An epidemiological study of respiratory cancer in West Lothian

• Main Author: Lloyd, O. L.
• Published: University of Edinburgh 1978
• Subjects: 610.7343
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.653980

Towards the end of the 1960s there was a sudden and sustained increase in the general mortality rates (crude and standardised) and in the numbers of deaths from respiratory cancer in Armadale burgh, West Lothian: the data appeared in routine publications of the Registrar General for Scotland. The present study constitutes an investigation of this phenomenon. Firstly, it was demonstrated that the increased incidence of respiratory cancer in Armadale was real, and not due to clerical, diagnostic, or statistical artefact. The sources of data used included the Annual Reports of the Registrar General for Scotland, parish death certificates, hospital morbidity records and statistics, the Regional Cancer Registry, and clinical files at the local general hospital. The contributions of other common diseases to the increased general mortality rates were identified. The incidence of respiratory cancer in other communities in West Lothian and Lanarkshire was investigated. Secondly, causes for the excessive incidence of respiratory cancer in Armadale were sought amongst some of the attributes of the victims of the diseases: age, sex, occupation, smoking history, and the anatomical site and histological type of the cancer. Thirdly, potentially carcinogenic factors in the air, soil and water of Armadale's environment were investigated. These factors included general air pollution and some metallic pollutants from past and present industrial activities in and around the burgh. Fourth, a district of the burgh was identified where there was a significant geographical clustering of the death-residences of the victims of respiratory cancer. This clustering was related to a local source of industrial pollution. Fifthly, the hypothesis of causation was tested by, and supported by, the results from another study of respiratory cancer within a similar community, nearby. Further support for the hypothesis came through the process of diagnosis by exclusion, the roles of other potential sources of pollution - both local and district - in the outbreak of respiratory cancer in Armadale were investigated and eliminated.