Authors Teja Oblak Onkološki inštitut Ljubljana Tanja Carli Univerza v Ljubljani, Medicinska fakulteta Vesna Zadnik Onkološki inštitut Ljubljana Niko Samec Univerza v Mariboru, Fakulteta za strojništvo Andreja Kukec Univerza v Ljubljani, Medicinska fakulteta DOI: https://doi.org/10.25670/oi2023-007on Keywords: cancer, neoplasms, waste, incineration, co-incineration, cement plant, pollutants Abstract

Izhodišča: V procesih sežiga in sosežiga odpadkov ter proizvodnje cementa se v okolje sproščajo izpusti, ki vsebujejo različna onesnaževala. Z namenom oceniti povezanost med rakom pri poklicno izpostavljenih in okoliških prebivalcih ter izpostavljenostjo okoljskim onesnaževalom iz sežigalnic, naprav za sosežig in cementarn smo si za cilj zadali izdelavo krovnega pregleda literature. Metode: V krovni pregled literature so bile vključene metaanalize in sistematični pregledi literature v angleščini v obdobju od leta 1980 do leta 2023. Iskanje je bilo izvedeno v štirih podatkovnih zbirkah (PubMed, Scopus, Web of Science, Cochrane Reviews). Kakovost je bila ocenjena z orodjema AMSTAR-2 (metodologija) in GRADE (dokazi). Rezultati: Izmed 7.701 opredeljenih dokumentov jih je bilo v končno analizo vključenih 14 (pet metaanaliz, devet sistematičnih pregledov). Obstajajo nizki do zmerni dokazi o povezanosti med sarkomom mehkih tkiv in ne-Hodgkinovim limfomom z izpostavljenostjo dioksinom v okolici sežigalnic I. generacije, česar študije niso dokazale za sežigalnice naslednjih generacij. Zaenkrat ne razpolagamo z dokazi za sosežig. Pri delavcih v cementarnah I. do II. generacije obstaja nekaj zmernih dokazov o povezanosti med incidenco vseh rakov, pljučnega raka, raka ustne votline in žrela, prostate in želodca z izpostavljenostjo šestvalentnemu kromu. Velika večina dokazov je omejenih zaradi mešanih rezultatov, razlik v tehniki vprašanj, heterogenosti in potencialni pristranosti. Zaključek: Obstajajo omejeni dokazi o povezanosti med rakom in izpostavljenostjo onesnaževalom iz sežigalnic I. in cementarn I. do II. generacije. Za oceno morebitne povezanosti med rakom in onesnaževali iz najsodobnejših naprav za sosežig je smiselno načrtovati ciljane epidemiološke študije in študije notranje izpostavljenosti z uporabo humanega biomonitoringa.

Abstract (Eng)

Introduction: During the process of waste incineration, co-incineration and cement production, various emissions are released into the environment containing different pollutants. The aim was to assess a possible association between exposure to pollutants emitted from co-/incinerators and cement plants and cancer in occupationally exposed persons and residents living near these plants. Methods: Inclusion criteria for the umbrella review were meta-analyses and systematic literature reviews, English, period 1980– 2023. Searches were performed in 4 databases (PubMed, Scopus, Web of Science, Cochrane Reviews). The quality of documents was assessed by AMSTAR-2 (methodology) and GRADE (evidence) tools. Results: Of 7 701 documents, 14 were finally included (5 meta- -analyses, 9 systematic reviews). There is some low to moderate evidence of an association between soft tissue sarcomas and non-Hodgkin lymphomas in population exposed to dioxins near I. generation incinerators, but there is no evidence for next generation incinerators. To date, there is no evidence for co-incinerators. There is moderate evidence for an association between incidence of all cancers, lung, prostate, stomach and oropharyngeal cancer and exposure to chromium in occupationally exposed persons at I.-II. generation cement plants. Most of the evidence is limited due to mixed results, differences in questionˊ technique, heterogeneity, and potential bias. Conclusions: There is limited evidence for an association between cancer and exposure to pollutants emitted from I. generation incinerators and I.-II. generation cement plants. To evaluate the possible association between pollutant emissions from the most modern co-incinerators, it seems reasonable to plan targeted epidemiological studies and human biomonitoring studies.

Published

2023-12-13 — Updated on 2023-12-18

Versions How to Cite

Oblak , T., Carli, . T., Zadnik, V., Samec, N., & Kukec, A. (2023). Correlation between cancer and pollutants formed from waste incineration and co-incineration processes: an umbrella review . Onkologija : A Medical-Scientific Journal, 27(2), 26–38. https://doi.org/10.25670/oi2023-007on (Original work published December 13, 2023)

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Scientific Review Article

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