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Table 5 Associations between heavy metals concentration and mortality/incidence of cancer in the cohort of residents in the area of Coriano (Italy) by cause (ICD-9) and gender.

From: Mortality and morbidity among people living close to incinerators: a cohort study based on dispersion modeling for exposure assessment

Cause (ICD-9) Heavy metals† Men Women
   mortality cancer incidence mortality cancer incidence
   obs§ RR§§ IC 95% obs RR† IC 95% obs§ RR§§ IC 95% obs RR§ IC 95%
All cancer (140-239) I 216 1.00 - - 413 1.00 - - 152 1.00 - - 396 1.00 - -
  II 194 1.12 0.92 1.38 327 0.94 0.81 1.08 154 1.24 0.98 1.57 323 0.96 0.83 1.11
  III 194 1.04 0.85 1.27 342 0.93 0.81 1.07 153 1.24 0.98 1.57 315 0.95 0.82 1.10
  IV 65 0.85 0.64 1.12 136 0.87 0.72 1.06 65 1.47* 1.09 1.99 112 0.90 0.73 1.11
Stomach (151) I 20 1.00 - - 27 1.00 - - 13 1.00 - - 24 1.00 - -
  II 20 1.44 0.76 2.73 28 1.18 0.69 2.00 13 1.32 0.59 2.98 22 1.02 0.57 1.81
  III 22 1.12 0.60 2.08 36 1.47 0.89 2.42 28 2.51* 1.27 4.97 31 1.54 0.91 2.63
  IV 7 0.85 0.35 2.03 13 1.24 0.64 2.40 7 1.86 0.73 4.75 8 1.09 0.49 2.44
Colon rectum (153-154) I 18 1.00 - - 45 1.00 - - 13 1.00 - - 34 1.00 - -
  II 11 0.61 0.28 1.35 31 0.82 0.52 1.29 16 1.32 0.61 2.87 27 0.91 0.55 1.51
  III 25 2.10* 1.10 4.00 51 1.28 0.86 1.91 19 1.94 0.93 4.06 56 2.00* 1.31 3.06
  IV 10 2.05 0.92 4.58 17 1.00 0.57 1.75 8 2.15 0.86 5.37 14 1.33 0.71 2.48
Liver (155) I 11 1.00 - - 10 1.00 - - 3 1.00 - - 7 1.00 - -
  II 6 0.61 0.21 1.75 7 0.80 0.30 2.10 3 0.92 0.17 5.11 2 0.30 0.06 1.46
  III 6 0.61 0.21 1.75 6 0.66 0.24 1.82 2 1.00 0.15 6.61 2 0.34 0.07 1.63
  IV 1 0.27 0.03 2.18 1 0.26 0.03 2.01 3 5.10 0.94 27.80 2 0.94 0.20 4.53
Larinx (161) I 6 1.00 - - 18 1.00 - - 0 1.00 - - 2 1.00 - -
  II 2 0.42 0.08 2.22 6 0.41 0.16 1.04 1 - - - 1 0.61 0.06 6.80
  III 3 0.53 0.13 2.25 4 0.26 0.09 0.76 1 - - - 1 0.60 0.05 6.62
  IV 0 0.00 0.00 . 1 0.15 0.02 1.14 0 - - - 1 1.60 0.15 17.64
Lung (162) I 54 1.00 - - 69 1.00 - - 15 1.00 - - 16 1.00 - -
  II 50 1.17 0.78 1.76 60 1.04 0.73 1.47 12 0.95 0.43 2.11 19 1.36 0.70 2.65
  III 56 1.15 0.78 1.71 64 1.05 0.75 1.48 10 0.89 0.39 2.06 11 0.82 0.38 1.78
  IV 18 0.91 0.53 1.57 25 0.96 0.61 1.52 4 0.96 0.31 2.97 4 0.81 0.27 2.42
Soft tissue sarcoma (171) I 0 1.00 - - 3 1.00 - - 0 1.00 - - 1 1.00 - -
  II 1 - - - 1 0.37 0.04 3.59 0 - - - 0 0.00 - -
  III 0 - - - 2 0.72 0.12 4.31 2 - - - 4 4.71 0.53 42.16
  IV 1 - - - 1 0.84 0.09 8.06 2 - - - 0 0.00 - -
Breast (175) I 0 1.00 - - 0 1.00 - - 21 1.00 - - 125 1.00 - -
  II 0 - - - 0 - - - 22 1.33 0.73 2.43 90 0.89 0.68 1.17
