Department of Internal Medicine, Changhua Christian Hospital, 135, Nan-Hsiao Street, Changhua 500, Taiwan.
BMC Public Health. 2010 Feb 12;10:67. doi: 10.1186/1471-2458-10-67.
To explore if exposures to specific heavy metals in the environment is a new risk factor of oral cancer, one of the fastest growing malignancies in Taiwan, in addition to the two established risk factors, cigarette smoking and betel quid chewing.
This is an observational study utilized the age-standardized incidence rates of oral cancer in the 316 townships and precincts of Taiwan, local prevalence rates of cigarette smoking and betel quid chewing, demographic factors, socio-economic conditions, and concentrations in farm soils of the eight kinds of heavy metal. Spatial regression and GIS (Geographic Information System) were used. The registration contained 22,083 patients, who were diagnosed with oral cancer between 1982 and 2002. The concentrations of metal in the soils were retrieved from a nation-wide survey in the 1980s.
The incidence rate of oral cancer is geographically related to the concentrations of arsenic and nickel in the patients' residential areas, with the prevalence of cigarette smoking and betel quid chewing as controlled variables.
Beside the two established risk factors, cigarette smoking and betel quid chewing, arsenic and nickel in farm soils may be new risk factors for oral cancer. These two kinds of metal may involve in the development of oral cancer. Further studies are required to understand the pathways via which metal in the farm soils exerts its effects on human health.
为了探索环境中特定重金属暴露是否是台湾地区癌症发病率增长最快的恶性肿瘤之一——口腔癌的新的危险因素，除了已确定的两个危险因素，即吸烟和嚼槟榔，我们进行了这项观察性研究。
本研究利用台湾 316 个乡镇和分区的口腔癌年龄标准化发病率、当地吸烟和嚼槟榔流行率、人口统计学因素、社会经济条件以及 8 种重金属在农田土壤中的浓度，进行了空间回归和 GIS（地理信息系统）分析。该登记册包含了 1982 年至 2002 年间被诊断为口腔癌的 22083 名患者。土壤中金属的浓度是从 20 世纪 80 年代的全国范围内的调查中检索到的。
口腔癌的发病率与患者居住地区砷和镍的浓度在地理上相关，以控制吸烟和嚼槟榔的流行率。
除了已确定的两个危险因素，即吸烟和嚼槟榔，农田土壤中的砷和镍可能是口腔癌的新的危险因素。这两种金属可能参与了口腔癌的发生。需要进一步的研究来了解农田土壤中的金属通过哪些途径对人类健康产生影响。
