Research

Sarcoma risk and dioxin emissions from incinerators and industrial plants: a population-based case-control study (Italy)

Paola Zambon^1,2* , Paolo Ricci^3* , Emanuela Bovo^1* , Alessandro Casula^4* , Massimo Gattolin^5* , Anna Rita Fiore^1* , Francesco Chiosi^5* and Stefano Guzzinati^1*

¹  Veneto Region, Assessorato alle Politiche Sanitarie, Istituto Oncologico Veneto, I.R.C.C.S. Veneto Tumour Registry, Via Gattamelata, 64, 35128 Padova, Italy

²  Department of Oncological and Surgical Sciences, University of Padua, Via Gattamelata, 64, 35128 Padova, Italy

³  Local Health Unit of Mantova, Unit of Epidemiology, Via Trento, 6, 46100 Mantova, Italy

⁴  Province of Venice, Adviser, Department of Environment, Via Forte Marghera, 191- 30173 Mestre – Venice, Italy

⁵  Province of Venice, Department of Environment, Via Forte Marghera, 191- 30173 Mestre, Venice, Italy

author email corresponding author email* Contributed equally

Environmental Health 2007, 6:19doi:10.1186/1476-069X-6-19

Published:	16 July 2007

Abstract

Background

It is not clear whether environmental exposure to dioxin affects the general population. The aim of this research is to evaluate sarcoma risk in relation to the environmental pollution caused by dioxin emitted by waste incinerators and industrial sources of airborne dioxin. The study population lives in a part of the Province of Venice (Italy), where a population-based cancer registry (Veneto Tumour Registry – RTV) has been active since 1987.

Methods

Two hundred and five cases of visceral and extravisceral sarcoma, confirmed by microscopic examination, diagnosed from 01.01.1990 to 31.12.1996, were extracted from the RTV database. Diagnoses were revised using the actual pathology reports and clinical records. For each sarcoma case, three controls of the same age and sex were randomly selected from the population files of the Local Health Units (LHUs). The residential history of each subject, whether case or control, was reconstructed, address by address, from 1960 to the date of diagnosis. All waste incinerators and industrial sources of airborne dioxin in the Province of Venice were taken into account, as was one very large municipal waste incinerator outside the area but close to its boundaries. The Industrial Source Complex Model in Long Term mode, version 3 (ISCLT3), was used to assess the level of atmospheric dispersion. A specific value for exposure was calculated for each point (geo-referenced address) and for each calendar year; the exposure value for each subject is expressed as the average of specific time-weighted values. The analysis takes into account 172 cases and 405 controls, aged more than 14 years.

Results

The risk of developing a sarcoma is 3.3 times higher (95% Confidence Interval – 95% CI: 1.24 – 8.76) among subjects, both sexes, with the longest exposure period and the highest exposure level ; a significant excess of risk was also observed in women (Odds Ratio OR = 2.41, 95% CI: 1.04 – 5.59) and for cancers of the connective and other soft tissue (International Classification of Diseases, ninth Revision – ICD-IX 171), both sexes (OR = 3.27, 95% CI: 1.35 – 7.93).

Conclusion

Our study supports the association between modelled dioxin exposure and sarcoma risk.