title: Long-term mortality patterns in a residential cohort exposed to inorganic selenium in drinking water.
abstract: Selenium (Se) is a metalloid of considerable nutritional and toxicological importance in humans. To date, limited epidemiologic evidence exists about the health effects of exposure to this trace element in drinking water. We investigated the relationship between Se levels in water and mortality in the municipality of Reggio Emilia, Italy, where high levels of Se were previously observed in drinking water. From 1974 to 1985, 2065 residents consumed drinking water with Se levels close to the European standard of 10μg/l, in its inorganic hexavalent form (selenate). Follow-up was conducted for the years 1986-2012 in Reggio Emilia and a lesser exposed comparison group of around 100,000 municipal residents, with comparable socio-demographic characteristics. Overall mortality from all causes, cardiovascular disease and cancer showed little evidence of differences. However, excess rate ratios were seen for some site specific cancers such as neoplasms of buccal cavity and pharynx, urinary tract, lymphohematopoietic tissue, melanoma, and two neurodegenerative diseases, Parkinson's disease and amyotrophic lateral sclerosis. Excess mortality in the exposed cohort for specific outcomes was concentrated in the first period of follow-up (1986-1997), and waned starting 10 years after the high exposure ended. We also found lower mortality from breast cancer in females during the first period of follow-up. When we extended the analysis to include residents who had been consuming the high-selenium drinking water for a shorter period, mortality rate ratios were also increased, but to a lesser extent. Overall, we found that the mortality patterns related to long-term exposure to inorganic hexavalent selenium through drinking water were elevated for several site-specific cancers and neurodegenerative disease.
authors.affiliation: CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Reggio Emilia, Italy. Electronic address: marco.vinceti@unimore.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Vinceti
authors.affiliation: Interinstitutional Epidemiology Unit, Local Health Authority, Reggio Emilia and Arcispedale S. Maria Nuova, IRCCS, Reggio Emilia, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Ballotari
authors.affiliation: Department of Epidemiology, UC Berkeley School of Public Health, Berkeley, CA, United States.
authors.forename: Craig
authors.initials: C
authors.lastname: Steinmaus
authors.affiliation: CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Reggio Emilia, Italy.
authors.forename: Carlotta
authors.initials: C
authors.lastname: Malagoli
authors.affiliation: Interinstitutional Epidemiology Unit, Local Health Authority, Reggio Emilia and Arcispedale S. Maria Nuova, IRCCS, Reggio Emilia, Italy.
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Luberto
authors.affiliation: CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Reggio Emilia, Italy.
authors.forename: Marcella
authors.initials: M
authors.lastname: Malavolti
authors.affiliation: Interinstitutional Epidemiology Unit, Local Health Authority, Reggio Emilia and Arcispedale S. Maria Nuova, IRCCS, Reggio Emilia, Italy.
authors.forename: Paolo Giorgi
authors.initials: PG
authors.lastname: Rossi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000690:Amyotrophic Lateral Sclerosis / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D060766:Drinking Water / Q000032:analysis*; D004781:Environmental Exposure / Q000032:analysis; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D010300:Parkinson Disease / Q000401:mortality*; D012643:Selenium / Q000032:analysis*; D014874:Water Pollutants, Chemical / Q000032:analysis*; D055815:Young Adult
chemical_list: D060766:Drinking Water; D014874:Water Pollutants, Chemical; D012643:Selenium
keywords: Cancer; Cardiovascular disease; Cohort study; Drinking water; Mortality; Neurologic disease; Selenium