Abstract
The rates of mortality, morbidity as hospitalizations, and congenital anomalies in the Windsor Area of Concern ranked among the highest of the 17 Areas of Concern on the Canadian side of the Great Lakes for selected end points that might be related to pollution in this relatively highly industrialized city. Mortality and morbidity rates from all causes were higher than in the rest of the province. Anomalously high rates of diseases included various cancers; endocrine, nutritional, metabolic, and immunity disorders; diseases of the blood and blood-forming organs, nervous system and sense organs, circulatory and respiratory systems, digestive system, genitourinary system, skin and subcutaneous tissue, musculoskeletal system and connective tissues; congenital anomalies, and infant mortality. Of particular concern was the early onset of the elevated rates of many of these diseases and conditions. Comparison of these incident rates with those in Hamilton, another industrial municipality in southern Ontario, suggested that in addition to a variety of local sources of industrial pollution from automobile manufacturing and use, transboundary air and water pollution from Detroit, Michigan, should be investigated as potentially important causes of these health outcomes in the Windsor Area of Concern. Some of the institutional and political trends of the past decade may need to be reversed before effective remedial programs are implemented for cleaning up contaminated sediments and for containment of leaking hazardous waste sites. This pilot project would seem to be a useful preliminary method of integrating human health concerns and of priority setting for the administration of the Great Lakes Water Quality Agreement and the Canada-United States Air Quality Agreement.
Full Text
The Full Text of this article is available as a PDF (598.5 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Black R. J., Sharp L., Finlayson A. R., Harkness E. F. Cancer incidence in a population potentially exposed to radium-226 at Dalgety Bay, Scotland. Br J Cancer. 1994 Jan;69(1):140–143. doi: 10.1038/bjc.1994.23. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bove F. J., Fulcomer M. C., Klotz J. B., Esmart J., Dufficy E. M., Savrin J. E. Public drinking water contamination and birth outcomes. Am J Epidemiol. 1995 May 1;141(9):850–862. doi: 10.1093/oxfordjournals.aje.a117521. [DOI] [PubMed] [Google Scholar]
- Brender J. D., Suarez L. Paternal occupation and anencephaly. Am J Epidemiol. 1990 Mar;131(3):517–521. doi: 10.1093/oxfordjournals.aje.a115526. [DOI] [PubMed] [Google Scholar]
- Brophy J., Parent M. Documenting the asbestos story in Sarnia. New Solut. 1999;9(3):297–316. doi: 10.2190/4QWT-08TY-RX5J-D5LH. [DOI] [PubMed] [Google Scholar]
- Brouwer A., Longnecker M. P., Birnbaum L. S., Cogliano J., Kostyniak P., Moore J., Schantz S., Winneke G. Characterization of potential endocrine-related health effects at low-dose levels of exposure to PCBs. Environ Health Perspect. 1999 Aug;107 (Suppl 4):639–649. doi: 10.1289/ehp.99107s4639. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Brucker-Davis F. Effects of environmental synthetic chemicals on thyroid function. Thyroid. 1998 Sep;8(9):827–856. doi: 10.1089/thy.1998.8.827. [DOI] [PubMed] [Google Scholar]
- Burnett R. T., Brook J. R., Yung W. T., Dales R. E., Krewski D. Association between ozone and hospitalization for respiratory diseases in 16 Canadian cities. Environ Res. 1997 Jan;72(1):24–31. doi: 10.1006/enrs.1996.3685. [DOI] [PubMed] [Google Scholar]
