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

• Published in: American journal of epidemiology 2002-05, Vol.155 (9), p.798-809
• Main Authors: Pesch, Beate, Ranft, Ulrich, Jakubis, Pavel, Nieuwenhuijsen, Mark J., Hergemöller, Andre, Unfried, Klaus, Jakubis, Marian, Miskovic, Peter, Keegan, Tom
• Format: Article
• Language: English
• Subjects: Adult; arsenic; Arsenic - adverse effects; Arsenic - analysis; arsenic exposure as a function of the distances of the residences to the coal-burning power plant; arsenic uptake calculated by weighting food frequencies with arsenic concentrations and annual consumption of food items; Asnut1; Asnut2; Asres1; Asres2; Biological and medical sciences; Case-Control Studies; coal; Coal - adverse effects; confidence interval; Confounding Factors (Epidemiology); Dermatology; Diet; environmental exposure; Environmental Exposure - analysis; EXPASCAN; EXPosure to ArSenic and CANcer Risk in Central and East Europe; Female; heavy; Humans; Incidence; Interviews as Topic; Male; Medical sciences; metals; Middle Aged; neoplasms; NMSC; nonmelanoma skin cancer; odds ratio; Power Plants; Regression Analysis; Residence Characteristics; Risk Assessment; Risk Factors; same as Asnut 1 multiplied by a factor for consumption of homegrown food; same as Asres1 plus the distances to work locations; skin neoplasms; Skin Neoplasms - chemically induced; Skin Neoplasms - epidemiology; Slovakia - epidemiology; Tumors of the skin and soft tissue. Premalignant lesions
• ISSN: 0002-9262; 1476-6256; 0002-9262
• DOI: 10.1093/aje/155.9.798

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.