EPA 560/6-76-003
EPIDEMIOLOGY STUDIES
TASK I - PHASE I
PILOT STUDY OF CANCER MORTALITY
NEAR AN ARSENICAL PESTICIDE PLANT IN BALTIMORE
MAY 1976
RNAL REPORT
\
U.S. ENVIRONMENTAL PROTECTION AGENCY
Office of Toxic Substances
4th and M Streets, S.W.
Washington, D.C. 20460
-------
EPA 560/6-76-003
EPIDEMIOLOGY STUDIES
TASK I PHASE I
PILOT STUDY OF CANCER MORTALITY
NEAR AN ARSENICAL PESTICIDE PLANT IN BALTIMORE
MAY 1976
FINAL REPORT
U.S. ENVIRONMENTAL PROTECTION AGENCY
Office of Toxic Substances
4th and M Streets, S.W.
Washington, D.C. 20460
-------
EPA 560/6-76-003
EPIDEMIOLOGY STUDIES
TASK I - PHASE I
PILOT STUDY OF CANCER MORTALITY
NEAR AN ARSENICAL PESTICIDE PLANT IN BALTIMORE
BY
Genevieve Matanoski, M.D., Dr. P. H.
Emanuel Landau, Ph. D.
Elizabeth Elliott, B. A.
EPA Contract No. 68-01-2490
EPA Project Officer: Robert J. Carton, Ph. D.
For
U. S. Environmental Protection Agency
Office of Toxic Substances
4th and M Streets, S. W.
Washington, D. C. 20460
May 1976
-------
NOTICE
This report has been reviewed by the Office of Toxic
Substances, Environmental Protection Agency, and approved
for publication. Approval does not signify that the contents
necessarily reflect the views and policies of the Environmental
Protection Agency. Mention of tradenames or commercial products
is for purposes of clarity only and does not constitute endorse-
ment or recommendation for use.
-------
Acknowledgements
The authors wish to thank Drs. Baetjer, Levin, and Lilienfeld
for their suggestions and support as well as for the provision of
relevant information which permitted the completion of certain
portions of this study. They would also like to thank Dr. C. W. Kruse'
for providing information on local wind directions.
111
-------
The measurement of long-term effects from low-level exposure to
carcinogens in air has been a difficult problem because of the presence of
multiple agents, the changing population bases exposed, and the involvement
of personal risk factors during the long latent period before cancer is
manifest-. Possibly because of these confounding variables, the studies re-
lating levels of air pollution to localized cancer mortality by census tracts
have been few in number and frequently unrewarding. Winkelstein and co-
workers (1) in Buffalo and Zeidberg, Horton and Landau (2) in Nashville found
no correlation between the level of pollution and the risk of lung cancer.
However, Menck, Casagrande and Henderson (3) did find higher rates in contamin-
ated areas of Los Angeles which they associated with the presence of benzo(a)pyrene
in air.
Studies aimed specifically at determining the health effects of arsenic
in the general environment, especially around smelters, are also limited. Milham
and Strong (4) have demonstrated excessive levels of arsenic in urine and hair
of children exposed to the emissions from a copper smelter but no detrimental
health effects were noted. Blot and Fraumeni (5) have reported excess lung
cancer mortality for both males and females in counties with copper, lead or
zinc smelting industries. The latter data agree with the reported risks of
lung cancer in populations occupationally exposed to arsenic (6, 7). A direct
association of cancer and environmental arsenic has not been demonstrated.
The current pilot project tests the feasibility of determining the
carcinogenic effects of arsenic by examining the mortality of populations
living near an insecticide-producing industry. Cancer death rates in
populations from census tracts near the plant are compared to all the tracts
in the city which match on several variables. The advantage of using this
matching study design is that data from other projects with similar designs
might be combined despite differences in the characteristics of the populations
exposed to the arsenic in various cities.
