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Assessing the impact of waste co-incineration at the Anhovo cement plant (Slovenia) on the regional cancer burden

Vesna Zadnik

Vesna Zadnik

Slovenian Cancer Registry, Institute of Oncology LjubljanaLjubljana, Slovenia
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Zadnik, Vesna
, 
Mojca Birk

Mojca Birk

Slovenian Cancer Registry, Institute of Oncology LjubljanaLjubljana, Slovenia
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Birk, Mojca
, 
Teja Oblak

Teja Oblak

Slovenian Cancer Registry, Institute of Oncology LjubljanaLjubljana, Slovenia
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Oblak, Teja
, 
Maja Jurtela

Maja Jurtela

Slovenian Cancer Registry, Institute of Oncology LjubljanaLjubljana, Slovenia
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Jurtela, Maja
, 
Sonja Tomsic

Sonja Tomsic

Slovenian Cancer Registry, Institute of Oncology LjubljanaLjubljana, Slovenia
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Tomsic, Sonja
, 
Katarina Lokar

Katarina Lokar

Slovenian Cancer Registry, Institute of Oncology LjubljanaLjubljana, Slovenia
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Lokar, Katarina
, 
Ana Mihor

Ana Mihor

Slovenian Cancer Registry, Institute of Oncology LjubljanaLjubljana, Slovenia
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Mihor, Ana
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Nika Bric

Nika Bric

Slovenian Cancer Registry, Institute of Oncology LjubljanaLjubljana, Slovenia
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Bric, Nika
, 
Miran Mlakar

Miran Mlakar

Slovenian Cancer Registry, Institute of Oncology LjubljanaLjubljana, Slovenia
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Mlakar, Miran
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Amela Duratovic Konjevic

Amela Duratovic Konjevic

Slovenian Cancer Registry, Institute of Oncology LjubljanaLjubljana, Slovenia
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Konjevic, Amela Duratovic
 and 
Tina Zagar

Tina Zagar

Slovenian Cancer Registry, Institute of Oncology LjubljanaLjubljana, Slovenia
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Zagar, Tina
  
Sep 05, 2025
Assessing the impact of waste co-incineration at the Anhovo cement plant (Slovenia) on the regional cancer burden's Cover Image
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Published Online: Sep 05, 2025
Page range: 412 - 424
Received: Apr 03, 2025
Accepted: Jun 11, 2025
DOI: https://doi.org/10.2478/raon-2025-0050
Keywords
© 2025 Vesna Zadnik et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

FIGURE 1.

Map of the settlements categorized into three zones constructed for point source analysis and the location of the study area in four municipalities in Western Slovenia. The radius r indicates the distance from the three chimneys of the Anhovo cement plant.
Map of the settlements categorized into three zones constructed for point source analysis and the location of the study area in four municipalities in Western Slovenia. The radius r indicates the distance from the three chimneys of the Anhovo cement plant.

FIGURE 2.

Age-standardised cancer incidence rates (Slovenian standard) with the average annual change (expressed as a percentage) in the Kanal municipality, Goriška statistical region and Slovenia in the 2001-2020 period for (A) all cancers and (B) all cancers excluding mesothelioma. Statistically significant (at the 5% level) average annual changes are marked with an asterisk.
Age-standardised cancer incidence rates (Slovenian standard) with the average annual change (expressed as a percentage) in the Kanal municipality, Goriška statistical region and Slovenia in the 2001-2020 period for (A) all cancers and (B) all cancers excluding mesothelioma. Statistically significant (at the 5% level) average annual changes are marked with an asterisk.

FIGURE 3.

