title: A follow-up study of mortality among the arseniasis patients exposed to indoor combustion of high arsenic coal in Southwest Guizhou Autonomous Prefecture, China.
abstract: OBJECTIVE
  This study was directed to ascertain the mortality of a group of arseniasis patients in an endemic rural township in Southwest China, where the residents were exposed for decades to indoor combustion of high arsenic coal.
  
  
  METHODS
  All the diagnosed arseniasis cases registered in 1991 were defined as the target population, which were assigned to three symptom subgroups by the severity of dermal lesions. The death cases were surveyed and checked. The follow-up period was 12.5 years. The standardized mortality ratio (SMR) of all death causes combined, all cancers combined, and the cancers at every site were analyzed. The age standardized mortality rates (ASMRs) were calculated in three subgroups using the procedure of standardization.
  
  
  RESULTS
  One hundred and six death cases were recorded. Liver cirrhosis, non-melanotic skin cancer, lung and liver cancer were the four most prevalent death causes and referred to 70.8% (75/106) of the total death cases. The mortality of all death causes combined was not higher than that of the whole of China in 2001 (SMR = 0.76, 95% CI 0.63-0.93). The crude mortality rate of non-melanotic skin cancer in males reached up to 128.66/10(5). SMRs of lung cancer and larynx cancer in males (SMRs 2.84 and 27.27, 95% CIs 1.51-4.86 and 5.61-79.62, respectively) significantly exceeded the levels for all male Chinese. ASMRs of all death causes combined, all cancers combined and non-melanotic skin cancer in males of the severe dermal symptoms subgroup were significantly higher than those in medium and/or mild dermal symptom subgroups.
  
  
  CONCLUSIONS
  A significantly increased mortality due to lung cancer and non-melanotic skin cancer was confirmed, alike the situation in other arseniasis endemic areas in the world. No significant elevation of mortality due to liver cancer and bladder cancer was observed. Male arseniasis patients diagnosed with severe skin lesions face higher risks of malignancies and of non-melanotic skin cancer in particular in the following years.
authors: Municipal Center for Disease Prevention and Control of Shanghai, Shanghai 200336, China.
authors: Ji-gang
authors: JG
authors: Chen
authors: Yu-gang
authors: YG
authors: Chen
authors: Yun-shu
authors: YS
authors: Zhou
authors: Guo-fang
authors: GF
authors: Lin
authors: Xiu-jie
authors: XJ
authors: Li
authors: Chao-Gang
authors: CG
authors: Jia
authors: Wei-chao
authors: WC
authors: Guo
authors: Hui
authors: H
authors: Du
authors: Hong-chao
authors: HC
authors: Lu
authors: Hong
authors: H
authors: Meng
authors: Xin-jiang
authors: XJ
authors: Zhang
authors: Klaus
authors: K
authors: Golka
authors: Jian-hua
authors: JH
authors: Shen
mesh_terms: D000328:Adult; D000368:Aged; D016902:Air Pollution, Indoor / Q000009:adverse effects*; D020261:Arsenic Poisoning / Q000209:etiology / Q000401:mortality*; D002423:Cause of Death; D002681:China / Q000453:epidemiology; D003031:Coal / Q000506:poisoning*; D005260:Female; D005390:Fires; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012424:Rural Population
chemical_list: D003031:Coal