- Burnett R. T., Cakmak S., Brook J. R. The effect of the urban ambient air pollution mix on daily mortality rates in 11 Canadian cities. Can J Public Health. 1998 May-Jun;89(3):152–156. doi: 10.1007/BF03404464. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Burnett R. T., Dales R. E., Brook J. R., Raizenne M. E., Krewski D. Association between ambient carbon monoxide levels and hospitalizations for congestive heart failure in the elderly in 10 Canadian cities. Epidemiology. 1997 Mar;8(2):162–167. doi: 10.1097/00001648-199703000-00007. [DOI] [PubMed] [Google Scholar]
- Calderon-Garcidueñas L., Osorno-Velazquez A., Bravo-Alvarez H., Delgado-Chavez R., Barrios-Marquez R. Histopathologic changes of the nasal mucosa in southwest Metropolitan Mexico City inhabitants. Am J Pathol. 1992 Jan;140(1):225–232. [PMC free article] [PubMed] [Google Scholar]
- Cikrt M., Tichý M., Bláha K., Bittnerová D., Havrdová J., Lepsi P., Sperlingová I., Nemecek R., Roth Z., Vit M. The study of exposure to cadmium in the general population. II. Morbidity studies. Pol J Occup Med Environ Health. 1992;5(4):345–356. [PubMed] [Google Scholar]
- Cranmer M., Louie S., Kennedy R. H., Kern P. A., Fonseca V. A. Exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) is associated with hyperinsulinemia and insulin resistance. Toxicol Sci. 2000 Aug;56(2):431–436. doi: 10.1093/toxsci/56.2.431. [DOI] [PubMed] [Google Scholar]
- Daniels J. L., Olshan A. F., Savitz D. A. Pesticides and childhood cancers. Environ Health Perspect. 1997 Oct;105(10):1068–1077. doi: 10.1289/ehp.971051068. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Davis J. R., Brownson R. C., Garcia R., Bentz B. J., Turner A. Family pesticide use and childhood brain cancer. Arch Environ Contam Toxicol. 1993 Jan;24(1):87–92. doi: 10.1007/BF01061094. [DOI] [PubMed] [Google Scholar]
- Dawson B. V., Johnson P. D., Goldberg S. J., Ulreich J. B. Cardiac teratogenesis of halogenated hydrocarbon-contaminated drinking water. J Am Coll Cardiol. 1993 May;21(6):1466–1472. doi: 10.1016/0735-1097(93)90325-u. [DOI] [PubMed] [Google Scholar]
- Dawson B. V., Johnson P. D., Goldberg S. J., Ulreich J. B. Cardiac teratogenesis of trichloroethylene and dichloroethylene in a mammalian model. J Am Coll Cardiol. 1990 Nov;16(5):1304–1309. doi: 10.1016/0735-1097(90)90569-b. [DOI] [PubMed] [Google Scholar]
- DeRosa C. T., Johnson B. L. Strategic elements of ATSDR's Great Lakes Human Health Effects Research Program. Toxicol Ind Health. 1996 May-Aug;12(3-4):315–325. doi: 10.1177/074823379601200304. [DOI] [PubMed] [Google Scholar]
- Elinder C. G. Cadmium as an environmental hazard. IARC Sci Publ. 1992;(118):123–132. [PubMed] [Google Scholar]
- Foster W. G. Reproductive toxicity of chronic lead exposure in the female cynomolgus monkey. Reprod Toxicol. 1992;6(2):123–131. doi: 10.1016/0890-6238(92)90113-8. [DOI] [PubMed] [Google Scholar]
- Fox G. A. Practical causal inference for ecoepidemiologists. J Toxicol Environ Health. 1991 Aug;33(4):359–373. doi: 10.1080/15287399109531535. [DOI] [PubMed] [Google Scholar]
- Gerhardsson de Verdier M., Plato N., Steineck G., Peters J. M. Occupational exposures and cancer of the colon and rectum. Am J Ind Med. 1992;22(3):291–303. doi: 10.1002/ajim.4700220303. [DOI] [PubMed] [Google Scholar]
- Goldberg S. J., Lebowitz M. D., Graver E. J., Hicks S. An association of human congenital cardiac malformations and drinking water contaminants. J Am Coll Cardiol. 1990 Jul;16(1):155–164. doi: 10.1016/0735-1097(90)90473-3. [DOI] [PubMed] [Google Scholar]
