Dolk H, Shaddick G, Walls P, Grundy C, Thakrar B, Kleinschmidt I, Elliott P
Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, England.
Am J Epidemiol. 1997 Jan 1;145(1):1-9. doi: 10.1093/oxfordjournals.aje.a009025.
A small area study of cancer incidence in 1974-1986 was carried out to investigate an unconfirmed report of a "cluster" of leukemias and lymphomas near the Sutton Coldfield television (TV) and frequency modulation (FM) radio transmitter in the West Midlands, England. The study used a national database of postcoded cancer registrations, and population and socioeconomic data from the 1981 census. Selected cancers were hematopoietic and lymphatic, brain, skin, eye, male breast, female breast, lung, colorectal, stomach, prostate, and bladder. Expected numbers of cancers in small areas were calculated by indirect standardization, with stratification for a small area socioeconomic index. The study area was defined as a 10 km radius circle around the transmitter, within which 10 bands of increasing distance from the transmitter were defined as a basis for testing for a decline in risk with distance, and an inner area was arbitrarily defined for descriptive purposes as a 2 km radius circle. The risk of adult leukemia within 2 km was 1.83 (95% confidence interval 1.22-2.74), and there was a significant decline in risk with distance from the transmitter (p = 0.001). These findings appeared to be consistent over the periods 1974-1980, 1981-1986, and were probably largely independent of the initially reported cluster, which appeared to concern mainly a later period. In the context of variability of leukemia risk across census wards in the West Midlands as a whole, the Sutton Coldfield findings were unusual. A significant decline in risk with distance was also found for skin cancer, possibly related to residual socioeconomic confounding, and for bladder cancer. Study of other radio and TV transmitters in Great Britain is required to put the present results in wider context. No causal implications can be made from a single cluster investigation of this kind.
1974年至1986年开展了一项关于癌症发病率的小范围研究,以调查一份未经证实的报告,该报告称在英格兰西米德兰兹郡萨顿科尔德菲尔德电视(TV)和调频(FM)无线电发射机附近出现了白血病和淋巴瘤“聚集”现象。该研究使用了一个全国性的癌症登记邮政编码数据库,以及1981年人口普查的人口和社会经济数据。选定的癌症类型包括造血和淋巴系统、脑、皮肤、眼、男性乳腺、女性乳腺、肺、结肠直肠、胃、前列腺和膀胱。通过间接标准化计算小区域内癌症的预期数量,并根据小区域社会经济指数进行分层。研究区域被定义为以发射机为中心、半径10公里的圆圈,在该圆圈内,根据与发射机距离增加的情况划分出10个区域,以此作为检验风险是否随距离下降的基础,并且为了描述目的,任意定义了一个半径2公里的内圈区域。在2公里范围内成人白血病的风险为1.83(95%置信区间1.22 - 2.74),并且风险随与发射机距离的增加而显著下降(p = 0.001)。这些发现在1974 - 1980年、1981 - 1986年期间似乎是一致的,并且可能在很大程度上独立于最初报告的聚集现象,最初报告的聚集现象似乎主要涉及较晚时期。在西米德兰兹郡整个普查区白血病风险存在变异性的背景下,萨顿科尔德菲尔德的研究结果是不寻常的。对于皮肤癌(可能与残留的社会经济混杂因素有关)和膀胱癌,也发现风险随距离显著下降。需要对英国其他无线电和电视发射机进行研究,以便将当前结果置于更广泛的背景中。此类单一聚集现象调查无法得出因果关系结论。