PP-31-188 Background/Aims: Soft-tissue sarcoma is a rare neoplasia of the connective tissue with unknown etiology. Heavy metals and dioxins, which are also emitted by municipal solid waste incinerators, are among the environmental factors suspected to play a role in its etiology. We assessed the possible relation between long-term exposure to emissions of a municipal solid waste incinerator and risk of soft-tissue sarcoma in the Italian municipality of Reggio Emilia, through a population-based case-control study. Methods: We identified 50 cases of newly diagnosed sarcomas from 2001 to 2008, and we randomly selected 4 population controls for each case, matched for sex and age, of whom we geocoded residential history. We also identified 2 areas of the municipal territory with intermediate and high exposures to emissions of the solid waste incinerator. All this information was added to a Geographical Information System database, to assess exposure status of study subjects, and to calculate the associated relative risk (RR) of soft-tissue sarcoma in a conditional logistic regression model. Results: Three cases of soft-tissue sarcoma occurred among previously exposed subjects. Residence in 1 of the 2 exposed areas was associated with a RR of 0.52 (95% confidence interval [CI]: 0.12–2.37) at disease diagnosis and with a RR of 1.10 (95% CI: 0.28–4.35) 20 years before, after adjusting for educational attainment. When we limited the analysis to highly exposed subjects, we found a RR relative risk of 1.93 (95% CI: 0.32–11.71) at diagnosis and of 3.70 (95% CI: 0.72–18.97) 20 years before. No dose-response relation between exposure status and disease risk was detected. Conclusion: Overall, the risk of soft-tissue sarcoma was increased among subjects with high exposure to incinerator emissions, but risk estimates were statistically very unstable and no evidence of dose-response relation emerged. Larger studies are required to confirm a relation between emissions from waste incineration and incidence of soft-tissue sarcoma.

We tested the usefulness of the National Health Service Databases for investigating the incidence of lymphoid malignancies in an Italian community. We analyzed hospital discharge data, drug prescription, pathologic records and death certificates to identify the new cases of Hodgkin's disease, non Hodgkin's lymphoma, multiple myeloma, and acute and chronic lymphocytic leukemia diagnosed in the municipal population of Reggio Emilia, northern Italy, 1991 through 1996. The completeness of Hospital discharge data was very high, and several incident cases could be identified only through this source. Completeness of the pathologic registry was satisfactory for Hodgkin's disease and non-Hodgkin's lymphoma, and this source independently yielded a few incident cases of lymphoid neoplasms. Analysis of death certificates and drug prescriptions appears to be of limited value in the epidemiology of lymphoproliferative diseases.

We examined the incidence of primary invasive melanoma in the municipality of Reggio Emilia, northern Italy, in the period from 1986 to 1997. We identified 169 cases, five of which were intraocular. After adjustment for confounders, the risk of having a thick melanoma (Breslow > or = 1 mm) did not decrease over time, except in older females. The age-standardized incidence of cutaneous melanoma during the entire study period was 7.57 in males and 11 in females; from 1986-1991 to 1992-1997, it rose from 5.04 to 10.04 cases/100,000 person-years in males and from 8.96 to 13.09 cases/100,000 person-years in females. In males, the increase in incidence was almost entirely confined to subjects aged 30 or more, suggesting a possible cohort effect. We noted rising age-standardized incidences over time both in males with thin tumours (Breslow < 1 mm) (from 2.05 to 4.38 cases/100,000 person-years) and thick tumours (from 2.73 to 5.51 cases/100,000 person-years), while in females the increase was limited to thin melanomas (from 3.14 to 6.93 cases/100,000 person-years), mainly due to an increase in the older age groups (50 69 years and > or =70 years). The increase in thick melanomas among males and the expected cohort effects suggests antecedent exposure to environmental risk factors.

Epidemiological studies on the relation between selenium and human cancer have yielded strongly conflicting results. Prompted by the observation of a positive association between selenium intake and site-specific cancers, including melanoma, in a large cohort of nurses, we studied the 11-year melanoma incidence in an Italian cohort that consumed unusually high levels of inorganic selenium in tap water from 1975 to 1985, The setting was Reggio Emilia, an Italian municipality that provided a natural experiment relating to intake of high levels of inorganic selenium, We identified 2,065 individuals with high selenium exposure, who contributed a total of 20,179 person-years of follow-up, and we compared their experience with the 1,384,386 person-years of follow-up in the remaining population of Reggio Emilia, We included all cases of pathologically confirmed malignant melanoma, including intraocular melanoma, identified from the Reggio Emilia Hospital, the Bologna regional registry of hospital discharges, and the Milan National Cancer Institute. Eight cases of malignant melanoma occurred in the exposed cohort during the follow-up. Melanoma incidence was 3.9 times greater in the exposed than in the unexposed cohort (95% exact confidence limits, 1.8-7.4).