DOES LIVING NEAR A CONSTELLATION OF PETROCHEMICAL, STEEL, AND OTHER INDUSTRIES IMPAIR HEALTH

Objectives-To investigate concern that local industrial air pollution in Teesside, England, was causing poor health, several areas there wer e compared with parts of the City of Sunderland. Methods-Populations i n similar social and economic circumstances but varying in their proxi mity to major industries were compared. Study populations lived in 27 housing estates in Teesside and Sunderland, north east England, with s ome data from subsets of estates. The estates were aggregated into zon es (designated as A, B, and C in Teesside where A is closest to and C furthest from industry, and S in Sunderland). Zone S provided a refere nce area. The hypothesis was that a health gradient both within Teessi de (A>B>C) and between Teesside and Sunderland (ABC>S) would indicate a possible health effect of local industrial air pollution. Data prese nted were: mortality (1981-91) from 27 housing estates; population sel f completion questionnaire survey data (1993, 9115 subjects) from 15 h ousing estates; and general practitioner (GP) consultation data (1989- 91) from 2201 subjects in 12 Teesside estates. Results-The populations in the four zones were comparable for indicators including smoking ha bits, residential histories, and unemployment. Al cause and cause spec ific mortalities were high compared with England and Wales. Mortality in all Teesside zones (ABC) combined was mostly higher than in zone S. In people aged 0-64, lung cancer and respiratory disease showed gradi ents with highest mortality in areas closest to industry (A>B>C and AB C>S). The association was dearest for lung cancer in women (0-64 years old, trend across zones ABC, p=0.07, directly standardised rate ratio relative to zone S was 169 (95% confidence interval (95% CI) 116-122) ). There were no important, consistent gradients in the hypothesised d irection between zones in consultation rates in general practice, and self reported respiratory and nonrespiratory health including asthma. Conclusions-There was no clear evidence that living close to industry was associated with morbidity, including asthma, or for most measures of mortality. For lung cancer in women the gradients indicated a healt h effect of local industrial air pollution. In the age group 0-64 obse rved gradients in lung cancer in men and mortality from respiratory di sease in men and women were consistent with the study hypothesis, alth ough not significant. The reasons for the different patterns at differ ent ages, and between men and women, remain a puzzle.