title: Risk of mortality, cancer incidence, and stroke in a population potentially exposed to cadmium.
abstract: OBJECTIVE
  To follow up mortality and cancer incidence in a cohort potentially exposed to cadmium and to perform a geographical (ecological) analysis to further assess the health effects of potential exposure to cadmium.
  
  
  METHODS
  The English village of Shipham has very high concentrations of cadmium in the soil. A previous cohort study of residents of Shipham in 1939 showed overall mortality below that expected, but a 40% excess of mortality from stroke. This study extends the follow up of the cohort for mortality to 1997, and includes an analysis of cancer incidence from 1971 to 1992, and a geographical study of mortality and cancer incidence. Standardised mortality and incidence ratios (SMRs and SIRs) were estimated with regional reference rates. Comparisons were made with the nearby village of Hutton.
  
  
  RESULTS
  All cause cohort mortality was lower than expected in both villages, although there was excess cancer incidence in both Shipham (SIR 167, 95% confidence interval (95% CI) 106 to 250) and Hutton (SIR 167, 95% CI 105 to 253). There was an excess of mortality from hypertension, cerebrovascular disease, and nephritis and nephrosis, of borderline significance, in Shipham (SMR 128, 95% CI 99 to 162). In the geographical study, all cause mortality in Shipham was also lower than expected (SMR 84, 95% CI 71 to 100). There was an excess in genitourinary cancers in both Shipham (SIR 160, 95% CI 107 to 239) and Hutton (SIR 153, 95% CI 122 to 192).
  
  
  CONCLUSIONS
  No clear evidence of health effects from possible exposure to cadmium in Shipham was found despite the extremely high concentrations of cadmium in the soil.
authors.affiliation: Small Area Health Statistics Unit, Imperial College School of Medicine, Norfolk Place, London, UK.
authors.forename: P
authors.initials: P
authors.lastname: Elliott
authors.forename: R
authors.initials: R
authors.lastname: Arnold
authors.forename: S
authors.initials: S
authors.lastname: Cockings
authors.forename: N
authors.initials: N
authors.lastname: Eaton
authors.forename: L
authors.initials: L
authors.lastname: Järup
authors.forename: J
authors.initials: J
authors.lastname: Jones
authors.forename: M
authors.initials: M
authors.lastname: Quinn
authors.forename: M
authors.initials: M
authors.lastname: Rosato
authors.forename: I
authors.initials: I
authors.lastname: Thornton
authors.forename: M
authors.initials: M
authors.lastname: Toledano
authors.forename: E
authors.initials: E
authors.lastname: Tristan
authors.forename: J
authors.initials: J
authors.lastname: Wakefield
mesh_terms: D002105:Cadmium Poisoning / Q000401:mortality*; D002423:Cause of Death; D015331:Cohort Studies; D004739:England / Q000453:epidemiology; D004781:Environmental Exposure / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D009369:Neoplasms / Q000401:mortality*; D012989:Soil Pollutants / Q000009:adverse effects*
chemical_list: D012989:Soil Pollutants