Journal Article

Case-Control Study of Bladder Cancer and Drinking Water Arsenic in the Western United States

Craig Steinmaus, Yan Yuan, Michael N. Bates and Allan H. Smith

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 158, issue 12, pages 1193-1201
Published in print December 2003 | ISSN: 0002-9262
Published online December 2003 | e-ISSN: 1476-6256 | DOI:
Case-Control Study of Bladder Cancer and Drinking Water Arsenic in the Western United States

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Numerous epidemiologic investigations have identified links between high concentrations of arsenic in drinking water and cancer, although the risks at lower exposures are largely unknown. This paper presents the results of a case-control study of arsenic ingestion and bladder cancer in seven counties in the western United States. These counties contain the largest populations historically exposed to drinking water arsenic at concentrations near 100 µg/liter. All incident cases diagnosed from 1994 to 2000 were recruited. Individual data on water sources, water consumption patterns, smoking, and other factors were collected for 181 cases and 328 controls. Overall, no increased risks were identified for arsenic intakes greater than 80 µg/day (odds ratio = 0.94, 95% confidence interval: 0.56, 1.57; linear trend, p = 0.48). These risks are below predictions based on high dose studies from Taiwan. When the analysis was focused on exposures 40 or more years ago, an odds ratio of 3.67 (95% confidence interval: 1.43, 9.42; linear trend, p < 0.01) was identified for intakes greater than 80 µg/day (median intake, 177 µg/day) in smokers. These data provide some evidence that smokers who ingest arsenic at concentrations near 200 µg/day may be at increased risk of bladder cancer.

Keywords: arsenic; bladder neoplasms; smoking; water supply; Abbreviations: CI, confidence interval; HCFA, Health Care Financing Administration.

Journal Article.  6730 words. 

Subjects: Public Health and Epidemiology

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