Academic journal article Environmental Health Perspectives

Increased Mortality from Lung Cancer and Bronchiectasis in Young Adults after Exposure to Arsenic in Utero and in Early Childhood

Academic journal article Environmental Health Perspectives

Increased Mortality from Lung Cancer and Bronchiectasis in Young Adults after Exposure to Arsenic in Utero and in Early Childhood

Article excerpt

Arsenic in drinking water is an established cause of lung cancer, and preliminary evidence suggests that ingested arsenic may also cause nonmalignant lung disease. Antofagasta is the second largest city in Chile and had a distinct period of very high arsenic exposure that began in 1958 and lasted until 1971, when an arsenic removal plant was installed. This unique exposure scenario provides a rare opportunity to investigate the long-term mortality impact of early-life arsenic exposure. In this study, we compared mortality rates in Antofagasta in the period 1989-2000 with those of the rest of Chile, focusing on subjects who were born during or just before the peak exposure period and who were 30-49 years of age at the time of death. For the birth cohort born just before the high-exposure period (1950-1957) and exposed in early childhood, the standardized mortality ratio (SMR) for lung cancer was 7.0 [95% confidence interval (CI), 5.4-8.9; p < 0.001] and the SMR for bronchiectasis was 12.4 (95% CI, 3.3-31.7; p < 0.001). For those born during the high-exposure period (1958-1970) with probable exposure in utero and early childhood, the corresponding SMRs were 6.1 (95% CI, 3.5-9.9; p < 0.001) for lung cancer and 46.2 (95% CI, 21.1-87.7; p < 0.001) for bronchiectasis. These findings suggest that exposure to arsenic in drinking water during early childhood or in utero has pronounced pulmonary effects, greatly increasing subsequent mortality in young adults from both malignant and nonmalignant lung disease. Key words: arsenic, bronchiectasis, childhood exposure, chronic obstructive pulmonary disease, drinking water, in utero exposure. Environ Health Perspect 114:1293-1296 (2006). doi:10.1289/ehp.8832 available via http://dx.doi.org/ [Online 27 March 2006]

**********

The International Agency for Research on Cancer (IARC) has classified arsenic in drinking water as a group 1 carcinogen that causes skin cancer, bladder cancer, and lung cancer (IARC 2002). Substantial evidence supports the biologic plausibility that exposure to arsenic can lead to skin and bladder cancer. For example, arsenic concentrates in the skin and is known to cause nonmalignant skin lesions [National Research Council (NRC) 2001], and the major pathway of excretion is in urine, giving plausibility to increased bladder cancer rates (NRC 2001). Although it is known that inhalation of arsenic may cause lung cancer, the findings of increased lung cancer mortality after ingestion in drinking water were unexpected because all other known lung carcinogens act via inhalation. However, the evidence based on multiple studies in Taiwan (Chen and Wang 1990; Chen et al. 1985, 1988; Wu et al. 1989), Chile (Ferreccio et al. 2000; Smith et al. 1998), Argentina (Hopenhayn-Rich et al. 1998), and Japan (Tsuda et al. 1989, 1995) is sufficient to conclude that there is a causal relationship. In fact, lung cancer is the main long-term cause of death from ingesting arsenic in drinking water (NRC 2001). In region II of Chile, which includes the city of Antofagasta, overall lung cancer mortality rates for men and women were previously found to be at least 3-fold higher than for the rest of Chile (Smith et al. 1998), and lung cancer relative risk estimates increased nearly 9-fold in those with the highest exposures (Ferreccio et al. 2000).

Several known lung carcinogens cause chronic nonmalignant respiratory diseases, including cigarette smoking, which causes chronic obstructive pulmonary disease (COPD); asbestos, which causes asbestosis; and silica, which causes silicosis. To date, however, relatively little attention has been given to whether or not ingestion of arsenic in drinking water causes nonmalignant pulmonary disease. The first reports of chronic respiratory symptoms came from small investigations in Antofagasta in the 1970s (Zaldivar 1974, 1977, 1980; Zaldivar and Ghai 1980). Before 1958, the water supply in the main city of Antofagasta had an arsenic concentration of about 90 [micro]g/L. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.