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Risk of laryngeal and nasopharyngeal cancer associated with arsenic and cadmium in the Tunisian population

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Abstract

Chronic exposure to heavy metals has long been recognized as being capable of increasing head and neck cancer (HNC) incidence, such as laryngeal (LC) and nasopharyngeal (NPC), among exposed human populations. The aim of the present study was to evaluate the concentrations of arsenic (As) and cadmium (Cd) in the blood of 145 patients (LC and NPC) and 351 controls in order to establish a potential relationship between these factors and the occurrence of LC and NPC. Mean blood levels of As and Cd in patients (5.67 and 3.51 μg/L, respectively) were significantly higher than those of controls (1.57 and 0.74 μg/L, respectively). The blood levels of As and Cd were mostly significantly higher than those of controls (p < 0.05) after controlling the other risk factors of HNC including tobacco smoking and chewing, and alcohol drinking. Cd levels in blood increase significantly with the number of occupational exposure years for patients (p < 0.05). However, seafood was not found to be contributing as an exposure source. Among these risk factors, smoking (>30 pack years) and occupational exposure (>20 years) presented the most significant association with HNC (OR = 10.22 and 10.38, respectively, p < 0.001). Cd level in blood sample of cases that are occupationally exposed/tobacco users (smokers and chewers) were higher than that of non-occupationally exposed/nontobacco users (p < 0.001). The logistic regression model illustrated that HNC (LC + NPC) was significantly associated with blood levels of As (OR = 2.41, p < 0.001) and Cd (OR = 4.95, p < 0.001).

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Abbreviations

As:

Arsenic

Cd:

Cadmium

CRM:

Certified reference materials

CY:

Consumption years

FI-HGAAS:

Flow injection atomic absorption spectrometric technique

HNC:

Head and neck cancers

LC:

Laryngeal cancer

NPC:

Nasopharyngeal cancer

OR:

Odd ratio

PY:

Pack years

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Acknowledgments

This study was supported by the Ministry of Higher Education, Scientific Research, and Technology. We thank the Department of Otorhinolaryngology, Habib Borguiba Hospital, Sfax, Tunisia for the recruitment of patients. We thank all members of this department and specially Dr Adel CHAKROUN and Amine CHAKROUN for their efforts and assistance in recruiting patients. I wish to gratefully acknowledge Olfa MESSAOUD EZZEDDINE, PhD (Molecular Investigation of Genetic Orphan Diseases, Research Unit, Pasteur Institute of Tunis, Tunis, Tunisia) for her assistance in the English revision of the manuscript.

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Authors and Affiliations

  1. Unit of Marine and Environmental Toxicology, UR 09-03, Sfax University, IPEIS, BP 1172, 3018, Sfax, Tunisia

    Rim Khlifi, Molka Feki-Tounsi & Amel Hamza-Chaffai

  2. Bioinformatics Unit, Centre of Biotechnology of Sfax, BP 1177, 3018, Sfax, Tunisia

    Rim Khlifi, Molka Feki-Tounsi & Ahmed Rebai

  3. Department of Legal Medicine and Toxicology, University of Granada, Granada, Spain

    Pablo Olmedo & Fernando Gil

  4. Department of Otorhinolaryngology, Habib Borguiba Hospital, Sfax, Tunisia

    Bouthaina Hammami

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  1. Rim Khlifi
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Correspondence to Rim Khlifi.

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Responsible editor: Philippe Garrigues

This study suggests the potential role of As and Cd in the mechanism of HNC development.

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Khlifi, R., Olmedo, P., Gil, F. et al. Risk of laryngeal and nasopharyngeal cancer associated with arsenic and cadmium in the Tunisian population. Environ Sci Pollut Res 21, 2032–2042 (2014). https://doi.org/10.1007/s11356-013-2105-z

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