Background
For many years a chemical .plant in south Baltimore produced arsenicals
as well as other chemicals for agricultural use. Arsenic acid was manufactured
in the early 1900*s but this operation was discontinued over 20 years ago and
the plant reconstructed in 1952. The insecticide portion of the plant produced
several arsenates but these chemical procedures have also been terminated.
Lead arsenate production was discontinued in 1967, calcium arsenate in 1973 and
sodium arsenate in 1974. The plant continues to package many of these arsen-
icals for distribution. The insecticide plant has also produced chlorinated
hydrocarbons and organic phosphates.
The area around the plant is heavily industrialized. Adjacent to the
chemical plant was a Gas and Electric Company operation. Rubber production also
took place nearby. The significance of these possible sources of contamination
must be investigated.
-------
Methods
Index census tracts with possible environmental exposure to arsenic
were defined empirically as those tracts for which at least fifty percent of
the area was included within a 3/4 mile radius of the plant (Figure 1). This
distance was selected because any smaller radii would have included only the
single tract in which the plant was located and larger radii would have
included tracts across the river in an area with heavy industry and few
private dwellings within one mile of the chemical plant. Four census tracts
which fell within these boundaries are 2303, 2302, 2404 and 2301. The
populations of the first three tracts were similar in demographic and socio-
economic characteristics (See tables 1 and 2, Figure 2). The 1970 census
data indicated that the residents were an older, stable, white population
with median incomes from $8400-9200 per annum. The population of tract 2301
had a lower median income, a higher proportion of families at poverty level,
and a higher percentage of blacks than the other three tracts. Separate
matching control tracts were selected for the first three index tracts, Match
I, and for 2301, Match II. All census tracts in Baltimore City which matched
the index tracts on six variables were chosen as controls. The variables and
the range of differences which were acceptable for matching were:
Age distribution 10% for each age group
Race _ 15% expressed as % black
Sex 5% expressed as % male
Median income ± $1000
% below poverty level ± 10%
% head of household ± 20%
over 65 years
Several of the matching tracts were adjacent to the index tracts and
have been analyzed separately in the event that the population of those tracts
may also have had minimal exposure. One possible control tract was dropped
because of an excess of white females in the older age group resulting from
the presence of a nursing home in that tract.
For some of the analyses, the control tracts have been subdivided
into groups according to geographic location since the populations in various
areas of -the city differ in their exposure to heavy industry or in mobility.
The southern tracts have several areas of industrialization. The central
area includes inner city tracts with both problems of industrial exposure
and mobility. The northern tracts are found in primarily residential areas.
No Match II controls were found in the south.
All death certificates in Baltimore City for the three years 1970-
1972 have been examined for cancer listed anywhere among the causes of death.
All cancers have been classified according to the 1965 ISCD code. If no
cancer code appeared on the certificate, the' cancer was classified by the
staff; otherwise the coding as recorded by city vital statistics personnel
was accepted.
-------
The occupation and place of employment as recorded on the certificate
were listed in order to detect deaths of chemical plant workers. Such infor-
mation iJ.ght also identify other dangerous occupations.
The census tract codes noted on the certificates were used for
classifying residence. The validity of the codes was checked by selecting a
seven and ten percent systematic sample of the cancer deaths in the years 1971
and 1972 respectively. The census tracts incorrectly coded were eight percent
in the first sample and fifteen percent in the second sample. To avoid
erroneously adding cancer deaths to index tract mortality from misclassification,
the residence was listed for all cancer deaths in the index tracts and recoded
correctly. This procedure allowed elimination of deaths from the index tracts
but no additions from misclassifications in other tracts, thus providing a
minimum estimate of cancer mortality in these tracts.
Results
The crude cancer death rates for selected sites and total cancers
in each sex are presented in tables 3 and 4 for the combined tracts. The
data-suggest that the risk of lung cancer in males is 1.4 times higher in
the index as compared to the non-adjacent control tracts. The risk in the
mixed racial index tract is even higher in comparison to its matched controls.
