Incidence of transitional cell carcinoma and arsenic in drinking water: A follow-up study of 8,102 residents in an arseniasis-endemic area in northeastern Taiwan

Hung Yi Chiou, Shu Ti Chiou, Yi Hsiang Hsu, Yi Li Chou, Chin Hsiao Tseng, Min Li Wei, Chien Jen Chen

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Abstract

A significant association between ingested arsenic and bladder cancer has been reported in an arseniasisendemic area in southwestern Taiwan, where many households share only a few wells in their villages. In another arseniasis-endemic area in northeastern Taiwan, each household has its own well for obtaining drinking water. In 1991-1994, the authors examined risk of transitional cell carcinoma (TCC) in relation to ingested arsenic in a cohort of 8,102 residents in northeastern Taiwan. Estimation of each study subject's individual exposure to inorganic arsenic was based on the arsenic concentration in his or her own well water, which was determined by hydride generation combined with atomic absorption spectrometry. Information on duration of consumption of the well water was obtained through standardized questionnaire interviews. The occurrence of urinary tract cancers was ascertained by follow-up interview and by data linkage with community hospital records, the national death certification profile, and the cancer registry profile. Cox proportional hazards regression analysis was used to estimate multivariate-adjusted relative risks and 95% confidence intervals. There was a significantly increased incidence of urinary cancers for the study cohort compared with the general population in Taiwan (standardized incidence ratio = 2.05; 95% confidence interval (Cl): 1.22, 3.24). A significant dose-response relation between risk of cancers of the urinary organs, especially TCC, and indices of arsenic exposure was observed after adjustment for age, sex, and cigarette smoking. The multivariate-adjusted relative risks of developing TCC were 1.9, 8.2, and 15.3 for arsenic concentrations of 10.1-50.0, 50.1-100, and >100 μg/liter, respectively, compared with the referent level of ≤10.0 μg/liter.

Original languageEnglish
Pages (from-to)411-418
Number of pages8
JournalAmerican Journal of Epidemiology
Volume153
Issue number5
DOIs
Publication statusPublished - Mar 1 2001

Fingerprint

Transitional Cell Carcinoma
Arsenic
Taiwan
Drinking Water
Incidence
Confidence Intervals
Interviews
Urologic Neoplasms
Neoplasms
Hospital Records
Information Storage and Retrieval
Community Hospital
Certification
Urinary Bladder Neoplasms
Drinking
Registries
Spectrum Analysis
Cohort Studies
Smoking
Regression Analysis

Keywords

  • Arsenic
  • Carcinoma
  • Drinking
  • Incidence
  • Risk assessment
  • Transitional cell
  • Urologic neoplasms
  • Water supply

ASJC Scopus subject areas

  • Epidemiology

Cite this

Incidence of transitional cell carcinoma and arsenic in drinking water : A follow-up study of 8,102 residents in an arseniasis-endemic area in northeastern Taiwan. / Chiou, Hung Yi; Chiou, Shu Ti; Hsu, Yi Hsiang; Chou, Yi Li; Tseng, Chin Hsiao; Wei, Min Li; Chen, Chien Jen.

In: American Journal of Epidemiology, Vol. 153, No. 5, 01.03.2001, p. 411-418.

Research output: Contribution to journalArticle

Chiou, Hung Yi ; Chiou, Shu Ti ; Hsu, Yi Hsiang ; Chou, Yi Li ; Tseng, Chin Hsiao ; Wei, Min Li ; Chen, Chien Jen. / Incidence of transitional cell carcinoma and arsenic in drinking water : A follow-up study of 8,102 residents in an arseniasis-endemic area in northeastern Taiwan. In: American Journal of Epidemiology. 2001 ; Vol. 153, No. 5. pp. 411-418.
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abstract = "A significant association between ingested arsenic and bladder cancer has been reported in an arseniasisendemic area in southwestern Taiwan, where many households share only a few wells in their villages. In another arseniasis-endemic area in northeastern Taiwan, each household has its own well for obtaining drinking water. In 1991-1994, the authors examined risk of transitional cell carcinoma (TCC) in relation to ingested arsenic in a cohort of 8,102 residents in northeastern Taiwan. Estimation of each study subject's individual exposure to inorganic arsenic was based on the arsenic concentration in his or her own well water, which was determined by hydride generation combined with atomic absorption spectrometry. Information on duration of consumption of the well water was obtained through standardized questionnaire interviews. The occurrence of urinary tract cancers was ascertained by follow-up interview and by data linkage with community hospital records, the national death certification profile, and the cancer registry profile. Cox proportional hazards regression analysis was used to estimate multivariate-adjusted relative risks and 95{\%} confidence intervals. There was a significantly increased incidence of urinary cancers for the study cohort compared with the general population in Taiwan (standardized incidence ratio = 2.05; 95{\%} confidence interval (Cl): 1.22, 3.24). A significant dose-response relation between risk of cancers of the urinary organs, especially TCC, and indices of arsenic exposure was observed after adjustment for age, sex, and cigarette smoking. The multivariate-adjusted relative risks of developing TCC were 1.9, 8.2, and 15.3 for arsenic concentrations of 10.1-50.0, 50.1-100, and >100 μg/liter, respectively, compared with the referent level of ≤10.0 μg/liter.",
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