MW-year study of lung and bladder canceir mortality in Chile related to arsenic in drinking water
MW-year study of lung and bladder canceir mortality in Chile related to arsenic in drinking water
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DOI：
10.1093/jnci/djm004
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发表时间：
2007-06-20
影响因子：
10.3
通讯作者：
Smith, Allan H.
中科院分区：
文献类型：
--
作者：
Marshall, Guillermo;Ferreccio, Catterina;Smith, Allan H.
背景智利第11区（最北第二行政区）从1958年开始，平均砷水浓度急剧增加，随后在20世纪70年代安装水处理厂后显着下降。这段历史提供了一个独特的机会，研究砷相关的癌症，包括肺癌和膀胱cancer.Methods的发展的时间趋势，我们调查了肺癌和膀胱癌的死亡率，从1950年至2000年的区域11相比，区域V，饮用水不受砷污染。死亡率数据来自1950-1970年这两个地区的218174份死亡证明和1971-2000年这两个地区的307541例死亡的死亡率数据磁带。泊松回归模型被用来确定时间趋势的肺癌和膀胱癌的死亡率比（RR）比较区域11与区域V。结果肺癌和膀胱癌的死亡率比区域11与区域V相比，开始增加约10年后，高砷暴露开始，并继续上升，直到1986-1997年达到峰值。男性和女性的峰值肺癌死亡率RR分别为3.61（95%置信区间[CI] = 3.13至4.16）和3.26（95% CI = 2.50至4.23）。男性和女性的峰值膀胱癌RR分别为6.10（95% CI = 3.97 - 9.39）和13.8（95% CI = 7.74 - 24.5）。1992-1994年期间，第11区的肺癌和膀胱癌合并死亡率最高，死亡率分别为每10万名男子和妇女153和50人，而第五区为每10万名男子和妇女54和19人。未记录任何其他环境暴露。长期潜伏模式值得注意，肺癌和膀胱癌的死亡率一直居高不下，直到20世纪90年代末，尽管砷暴露的主要减少发生在25年前。
Background Region 11 of Chile (the second most northerly administrative region) experienced dramatic increases in average arsenic water concentrations beginning in 1958, followed by marked declines in the 1970s when water treatment plants were installed. This history provides a unique opportunity to study time trends in the development of arsenic-related cancers, including lung and bladder cancers.Methods We investigated lung and bladder cancer mortality from 1950 to 2000 for region 11 compared with region V, where drinking water was not contaminated with arsenic. Mortality data were obtained from 218174 death certificates for the two regions for 1950-1970 and from mortality data tapes that identified 307541 deaths in the two regions for 1971-2000. Poisson regression models were used to identify time trends in rate ratios (RRs) of mortality from lung and bladder cancers comparing region 11 with region V.Results Lung and bladder cancer mortality rate ratios for region 11 compared with region V started to increase about 10 years after high arsenic exposures commenced and continued to rise until peaking in 1986-1997. The peak lung cancer mortality RRs were 3.61 (95% confidence interval [Cl] = 3.13 to 4.16) for men and 3.26 (95% Cl = 2.50 to 4.23) for women. The peak bladder cancer RRs were 6.10 (95% Cl = 3.97 to 9.39) for men and 13.8 (95% Cl = 7.74 to 24.5) for women. Combined lung and bladder cancer mortality rates in region 11 were highest in the period 1992-1994, with mortality rates of 153 and 50 per 100000 men and women, respectively, in region 11 compared with 54 and 19 per 100000 in region V.Conclusions Such large increases in total population cancer mortality rates have, to our knowledge, not been documented for any other environmental exposure. The long latency pattern is noteworthy, with mortality from lung and bladder cancers continuing to be high until the late 1990s, even though major decreases in arsenic exposure occurred more than 25 years earlier.