title: Study on the relationship between manganese concentrations in rural drinking water and incidence and mortality caused by cancer in Huai'an city.
abstract: BACKGROUND
  Cancer is a significant disease burden in the world. Many studies showed that heavy metals or their compounds had connection with cancer. But the data conflicting about the relationship of manganese (Mn) to cancer are not enough. In this paper, the relationship was discussed between Mn concentrations in drinking water for rural residents and incidence and mortality caused by malignant tumors in Huai'an city.
  
  
  METHODS
  A total of 158 water samples from 28 villages of 14 towns were, respectively, collected during periods of high flow and low flow in 3 counties of Huai'an city, along Chinese Huai'he River. The samples of deep groundwater, shallow groundwater, and surface water were simultaneously collected in all selected villages. Mn concentrations in all water samples were determined by inductively coupled plasma-mass spectrometry (ICP-MS 7500a). The correlation analysis was used to study the relationship between the Mn concentration and cancer incidence and mortality.
  
  
  RESULTS
  Mn concentrations detectable rate was 100% in all water samples. The mean concentration was 452.32 μg/L ± 507.76 μg/L. There was significant difference between the high flow period and low flow period (t = -5.23, P < 0.05) and also among deep groundwater, shallow groundwater, and surface water (F = 5.02, P < 0.05). The ratio of superscale of Mn was 75.32%. There was significant difference of Mn level between samples in the high flow period and low flow period (χ(2) = 45.62, P < 0.05) and also among deep groundwater, shallow groundwater, and surface water (χ(2) = 10.66, P < 0.05). And also we found that, during the low flow period, Mn concentration has positive correlation with cancer incidence and mortality; for a 1 μg/L increase in Mn concentration, there was a corresponding increase of 0.45/100000 new cancer cases and 0.35/100000 cancer deaths (P < 0.05).
  
  
  CONCLUSIONS
  In Huai'an city, the mean concentration of Mn in drinking water was very high. Mn concentration correlated with cancer incidence and mortality.
authors.affiliation: Huai'an City Center for Disease Prevention and Control, Huai'an, Jiangsu 223001, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: The Department of No-Communicable Diseases Control and Prevention, Huai'an City Center for Disease Prevention and Control, 118 Huaihai North Road, Huai'an, Jiangsu 22300, China.
authors.forename: Enchun
authors.initials: E
authors.lastname: Pan
authors.affiliation: Huai'an City Center for Disease Prevention and Control, Huai'an, Jiangsu 223001, China.
authors.forename: Linfei
authors.initials: L
authors.lastname: Liu
authors.affiliation: Huai'an City Center for Disease Prevention and Control, Huai'an, Jiangsu 223001, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Hu
authors.affiliation: Huai'an City Center for Disease Prevention and Control, Huai'an, Jiangsu 223001, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: He
authors.affiliation: China Research Academy of Environmental Science, Beijing 100012, China.
authors.forename: Qiujin
authors.initials: Q
authors.lastname: Xu
authors.affiliation: Department of Environmental Engineering, Beijing Petrochemical College, Beijing 102617, China.
authors.forename: Cunzhen
authors.initials: C
authors.lastname: Liang
mesh_terms: D002681:China; D002947:Cities; D060766:Drinking Water / Q000009:adverse effects*; D004784:Environmental Monitoring; D006801:Humans; D008345:Manganese / Q000302:isolation & purification / Q000633:toxicity*; D009369:Neoplasms / Q000139:chemically induced / Q000401:mortality*; D045483:Rivers; D014874:Water Pollutants, Chemical / Q000633:toxicity
chemical_list: D060766:Drinking Water; D014874:Water Pollutants, Chemical; D008345:Manganese