|LETTERS TO EDITOR
|Year : 2021 | Volume
| Issue : 1 | Page : 149-151
Exposure to a high level of arsenic in drinking water and the risk of bladder cancer in Taiwan
Chidiebere Emmanuel Okechukwu
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
|Date of Submission||29-Dec-2020|
|Date of Decision||05-Mar-2021|
|Date of Acceptance||05-Mar-2021|
|Date of Web Publication||26-Mar-2021|
Chidiebere Emmanuel Okechukwu
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome 00185
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Okechukwu CE. Exposure to a high level of arsenic in drinking water and the risk of bladder cancer in Taiwan. Cancer Res Stat Treat 2021;4:149-51
|How to cite this URL:|
Okechukwu CE. Exposure to a high level of arsenic in drinking water and the risk of bladder cancer in Taiwan. Cancer Res Stat Treat [serial online] 2021 [cited 2021 Apr 23];4:149-51. Available from: https://www.crstonline.com/text.asp?2021/4/1/149/312098
Arsenate (AsV) and arsenite (AsIII) are commonly detected in well water. AsIII is more toxic, and it is a known risk factor for bladder cancer (BCa); AsIII and methyltransferase gene might play a part in the development of BCa by controlling inorganic arsenic metabolism. In humans, arsenic in its mineral form is transformed to monomethylarsonic acid and dimethylarsinic acid in a detoxification process. The diffusion of some organic and nitrogenous compounds from anthropogenic sources into the groundwater can cause arsenic mobilization in the aquifer.
A multivariate regression and post hoc analysis conducted by Lin et al. showed that exposure to high arsenic concentration in drinking water led to an increased incidence of liver cancer in Taiwan, but such an impact was not noticeable at an exposure level <0.64 mg/L. This corroborates the fact that exposure to a higher level of arsenic is linked to carcinogenesis. Moreover, Chen et al. found that patients with arsenic-related BCa might have reduced chances of survival because of their tumor phenotypes. The prevalence of BCa in villages that rely on artesian well water might be because of arsenic acting as an elevated-dose carcinogen or as a co-cancer causing agent with humic acid in artesian well water. Based on the outcome of a prolonged follow-up study of residents in endemic areas, arsenic ingested from drinking artesian well-water and the associated deoxyribonucleic acid lesions increased the risk of BCa in northeastern Taiwan. Interestingly, Yang et al. estimated the standardized mortality ratios for BCa in the blackfoot disease (BFD)-prevalent area in southwestern Taiwan from 1971 to 2000. The outcome of their quantitative analysis showed that the mortality rate due to BCa reduced progressively after upgrading the drinking water supply system to remove arsenic and its associated compounds from artesian well water. This discovery was further evidence that the exposure to arsenic present in artisan well water may have accounted for the diagnosed cases of BCa in the BFD-endemic area and mortality due to cancer. Several researchers found a significant correlation between the degree of exposure to higher levels of arsenic in artesian well water and the risk of BCa in the southwestern and northeastern areas in Taiwan [Table 1]. Moreover, elevated concentration of arsenic in the urine was correlated with a high risk of BCa.
|Table 1: Summary of studies on exposure to a high arsenic level in drinking water and risk of bladder cancer in Taiwan|
Click here to view
In conclusion, exposure to the high concentration of arsenic over a long period through drinking artesian well water was associated with the occurrence of BCa in Taiwan, particularly in the arsenian-endemic areas of Southwest and Northeast Taiwan. Moreover, the prevalence of high-grade tumors was more in the BFD-endemic area. Proper evaluation of the risk of BCa on exposure to a lower concentration of arsenic over a longer period requires further investigation.
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Conflicts of interest
There are no conflicts of interest.
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