TY - JOUR
T1 - Low-level arsenic exposure from drinking water is associated with prostate cancer in Iowa
AU - Roh, Taehyun
AU - Lynch, Charles F.
AU - Weyer, Peter
AU - Wang, Kai
AU - Kelly, Kevin M.
AU - Ludewig, Gabriele
N1 - Funding Information:
Financial support for T.R. was provided by the Training Core of the Iowa Superfund Research Program P42 ES013661 from NIEHS and the Center for Health Effects of Environmental Contaminants (CHEEC). We also appreciate the help from the Iowa Department of Public Health for access to data from the Iowa Behavioral Risk Factor Surveillance System (BRFSS) and the Iowa Department of Natural Resources for access to public water data. Cancer data were provided with contract support (N01-PC-35143 and HHSN261201300020I) from the National Cancer Institute.
Funding Information:
Financial support was provided by the: – Training Core of the Iowa Superfund Research Program P42 ES013661 from NIEHS . – Center for Health Effects of Environmental Contaminants (CHEEC) of the University of Iowa. – Cancer data were provided with contract support ( N01-PC-35143 and HHSN261201300020I ) from the National Cancer Institute .
Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2017/11
Y1 - 2017/11
N2 - Inorganic arsenic is a toxic naturally occurring element in soil and water in many regions of the US including the Midwest. Prostate cancer is the second most common type of cancer in men in Iowa, surpassed only by non-melanotic skin cancer. Epidemiology studies have evaluated arsenic exposure from drinking water and prostate cancer, but most have focused on high-level exposures outside the US. As drinking water from groundwater sources is a major source of arsenic exposure, we conducted an ecologic study to evaluate prostate cancer and arsenic in drinking water from public water sources and private wells in Iowa, where exposure levels are low, but duration of exposure can be long. Arsenic data from public water systems were obtained from the Iowa Safe Drinking Water Information System for the years 1994–2003 and for private wells from two Iowa Well Water Studies, the Iowa Community Private Well Study (ICPWS, 2002–2003) and Iowa Statewide Rural Well Water Survey Phase 2 (SWIRL2, 2006–2008) that provided data for 87 Iowa counties. Prostate cancer incidence data from 2009 to 2013 for Iowa were obtained from Surveillance, Epidemiology and End Results’ SEER*Stat software. County averages of water arsenic levels varied from 1.08 to 18.6 ppb, with three counties above the current 10 ppb limit. Based on the tertiles of arsenic levels, counties were divided into three groups: low (1.08–2.06 ppb), medium (2.07–2.98 ppb), and high (2.99–18.6 ppb). Spatial Poisson regression modeling was conducted to estimate the risk ratios (RR) of prostate cancer by tertiles of arsenic level at a county level, adjusted for demographic and risk factors. The RR of prostate cancer were 1.23 (95% CI, 1.16–1.30) and 1.28 (95% CI, 1.21–1.35) in the medium and high groups, respectively, compared to the low group after adjusting for risk factors. The RR increased to 1.36 (95% CI, 1.28–1.45) in the high group when analyses were restricted to aggressive prostate cancers (Gleason score ≥ 7). This study shows a significant dose-dependent association between low-level arsenic exposure and prostate cancer, and if this result is replicated in future individual-level studies, may suggest that 10 ppb is not protective for human health.
AB - Inorganic arsenic is a toxic naturally occurring element in soil and water in many regions of the US including the Midwest. Prostate cancer is the second most common type of cancer in men in Iowa, surpassed only by non-melanotic skin cancer. Epidemiology studies have evaluated arsenic exposure from drinking water and prostate cancer, but most have focused on high-level exposures outside the US. As drinking water from groundwater sources is a major source of arsenic exposure, we conducted an ecologic study to evaluate prostate cancer and arsenic in drinking water from public water sources and private wells in Iowa, where exposure levels are low, but duration of exposure can be long. Arsenic data from public water systems were obtained from the Iowa Safe Drinking Water Information System for the years 1994–2003 and for private wells from two Iowa Well Water Studies, the Iowa Community Private Well Study (ICPWS, 2002–2003) and Iowa Statewide Rural Well Water Survey Phase 2 (SWIRL2, 2006–2008) that provided data for 87 Iowa counties. Prostate cancer incidence data from 2009 to 2013 for Iowa were obtained from Surveillance, Epidemiology and End Results’ SEER*Stat software. County averages of water arsenic levels varied from 1.08 to 18.6 ppb, with three counties above the current 10 ppb limit. Based on the tertiles of arsenic levels, counties were divided into three groups: low (1.08–2.06 ppb), medium (2.07–2.98 ppb), and high (2.99–18.6 ppb). Spatial Poisson regression modeling was conducted to estimate the risk ratios (RR) of prostate cancer by tertiles of arsenic level at a county level, adjusted for demographic and risk factors. The RR of prostate cancer were 1.23 (95% CI, 1.16–1.30) and 1.28 (95% CI, 1.21–1.35) in the medium and high groups, respectively, compared to the low group after adjusting for risk factors. The RR increased to 1.36 (95% CI, 1.28–1.45) in the high group when analyses were restricted to aggressive prostate cancers (Gleason score ≥ 7). This study shows a significant dose-dependent association between low-level arsenic exposure and prostate cancer, and if this result is replicated in future individual-level studies, may suggest that 10 ppb is not protective for human health.
KW - Arsenic
KW - Drinking water
KW - Iowa
KW - Private well water
KW - Prostate cancer
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U2 - 10.1016/j.envres.2017.08.026
DO - 10.1016/j.envres.2017.08.026
M3 - Article
C2 - 28841521
AN - SCOPUS:85027891895
SN - 0013-9351
VL - 159
SP - 338
EP - 343
JO - Environmental Research
JF - Environmental Research
ER -