American Journal of Epidemiology Vol. 155, No. 9 : 798-809
Copyright © 2002 by The Johns Hopkins University School of Hygiene and Public Health
ORIGINAL CONTRIBUTIONS |
Environmental Arsenic Exposure from a Coal-burning Power Plant as a Potential Risk Factor for Nonmelanoma Skin Carcinoma: Results from a Case-Control Study in the District of Prievidza, Slovakia
1 Medical Institute for Environmental Hygiene at Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
2 State Health Institute, Prievidza, Slovakia.
3 Department of Environmental Sciences and Technology, Imperial College of Science, Technology and Medicine, London, United Kingdom.
4 State Health Institute, Banska Bystrica, Slovakia.
To investigate the risk of arsenic exposure from a coal-burning power plant in Slovakia on nonmelanoma skin cancer (NMSC) development, a 1996–1999 population-based case-control study was conducted with 264 cases and 286 controls. Exposure assessment was based on residential history and annual emissions (Asres1, Asres2) and on nutritional habits and arsenic content in food (Asnut1, Asnut2). Asres1 was assessed as a function of the distance of places of residence to the plant. Asres2 additionally considered workplace locations. Asnut1 was used to calculate arsenic uptake by weighting food frequencies with arsenic concentrations and annual consumption of food items. Asnut2 additionally considered consumption of local products. Age- and gender-adjusted risk estimates for NMSC in the highest exposure category (90th vs. 30th percentile) were 1.90 (95% confidence interval (CI): 1.39, 2.60) for Asres1, 1.90 (95% CI: 1.38, 2.62) for Asres2, 1.19 (95% CI: 0.64, 2.12) for Asnut1, and 1.83 (95% CI: 0.98, 3.43) for Asnut2. No interaction was found between arsenic exposure and dietary and residential data. Other plant emissions could have confounded the distance-based exposure variables. Consumption of contaminated vegetables and fruits could be confounded by the protective effects of such a diet. Nevertheless, the authors found an excess NMSC risk for environmental arsenic exposure.
arsenic; case-control studies; coal; environmental exposure; metals, heavy; neoplasms; power plants; skin neoplasms
Abbreviations: Asnut1, arsenic uptake calculated by weighting food frequencies with arsenic concentrations and annual consumption of food items; Asnut2, same as Asnut 1 multiplied by a factor for consumption of homegrown food; Asres1, arsenic exposure as a function of the distances of the residences to the coal-burning power plant; Asres2, same as Asres1 plus the distances to work locations; CI, confidence interval; EXPASCAN, EXPosure to ArSenic and CANcer Risk in Central and East Europe; NMSC, nonmelanoma skin cancer; OR, odds ratio
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