Mendez William M, Eftim Sorina, Cohen Jonathan, Warren Isaac, Cowden John, Lee Janice S, Sams Reeder
ICF International, Fairfax, Virginia, USA.
ICF International, Rohnert Park, California, USA.
J Expo Sci Environ Epidemiol. 2017 May;27(3):235-243. doi: 10.1038/jes.2016.58. Epub 2016 Nov 30.
Increased risks of lung and bladder cancer have been observed in populations exposed to high levels of inorganic arsenic. However, studies at lower exposures (i.e., less than 100 μg/l in water) have shown inconsistent results. We therefore conducted an ecological analysis of the association between historical drinking water arsenic concentrations and lung and bladder cancer incidence in U.S. counties. We used drinking water arsenic concentrations measured by the U.S. Geological Survey and state agencies in the 1980s and 1990s as proxies for historical exposures in counties where public groundwater systems and private wells are important sources of drinking water. Relationships between arsenic levels and cancer incidence in 2006-2010 were explored by Poisson regression analyses, adjusted for groundwater dependence and important demographic covariates. The median and 95th percentile county mean arsenic concentrations were 1.5 and 15.4 μg/l, respectively. Water arsenic concentrations were significant and positively associated with female and male bladder cancer, and with female lung cancer. Our findings support an association between low water arsenic concentrations and lung and bladder cancer incidence in the United States. However, the limitations of the ecological study design suggest caution in interpreting these results.
在接触高浓度无机砷的人群中，已观察到肺癌和膀胱癌风险增加。然而，较低暴露水平（即水中砷含量低于100μg/l）的研究结果并不一致。因此，我们对美国各县历史饮用水砷浓度与肺癌和膀胱癌发病率之间的关联进行了生态分析。我们使用美国地质调查局和各州机构在20世纪80年代和90年代测量的饮用水砷浓度，作为公共地下水系统和私人水井为重要饮用水源的各县历史暴露水平的替代指标。通过泊松回归分析探讨了2006 - 2010年砷水平与癌症发病率之间的关系，并对地下水依赖程度和重要人口统计学协变量进行了调整。各县平均砷浓度的中位数和第95百分位数分别为1.5μg/l和15.4μg/l。水砷浓度与女性和男性膀胱癌以及女性肺癌显著正相关。我们的研究结果支持美国低水砷浓度与肺癌和膀胱癌发病率之间存在关联。然而，生态研究设计的局限性表明在解释这些结果时应谨慎。
