Lung, Bladder, and Kidney Cancer Mortality 40Years After Arsenic Exposure Reduction.
Lung, Bladder, and Kidney Cancer Mortality 40Years After Arsenic Exposure Reduction.
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DOI：
10.1093/jnci/djx201
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发表时间：
2018-03-01
期刊：
影响因子：
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通讯作者：
Steinmaus, Craig
中科院分区：
文献类型：
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作者：
Smith, Allan H;Marshall, Guillermo;Steinmaus, Craig
背景资料：智利北方的第二区（人口442570）在1958年的主要城市安托法加斯塔经历了砷水浓度的突然大幅度增加，随后在1970年安装了一个除砷厂时，暴露量大幅减少。它提供了一个独特的机会，研究暴露于砷的潜伏期的影响，这是第一次研究死亡率数据高达40 years后，暴露reduction.Methods：我们以前确定的高死亡率在区域II到2000年。在这里，我们提出率比（RR）的第二区与智利所有其他地区相比，从2001年至2010年，并与未暴露的第五区（人口1539852）的所有年份，从1950年至2010年。结果：从2001年到2010年，与智利其他地区相比，第二区的肺部和膀胱死亡率仍然大幅上升（男性肺癌RR=3.38，95%可信区间[CI] = 3.19 ~ 3.58，P <0.001;女性肺癌RR=2.41，95% CI=2.20 ~ 2.64，P <0.001;男性膀胱癌RR=4.79，95%CI =4.20 ~ 5.46，P <0.001;女性膀胱癌RR=6.43，95%CI =5.49 ~ 7.54，P <0.001）。肾癌死亡率也升高（男性RR=1.75，95%CI =1.49至2.05，P <0.001;女性RR=2.09，95%CI =1.69至2.57，P <0.001）。早期短潜伏期急性心肌梗死死亡率的增加已经消退。结论：肺癌，膀胱癌和肾癌的死亡率由于砷暴露有很长的潜伏期，暴露减少后40年的风险增加。我们的研究结果表明，饮用水中的砷可能是人类致癌物质中最长的癌症潜伏期之一。
Background: Region II in northern Chile (population 442570) experienced a sudden major increase in arsenic water concentrations in 1958 in the main city of Antofagasta, followed by a major reduction in exposure when an arsenic removal plant was installed in 1970. It provides a unique opportunity to study latency effects of exposure to arsenic, and this is the first study with mortality data up to 40years after exposure reduction.Methods: We previously identified high mortality rates in Region II up to the year 2000. Here we present rate ratios (RRs) for Region II compared with all the rest of Chile from 2001 to 2010, and with unexposed Region V (population 1539852) for all years from 1950 to 2010. All statistical tests were one-sided.Results: From 2001 to 2010, comparing Region II with the rest of Chile, lung and bladder mortality were still greatly elevated (RR=3.38, 95% confidence interval [CI] = 3.19 to 3.58, P < .001 for lung cancer in men; RR=2.41, 95% CI=2.20 to 2.64, P < .001 for lung cancer in women; RR=4.79, 95% CI=4.20 to 5.46, P < .001 for bladder cancer in men; RR=6.43, 95% CI=5.49 to 7.54, P < .001 for bladder cancer in women). Kidney cancer mortality was also elevated (RR=1.75, 95% CI=1.49 to 2.05, P < .001 for men; RR=2.09, 95% CI=1.69 to 2.57, P < .001 for women). Earlier short latency acute myocardial infarction mortality increases had subsided.Conclusions: Lung, bladder, and kidney cancer mortality due to arsenic exposure have very long latencies, with increased risks manifesting 40years after exposure reduction. Our findings suggest that arsenic in drinking water may involve one of the longest cancer latencies for a human carcinogen.