title: Thyroid cancer incidence around the Belgian nuclear sites: surrogate exposure modelling.
abstract: BACKGROUND
  In a recent ecological study among residents living around Belgian nuclear sites (the NUCABEL study), significant increased incidences of thyroid cancer were observed around the two nuclear facilities with industrial and research activities (Mol-Dessel and Fleurus), prompting further research.
  
  
  METHODS
  The data from the NUCABEL study were reanalysed to test the hypothesis of a gradient in cancer incidence with increasing levels of exposure from these sites using three measures of surrogate exposure, being (i) residential proximity, (ii) prevailing wind directions and (iii) simulated dispersion of radioactive discharges. Single-site focussed hypothesis tests were complemented with Generalized Additive Models to estimate the exposure-response relationships.
  
  
  RESULTS
  For Mol-Dessel, the results of the focussed hypothesis tests were far from significant. For Fleurus, the p-values were much closer to significance with p=0.05 for Bithell's Linear Risk Score using radioactive discharge estimates as surrogate.
  
  
  CONCLUSIONS
  The re-analyses refute an association with the nuclear facilities for the site of Mol-Dessel. For the site of Fleurus, one of Europe's major production sites of radio-iodines, the results were less conclusive and further research suggests itself.
authors.affiliation: Scientific Institute of Public Health, OD Public Health and Surveillance, Brussels, Belgium. Electronic address: kaatje.bollaerts@p-95.com.
authors.forename: Kaatje
authors.initials: K
authors.lastname: Bollaerts
authors.affiliation: Federal Agency for Nuclear Control, Brussels, Belgium; Free University Brussels (VUB), ETRO, Brussels, Belgium. Electronic address: michel.sonck@fanc.fgov.be.
authors.forename: Michel
authors.initials: M
authors.lastname: Sonck
authors.affiliation: Scientific Institute of Public Health, OD Public Health and Surveillance, Brussels, Belgium. Electronic address: koen.simons@wiv-isp.be.
authors.forename: Koen
authors.initials: K
authors.lastname: Simons
authors.affiliation: Scientific Institute of Public Health, OD Public Health and Surveillance, Brussels, Belgium. Electronic address: sfierens@wiv-isp.be.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Fierens
authors.affiliation: Federal Agency for Nuclear Control, Brussels, Belgium. Electronic address: andre.poffijn@fanc.fgov.be.
authors.forename: André
authors.initials: A
authors.lastname: Poffijn
authors.affiliation: Federal Agency for Nuclear Control, Brussels, Belgium. Electronic address: lodewijk.vanbladel@fanc.fgov.be.
authors.forename: Lodewijk
authors.initials: L
authors.lastname: Van Bladel
authors.affiliation: Scientific Institute of Public Health, OD Public Health and Surveillance, Brussels, Belgium. Electronic address: dgeraets@dsimprove.be.
authors.forename: David
authors.initials: D
authors.lastname: Geraets
authors.affiliation: Scientific Institute of Public Health, OD Public Health and Surveillance, Brussels, Belgium. Electronic address: polgosselin@hotmail.com.
authors.forename: Pol
authors.initials: P
authors.lastname: Gosselin
authors.affiliation: Scientific Institute of Public Health, OD Public Health and Surveillance, Brussels, Belgium. Electronic address: herman.vanoyen@wiv-isp.be.
authors.forename: Herman
authors.initials: H
authors.lastname: Van Oyen
authors.affiliation: Belgian Cancer Registry, Brussels, Belgium. Electronic address: julie.francart@registreducancer.org.
authors.forename: Julie
authors.initials: J
authors.lastname: Francart
authors.affiliation: Scientific Institute of Public Health, OD Public Health and Surveillance, Brussels, Belgium. Electronic address: an.vannieuwenhuyse@wiv-isp.be.
authors.forename: An
authors.initials: A
authors.lastname: Van Nieuwenhuyse
mesh_terms: D001530:Belgium / Q000453:epidemiology; D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008962:Models, Theoretical; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology*; D055848:Nuclear Power Plants; D012042:Registries; D013964:Thyroid Neoplasms / Q000453:epidemiology*
keywords: Nuclear sites; Prevailing wind directions; Radioactive discharge simulations; Residential proximity; Surrogate-exposure modelling; Thyroid cancer