Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias str,, Athens, 11527, Greece.
Environ Health. 2011 May 24;10:50. doi: 10.1186/1476-069X-10-50.
Hexavalent chromium is a known carcinogen when inhaled, but its carcinogenic potential when orally ingested remains controversial. Water contaminated with hexavalent chromium is a worldwide problem, making this a question of significant public health importance.
We conducted an ecological mortality study within the Oinofita region of Greece, where water has been contaminated with hexavalent chromium. We calculated gender, age, and period standardized mortality ratios (SMRs) for all deaths, cancer deaths, and specific cancer types of Oinofita residents over an 11-year period (1999 - 2009), using the greater prefecture of Voiotia as the standard population.
A total of 474 deaths were observed. The SMR for all cause mortality was 98 (95% CI 89-107) and for all cancer mortality 114 (95% CI 94-136). The SMR for primary liver cancer was 1104 (95% CI 405-2403, p-value < 0.001). Furthermore, statistically significantly higher SMRs were identified for lung cancer (SMR = 145, 95% CI 100-203, p-value = 0.047) and cancer of the kidney and other genitourinary organs among women (SMR = 368, 95% CI 119-858, p-value = 0.025). Elevated SMRs for several other cancers were also noted (lip, oral cavity and pharynx 344, stomach 121, female breast 134, prostate 128, and leukaemias 168), but these did not reach statistical significance.
Elevated cancer mortality in the Oinofita area of Greece supports the hypothesis of hexavalent chromium carcinogenicity via the oral ingestion pathway of exposure. Further studies are needed to determine whether this association is causal, and to establish preventive guidelines and public health recommendations.
六价铬吸入时是一种已知的致癌物，但口服摄入的致癌潜能仍存在争议。受六价铬污染的水是一个全球性问题，因此这是一个具有重要公共卫生意义的问题。
我们在希腊的 Oinofita 地区进行了一项生态学死亡率研究，该地区的水受到六价铬的污染。我们使用更大的 Voiotia 州作为标准人群，计算了 11 年间（1999-2009 年）Oinofita 居民的所有死亡、癌症死亡和特定癌症类型的性别、年龄和时期标准化死亡率比（SMR）。
共观察到 474 例死亡。全因死亡率的 SMR 为 98（95%CI 89-107），所有癌症死亡率的 SMR 为 114（95%CI 94-136）。原发性肝癌的 SMR 为 1104（95%CI 405-2403，p 值<0.001）。此外，还发现女性肺癌（SMR=145，95%CI 100-203，p 值=0.047）和肾脏及其他泌尿生殖器官癌症（SMR=368，95%CI 119-858，p 值=0.025）的 SMR 显著更高。还注意到其他几种癌症的 SMR 升高（唇、口腔和咽 344，胃 121，女性乳腺癌 134，前列腺 128，白血病 168），但未达到统计学意义。
希腊 Oinofita 地区癌症死亡率升高支持六价铬通过口服途径暴露致癌的假说。需要进一步研究以确定这种关联是否具有因果关系，并制定预防指南和公共卫生建议。
