Abstract
The distribution of mortality from 11 causes of death (lymphoid leukaemia, other leukaemia, leukaemia of all types, Hodgkin's disease, other lymphomas, all lymphomas, multiple myeloma, lung cancer, other malignancies, all malignancies and all other causes) has been examined in three age groups throughout England and Wales over the period 1969-78. The reorganisation of local authority administration in 1974 meant that the smallest areas that could be examined were 400 county districts or (in some cases) approximate county districts formed by aggregating pre-1974 local authority areas. The variation in the numbers of deaths observed about the numbers expected was assessed using log-linear models to estimate the effect on the relative risk in each district associated with social class, rural status, population size, health authority region and proximity to one of 15 nuclear installations. Trends in risk with increasing proximity to an installation (as judged by the proportion of the population resident within 10 miles) were examined after adjustment for the other four variables. The results showed that in districts near to an installation there were significant excess mortalities in persons under 25 years of age from leukaemia (RR = 1.15, P = 0.01) and especially from lymphoid leukaemia (RR 1.21, P = 0.01) and from Hodgkin's disease (RR 1.24, P = 0.05) and a significant deficiency of mortality from lymphoid leukaemia in persons aged 25-64 years. No significant trends were observed with an increasing proportion of the population near to the installations and the greatest excess mortality from lymphoid leukaemia in young persons was observed in the districts with the intermediate proportion of the population (10.0-65.9%) near an installation.
Highlights
Reports of an increased incidence of leukaemia in young people in the vicinity of certain nuclear installations have caused concern about the possible effect on communities that live near other such installations
This limited calendar period was chosen for study for three reasons: (i) to concentrate on the period after the start-up of almost all the installations, when any hazard with a latent period measured in years would be capable of detection; (ii) to be able to examine separately figures for lymphoid leukaemia which, until 1968, had not been possible as deaths from acute lymphoid and acute myeloid leukaemia had been classed together; and (iii) because OPCS were able to make available deaths only for complete quinquennia
The variation in relative risk (RR) by these four variables is given in Table III for all leukaemia and the leukaemia sub-types at
Summary
Reports of an increased incidence of leukaemia in young people in the vicinity of certain nuclear installations have caused concern about the possible effect on communities that live near other such installations. The extent and localisation of the increase near Sellafield leaves no doubt about its reality (Gardner & Winter, 1984) but it is unclear how far many of the other reports represent selection of high rates that are bound to occur by chance, while low rates are neglected. To check this possibility the evidence relating to all the installations in the country needs to be examined. This, is not easy to do as the reorganisation of local government in 1974 altered the boundaries of most administrative units and made it difficult to obtain relevant figures for each area of interest over a long enough period
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