The lung cancer mortality for females is not higher in the index as compared
to the adjacent control tracts.
The rates in these tables include cancer as listed anywhere on the
death certificate but the relationship is not changed if only underlying cause
is used. The inclusion of lung cancers classified as secondary or unspecified
does not change these observations.
Although the tracts have been matched by age, race and sex so that
crude rates should be comparable in the populations, the sex-specific rates
of the white population have been adjusted for age in tables 5 and 6 in
order to determine whether this variable had any influence on lung cancer
mortality. The 1970 Baltimore City population has been used as the standard
for a direct adjustment. In these tables, the matching tracts have been
subdivided by their location in northern, central and southern geographic
areas in order to detect any possible internal differences in controls.
None of these adjustments have altered the conclusions based on the crude
rates although the magnitude of the excess risk of lung cancer mortality
varies depending on which geographic area control is used.
Race-specific rates adjusted for age and sex in tables 7 and 3
indicate that the blacks in the one index tract 2301 may not have a higher
rate than inner city populations after adjustment although the white population
still has a higher rate. The number of deaths in blacks is small.
The crude death rates for individual index tracts are presented in
tables 9 and 10 The data in table 9 indicate that the differences
between lung cancer death rates in white males in tract 2303 where the plant
is located and the northern and southern controls are significant for both
comparisons with probabilities of .0002 and .0003 respectively (b, y). The
-------
relative risk weighted by age of lung cancer deaths in males in this tract
is 3.3 and 4.0 times higher than in the southern and northern controls
respectively. Although the relative risk of lung cancer is higher in males
in tracts 2301 and 2302, suggesting a possible gradient in death rates for
this disease, the differences between index and control rates are significant
for 2301 only. The death rates for several other cancer sites (oral, stomach,
pancreas, and prostate) appear high in one or more of the census tracts near
the plant but the numbers of deaths are so small that no importance can be
attached to the observation.
It was suspected that employees of the plant who lived in the local
area might be contributing to the excess mortality in the index tracts. An
examination of the industries of employment recorded on the death certificates
revealed one man with lung cancer who worked in a chemical plant. Employment
records from the insecticide plant were checked to determine whether any of
the cancer deaths had occurred in workers. The same case of lung cancer noted
above and a prostatic cancer death were matched to plant employees. Removing
the case of lung cancer reduces the rate for tract 2303 from 395 to 355 per
100,000 white males. The significant difference in lung cancer deaths in
tract 2303 as compared to controls remains.
The occupation as listed on the death certificate indicated no
other work exposure which might explain the excess deaths. It is recognized
how inaccurate such data are in determining an individual1s occupational history.
Out of the 96 cancer deaths in the index tracts 28 had no reported
occupation and an additional 19 were listed as housewives. Among the remaining
49 cancers, 5 occurred in laborers, 4 in machinists, 4 in truck drivers, 3 in
salesmen with all other occupations being noted less frequently. The industries
recorded on the death certificates also did not indicate any remarkable excesses.
Fifty cancer deaths had no industry noted and the 19 housewives are included
here. The only industry noted three times was "shipbuilding and repair" which
may relate to the presence of a large shipyard in the south-eastern corner of
the city.
The data were suggestive of a gradient in lung cancer mortality
in a northerly direction with intermediate rates in index tracts 2302 and 2301
as compared to the tract with the chemical plant and lower rates in the
adjacent control tracts. A spot map of the residences of individuals dying
of lung and other cancers during the three year period 1970-72 are noted in
Figure 3. These data also suggest a clustering of lung cancer deaths. An
examination of the direction of wind currents in Baltimore indicate the winds
with highest velocity flow from the wast and northwest 32 percent of the time
in the winter. These winds should dump most of the contamination into relatively
unpopulated areas. The south and southwest winds which could be carrying
contamination into the northern tracts occur 22 percent of the time in the
summer and only 13 percent of the time in the winter and .have a lower velocity.
