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Comparative Study
. 2013 Apr;22(4):623-30.
doi: 10.1158/1055-9965.EPI-12-1190. Epub 2013 Jan 25.

Drinking water arsenic in northern chile: high cancer risks 40 years after exposure cessation

Craig M Steinmaus  1 , Catterina Ferreccio, Johanna Acevedo Romo, Yan Yuan, Sandra Cortes, Guillermo Marshall, Lee E Moore, John R Balmes, Jane Liaw, Todd Golden, Allan H Smith
Affiliations
Comparative Study

Drinking water arsenic in northern chile: high cancer risks 40 years after exposure cessation

Craig M Steinmaus et al. Cancer Epidemiol Biomarkers Prev. 2013 Apr.

Abstract

Background: Millions of people worldwide are exposed to arsenic-contaminated water. In the largest city in northern Chile (Antofagasta), more than 250,000 people were exposed to high arsenic drinking water concentrations from 1958 until 1970 when a water treatment plant was installed. Because of its unique geology, limited water sources, and good historical records, lifetime exposure and long-term latency patterns can be assessed in this area with better accuracy than in other arsenic-exposed areas worldwide.

Methods: We conducted a population-based case-control study in northern Chile from October 2007 to December 2010 involving 232 bladder and 306 lung cancer cases and 640 age- and gender-matched controls, with detailed information on past exposure and potential confounders, including smoking and occupation.

Results: Bladder cancer ORs for quartiles of average arsenic concentrations in water before 1971 (<11, 11-90, 91-335, and >335 μg/L) were 1.00, 1.36 [95% confidence interval (CI), 0.78-2.37], 3.87 (2.25-6.64), and 6.50 (3.69-11.43), respectively. Corresponding lung cancer ORs were 1.00, 1.27 (0.81-1.98), 2.00 (1.24-3.24), and 4.32 (2.60-7.17). Bladder and lung cancer ORs in those highly exposed in Antofagasta during 1958 to 1970 but not thereafter were 6.88 (3.84-12.32) and 4.35 (2.57-7.36), respectively.

Conclusions: The lung and bladder cancer risks that we found up to 40 years after high exposures have ended are very high.

Impact: Our findings suggest that prevention, treatment, and other mortality reduction efforts in arsenic-exposed countries will be needed for decades after exposure cessation.

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Conflict of interest statement

Conflicts of Interest: The authors declare that there are no financial or personal conflicts of interest regarding the materials discussed in the manuscript.

Figures

Figure 1
Figure 1
Arsenic concentrations in the drinking water in Antofagasta, northern Chile
Figure 2
Figure 2
Bladder and lung cancer odds ratios* including only cases with histologic confirmation, in non-proxy subjects, and in males and females comparing subjects in the upper to lower quartiles of average lifetime arsenic concentration prior to 1971. *Odds ratios are adjusted for age, sex, smoking, mining work, race, body-mass index, and socioeconomic status. For display purposes, the bladder cancer odds ratio in females of 23.6 (95% CI, 4.14 to 135.3) is truncated.
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