Mortality and morbidity among people living close to incinerators: a cohort study based on dispersion modeling for exposure assessment

Ranzi, Andrea; Fano, Valeria; Erspamer, Laura; Lauriola, Paolo; Perucci, Carlo A; Forastiere, Francesco

doi:10.1186/1476-069X-10-22

Environmental Health

Table 5 Associations between heavy metals concentration and mortality/incidence of cancer in the cohort of residents in the area of Coriano (Italy) by cause (ICD-9) and gender.

From: Mortality and morbidity among people living close to incinerators: a cohort study based on dispersion modeling for exposure assessment

Cause (ICD-9)	Heavy metals^†	Men								Women
		mortality				cancer incidence				mortality				cancer incidence
		obs^§	RR^§§	IC 95%		obs	RR^†	IC 95%		obs^§	RR^§§	IC 95%		obs	RR^§	IC 95%
All cancer (140-239)	I	216	1.00	-	-	413	1.00	-	-	152	1.00	-	-	396	1.00	-	-
	II	194	1.12	0.92	1.38	327	0.94	0.81	1.08	154	1.24	0.98	1.57	323	0.96	0.83	1.11
	III	194	1.04	0.85	1.27	342	0.93	0.81	1.07	153	1.24	0.98	1.57	315	0.95	0.82	1.10
	IV	65	0.85	0.64	1.12	136	0.87	0.72	1.06	65	1.47*	1.09	1.99	112	0.90	0.73	1.11
Stomach (151)	I	20	1.00	-	-	27	1.00	-	-	13	1.00	-	-	24	1.00	-	-
	II	20	1.44	0.76	2.73	28	1.18	0.69	2.00	13	1.32	0.59	2.98	22	1.02	0.57	1.81
	III	22	1.12	0.60	2.08	36	1.47	0.89	2.42	28	2.51*	1.27	4.97	31	1.54	0.91	2.63
	IV	7	0.85	0.35	2.03	13	1.24	0.64	2.40	7	1.86	0.73	4.75	8	1.09	0.49	2.44
Colon rectum (153-154)	I	18	1.00	-	-	45	1.00	-	-	13	1.00	-	-	34	1.00	-	-
	II	11	0.61	0.28	1.35	31	0.82	0.52	1.29	16	1.32	0.61	2.87	27	0.91	0.55	1.51
	III	25	2.10*	1.10	4.00	51	1.28	0.86	1.91	19	1.94	0.93	4.06	56	2.00*	1.31	3.06
	IV	10	2.05	0.92	4.58	17	1.00	0.57	1.75	8	2.15	0.86	5.37	14	1.33	0.71	2.48
Liver (155)	I	11	1.00	-	-	10	1.00	-	-	3	1.00	-	-	7	1.00	-	-
	II	6	0.61	0.21	1.75	7	0.80	0.30	2.10	3	0.92	0.17	5.11	2	0.30	0.06	1.46
	III	6	0.61	0.21	1.75	6	0.66	0.24	1.82	2	1.00	0.15	6.61	2	0.34	0.07	1.63
	IV	1	0.27	0.03	2.18	1	0.26	0.03	2.01	3	5.10	0.94	27.80	2	0.94	0.20	4.53
Larinx (161)	I	6	1.00	-	-	18	1.00	-	-	0	1.00	-	-	2	1.00	-	-
	II	2	0.42	0.08	2.22	6	0.41	0.16	1.04	1	-	-	-	1	0.61	0.06	6.80
	III	3	0.53	0.13	2.25	4	0.26	0.09	0.76	1	-	-	-	1	0.60	0.05	6.62
	IV	0	0.00	0.00	.	1	0.15	0.02	1.14	0	-	-	-	1	1.60	0.15	17.64
Lung (162)	I	54	1.00	-	-	69	1.00	-	-	15	1.00	-	-	16	1.00	-	-
	II	50	1.17	0.78	1.76	60	1.04	0.73	1.47	12	0.95	0.43	2.11	19	1.36	0.70	2.65
	III	56	1.15	0.78	1.71	64	1.05	0.75	1.48	10	0.89	0.39	2.06	11	0.82	0.38	1.78
	IV	18	0.91	0.53	1.57	25	0.96	0.61	1.52	4	0.96	0.31	2.97	4	0.81	0.27	2.42
Soft tissue sarcoma (171)	I	0	1.00	-	-	3	1.00	-	-	0	1.00	-	-	1	1.00	-	-
	II	1	-	-	-	1	0.37	0.04	3.59	0	-	-	-	0	0.00	-	-
	III	0	-	-	-	2	0.72	0.12	4.31	2	-	-	-	4	4.71	0.53	42.16
