title: Cancer rates after the Three Mile Island nuclear accident and proximity of residence to the plant.
abstract: BACKGROUND
  In the light of a possible link between stress and cancer promotion or progression, and of previously reported distress in residents near the Three Mile Island (TMI) nuclear power plant, we attempted to evaluate the impact of the March 1979 accident on community cancer rates.
  
  
  METHODS
  Proximity of residence to the plant, which related to distress in previous studies, was taken as a possible indicator of accident stress; the postaccident pattern in cancer rates was examined in 69 "study tracts" within a 10-mile radius of TMI, in relation to residential proximity.
  
  
  RESULTS
  A modest association was found between postaccident cancer rates and proximity (OR = 1.4; 95% CI = 1.3, 1.6). After adjusting for a gradient in cancer risk prior to the accident, the odds ratio contrasting those closest to the plant with those living farther out was 1.2 (95% CI = 1.0, 1.4). A postaccident increase in cancer rates near the Three Mile Island plant was notable in 1982, persisted for another year, and then declined. Radiation emissions, as modeled mathematically, did not account for the observed increase.
  
  
  CONCLUSIONS
  Interpretation in terms of accident stress is limited by the lack of an individual measure of stress and by uncertainty about whether stress has a biological effect on cancer in humans. An alternative mechanism for the cancer increase near the plant is through changes in care-seeking and diagnostic practice arising from postaccident concern.
authors.affiliation: Division of Epidemiology, Columbia University, School of Public Health, New York, NY 10032.
authors.forename: M C
authors.initials: MC
authors.lastname: Hatch
authors.forename: S
authors.initials: S
authors.lastname: Wallenstein
authors.forename: J
authors.initials: J
authors.lastname: Beyea
authors.forename: J W
authors.initials: JW
authors.lastname: Nieves
authors.forename: M
authors.initials: M
authors.lastname: Susser
mesh_terms: D015982:Bias; D004522:Educational Status; D006801:Humans; D015994:Incidence; D007182:Income; D015233:Models, Statistical; D009369:Neoplasms / Q000145:classification / Q000453:epidemiology* / Q000401:mortality; D009678:Nuclear Energy; D016017:Odds Ratio; D010414:Pennsylvania / Q000453:epidemiology; D011210:Power Plants; D011848:Radioactive Pollutants / Q000009:adverse effects; D012111:Residence Characteristics; D013315:Stress, Psychological / Q000453:epidemiology*
chemical_list: D011848:Radioactive Pollutants