Spatial analysis of health effects of large industrial incinerators in England, 1998-2008: A study using matched case-control areas
Reeve NF., Fanshawe TR., Keegan TJ., Stewart AG., Diggle PJ.
Objectives: To assess whether residential proximity to industrial incinerators in England is associated with increased risk of cancer incidence and mortality. Design: Retrospective study using matched case-control areas. Setting: Five circular regions of radius 10 km near industrial incinerators in England (case regions) and five matched control regions, 1998-2008. Participants: All cases of diseases of interest within the circular areas. Primary and secondary outcome measures: Counts of childhood cancer incidence ( < 15 years); childhood leukaemia incidence ( < 15 years); leukaemia incidence; liver cancer incidence; lung cancer incidence; non-Hodgkin's lymphoma incidence; allcause mortality; infant mortality ( < 1 year) and liver cancer mortality. Results: The estimated relative risks for case circles versus control circles for the nine outcomes considered range from 0.94 to 1.14, and show neither elevated risk in case circles compared to control areas nor elevated risk with proximity to incinerators within case circles. Conclusions: This study applies statistical methods for analysing spatially referenced health outcome data in regions with a hypothesised exposure relative to matched regions with no such exposure. There is no evidence of elevated risk of cancer incidence or mortality in the vicinity of large industrial incinerators in England.