Figure 4 demonstrates wind roses for Dundalk Terminal four decades ago; they
are not believed to have changed significantly since that time.
-------
Discussion
A matched control design similar to that utilized in the present
pilot study might be effective in determining th« cancer risks associated with
environmental pollution. Frequently the population exposed to any single
source of pollution nay be too small and the cancers too infrequent to be
sure ȣ significant results. By using the matched census tract design to
study several exposure sites even in different cities, one may be able to
add the data or at least find consistent results which will support an
association between a specific contaminant and a specific cancer even though
there are basic differences in the characteristics of the populations exposed
at each of the various sites.
In the current pilot project there is a significant increase in
lung cancer mortality in males in a census tract adjoining an industrialized
area containing an arsenical-producing chemical plant. The data also suggest
a decreasing northerly gradient in rates for this cancer which could be related
to distance from the plant. Although cancer rates for several other sites
may appear high, the numbers are too small to attach any weight to the
observation.
The lack of any excess lung cancer mortality in females raises
questions about whether the differences should be attributed to environmental
or occupational exposure. An examination of plant records indicates that
employment in the chemical plant cannot explain the male-female discrepancy
or the excess lung cancer mortality. From death certificate data no other
industrial exposure predominated in these men but this occupational informa-
tion is incomplete and unreliable. It is possible, however, that environmental
exposure to agents such as arsenic may require the synergistic action of
cigarette smoking before lung cancers are manifest. This hypothesis would
be compatible with the data on occupational lung cancer in asbestos and uranium
mine workers who experienced an excess of lung cancers only in association
with cigarette smoking. Exposure to arsenic in females may not produce lung
cancer because of infrequent cigarette smoking in the past, although it may
produce cancer at a site other than the lung. Moss (10) reported that female
woolen textile workers had an excess risk of oral cancers which he attributed
to arsenic exposure from sheep-dip; he did not report an excess risk of lung
cancers. Thus, health effects from environmental exposure to an agent may
be different depending on sex, age, and simultaneous exposure to other personal
risk factors.
The data from this study are still preliminary. The information
should be expanded with deaths from additional years, validation of pathology
records and further information on the personal characteristics of the deceased.
Sampling of soil and dust in-the area to detect the presence of arsenic or
other contaminants should be accomplished.
-------
Summary
The present study was a preliminary attempt to determine the feasibility
of using cancer mortality data to indicate the carcinogenic effects of possible
arsenic exposure in the environment. The four census tracts for which fifty
percent of the areas lay within a 3/4 mile radius of an arsenical-producing
insecticide plant were matched by such demographic characteristics as age, race,
sex, and socioeconomic status with all other similar tracts in Baltimore City.
The matching tracts were then subdivided according to suspected differences
in exposure to environmental pollution. The lung cancer mortality was higher
for the combined tracts adjacent to the plant as compared to the control tracts.
The lung cancer mortality for the tract in which the plant was located was three
to four times higher than in controls tracts, a difference which was significant.
The data also support a northerly gradient in rates with increasing distance
from the plant.
The difference in lung cancer mortality which was present only in males
could not be explained by employment in the insecticide plant or in other high
risk occupations. It is possible that differences in smoking habits in pre-
vious time periods might explain the discrepancy in rates by sex. Additional
deaths as well as further information on occupation and personal habits are
needed to validate the findings.
-------
Figure 1
Map of area surrounding chemical plant
-------
1306.02
X**"*.
1203 *'v
03 '--g;.'
%: .**"
?::: ''**
2503.03
INDEX TRACTS
CONTROL TRACTS
MATCH II £:v: .
PLANT LOCATION *
PATAPSCO RIVER
^12504.0! ':">*
*d ^
Figure 2 ^
^--ts
Map of Baltimore City showing location of index and control census
tracts. 0
o
-------
Lung
Other
Census
cancer death
cancer death
tract boundary
N
Figure 3
Spot map showing cancer deaths
for 1970-72 by residence at
death, excluding chemical plant
employees.