Map of the smoothed standardised incidence ratios (SIRs) of all cancers combined (excluding non-melanoma skin cancer) for the 2011–2020 period: (A) for model 4 (with two explanatory variables) with the SI-EDI deprivation index and PM10 concentration in the air by settlement in the municipalities of Brda (B), Kanal (K), Nova Gorica (N) and Tolmin (T); (B) for model 4 with the SI-EDI and PM10 by settlement in the Kanal municipality (K); (C) for model 4 with the SI-EDI and chromium (Cr) content in the soil by selected settlements in the municipality of Kanal (K); where Cr measurements were performed. Codes for settlements: B1 = Barbana; B10 = Dobrovo; B11 = Dolnje Cerovo; B12 = Drnovk; B13 = Fojana; B14 = Golo Brdo; B15 = Gonjače; B16 = Gornje Cerovo; B17 = Gradno; B18 = Hlevnik; B19 = Hruševlje; B2 = Belo; B20 = Hum; B21 = Imenje; B22 = Kojsko; B23 = Kozana; B24 = Kozarno; B25 = Kožbana; B26 = Krasno; B27 = Medana; B28 = Neblo; B29 = Nozno; B3 = Biljana; B30 = Plešivo; B31 = Podsabotin; B32 = Pristavo; B33 = Senik; B34 = Slapnik; B35 = Slavče; B36 = Snežatno; B37 = Snežeče; B38 = Šlovrenc; B39 = Šmartno; B4 = Brdice pri Kožbani; B40 = Vedrijan; B41 = Vipolže; B42 = Višnjevik; B43 = Vrhovlje pri Kojskem; B44 = Vrhovlje pri Kožbani; B45 = Zali Breg; B5 = Brdice pri Neblem; B6 = Breg pri Golem Brdu; B7 = Brestje; B8 = Brezovk; B9 = Ceglo; K1 = Ajba; K10 = Kanal; K11 = Kanalski Vrh; K12 = Levpa; K13 = Lig; K14 = Morsko; K15 = Plave; K16 = Ročinj; K17 = Seniški Breg; K18 = Ukanje; K19 = Zapotok; K2 = Anhovo; K20 = Goljevica; K21 = Kamenca nad Ložicami; K22 = Zagomila; K23 = Zagora; K24 = Paljevo; K25 = Prilesje pri Plavah; K26 = Ravna; K27 = Jesen; K28 = Krstenica; K29 = Čolnica; K3 = Avče; K30 = Ložice; K31 = Močila; K32 = Robidni Breg; K33 = Gorenje Nekovo; K34 = Gorenje Polje; K35 = Dolenje Nekovo; K4 = Bodrež; K5 = Deskle; K6 = Doblar; K7 = Gorenja vas; K8 = Kal nad Kanalom; K9 = Kambreško; N1 = Ajševica; N11 = Dornberk; N12 = Draga; N13 = Gradišče nad Prvačino; N14 = Grgar; N15 = Grgarske Ravne; N16 = Kromberk; N17 = Lazna; N18 = Loke; N19 = Lokovec; N20 = Lokve; N25 = Nemci; N26 = Nova Gorica; N27 = Osek; N29 = Ozeljan; N3 = Banjšice; N30 = Potok pri Dornberku; N31 = Preserje; N32 = Pristava; N33 = Prvačina; N34 = Ravnica; N37 = Rožna Dolina; N38 = Saksid; N39 = Solkan; N4 = Bate; N40 = Spodnja Branica; N41 = Stara Gora; N42 = Steske; N43 = Šempas; N45 = Šmaver; N46 = Šmihel; N47 = Tabor; N48 = Trnovo; N49 = Vitovlje; N5 = Branik; N50 = Voglarji; N54 = Zalošče; N56 = Podgozd; N57 = Dragovica; N58 = Sveta Gora; N59 = Pedrovo; N6 = Brdo; N7 = Budihni; N9 = Čepovan; T1 = Bača pri Modreju; T10 = Drobočnik; T11 = Gabrje; T12 = Gorenja Trebuša; T13 = Gorenji Log; T14 = Gorski Vrh; T15 = Grahovo ob Bači; T16 = Grant; T17 = Grudnica; T18 = Hudajužna; T19 = Idrija pri Bači; T2 = Bača pri Podbrdu; T20 = Kal; T21 = Kamno; T22 = Kanalski Lom; T23 = Klavže; T24 = Kneške Ravne; T25 = Kneža; T26 = Koritnica; T27 = Kozaršče; T28 = Kozmerice; T29 = Kuk; T3 = Bukovski Vrh; T30 = Lisec; T31 = Ljubinj; T32 = Logaršče; T33 = Loje; T34 = Modrej; T35 = Modrejce; T36 = Most na Soči; T37 = Obloke; T38 = Pečine; T39 = Petrovo Brdo; T4 = Čadrg; T40 = Podbrdo; T41 = Podmelec; T42 = Polje; T43 = Poljubinj; T44 = Ponikve; T45 = Porezen; T46 = Postaja; T47 = Prapetno; T48 = Prapetno Brdo; T49 = Roče; T5 = Čiginj; T50 = Rut; T51 = Sela nad Podmelcem; T52 = Sela pri Volčah; T53 = Selce; T54 = Selišče; T55 = Slap ob Idrijci; T56 = Stopnik; T57 = Stržišče; T58 = Šentviška Gora; T59 = Temljine; T6 = Daber; T60 = Tolmin; T61 = Tolminske Ravne; T62 = Tolminski Lom; T63 = Trtnik; T64 = Volarje; T65 = Volčanski Ruti; T66 = Volče; T67 = Zadlaz-Čadrg; T68 = Zadlaz-Žabče; T69 = Zakraj; T7 = Dolenja Trebuša; T70 = Zatolmin; T71 = Znojile; T72 = Žabče; T8 = Dolgi Laz; T9 = Dolje
