Study [reference] (Table from original publication) | Study locale | Outcome | Exposure1[comments] | ICD2 | Outcome measure | Cases | Risk estimate (95% CI) |
---|---|---|---|---|---|---|---|
Chen et al. 19853[24] | 84 villages from 4 neighbouring townships on SW coast, Taiwan | Mortality 1968-82 | Median arsenic content of artesian well and (range): 780 μg˙•L-1 (350–1,140); in shallow well: 40 (0.0–300). Period of samples collection not reported. | ICD 188 | SMRmale | 167 | 11.0 (9.33–12.7) |
SMRfemale | 165 | 20.1 (17.0–23.2) | |||||
[Comparison of mortality rate in Blackfoot disease-endemic areas (BFD) with those of the general population.] | |||||||
* Chen et al. 19884[26] (Table One) | BFD endemic area, Taiwan | Mortality 1973-86 | Arsenic well water concentration (μg˙•L-1). Period of samples collection not reported. | ICD9 188 | |||
General population | ASMRmale | ||||||
< 300 | – | 3.1 | |||||
300-590 | – | 15.7 | |||||
≥ 600 | – | 37.8 | |||||
– | 89.1 | ||||||
General population | ASMRfemale | ||||||
< 300 | – | 1.4 | |||||
300-590 | – | 16.7 | |||||
≥ 600 | – | 35.1 | |||||
[Comparison of mortality rate in BFD with those of the general population.] | – | 91.5 | |||||
*Wu et al. 19895[27] (Table Three) | BFD endemic area, Taiwan (42 villages) | Mortality 1973-86 | Arsenic well water concentration (μg˙•L-1) based on well water samples collected between 1964–66. | ICD8 188 | |||
< 300 | ASMRmale | 23 | 22.6 | ||||
300–590 | 36 | 61.0 | |||||
≥ 600 | 26 | 92.7 | |||||
< 300 | ASMRfemale | 30 | 25.6 | ||||
300–590 | 36 | 57.0 | |||||
≥ 600 | 30 | 111.3 | |||||
Chen and Wang 19906[28] (Table Four) | 314 precincts & townships in Taiwan, including 4 from BFD endemic area | Mortality 1972-83 | Average arsenic levels in water samples of all 314 geographical units. 73.9% had < 5% of wells with > 50 μg˙•L-1 ; 14.7% had 5-14%; 11.5% had ≥ 15%. Well water samples collected between 1974–76. | ICD 188 | |||
All precincts & townships | ASMRmale | – | 3.9 (0.5) | ||||
ASMRfemale | – | 4.2 (0.5) | |||||
Southwestern townships | ASMRmale | – | 3.7 (0.7) | ||||
ASMRfemale | – | 4.5 (0.7) | |||||
Chiang et al. 19937[29] (Table Two) | BFD endemic area in Taiwan and 2 neighbouring areas | Incidence 1981-85 | Exposure not evaluated, but based on Chen et al. 1985, the median arsenic content of artesian well in this area was 780 μg˙•L-1 (350 – 1,140); that of shallow well was 40 μg˙•L-1 (0.0 – 300). Period of samples collection not reported. | N/A | Endemic area | ||
IR_both_sex | 140 | 23.5 | |||||
IRmale | 81 | 26.1 | |||||
IRfemale | 59 | 21.1 | |||||
[Comparison of incidence rate in BFD with those of neighbouring areas and Taiwan as a whole.] | Neighbouring Endemic area | ||||||
IR_both_sex | 13 | 4.45 | |||||
IRmale | 7 | 4.65 | |||||
IRfemale | 6 | 4.28 | |||||
All Taiwan | |||||||
IR_both_sex | 2,135 | 2.29 | |||||
IRmale | 1,608 | 3.31 | |||||
IRfemale | 527 | 1.17 | |||||
Hopenhayn-Rich et al. 19968[35] (Table Three) | 26 counties in Cordoba, Argentina | Mortality 1986-91 | Arsenic drinking water concentration ranging from 100 to 2,000 μg˙•L-1. | ICD9 188 | |||
