Division of Hematology and Oncology, Department of Internal Medicine, An Nan Hospital, China Medical University, Tainan, Taiwan.
Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Front Public Health. 2022 Apr 29;10:863882. doi: 10.3389/fpubh.2022.863882. eCollection 2022.
Arsenic in drinking water has been recognized as carcinogenic to humans and can cause solid cancers of lung, urinary bladder, and skin. Positive associations have also been reported between arsenic ingestion and cancers of kidney, liver and prostate. Nevertheless, arsenic trioxide has been used successfully in the treatment of acute promyelocytic leukemia. Therefore, arsenic might play different roles in the carcinogenesis of solid cancers and hematologic malignancies. The relationship between arsenic in drinking water and the incidences of hematologic malignancies has not been fully investigated. We established a cohort of Taiwanese population and assorted 319 townships of Taiwan into two exposure categories using 0.05 mg/L as the cutoff. Then, we linked these data to the Taiwan Cancer Registry and computed standardized incidence ratios (SIRs) of lymphoma and leukemia by sex, exposure category and time period. The trend of changes in the SIRs over time was assessed, from 1981-1990 to 1991-2000 and then to 2001-2010. We found that in both lymphoma and leukemia, the higher exposure category was associated with lower SIRs in both men and women. In terms of time trends, the SIRs in both lymphoma and leukemia showed increasing trends in both sexes, while exposure to arsenic in drinking water decreased over time. The arsenic level in drinking water was negatively associated with the incidences of lymphoma and leukemia in both men and women. This study supports the dual effects of arsenic on carcinogenesis, with a potential protective effect against hematologic malignancies.
饮用水中的砷已被确认为人类致癌物质，可导致肺部、膀胱和皮肤的实体癌。也有报道称，砷摄入与肾脏、肝脏和前列腺癌之间存在正相关关系。然而，三氧化二砷已成功用于治疗急性早幼粒细胞白血病。因此，砷可能在实体癌和血液系统恶性肿瘤的致癌作用中发挥不同的作用。饮用水中的砷与血液系统恶性肿瘤的发病率之间的关系尚未得到充分研究。我们建立了一个台湾人群队列，并使用 0.05 毫克/升作为截断值，将台湾的 319 个乡镇分为两个暴露类别。然后，我们将这些数据与台湾癌症登记处相关联，并按性别、暴露类别和时间段计算淋巴瘤和白血病的标准化发病比 (SIR)。评估了 SIR 随时间变化的趋势，从 1981-1990 年到 1991-2000 年，然后到 2001-2010 年。我们发现，在淋巴瘤和白血病中，较高的暴露类别与男性和女性的 SIR 较低相关。就时间趋势而言，男女两性的淋巴瘤和白血病 SIR 均呈上升趋势，而饮用水中的砷暴露则随时间下降。饮用水中的砷水平与男性和女性的淋巴瘤和白血病发病率呈负相关。本研究支持砷对致癌作用的双重影响，可能对血液系统恶性肿瘤具有保护作用。
