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台湾地区饮用水砷暴露与脑血管疾病死亡率的关系。

The association between arsenic exposure from drinking water and cerebrovascular disease mortality in Taiwan.

机构信息

Department of Environmental and Occupational Health, Medical College, National Cheng Kung University, 138 Sheng Li Road, Tainan 704, Taiwan.

出版信息

Water Res. 2010 Nov;44(19):5770-6. doi: 10.1016/j.watres.2010.05.040. Epub 2010 Jun 1.

Abstract

BACKGROUND

Chronic arsenic exposure is associated with a variety of diseases, including cancer, peripheral vascular disease, and diabetes. However, its association with cerebrovascular diseases (CVD) has not yet been resolved. The aim of this study is to explore this association in Taiwan using nation-wide data.

MATERIALS AND METHODS

We analyzed mortality data in Taiwan from 1971 to 2005 and choose two geographic areas with populations suffering from chronic exposure to arsenic in drinking water for study, the blackfoot disease endemic area (BFDEA) in the southwest and Lan-Yang Basin (LYB) in the northeast parts of Taiwan. The Chia-Yi and Tainan Counties, which surround the BFDEA, and the nation of Taiwan as a whole were used as reference populations. Direct standardized mortality rates and gender-specific indirect standardized mortality ratios (SMRs) were calculated for the four populations.

RESULTS

The direct standardized mortality rate for CVD in Taiwan decreased from 2.46/10(3) person-year in 1971 to 0.63/10(3) person-year in 2005, and women had significantly lower mortality than men (SMR = 0.80; p < 0.05). The CVD mortality rates of populations with chronic arsenic exposure were significantly higher than the reference populations (SMR ranging from 1.06 to 1.09 in men and 1.12 to 1.14 in women; p < 0.05). The BFDEA had higher CVD mortality rates than the LYB, with SMR = 1.05 (p < 0.05) in men and SMR = 1.04 (p = 0.05) in women.

CONCLUSION

In Taiwan, while CVD mortality decreased in both genders between 1971 and 2005, chronic arsenic exposure from drinking water was associated with increased risks of CVD.

摘要

背景

慢性砷暴露与多种疾病有关,包括癌症、外周血管疾病和糖尿病。然而,其与脑血管疾病(CVD)的关系尚未得到解决。本研究旨在利用台湾的全国性数据对此进行探讨。

材料与方法

我们分析了台湾 1971 年至 2005 年的死亡率数据,并选择了两个因饮用水中慢性砷暴露而患病的地理区域进行研究,即台湾西南部的黑脚病流行区(BFDEA)和东北部的兰阳流域(LYB)。嘉义县和台南县环绕 BFDEA,以及整个台湾地区被用作参考人群。对四个人群计算了直接标准化死亡率和性别特异性间接标准化死亡率比(SMR)。

结果

台湾 CVD 的直接标准化死亡率从 1971 年的 2.46/10^3 人年降至 2005 年的 0.63/10^3 人年,女性死亡率明显低于男性(SMR = 0.80;p < 0.05)。慢性砷暴露人群的 CVD 死亡率明显高于参考人群(SMR 范围为男性 1.06 至 1.09,女性 1.12 至 1.14;p < 0.05)。BFDEA 的 CVD 死亡率高于 LYB,男性 SMR = 1.05(p < 0.05),女性 SMR = 1.04(p = 0.05)。

结论

在台湾,1971 年至 2005 年间,两性 CVD 死亡率均有所下降,但饮用水中慢性砷暴露与 CVD 风险增加有关。

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