	IV	1	-	-	-	1	0.84	0.09	8.06	2	-	-	-	0	0.00	-	-
Breast (175)	I	0	1.00	-	-	0	1.00	-	-	21	1.00	-	-	125	1.00	-	-
	II	0	-	-	-	0	-	-	-	22	1.33	0.73	2.43	90	0.89	0.68	1.17
	III	0	-	-	-	0	-	-	-	18	1.02	0.55	1.92	81	0.78	0.59	1.03
	IV	0	-	-	-	0	-	-	-	13	2.00	1.00	3.99	30	0.76	0.51	1.13
Prostate (185)	I	14	1.00	-	-	60	1.00	-	-	0	1.00	-	-	0	1.00	-	-
	II	12	1.08	0.50	2.33	48	0.93	0.64	1.37	0	-	-	-	0	-	-	-
	III	23	1.85	0.95	3.59	58	1.08	0.75	1.55	0	-	-	-	0	-	-	-
	IV	8	1.57	0.66	3.74	29	1.27	0.82	1.99	0	-	-	-	0	-	-	-
Bladder (188)§	I	10	1.00	-	-	48	1.00	-	-	4	1.00	-	-	7	1.00	-	-
	II	13	1.50	0.62	3.61	33	0.83	0.53	1.29	4	1.09	0.25	4.78	9	1.49	0.55	4.01
	III	14	1.50	0.64	3.51	32	0.76	0.48	1.18	3	1.00	0.21	4.82	5	0.85	0.27	2.68
	IV	6	1.48	0.52	4.22	14	0.78	0.43	1.42	3	3.06	0.64	14.70	5	2.30	0.73	7.24
Central nerv. sys. (191-192;225)§	I	4	1.00	-	-	6	1.00	-	-	4	1.00	-	-	8	1.00	-	-
	II	3	0.51	0.10	2.55	9	1.84	0.65	5.17	4	0.76	0.17	3.43	5	0.77	0.25	2.36
	III	5	1.65	0.38	7.21	7	1.32	0.44	3.93	6	2.38	0.61	9.21	6	0.90	0.31	2.61
	IV	0	0.00	-	-	3	1.35	0.34	5.39	0	0.00	-	-	0	0.00	-	-
Lymphoemat.system (200-208)	I	27	1.00	-	-	50	1.00	-	-	17	1.00	-	-	34	1.00	-	-
	II	19	0.87	0.47	1.62	31	0.75	0.48	1.18	14	0.93	0.44	1.97	29	1.02	0.62	1.67
	III	14	0.58	0.30	1.14	34	0.77	0.50	1.19	12	0.94	0.44	2.05	23	0.81	0.48	1.38
	IV	4	0.42	0.15	1.23	13	0.70	0.38	1.28	8	1.78	0.74	4.25	13	1.23	0.65	2.33
Non-Hodgkin Limphoma (200,202)	I	10	1.00	-	-	23	1.00	-	-	7	1.00	-	-	15	1.00	-	-
	II	6	0.80	0.28	2.29	10	0.54	0.26	1.14	7	0.83	0.27	2.56	14	1.10	0.53	2.29
	III	6	0.63	0.22	1.82	13	0.65	0.33	1.28	2	0.47	0.09	2.44	8	0.64	0.27	1.51
	IV	2	0.52	0.11	2.45	5	0.59	0.23	1.57	3	2.03	0.48	8.67	5	1.06	0.39	2.93
Myeloma (203)	I	7	1.00	-	-	13	1.00	-	-	3	1.00	-	-	8	1.00	-	-
	II	3	0.37	0.09	1.62	14	0.45	0.16	1.27	1	0.32	0.03	3.53	9	0.36	0.10	1.30
	III	2	0.33	0.06	1.72	11	0.61	0.24	1.52	3	1.44	0.26	7.93	9	0.48	0.15	1.54
	IV	0	0.00	-	-	5	0.61	0.17	2.13	3	4.28	0.77	23.80	3	0.95	0.26	3.45
Leukaemia (204-208)	I	9	1.00	-	-	13	1.00	-	-	5	1.00	-	-	10	1.00	-	-
	II	9	1.33	0.51	3.49	5	1.27	0.60	2.72	6	1.82	0.54	6.19	3	1.31	0.50	3.40
	III	6	0.78	0.27	2.25	7	0.94	0.42	2.11	7	1.69	0.52	5.55	4	1.35	0.52	3.49
	IV	2	0.67	0.14	3.16	3	1.01	0.36	2.84	2	1.31	0.25	6.95	3	1.23	0.33	4.62

* p-value < 0.05; ^† Categories of heavy metals: I (reference) <0.5 ng/m³; II 0.5-1 ng/m³; III 1-2 ng/m³ ; IV >2 ng/m³; § Observed cases; §§ Rate Ratios (RR) versus the reference category of heavy metals adjusted for age and socioeconomic status; ‡ ICD-9 codes considered for cancer incidence were: bladder cancer = 188;223.3;223.7;236.7;239.4; cancer of the central nervous system = 191-192. Period: 1990-2003.

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