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American Journal of Epidemiology Vol. 130, No. 6: 1123-1132
Copyright © 1989 by The Johns Hopkins University School of Hygiene and Public Health


research-article

DOSE-RESPONSE RELATION BETWEEN ARSENIC CONCENTRATION IN WELL WATER AND MORTALITY FROM CANCERS AND VASCULAR DISEASES

MEEI-MAAN WU1, TSUNG-LI KUO2, YI-HAN HWANG1 and CHIEN-JEN CHEN1,3,

1Institute of Biomedical Sciences, Academia Si-nica, Taipei Taiwan, Republic of China
2Institute of Legal Medicine, National Taiwan University College of Medicine Taipei, Taiwan, Republic of China
3Institute of Public Health, National Taiwan University College of Medicine Taipei, Taiwan, Republic of China

Reprint requests to Prof. Chien-Jen Chen, Division of Environmental Sciences, School of Public Health, Columbia University, 650 West 168th Street, Room 209, Black Building, New York, NY 10032

Age-adjusted mortality rates were analyzed to examine the dose-response relation between ingested arsenic levels and risk of cancers and vascular diseases among residents in the endemic area of blackfoot disease, a unique peripheral vascular disease associated with long-term exposure to high-arsenic artesian well water and confined to the southwestern coast of Taiwan. The arsenic levels in well water determined in 1964–1966 were available in 42 villages of the study area, while mortality and population data during 1973–1986 were obtained from the local household registration offices and Taiwan Provincial Department of Health. Age-adjusted mortality rates from various cancers and vascular diseases by sex were calculated using the 1976 world population as the standard population. A significant dose-response relation was observed between arsenic levels in well water and cancers of the bladder, kidney, skin, and lung in both males and females, and cancers of the prostate and liver in males. However, there was no association for cancers of the nasopharynx, esophagus, stomach, colon, and uterine cervix, and for leukemia. Arsenic levels in well water were also associated with peripheral vascular diseases and cardiovascular diseases in a dose-response pattern, but not with cerebrovascular accidents. The dual effect of arsenic on carcinogenesis and arteriosclerosis and the interrelation between these two pathogenic mechanisms deserve more intensive study.

arsenic; neoplasms; vascular diseases; water supply


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