Cancer incidence near municipal solid waste incinerators in Great Britain

Abstract

Summary By use of the postcoded database held by the Small Area Health Statistics Unit, cancer incidence of over 14 million people living near 72 municipal solid waste incinerators in Great Britain was examined from 1974-86 (England), 1974-84 (Wales) and 1975. Numbers of observed cases were compared with expected numbers calculated from national rates (regionally adjusted) after stratification by a deprivation index based on 1981 census small-area statistics. Observed-expected ratios were tested for decline in risk with distance up to 7.5 km. The study was conducted in two stages: the first involved a stratified random sample of 20 incinerators; the second the remaining 52 incinerators. Over the two stages of the study there was a statistically significant (P<0.05) decline in risk with distance from incinerators for all cancers combined, stomach, colorectal, liver and lung cancer. Among these cancers in the second stage, the excess from 0 to 1 km ranged from 37% for liver cancer (0.95 excess cases 10-5 year-1) to 5% for colorectal cancer. There was evidence of residual confounding near the incinerators, which seemed to be a likely explanation of the findings for all cancers, stomach and lung, and also to explain at least part of the excess of liver cancer. For this reason and because of a substantial level of misdiagnosis (mainly secondary tumours) found among registrations and death certificates for liver cancer, further investigation, including histological review of the cases, is to be done to help determine whether or not there is an increase in primary liver cancer in the vicinity of incinerators.

Cancer risks in populations living near landfill sites in Great Britain

“…The major studies are listed in Table 1, showing that bladder cancer is the most frequently reported malignancy associated with landfills. The detoxifying properties of the liver suggest that environmental toxicants may accumulate in the liver and biliary tract; small excess risks of liver cancer were reported in previous studies around UK incinerators (Elliott et al, 1996(Elliott et al, , 2000. Several studies have shown an association between brain cancer and exposure to pesticides (Bohnen and Kurland, 1995), which are frequently used on landfill sites.…”

Ecologic Studies Revisited

“…Thus we need the confounder distribution within each exposure category, unless z is not a within-area confounder. The requirement for stratumdefined exposure distributions is closely related to mutual standardization as described Often one can attempt to control for confounding via expected numbers E using the regression model: (17,18,22). This approach implicitly assumes, however, that there is no within-area confounding (75).…”

Risk of Adverse Reproductive Outcomes Associated with Proximity to Municipal Solid Waste Incinerators with High Dioxin Emission Levels in Japan

“…Quite a similar study, in its design and statistical analyses, of health effects related to MSW incineration among general population has been performed in Great Britain, [27][28] where cancer incidence near the MSW incinerators has been investigated.…”

“…In the absence of such exposure information, even a simple model of decline in risk with distance, equal in all directions, has been used to examine environmental excess risks around putative sources. [23][24][25][27][28] Regarding the blood levels of dioxins around MSW incinerators, the investigator group of Ibaraki prefecture has conducted a well-designed study whose primary purpose is to examine the association of the resident's blood levels of dioxins with the distance from the Shiratori MSW incinerator in Ryugasaki, Ibaraki. 29 At the design stage, 120 residents were selected so as to adjust sex, age, and distance from the incinerator.…”