Permitted water pollution discharges and population cancer and non-cancer mortality: toxicity weights and upstream discharge effects in US rural-urban areas

Abstract

BackgroundThe study conducts statistical and spatial analyses to investigate amounts and types of permitted surface water pollution discharges in relation to population mortality rates for cancer and non-cancer causes nationwide and by urban-rural setting. Data from the Environmental Protection Agency's (EPA) Discharge Monitoring Report (DMR) were used to measure the location, type, and quantity of a selected set of 38 discharge chemicals for 10,395 facilities across the contiguous US. Exposures were refined by weighting amounts of chemical discharges by their estimated toxicity to human health, and by estimating the discharges that occur not only in a local county, but area-weighted discharges occurring upstream in the same watershed. Centers for Disease Control and Prevention (CDC) mortality files were used to measure age-adjusted population mortality rates for cancer, kidney disease, and total non-cancer causes. Analysis included multiple linear regressions to adjust for population health risk covariates. Spatial analyses were conducted by applying geographically weighted regression to examine the geographic relationships between releases and mortality.ResultsGreater non-carcinogenic chemical discharge quantities were associated with significantly higher non-cancer mortality rates, regardless of toxicity weighting or upstream discharge weighting. Cancer mortality was higher in association with carcinogenic discharges only after applying toxicity weights. Kidney disease mortality was related to higher non-carcinogenic discharges only when both applying toxicity weights and including upstream discharges. Effects for kidney mortality and total non-cancer mortality were stronger in rural areas than urban areas. Spatial results show correlations between non-carcinogenic discharges and cancer mortality for much of the contiguous United States, suggesting that chemicals not currently recognized as carcinogens may contribute to cancer mortality risk. The geographically weighted regression results suggest spatial variability in effects, and also indicate that some rural communities may be impacted by upstream urban discharges.ConclusionsThere is evidence that permitted surface water chemical discharges are related to population mortality. Toxicity weights and upstream discharges are important for understanding some mortality effects. Chemicals not currently recognized as carcinogens may nevertheless play a role in contributing to cancer mortality risk. Spatial models allow for the examination of geographic variability not captured through the regression models.

Impacts of soil and water pollution on food safety and health risks in China

“…It is reported that digestive cancer mortality has a close relationship with water quality and distance from rivers (Hendryx et al, 2012). Esophageal cancer mortality had a significant positive correlation with widespread water pollution and a negative correlation with buffer distance from polluted rivers and lakes .…”

“…Cancer mortality exhibited higher correlations with water quality grades than with distance from rivers and lakes (Ebenstein, 2012;Hendryx et al, 2012;Gao, 2013;He, 2013;Massaquoi et al, 2014;Zhang et al, 2014).…”

Public health in linkage to land use: Theoretical framework, empirical evidence, and critical implications for reconnecting health promotion to land use policy

“…Scholars have associated green spaces with decreased risks of cardiovascular and cerebrovascular diseases, missed abortions, low birth weight, cancer, and mental problems (Barton and Pretty, 2010;Dadvand et al, 2012;Richardson and Mitchell, 2010;Gascon et al, 2016;Sugiyama et al, 2016). On the other hand, industrial area has been associated with increased depression, cancer, low birth weight, and excessive mortality (Cambra et al, 2011;Hendryx et al, 2012;Lopez-Cima et al, 2011). In addition, better health outcomes are observed in neighborhood with greater area devoted to health facilities (e.g., clinics and hospitals) and institutional land (e.g., schools, square, and community centers) (Brown et al, 2009;Mobley et al, 2008).…”

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“…About 59% of the articles refer only one cancer site, and 38% refer two or more sites. The remain articles do not refer to a particular cancer site, considering cancer as a whole, or they indicate various types of cancer but did not mentioned exactly which (Bhowmick et al, 2008;Hendryx et al, 2012;Ruktanonchai et al, 2014). Table 2 summarises the frequency of all cancers analysed, classified according to the 9 th revision of International Statistical Classification of Diseases and Related Health Problems (ICD).…”