Objectives-To investigate concern that local industrial air pollution in Teesside, England, was causing poor health, several areas there were compared with parts of the City of Sunderland. Results-The populations in the four zones were comparable for indicators including smoking habits, residential histories, and unemployment. All cause and cause specific mortalities were high compared with England and Wales. Mortality in all Teesside zones (ABC) combined was mostly higher than in zone S. In people aged 0-64, lung cancer and respiratory disease showed gradients with highest mortality in areas closest to industry (A>B>C and ABC>S). The association was clearest for lung cancer in women (0-64 years old, trend across zones ABC, p=0.07, directly standardised rate ratio relative to zone S was 169 (95% confidence interval (95% CI) 116-122)). There were no important, consistent gradients in the hypothesised direction between zones in consultation rates in general practice, and self reported respiratory and nonrespiratory health including asthma. Conclusions-There was no clear evidence that living close to industry was associated with morbidity, including asthma, or for most measures of mortality. For lung cancer in women the gradients indicated a health eVect of local industrial air pollution. In the age group 0-64 observed gradients in lung cancer in men and mortality from respiratory disease in men and women were consistent with the study hypothesis, although not significant. The reasons for the diVerent patterns at diVerent ages, and between men and women, remain a puzzle. (Occup Environ Med 1998;55:812-822)
Methods-Populations