-------
FIGURE 4
NW
w
SW
NW
W
ANNUAL
LEGEND
tZZZdVELOCITIES 4 THRU 15 MPH
^VELOCITIES 16 MPH AND OVER
VELOCITIES 0 THRU 3 MPH RECORDED AS CALM.
NUMBERS ARE PER CENT OF
TIME WINDS BLEW FROM DIRECTION INDICATED
NOTE: WIND ROSES BASED ON ANALYSIS OF MUNICIPAL
AIRPORT WBO HOURLY WIND RECORDS (1933 THRU 1938)
NW
SW
WINTER
PER CENT OF TIME
5 0 5 10
WIND DATA
BALTIMORE, MD
Dace: March 1950 Drawn by: THG
-------
Table 1. Designation of census tracts
Match I
Match II
Index
Tracts
2302
2303'
2404
2301
Adjacent
Controls
2401
2402
2403
2101
2201
South
Controls
2005
2502.05
2503.03
2504.01
2504.02
2505
Central
Controls
101
104
105
601
602
2608
703
North
Controls
1308.02
2604.01
2702
905
1203
Plant located in this tract.
-------
Table 2. Characteristics of Index and control census tracts from 1970 census for selected Baltimore areas.
TRACTS
Characteristics
Total Population
Range between tracts
%
-------
Table .3. Crude death rates for specific types of cancer for total population
In Index tracts and matched controls for both Match I and Match II,
average rates per 100,000 per year,
total deaths for 1970-72,
males only.
Match I
Match II
Type of cancer and
8th revision (SCO code
Oral
(140-149)
Stomach
(151)
Colon
(153)
Rectum
(154)
Pancreas
(157)
Lung
(162)
Prostate
(185)
Bladder
(188)
Lymphomas
(200-203)
Leukemia
(204-207)
All cancer
(140-209)
#
rate
#
rate
#
rate
#
rate
#
rate
#
rate
#
rate
#
rate
#
rate
#
rate
#
rate
Index
2
15.46
1
7.73
2
15.46
2
15.46
2
15.46
19 h
146.88
3
23.19
0
-
1
7.73
0
-
38
293.75
Adjacent
Controls
3
21.99
1
7.33
3
21.99
3
21.99
0
-
10
73.31
3
21.99
1
7.33
0
0
-
40
293.23
Non-adjacent
Controls
6
6.47
13
14.02
15
16.18
7
7.55
10
10.79
97
104.61
13
14.02
9
9.71
11
11.86
6
6.47
241
259.92
Index
1
19.11
0
-
0
-
0
-
1
19.11
11 a
210.24
3
57.34
0
-
1
19.11
1
19.11
24 a
458.72
Adjacent
Controls
2
23.68
1
11.84
3
35.52
0
-
1
11.84
10
118.41
3
35.52
0
-
2
23.68
0
-
31
367.08
Non-adjacent
Controls
0
-
1-
6.20
4
24.80
0
-
0
-
12 a
74.40
3
18.60
1
6.20
0
3
18.60
40 a
248.02
a Index significantly different from non-adjacent controls by Woolf-Haldane method (8, 9).
b Index not significantly different from non-adjacent controls.
13
-------
Table 4. Crude death rates for specific types of cancer for total population
In Index tracts and matched controls for both Match I and Match II,
average rates per 100,000 per year,
total deaths for 1970-72,
females only.
