An epidemiologic study of arsenic-related skin disorders and skin cancer and the consumption of arsenic-contaminated well waters in Huhhot, inner Mongolia, China

Steven H. Lamm, Zhen Dong Luo, Fu Bao Bo, Ge You Zhang, Ye Min Zhang, Richard Wilson, Daniel M. Byrd, Shenghan Lai, Feng Xiao Li, Michael Polkanov, Ying Tong, Lian Loo, Stephen B. Tucker

Research output: Contribution to journalArticle

Abstract

Well-use histories were obtained and dermatological examinations were conducted for 3,179 of the 3,228 (98.5%) residents of 3 villages in Inner Mongolia with well water arsenic levels as high as 2,000 ppb (ug/L). Eight persons were found to have skin cancer, 172 had hyperkeratoses, 121 had dyspigmentation, 94 had both hyperkeratoses and dyspigmentation, and, strikingly, none had Blackfoot disease. All 8 subjects with skin cancer also had both hyperkeratoses and dyspigmentation. Arsenic levels were measured for 184 wells and individual well-use histories were obtained. Arsenic exposure histories were summarized as both highest arsenic concentration (highest exposure level for at least 1-year duration) and cumulative arsenic exposure (ppb-years). Sixty-nine percent of the participants had highest arsenic concentrations below 100 ppb; 71% had cumulative arsenic exposures below 2,000 ppb-years. Exposure-response analyses included frequency-weighted, simple linear regression, and most-likely estimate (hockey-stick) models. Skin cancer cases were only found for those with a highest arsenic concentration greater than 150 ppb, and those with exposure less than 150 ppb had a statistically significant deficit. A frequency-weighted model showed a threshold at 150 ppb, and a hockey-stick model showed a threshold at 122 ppb. Considerations of duration, age, latency, and misclassification did not appear to markedly affect the analysis. The non-malignant skin findings showed thresholds of 40-50 ppb in the hockey-stick models. Application of these analytic models to the data from other epidemiological studies of arsenic ingestion and malignant and non-malignant skin disorders can be used to examine patterns of arsenic carcinogenicity.

Original languageEnglish (US)
Pages (from-to)713-746
Number of pages34
JournalHuman and Ecological Risk Assessment
Volume13
Issue number4
DOIs
StatePublished - Jul 2007

Fingerprint

skin disorder
Arsenic
Skin Neoplasms
well water
Epidemiologic Studies
arsenic
cancer
China
skin
Skin
Water
Hockey
history
consumption
Linear regression
exposure
Linear Models

Keywords

  • Akin cancer risk
  • Arsenic-related skin effects
  • Inner Mongolia
  • Threshold (hockey-stick) model

ASJC Scopus subject areas

  • Ecological Modeling
  • Management, Monitoring, Policy and Law

Cite this

An epidemiologic study of arsenic-related skin disorders and skin cancer and the consumption of arsenic-contaminated well waters in Huhhot, inner Mongolia, China. / Lamm, Steven H.; Luo, Zhen Dong; Bo, Fu Bao; Zhang, Ge You; Zhang, Ye Min; Wilson, Richard; Byrd, Daniel M.; Lai, Shenghan; Li, Feng Xiao; Polkanov, Michael; Tong, Ying; Loo, Lian; Tucker, Stephen B.

In: Human and Ecological Risk Assessment, Vol. 13, No. 4, 07.2007, p. 713-746.

Research output: Contribution to journalArticle

Lamm, Steven H. ; Luo, Zhen Dong ; Bo, Fu Bao ; Zhang, Ge You ; Zhang, Ye Min ; Wilson, Richard ; Byrd, Daniel M. ; Lai, Shenghan ; Li, Feng Xiao ; Polkanov, Michael ; Tong, Ying ; Loo, Lian ; Tucker, Stephen B. / An epidemiologic study of arsenic-related skin disorders and skin cancer and the consumption of arsenic-contaminated well waters in Huhhot, inner Mongolia, China. In: Human and Ecological Risk Assessment. 2007 ; Vol. 13, No. 4. pp. 713-746.
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abstract = "Well-use histories were obtained and dermatological examinations were conducted for 3,179 of the 3,228 (98.5{\%}) residents of 3 villages in Inner Mongolia with well water arsenic levels as high as 2,000 ppb (ug/L). Eight persons were found to have skin cancer, 172 had hyperkeratoses, 121 had dyspigmentation, 94 had both hyperkeratoses and dyspigmentation, and, strikingly, none had Blackfoot disease. All 8 subjects with skin cancer also had both hyperkeratoses and dyspigmentation. Arsenic levels were measured for 184 wells and individual well-use histories were obtained. Arsenic exposure histories were summarized as both highest arsenic concentration (highest exposure level for at least 1-year duration) and cumulative arsenic exposure (ppb-years). Sixty-nine percent of the participants had highest arsenic concentrations below 100 ppb; 71{\%} had cumulative arsenic exposures below 2,000 ppb-years. Exposure-response analyses included frequency-weighted, simple linear regression, and most-likely estimate (hockey-stick) models. Skin cancer cases were only found for those with a highest arsenic concentration greater than 150 ppb, and those with exposure less than 150 ppb had a statistically significant deficit. A frequency-weighted model showed a threshold at 150 ppb, and a hockey-stick model showed a threshold at 122 ppb. Considerations of duration, age, latency, and misclassification did not appear to markedly affect the analysis. The non-malignant skin findings showed thresholds of 40-50 ppb in the hockey-stick models. Application of these analytic models to the data from other epidemiological studies of arsenic ingestion and malignant and non-malignant skin disorders can be used to examine patterns of arsenic carcinogenicity.",
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AU - Zhang, Ge You

AU - Zhang, Ye Min

AU - Wilson, Richard

AU - Byrd, Daniel M.

AU - Lai, Shenghan

AU - Li, Feng Xiao

AU - Polkanov, Michael

AU - Tong, Ying

AU - Loo, Lian

AU - Tucker, Stephen B.

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AB - Well-use histories were obtained and dermatological examinations were conducted for 3,179 of the 3,228 (98.5%) residents of 3 villages in Inner Mongolia with well water arsenic levels as high as 2,000 ppb (ug/L). Eight persons were found to have skin cancer, 172 had hyperkeratoses, 121 had dyspigmentation, 94 had both hyperkeratoses and dyspigmentation, and, strikingly, none had Blackfoot disease. All 8 subjects with skin cancer also had both hyperkeratoses and dyspigmentation. Arsenic levels were measured for 184 wells and individual well-use histories were obtained. Arsenic exposure histories were summarized as both highest arsenic concentration (highest exposure level for at least 1-year duration) and cumulative arsenic exposure (ppb-years). Sixty-nine percent of the participants had highest arsenic concentrations below 100 ppb; 71% had cumulative arsenic exposures below 2,000 ppb-years. Exposure-response analyses included frequency-weighted, simple linear regression, and most-likely estimate (hockey-stick) models. Skin cancer cases were only found for those with a highest arsenic concentration greater than 150 ppb, and those with exposure less than 150 ppb had a statistically significant deficit. A frequency-weighted model showed a threshold at 150 ppb, and a hockey-stick model showed a threshold at 122 ppb. Considerations of duration, age, latency, and misclassification did not appear to markedly affect the analysis. The non-malignant skin findings showed thresholds of 40-50 ppb in the hockey-stick models. Application of these analytic models to the data from other epidemiological studies of arsenic ingestion and malignant and non-malignant skin disorders can be used to examine patterns of arsenic carcinogenicity.

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