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Low-level arsenic exposure from drinking water is associated with prostate cancer in Iowa.
Environ Res. 2017 11; 159:338-343.ER

Abstract

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.

Authors+Show Affiliations

Interdisciplinary Graduate Program in Human Toxicology, University of Iowa, Iowa City, IA 52242, United States.Department of Epidemiology, University of Iowa, Iowa City, IA 52242, United States.Center for Health Effects of Environmental Contamination, University of Iowa, Iowa City, IA 52242, United States.Department of Biostatistics, University of Iowa, Iowa City, IA 52242, United States.Department of Occupational and Environmental Health, University of Iowa, Iowa City, IA 52242, United States.Interdisciplinary Graduate Program in Human Toxicology, University of Iowa, Iowa City, IA 52242, United States; Department of Occupational and Environmental Health, University of Iowa, Iowa City, IA 52242, United States. Electronic address: gabriele-ludewig@uiowa.edu.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

28841521

Citation

Roh, Taehyun, et al. "Low-level Arsenic Exposure From Drinking Water Is Associated With Prostate Cancer in Iowa." Environmental Research, vol. 159, 2017, pp. 338-343.
Roh T, Lynch CF, Weyer P, et al. Low-level arsenic exposure from drinking water is associated with prostate cancer in Iowa. Environ Res. 2017;159:338-343.
Roh, T., Lynch, C. F., Weyer, P., Wang, K., Kelly, K. M., & Ludewig, G. (2017). Low-level arsenic exposure from drinking water is associated with prostate cancer in Iowa. Environmental Research, 159, 338-343. https://doi.org/10.1016/j.envres.2017.08.026
Roh T, et al. Low-level Arsenic Exposure From Drinking Water Is Associated With Prostate Cancer in Iowa. Environ Res. 2017;159:338-343. PubMed PMID: 28841521.
* Article titles in AMA citation format should be in sentence-case
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, Y1 - 2017/09/18/ PY - 2017/06/07/received PY - 2017/07/24/revised PY - 2017/08/12/accepted PY - 2017/8/26/pubmed PY - 2017/10/17/medline PY - 2017/8/26/entrez KW - Arsenic KW - Drinking water KW - Iowa KW - Private well water KW - Prostate cancer SP - 338 EP - 343 JF - Environmental research JO - Environ. Res. VL - 159 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. SN - 1096-0953 UR - https://www.unboundmedicine.com/medline/citation/28841521/Low_level_arsenic_exposure_from_drinking_water_is_associated_with_prostate_cancer_in_Iowa_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0013-9351(17)31118-0 DB - PRIME DP - Unbound Medicine ER -