Match I
Match II
Type of cancer and
8th revision ISCD code
Oral
(140-149)
Stomach
(151)
Colon
(153)
Rectum
(154)
Pancreas
(157)
Lung
(162)
Breast
(174)
Cervix
(180)
Bladder
(188)
Lymphomas
(200-203)
Leukemia
(204-207)
All Cancer
(140-209)
#
rate
#
rate
#
rate
#
rate
#
rate
#
rate
#
rate
#
rate
#
rate
#
rate
#
rate
#
rate
Index
2
14.87
0
1
7.44
0
3
22.31
3
22.31
1
7.44
1
7.44
0
0
2
14.87
18
133.84
Adjacent
Controls
3
20.83
3
20.83
2
13.89
1
6.94
1
6.94
1
27.78
1
6.94
2
13.89
0
1
6.94
0
28
194.44
Non-adjacent
Controls
3
2.98
8
7.93
21
20.83
8
7.93
14
13.89
15
14.88
27
26.78
5
4.96
3
2.98
10
9.92
5
4.96
177
175.55
Index
0
1
18.36
1
iase
0
0
1
18.36
5
91.78
1
18.36
0
0
1
18.36
16
293.69
Adjacent
Controls
1
11.94
1
11.94
3
35.83
0
2
23.89
3
35.83
3
35.83
4
47.77
1
11.94
0
0
23
274.69
Non-adjacent
Controls
0
3
16.83
6
33.65
1
5.61
2
11.22
2
11.22
6
33.65
1
5.61
2
11.22
1
5.61
0
33
185.09
14
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Table 5. Death rates for selected cancer In white male populations of
Match I and white Match II Index and control census tracts,
rates per 100,000 adjusted for age to
1970 Baltimore City white males.
Type of cancer and
8th revision ISCD code
Oral (140-149)
Colon (153)
Pancreas (157)
Lung (162)
Prostate (185)
Lymphomas (200-203)
Leukemias (204-207)
All Cancer (140-209)
a This rate includes ISCD
b This rate includes ISCO
Baltimore
City
12.06
36.34a
11.47
95.62
24.13
20.89b
282.75
codes 153 and
codes 200-209.
Index
13.11
18.71
13.11
181.52
37.38
15.89
608.91
154.
Adjacent
Controls
22.91
27.85
-
90.12
17.43
5.47
308.76
South
Controls
2.53
24.82
14.48
144.07
23.21
16.66
8.15
328.91
Central
Controls
10.06
13.24
12.71
105.13
16.29
12.53
9.67
301.03
North
Controls
9.75
20.21
5.03
103.01
10,11
4.72
9.40
274.55
Table 6. Death rates for selected cancers In white female populations of
Match 1 and white Match II index and control census tracts,
rates per 100,000 adjusted for age to
1970 Baltimore City white females.
Type of cancer and
8th revision ISCO code
Oral (140-149)
Colon (153)
Pancreas (157)
Lung (162)
Breast (174)
Cervix (180)
Lymphomas (200-203)
LeuKemia (204-207)
All Cancer (140-209)
Baltimore
City
4.08
32.51°
9.35
18.43
35.67
7.90
16.06b
192.96
Index
15.60
8.88
26.69
26.77
44.03
8.88
6.16
144.64
Adjacent
Controls
17.57
23.57
6.00
29.18
18.01
29.22
6.00
240.28
South
Controls
5.98
24.83
21.61
11.95
35.40
7.81
6.89
11.04
212.06
Central
Controls
-
28.27
23.89
16.27
30.84
3.28
15.04
2.72
212.20
North
Controls
5.01
39.25
5.01
26.81
47.66
3.55
14.22
5.01
277.08
a This rate includes ISCD codes 153 and 154.
b This rate includes ISCD codes 200-209.
15
-------
Table 7. Death rates for selected cancers In populations of
Match I and whites In Match II Index and control census
tracts, rates per 100,000 adjusted for age and sex to
white 1970 Baltimore City population.
Type of cancer and
8th revision ISCD code
Oral (140-149)
Colon (153)
Pancreas (157)
Lung (162)
Lymphomas (200-203)
Leukemia (204-207)
All Cancer (140-209)
Baltimore
City
7.85
34.32a
10.35
54.88
18.34b
235.36
Index
14.42
13.53
20.28
99.85
7.50
3.25
363.87
Adjacent
Controls
20.09
25.59
3.17
57.96
5.75
272.61
South
Controls
4.35
24.82
18.24
74.34
11.50
9.68
267.24
Central
Controls
4.75
21.17
18.61
58.23
13.86
6.00
254.15
North
Controls
7.25
30.26
5.01
62.79
9.73
7.09
275.89
a This rate includes ISCD codes 153 and 154.
b This rate includes (SCO codes 200-209.
