Naddafi Kazem, Mesdaghinia Alireza, Abtahi Mehrnoosh, Hassanvand Mohammad Sadegh, Beiki Ayoub, Shaghaghi Gholamreza, Shamsipour Mansour, Mohammadi Fatemeh, Saeedi Reza
Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Center for Air Pollution Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran.
Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Environ Res. 2022 Mar;204(Pt B):112057. doi: 10.1016/j.envres.2021.112057. Epub 2021 Sep 14.
The burden of disease attributable to exposure to heavy metals via drinking water in Iran (2019) was assessed at the national and regional levels. The non-carcinogenic risk, carcinogenic risk, and attributable burden of disease of heavy metals in drinking water were estimated in terms of hazard quotient (HQ), incremental lifetime cancer risk (ILCR), and disability-adjusted life year (DALY), respectively. The average drinking water concentrations of arsenic (As), cadmium (Cd), chromium (Cr), lead (Pb), mercury (Hg), and nickel (Ni) in Iran were determined to be 2.3, 0.4, 12.1, 2.5, 0.7, and 19.7 μg/L, respectively, which were much lower than the standard values. The total average HQs of heavy metals in drinking water in the entire country, rural, and urban communities were 0.48, 0.65 and 0.45, respectively. At the national level, the average ILCRs of heavy metal in the entire country were in the following order: 1.06 × 10 for As, 5.89 × 10 for Cd, 2.05 × 10 for Cr, and 3.76 × 10 for Pb. The cancer cases, deaths, death rate (per 100,000 people), DALYs, and DALY rate (per 100,000 people) attributed to exposure to heavy metals in drinking water at the national level were estimated to be 213 (95% uncertainty interval: 180 to 254), 87 (73-104), 0.11 (0.09-0.13), 4642 (3793-5489), and 5.81 (4.75-6.87), respectively. The contributions of exposure to As, Cd, Cr, and Pb in the attributable burden of disease were 14.7%, 65.7%, 19.3%, and 0.2%, respectively. The regional distribution of the total attributable DALY rate for all heavy metals was as follows: Region 5> Region 4> Region 1> Region 3> Region 2. The investigation and improvement of relatively high exceedance of As levels in drinking water from the standard value, especially in Regions 5 and 3 as well as biomonitoring of heavy metals throughout the country were recommended.
对伊朗全国和地区层面因饮用受重金属污染的水所致疾病负担（2019年）进行了评估。分别根据危害商数（HQ）、终生癌症风险增量（ILCR）和伤残调整生命年（DALY）估算了饮用水中重金属的非致癌风险、致癌风险和疾病归因负担。伊朗饮用水中砷（As）、镉（Cd）、铬（Cr）、铅（Pb）、汞（Hg）和镍（Ni）的平均浓度分别测定为2.3、0.4、12.1、2.5、0.7和19.7μg/L，远低于标准值。全国、农村和城市社区饮用水中重金属的总平均HQ分别为0.48、0.65和0.45。在国家层面，全国重金属的平均ILCR排序如下：As为1.06×10，Cd为5.89×10，Cr为2.05×10，Pb为3.76×10。国家层面因饮用受重金属污染的水导致的癌症病例、死亡人数、死亡率（每10万人）、DALY和DALY率（每10万人）估计分别为213例（95%不确定区间：180至254）、87例（73 - 104）、0.11（0.09 - 0.13）、4642例（3793 - 5489）和5.81（4.75 - 6.87）。在疾病归因负担中，As、Cd、Cr和Pb暴露的贡献分别为14.7%、65.7%、19.3%和0.2%。所有重金属所致DALY率的区域分布如下：地区5＞地区4＞地区1＞地区3＞地区2。建议对饮用水中As含量相对较高超过标准值的情况进行调查和改善，特别是在地区5和地区3，并在全国范围内开展重金属生物监测。