- Gorski J. R., Rozman K. Dose-response and time course of hypothyroxinemia and hypoinsulinemia and characterization of insulin hypersensitivity in 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)-treated rats. Toxicology. 1987 Jun;44(3):297–307. doi: 10.1016/0300-483x(87)90031-x. [DOI] [PubMed] [Google Scholar]
- Goyer R. A., Epstein S., Bhattacharyya M., Korach K. S., Pounds J. Environmental risk factors for osteoporosis. Environ Health Perspect. 1994 Apr;102(4):390–394. doi: 10.1289/ehp.94102390. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hadfield M. G., Adera T., Smith B., Fortner-Burton C. A., Gibb R. D., Mumaw V. Human brain tumors and exposure to metal and non-metal elements: a case-control study. J Environ Pathol Toxicol Oncol. 1998;17(1):1–9. [PubMed] [Google Scholar]
- Harada M. Minamata disease: methylmercury poisoning in Japan caused by environmental pollution. Crit Rev Toxicol. 1995;25(1):1–24. doi: 10.3109/10408449509089885. [DOI] [PubMed] [Google Scholar]
- Holmberg P. C., Nurminen M. Congenital defects of the central nervous system and occupational factors during pregnancy. A case-referent study. Am J Ind Med. 1980;1(2):167–176. doi: 10.1002/ajim.4700010207. [DOI] [PubMed] [Google Scholar]
- Holt G. R. Toxicology of upper aerodigestive tract pollutants. Otolaryngol Head Neck Surg. 1992 Jun;106(6):655–659. doi: 10.1177/019459989210600607. [DOI] [PubMed] [Google Scholar]
- Jacobson J. L., Jacobson S. W. Intellectual impairment in children exposed to polychlorinated biphenyls in utero. N Engl J Med. 1996 Sep 12;335(11):783–789. doi: 10.1056/NEJM199609123351104. [DOI] [PubMed] [Google Scholar]
- Jarrell J. F., McMahon A., Villeneuve D., Franklin C., Singh A., Valli V. E., Bartlett S. Hexachlorobenzene toxicity in the monkey primordial germ cell without induced porphyria. Reprod Toxicol. 1993;7(1):41–47. doi: 10.1016/0890-6238(93)90008-u. [DOI] [PubMed] [Google Scholar]
- Jockenhövel F., Bals-Pratsch M., Bertram H. P., Nieschlag E. Seminal lead and copper in fertile and infertile men. Andrologia. 1990 Nov-Dec;22(6):503–511. [PubMed] [Google Scholar]
- Johnson B. L., Hicks H. E., De Rosa C. T. Key environmental human health issues in the Great Lakes and St. Lawrence River basins. Environ Res. 1999 Feb;80(2 Pt 2):S2–S12. doi: 10.1006/enrs.1998.3938. [DOI] [PubMed] [Google Scholar]
- Kaltreider R. C., Davis A. M., Lariviere J. P., Hamilton J. W. Arsenic alters the function of the glucocorticoid receptor as a transcription factor. Environ Health Perspect. 2001 Mar;109(3):245–251. doi: 10.1289/ehp.01109245. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kilburn C. J. Manganese, malformations and motor disorders: findings in a manganese-exposed population. Neurotoxicology. 1987 Fall;8(3):421–429. [PubMed] [Google Scholar]
- Lai M. S., Hsueh Y. M., Chen C. J., Shyu M. P., Chen S. Y., Kuo T. L., Wu M. M., Tai T. Y. Ingested inorganic arsenic and prevalence of diabetes mellitus. Am J Epidemiol. 1994 Mar 1;139(5):484–492. doi: 10.1093/oxfordjournals.aje.a117031. [DOI] [PubMed] [Google Scholar]
- Lamb E. J., Bennett S. Epidemiologic studies of male factors in infertility. Ann N Y Acad Sci. 1994 Feb 18;709:165–178. doi: 10.1111/j.1749-6632.1994.tb30396.x. [DOI] [PubMed] [Google Scholar]
- Lisiewicz J. Immunotoxic and hematotoxic effects of occupational exposures. Folia Med Cracov. 1993;34(1-4):29–47. [PubMed] [Google Scholar]
