Site-Specific A Priori Cancer Risk Estimator for Mixtures and Multiple Sources: Net Excess Relative Odds

Abstract

An essential requirement for effective cancer prevention, cancer surveillance, and cancer hot-spot analysis is the ability to evaluate cancer site-specific environmental risk factors associated with the operation of multiple industrial point sources and plumes as mixtures. Here we describe a methodology to make a priori estimates of environmental risk factors for minimal exposure by linking an inventory of releases associated with one of 60 standard industrial codes with an inventory of cancer risks associated with minimal occupational exposure to the same chemical releases. We show that an estimate of the risk of developing one of 10 cancers from living within 5 km of a pulp mill, a refinery, a wood treating plant, a chlorine generator, and a paint factory within a community of 36 000 is easily conducted with net excess relative odds (NERO). While this work is confined to cancer risk, the approach outlined can be expanded to estimate outcomes as diverse from cardiovascular disease to spontaneous abortion. This is the second in a series reexamining environmental risk factors using retrospective exposure assessment with emission inventories.