Breme raka v občini Kanal ob Soči in Goriški statistični regiji ter potencialna povezanost z okoljskimi onesnaževali zaradi sosežiga odpadkov Cancer burden in Kanal ob Soči Municipality and Goriška Statistical Region (Slovenia) and potential association with environmental pollutants due to waste co-incineration

Abstract

Izhodišče: V občini Kanal ob Soči so prebivalci dolgotrajno izpostavljeni preteklemu onesnaženju z azbestom ter sodobnim izpustom iz sosežiga odpadkov v cementarni. Prispevek obravnava časovne trende raka z osredotočenostjo na mezoteliom ter ocenjuje povezavo med okoljskimi onesnaževali in pojavnostjo raka.
Metode: Na podlagi podatkov Registra raka Republike Slovenije so predstavljeni trendi starostno standardiziranih stopenj (SSS) incidence in umrljivosti za vse rake (2001–2020) in mezoteliom (2001–2022) v Kanalu ob Soči, Goriški statistični regiji in Sloveniji. Povzeti so izsledki krovnega pregleda literature o povezavi med rakom in onesnaževali pri sosežigu (1980–2023) ter opisno-korelacijske geografske analize za tveganje raka (vsi, pljučni, ne-Hodgkinov limfom, sarkomi) v obdobju 2011–2020 glede na ocene PM10 in kroma (Cr) v tleh v štirih občinah (Kanal ob Soči, Tolmin, Nova Gorica, Brda).
Rezultati: Incidenca raka v Kanalu ob Soči je višja kot v Goriški regiji in Sloveniji zaradi več mezotelioma, vendar SSS ostaja stabilna, medtem ko v Goriški in Sloveniji narašča. Vrh mezotelioma v Sloveniji je nastopil okoli leta 2004, od obdobja 2014–2022 beležimo letni upad za 3,1 %. Dokazov o povezavi med rakom in onesnaževalci iz sosežiga ni; povezav s PM10 in Cr nismo ugotovili.
Zaključek: Presežek bremena raka v Kanalu ob Soči je predvsem posledica pretekle izpostavljenosti azbestu; vpliva sosežiga nismopotrdili. Razvita metodologija omogoča nadaljnje spremljanje vplivov okolja. Na tej podlagi podajamo predloge za javnozdravstvene ukrepe.

Abstract (Eng)

Background: In the municipality of Kanal ob Soči, residents are exposed to historical asbestos pollution and current emissions from waste co-incineration in a cement plant. This paper discusses the trends over time in the cancer burden with a focus on mesothelioma and assesses the association between environmental pollutants and cancer incidence.
Methods: Using data from the Slovenian Cancer Registry, we present the trends in the age-standardised incidence and mortality rates (ASRs) for all cancers (2001–2020) and mesothelioma (2001–2022) in Kanal ob Soči, the Goriška statistical region, and in Slovenia as a whole. We summarise the findings from an umbrella review on the association between cancer and pollutants from co-incineration (1980–2023), and from a descriptive-correlational geographical analysis of cancer risk (all cancers, lung cancer,  non-Hodgkin lymphoma and sarcomas) in the 2011–2020 period in relation to the estimated PM10 levels and chromium (Cr) in the soil across four municipalities (Kanal ob Soči, Tolmin, Nova Gorica and Brda).
Results: The cancer incidence in Kanal ob Soči is higher than in the Goriška region and in Slovenia as a whole, mainly due to a higher number of mesothelioma cases. However, the ASR remains stable in Kanal ob Soči, while it is increasing in the Goriška region and in Slovenia. The peak of mesothelioma incidence in Slovenia occurred around 2004; from 2014 to 2022, we can observe an annual decline of 3.1%. There is no evidence of an association between cancer and emissions from co-incineration. No links were found with the PM10 or Cr levels.
Conclusion: The excess cancer burden in Kanal ob Soči is primarily due to historical asbestos exposure; the impact of waste co-incineration was not confirmed. The developed methodology enables continued environmental impact monitoring. Based on this, we propose some public health measures.