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

ARIEL ESTEBAN BARDACH; AGUSTIN CIAPPONI ; NATALIE SOTO; MARTIN R. CHAPARRO; MARIA CALDERON; AGUSTINA BRIATORE; NORMA CADOPPI; ROBERTO TASSARA ; MARTA I. LITTER

ELSEVIER SCIENCE B. V.

ELSEVIER

Año: 2015

Four million people in Argentina are exposed to arsenic contamination from drinking waters of several centernorthernprovinces. 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 informantswere also contacted. Of the 430 references identified, 47 (mostly cross-sectional and ecological designs)referred to arsenic concentration in water and its relationship with the incidence and mortality of cancer, dermatologicaldiseases 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 associatedwith an increased risk of serious chronic diseases, including cancer, showing the need for adequate andtimely actions.