Risk of mortality, cancer incidence, and stroke in a population potentially exposed to cadmium
Paul Elliotta, Richard Arnolda, Samantha Cockingsa, Naomi Eatona, Lars Järupa, Jennifer Jonesc, Mike Quinnc, Michael Rosatoc, Iain Thorntonb, Mireille Toledanoa, Emma Tristanb, Jon Wakefielda
a Small
Area Health Statistics Unit, Imperial College School of Medicine,
Norfolk Place, London W2 1PG, UK, b Environmental Geochemistry
Research Group, TH Huxley School of the Environment, Earth Sciences and
Engineering, Imperial College, London, UK, c Office
for National Statistics, 1 Drummond Gate, London SW1V 2QQ,
UK
Correspondence to: Dr Lars Järup, Department of Epidemiology and Public Health, Imperial College School of Medicine, Norfolk Place, London W2 1PG, UK
Accepted 27 September 1999
OBJECTIVES
To follow
up mortality and cancer incidence in a cohort potentially exposed to
cadmium and to perform a geographical (ecological) analysis to further
assess the health effects of potential exposure to cadmium.
METHODSThe English
village of Shipham has very high concentrations of cadmium in the soil.
A previous cohort study of residents of Shipham in 1939 showed overall
mortality below that expected, but a 40% excess of mortality from
stroke. This study extends the follow up of the cohort for mortality to
1997, and includes an analysis of cancer incidence from 1971 to 1992, and a geographical study of mortality and cancer incidence.
Standardised mortality and incidence ratios (SMRs and SIRs) were
estimated with regional reference rates. Comparisons were made with the
nearby village of Hutton.
RESULTSAll cause
cohort mortality was lower than expected in both villages, although
there was excess cancer incidence in both Shipham (SIR 167, 95%
confidence interval (95% CI) 106 to 250) and Hutton (SIR 167, 95% CI
105 to 253). There was an excess of mortality from hypertension,
cerebrovascular disease, and nephritis and nephrosis, of borderline
significance, in Shipham (SMR 128, 95% CI 99 to 162). In the
geographical study, all cause mortality in Shipham was also lower than
expected (SMR 84, 95% CI 71 to 100). There was an excess in
genitourinary cancers in both Shipham (SIR 160, 95% CI 107 to 239) and
Hutton (SIR 153, 95% CI 122 to 192).
CONCLUSIONNo clear
evidence of health effects from possible exposure to cadmium in Shipham
was found despite the extremely high concentrations of cadmium in the soil.
Keywords: cadmium; mortality; cancer incidence
© 2000 by Occupational and Environmental Medicine
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