title: Dioxin emissions from a solid waste incinerator and risk of non-Hodgkin lymphoma.
abstract: BACKGROUND
  It is not clear whether low environmental doses of dioxin affect the general population. We previously detected a cluster of patients with non-Hodgkin lymphoma around a French municipal solid waste incinerator with high dioxin emissions. To explore the environmental route suggested by these findings, we carried out a population-based case-control study in the same area.
  
  
  METHODS
  We compared 222 incident cases of non-Hodgkin lymphoma diagnosed between 1980 and 1995 and controls randomly selected from the 1990 population census, using a 10-to-1 match. Dioxin ground-level concentrations were modeled with a second-generation Gaussian-type dispersion model, yielding four dioxin exposure categories. The latter were linked to individual places of residence, using Geographic Information System technology.
  
  
  RESULTS
  The risk of developing non-Hodgkin lymphoma was 2.3 times higher (95% confidence interval = 1.4-3.8) among individuals living in the area with the highest dioxin concentration than among those living in the area with the lowest dioxin concentration. No increased risk was found for the intermediate dioxin exposure categories. Adjustment for a wide range of socioeconomic characteristics at the block group level did not alter the results.
  
  
  CONCLUSIONS
  Although emissions from incinerators are usually not regarded as an important source of exposure to dioxins compared with other background sources, our findings support the hypothesis that environmental dioxins increase the risk of non-Hodgkin lymphoma among the population living in the vicinity of a municipal solid waste incinerator.
authors.affiliation: Department of Public Health, Biostatistics and Epidemiology Unit, Faculty of Medicine, Besançon, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Floret
authors.forename: Frédéric
authors.initials: F
authors.lastname: Mauny
authors.forename: Bruno
authors.initials: B
authors.lastname: Challier
authors.forename: Patrick
authors.initials: P
authors.lastname: Arveux
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Cahn
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Viel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004147:Dioxins / Q000032:analysis / Q000506:poisoning*; D004785:Environmental Pollutants / Q000032:analysis / Q000506:poisoning*; D005260:Female; D040362:Geographic Information Systems; D006801:Humans; D015994:Incidence; D017745:Incineration; D007223:Infant; D007231:Infant, Newborn; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012037:Refuse Disposal; D018570:Risk Assessment
chemical_list: D004147:Dioxins; D004785:Environmental Pollutants