Arsenic and nonmelanoma skin cancer in slovakia l.jpg
Sponsored Links
This presentation is the property of its rightful owner.
1 / 32

Arsenic and Nonmelanoma Skin Cancer in Slovakia PowerPoint PPT Presentation


  • 245 Views
  • Uploaded on
  • Presentation posted in: General

Arsenic and Nonmelanoma Skin Cancer in Slovakia. Beate Pesch Environmental Health Research Institute, Germany. Part of the EU-funded Project EXPASCAN ‚Exposure to Arsenic and Cancer in Central & Eastern Europe‘. www.icconsultants.co.uk/ EXPASCAN.html. PARTNERS

Download Presentation

Arsenic and Nonmelanoma Skin Cancer in Slovakia

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Arsenic and Nonmelanoma Skin Cancer in Slovakia

Beate Pesch

Environmental Health Research Institute, Germany


Part of the EU-funded Project EXPASCAN‚Exposure to Arsenic and Cancer in Central & Eastern Europe‘

www.icconsultants.co.uk/EXPASCAN.html


PARTNERS

Imperial College & IC Consultants, London, UK

State Health Institutes, Prievidza, Bankska Bystrica, SK

Institute of Hygiene and Epidemiology, Prague, CZ

Environmental Health Research Institute, Duesseldorf, D

University of Cluj, RO


Objective

Estimation of the risk of environmental arsenic exposure from power plant emissions for non-melanoma skin cancer (NMSC)


Estimation of the risk of environmental arsenic exposure

  • Choose study design(s)

  • Assess exposure

  • Estimate risk

  • Discuss confounders


Arsenic and arsenic compounds

Environmental Health Criteria (EHC) 2nd edition, 224; 2001

WHO, Geneva

www.inchem.org


Estimate by Distance to the Power Plant

  • Environmental As exposure

  • NMSC incidence

    Associate As exposure with NMSC risk& control for covariates


ENO Power Plant (Slovakia)


Environmental Arsenic Exposure

  • Historical As exposure

    Air pollution modelling

    (Colvile et al. 2001)

  • Current As exposure

    Measurement of As in soil, house dust

    (Keegan et al. 2002)


Arsenic Emissions (tons/year) of the ENO Power Plant, Slovakia

200

As t/a

100

0

1953

1960

1970

1980

1990

1999

Year


Arsenic (mg/g) in soil 1999

by distance from the plant

Distance N Median MinMax

< 5 km 404114 134

5-10 km 102 23 9 139

>10km 6820 10 53


Cancer Incidence Analysis

  • Prievidza district versus Slovakia

  • Within Prievidza district by distance to the plant


Comparative Incidence Figures (CIF) Prievidza district versusSlovakia 1975-84

All malignancies 1.1

NMSC 1.6

Lung cancer 1.0

Bladder cancer 0.9


CIF by Distance to the Power Plantcutoff 7.5 km 1977-1991

Basal cell carcinoma 1.6Squamous cell ca. 1.6

Lung cancer 1.0

Bladder cancer 1.1


SIR NMSC (1996-1999)by Distance to the Plant

<5km5-10 km >10km

Reference

District 1.21.10.8

0.9- 1.6 1.0-1.3 0.6-0.9

Slovakia 1.6 1.5 1.0

1.2- 2.2 1.3-1.7 0.9-1.3


Population-based Case-Control Study

  • 264 NMSC cases (1996-99)response rate 80%

  • 286 population controls

    response rate 72%

    Matching by sex, age


Statistical Power

  •  = 5% one-sided

  • = 20% (power 80%)

  • controls exposed to As=10%

  • N cases = 264

  • N controls = 286

  • RR to be detected >= 1.9


NMSC Risk Estimation

  • Logistic regression

    conditional on age, gender:Odds Ratio (OR), 95% CI

  • Potential confounders: occupational As exposure

    smoking


Occupational As exposure (Job-Exposure Matrix)


Cigarette Smoking


Skin Type & UV Exposure


Fresh Vegetables & Fruits


Exposure Assessment and Risk Estimationfor Environmental Arsenic

  • Dietary habits

  • Residential history


Arsenic Exposurefrom Dietary Habits

  • AsNut1 = Σ w(f )* I(f)25 food items f: w(f) food frequencies I(f) annual As intake

  • AsNut2 = AsNut1 * s if self-support s= 2, else 1


Arsenic Exposure with Dietary Habits


As Exposurefrom Residential Data

AsRes1 = Σ E(t)* w(d(t),t)

for all places of residence:E(t) annual emissionw(d(t),t) immission weight


Correction of spatial selection bias for distance-related variables AsRes

  • (1) Random re-sampling of controls SAS Surveyselect

  • (2) Bootstrap method OR, 95% CI for R=800 re-sampled groups


Arsenic Exposure with Residential Data


Environmental Arsenic Exposure & NMSC Risk

  • Elevated NMSC incidence in the vicinity of the plant.

  • As exposure from dietary and residential data are associated with excess risk.

  • Residual confounding can not be excluded.


  • Login