  III 0 - - - 0 - - - 18 1.02 0.55 1.92 81 0.78 0.59 1.03
  IV 0 - - - 0 - - - 13 2.00 1.00 3.99 30 0.76 0.51 1.13
Prostate (185) I 14 1.00 - - 60 1.00 - - 0 1.00 - - 0 1.00 - -
  II 12 1.08 0.50 2.33 48 0.93 0.64 1.37 0 - - - 0 - - -
  III 23 1.85 0.95 3.59 58 1.08 0.75 1.55 0 - - - 0 - - -
  IV 8 1.57 0.66 3.74 29 1.27 0.82 1.99 0 - - - 0 - - -
Bladder (188)§ I 10 1.00 - - 48 1.00 - - 4 1.00 - - 7 1.00 - -
  II 13 1.50 0.62 3.61 33 0.83 0.53 1.29 4 1.09 0.25 4.78 9 1.49 0.55 4.01
  III 14 1.50 0.64 3.51 32 0.76 0.48 1.18 3 1.00 0.21 4.82 5 0.85 0.27 2.68
  IV 6 1.48 0.52 4.22 14 0.78 0.43 1.42 3 3.06 0.64 14.70 5 2.30 0.73 7.24
Central nerv. sys. (191-192;225)§ I 4 1.00 - - 6 1.00 - - 4 1.00 - - 8 1.00 - -
  II 3 0.51 0.10 2.55 9 1.84 0.65 5.17 4 0.76 0.17 3.43 5 0.77 0.25 2.36
  III 5 1.65 0.38 7.21 7 1.32 0.44 3.93 6 2.38 0.61 9.21 6 0.90 0.31 2.61
  IV 0 0.00 - - 3 1.35 0.34 5.39 0 0.00 - - 0 0.00 - -
Lymphoemat.system (200-208) I 27 1.00 - - 50 1.00 - - 17 1.00 - - 34 1.00 - -
  II 19 0.87 0.47 1.62 31 0.75 0.48 1.18 14 0.93 0.44 1.97 29 1.02 0.62 1.67
  III 14 0.58 0.30 1.14 34 0.77 0.50 1.19 12 0.94 0.44 2.05 23 0.81 0.48 1.38
  IV 4 0.42 0.15 1.23 13 0.70 0.38 1.28 8 1.78 0.74 4.25 13 1.23 0.65 2.33
Non-Hodgkin Limphoma (200,202) I 10 1.00 - - 23 1.00 - - 7 1.00 - - 15 1.00 - -
  II 6 0.80 0.28 2.29 10 0.54 0.26 1.14 7 0.83 0.27 2.56 14 1.10 0.53 2.29
  III 6 0.63 0.22 1.82 13 0.65 0.33 1.28 2 0.47 0.09 2.44 8 0.64 0.27 1.51
  IV 2 0.52 0.11 2.45 5 0.59 0.23 1.57 3 2.03 0.48 8.67 5 1.06 0.39 2.93
Myeloma (203) I 7 1.00 - - 13 1.00 - - 3 1.00 - - 8 1.00 - -
  II 3 0.37 0.09 1.62 14 0.45 0.16 1.27 1 0.32 0.03 3.53 9 0.36 0.10 1.30
  III 2 0.33 0.06 1.72 11 0.61 0.24 1.52 3 1.44 0.26 7.93 9 0.48 0.15 1.54
  IV 0 0.00 - - 5 0.61 0.17 2.13 3 4.28 0.77 23.80 3 0.95 0.26 3.45
Leukaemia (204-208) I 9 1.00 - - 13 1.00 - - 5 1.00 - - 10 1.00 - -
  II 9 1.33 0.51 3.49 5 1.27 0.60 2.72 6 1.82 0.54 6.19 3 1.31 0.50 3.40
  III 6 0.78 0.27 2.25 7 0.94 0.42 2.11 7 1.69 0.52 5.55 4 1.35 0.52 3.49
  IV 2 0.67 0.14 3.16 3 1.01 0.36 2.84 2 1.31 0.25 6.95 3 1.23 0.33 4.62
  1. * p-value < 0.05; † Categories of heavy metals: I (reference) <0.5 ng/m3; II 0.5-1 ng/m3; III 1-2 ng/m3 ; IV >2 ng/m3; § Observed cases; §§ Rate Ratios (RR) versus the reference category of heavy metals adjusted for age and socioeconomic status; ‡ ICD-9 codes considered for cancer incidence were: bladder cancer = 188;223.3;223.7;236.7;239.4; cancer of the central nervous system = 191-192. Period: 1990-2003.
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Environmental Health

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