Map of the smoothed standardised incidence ratios (SIRs) of all cancers combined (excluding non-melanoma skin cancer) for the 2011–2020 period: (A) for model 4 (with two explanatory variables) with the SI-EDI deprivation index and PM10 concentration in the air by settlement in the municipalities of Brda (B), Kanal (K), Nova Gorica (N) and Tolmin (T); (B) for model 4 with the SI-EDI and PM10 by settlement in the Kanal municipality (K); (C) for model 4 with the SI-EDI and chromium (Cr) content in the soil by selected settlements in the municipality of Kanal (K); where Cr measurements were performed. Codes for settlements: B1 = Barbana; B10 = Dobrovo; B11 = Dolnje Cerovo; B12 = Drnovk; B13 = Fojana; B14 = Golo Brdo; B15 = Gonjače; B16 = Gornje Cerovo; B17 = Gradno; B18 = Hlevnik; B19 = Hruševlje; B2 = Belo; B20 = Hum; B21 = Imenje; B22 = Kojsko; B23 = Kozana; B24 = Kozarno; B25 = Kožbana; B26 = Krasno; B27 = Medana; B28 = Neblo; B29 = Nozno; B3 = Biljana; B30 = Plešivo; B31 = Podsabotin; B32 = Pristavo; B33 = Senik; B34 = Slapnik; B35 = Slavče; B36 = Snežatno; B37 = Snežeče; B38 = Šlovrenc; B39 = Šmartno; B4 = Brdice pri Kožbani; B40 = Vedrijan; B41 = Vipolže; B42 = Višnjevik; B43 = Vrhovlje pri Kojskem; B44 = Vrhovlje pri Kožbani; B45 = Zali Breg; B5 = Brdice pri Neblem; B6 = Breg pri Golem Brdu; B7 = Brestje; B8 = Brezovk; B9 = Ceglo; K1 = Ajba; K10 = Kanal; K11 = Kanalski Vrh; K12 = Levpa; K13 = Lig; K14 = Morsko; K15 = Plave; K16 = Ročinj; K17 = Seniški Breg; K18 = Ukanje; K19 = Zapotok; K2 = Anhovo; K20 = Goljevica; K21 = Kamenca nad Ložicami; K22 = Zagomila; K23 = Zagora; K24 = Paljevo; K25 = Prilesje pri Plavah; K26 = Ravna; K27 = Jesen; K28 = Krstenica; K29 = Čolnica; K3 = Avče; K30 = Ložice; K31 = Močila; K32 = Robidni Breg; K33 = Gorenje Nekovo; K34 = Gorenje Polje; K35 = Dolenje Nekovo; K4 = Bodrež; K5 = Deskle; K6 = Doblar; K7 = Gorenja vas; K8 = Kal nad Kanalom; K9 = Kambreško; N1 = Ajševica; N11 = Dornberk; N12 = Draga; N13 = Gradišče nad Prvačino; N14 = Grgar; N15 = Grgarske Ravne; N16 = Kromberk; N17 = Lazna; N18 = Loke; N19 = Lokovec; N20 = Lokve; N25 = Nemci; N26 = Nova Gorica; N27 = Osek; N29 = Ozeljan; N3 = Banjšice; N30 = Potok pri Dornberku; N31 = Preserje; N32 = Pristava; N33 = Prvačina; N34 = Ravnica; N37 = Rožna Dolina; N38 = Saksid; N39 = Solkan; N4 = Bate; N40 = Spodnja Branica; N41 = Stara Gora; N42 = Steske; N43 = Šempas; N45 = Šmaver; N46 = Šmihel; N47 = Tabor; N48 = Trnovo; N49 = Vitovlje; N5 = Branik; N50 = Voglarji; N54 = Zalošče; N56 = Podgozd; N57 = Dragovica; N58 = Sveta Gora; N59 = Pedrovo; N6 = Brdo; N7 = Budihni; N9 = Čepovan; T1 = Bača pri Modreju; T10 = Drobočnik; T11 = Gabrje; T12 = Gorenja Trebuša; T13 = Gorenji Log; T14 = Gorski Vrh; T15 = Grahovo ob Bači; T16 = Grant; T17 = Grudnica; T18 = Hudajužna; T19 = Idrija pri Bači; T2 = Bača pri Podbrdu; T20 = Kal; T21 = Kamno; T22 = Kanalski Lom; T23 = Klavže; T24 = Kneške Ravne; T25 = Kneža; T26 = Koritnica; T27 = Kozaršče; T28 = Kozmerice; T29 = Kuk; T3 = Bukovski Vrh; T30 = Lisec; T31 = Ljubinj; T32 = Logaršče; T33 = Loje; T34 = Modrej; T35 = Modrejce; T36 = Most na Soči; T37 = Obloke; T38 = Pečine; T39 = Petrovo Brdo; T4 = Čadrg; T40 = Podbrdo; T41 = Podmelec; T42 = Polje; T43 = Poljubinj; T44 = Ponikve; T45 = Porezen; T46 = Postaja; T47 = Prapetno; T48 = Prapetno Brdo; T49 = Roče; T5 = Čiginj; T50 = Rut; T51 = Sela nad Podmelcem; T52 = Sela pri Volčah; T53 = Selce; T54 = Selišče; T55 = Slap ob Idrijci; T56 = Stopnik; T57 = Stržišče; T58 = Šentviška Gora; T59 = Temljine; T6 = Daber; T60 = Tolmin; T61 = Tolminske Ravne; T62 = Tolminski Lom; T63 = Trtnik; T64 = Volarje; T65 = Volčanski Ruti; T66 = Volče; T67 = Zadlaz-Čadrg; T68 = Zadlaz-Žabče; T69 = Zakraj; T7 = Dolenja Trebuša; T70 = Zatolmin; T71 = Znojile; T72 = Žabče; T8 = Dolgi Laz; T9 = Dolje