16
-------
Table 8. Death rates for selected cancers In black populations of
Match II Index and control census tracts, rates per 100,000
adjusted tor age and sex to black 1970 Baltimore City population.
Type of cancer and
8th revision ISCD code
Oral (140-149)
Colon (153)
Pancreas (157)
Lung (162)
Lymphomas (200-203)
Leukemia (204-207)
All Cancer (140-209)
Baltimore
City
4.28
17.778
8.01
39.98
11.03b
167.93
Index
9.07
9.97
9.07
79.77
31.37
236.33
'Adjacent
Controls
17.21
17.02
25.63
49.26
8.59
215.82
Central
Controls
-
60.11
-
118.46
.
353.44
North
Controls
-
35.51
-
35.98
17.56
206.31
a This rate includes ISCD codes 153 and 154.
b This rate includes ISCD codes 200-209.
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Table 9. Crude cancer death rates for selected sites In males
by Individual tract and matched controls,
average annual death rate per 100,000.
MATCH I
oo
Cancer Site 2303
Oral
Pancreas
Lung
Prostate
39.5
39.5
394.9s
39.5
Index
2302
19.8
-
138.9b
19.8
2404
-
18.6
37.3b
18.6
Adjacent
Controls
22.0
-
73.3
22.0
South
Controls
2.2
11.1
109.2
15.6
Central
Controls
10.3
21.9
102.8
17.1
North
Controls
10.7
29.7
96.4
5.4
MATCH II
Index
Cancer Site WM
Oral
Pancreas
Lung
Prostate
-
-
146.0°
36.5
2301
BM
40.1
40.1
280.8°
80.2
Adjacent Controls
WM BM
24.0
-
144.2
-
23.3
23.3
93.4
70.0
Central
WM
-
-
114.8
-
Controls
BM
-
-
153.1
.
North Controls
WM BM
-
-
56.2 48.2
18.8 32.1
a Significant difference compared to each control.
b Not significant compared to each control.
c Lung cancer rates combined for races significantly different from comparable rates of north and adjacent controls.
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Table 10. Crude cancer death rates for selected sites In females
by Individual tract and matched controls,
average annual death rate per 100,000.
MATCH I
Index Adjacent
Cancer Site 2303 2302 2404 Controls
Oral
Pancreas
Lung
Breast
Cervix
77.6
19.4 3
58.3
19.4
19.4
20.8
4.9 6.9
27.8
6.9
13.9
MATCH II
Index 2301 Adjacent Controls
Cancer Site WF BF WF BF
Oral
Pancreas
Lung
Breast
Cervix
-
-
39.3 - 2E
196.5 - 5C
34.4 7£
22.9
45.8
>.0 45.8
).0 22.9
>.0 22.9
South Central
Controls Controls
4.1
14.4 21.9
8.2 18.8
24.7 31.3
6.2 3.1
Central Controls
WF BF
37.7
43.2
-
-
North
Controls
5.0
'-
24.7
24.7
5.0
North Controls
WF BF
-
17.4
17.4
87.1 14.0
14.0
-------
REFERENCES
1. W. Winkelstein, S. Kantor, et al, "The relationship of
air pollution and economic status to total mortality and
selected respiratory system mortality in men,1' Arch
Environ Health 14; 1620 (1967).
2. L. Zeidberg, R.J.M. Horton/ and E. Landau, "The Nashville
air pollution study. V. Mortality from diseases of the
respiratory system in relation to air pollution," Arch
Environ- Health 15: 214 (1967)
3. H.R. Menck, J.T. Casagrande and B.E. Henderson, "Industrial
air pollution: Possible effect on lung cancer," Science
183: 210 (1974).
