Abstract
Background: Although inorganic arsenic in drinking water at high levels (100s–1000s ug/L [ppb]) increases cancer risk (skin, bladder, lung, and possibly prostate), the evidence at lower levels is limited.Methods: We conducted an ecologic analysis of the dose-response relationship between prostate cancer incidence and low arsenic levels in drinking water in a large study of U.S. counties (N = 710). County arsenic levels were < 200 ug/L with median < 100 ug/L and dependency greater than 10%. Groundwater well usage, water arsenic levels, prostate cancer incidence rates (2009–2013), and co-variate data were obtained from various U.S. governmental agencies. Poisson and negative-binomial regression analyses and stratified analysis were performed.Results: The best fitting polynomial analysis yielded a J-shaped linear-quadratic model. Linear and quadratic terms were significant (p < 0.001) in the Poisson model, and the quadratic term was significant (p < 0.05) in the negative binomial model. This model indicated a decreasing risk of prostate cancer with increasing arsenic level in the low range and increasing risk above.Conclusions: This study of prostate cancer incidence in US counties with low levels of arsenic in their well-water arsenic levels finds a j-shaped model with decreasing risk at very low levels and increasing risk at higher levels.
Highlights
Arsenic is a well-known human carcinogen, primarily noted as an etiological agent for skin cancer, bladder cancer, and lung cancer
In like manner, to use these same US national datasets to examine the dose-response relationship between drinking water arsenic level and prostate cancer incidence rates for US counties in the same respect
We have assessed the dose-response relationship between prostate cancer and arsenic levels in drinking water using county level exposure data aggregated by the United States Geological Survey (USGS) and cancer incidence data aggregated by the National Cancer Institute (NCI) and as previously described [12]
Summary
Arsenic is a well-known human carcinogen, primarily noted as an etiological agent for skin cancer, bladder cancer, and lung cancer. Occupational health studies have demonstrated this association through inhalation exposure of industrial particulates, and environmental health studies have demonstrated this association through ingestion exposure from drinking water. These findings have been shown for dosages in the range of 100 s to 1000 s of micrograms per day or per liter. Inorganic arsenic in drinking water at high levels (100s–1000s μg/L [ppb]) increases cancer risk (skin, bladder, lung, and possibly prostate), the evidence at lower levels is limited. Methods: We conducted an ecologic analysis of the dose-response relationship between prostate cancer incidence and low arsenic levels in drinking water in a large study of U.S. counties (N = 710). Linear and quadratic terms were significant (p < 0.001) in the Poisson model, and the quadratic term was significant (p < 0.05)
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