FIGURE 4.

Standardised incidence ratio (SIR) (interpreted as relative risk) with 95% confidence intervals by distance from the three chimneys of the Anhovo cement plant for the analysed cancer types in the 2011–2020 period.
Standardised incidence ratio (SIR) (interpreted as relative risk) with 95% confidence intervals by distance from the three chimneys of the Anhovo cement plant for the analysed cancer types in the 2011–2020 period.

Standardised incidence ratios (SIRs) with 95% confidence intervals (CIs) by PM10 concentration category and by categories of Chromium (Cr) content in soil for the analysed cancer types for the 2011–2020 period in the municipality of Kanal at two spatial levels (by settlements and by 1 km × 1 km grid)_

Settlements 1 km × 1 km grid
Category Incidence Population SIR [95% CI] cidence Population SIR [95% CI]
Lung cancer PM10 concentration in the air
3 (highest) 12 1,010 1.49 [0.77–2.60] 12 880 1.68 [0.87–2.94]
2 (middle) 16 2,267 0.89 [0.51–1.44] 15 2,362 0.78 [0.44–1.29]
1 (lowest) 15 2,205 0.89 [0.50–1.46] 19 2,535 0.97 [0.58–1.51]
Chromium (Cr) content in soil
3 (highest) 0 100 / 1 57 2.49 [0.06–13.87]
2 (middle) 15 1,716 1.04 [0.58–1.72] 16 1,778 1.10 [0.63–1.78]
1 (lowest) 13 1,626 1.01 [0.54–1.73] 11 1,710 0.85 [0.42–1.51]
Non-Hodgkin’s lymphoma PM10 concentration in the air
3 (highest) 3 1,010 2.62 [0.54–7.64] 4 880 4.18 [1.14–10.71]
2 (middle) 3 2,267 1.21 [0.25–3.52] 2 2,362 0.82 [0.10–2.96]
1 (lowest) 0 2,205 / 0 2,535 /
Chromium (Cr) content in soil
3 (highest) 1 100 / 0 57 /
2 (middle) 1 1,716 / 2 1,778 /
1 (lowest) 0 1,626 / 0 1,710 /
Sarcoma PM10 concentration in the air
3 (highest) 2 1,010 1.32 [0.16–4.78] 1 880 0.80 [0.02–4.48]
2 (middle) 2 2,267 0.59 [0.07–2.13] 2 2,362 0.59 [0.07–2.14]
1 (lowest) 4 2,205 1.20 [0.35–3.31] 5 2,535 1.48 [0.48–3.45]
Chromium (Cr) content in soil
3 (highest) 0 100 / 0 57 /
2 (middle) 2 1,716 0.63 [0.08–2.28] 2 1,778 0.62 [0.07–2.24]
1 (lowest) 4 1,626 1.50 [0.41–3.85] 4 1,710 1.49 [0.41–3.82]
Language:
English
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Journal Subjects:
Medicine, Clinical Medicine, Internal Medicine, Haematology, Oncology, Radiology
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