Abstract
To ascertain solid tumor mortality in towns near Spain's four nuclear power plants and four nuclear fuel facilities from 1975 to 1993, we conducted a mortality study based on 12,245 cancer deaths in 283 towns situated within a 30-km radius of the above installations. As nonexposed areas, we used 275 towns lying within a 50- to 100-km radius of each installation, matched by population size and sociodemographic characteristics (income level, proportion of active population engaged in farming, proportion of unemployed, percentage of illiteracy, and province). Using log-linear models, we examined relative risk for each area and trends in risk with increasing proximity to an installation. The results reveal a pattern of solid-tumor mortality in the vicinity of uranium cycle facilities, basically characterized by excess lung [relative risk (RR) 1.12, 95% confidence interval (CI), 1.02-1.25] and renal cancer mortality (RR 1.37, 95% CI, 1.07-1.76). Besides the effects of natural radiation, these results could well be evincing the influence on public health exerted by the environmental impact of mining. No such well-defined pattern appeared in the vicinity of nuclear power plants. Monitoring of cancer incidence and mortality is recommended in areas surrounding nuclear fuel facilities and nuclear power plants, and more specific studies are called for in areas adjacent to installations that have been fully operational for longer periods. In this regard, it is important to use dosimetric information in all future studies.
Highlights
To ascertain solid tumor mortality in towns near Spain’s four nuclear power plants and four nuclear fuel facilities from 1975 to 1993, we conducted a mortality study based on 12,245 cancer deaths in 283 towns situated within a 30-km radius of the above installations
The results of the study indicate a cancer mortality pattern in areas adjacent to uranium cycle facilities that is basically characterized by excess deaths due to renal and lung cancer [and leukemias [11]]
These results may well be evincing the influence exerted on public health by the environmental impact of mining activities and the effects of natural radiation
Summary
A more detailed description of the methodology may be found in a previous study [11]. The regression coefficient of this exposure term gave us the logarithm of the ratio between the respective standard mortality ratios (SMRs) for the exposed and reference zones, which we called “relative risk” (RR) This estimator was adjusted for age, sex, period, and matching variables. The statistical significance of this change was obtained following two criteria: fitting a model that compares the SMRs before versus after start-up only for the 0–30 km areas; and a likelihood ratio test, which evaluates the interaction term— exposure × plant operation—in regression models, including reference areas. The former evaluates time trends in exposed areas in contrast with trends at the national level, and the latter evaluates time trend differences between exposed and unexposed areas (reference areas). We checked and corrected model results for overdispersion problems [16] using the robust methods recommended by Breslow, because these methods are insensitive to the form adopted by variance [17]
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