Impact of large industrial emission sources on mortality and morbidity in Chile: A small-areas study.

Chile suffers significant pollution from large industrial emitters associated with the mining, metal processing, paper production, and energy industries. The aim of this research was to determine whether the presence of large industrial facilities (i.e. coal- and oil-fired power plants, pulp and paper mills, mining facilities, and smelters) affects mortality and morbidity rates in Chile. For this, we conducted an ecological study that used Chilean communes as small-area observation units to assess mortality and morbidity. Public databases provided information on large pollution sources relevant to Chile. The large sources studied were oil- and coal-fired power plants, copper smelters, pulp and paper mills, and large mining facilities. Large sources were filtered by first year of production, type of process, and size. Mortality and morbidity data were acquired from public national databases, with morbidity being estimated from hospitalization records. Cause-specific rates were calculated for the main outcomes: cardiovascular, respiratory, cancer; and other more specific health outcomes. The impact of the large pollution sources was estimated using Bayesian models that included spatial correlation, overdispersion, and other covariates. Large and significant increases in health risks (around 20%-100%) were found for communes with power plants and smelters for total, cardiovascular, respiratory, all-cancer, and lung cancer mortality. Higher hospitalization rates for cardiovascular disease, respiratory disease, cancer, and pneumonia (20-100%) were also found for communes with power plants and smelters. The impacts were larger for men than women in terms of both mortality and hospitalizations. The impacts were also larger when the sources were analyzed as continuous (production volume) rather than dichotomous (presence/absence) variables. In conclusion, significantly higher rates of total cardiovascular, respiratory, all-cancer and lung cancer mortality and cardiovascular, respiratory, cancer and pneumonia hospitalizations were observed in communes with power plants and smelters.

[1]  Gonzalo López-Abente,et al.  Lung cancer mortality in towns near paper, pulp and board industries in Spain: a point source pollution study , 2008, BMC public health.

[2]  Enrico Daminelli,et al.  Lung cancer in an urban area in Northern Italy near a coke oven plant. , 2005, Lung cancer.

[3]  David N. Pellow,et al.  Environmental justice: human health and environmental inequalities. , 2006, Annual review of public health.

[4]  T. Louis,et al.  Bayes and Empirical Bayes Methods for Data Analysis. , 1997 .

[5]  P. Fernández-Navarro,et al.  Risk of dying of cancer in the vicinity of multiple pollutant sources associated with the metal industry. , 2012, Environment international.

[6]  Rebeca Ramis-Prieto,et al.  Modelling of municipal mortality due to haematological neoplasias in Spain , 2007, Journal of Epidemiology and Community Health.

[7]  Núñez F Ml,et al.  [Quality of Mortality statistics in Chile, 1997-2003]. , 2006 .

[8]  C. Jia,et al.  Uneven Magnitude of Disparities in Cancer Risks from Air Toxics , 2012, International journal of environmental research and public health.

[9]  E. Boldo,et al.  Leukemia-related mortality in towns lying in the vicinity of metal production and processing installations. , 2010, Environment international.

[10]  E. Boldo,et al.  Mortality due to lung, laryngeal and bladder cancer in towns lying in the vicinity of combustion installations. , 2009, The Science of the total environment.

[11]  E. Boldo,et al.  Colorectal cancer mortality and industrial pollution in Spain , 2012, BMC Public Health.

[12]  P. Diggle,et al.  Prostate cancer and industrial pollution Risk around putative focus in a multi-source scenario. , 2011, Environment international.

[13]  E. Boldo,et al.  Risk of Cancer Mortality in Spanish Towns Lying in the Vicinity of Pollutant Industries , 2012, ISRN oncology.

[14]  Gonzalo López-Abente,et al.  Industrial pollution and pleural cancer mortality in Spain. , 2012, The Science of the total environment.

[15]  P. Wilkinson,et al.  Mortality among residents near cokeworks in Great Britain. , 1999, Occupational and environmental medicine.

[16]  Monica Pirani,et al.  Cancer incidence in people with residential exposure to a municipal waste incinerator: an ecological study in Modena (Italy), 1991-2005. , 2010, Waste management.

[17]  Gonzalo López-Abente,et al.  Cancer mortality in towns in the vicinity of incinerators and installations for the recovery or disposal of hazardous waste. , 2013, Environment international.

[18]  M. Bilancia,et al.  Geographical clustering of lung cancer in the province of Lecce, Italy: 1992–2001 , 2009, International journal of health geographics.

[19]  Gonzalo López-Abente,et al.  Cancer mortality in towns in the vicinity of installations for the production of cement, lime, plaster, and magnesium oxide. , 2014, Chemosphere.

