Cancer incidence in a petrochemical industry area in Sweden

doi:10.1016/j.scitotenv.2010.06.028

Science of The Total Environment

Volume 408, Issue 20, 15 September 2010, Pages 4482-4487

https://doi.org/10.1016/j.scitotenv.2010.06.028 Get rights and content

Abstract

Emissions from petrochemical industries may contain suspected or established carcinogens. As increased incidence of cancer in residential areas close to petrochemical industries has been reported in the literature, we conducted a study of cancer incidence in Stenungsund, Sweden, where petrochemical industries were established in the mid1960s.

A number of cancer cases in the central parts of Stenungsund were collected from the regional cancer registry for each year between 1974 and 2005. In addition to the total number of cases, the numbers of leukemia, lymphoma, liver cancer, lung cancer, and brain cancer were also collected. Expected numbers for each year were calculated based on age- and sex-specific incidence rates in reference areas. Levels of carcinogenic volatile hydrocarbons (VOC) were estimated from measurements and emission data. A dispersion model was used to classify Stenungsund into a “low” and “high” ethylene level area.

Standardized Incidence Ratio (SIR) for all cancer for the entire period was 1.02 (95% CI 0.97–1.08). The occurrence of leukemia, lymphoma, and cancer in the central nervous system was slightly lower than expected for the entire period. SIR for lung cancer was 1.37 (95% CI 1.10–1.69), and SIR for liver cancer was 1.50 (0.82–2.53). VOC levels were low.

Taking estimated exposure and demographic factors into account, our assessment is that occurrence of cancer was not affected by industrial emissions in any of the studied sites.

Introduction

Emissions from petrochemical industries contain suspected or established carcinogens. The occurrence of cancer in residential areas close to petrochemical industries has been studied in Great Britain, the USA, Italy, and Taiwan. Yang et al. (1997) reported increased incidence of liver cancer compared to ‘unexposed areas’ in a study from Taiwan. In another Taiwanese study, increased cancer mortality was reported in children and adolescents living within 3 km of a petrochemical plant (Pan et al. 1994).

In a study conducted in northeast England, a region with extensive industrial activity was compared to a socio-economically comparable non-industrial area. Even after adjustment for smoking habits, increased lung cancer mortality was seen in women from the ‘exposed’ area (Bophal et al. 1998). Leukemia and lymphoma were found to be increased, although not significantly so, in inhabitants living within 1.5–3 km of a petrochemical plant in Wales (Lyons et al. 1995). An increased mortality from myeloma was reported for people living within 7.5 km of the same plant (Sans et al. 1995).

In the USA, a study conducted in a Louisiana area with a dense location of refineries and other petrochemical industries revealed that cancer mortality was no higher than in other parts of Louisiana (Tsai et al. 2004a). A case-control study from Brindisi in Italy found an odds ratio (OR) of about 3 for lung cancer among people living within 2 km of petrochemical industries, though this was not statistically significant (Belli et al. 2004).

There are conflicting results regarding employees in the petrochemical industry. Increased incidence of brain tumors (Beall et al. 2001) and lymphatic tumors (Huebner et al. 2004) has been reported, while other researchers (e.g. Tsai et al. 2004b) found no increased risk. Vinyl chloride exposure has been shown to cause both lung cancer and liver cancer (IARC, 1979).

In Sweden, the petrochemical industry is found on the western coast line, with a particular concentration around the municipality of Stenungsund. The industrial complex includes a large cracker producing ethylene and propene, and other plants producing polyethylene, Poly Vinyl Chloride (PVC), amines, surfactants, and oxo-alcohols. The complex was established between 1963 and 1980, and included 2000 employees in 2005. The ambient air is polluted with a large spectrum of compounds, including established or suspected carcinogens such as ethylene, benzene, 1,3-butadiene, propene, ethylene oxide, and vinyl chloride (VCM).

Previous studies in this area on annoyance and anxiety due to ambient air exposure from the petrochemical industry have shown that approximately 40% of the population are concerned about possible health effects. Against this background, and the increased incidence of cancer reported in the literature, we designed a new study of cancer incidence in Stenungsund.

