Department of Environmental Health, Harvard School of Public Health, 401 Park Drive, 3-112-12 East, Boston, MA 02215, USA.
Environ Health Prev Med. 2011 May;16(3):164-70. doi: 10.1007/s12199-010-0182-x. Epub 2010 Sep 29.
Long-term exposure to inorganic arsenic is related to increased risk of cancer in the lung, skin, bladder, and, possibly, other sites. However, little is known about the consequences of developmental exposures in regard to cancer risk. During early summer in 1955, mass arsenic poisoning of infants occurred in the western part of Japan because of contaminated milk powder. Okayama Prefecture was most severely affected. We examined whether the affected birth cohorts in this prefecture experienced increased cancer mortality.
We targeted subjects who were born from September 1950 to August 1960 and died in Okayama Prefecture between January 1969 and March 2008 due to malignant neoplasm (N = 3,141). We then compared cancer mortality (total, liver, pancreatic, lung, bladder/kidney, and hematopoietic cancers) between cohorts born before the milk poisoning (exposed group) and cohorts born after the poisoning (nonexposed group). We estimated mortality ratios and 95% confidence intervals.
Total and liver cancers were elevated in the cohort up to 1 year of age at time of the poisoning. In addition, pancreatic and hematopoietic cancers were elevated in the cohorts up to 5 years of age, and mortality ratios were approximately twice those of the nonexposed group. Increased risk of lung and bladder/kidney cancers was not apparent.
Although dilution is present in these cohort-based data, our study highlights the notion that developmental arsenic exposure may lead to a different pattern of cancer, including increases in pancreatic and hematopoietic cancer, as compared with adult or lifetime exposures to inorganic arsenic.
长期接触无机砷与肺癌、皮肤癌、膀胱癌以及可能的其他部位的癌症风险增加有关。然而,对于发育过程中暴露于砷的后果与癌症风险之间的关系知之甚少。1955 年夏初,由于受污染的奶粉,日本西部发生了大规模婴儿砷中毒事件。冈山县受影响最为严重。我们研究了该地区受影响的出生队列是否经历了癌症死亡率的增加。
我们以 1950 年 9 月至 1960 年 8 月出生且于 1969 年 1 月至 2008 年 3 月期间因恶性肿瘤(N=3141)死于冈山县的人群为研究对象。然后,我们比较了砷中毒(暴露组)前出生和砷中毒后出生(非暴露组)的队列的癌症死亡率(总死亡率、肝癌、胰腺癌、肺癌、膀胱癌/肾脏癌和血液癌)。我们计算了死亡率比及其 95%置信区间。
在中毒时年龄为 1 岁以下的队列中,总癌症和肝癌的发病率较高。此外,在中毒时年龄为 5 岁以下的队列中,胰腺癌和血液癌的发病率较高,且死亡率比约为非暴露组的两倍。肺癌和膀胱癌/肾脏癌的风险增加不明显。
尽管这些基于队列的数据存在稀释,但我们的研究强调了这样一种观点,即发育性砷暴露可能导致不同的癌症模式,包括胰腺癌和血液癌的增加,与无机砷的成人或终身暴露相比。