title: Residential proximity to industrial combustion facilities and risk of non-Hodgkin lymphoma: a case-control study.
abstract: BACKGROUND
  Residence near municipal solid waste incinerators, a major historical source of dioxin emissions, has been associated with increased risk of non-Hodgkin lymphoma (NHL) in European studies. The aim of our study was to evaluate residence near industrial combustion facilities and estimates of dioxin emissions in relation to NHL risk in the United States.
  
  
  METHODS
  We conducted a population-based case-control study of NHL (1998-2000) in four National Cancer Institute-Surveillance Epidemiology and End Results centers (Detroit, Iowa, Los Angeles, Seattle). Residential histories 15 years before diagnosis (similar date for controls) were linked to an Environmental Protection Agency database of dioxin-emitting facilities for 969 cases and 749 controls. We evaluated proximity (3 and 5 km) to 10 facility types that accounted for >85% of U.S. emissions and a distance-weighted average emission index (AEI [ng toxic equivalency quotient (TEQ)/year]).
  
  
  RESULTS
  Proximity to any dioxin-emitting facility was not associated with NHL risk (3 km OR = 1.0, 95% CI 0.8-1.3). Risk was elevated for residence near cement kilns (5 km OR = 1.7, 95% CI 0.8-3.3; 3 km OR = 3.8, 95% CI 1.1-14.0) and reduced for residence near municipal solid waste incinerators (5 km OR = 0.5, 95% CI 0.3-0.9; 3 km OR = 0.3, 95% CI 0.1-1.4). The AEI was not associated with risk of NHL overall. Risk for marginal zone lymphoma was increased for the highest versus lowest quartile (5 km OR = 2.6, 95% CI 1.0-6.8; 3 km OR = 3.0, 95% CI 1.1-8.3).
  
  
  CONCLUSIONS
  Overall, we found no association with residential exposure to dioxins and NHL risk. However, findings for high emissions and marginal zone lymphoma and for specific facility types and all NHL provide some evidence of an association and deserve future study.
authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Department of Health and Human Services, Rockville, MD, USA.
authors: Anjoeka
authors: A
authors: Pronk
authors: John R
authors: JR
authors: Nuckols
authors: Anneclaire J
authors: AJ
authors: De Roos
authors: Matthew
authors: M
authors: Airola
authors: Joanne S
authors: JS
authors: Colt
authors: James R
authors: JR
authors: Cerhan
authors: Lindsay
authors: L
authors: Morton
authors: Wendy
authors: W
authors: Cozen
authors: Richard
authors: R
authors: Severson
authors: Aaron
authors: A
authors: Blair
authors: David
authors: D
authors: Cleverly
authors: Mary H
authors: MH
authors: Ward
mesh_terms: D000328:Adult; D000368:Aged; D000393:Air Pollutants / Q000032:analysis / Q000633:toxicity*; D016022:Case-Control Studies; D004147:Dioxins / Q000032:analysis / Q000633:toxicity*; D004781:Environmental Exposure; D004784:Environmental Monitoring; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000139:chemically induced* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States / Q000453:epidemiology; D008962:Models, Theoretical; D019601:Pacific States / Q000453:epidemiology; D012111:Residence Characteristics; D012307:Risk Factors; D018426:SEER Program; D055815:Young Adult
chemical_list: D000393:Air Pollutants; D004147:Dioxins