Acute myocardial infarction mortality in comparison with lung and bladder cancer mortality in arsenic-exposed region II of Chile from 1950 to 2000
Acute myocardial infarction mortality in comparison with lung and bladder cancer mortality in arsenic-exposed region II of Chile from 1950 to 2000
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DOI：
10.1093/aje/kwm238
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发表时间：
2007-12-15
影响因子：
5
通讯作者：
Smith, Allan H.
中科院分区：
文献类型：
--
作者：
Yuan, Yan;Marshall, Guillermo;Smith, Allan H.
众所周知，饮用水中的砷是肺癌、膀胱癌和皮肤癌的原因，一些研究报告称砷对心血管疾病有影响。作者调查了1950年至2000年智利砷暴露II区的死亡率（人口：2000年为477，000人）与未受照射地区相比，发现急性心肌梗死（AMI）的风险增加，男性死亡率比为1.48（95%置信区间（CI）：1.37，1.59; p < 0.001）和1.26（95% CI：1.14，1.40; p < 0.001）在1958年至1970年II区高暴露期。最高比率发生在30-49岁的年轻成年男性中，他们出生于高暴露期，可能在子宫内和幼儿期接触（比率= 3.23，95% CI：2.79，3.75; p < 0.001）。与肺癌和膀胱癌相比，急性心肌梗死死亡率是高暴露期间和之后死亡人数增加的主要原因。在减少暴露量10年后，AMI死亡率下降，肺癌和膀胱癌的潜伏期较长的超额死亡占主导地位。将这三种死因结合起来，死亡率在1991-1995年达到高峰，估计与接触砷有关的额外死亡人数占男子死亡总数的10.9%，妇女的4.0%。
Arsenic in drinking water is known to be a cause of lung, bladder, and skin cancer, and some studies report cardiovascular disease effects. The authors investigated mortality from 1950 to 2000 in the arsenic-exposed region II of Chile (population: 477,000 in 2000) in comparison with the unexposed region V. Increased risks were found for acute myocardial infarction (AMI), with mortality rate ratios of 1.48 for men (95% confidence interval (CI): 1.37, 1.59; p < 0.001) and 1.26 for women (95% CI: 1.14, 1.40; p < 0.001) during the high-exposure period in region II from 1958 to 1970. The highest rate ratios were for young adult men aged 30-49 years who were born during the high-exposure period with probable exposure in utero and in early childhood (rate ratio = 3.23, 95% CI: 2.79, 3.75; p < 0.001). Compared with lung and bladder cancer, AMI mortality was the predominant cause of excess deaths during and immediately after the high-exposure period. Ten years after reduction of exposures, AMI mortality had decreased, and longer latency excess deaths from lung and bladder cancer predominated. With these three causes of death combined, increased mortality peaked in 1991-1995, with estimated excess deaths related to arsenic exposure constituting 10.9% of all deaths among men and 4.0% among women.