“…Among the better known factors are the following: tobacco and opium consumption (Brown et al 2001;Tuyns 1983), low intake of fresh fruits and vegetables (Yang et al 2005;Tzonou et al 1996), poor socioeconomic living conditions (Hill 1997;Gammon et al 1997), selenium, zinc, molybdenum, manganese and magnesium deficiency (Chen et al 1992;Jaskiewicz et al 1988), total hardness of drinking water (Yang et al 1999), and high nitrate concentration in drinking water (Barrett et al 1998). Previous studies in Golestan province of Iran suggest poor socioeconomic conditions (Kamangar et al 2007), opium consumption , drinking hot tea (Islami et al 2009a), and silica contamination of flour (Jabbari et al 2008) as possible risk factors for EC. Among this long list of probable causes of high incidence rate of EC, anomalous concentration of certain ions and elements in the drinking water is noticeable.…”