title: Environmental arsenic exposure from a coal-burning power plant as a potential risk factor for nonmelanoma skin carcinoma: results from a case-control study in the district of Prievidza, Slovakia.
abstract: To investigate the risk of arsenic exposure from a coal-burning power plant in Slovakia on nonmelanoma skin cancer (NMSC) development, a 1996-1999 population-based case-control study was conducted with 264 cases and 286 controls. Exposure assessment was based on residential history and annual emissions (Asres1, Asres2) and on nutritional habits and arsenic content in food (Asnut1, Asnut2). Asres1 was assessed as a function of the distance of places of residence to the plant. Asres2 additionally considered workplace locations. Asnut1 was used to calculate arsenic uptake by weighting food frequencies with arsenic concentrations and annual consumption of food items. Asnut2 additionally considered consumption of local products. Age- and gender-adjusted risk estimates for NMSC in the highest exposure category (90th vs. 30th percentile) were 1.90 (95% confidence interval (CI): 1.39, 2.60) for Asres1, 1.90 (95% CI: 1.38, 2.62) for Asres2, 1.19 (95% CI: 0.64, 2.12) for Asnut1, and 1.83 (95% CI: 0.98, 3.43) for Asnut2. No interaction was found between arsenic exposure and dietary and residential data. Other plant emissions could have confounded the distance-based exposure variables. Consumption of contaminated vegetables and fruits could be confounded by the protective effects of such a diet. Nevertheless, the authors found an excess NMSC risk for environmental arsenic exposure.
authors.affiliation: Medical Institute for Environmental Hygiene at Heinrich Heine University of Düsseldorf, Düsseldorf, Germany. beate.pesch@uni-duesseldorf.de
authors.forename: Beate
authors.initials: B
authors.lastname: Pesch
authors.forename: Ulrich
authors.initials: U
authors.lastname: Ranft
authors.forename: Pavel
authors.initials: P
authors.lastname: Jakubis
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Nieuwenhuijsen
authors.forename: Andre
authors.initials: A
authors.lastname: Hergemöller
authors.forename: Klaus
authors.initials: K
authors.lastname: Unfried
authors.forename: Marian
authors.initials: M
authors.lastname: Jakubis
authors.forename: Peter
authors.initials: P
authors.lastname: Miskovic
authors.forename: Tom
authors.initials: T
authors.lastname: Keegan
mesh_terms: D000328:Adult; D001151:Arsenic / Q000009:adverse effects / Q000032:analysis*; D016022:Case-Control Studies; D003031:Coal / Q000009:adverse effects; D015986:Confounding Factors, Epidemiologic; D004032:Diet; D004781:Environmental Exposure / Q000032:analysis*; D005260:Female; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011210:Power Plants; D012044:Regression Analysis; D012111:Residence Characteristics; D018570:Risk Assessment; D012307:Risk Factors; D012878:Skin Neoplasms / Q000139:chemically induced / Q000453:epidemiology*; D018154:Slovakia / Q000453:epidemiology
chemical_list: D003031:Coal; D001151:Arsenic