Lung cancer in a U.S. population with low to moderate arsenic exposure.
BACKGROUND
Little is known about the carcinogenic potential of arsenic in areas with low to moderate concentrations of arsenic (< 100 microg/L) in drinking water.


OBJECTIVE
We examined associations between arsenic and lung cancer.


METHODS
A population-based case-control study of primary incident lung cancer was conducted in 10 counties in two U.S. states, New Hampshire and Vermont. The study included 223 lung cancer cases and 238 controls, each of whom provided toenail clippings for arsenic exposure measurement by inductively coupled-plasma mass spectrometry. We estimated odds ratios (ORs) of the association between arsenic exposure and lung cancer using unconditional logistic regression with adjustment for potential confounders (age, sex, race/ethnicity, smoking pack-years, education, body mass index, fish servings per week, and toenail selenium level).


RESULTS
Arsenic exposure was associated with small-cell and squamous-cell carcinoma of the lung [OR = 2.75; 95% confidence interval (CI), 1.00-7.57] for toenail arsenic concentration > or = 0.114 microg/g, versus < 0.05 microg/g. A history of lung disease (bronchitis, chronic obstructive pulmonary disease, or fibrosis) was positively associated with lung cancer (OR = 2.86; 95% CI, 1.39-5.91). We also observed an elevated risk of lung cancer among participants with a history of lung disease and toenail arsenic > or = 0.05 microg/g (OR = 4.78; 95% CI, 1.87-12.2) than among individuals with low toenail arsenic and no history of lung disease.


CONCLUSIONS
Although this study supports the possibility of an increased risk of specific lung cancer histologic types at lower levels of arsenic exposure, we recommend large-scale population-based studies.
Heck
Julia E
JE
International Agency for Research on Cancer, Lyon, France.
Andrew
Angeline S
AS
Onega
Tracy
T
Rigas
James R
JR
Jackson
Brian P
BP
Karagas
Margaret R
MR
Duell
Eric J
EJ
D000328:Adult; D000368:Aged; D001151:Arsenic / Q000032:analysis / Q000633:toxicity*; D002294:Carcinoma, Squamous Cell / Q000139:chemically induced / Q000453:epidemiology / Q000473:pathology; D016022:Case-Control Studies; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008171:Lung Diseases / Q000150:complications; D008175:Lung Neoplasms / Q000139:chemically induced / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009262:Nails / Q000737:chemistry; D009513:New Hampshire / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012643:Selenium / Q000378:metabolism; D055752:Small Cell Lung Carcinoma / Q000139:chemically induced / Q000453:epidemiology / Q000473:pathology; D013054:Spectrophotometry, Atomic; D014707:Vermont / Q000453:epidemiology; D014874:Water Pollutants, Chemical / Q000032:analysis / Q000633:toxicity*
D014874:Water Pollutants, Chemical; D012643:Selenium; D001151:Arsenic