| Cancer Risk Near a Polluted River in Finland Pia K. Verkasalo,1 Esa Kokki,1 Eero Pukkala,2 Terttu
Vartiainen,1 Hannu Kiviranta,1 Antti Penttinen,3 and
Juha Pekkanen1 1Department of Environmental Health, National Public Health Institute,
Kuopio, Finland; 2Finnish Cancer Registry, Institute for Statistical
and Epidemiological Cancer Research, Helsinki, Finland; 3Department
of Mathematics and Statistics, University of Jyväskylä, Jyväskylä,
Finland Abstract
The River Kymijoki in southern Finland is heavily polluted with polychlorinated dibenzo-p-dioxins and dibenzofurans and may pose a health threat to local residents, especially farmers. In this study we investigated cancer risk in people living near the river (< 20.0 km) in 1980. We used a geographic information system, which stores registry data, in 500 m  500 m grid squares, from the Population Register Centre, Statistics Finland, and Finnish Cancer Registry. From 1981 to 2000, cancer incidence in all people (N = 188,884) and in farmers (n = 11,132) residing in the study area was at the level expected based on national rates. Relative risks for total cancer and 27 cancer subtypes were calculated by distance of individuals to the river in 1980 (reference: 5.0-19.9 km, 1.0-4.9 km, < 1.0 km) , adjusting for sex, age, time period, socioeconomic status, and distance of individuals to the sea. The respective relative risks for total cancer were 1.00, 1.09 [95% confidence interval (CI) , 1.04-1.13], and 1.04 (95% CI, 0.99-1.09) among all residents, and 1.00, 0.99 (95% CI, 0.85-1.15) , and 1.13 (95% CI, 0.97-1.32) among farmers. A statistically significant increase was observed for basal cell carcinoma of the skin (not included in total cancers) in all residents < 5.0 km. Several other common cancers, including cancers of the breast, uterine cervix, gallbladder, and nervous system, showed slightly elevated risk estimates at < 5.0 km from the river. Despite the limitations of exposure assessment, we cannot exclude the possibility that residence near the river may have contributed to a small increase in cancer risk, especially among farmers. Key words: cancer, dioxins, epidemiology, GIS, PCDD, PCDF, record linkage. Environ Health Perspect 112:1026-1031 (2004) . doi:10.1289/ehp.6741 available via http://dx.doi.org/ [Online 15 April 2004]
This article is part of the mini-monograph "Health and Environment Information Systems for Exposure and Disease Mapping, and Risk Assessment." Address correspondence to P.K. Verkasalo, Department of Environmental Health, National Public Health Institute, P.O. Box 95 (Neulaniementie 4) , FIN-70701, Kuopio, Finland. Telephone: 358 17 201 481. Fax: 358 17 201 265. E-mail: pia.verkasalo@ktl.fi We thank our collaborators in the European Health and Environment Information System for Disease and Exposure Mapping and Risk Assessment (EUROHEIS) project for sharing their expertise in fruitful discussions. This research was supported by grants EU SI2.291820 (2000CVG2-605) and SI2.329122 (2001CVG2-604) from the European Commission Health and Consumer Protection Directorate-General ; grant 52876 from the Academy of Finland ; the Ellen and Artturi Nyyssönen Foundation ; and the Paavo Koistinen Foundation. The authors declare they have no competing financial interests. Received 12 September 2003 ; accepted 13 April 2004.
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