LUNG-CANCER, PROXIMITY TO INDUSTRY, AND POVERTY IN NORTHEAST ENGLAND

This study assesses whether deprived populations living close to indus try experience greater mortality from lung cancer than populations wit h comparable socioeconomic characteristics living farther a way. Morta lity data, census data, a postal survey of living circumstances, histo ric and contemporary data on air quality and a historic land-use sun-e y were used. Analysis was based on two conurbations in England, Teessi de and Sunderland. Housing estates in Teesside were select ed based on socioeconomic criteria and distinguished by proximity to steel and ch emical industries; they were grouped into three zones: near (A), inter mediate (B), and farther (C), with a single zone in Sunderland. We inc luded 14,362 deaths in 27 estates. Standardized mortality ratios (SMR) for lung cancer [International Classification of Diseases #9 (ICD-9) 162] and cancers other than lung (ICD-9 140-239, excluding 162), and s ex ratios were calculated. Mortality from lung cancer was well above n ational levels in all zones. For men, a weak gradient corresponding wi th proximity to industry at younger ages reversed at older ages. In wo men 0-64 years of age, stronger gradients in lung cancer mortality cor responded with proximity to industry across zones A, B, and C (SMR = 3 93, 251., 242, respectively). Overall rates in Teesside were higher th an Sunderland rates for women aged 0-64 years (SMR = 287 vs. 185) and 65-74 years (SMR = 190 vs. 157). The association between raised lung c ancer mortality and proximity to industry in women under 75 years of a ge could not be explained by smoking, occupation, socioeconomic factor s, or artifact. Explanations for differences between men and women may include gender-specific occupational experiences and smoking patterns . Our judgment is that the observed gradient in women points to a role for industrial air pollution.