- Longnecker M. P., Klebanoff M. A., Brock J. W., Zhou H., Collaborative Perinatal Project (CPP) Polychlorinated biphenyl serum levels in pregnant subjects with diabetes. Diabetes Care. 2001 Jun;24(6):1099–1101. doi: 10.2337/diacare.24.6.1099. [DOI] [PubMed] [Google Scholar]
- Longnecker M. P., Michalek J. E. Serum dioxin level in relation to diabetes mellitus among Air Force veterans with background levels of exposure. Epidemiology. 2000 Jan;11(1):44–48. doi: 10.1097/00001648-200001000-00010. [DOI] [PubMed] [Google Scholar]
- Luoma P. V., Näyhä S., Pyy L., Hassi J. Association of blood cadmium to the area of residence and hypertensive disease in Arctic Finland. Sci Total Environ. 1995 Jan 15;160-161:571–575. doi: 10.1016/0048-9697(95)04391-d. [DOI] [PubMed] [Google Scholar]
- Luster M. I., Rosenthal G. J. Chemical agents and the immune response. Environ Health Perspect. 1993 Apr;100:219–226. doi: 10.1289/ehp.93100219. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Miller M. M., Plowchalk D. R., Weitzman G. A., London S. N., Mattison D. R. The effect of benzo(a)pyrene on murine ovarian and corpora lutea volumes. Am J Obstet Gynecol. 1992 May;166(5):1535–1541. doi: 10.1016/0002-9378(92)91630-s. [DOI] [PubMed] [Google Scholar]
- Moccia R. D., Fox G. A., Britton A. A quantitative assessment of thyroid histopathology of herring gulls (Larus argentatus) from the Great Lakes and a hypothesis on the causal role of environmental contaminants. J Wildl Dis. 1986 Jan;22(1):60–70. doi: 10.7589/0090-3558-22.1.60. [DOI] [PubMed] [Google Scholar]
- Nordström M., Hardell L., Lindström G., Wingfors H., Hardell K., Linde A. Concentrations of organochlorines related to titers to Epstein-Barr virus early antigen IgG as risk factors for hairy cell leukemia. Environ Health Perspect. 2000 May;108(5):441–445. doi: 10.1289/ehp.108-1638040. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Park R. M., Silverstein M. A., Green M. A., Mirer F. E. Brain cancer mortality at a manufacturer of aerospace electromechanical systems. Am J Ind Med. 1990;17(5):537–552. doi: 10.1002/ajim.4700170501. [DOI] [PubMed] [Google Scholar]
- Paulu C., Aschengrau A., Ozonoff D. Tetrachloroethylene-contaminated drinking water in Massachusetts and the risk of colon-rectum, lung, and other cancers. Environ Health Perspect. 1999 Apr;107(4):265–271. doi: 10.1289/ehp.99107265. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pearce N. Traditional epidemiology, modern epidemiology, and public health. Am J Public Health. 1996 May;86(5):678–683. doi: 10.2105/ajph.86.5.678. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pekkanen J., Pearce N. Environmental epidemiology: challenges and opportunities. Environ Health Perspect. 2001 Jan;109(1):1–5. doi: 10.1289/ehp.011091. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rahman M., Axelson O. Diabetes mellitus and arsenic exposure: a second look at case-control data from a Swedish copper smelter. Occup Environ Med. 1995 Nov;52(11):773–774. doi: 10.1136/oem.52.11.773. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rier S. E., Martin D. C., Bowman R. E., Dmowski W. P., Becker J. L. Endometriosis in rhesus monkeys (Macaca mulatta) following chronic exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin. Fundam Appl Toxicol. 1993 Nov;21(4):433–441. doi: 10.1006/faat.1993.1119. [DOI] [PubMed] [Google Scholar]
- Sever L. E. Congenital malformations related to occupational reproductive hazards. Occup Med. 1994 Jul-Sep;9(3):471–494. [PubMed] [Google Scholar]
