrinkers and nonsmokers and question what other cofactors may contribute. Gastroesophageal reflux disease makes a small but significant contribution to the causal development of laryngeal cancer; however, what remains to be understood is the mechanism of its action. Bile reflux appears to be an additional causative factor in achlorhydrics. After controlling for the effects of alcohol and tobacco, exposure to oncogenic types of human papilloma virus is associated with an increased risk of laryngeal carcinoma. Evidence does not support asbestos exposure itself as increasing the relative risk of laryngeal cancer. A dietary increase in vegetables and fruit may confer an advantage in reducing the laryngeal cancer incidence. Inherited differences in cell cycle control systems, DNA repair systems, and carcinogen-metabolizing enzymes can increase the risk for laryngeal cancer, but as yet, no causal mechanism has been demonstrated.
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Affiliation(s)
- Richard Wight
- North Riding Infirmary, Middlesbrough, Cleveland, UK.
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Wildner M, Fischer R, Brunner A. Development of a questionnaire for quantitative assessment in the field of health and human rights. Soc Sci Med 2002; 55:1725-44. [PMID: 12383458 DOI: 10.1016/s0277-9536(01)00300-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We hypothesize that a human rights framework would be able to analyse central health-related societal issues within important settings like the work place, the family or the health care system. Our study goal was the development and population-based evaluation of a questionnaire for assessment of the perceived human rights status. A questionnaire (HR-14) was developed from the guiding principles of international human rights legislation. For its psychometric evaluation, computer-assisted telephone interviews were conducted in four cities in Europe (Munich, Dresden, Vienna and Bern). Cronbach's alpha for internal consistency was 0.76. Factor analysis supported the concept of human rights as indivisible and interdependent. Extracted factors were consistent with the preliminary settings of family and friends, health care system and community at large, and a supplementary setting workplace. Perceived human rights status was associated with physical function, mental/emotional health, age, study region, general health and employment status. We conclude that it is possible to develop a human rights questionnaire with good psychometric properties. Measurement of the perceived human rights status of populations and population groups may contribute to health policies sensitive to human rights.
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Affiliation(s)
- Manfred Wildner
- Bavarian Public Health Research Center, Ludwig-Maximilians-University Munich, Tegernseer Landstr 243, D-81549, Munich, Germany
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Luginaah IN, Taylor SM, Elliott SJ, Eyles JD. Community reappraisal of the perceived health effects of a petroleum refinery. Soc Sci Med 2002; 55:47-61. [PMID: 12137188 DOI: 10.1016/s0277-9536(01)00206-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This paper presents results from a study of the community health impacts of a petroleum refinery in Oakville, Ontario in Canada. The research is informed by the environmental stress and coping literatures and the focus is on community reappraisal of the refinery's impacts before and after the implementation of a substantive odour reduction initiative on the part of the refinery operators. Community health surveys were conducted in 1992 (n = 391) and 1997 (n = 427) to examine changes in odour perception and annoyance and self-reported health status attributable to the odour reduction plan. The findings reported here suggest an on-going process of cognitive reappraisal, whereby negative perceptions and concerns decreased between 1992 and 1997. Irrespective of this positive reappraisal of the refinery efforts, those living close to the refinery continue to report negative health impacts. A strong mediating effect of odours on the refinery exposure-symptom reporting relationship was confirmed by our results. While the relationship between odour perception and symptom reporting indicates the importance of odour perception and annoyance as the principal mechanism mediating ill-health reporting, the plausibility of other causal pathways is recognized. Residents' sensitivity to the negative effects of the refinery on their health and the health of their children suggests a psychosocial reaction to the environmental stress associated with perceived and actual refinery emissions.
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Affiliation(s)
- Isaac N Luginaah
- Department of Sociology & Anthropology, University of Windsor, Ont, Canada.
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Aylin P, Bottle A, Wakefield J, Jarup L, Elliott P. Proximity to coke works and hospital admissions for respiratory and cardiovascular disease in England and Wales. Thorax 2001; 56:228-33. [PMID: 11182017 PMCID: PMC1758773 DOI: 10.1136/thorax.56.3.228] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The incidence of hospital admissions for respiratory and cardiovascular diseases in areas close to operating coke works in England and Wales was investigated. METHODS A small area study using distance from source as a proxy for exposure was undertaken in subjects aged 65 or over and children under 5 years within 7.5 km of four coke works (1991 estimated populations 87 760 and 43 932, respectively). The main outcome measures were emergency hospital admissions in 1992/3-1994/5 with a primary diagnosis of coronary heart disease (ICD 410-414), stroke (ICD 431-438), all respiratory diseases (ICD 460-519), chronic obstructive pulmonary disease (ICD 491-492), and asthma (ICD 493) in those aged 65 or over, and all respiratory and asthma admissions in children under 5 years of age. RESULTS At age 65 or over the combined estimate of relative risk with proximity to coke works (per km) ranged from 0.99 (95% CI 0.90 to 1.09) for chronic obstructive pulmonary disease to 1.03 (95% CI 0.94 to 1.13) for asthma. For children under 5 years the combined estimate of risk was 1.08 (95% CI 0.98 to 1.20) for all respiratory disease and 1.07 (95% CI 0.98 to 1.18) for asthma. There was evidence of significant heterogeneity in risk estimates between coke work groups, especially in children under 5 years (p<0.001 and p=0.004 for respiratory disease and asthma, respectively). For the Teesside coke works in North East England the relative risk with proximity (per km) was 1.09 (95% CI 1.06 to 1.12) for respiratory disease and 1.09 (95% CI 1.04 to 1.15) for asthma. CONCLUSIONS No evidence overall was found for an association between hospital admissions and living near operational coke works in England and Wales. Trends of a higher risk of hospital admission for respiratory disease and asthma among children with proximity to the Teesside plant require further investigation.
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Affiliation(s)
- P Aylin
- The Small Area Health Statistics Unit, Department of Epidemiology and Public Health, Imperial College School of Medicine, St Mary's Campus, Norfolk Place, London W2 1PG, UK.
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Corella D, Herranz C, Calatayud A, Font G, Celma C, Laborda R. Cancer mortality and exposure to chemical carcinogens in the work place: an ecological study in the Valencian Community, Spain (1981-1995). Eur J Epidemiol 2000; 16:401-9. [PMID: 10997826 DOI: 10.1023/a:1007627332215] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
To evaluate the geographical distribution of the mortality from malignant tumours in relationship with exposure to chemical carcinogens in the work place, and to asses the possible association between these questions and the percentage of population employed in certain high-risk sectors, an ecological study in the Valencian Community (VC), Spain was carried out. Age-adjusted mortality rates for the total number of malignant tumours, lung, bladder, lymphomas and leukaemia during the periods 1981-1985 and 1991-1995 were calculated for the 34 geographical areas. The percentage of population in each area working in sectors in which they may be exposed to chemical carcinogens was obtained. The relationship between mortality on-the-job exposure was studied using linear regression methods. Large differences in cancer mortality were seen. In men, the geographical pattern was very stable and reveals a significant association with the distribution of certain high-risk jobs. Statistically significant positive correlations (p < 0.001) were found between cancer mortality and the percentage of the population working in metal, wood and furniture sectors. In contrast, a negative and statistically significant (p < 0.001) correlation was observed between cancer mortality and the percentage of the population working in agriculture. In conclusion, although the variability in cancer mortality in men was significantly associated with some occupational sectors in the VC, caution is needed when drawing conclusions about causation from ecological studies.
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Affiliation(s)
- D Corella
- Department of Preventive Medicine and Public Health, Universitat de València, Spain.
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