The aim of this study was to examine whether cancer incidence was increased in people living in the Stenungsund area. We focused on leukemia, lymphoma, and cancers of the lung, liver, and central nervous system (CNS) as well as all cancer taken together. This was also studied in the part of the municipality which is supposed to have the highest levels of ambient air pollutants.

Section snippets

Study population and assessment of cancer incidence

The numbers of cancer cases in the central parts of Stenungsund (parish of Norum) were collected from the regional cancer registry for each year between 1974 and 2005. The data were subdivided into five-year age groups in females and males separately. In addition to the total number of cases, the numbers of leukemia, lymphoma, liver cancer, lung cancer, and brain cancer cases were collected and classified according to the International classification of diseases 7, (ICD 7). Expected numbers for

Cancer

Fig. 2 shows the observed and expected number of cancer cases in central Stenungsund (the Norum parish) from 1974 to 2005. The expected number of cases/year increased from 15 to 70, mainly due to increasing population and mean age. With a few exceptions, the observed number each year was close to that expected.

Table 1 shows the distribution of these cases in the three time periods for males and females separately as well as combined. No significant differences between observed and expected

Exposure and assessment of cancer risk

The industry in Stenungsund is dominated by four large petrochemical companies which have emitted many different VOCs into the air, some of which are classified as carcinogenic to humans. Another source of air pollution was an oil based power plant, which was in use between 1959 and the beginning of the 1990s. We used the estimated average contribution (1970s–2000) of each VOC in the ‘high’ exposure area as the estimate for the whole population's exposure (10 000 subjects). This exposure

Conclusions

Although there are several reports, mainly from Taiwan, that living close to petrochemical industries increases the risk of cancer, we found no evidence for this in Stenungsund, Sweden. Between 1974 and 2005, the total number of cases was close to the expected number, and this was also true when leukemia, lymphoma, and brain cancer were evaluated separately. Lung cancer in women was slightly more common in Stenungsund than in the reference area, but examination of addresses showed that the

Acknowledgements

This study was supported by funds from the Swedish Research Council Formas and the Cancer and Allergy Foundation.

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^☆: The work was performed at Department of Occupational and Environmental Medicine, University of Gothenburg, Box 414, S-405 30 Gothenburg, Sweden.

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Cancer incidence in a petrochemical industry area in Sweden☆

Abstract

Introduction

Section snippets

Study population and assessment of cancer incidence

Cancer

Exposure and assessment of cancer risk

Conclusions

Acknowledgements

Environ Res

J Hepatol

Ann Epidemiol

Case-control study of intracranial tumours among employees at a petrochemical research facility

J Occup Environ Med

Case-control study on cancer risk associated to residence in the neighbourhood of a petrochemical plant

Eur J Epidemiol

Reactive chemicals and cancer

Cancer Causes Control

Meta-analysis of studies of occupational exposure to vinyl chloride in relation to cancer mortality

Scand J Work Environ Health

Does living near a constellation of petrochemical, steel and other industries impair health?

Occup Environ Med

Occupational exposure to vinyl chloride and cancer risk: a review of the epidemiologic literature

Eur J Cancer Prev

Does living near heavy industry cause lung cancer in women? A case-control study using life grid interviews

Thorax

Lung cancer and diesel exhaust: a critical review of the occupational epidemiology literature

Crit Rev Toxicol

Reanalysis of updated mortality among vinyl and polyvinyl chloride workers: confirmation of historical evidence and new findings

BMC Public Health

Mortality updates (1970–1997) of two refinery/petrochemical plant cohorts at Baton Rouge, Louisiana, and Baytown, Texas

J Occup Environ Med

Statistical association between cancer incidence and major-cause mortality, and estimated residential exposure to air emissions from petroleum and chemical plants

Environ Health Perspect

Association of brain cancer with residential exposure to petrochemical air pollution in Taiwan

J Toxicol Environ Health

Incidence of leukemia and lymphoma in young people in the vicinity of the petrochemical plant at Baglan Bay, South Wales, 1974 to 1991

Occup Environ Med