Cause - specific morbidity study of a population Cause - specific morbidity study of a population

exposed to 50 Hz magnetic fieldsexposed to 50 Hz magnetic fields

Lucia Fazzo Lucia Fazzo 11, Valeria Tancioni , Valeria Tancioni 22, Nicola Vanacore , Nicola Vanacore 33, Paolo Papini , Paolo Papini 22, ,

Ivano Iavarone Ivano Iavarone 11, Sara Farchi , Sara Farchi 22, Caterina Bruno , Caterina Bruno 11, Alessandro Polichetti , Alessandro Polichetti 44, ,

Piero Borgia Piero Borgia 22, Pietro Comba , Pietro Comba 11

1) Istituto Superiore di Sanità, Dept. of Environment and Primary Prevention, Rome , Italy

2) Latium Region Agency for Public Health, Rome, Italy

3) Istituto Superiore di Sanità, National Centre for Epidemiology, Surveillance and Health Promotion, Rome, Italy

4) Istituto Superiore di Sanità, Dept. of Technology and Health, Rome, Italy

ISEE/ISEA ConferenceISEE/ISEA Conference

Paris, France, sept. 2-6, 2006Paris, France, sept. 2-6, 2006

FOREWORDFOREWORD

Extremely low frequency (essentially 50/60 Hz) magnetic

fields have been categorized by IARC (2002)

as “Possibly carcinogenic to humans” (Group 2B)

The authors of two pooled analyses of case-control studies

on childhood leukemia and magnetic field exposure

(Ahlbom et al, 2000; Greenland et al, 2000) have recommended

to conduct future studies in populations exposed to relatively high

exposure levels (approximetely, > 0.4-0.5 microtesla)

In this context ISS designed the “Longarina” project,

an epidemiologic study on a district of Ostia Antica (Rome)

built in the fifties under a 60 kV distribution line

EVALUATION EVALUATION OF MAGNETIC FIELD EXPOSUREOF MAGNETIC FIELD EXPOSURE

Spot and long term measurements of magnetic induction Spot and long term measurements of magnetic induction

with Emdex Lite equipment produced by Enertech Consultantswith Emdex Lite equipment produced by Enertech Consultants

Theoretical evaluation was performed by CAMPI software

(Dr. Daniele Andreuccetti of “Nello Carrara” Institute of Applied

Physic of National Research Council in Florence), based

on geometric configuration of electric line and current

data from 1/1/1995 to 30/9/2004, both provided

by ACEA SpA, and distance of dwellings from the line

 

CURRENT LOAD ON AUGUST 4th 2004CURRENT LOAD ON AUGUST 4th 2004

MAGNETIC INDUCTION MEASURED ON AUGUST 4th 2004

THE STUDY POPULATION:THE STUDY POPULATION: INCLUSION CRITERIAINCLUSION CRITERIA

All subjects resident in any period between 1954 and 2003 in an

area 100 meters right and left of the power line: 357 subjects

We defined three sub-cohorts, based on the distance We defined three sub-cohorts, based on the distance

from the line and on the estimated exposure level:from the line and on the estimated exposure level:

A) the residents in dwellings closest to the line A) the residents in dwellings closest to the line (0-28 mt)(0-28 mt), ,

completely exposed above completely exposed above 0,4 0,4 µµT T (value estimated for an electric(value estimated for an electric current of 389 A, the maximum value registered in the last years)current of 389 A, the maximum value registered in the last years)

R) the residents in dwellings farthest from the line R) the residents in dwellings farthest from the line

(33-100 mt)(33-100 mt), completely exposed below , completely exposed below 0,33 0,33 µµT T (389 A)(389 A)

B) the residents in dwellings with parts of the buildings B) the residents in dwellings with parts of the buildings

at intermediate distances from the line, at intermediate distances from the line,

not satisfying the inclusion criteria of A and Rnot satisfying the inclusion criteria of A and R

21

MORTALITY STUDYMORTALITY STUDY

Follow-up: 1980-2003; reference population: RegionFollow-up: 1980-2003; reference population: Region

Results:Results:

All-causes mortalityAll-causes mortality of the cohort did not differ from expected values of the cohort did not differ from expected values (SMR 0.99, 95%CI: 0.73-1.35; 40 obs.)(SMR 0.99, 95%CI: 0.73-1.35; 40 obs.)

All cancer mortalityAll cancer mortality showed a non-significant increase (SMR 1.34, 95%CI: 0.82-showed a non-significant increase (SMR 1.34, 95%CI: 0.82-

2.18; 16 obs.), that reached statistical significance in the analyses limited to 2.18; 16 obs.), that reached statistical significance in the analyses limited to

subjects with more than 30 years of residence (SMR 2.09; 8 obs.), or of latency subjects with more than 30 years of residence (SMR 2.09; 8 obs.), or of latency

(SMR 2.24; 9 obs).(SMR 2.24; 9 obs).

