Arsenic in drinking water and lung cancer: A systematic review
- Department of Medical Oncology, Hacettepe University Institute of Oncology, Ankara (Turkey)
- Prevention and Research Center, Mercy Medical Center (United States)
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health (United States)
- Department of International Health, Center for Human Nutrition, Johns Hopkins University Bloomberg School of Public Health (United States)
- Department of General Internal Medicine, Johns Hopkins University School of Medicine (United States)
- Department of Oncology, Johns Hopkins University School of Medicine (United States)
Exposure to inorganic arsenic via drinking water is a growing public health concern. We conducted a systematic review of the literature examining the association between arsenic in drinking water and the risk of lung cancer in humans. Towards this aim, we searched electronic databases for articles published through April 2006. Nine ecological studies, two case-control studies, and six cohort studies were identified. The majority of the studies were conducted in areas of high arsenic exposure (100 {mu}g/L) such as southwestern Taiwan, the Niigata Prefecture, Japan, and Northern Chile. Most of the studies reported markedly higher risks of lung cancer mortality or incidence in high arsenic areas compared to the general population or a low arsenic exposed reference group. The quality assessment showed that, among the studies identified, only four assessed arsenic exposure at the individual level. Further, only one of the ecological studies presented results adjusted for potential confounders other than age; of the cohort and case-control studies, only one-half adjusted for cigarette smoking status in the analysis. Despite these methodologic limitations, the consistent observation of strong, statistically significant associations from different study designs carried out in different regions provide support for a causal association between ingesting drinking water with high concentrations of arsenic and lung cancer. The lung cancer risk at lower exposure concentrations remains uncertain.
- OSTI ID:
- 21130769
- Journal Information:
- Environmental Research, Journal Name: Environmental Research Journal Issue: 1 Vol. 108; ISSN ENVRAL; ISSN 0013-9351
- Country of Publication:
- United States
- Language:
- English
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