Elliott P, Hills M, Beresford J, Kleinschmidt I, Jolley D, Pattenden S, Rodrigues L, Westlake A, Rose G
Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, UK.
Lancet. 1992 Apr 4;339(8797):854-8. doi: 10.1016/0140-6736(92)90290-j.
The Small Area Health Statistics Unit (SAHSU) is a new independent facility for the investigation of disease near industrial installations in the UK. SAHSU analysed the incidence of cancers of the larynx and lung near the incinerator of waste solvents and oils at Charnock Richard, Coppull, Lancashire (which operated between 1972 and 1980) and nine other similar incinerators in Great Britain, after reports of a cluster of cases of cancer of the larynx near the Charnock Richard site. Postcoded cancer registration data were available for 1974-84 in England and Wales and 1975-87 in Scotland. Lag periods of 5 and 10 years were used between start-up (or first registration) of the incinerators and cancer incidence. Standardised observed/expected (O/E) ratios were assessed within 3 km and 3-10 km of each site and then aggregated over all sites. Expected values were based on national rates (regionally adjusted) with and without stratification by Carstairs' index, a measure of the socioeconomic profile of areas that uses census data for enumeration districts. Data were also assessed over a range of circles up to 10 km to test for trend in O/E ratios with distance. For Charnock Richard, none of the O/E ratios within 3 km or from 3-10 km differed significantly from unity, for either cancer or lag period. In the analysis of all sites with stratification by Carstairs' index, none of these O/E ratios differed significantly from unity for the two cancers. There was no evidence of decreasing risk with distance from the sites of either cancer. We conclude that the apparent cluster of cases of cancer of the larynx reported near Charnock Richard was unlikely to be due to its former incinerator.
小区域健康统计单位(SAHSU)是英国一家新的独立机构,用于调查工业设施附近的疾病情况。在接到关于查诺克理查德(位于兰开夏郡科普尔,1972年至1980年运营)废溶剂和废油焚烧炉附近喉癌和肺癌聚集病例的报告后,SAHSU分析了该焚烧炉以及英国其他九个类似焚烧炉附近喉癌和肺癌的发病率。1974 - 1984年的邮政编码癌症登记数据可用于英格兰和威尔士,1975 - 1987年的数据可用于苏格兰。在焚烧炉启动(或首次登记)与癌症发病之间采用了5年和10年的潜伏期。在每个站点3公里和3 - 10公里范围内评估标准化观察/预期(O/E)比率,然后汇总所有站点的数据。预期值基于全国发病率(区域调整),有或没有按卡斯尔斯指数分层,卡斯尔斯指数是一种利用普查数据对枚举区进行区域社会经济概况测量的指标。还在半径达10公里的一系列圆圈范围内评估数据,以测试O/E比率随距离的变化趋势。对于查诺克理查德站点,无论是癌症还是潜伏期,3公里内或3 - 10公里范围内的O/E比率与1均无显著差异。在按卡斯尔斯指数分层对所有站点进行分析时,这两种癌症的这些O/E比率与1均无显著差异。没有证据表明这两种癌症的发病风险随离站点距离的增加而降低。我们得出结论,查诺克理查德附近报告的明显喉癌病例聚集不太可能是由于其以前的焚烧炉所致。