All cancer mortalityAll cancer mortality was highest in the subcohort closest to the power line (0-was highest in the subcohort closest to the power line (0-28 meters) and exposed to highest levels of magnetic field (SMR 1.94, 95%CI: 28 meters) and exposed to highest levels of magnetic field (SMR 1.94, 95%CI: 0.97-3.88; 8 obs). 0.97-3.88; 8 obs).

A significantly increased risk forA significantly increased risk for digestive tract neoplasmsdigestive tract neoplasms (SMR 3.57; 5 obs)(SMR 3.57; 5 obs)

was observed, which was mainly caused bywas observed, which was mainly caused by pancreatic cancerpancreatic cancer (SMR 8.19; 4(SMR 8.19; 4

obs).obs). Mortality fromMortality from lymphohaematopoietic malignancies lymphohaematopoietic malignancies was increased based was increased based

on two cases of leukemia (SMR 2.10, 95%CI: 0.53-8.41; 2 obs). on two cases of leukemia (SMR 2.10, 95%CI: 0.53-8.41; 2 obs).

Fazzo et al, Epidemiol Prev 2005; 29:243-252Fazzo et al, Epidemiol Prev 2005; 29:243-252

MORBIDITY STUDYMORBIDITY STUDY

Objective: Objective: To investigate the occurrence of nonfatal diseases

and to have access to hospital discharge files

which are more accurate than death certificates

Methods: Methods: We analyzed the hospital discharge records of Latium Region

for cohort members, from 1st January, 1998

through 31st December, 2003 (331 subjects)

We considered the first-visit hospital discharge record

for selected causes of each subject, subsequent

to the beginning of residence in the study area

Standardized morbidity ratios (SMR’s),

using regional population as reference,

were computed, with 95% Confidence Intervals

MORBIDITY STUDY: RESULTS 1MORBIDITY STUDY: RESULTS 1We found 83 first-visit hospital discharge cards of study subjectsWe found 83 first-visit hospital discharge cards of study subjects

All cancerAll cancer:

non-statistically significant increase in the overall cohort

(SMR 1.25, 95%CI: 0.85-1.83; 26 obs.)

significant increase among the subjects closest (0-28 mt) to the line (SMR 1.94; 16 obs)

Primary neoplasmsPrimary neoplasms:

non-statistically significant increase in the overall cohort

(SMR 1.61, 95%CI: 0.98-2.62; 16 obs)

significant increase among subjects with more than 30 years of residence

(SMR 1.96; 10 obs) and latency (SMR 1.94; 11 obs)

significant increase among subjects closest (0-28mt) to the line (SMR 2.29; 9 obs)

Pancreatic cancer:

significant increase among men significant increase among men (SMR 16; 2 obs)(SMR 16; 2 obs)

significant increase among the subjects closest (0-28 mt) to the line significant increase among the subjects closest (0-28 mt) to the line (SMR 23; 2 obs)(SMR 23; 2 obs)

MORBIDITY STUDY: RESULTS 2

Secondary and unspecified neoplasms:

significant increase among men in the overall cohort (SMR 4.77; 4 obs)

significant increase among the subjects closest (0-28 mt) to the line

(SMR 6.20; 4 obs)

Haematological diseases:

significant increase in the overall cohort significant increase in the overall cohort (SMR 3.13; 6 obs.)(SMR 3.13; 6 obs.)

significant increase among subjects with more than 30 years of residence significant increase among subjects with more than 30 years of residence

(SMR 5.39; 4 obs)(SMR 5.39; 4 obs) and latency and latency (SMR 5.80; 5 obs)(SMR 5.80; 5 obs)

Ischaemic heart disease:

significant increase among the subjects closest (0-28 mt) to the line significant increase among the subjects closest (0-28 mt) to the line

(SMR 2.82; 6 obs)(SMR 2.82; 6 obs)

CONCLUDING REMARKSCONCLUDING REMARKS

The findings of mortality and morbidity studies, The findings of mortality and morbidity studies, even if based on a small number of subjects, support even if based on a small number of subjects, support

the hypothesis of an anomaly in the health status the hypothesis of an anomaly in the health status of the study population, in particular among subjects of the study population, in particular among subjects

with the longest residence and latency (more than 30 years), with the longest residence and latency (more than 30 years), and among those resident closest (0-28 mt) to the power lineand among those resident closest (0-28 mt) to the power line

Further evaluation of these findings, together with those of Further evaluation of these findings, together with those of an on-going cross-sectional health survey, an on-going cross-sectional health survey,

will help us to gain deeper insightwill help us to gain deeper insight

In the meanwhile, suitable locations for replicating In the meanwhile, suitable locations for replicating the study are being researched; a pilot study the study are being researched; a pilot study

in a district of Pisa is currently in progressin a district of Pisa is currently in progress

Thank you for your attention.

Thanks to my colleagues, to the whole community

involved in this research, and especially to the

local Committee “against the power line”