Boffetta Paolo, Borron Claire
Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Dose Response. 2019 Jul 22;17(3):1559325819863634. doi: 10.1177/1559325819863634. eCollection 2019 Jul-Sep.
Exposure to high levels of arsenic in drinking water has been associated with an increased risk of lung and bladder cancer, but the presence of an increased risk at low levels is questionable.
A systematic review and a dose-response meta-analysis were conducted on risk estimates of lung and bladder cancer for exposure to arsenic in drinking water up to 150 µg/L, using a 2-stage approach based on a random-effects model.
Five studies of lung cancer were identified; the meta-relative risk (RR) for an increase of 10 µg/L arsenic level was 1.03 (95% confidence interval [CI]: 0.99-1.06; heterogeneity = .05). The meta-analysis of bladder cancer included 8 studies; the meta-RR for an increase of 10 µg/L arsenic level was 1.02 (95% CI: 0.97-1.07, heterogeneity = .01). Sensitivity analyses, including a 1-stage meta-regression, confirmed the main findings.
This systematic review and meta-analysis provided evidence of a lack of an increased risk of lung and bladder cancer for exposure to arsenic in drinking water up to 150 µg/L, the highest concentration studied.
饮用水中高浓度砷暴露与肺癌和膀胱癌风险增加有关，但低浓度时风险增加情况存疑。
采用基于随机效应模型的两阶段方法，对饮用水中砷暴露量高达150微克/升时肺癌和膀胱癌的风险估计进行系统评价和剂量反应荟萃分析。
确定了五项肺癌研究；砷水平每增加10微克/升的荟萃相对风险（RR）为1.03（95%置信区间[CI]：0.99 - 1.06；异质性 = 0.05）。膀胱癌的荟萃分析纳入了八项研究；砷水平每增加10微克/升的荟萃RR为1.02（95% CI：0.97 - 1.07，异质性 = 0.01）。敏感性分析，包括单阶段荟萃回归，证实了主要发现。
本系统评价和荟萃分析提供的证据表明，饮用水中砷暴露量高达150微克/升（研究的最高浓度）时，肺癌和膀胱癌风险未增加。
