Arsenic levels in drinking water and mortality of liver cancer in Taiwan.
The carcinogenic effect of arsenic is well documented, but epidemiologic data on liver cancer were limited. To evaluate the dose-response relationship between arsenic in drinking water and mortality of liver cancer, we conducted a study in 138 villages in the southwest coast area of Taiwan. We assessed arsenic levels in drinking water using data from a survey conducted by the government and reviewed death certificates from 1971 to 1990 to identify liver cancer cases. Using village as the unit, we conducted multi-variate regression analyses and then performed post hoc analyses to validate the findings. During the 20-year period, 802 male and 301 female mortality cases of liver cancer were identified. After adjusting for age, arsenic levels above 0.64 mg/L were associated with an increase in the liver cancer mortality in both genders, but no significant effect was observed for lower exposure categories. Post hoc analyses and a review of literature supported these findings. We concluded that exposures to high arsenic levels in drinking water are associated with the occurrence of liver cancer, but such an effect is not prominent at exposure levels lower than 0.64 mg/L.
Cancer Research Center, Chi-Mei Medical Center, Tainan, Taiwan; Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan; Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan; Graduate Institute of Injury Prevention and Control, College of Public Health and Nutrition, Taipei Medical University, Taipei,Taiwan.
Hung-Jung
HJ
Lin
Tzu-I
TI
Sung
Chi-Yi
CY
Chen
How-Ran
HR
Guo
D000293:Adolescent; D000328:Adult; D000368:Aged; D001151:Arsenic / Q000633:toxicity*; D002648:Child; D002675:Child, Preschool; D002947:Cities; D004305:Dose-Response Relationship, Drug; D060766:Drinking Water; D004781:Environmental Exposure; D004784:Environmental Monitoring / Q000379:methods; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008099:Liver / Q000187:drug effects; D008113:Liver Neoplasms / Q000139:chemically induced* / Q000453:epidemiology / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012042:Registries; D012044:Regression Analysis; D018570:Risk Assessment; D012984:Software; D013624:Taiwan / Q000453:epidemiology; D014874:Water Pollutants, Chemical / Q000032:analysis* / Q000737:chemistry; D055815:Young Adult
D060766:Drinking Water; D014874:Water Pollutants, Chemical; D001151:Arsenic
Arsenic; Dose–response; Drinking water; Environmental health; Epidemiology; Liver cancer; Risk assessment