- Silman A. J., Hochberg M. C. Occupational and environmental influences on scleroderma. Rheum Dis Clin North Am. 1996 Nov;22(4):737–749. doi: 10.1016/s0889-857x(05)70298-2. [DOI] [PubMed] [Google Scholar]
- Spencer P. S., Ludolph A. C., Kisby G. E. Are human neurodegenerative disorders linked to environmental chemicals with excitotoxic properties? Ann N Y Acad Sci. 1992 May 11;648:154–160. doi: 10.1111/j.1749-6632.1992.tb24533.x. [DOI] [PubMed] [Google Scholar]
- Susser M., Susser E. Choosing a future for epidemiology: II. From black box to Chinese boxes and eco-epidemiology. Am J Public Health. 1996 May;86(5):674–677. doi: 10.2105/ajph.86.5.674. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Swan S. H., Shaw G., Harris J. A., Neutra R. R. Congenital cardiac anomalies in relation to water contamination, Santa Clara County, California, 1981-1983. Am J Epidemiol. 1989 May;129(5):885–893. doi: 10.1093/oxfordjournals.aje.a115222. [DOI] [PubMed] [Google Scholar]
- Thomas D. B. Alcohol as a cause of cancer. Environ Health Perspect. 1995 Nov;103 (Suppl 8):153–160. doi: 10.1289/ehp.95103s8153. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Thomas T. L., Fontham E. T., Norman S. A., Stemhagen A., Hoover R. N. Occupational risk factors for brain tumors. A case-referent death-certificate analysis. Scand J Work Environ Health. 1986 Apr;12(2):121–127. doi: 10.5271/sjweh.2168. [DOI] [PubMed] [Google Scholar]
- Tremblay N. W., Gilman A. P. Human health, the Great Lakes, and environmental pollution: a 1994 perspective. Environ Health Perspect. 1995 Dec;103 (Suppl 9):3–5. doi: 10.1289/ehp.95103s93. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tsuchiya H., Shima S., Kurita H., Ito T., Kato Y., Kato Y., Tachikawa S. Effects of maternal exposure to six heavy metals on fetal development. Bull Environ Contam Toxicol. 1987 Apr;38(4):580–587. doi: 10.1007/BF01608589. [DOI] [PubMed] [Google Scholar]
- Verity M. A. Environmental neurotoxicity of chemicals and radiation. Curr Opin Neurol Neurosurg. 1993 Jun;6(3):437–442. [PubMed] [Google Scholar]
- Walter S. D., Birnie S. E., Marrett L. D., Taylor S. M., Reynolds D., Davies J., Drake J. J., Hayes M. The geographic variation of cancer incidence in Ontario. Am J Public Health. 1994 Mar;84(3):367–376. doi: 10.2105/ajph.84.3.367. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Walter S. D., Marrett L. D., Taylor S. M., King D. An analysis of the geographic variation in cancer incidence and its determinants in Ontario. Can J Public Health. 1999 Mar-Apr;90(2):104–108. doi: 10.1007/BF03404111. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Weiderpass E., Partanen T., Kaaks R., Vainio H., Porta M., Kauppinen T., Ojajärvi A., Boffetta P., Malats N. Occurrence, trends and environment etiology of pancreatic cancer. Scand J Work Environ Health. 1998 Jun;24(3):165–174. doi: 10.5271/sjweh.295. [DOI] [PubMed] [Google Scholar]
- Weisglas-Kuperus N., Patandin S., Berbers G. A., Sas T. C., Mulder P. G., Sauer P. J., Hooijkaas H. Immunologic effects of background exposure to polychlorinated biphenyls and dioxins in Dutch preschool children. Environ Health Perspect. 2000 Dec;108(12):1203–1207. doi: 10.1289/ehp.001081203. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Whorton D., Krauss R. M., Marshall S., Milby T. H. Infertility in male pesticide workers. Lancet. 1977 Dec 17;2(8051):1259–1261. doi: 10.1016/s0140-6736(77)92665-4. [DOI] [PubMed] [Google Scholar]