Karagas M R, Tosteson T D, Blum J, Morris J S, Baron J A, Klaue B
Department of Community and Family Medicine, Dartmouth Medical School, Dartmouth College, Hanover, New Hampshire, USA.
Environ Health Perspect. 1998 Aug;106 Suppl 4(Suppl 4):1047-50. doi: 10.1289/ehp.98106s41047.
Ingestion of arsenic-contaminated drinking water is associated with an increased risk of several cancers, including skin and bladder malignancies; but it is not yet clear whether such adverse effects are present at levels to which the U.S. population is exposed. In New Hampshire, detectable levels of arsenic have been reported in drinking water supplies throughout the state. Therefore, we have begun a population-based epidemiologic case-control study in which residents of New Hampshire diagnosed with primary squamous cell (n = 900) and basal cell (n = 1200) skin cancers are being selected from a special statewide skin cancer incidence survey; patients diagnosed with primary bladder cancers (n = 450) are being identified through the New Hampshire State Cancer Registry. Exposure histories of these patients will be compared to a control group of individuals randomly selected from population lists (n = 1200). Along with a detailed personal interview, arsenic and other trace elements are being measured in toenail clipping samples using instrumental neutron activation analysis. Household water samples are being tested on selected participants using a hydride generation technique with high-resolution inductively coupled plasma mass spectrometry. In the first 793 households tested arsenic concentrations ranged from undetectable (0.01 microgram/l) to 180 microgram/l. Over 10% of the private wells contained levels above 10 microgram/l and 2.5% were above 50 microgram/l. Based on our projected sample size, we expect at least 80% power to detect a 2-fold risk of basal cell or squamous cell skin cancer or bladder cancer among individuals with the highest 5% toenail concentrations of arsenic.
摄入受砷污染的饮用水会增加患几种癌症的风险，包括皮肤癌和膀胱癌；但尚不清楚在美国人群接触的砷水平下是否会出现此类不良影响。在新罕布什尔州，全州的饮用水供应中均报告有可检测到的砷含量。因此，我们已启动一项基于人群的流行病学病例对照研究，从一项全州范围的特殊皮肤癌发病率调查中选取新罕布什尔州被诊断患有原发性鳞状细胞癌（n = 900）和基底细胞癌（n = 1200）的居民；通过新罕布什尔州癌症登记处确定被诊断患有原发性膀胱癌的患者（n = 450）。将把这些患者的接触史与从人群名单中随机选取的对照组个体（n = 1200）进行比较。除了进行详细的个人访谈外，还使用仪器中子活化分析法对趾甲剪样本中的砷和其他微量元素进行测量。对部分选定参与者的家庭水样使用氢化物发生技术和高分辨率电感耦合等离子体质谱法进行检测。在最初检测的793户家庭中，砷浓度范围从检测不到（0.01微克/升）到每升180微克。超过10%的私人水井砷含量高于10微克/升，2.5%高于50微克/升。根据我们预计的样本量，我们预计至少有80%的把握检测出在趾甲砷含量最高的5%人群中患基底细胞癌或鳞状细胞皮肤癌或膀胱癌的风险增加两倍。
