Abstract
We assessed the risk of lung cancer in people living near the iron foundry located within the city of Trieste, Northeastern Italy. Between 1995 and 2009, all incident cases of lung cancer and corresponding population were considered. A deposition model of the foundry-specific emissions of SO2 defined: “nearby”, “urban”, and “outlying” areas. Rate ratios (RRs) and annual percent changes (APCs) were computed. Among nearby residents, significantly increased risks of lung cancer were noted in men below age 75 years (RR = 1.35 vs. urban area; 95% CI: 1.03–1.77). In women, and in men aged 75 years or older, no significant RRs were observed. Conversely, people living in the outlying area appeared to be at lower risk than residents in the urban area- in all age groups, in men (RR = 0.87; 95% CI: 0.78–0.98) and in women (RR = 0.74; 95% CI: 0.62–0.88). Negative statistically significant APC was recorded in men living in urban areas (–2.6%), whereas in women APC significantly increased among those living in the urban area (+2.3%). Multiple interpretations for this observation are plausible, since several factors might have modified and/or confounded the risk of lung cancer, including air pollution from other sources and road traffic, occupational and smoking patterns.
Highlights
Lung cancer is largely caused by cigarette smoking, while other recognized risk factors are occupational exposures in some industrial facilities [1,2,3,4], air pollution due to road traffic, heating-related and industrial emissions [4,5,6,7,8].Trieste is a border city located in the northeastern part of Italy, and it is characterized by a major port and by an elevated concentration of industries
The risk of lung cancer tended to be lower in the outlying area in both men (RR = 0.87; 95% confidence intervals (CI): 0.72–0.98) and women (RR = 0.74; 95% CI: 0.62–0.88), than in the urban area
Among men and women living near the foundry, a statistically significant increased risk of lung cancer was noted solely for men under 75 years of age (RR = 1.35, 95% CI: 1.03–1.77), as compared to those living in the urban area (Table 1)
Summary
Lung cancer is largely caused by cigarette smoking, while other recognized risk factors are occupational exposures in some industrial facilities [1,2,3,4], air pollution due to road traffic, heating-related and industrial emissions [4,5,6,7,8].Trieste is a border city located in the northeastern part of Italy, and it is characterized by a major port and by an elevated concentration of industries. A case-control study conducted in the early 1990s examined lung cancer mortality in men living in Trieste according to these sources of pollution. Results from this study, adjusted for smoking, occupational exposure to respiratory carcinogens and social class showed a moderate elevation in risk among men residing in all the four polluted areas, with significant variations according to histologic types [10]. A later analysis of these data, which included further geographical modeling of distances from the sources, specified that the risk of lung cancer was especially high among residents in the city center of Trieste or near the incinerator [11]. Additional publications from that case-control study estimated that, in Trieste, the lung cancer attributable risk was 87.5% for cigarette smoking, while it ranged between 16.0% and 23% for occupational exposures [9]. The risk of lung cancer attributable to smoking seemed to be lower for adenocarcinoma than for other histological types [12]
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