Abstract
BackgroundResidence near municipal solid waste incinerators, a major historical source of dioxin emissions, has been associated with increased risk of non-Hodgkin lymphoma (NHL) in European studies. The aim of our study was to evaluate residence near industrial combustion facilities and estimates of dioxin emissions in relation to NHL risk in the United States.MethodsWe conducted a population-based case–control study of NHL (1998–2000) in four National Cancer Institute-Surveillance Epidemiology and End Results centers (Detroit, Iowa, Los Angeles, Seattle). Residential histories 15 years before diagnosis (similar date for controls) were linked to an Environmental Protection Agency database of dioxin-emitting facilities for 969 cases and 749 controls. We evaluated proximity (3 and 5 km) to 10 facility types that accounted for >85% of U.S. emissions and a distance-weighted average emission index (AEI [ng toxic equivalency quotient (TEQ)/year]).ResultsProximity to any dioxin-emitting facility was not associated with NHL risk (3 km OR = 1.0, 95% CI 0.8-1.3). Risk was elevated for residence near cement kilns (5 km OR = 1.7, 95% CI 0.8-3.3; 3 km OR = 3.8, 95% CI 1.1-14.0) and reduced for residence near municipal solid waste incinerators (5 km OR = 0.5, 95% CI 0.3-0.9; 3 km OR = 0.3, 95% CI 0.1-1.4). The AEI was not associated with risk of NHL overall. Risk for marginal zone lymphoma was increased for the highest versus lowest quartile (5 km OR = 2.6, 95% CI 1.0-6.8; 3 km OR = 3.0, 95% CI 1.1-8.3).ConclusionsOverall, we found no association with residential exposure to dioxins and NHL risk. However, findings for high emissions and marginal zone lymphoma and for specific facility types and all NHL provide some evidence of an association and deserve future study.
Highlights
Residence near municipal solid waste incinerators, a major historical source of dioxin emissions, has been associated with increased risk of non-Hodgkin lymphoma (NHL) in European studies
Ever working in an industry with potential dioxin exposure was associated with elevated risk of NHL in both the total National Cancer Institute (NCI)-SEER NHL study population (OR = 1.7, 95% confidence intervals (CI) 0.9-3.4) and our analysis population (OR = 1.8; 95% CI: 0.8-4.1)
We observed an elevated risk for residence
Summary
Residence near municipal solid waste incinerators, a major historical source of dioxin emissions, has been associated with increased risk of non-Hodgkin lymphoma (NHL) in European studies. The potency of a mixture of congeners is expressed in terms of the toxic equivalency quotient (TEQ), a summed metric that weights congeners relative to the potency of TCDD using toxic equivalency factors that are established for all biologically active PCDD/Fs [8] and dioxin-like PCBs. PCDD/F exposure has been associated with an increased risk of non-Hodgkin lymphoma (NHL) in industrial cohorts [10,11,12,13,14,15,16] and a population in the vicinity of an accidental release [17]. In an ecologic study using a proximity exposure metric, NHL incidence was not significantly increased within 3 km of 72 municipal solid waste incinerators in Great Britain compared to incidence within 3 to 7.5 km [21]
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