title: Effect of a chemical manufacturing plant on community cancer rates.
abstract: BACKGROUND
  We conducted a retrospective study to determine if potential past exposure to dioxin had resulted in increased incidence of cancer in people living near a former manufacturing plant in New South Wales, Australia. During operation, from 1928 to 1970, by-products of the manufacturing process, including dioxin and other chemical waste, were dumped into wetlands and mangroves, discharged into a nearby bay and used to reclaim land along the foreshore, leaving a legacy of significant dioxin contamination.
  
  
  METHODS
  We selected 20 Census Collector Districts within 1.5 kilometres of the former manufacturing plant as the study area. We obtained data on all cases of cancer and deaths from cancer in New South Wales from 1972 to 2001. We also compared rates for some cancer types that have been associated with dioxin exposure. Based on a person's residential address at time of cancer diagnosis, or at time of death due to cancer, various geo-coding software and processes were used to determine which collector district the case or death should be attributed to. Age and sex specific population data were used to calculate standardised incidence ratios and standardised mortality ratios, to compare the study area to two comparison areas, using indirect standardisation.
  
  
  RESULTS
  During the 30-year study period 1,106 cases of cancer and 524 deaths due to cancer were identified in the study area. This corresponds to an age-sex standardised rate of 3.2 cases per 1,000 person-years exposed and 1.6 deaths per 1,000 person-years exposed. The study area had a lower rate of cancer and deaths from cancer than the comparison areas. The case incidence and mortality due to lung and bronchus carcinomas and haematopoietic cancers did not differ significantly from the comparison areas for the study period. There was no obvious geographical trend in ratios when comparing individual collector districts to New South Wales according to distance from the potential source of dioxin exposure.
  
  
  CONCLUSIONS
  This investigation found no evidence that dioxin contamination from this site resulted in increased cancer rates in the potentially exposed population living around the former manufacturing plant.
authors.affiliation: New South Wales Public Health Officer Training Program, Centre for Epidemiology and Research, NSW Department of Health, LMB 961, North Sydney NSW, 2059, Australia. PAMAN@doh.health.nsw.gov.au
authors.forename: Trish
authors.initials: T
authors.lastname: Mannes
authors.forename: Katy
authors.initials: K
authors.lastname: Emmett
authors.forename: Alan
authors.initials: A
authors.lastname: Willmore
authors.forename: Tim
authors.initials: T
authors.lastname: Churches
authors.forename: Vicky
authors.initials: V
authors.lastname: Sheppeard
authors.forename: Jill
authors.initials: J
authors.lastname: Kaldor
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019352:Censuses; D002617:Chemical Industry; D002648:Child; D004147:Dioxins / Q000633:toxicity*; D004781:Environmental Exposure / Q000009:adverse effects*; D004785:Environmental Pollutants / Q000009:adverse effects; D005260:Female; D040362:Geographic Information Systems; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000139:chemically induced / Q000145:classification / Q000453:epidemiology*; D009517:New South Wales / Q000453:epidemiology; D012042:Registries; D012189:Retrospective Studies
chemical_list: D004147:Dioxins; D004785:Environmental Pollutants