 this study assesses whether deprived populations living close to industry experience greater mortality from lung cancer than populations with comparable socioeconomic characteristics living farther away . mortality data , census data , a postal survey of living circumstances , historic and contemporary data on air quality and a historic land - use survey were used . 
 analysis was based on two conurbations in england , teesside and sunderland . 
 housing estates in teesside were selected based on socioeconomic criteria and distinguished by proximity to steel and chemical industries ; they were grouped into three zones : near ( a ) , intermediate ( b ) , and farther ( c ) , with a single zone in sunderland . 
 we included 14,962 deaths in 27 estates . 
 standardized mortality ratios ( smr ) for lung cancer [ international classification of diseases # 9 ( icd-9 ) 162 ] and cancers other than lung ( icd-9 140 - 239 , excluding 162 ) , and sex ratios were calculated . 
 mortality from lung cancer was well above national levels in all zones . 
 for men , a weak gradient corresponding with proximity to industry at younger ages reversed at older ages . in women 0 - 64 years of age , stronger gradients in lung cancer mortality corresponded with proximity to industry across zones a , b , and c ( smr = 393 , 251 , 242 , respectively ) . 
 overall rates in teesside were higher than sunderland rates for women aged 0 - 64 years ( smr = 287 vs. 185 ) and 65 - 74 years ( smr = 190 vs. 157 ) . 
 the association between raised lung cancer mortality and proximity to industry in women under 75 years of age could not be explained by smoking , occupation , socioeconomic factors , or artifact . 
 explanations for differences between men and women may include gender - specific occupational experiences and smoking patterns . 
 our judgment is that the observed gradient in women points to a role for industrial air pollution.imagesfigure 1figure 2 
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