Long-term health impacts of industrial development: I. Trends in lung cancer mortality among residents living near petrochemical industrial complexes.

The Mailiao petrochemical industrial complexes (PICs), which began operations in 1999, are the largest PIC facility in Taiwan and have operated for 25 years. Since residents living near the Mailiao PICs were found to be exposed to multiple air pollutants for more than two decades, the aim of this study was to examine whether residence near the PIC site was associated with increased mortality rates attributed to lung cancer and to identify change points. Mailiao and Taishi, townships located closest to and within 10 km of PIC, were designated as high-exposure (HE) areas. Four neighboring townships located more than 10 km from PIC- Erlun, Lunbei, Sihhu, and Baojhong, were designated as low-exposure (LE) areas. Standardized mortality ratios (SMRs) for lung cancer were calculated for HE and LE locations from 1989 to 2024. Cumulative-sum (CuSum) analysis was employed to identify temporal changes in mortality rates due to lung cancer. Lung cancer SMRs rose gradually in both genders and at both HE and LE sites following commencement of PIC operation. However, upward trends were more pronounced at HE areas than LE locations for both genders. At HE site, elevated lung cancer SMRs became apparent approximately 16-20 years following commencement of PICs operation. These findings demonstrate a temporal association between PIC operations and increase in mortality frequencies in lung cancer in nearby communities, with a latency period approximately 16-20 years. Further studies incorporating individual-level exposure and major potential confounders are warranted to elucidate the role of long-term petrochemical-related air pollutants in mortality related to lung cancer.