Goldsmith J R
Epidemiology and Health Services Evaluation Unit, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
Sci Total Environ. 1992 Dec 15;127(1-2):13-35; discussion 43-55. doi: 10.1016/0048-9697(92)90465-5.
Data on cancer incidence and mortality in the vicinity of nuclear installations in England and Wales have been published, covering the period 1959-1980. Several age classes and a number of cancer sites have been included. Systematic analysis has so far been limited to cancer mortality. This suggests that childhood leukemia is unusually frequent near some types of installations and the excess is greater for years 0-9 than for later ages. In the earlier decade, 1959-1969, there was questionable consistency of incidence reporting. This report uses the incidence and mortality data only for the period 1971-1980; leukemia and non-leukemia cancer data for those 0-9 years are analyzed, and consistency of incidence reporting is evaluated by comparing incidence and mortality. For comparison with reported data for grouped local authority areas (LAAs) near to 21 different installations, two sources of expected incidence are used. The first is based on regional data, and the second is based on a group of LAAs similar in location, urban/rural character and population size. Effectiveness of treatment of acute lymphocytic leukemia (ALL, the principal type among 0-9-year-old children) has improved in recent decades and this has decreased the case fatality rate, and increased the relevance of incidence data. No significant differences in the mortality/incidence ratio were found when comparing areas near installations with their matched reference areas. Although some standardized incidence ratios (SIRs) are low in comparison areas, these are a reflection of the small numbers in the denominator. Low and high SIRs are observed in both installation and comparison areas. Excluding the populations near Sellafield and Dounreay, the installations of which include nuclear reprocessing and which are reported elsewhere, children living near one of a group of six installations have significantly increased leukemia incidence. One hundred sixty-five cases were observed for the combined population group, whereas 133.6 were expected on the basis of regional data and 141.9 on the basis of comparison areas. The operations of these installations include nuclear research, nuclear fuel production, nuclear weapons manufacture, and radio-isotopic reagent manufacture and marketing. No evidence of any increase of leukemia incidence is found for populations surrounding nuclear power installations, nor in coastal communities possibly affected by Sellafield discharges.(ABSTRACT TRUNCATED AT 400 WORDS)
