Kurttio P, Pukkala E, Kahelin H, Auvinen A, Pekkanen J
National Public Health Institute, Unit of Environmental Epidemiology, Kuopio, Finland.
Environ Health Perspect. 1999 Sep;107(9):705-10. doi: 10.1289/ehp.99107705.
We assessed the levels of arsenic in drilled wells in Finland and studied the association of arsenic exposure with the risk of bladder and kidney cancers. The study persons were selected from a register-based cohort of all Finns who had lived at an address outside the municipal drinking-water system during 1967-1980 (n = 144,627). The final study population consisted of 61 bladder cancer cases and 49 kidney cancer cases diagnosed between 1981 and 1995, as well as an age- and sex-balanced random sample of 275 subjects (reference cohort). Water samples were obtained from the wells used by the study population at least during 1967-1980. The total arsenic concentrations in the wells of the reference cohort were low (median = 0.1 microg/L; maximum = 64 microg/L), and 1% exceeded 10 microg/L. Arsenic exposure was estimated as arsenic concentration in the well, daily dose, and cumulative dose of arsenic. None of the exposure indicators was statistically significantly associated with the risk of kidney cancer. Bladder cancer tended to be associated with arsenic concentration and daily dose during the third to ninth years prior to the cancer diagnosis; the risk ratios for arsenic concentration categories 0.1-0.5 and [Greater/equal to] 0.5 microg/L relative to the category with < 0.1 microg/L were 1.53 [95% confidence interval (CI), 0.75-3.09] and 2.44 (CI, 1.11-5.37), respectively. In spite of very low exposure levels, we found some evidence of an association between arsenic and bladder cancer risk. More studies are needed to confirm the possible association between arsenic and bladder cancer risk at such low exposure levels.
我们评估了芬兰钻井水中的砷含量,并研究了砷暴露与膀胱癌和肾癌风险之间的关联。研究对象选自一个基于登记的队列,该队列包含1967年至1980年期间居住在市政饮用水系统以外地址的所有芬兰人(n = 144,627)。最终的研究人群包括1981年至1995年期间诊断出的61例膀胱癌病例和49例肾癌病例,以及275名年龄和性别均衡的随机样本对象(参照队列)。至少在1967年至1980年期间从研究人群使用的水井中采集水样。参照队列水井中的总砷浓度较低(中位数 = 0.1微克/升;最大值 = 64微克/升),1% 的样本超过10微克/升。砷暴露通过水井中的砷浓度、每日剂量和砷的累积剂量来估算。没有任何暴露指标与肾癌风险存在统计学显著关联。膀胱癌倾向于与癌症诊断前第三至第九年的砷浓度和每日剂量相关;相对于<0.1微克/升的类别,砷浓度类别为0.1 - 0.5和≥0.5微克/升的风险比分别为1.53 [95%置信区间(CI),0.75 - 3.09] 和2.44(CI,1.11 - 5.37)。尽管暴露水平极低,但我们发现了一些砷与膀胱癌风险之间存在关联的证据。需要更多研究来证实如此低暴露水平下砷与膀胱癌风险之间可能存在的关联。