The Disease Burden of Dietary Exposure to Inorganic Arsenic in Denmark, 2018

Abstract

Arsenic is a naturally occurring metalloid in soil, air, water and food in organic and inorganic forms. Several epidemiological studies have shown that inorganic arsenic (i-As) is carcinogenic to humans. Previous studies have raised concern about dietary i-As exposure from various sources, including brown rice. We estimated the burden of disease in terms of disability-adjusted life years (DALY) of lung, bladder and skin cancer caused by dietary exposure to i-As in Denmark. Moreover, we investigated the impact of different rice-consumption scenarios of white and brown rice. We combined exposure assessment with dose response relationships of i-As exposure and lifetime risk of each cancer type to estimate the annual incidence due to i-As exposure. Associated DALY was calculated based on national health statistics. We estimated 0.57 extra cancer cases and 4.5 DALY [95% UI 4.2–4.8] in the Danish population in 2018. Even though rice was found not to be the main contributor of i-As, substitution of white and parboiled rice by brown rice resulted in a 32.7% increase in DALY compared to the current consumption of rice. The estimated number of cancer cases due to dietary i-As equals 0.006% of the annual incidence of the three cancer types in Denmark. Our estimates exclude exposure to i-As from drinking water and other beverages, which should be accounted for in future estimates. Our study highlights the need for deriving national-specific estimates of food borne disease burden to allow for comparison and prioritization.