Epidemiology of chronic disease related to arsenic in Argentina: a systematic review

A. BARDACH; A. CIAPPONI; N. SOTO; M. CALDERÓN; A. BRIATORE; N. CADOPPI; R. TASSARA; M. LITTER

SCIENCE OF THE TOTAL ENVIRONMENT

ELSEVIER SCIENCE BV

Lugar: Amsterdam; Año: 2015 vol. 538 p. 802 - 816

0048-9697

Four million people in Argentina are exposed to arsenic contamination from drinking waters of several centernorthern provinces. A systematic review to examine the geographical distribution of arsenic-related diseasesin Argentina was conducted, searching electronic databases and gray literature up to November 2013. Key informants were also contacted. Of the 430 references identi fied, 47 (mostly cross-sectional and ecological designs)referred to arsenic concentration in water and its relationship with the incidence and mortality of cancer, dermatological diseases and genetic disorders. A high percentage of the water samples had arsenic concentrationsabove the WHO threshold value of 10 μg/L, especially in the province of Buenos Aires. The median prevalenceof arsenicosis was 2.6% in exposed areas. The proportion of skin cancer in patients with arsenicosis reached88% in case-series from the Buenos Aires province. We found higher incidence rate ratios per 100 μg/L incrementin inorganic arsenic concentration for colorectal, lung, breast, prostate and skin cancer, for both genders. Liver andskin cancer mortality risk ratios were higher in regions with medium/high concentrations than in those with lowconcentrations. The relative risk of mortality by skin cancer associated to arsenic exposure in the province ofBuenos Aires ranged from 2.5 to 5.2. In the north of this province, high levels of arsenic in drinking water werereported; however, removal interventions were scarcely documented. Arsenic contamination in Argentina is associated with an increased risk of serious chronic diseases, including cancer, showing the need for adequate andtimely actions.