[20]  S. Marshall,et al.  Race, Wealth, and Solid Waste Facilities in North Carolina , 2007, Environmental health perspectives.

[21]  I Kleinschmidt,et al.  Cancer incidence and mortality near the Baglan Bay petrochemical works, South Wales. , 1995, Occupational and environmental medicine.

[22]  M. Pollán,et al.  Municipal distribution of bladder cancer mortality in Spain: Possible role of mining and industry , 2006, BMC public health.

[23]  Andrew B. Lawson,et al.  Disease Mapping with WinBUGS and MLwiN , 2003 .

[24]  S R Palmer,et al.  Assessment of impact on health of residents living near the Nant-y-Gwyddon landfill site: retrospective analysis. , 2000, BMJ : British Medical Journal.

[25]  Bradley P. Carlin,et al.  BAYES AND EMPIRICAL BAYES METHODS FOR DATA ANALYSIS , 1996, Stat. Comput..

[26]  Ying C MacNab,et al.  On Gaussian Markov random fields and Bayesian disease mapping , 2011, Statistical methods in medical research.

[27]  M. Pollán,et al.  Mortality due to tumours of the digestive system in towns lying in the vicinity of metal production and processing installations. , 2010, The Science of the total environment.

[28]  Andrew Thomas,et al.  WinBUGS - A Bayesian modelling framework: Concepts, structure, and extensibility , 2000, Stat. Comput..

[29]  J. Besag,et al.  Bayesian image restoration, with two applications in spatial statistics , 1991 .

[30]  S. Parodi,et al.  Lung Cancer Mortality in a District of La Spezia (Italy) Exposed to Air Pollution from Industrial Plants , 2004, Tumori.

[31]  I Kleinschmidt,et al.  Cancer incidence near municipal solid waste incinerators in Great Britain , 1996, British Journal of Cancer.

[32]  A. FranciscoJTorres,et al.  [Geographical distribution of mortality caused by stomach, trachea, bronchi and lung malignant tumors in Chile]. , 2007, Revista medica de Chile.

[33]  M. Pollán,et al.  Study of non-Hodgkin's lymphoma mortality associated with industrial pollution in Spain, using Poisson models , 2009, BMC public health.

[34]  K. Arrow,et al.  Is there a role for benefit-cost analysis in environmental, health, and safety regulation? , 1996, Science.

[35]  Gonzalo López-Abente,et al.  Proximity to mining industry and cancer mortality. , 2012, The Science of the total environment.

[36]  P. Frenz,et al.  [Application of a simple methodological approach to analyze health inequalities: the case of infant mortality in Chile]. , 2010, Revista medica de Chile.

[37]  D. Jolley,et al.  Incidence of cancers of the larynx and lung near incinerators of waste solvents and oils in Great Britain , 1992, The Lancet.

[38]  L. Palència,et al.  Mortality due to haematological cancer in cities close to petroleum refineries in Spain , 2012, Environmental Science and Pollution Research.

[39]  Robert Haining,et al.  Analyzing the Relationship Between Smoking and Coronary Heart Disease at the Small Area Level: A Bayesian Approach to Spatial Modeling , 2006 .

[40]  S. Esnaola,et al.  Mortality in small geographical areas and proximity to air polluting industries in the Basque Country (Spain) , 2010, Occupational and Environmental Medicine.

[41]  David O. Carpenter,et al.  Association between Residential Proximity to Fuel-Fired Power Plants and Hospitalization Rate for Respiratory Diseases , 2012, Environmental health perspectives.

[42]  P. Wilkinson,et al.  Lymphohaematopoietic malignancy around all industrial complexes that include major oil refineries in Great Britain. , 1999, Occupational and environmental medicine.

[43]  María Gloria Icaza Noguera.  ATLAS DE MORTALIDAD POR ENFERMEDADES CARDIOVASCULARES, CHILE 1997-2002 , 2004 .

[44]  Carlos Castillo-Salgado,et al.  Variación de los indicadores de mortalidad evitable entre comunas chilenas como aproximación a las desigualdades de salud , 2002 .

[45]  F. Forastiere,et al.  Small area study of mortality among people living near multiple sources of air pollution. , 1998, Occupational and environmental medicine.

[46]  L Bernardinelli,et al.  Bayesian estimates of disease maps: how important are priors? , 1995, Statistics in medicine.

[47]  Robert Haining,et al.  Bayesian modelling of environmental risk: example using a small area ecological study of coronary heart disease mortality in relation to modelled outdoor nitrogen oxide levels , 2007 .