ARSENIC AND CANCER IN CENTRAL EUROPE

Abstract

ISEE-369 Introduction: A study of cancer risks in relation to arsenic was conducted in Central Europe with EU support: “ASHRAM” Arsenic Health Risk Assessment and Molecular Epidemiology”. This study has several components including: estimating cancer risk in relation to arsenic intake (principally from drinking water), estimating inter-individual differences in arsenic metabolism, estimating the role of polymorphisms in a number of genes involved in cell cycle regulation and DNA repair. This presentation focuses on the arsenic – cancer results. Methods: Study areas were defined as some counties in Hungary, Romania and Slovakia with known hotspots of current or past exposure to arsenic. Within these areas, new cases of skin, bladder and kidney cancer were identified along with hospital referents and invited to participate in the study. A detailed structured interview was conducted spanning their residential and occupational histories, and including a Food Frequency Questionnaire, and questions on lifestyle, smoking and key potential confounders for these cancers. Urine and blood samples were taken. Data on water consumption and all current and past sources of drinking water were identified. Water samples were taken for laboratory analysis, including wherever possible, the most recent and longest residential and occupational water sources. Some potentially important food items from the study areas have been analysed for arsenic content. Arsenic excretion is compared with current estimates of intake. Current, cumulative and average measures of arsenic are being computed and will be used for the results presented at the meeting. The risk for each cancer, adjusted for age, demographic variables, smoking, diet, occupation etc will be computed in relation to measure of arsenic intake by logistic regression. Results/Discussion: The following numbers of cases were enrolled non-melanoma skin cancer (612), bladder cancer (206), kidney cancer (107), referents (495), a total study population of 1420. Water supplies have been described by study participants for their full life history in most cases. Water samples could be taken from most target water supplies, their arsenic concentration determined, and the results matched to residential history to estimate current and past exposure. Work currently underway is integrating some historical water supply monitoring data in the estimate of exposure. Comparison of domestic and workplace consumption indicates that 10–25% of water consumption (by volume) of this population is at work. There is a good correlation between intake and excretion for arsenic in drinking water above 4 μg/l. Below that level, dietary sources predominate and work currently under way is quantifying the dietary arsenic component.