Cancer morbidity of residents living near an oil refinery plant in North-West Italy

Our plain-English summary of Cancer morbidity of residents living near an oil refinery plant in North-West Italy, by C. Salerno, P. Berchialla, L.A. Palin, et al (International Journal of Environmental Health Research, 2013).

The study

• Authors: C. Salerno, P. Berchialla, L.A. Palin, K. Vanhaecht, M. Panella
• Journal: International Journal of Environmental Health Research
• Published: 2013;23(4):342-51
• Cited by: 15 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Cerano is a municipality of the Province of Novara (North-West Italy). To assess the morbidity associated to its proximity to a petrochemical plant, standardized incidence ratios (SIRs) of oncological pathologies in the period 2003-2009 were calculated based on age-sex specific rates for the district of the Local Health Authority of Novara (ASL13) and the main regional city of Turin. For all cancers combined, men showed a significant higher risk (SIR: 1.21; 95% CI: 1.02-1.40) compared to the ASL13 population; significantly lower risks for both men and women were observed in comparison to the Turin population. Among women, a significant excess of mesothelioma cancers was reported; a significantly higher risk for lympho-haematopoietic pathologies was also observed compared to the Turin population only. Several other cancers have significantly lower rates in Cerano for both men and women. Despite some studies' limitations, these findings could suggest potential chemical risk factors and need further investigation.

In plain English

This study counted new cancer cases from 2003 to 2009 among residents of Cerano, a town of about 6980 people in North-West Italy, about 3 km from an oil refinery. The authors took cases from the regional hospital discharge registry. They compared them with the numbers expected from rates in the Novara health district (ASL13) and in the city of Turin. Men had more cancers overall than expected from ASL13 rates (SIR 1.21; 95% CI 1.02–1.40). Both sexes had fewer than expected from Turin rates. Among women, 4 mesothelioma cases were recorded, a significant excess compared with both ASL13 (SIR 9.09; 95% CI 6.13–12.0) and Turin (SIR 7.01; 95% CI 4.41–9.60). The article states that the increase among men was not statistically significant. All leukemias combined were higher than Turin rates in both sexes. The study could not evaluate occupational asbestos exposure. The authors concluded that the findings suggest chemical risk factors in the town's environment. They cautioned that many comparisons were made, so some results may be significant by chance.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Population-based cancer incidence study of one town's residents, using hospital discharge records and standardized incidence ratios (SIRs: observed new cancers divided by the number expected) against two reference populations
• Who was studied: All residents of Cerano, Province of Novara, Piedmont, North-West Italy, 2003–2009. In 2009 there were about 6980 residents (2944 families) with a mean age of 44. Reference populations were residents of the Novara health district (ASL13) and of the city of Turin.
• Exposure: Living near a petroleum refining hub in San Martino di Trecate, about 3 km from Cerano. No individual exposures were measured, and occupational asbestos exposure was not evaluated.
• Main results:
  • All cancers combined, men in Cerano compared with the ASL13 population: SIR 1.21 (95% CI 1.02–1.40), based on 118 observed cases.
  • All cancers combined compared with the Turin population: significantly lower incidence in men (SIR 0.77; 95% CI 0.61–0.92) and in women (SIR 0.56; 95% CI 0.38–0.73).
  • Mesothelioma (ICD-9 code 163) among women in Cerano, 4 cases: SIR 9.09 (95% CI 6.13–12.0) compared with ASL13 and SIR 7.01 (95% CI 4.41–9.60) compared with Turin.
  • Mesothelioma among men in Cerano, 2 cases: the text reports the increase as not statistically significant. The table gives SIR 1.11 (95% CI 0.0–2.57) compared with ASL13 and SIR 2.17 (95% CI 0.13–4.21) compared with Turin.
  • Lung cancer: lower risk in women and higher risk in men, neither statistically significant.
  • All leukemias combined compared with Turin: SIR 2.75 (95% CI 1.42–4.07) in men and SIR 2.92 (95% CI 1.59–4.28) in women. Compared with ASL13, the risk was lower but not significantly.
  • Multiple myeloma in women compared with Turin: SIR 2.57 (95% CI 1.28–3.85).
  • Prostate cancer in men compared with ASL13: SIR 2.35 (95% CI 1.81–2.88). Compared with Turin the risk was lower, not significantly.
  • Residents born in Cerano compared with residents not born there: RR 3.64 (95% CI 2.71–4.85) for all cancer (80 cases among those born in Cerano). Significantly higher risks were also reported for multiple myeloma, prostate, lung, liver and kidney tumors. For mesothelioma the RR was 2.32 (95% CI 0.04–3.98; p = 0.31; 2 cases), which was not significant.
• The authors' conclusion: The authors concluded that the findings suggest chemical risk factors in Cerano's environment. They said this conclusion is tempered because decreased SIRs were more common than increased ones and because the many hypotheses tested raise the chance that some findings were significant by chance.
• Limitations the authors state:
  • Occupational exposure to asbestos could not be evaluated, so the authors could not tell whether the mesothelioma excess was linked to occupational or other exposure.
  • Privacy restrictions prevented identifying individual patients by name to exclude previously existing cases.
  • The data could not be linked to histology, mortality registries or socio-demographic data.
  • Many hypotheses were tested, so some significant findings may be due to chance.
  • The higher risks among residents born in Cerano rest on small numbers of observed cases.
  • Novara has no cancer registry, and Turin, the second reference population, differs greatly from Cerano in degree of urbanization.

Topics

Medical terms in this study, explained in our Lexicon: Standardized Incidence Ratio (SIR), Mesothelioma.

Related studies

• Mortality and cancer morbidity in a cohort of Canadian petroleum workers — R.J. Lewis, A.R. Schnatter, et al. (2003)
• Increased risk of lung cancer mortality among residents near an asbestos product manufacturing plant — S. Kumagai, N. Kurumatani, et al. (2010)
• Incidence of Cancer and Asbestos-Related Diseases among Residents Living near Abandoned Asbestos Mines in South Korea: A Retrospective Cohort Study Using National Health Insurance Database — K. Kwak, K.E. Zoh, et al. (2021)
• Asbestos fiber concentration in the area surrounding a former asbestos cement plant and excess mesothelioma deaths in residents — S. Kumagai, N. Kurumatani (2009)
• Activity-Based Exposure Levels and Cancer Risk Assessment Due to Naturally Occurring Asbestos for the Residents Near Abandoned Asbestos Mines in South Korea — S. Lee, D. Kang, et al. (2021)
• Malignant pleural mesothelioma from nonoccupational asbestos exposure in Metsovo (north-west Greece): slow end of an epidemic? — K. Sakellariou, V. Malamou-Mitsi, et al. (1996)

Browse more research in International Journal of Environmental Health Research, or return to medical research.