Bladder Cancer Mortality Associated with Arsenic in Drinking Water in Argentina

Abstract

Inorganic arsenic (In-As) is known to be a human carcinogen, causing lung cancer by inhalation and skin cancer by ingestion. Ecologic studies in Taiwan have found a dose-response relation between ingestion of In-As from drinking water and bladder cancer, but questions have been raised concerning the validity and generalizability of the findings. Several areas of Argentina have had high exposures to arsenic from naturally contaminated drinking water, particularly the eastern region of the province of Córdoba. In this study, we investigated bladder cancer mortality for the years 1986-1991 in Córdoba's 26 counties, using rates for all of Argentina as the standard for comparison. Bladder cancer standardized mortality ratios (SMRs) were consistently higher in counties with documented arsenic exposure. We grouped counties into low-, medium-, and high-exposure categories; the corresponding SMRs [with 95% confidence intervals (CI)] were 0.80 (95% CI = 0.66-0.96), 1.42 (95% CI = 1.14-1.74), and 2.14 (95% CI = 1.78-2.53) for men, and 1.21 (95% CI = 0.85-1.64), 1.58 (95% CI = 1.01-2.35), and 1.82 (95% CI = 1.19-2.64) for women. The clear trends found in a population with different genetic composition and a high-protein diet support the findings in Taiwan.

Fluid intake and risk of bladder and other cancers

“…Some studies found that tap water with chlorine-and hence containing chlorination byproducts-may increase the risk of bladder cancer (Wilkins & Comstock, 1981;Gottlieb & Carr, 1982;Zierlier et al, 1986Zierlier et al, , 1988Cantor et al, 1987Cantor et al, , 1998McGeehin et al, 1993;Koivusalo et al, 1994;King & Marrett, 1996;Kiemeney & Schoenberg, 1996;Freedman et al, 1997). Arsenic in drinking water has also been associated with increased risk of bladder cancer (Chen et al, 1986(Chen et al, , 1992Wu et al, 1989;Bates et al, 1995;Hopenhayn-Rich et al, 1996;Chiou et al 2001), but it is unclear whether the levels of arsenic in drinking water from developed countries have any meaningful effect. It is also uncertain whether the apparent association reflects inadequate allowance for social class correlates of bladder cancer, since bladder cancer risk is elevated in smokers and in workers exposed to occupational carcinogens-and hence in lower social class individuals (La Vecchia et al, 1989, 1990Silverman et al, 1996;Negri & La Vecchia, 2001).…”

Examination of the effects of arsenic on glucose homeostasis in cell culture and animal studies: Development of a mouse model for arsenic-induced diabetes

“…iAs is classified as a human carcinogen (IARC, 1987). Numerous epidemiologic studies have associated chronic exposure to iAs with increased prevalence of cancers of the skin, bladder, liver, lung, and stomach (Bates et al, 1995;Bates et al, 1992;Chen et al, 1992;Chen et al, 1985;Chiang et al, 1988;Chiou et al, 1995;Guo et al, 1997;Hopenhayn-Rich et al, 1996;Hopenhayn-Rich et al, 1998;Lewis et al, 1999;Smith et al, 1998;Smith et al, 1992;Tseng et al, 1968;Tsuda et al, 1995;Wu et al, 1989). Previous research of the effects of chronic exposure to iAs has focused primarily on its carcinogenic potential.…”

Mapping of potentially hazardous elements in the Cambrian Vendian aquifer system, northern Estonia

“…The consumption of groundwater with high As content causes poisoning-arsenotosis, leading to chronic and even lethal health effects (Borzonyi et al, 1992;Hopenhayn-Rich et al, 1996;Kurttio et al, 1999).…”