A follow-up study of mortality among the arseniasis patients exposed to indoor combustion of high arsenic coal in Southwest Guizhou Autonomous Prefecture, China.
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.
Chen
Ji-gang
JG
Municipal Center for Disease Prevention and Control of Shanghai, Shanghai 200336, China.
Chen
Yu-gang
YG
Zhou
Yun-shu
YS
Lin
Guo-fang
GF
Li
Xiu-jie
XJ
Jia
Chao-Gang
CG
Guo
Wei-chao
WC
Du
Hui
H
Lu
Hong-chao
HC
Meng
Hong
H
Zhang
Xin-jiang
XJ
Golka
Klaus
K
Shen
Jian-hua
JH
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
D003031:Coal