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.
| 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 | |
* 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.