Analysis of Cancers Associated with Radiation in the Area Around

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Analysis of Cancers Associated with Radiation in the Area Around Information Services Division Analysis of cancers associated with radiation in the area around Dalgety Bay, 2008-2017 An update for the Committee on Medical Aspects of Radiation in the Environment (COMARE) 10 December 2019 An Official Statistics publication for Scotland Information Services Division This is an Official Statistics Publication The Official Statistics (Scotland) Order 2008 authorises NHS National Services Scotland (the legal name being the Common Services Agency for the Scottish Health Service) to produce official statistics. All official statistics should comply with the UK Statistics Authority’s Code of Practice which promotes the production and dissemination of official statistics that inform decision making. They can be formally assessed by the UK Statistics Authority’s regulatory arm for National Statistics status. Find out more about the Code of Practice at: https://www.statisticsauthority.gov.uk/osr/code-of-practice/ Find out more about official statistics at: https://www.statisticsauthority.gov.uk/national-statistician/producers-of-official-statistics/ 1 Information Services Division Contents Summary .................................................................................................................................. 3 Introduction .............................................................................................................................. 4 Methods ................................................................................................................................... 5 Results and Commentary ......................................................................................................... 8 Discussion .............................................................................................................................. 12 References ............................................................................................................................. 13 Glossary ................................................................................................................................. 14 Contact ................................................................................................................................... 15 Further Information ................................................................................................................ 15 Rate this publication ............................................................................................................... 15 Appendices ............................................................................................................................ 16 Appendix 1 – List of radiation-associated with cancers ...................................................... 16 Appendix 2 – Publication Metadata .................................................................................... 17 Appendix 3 – Early access details ...................................................................................... 19 Appendix 4 – ISD and Official Statistics ............................................................................. 20 2 Information Services Division Summary • Increased radioactivity levels have been found around Dalgety Bay, Fife, since at least 1990. In 2011, more radioactivity was found in particular locations. It is the result of scrapping luminous aircraft instruments that contained Radium-226, after the Second World War. • The Committee on Medical Aspects of Radiation in the Environment (COMARE) has led investigations of this radioactivity and ISD provided information on cancer occurrence. While there was no overall increase in cancer risk found between 1975 and 2009, COMARE recommended in 2014 that ISD should repeat its analysis of cancer incidence in the area in the future. This report comprises the update of our previous analysis of cancer incidence in the area around Dalgety Bay. • No significant increase in overall risk of cancer in Dalgety Bay was found, compared with the rest of Scotland between 2008 and 2017. No significant increased risk of any single group of cancers was found, including those for which there is stronger research evidence that radiation is a causal factor. • ISD will repeat its analysis of cancer incidence in and around the Dalgety Bay area in the future on the advice of COMARE. 3 Information Services Division Introduction Radioactive particles have been found in the vicinity of the town of Dalgety Bay, Fife, since at least 1990.1 These have been shown to be radium-226 and were deposited in the area as a result of military activity during and shortly after World War II. At this time, an air base was present which was involved in the servicing and disposal of aircraft fitted with components luminised with radium paint. COMARE (the Committee on Medical Aspects of Radiation in the Environment) has led investigations into radiation at Dalgety Bay since 1991. ISD has provided information on cancer occurrence to COMARE and the results have been publically available since at least 1994.1 In 2011, following the discovery of particles of significantly higher radioactivity than had previously been found in Dalgety Bay, restrictions were put in place, including fenced off areas and a ban on fishing. This also led to the 15th report of COMARE,2 which provided a comprehensive history of the site, the nature of the contamination, an assessment of the risk to human health and an analysis of the actual incidence of certain cancers in the area. Although COMARE’s conclusion was that, “the sources present at Dalgety Bay pose a potential risk to public health,” no evidence for a general increased risk of cancer was found in the examination of cancer incidence. The incidences of two specific types of cancer, primary liver and non-Hodgkin lymphoma (NHL), were found to be higher than would be expected between 2000 and 2009, but after a clinical review of liver cancer cases, COMARE concluded that, “It is thus very unlikely that the excess cases of liver cancer or of NHL during 2000–2009, or of [non-melanoma skin cancer] during 1975–2002, are due to the presence of radium-226 in the area.”2 Radiation monitoring and the disposal of contaminated material continue under the supervision of the Scottish Environmental Protection Agency (SEPA) and there is a long term remediation plan in place.3 Following a request from the Chair of COMARE in 2018, ISD has produced this publication. It updates the previous analyses of cancers in the Dalgety Bay area, using similar methodology used to describe cancers in the area between 2000 and 2009 for COMARE. This report covers the period 2008 to 2017 (the latest date for which cancer registrations are published). 4 Information Services Division Methods Cancer is not uncommon and about 2 in 5 people in Scotland will be diagnosed with it at some point in their lives.4 In order to understand whether the numbers of cancers in the Dalgety Bay area were significantly different to anywhere else in Scotland, we compared the incidence in Dalgety Bay to that expected in a population of the same size, in the same calendar years, with the same age, sex and socio-economic circumstances using indirect standardisation. We produced ratios of observed/expected (O/E) numbers, (also known as Standardised Incidence Ratios (SIRs)). We took into account the likelihood of chance findings by giving 99% confidence limits and also reported exact one-sided p-values. The methodology in this report is very similar to that used in previous analyses by ISD but our adjustment for socio-economic deprivation is more precise. Where previously results in Dalgety Bay were compared with those in the least deprived quintile of the Scottish population, this time the expected numbers were obtained from matching each socio- economic decile. We reported on cancers up to the end of December 2017, which was the latest complete year that had been published at the time of writing. There is evidence for associations between some types of cancer and exposure to radiation. In 2006, Boice5 (Appendix 1) categorised these into four groups, from 'frequently' to 'never or sporadically' associated with ionising radiation. Boice's groups were used to structure the results of this report. Additionally, childhood leukaemias are also looked at in a fifth group due to the known association with ionising radiation.6 Records of incident cases of the relevant cancers in the period 2008-2017 were extracted from the Scottish Cancer Registry. The geographical area examined in this report is the same as that used for previous investigations. Dalgety Bay has been defined as the 13 datazones between the Firth of Forth and A921 on the south and north, by Letham Hill to the west and the fields above Braefoot Point to the east – Figure 1. Datazones are small area geographies used by Scottish Neighbourhood Statistics, and are based on groups of 2001 Census output areas, with populations of between 500 and 1,000 residents. (NOTE: where possible, the datazones are drawn to respect physical boundaries and natural communities. They have a regular shape and, as far as possible, contain households with similar social characteristics.) 5 Information Services Division Figure 1: Area in and around Dalgety Bay. Area included in the analysis is highlighted in orange. Dalgety Bay is a relatively affluent area in comparison to the rest of Scotland. All 13 datazones included in the analysis are in the least deprived 40% of the Scottish population, according to the Scottish Index of Multiple Deprivation
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