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Cancer risk in the residents of a town near three industrial waste incinerators in Korea: a retrospective cohort study

  • Original Article
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Abstract

Background

Three industrial waste incinerators (IWIs) were built in 1999, 2001, and 2010, within a 3 km radius of a town with a population of around 5000 in Korea. This study evaluated whether residents near these three IWIs had increased cancer incidence than those from other areas in Korea using regional health data.

Methods

Standardized incidence ratios (SIR) were calculated using the frequency of cancer cases in the National Cancer Registry of the exposed area (Buki-myeon), Chungcheongbuk-do (Chungbuk, state including Buki-myeon), and whole Korea from 1999 to 2017. A retrospective cohort was created using National Health Insurance System data from 2002 to 2018. The exposed group was defined as those having a residential history in the exposed area. The control group was defined as those having a residential history in nearby towns or counties in Chungbuk, excluding counties having living and cultural areas in other provinces and cities. Hazard ratio (HR) and 95% confidence intervals (CI) were estimated using the Cox proportional hazard model adjusted for age, level of health insurance fee, and smoking history.

Results

In the ecological study using National Cancer Registry data, the risk of all cancers, all cancers excluding thyroid, esophageal, stomach, and lung cancers in the exposed area were 1.13 (95% CI 1.03–1.24), 1.15 (95% CI 1.04–1.26), 1.91 (95% CI 1.13–2.89), 1.39 (95% CI 1.14–1.66), and 1.29 (95% CI 1.03–1.57) times higher than in whole Korea among exposed males, respectively. In the retrospective cohort, 4300 males (26,821 person-years) and 3796 females (24,746 person-years) in exposed group, 150,964 males (1,212,010 person-years) and 134,535 females (1,104,025 person-years) in control group were analyzed. After adjusting for several confounding factors, the risks for gallbladder cancer among males and kidney cancer among females were 2.65 (95% CI 1.38–5.06) and 2.82 (95% CI 1.13–7.03) times higher in the exposed group versus the control group, respectively.

Conclusions

Cancer risk was higher in Koreans having residential history living near IWIs compared to the other areas. Further study warrants nationwide effects and longer follow-up of WIs for cancers in Korea.

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Availability of data and materials

Data are available from the Korean National Cancer Control Institute (KNCCI) and the Korean National Health Insurance System (KNHIS). However, the data cannot be shared publicly because KNCCI and KNHIS do not allow researchers to provide data personally or share it publicly. No researcher is permitted to export raw data from KNHIS.

Abbreviations

AAPC:

Average annual percent change

APC:

Annual percent change

ASR:

Age-standardized incidence rate

CI:

Confidence interval

DB:

Database

HR:

Hazard ratio

IARC:

International Agency Research on Cancer

ICD-10 code:

International classification of diseases, 10th revision

IWI:

Industrial waste incinerator

KNCCI:

Korean National Cancer Control Institute

KNHIS:

Korean National Health Insurance System

KOSIS:

Korean Statistical Information Service

PCB:

Polychlorinated biphenyls

PCDD/F:

Polychlorinated dibenzo-p-dioxins and furans

PIN:

Personal Identification Number

POP:

Persistent organic pollutants

SIR:

Standardized incidence ratio

TCDD:

2378-Tetrachlorodibenzo-p-dioxin

TSP:

Total suspended particles

WI:

Waste incinerator

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Funding

This work was supported by a grant from the National Institute of Environmental Research (NIER), funded by the Ministry of Environment (MOE) of the Republic of Korea (NIER-2019-04-02-069).

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Authors and Affiliations

  1. Department of Preventive Medicine, Dankook University College of Medicine, 119 Dandaero, Dongnam-gu, Cheonan, Chungnam, 31116, Republic of Korea

    Kyung-Hwa Choi, Hyungryul Lim, Mina Ha & Ho-Jang Kwon

  2. Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Sanghyuk Bae

  3. Environmental Health Research Department, National Institute of Environmental Research, Incheon, Republic of Korea

    Mira Yoon

  4. Department of Preventive Medicine, College of Medicine, Chungbuk National University, Cheongju, 28644, Republic of Korea

    Seonmi Hong, Sang-Yong Eom, Yong-Dae Kim & Heon Kim

  5. Chungbuk Regional Cancer Center, Chungbuk National University Hospital, Cheongju, 28644, Republic of Korea

    Yong-Dae Kim & Heon Kim

Authors
  1. Kyung-Hwa Choi
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  2. Hyungryul Lim
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  3. Sanghyuk Bae
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  4. Mina Ha
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Contributions

K-HC performed the statistical analysis and drafted the manuscript. HL and S-YE participated in the review and writing of the manuscript. SB, MH and HK provided a critical appraisal of the manuscript. SH and MY participated in the coordination and the execution of data. Y-DK and H-JK coordinated the study design and provided a critical appraisal of the manuscript. All the authors read and approved the final manuscript.

Corresponding authors

Correspondence to Ho-Jang Kwon or Yong-Dae Kim.

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Conflict of interest

The authors declared that they have no competing interests.

Ethics approval and consent to participate

There was no requirement for written informed consent in this study owing to the use of secondary data. The study protocol was approved by the Institutional Review Board at Chungbuk National University (CBNU-202012-HRBR-0207).

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Choi, KH., Lim, H., Bae, S. et al. Cancer risk in the residents of a town near three industrial waste incinerators in Korea: a retrospective cohort study. Int Arch Occup Environ Health 95, 1829–1843 (2022). https://doi.org/10.1007/s00420-022-01875-3

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