Search

It is likely that pollution from chemical facilities will affect the health of any exposed population; however, the majority of scientific evidence available has focused on occupational exposure rather than environmental. Consequently, this study assessed whether there could have been an excess of cancer-related mortality associated with environmental exposure to pollution from chemical installations - for populations residing in municipalities in the vicinity of chemical industries. To this end, we designed an ecological study which assessed municipal mortality due to 32 types of cancer in the period from 1999 to 2008. The exposure to pollution was estimated using distance from the facilities to the centroid of the municipality as a proxy for exposure. In order to assess any increased cancer mortality risk in municipalities potentially exposed to chemical facilities pollution (situated at a distance of ≤5 km from a chemical installation), we employed Bayesian Hierarchical Poisson Regression Models. This included two Bayesian inference methods: Integrated Nested Laplace Approximations (INLA) and Markov Chain Monte Carlo (MCMC, for validation). The reference category consisted of municipalities beyond the 5 km limit. We found higher mortality risk (relative risk, RR; estimated by INLA, 95% credible interval, 95%CrI) for both sexes for colorectal (RR, 1.09; 95%CrI, 1.05-1.15), gallbladder (1.14; 1.03-1.27), and ovarian cancers (1.10; 1.02-1.20) associated with organic chemical installations. Notably, pleural cancer (2.27; 1.49-3.41) in both sexes was related to fertilizer facilities. Associations were found for women, specifically for ovarian (1.11; 1.01-1.22) and breast cancers (1.06; 1.00-1.13) in the proximity of explosives/pyrotechnics installations; increased breast cancer mortality risk (1.10; 1.03-1.18) was associated with proximity to inorganic chemical installations. The results suggest that environmental exposure to pollutants from some types of chemical facilities may be associated with increased mortality from several different types of cancer., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest. This article presents independent research. The views expressed are those of the authors and not necessarily those of the Carlos III Institute of Health., (Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objectives: Air pollutant concentrations in many urban areas are still above the legal and recommended limits that are set to protect the citizens' health. Madrid is one of the cities where traffic causes high NO 2 levels. In this context, Madrid City Council launched the Air Quality and Climate Change Plan for the city of Madrid (Plan A), a local strategy approved by the previous government in 2017. The aim of this study was to conduct a quantitative health impact assessment to evaluate the number of premature deaths that could potentially be prevented by the implementation of Plan A in Madrid in 2020, at both citywide and within-city level. The main purpose was to support decision-making processes in order to maximize the positive health impacts from the implementation of Plan A measures., Methods: The Regional Statistical Office provided information on population and daily mortality in Madrid. For exposure assessment, we estimated PM 2.5 , NO 2 and O 3 concentration levels for Madrid city in 2012 (baseline air-quality scenario) and 2020 (projected air-quality scenario based on the implementation of Plan A), by means of an Eulerian chemical-transport model with a spatial resolution of 1 km × 1 km and 30 vertical levels. We used the concentration-response functions proposed by two relevant WHO projects to calculate the number of attributable annual deaths corresponding to all non-accidental causes (ICD-10: A00-R99) among all-ages and the adult population (>30 years old) for each district and for Madrid city overall. This health impact assessment was conducted dependant on health-data availability., Results: In 2020, the implementation of Plan A would imply a reduction in the Madrid citywide annual mean PM 2.5 concentration of 0.6 μg/m 3 and 4.0 μg/m 3 for NO 2 . In contrast, an increase of 1 μg/m 3 for O 3 would be expected. The annual number of all-cause deaths from long-term exposure (95% CI) that could be postponed in the adult population by the expected air-pollutant concentration reduction was 88 (57-117) for PM 2.5 and 519 (295-750) for NO 2 ; short-term exposure accounted for 20 (7-32) for PM 2.5 and 79 (47-111) for NO 2 in the total population. According to the spatial distribution of air pollutants, the highest mortality change estimations were for the city centre - including Madrid Central and mainly within the M-30 ring road -, as compared to peripheral districts. The positive health impacts from the reductions in PM 2.5 and NO 2 far exceeded the adverse mortality effects expected from the increase in O 3 ., Conclusions: Effective implementation of Plan A measures in Madrid city would bring about an appreciable decline in traffic-related air-pollutant concentrations and, in turn, would lead to significant health-related benefits., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. This article presents independent research. The views expressed are those of the authors and not necessarily those of the Carlos III Institute of Health. None of the funders played any role in conducting research or writing the paper., (Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.)