We were intrigued by the report and findings from Elliott et al 1 of overall mortality, cancer incidence, and stroke mortality in Shipham village. Their findings are similar to the conclusions we reported in 1982 after work funded by the Department of Health and Social Security.2 We noted that “the failure to demonstrate any excess morbidity requiring hospital admission is reassuring for Shipham residents”. We identified a small but significant excess of carcinoma of the ovary but thought it extremely unlikely that this could be explained by exposure to cadmium; the histology of the two reported neoplasms was different and one of the patients resided at an address with a normal soil cadmium content. Hospital admissions were not increased for essential benign hypertension, hypertensive heart disease, acute nephritis, other nephritis and nephrosis, and calculus of the urinary system,3 or from gastric cancer which had in North Wales been associated with similar patterns of contamination of the soil with heavy metal.4 These findings are not explored by Elliott et al. Although they explore biomarkers of blood and urine, they do not discuss the worth of in vivo neutron activation analysis or dental studies. Yet, in 1979, it was reported that the mean (SD) liver cadmium concentrations of 21 Shipham residents was 11.0 (2.0) ppm, which was significantly higher (p<0.001) than that of 10 non-Shipham controls (2.2 (2.0) ppm). These researchers also reported values of up to 260 ppm in industrially exposed workers, and that neither the workers nor the Shipham residents showed any evidence of cadmium toxicity.5 These findings were considered reassuring.6 The dental health of Shipham children was reported to be similar to children in neighbouring villages without the soil contamination,7 although increased concentrations of cadmium had been found in their teeth.8 …

Dr P Elliott

Dr P Elliott

Dr P Elliott