Cancer risks in naval divers with multiple exposures to carcinogens.

Abstract

We investigated risks for cancer and the case for a cause-effect relationship in five successive cohorts of naval commando divers (n = 682) with prolonged underwater exposures (skin, gastrointestinal tract, and airways) to many toxic compounds in the Kishon River, Israel's most polluted waterway, from 1948 to 1995. Releases of industrial, ship, and agricultural effluents in the river increased substantially, fish yields decreased, and toxic damage to marine organisms increased. Among the divers (16,343 person-years follow-up from 18 years of age to year 2000), the observed/expected ratio for all tumors was 2.29 (p<0.01). Risks increased in cohorts first diving after 1960 compared to risks in earlier cohorts, notably for hematolymphopoietic, central nervous system, gastrointestinal, and skin cancer; induction periods were often brief. The findings suggest that the increases in risk for cancer and short induction periods resulted from direct contact with and absorption of multiple toxic compounds. Early toxic effects in marine life predicted later risks for cancer in divers.

Regional Influences on Algal Biodiversity in Two Polluted Rivers of Eurasia (Rudnaya River, Russia, and Qishon River, Israel) by Bioindication and Canonical Correspondence Analysis

“…The Qishon's water is contaminated by agricultural runoff, various types of industrial effluents, and domestic sewage (Herut & Kress 1997); by heavy metals and a mixture of organic materials (Richter et al 2003;Herut et al 1994;Krumgalz 1993) including polycyclic aromatic hydrocarbons (PAHs), alkylated benzenes, halogenated alkanes, and chlorinated aromatic organic compounds; and some radionucleotides. As a result, the lower part of the Qishon River has been denuded for years of its multicellular life forms (Richter et al 2003). Moreover, tissue analyses of fishes, crustaceans, and mollusks from the shallow waters of Haifa Bay at the mouth of Qishon River revealed high levels of heavy metals and deviations in oxidizing enzyme activities ; Herut et al 1999).…”

“…The sediments at the Ports of Haifa, and Qishon river are also significantly contaminated by PCB's and by polycyclic aromatic pollutants (PAH's) not to speak about high levels (recorded from 1990 to 2002) of dissolved inorganic nutrients (nitrogen and phosphorous), representing a high degree of pollution by international environmental criteria (Herut et al 2003). The Qishon River has also elicited major public concern for its potential long-term cancer risks to fisherman working in its vicinity and to navy soldiers who used to dive in the river (Richter et al 2003). …”

Is Cancer in Israeli Professional Divers Exposed to Polluted Waters an Occupational Disease?

“…There are major differences in the methodology between the two reports on cancer morbidity in the Israeli Naval divers. Richter et al (2003) defined a cohort of 682 undersea divers from written materials received from one retired senior officer and from interviews with other senior officers and reported 51 cancers (44 after excluding malignant melanoma), an increased risk of 2.3 compared to expected cases in the general population. On the other hand The Israeli Government Committee (2001) identified 4256 soldiers from lists who were at any time in the Israeli Naval Diving unit.…”

“…No exact hours of diving were available, but we used the maximum hours reported from two sources (Government of Israel 2001; Richter et al 2003). Some divers claimed up to 300 h of diving time in the Kishon Harbor, and tens of hours in the Fisherman's cove.…”

“…Recently there were two studies in Israeli Navy divers with conflicting results. One suggested a two-fold increase in risk of cancer compared to the general population (Richter et al 2003) and the other no increased risk (Government of Israel 2001). Risk analysis was not done in these studies and we are unaware of previous attempts to quantify risks in divers exposed to polluted waters.…”