Mortality among residents near cokeworks in Great Britain.

Abstract

Objectives-To investigate whether residents near cokeworks have a higher standardised mortality than those further away, particularly from cardiovascular and respiratory causes, which may be associated with pollution from cokeworks. Method-Cross sectional small area study with routinely collected postcoded mortality data and small area census statistics. Populations within 7.5 km of 22 cokeworks in Great Britain, 1981-92. Expected numbers of deaths within 2 and 7.5 km of cokeworks, and in eight distance bands up to 7.5 km of cokeworks, were calculated by indirect standardisation from national rates stratified for age and sex and a small area deprivation index, and adjusted for region. Age groups examined were all ages, 1-14, 15-64, 65-74, >75. Only the 1-14 and 15-44 age groups were examined for asthma mortality. Results-There was a 3% (95% confidence interval (95% CI) 1% to 4%) excess of all deaths within 2 km of cokeworks, and a significant decline in mortality with distance from cokeworks. The excess of deaths within 2 km was slightly higher for females and elderly people, but excesses within 2 km and declines in risk with distance were significant for all adult age groups and both sexes. The size of the excess within 2 km was 5% (95%CI 3% to 7%) for cardiovascular causes, 6% (95%CI 3% to 9%) for ischaemic heart disease, and 2% (95% CI -2% to 6%) for respiratory deaths, with significant declines in risk with distance for all these causes. There was a non-significant 15% (95%CI −1% to 101%) excess in asthma mortality in the 15-44 age group. There were no significant excesses in mortality among children but 95% CIs were wide. Within 2 km of cokeworks, the estimated additional excess all cause mortality for all ages combined related to region and mainly to the greater deprivation of the population over national levels was 12%. Conclusions-A small excess mortality near cokeworks as found in this study is plausible in the light of current evidence about the health impact of air pollution. However, in this study the eVects of pollution from cokeworks, if any, are outweighed by the eVects of deprivation on mortality near cokeworks. It is not possible to confidently exclude socioeconomic confounding or biases resulting from inexact population estimation as explanations for the excess found. (Occup Environ Med 1999;56:34-40)

Lung cancer in an urban area in Northern Italy near a coke oven plant

“…Coke ovens are well-known sources of potential carcinogenic and toxic compounds, comprising benzene, benzo[a]pyrene, other polycyclic aromatic hydrocarbon, SO 2 and fine particulate matter [22,23]. Many occupational studies highlighted an excess risk for lung cancer in people working close to coke oven plants [24,25], whereas few evidences have been so far collected about the risk for resident populations [12,26].…”

Exposure to ambient air pollution and prenatal and early childhood health effects

“…In two of them exposure is evaluated based on the distance to exact sources such as coke works [41] or incinerators and crematoriums [38]. Only in the study in Me´xico City air pollution measurements from a monitoring station operated by the investigators were used [42].…”

„Environmental justice“ (Umweltgerechtigkeit)

“…Als mögliche Erklärung für eine fehlende Assoziation zwischen SES und Verkehrs lärmbelastung wird diskutiert, dass die soziökonomische Heterogenität in den Studiengebieten zumeist sehr groß ist [5]. Wichtiger ist jedoch ein anderer Punkt: Es wird wiederholt darauf hingewiesen, dass nicht nur die Assoziation zwischen SES und Exposition untersucht werden sollte, sondern auch die Rolle von SES als poten tieller Effektmodifikator bei der Assozia tion zwischen Exposition und Outcome [10,17,51].…”

“…Für Kinder besteht ein zweifach erhöhtes Risiko (OR=2,01; 95%KI=1,05-3,84), bei Luftverschmutzung an einer Mittelohrentzündung zu erkranken [6]. Aber auch industrielle Emissionen kön nen in Verbindung gebracht werden mit der Erhöhung der Mortalität in einer Re gion [10]. So ergibt eine Studie Hinwei se auf einen diesbezüglichen Zusammen hang beim Lungenkrebs [39].…”