The Exploration of the Possible Relationship Between Deaths, Births and Air Pollution in Scottish Towns

Abstract

Large-scale geographical patterns of diseases can be seen in most atlases of mortality or morbidity. These patterns reflect ill-defined regional differences of environments composed of intermingled and complex socioeconomic factors. Analysis of these broad patterns, however, may show individual communities that stand out as exceptions. These exceptions provide opportunities for more focused epidemiological and environmental studies to explore the possible environmental causes of these epidemiological abnormalities. In Atlas of mortality in Scotland from 1987, exceptional rates of various diseases were found in several towns. For the investigation of the high rate of lung cancer in one town and for the replication studies of other towns, the communities were subdivided into small areas for the combined epidemiological and environmental investigations and the results were subjected to geographical analysis. The detailed scale of these geographical frameworks suggests some possible mechanisms of environmental toxicity. These studies also demonstrated that two types of data resource might have substantial value for environmental epidemiology when geographical analysis by small area is required. Firstly, to interpret epidemiological studies related to environmental air quality in a community, detailed patterns of airborne pollution should be known. These patterns should be based on measurements of pollutants in samples collected simultaneously at many sampling sites; e.g., low-technology samplers, such as mosses, lichens and soils, collect metallic pollutants in the ambient air. Secondly, for demonstrating the effects of some toxic environments with minimal delay, obstetric data might perform a useful screening function, a view supported by some of our investigations in Scotland.