4. S. Milham, Jr., and T. Strong, "Human arsenic exposure in
relation to a copper smelter," Environ Res 7: 176 (1974).
5. W.J. Blot, and J.F. Fraumeni, Jr., "Arsenical air pollution
and lung cancer," Lancet, 142 (1975).
6. M.G. Ott, B.B. Holder, and H.L. Gordon, "Respiratory cancer
and occupational exposure to arsenicals," Arch Environ Health
29: 250 (1974).
7. A.M. Lee, and J.F. Fraumeni, Jr., "Arsenic and respiratory
cancer in man, an occupational study," JNCI 42, 6-, 1045 (1969)
8. B. Woolf, "On estimating the relation between blood group and
disease," Ann Eugen 19: 251 (1955).
9. J.B.S. Haldane, "The estimation and significance of the
logarithm of a ratio of frequencies," Ann Human Genetics
20: 309 (1956).
10. E. Moss, "Oral cancer in textile workers," Conference on
Occupational Carcinogenesis, New York Academy of Sciences,
(Radiation and Particulate Matter) New York, New York (1975);
-------
TECHNICAL REPORT DATA
(Please read Instructions on the reverse before completing)
1. REPORT NO.
560/6-76-003
2.
3. RECIPIENT'S ACCESSION1 NO.
4. TITLE AND SUBTITLE
EPDIEMIOLOGY STUDIES/ TASK I - PHASE I
Pilot Study of Cancer Mortality Near an
Arsenical Pesticide Plant in Baltimore
5. REPORT DATE
Mav 1976
6. PERFORMING ORGANIZATION CODE
7. AUTHOFUS)
Genevieve Matanoski, MD, Dr. PH, Johns Hopkins
Emanuel Landau/ PhD, APHA E. Elliott/ BA; JE
8. PERFORMING ORGANIZATION REPORT NO,
9. PERFORMING ORGANIZATION NAME AND ADDRESS
American Public Health Association
1015 Eighteenth Street N. W.
Washington, D. C. 20036
10. PROGRAM ELEMENT NO.
11. CONTRACT/GRANT NOT
68-01-2490
12. SPONSORING AGENCY NAME AND ADDRESS
Office of Toxic Substances
Environmental Protection Agency
401 M St. S. W. Washington, D. C.
13. TYPE OF REPORT AND PERIOD COVERED
Final Report
14. SPONSORING AGENCY CODE
20460
15. SUPPLEMENTARY NOTES
16. ABSTRACT
The population of the area surrounding a chemical plant which pro-
duced arsenical pesticides had possibly been exposed to arsenic in the
environment. In order to determine whether there had been a carcino
genie effect from the exposure, a pilot study of the cancer mortality
of the four census tracts for which at least half of the tract area lay
within three quarters of a mile of the plant was conducted for the year
1970-1972. The rates were compared to those of the other 23 tracts in
the city which were similar to the index tracts for five variables mea-
suring age, race, and sex distribution and socioeconomic characteristic
The results indicate that lung cancer mortality in males is signifi-
cantly higher for the tract in which the plant is located as compared
to control areas. Two of the other three tracts also had higher lung
cancer mortality than controls but the difference was not significant
and the values were lower than those of the tract in which the plant
was located. The four-fold excess in lung cancer deaths did not appear
to be related to occupational exposure.
Total cancers in females and those at other sites in males were too
few in number to place any reliance on death rates. The high mortality
from oral cancer, especially in females, deserve further study.
17.
KEY WORDS AND DOCUMENT ANALYSIS
DESCRIPTORS
b.lDENTIFIERS/OPEN ENDED TERMS C. COSATI Field/Group
Mortality analysis
Lung Cancer
Insecticide/arsenic exposure
Air pollution
Analysis by census tracts
Arsenic
Insecticides
Cancer
Census tracts
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Unclassified
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26
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