title: Environmental carcinogen releases and lung cancer mortality in rural-urban areas of the United States.
abstract: OBJECTIVE
  Environmental hazards are unevenly distributed across communities and populations; however, little is known about the distribution of environmental carcinogenic pollutants and lung cancer risk across populations defined by race, sex, and rural-urban setting.
  
  
  METHODS
  We used the Toxics Release Inventory (TRI) database to conduct an ecological study at the county level (a total of 3,141 counties). Multiple linear regressions were used to assess the associations of carcinogenic discharges from TRI sites and lung cancer mortality rates at the county level in the United States during the years 1990 through 2007.
  
  
  RESULTS
  We observed an excess risk of population lung cancer mortality associated with higher amounts of environmental carcinogen releases from TRI facilities in both males and females, and in both whites and African Americans. The strength of these associations tended to be stronger in African Americans. A significant dose-response relationship was observed for the total volume of carcinogen releases or carcinogen releases to the air, but not releases to water. These associations appeared to be present within nonmetropolitan counties but not metropolitan counties, and to be concentrated in certain urban-rural county typologies.
  
  
  CONCLUSIONS
  Our results suggest that exposure to higher carcinogen releases from industrial or chemical facilities in rural areas may increase the risk of lung cancer mortality. Our findings add to the evidence for undertaking prudent efforts to limit the release of carcinogenic chemicals into the environment.
authors.affiliation: Department of Community Medicine, West Virginia University, Morgantown, West Virginia 26506, USA. mhendryx@hsc.wvu.edu
authors.forename: Juhua
authors.initials: J
authors.lastname: Luo
authors.forename: Michael
authors.initials: M
authors.lastname: Hendryx
mesh_terms: D002274:Carcinogens, Environmental / Q000633:toxicity*; D055884:Chemical Hazard Release; D016208:Databases, Factual; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D016014:Linear Models; D008175:Lung Neoplasms / Q000401:mortality*; D008297:Male; D012423:Rural Health; D014481:United States / Q000453:epidemiology; D014504:Urban Health
chemical_list: D002274:Carcinogens, Environmental