title: A prospective study of blood selenium levels and the risk of arsenic-related premalignant skin lesions.
abstract: Arsenic exposure from drinking water is considered to be a risk factor for skin and internal cancers. Animal studies suggest a potential antagonism between arsenic and selenium in the body. We did a case-cohort analysis to prospectively evaluate the association between arsenic-related premalignant skin lesions and prediagnostic blood selenium levels in 303 cases of skin lesions newly diagnosed from November 2002 to April 2004 and 849 subcohort members randomly selected from the 8,092 participants in the Health Effects of Arsenic Longitudinal Study with available baseline blood and urine samples collected in 2000. Incidence rate ratios for skin lesions in increasing blood selenium quintiles were 1.00 (reference), 0.68 [95% confidence interval (95% CI), 0.39-1.18], 0.51 (95% CI, 0.29-0.87), 0.52 (95% CI, 0.30-0.91), and 0.53 (95% CI, 0.31-0.90). Effect estimates remained similar with adjustments for age, sex, body mass index, smoking status, excessive sunlight exposure (in men), well water arsenic concentration at baseline, and nutritional intakes of folate, iron, protein, vitamin E, and B vitamins. At any given arsenic exposure level, the risk of premalignant skin lesions was consistently greater among participants with blood selenium lower than the average level. The findings support the hypothesis that dietary selenium intake may reduce the incidence of arsenic-related premalignant skin lesions among populations exposed to arsenic exposure from drinking water.
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
authors.forename: Yu
authors.initials: Y
authors.lastname: Chen
authors.forename: Marni
authors.initials: M
authors.lastname: Hall
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Graziano
authors.forename: Vesna
authors.initials: V
authors.lastname: Slavkovich
authors.forename: Alexander
authors.initials: A
authors.lastname: van Geen
authors.forename: Faruque
authors.initials: F
authors.lastname: Parvez
authors.forename: Habibul
authors.initials: H
authors.lastname: Ahsan
mesh_terms: D000328:Adult; D001151:Arsenic / Q000633:toxicity*; D001459:Bangladesh / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000139:chemically induced* / Q000453:epidemiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012643:Selenium / Q000097:blood*; D012871:Skin Diseases / Q000139:chemically induced* / Q000453:epidemiology; D014881:Water Supply / Q000032:analysis*
chemical_list: D012643:Selenium; D001151:Arsenic