Han Yueh-Ying, Weissfeld Joel L, Davis Devra L, Talbott Evelyn O
Center for Environmental Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA.
Int Arch Occup Environ Health. 2009 Jul;82(7):843-9. doi: 10.1007/s00420-008-0362-9. Epub 2008 Oct 22.
Long-term exposure to arsenic above 50 microg/L in drinking water has been related to multiple types of cancers. Few epidemiologic studies conducted in the US have detected an association between regional exposures below this level in drinking water and corresponding cancer occurrence rates. This county-level ecologic study evaluates arsenic levels in ground water and its association with targeted cancer incidence in Idaho, where some regions have been found to contain higher arsenic levels.
Using cancer incidence data (1991-2005) from the Cancer Data Registry of Idaho and arsenic data (1991-2005) from the Idaho Department of Environmental Quality, we calculated the age-adjusted incidence rate for cancers of the urinary bladder, kidney and renal pelvis, liver and bile duct, lung and bronchus, non-Hodgkin's lymphoma (NHL), and all malignant cancers according to arsenic levels in ground water. Multivariate regression analysis was applied to evaluate the relationship between arsenic levels in ground water and cancer incidence.
For males, but not for females, age-adjusted incidence for lung cancer and all malignant cancers was significantly higher in the intermediate arsenic counties (2-9 microg/L, n = 16) and the high arsenic counties (>or=10 microg/L, n = 5) compared to the low arsenic counties (<2.0 microg/L, n = 23). When adjusted for race, gender, population density, smoking and body mass index (BMI), no relationship was found between arsenic levels in ground water and cancer incidence.
In this ecological design, exposure to low-level arsenic in ground water is not associated with cancer incidence when adjusting for salient variables. For populations residing in southwestern Idaho, where arsenic has been found to exceed 10 microg/L in ground water, individual risk assessment is required in order to determine whether there is a link between long-term arsenic exposure at these levels and cancer risk.
长期饮用砷含量超过50微克/升的水与多种癌症有关。在美国进行的少数流行病学研究未检测到饮用水中低于该水平的区域暴露与相应癌症发生率之间的关联。这项县级生态学研究评估了爱达荷州地下水的砷含量及其与特定癌症发病率的关联，该州部分地区被发现砷含量较高。
利用爱达荷州癌症数据登记处的癌症发病率数据（1991 - 2005年）和爱达荷州环境质量部的砷数据（1991 - 2005年），我们根据地下水中的砷含量计算了膀胱癌、肾盂癌、肝癌和胆管癌、肺癌和支气管癌、非霍奇金淋巴瘤（NHL）以及所有恶性癌症的年龄调整发病率。应用多变量回归分析来评估地下水中砷含量与癌症发病率之间的关系。
对于男性而非女性，与低砷县（<2.0微克/升，n = 23）相比，中等砷含量县（2 - 9微克/升，n = 16）和高砷含量县（≥10微克/升，n = 5）的肺癌和所有恶性癌症的年龄调整发病率显著更高。在对种族、性别、人口密度、吸烟和体重指数（BMI）进行调整后，未发现地下水中的砷含量与癌症发病率之间存在关联。
在这种生态学设计中，在调整显著变量后，地下水中低水平的砷暴露与癌症发病率无关。对于居住在爱达荷州西南部的人群，该地区地下水中砷含量已被发现超过10微克/升，需要进行个体风险评估，以确定这些水平的长期砷暴露与癌症风险之间是否存在联系。
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