Environmental Engineering Reference
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Among men, the RRs for a large versus a small area under cultivation are signifi -
cantly elevated for the following malignancies: malignant melanoma (C43 ICD-10;
RR = 1.50; 95% CI 1.18-1.91), prostate cancer (C61 ICD-10: RR = 1.26; 95% CI
1.11-1.43), bladder cancer (C67 ICD-10; RR = 1.31; 95% CI 1.10-1.55), follicular
NHL (C82 ICD-10; RR = 1.98; 95% CI 1.01-3.85), and other and unspecifi ed types of
NHL (C85 ICD-10; RR = 1.84; 95% CI 1.05-3.23). In contrast, we fi nd signifi cantly
decreased RRs for follicular NHL among women (RR = 0.29 (95% CI 0.11-0.76) for
a large vs. a small area under cultivation).
Furthermore RRs are signifi cantly decreased among men for lung cancer
(C34 ICD-10; RR = 0.77; 95% CI 0.64-0.92 for a large vs. a small area under cul-
tivation).
Both men and women showed a slightly elevated RR for all malignancies for com-
munities with medium (men: RR = 1.15; 95% CI 1.09-1.22; women: RR = 1.14; 95%
CI 1.08-1.21) as well as with a large area under cultivation (men: RR = 1.16; 95% CI
1.09-1.23; women: RR = 1.10; 95% CI 1.04-1.17).
When non-melanotic skin cancer was excluded, among men, risk ratios for all
malignancies remained signifi cantly elevated in communities with medium and a large
area under cultivation; among women, solely RRs in communities with a medium area
under cultivation retained signifi cance.
Tables 4 and 5 present SIR for cancer in males and females for winegrowing
communities with small (>0 to ≤5%), medium (>5 to ≤20%), and large (>20%) area
under cultivation using estimated incidence of cancer in the national population of
Germany as reference. As the incompleteness of the Rhineland-Palatinate cancer
registry would tend to result in potentially considerable underestimation, decreased
SIR are not mentioned in the following (and should not be interpreted). The SIRs of
malignant melanoma remains statistically increased in men (SIR for a medium area
under cultivation = 1.17 (95% CI 1.01-1.35), SIR for a large area under cultivation
= 1.31 (95% CI 1.08-1.56)). Furthermore, the SIR for prostate cancer remains sta-
tistically signifi cant: the SIR is 1.18 (95% CI 1.12-1.24) for a medium area under
cultivation and 1.25 (95% CI 1.17-1.34) for a large area under cultivation. The in-
creased incidence of testicular cancer in communities with a large area under wine
cultivation is of borderline statistical signifi cance (SIR = 1.26; 95% CI 0.99-1.57).
Among women, we fi nd an elevated SIR for endometrial cancer in communities
with a large area under cultivation (SIR = 1.43; 95% CI 1.20-1.68). Breast cancer
incidence is increased in communities with a medium area under cultivation (SIR =
1.07; 95% CI 1.02-1.12), but not in communities with a large area under cultivation
(SIR = 0.99; 95% CI 0.92-1.06).
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