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Small area study of mortality among people living near multiple sources of air pollution

Abstract
Objective—In the area of Malagrotta, a
suburb of Rome (Italy), a large waste disposal
site, a waste incinerator plant, and
an oil refinery plant became operational
in the early 1960s and have represented
three major sources of air pollution. To
evaluate the potential health risk due to
airborne contamination around these
point sources, a small area analysis of
mortality was conducted. Cancer of the
liver, larynx, lung, kidney, lymphatic, and
haematopoietic systems were evaluated.
Methods—Sex and age specific mortality
(1987–93) and population denominators
(1991) were available for the census tracts
of the metropolitan area of Rome. Standardised
mortality ratios (SMRs) were
computed separately for males and females
in bands of increasing distance
from the plants, up to a radius of 10 km.
Stone’s test for the decline in risk with
distance was performed with increments
in radius of 1 km; SMRs were also
computed after adjusting for a four level
index of socioeconomic status.
Results—No overall excess or decline in
risk with distance was found for liver,
lung, and lymphohaematopoietic cancers
in either sex. For laryngeal cancer, an
increased but not significant risk was
found at 0–3 km and at 3–8 km. A
significant decline with distance in
mortality from laryngeal cancer was
found among men (p=0.03); the trend
remained after adjusting for the
socioeconomic index (p=0.06).
Conclusions—The study showed no association
between proximity to the industrial
sites and mortality for most of the
several conditions considered. However,
mortality from laryngeal cancer declined
with distance from the sources of pollution.
This result is interesting, as previous
findings of an increased risk of laryngeal
cancer near incinerators have been controversial.
(Occup Environ Med 1998;55:611–615)
Keywords: environmental epidemiology; waste disposal;
small area analysis

AbstractObjective—In the area of Malagrotta, asuburb of Rome (Italy), a large waste disposalsite, a waste incinerator plant, andan oil refinery plant became operationalin the early 1960s and have representedthree major sources of air pollution. Toevaluate the potential health risk due toairborne contamination around thesepoint sources, a small area analysis ofmortality was conducted. Cancer of theliver, larynx, lung, kidney, lymphatic, andhaematopoietic systems were evaluated.Methods—Sex and age specific mortality(1987–93) and population denominators(1991) were available for the census tractsof the metropolitan area of Rome. Standardisedmortality ratios (SMRs) werecomputed separately for males and femalesin bands of increasing distancefrom the plants, up to a radius of 10 km.Stone’s test for the decline in risk withdistance was performed with incrementsin radius of 1 km; SMRs were alsocomputed after adjusting for a four levelindex of socioeconomic status.Results—No overall excess or decline inrisk with distance was found for liver,lung, and lymphohaematopoietic cancersin either sex. For laryngeal cancer, anincreased but not significant risk wasfound at 0–3 km and at 3–8 km. Asignificant decline with distance inmortality from laryngeal cancer wasfound among men (p=0.03); the trendremained after adjusting for thesocioeconomic index (p=0.06).Conclusions—The study showed no associationbetween proximity to the industrialsites and mortality for most of theseveral conditions considered. However,mortality from laryngeal cancer declinedwith distance from the sources of pollution.This result is interesting, as previousfindings of an increased risk of laryngealcancer near incinerators have been controversial.(Occup Environ Med 1998;55:611–615)Keywords: environmental epidemiology; waste disposal;small area analysis

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