* Hopenhayn-Rich et al. 1998 [36] (Tables Three, Four) | Low | 113 | 0.80 (0.66–0.96) | ||||
Medium | SMRmale | 116 | 1.28 (1.05–1.53) | ||||
High (178 μg˙•L-1 on average) | 131 | 2.14 (1.78–2.53) | |||||
Low | 39 | 1.21 (0.85–1.64) | |||||
Medium | SMRfemale | 29 | 1.39 (0.93–1.99) | ||||
High (178 μg˙•L-1 on average) | 27 | 1.82 (1.19–2.64) | |||||
[Arsenic measurements from a variety of sources, including official reports of water analyses from the 1930, 2 scientific sampling studies and a water survey.] | |||||||
Guo et al. 19979[37] (Table Two) | 243 townships in Taiwan | Incidence 1980-87 | Arsenic well water concentration ranging from < 50 to > 640 μg˙•L-1. | ICD 188 | RDmale | – | 0.57 (0.07) |
Estimate presented measured at > 640 μg˙•L-1. | RDfemale | – | 0.33 (0.04) | ||||
[Arsenic measurements from a National survey of 83,656 wells in 243 townships, collected mostly between 1974–76.] | |||||||
Rivara et al.1997 [38] (Table Four) | Chile | Mortality 1950-92 | Annual average arsenic concentration in drinking water for Antofagasta (Region II of Chile) ranging between 40 to 860 μg˙•L-1. Data from historical records from 1950–1992. | ICD 188 | RR | – | 10.2 (8.6–12.2) |
[Comparison of mortality rate in Region II (exposed populations) vs Region VIII (control populations.] | |||||||
Smith et al. 1998 [39] | Chile | Mortality 1989-93 | Region II of Northern Chile with population weighted average arsenic concentration in drinking water up to 569 μg˙•L-1 compared with the rest of Chile; exposure generally < 10 μg˙•L-1. | N/A | SMRmale | 93 | 6.0 (4.8–7.4) |
SMRfemale | 64 | 8.2 (6.3–10.5) | |||||
[Arsenic measurements from 1950–94.] | |||||||
Hinwood et al. 1999 [88] (Table Two) | 22 areas in Victoria, Australia | Incidence 1982-91 | Median water arsenic concentration ranging 13 μg˙•L-1 to 1,077 μg˙•L-1. | ICD 188, 189.1-189.3 | SIR | 303 | 0.94 (0.84–1.06) |
[Selected areas were those where samples with soil and/or water arsenic concentration were generally in excess of 10 μg˙•L-1. Period for samples collection is not available.] | |||||||
* Tsai et al. 1999 [41] (Tables Two, Three) | 4 townships from BFD endemic area in SW coast, Taiwan | Mortality 1971-94 | Median arsenic content of artesian well: 780 μg˙•L-1 (range: 350–1,140). Period of samples collection not reported. Authors state that artesian wells were no longer used by the mid-1970s. | ICD9 188 | SMRlocal-male | 312 | 8.92 (7.96–9.96) |
SMRnational-male | 312 | 10.5 (9.37–11.7) | |||||
[Comparison of mortality in BFD endemic area with that of a local reference population (Chiayi-Tainan county) and that of Taiwan as a whole.] | SMRlocal-female | 295 | 14.1 (12.51–15.8) | ||||
SMRnational-female | 295 | 17.8 (5.70–19.8) | |||||
* Lamm et al. 200410[89] (Table One) | 133 counties in 26 states, USA | Mortality 1950-79 | Arsenic groundwater water concentration (μg˙•L-1). Period of samples collection not reported. | N/A | Counties | ||
3.0–3.9 | SMRwhite_male | 53 | 0.95 (0.89–1.01) | ||||
4.0–4.9 | SMRwhite_male | 22 | 0.95 (0.88–1.02) | ||||
5.0–7.4 | SMRwhite_male | 28 | 0.97 (0.85–1.12) | ||||
7.5–9.9 | SMRwhite_male | 14 | 0.89 (0.75–1.06) | ||||
10.0–19.9 | SMRwhite_male | 11 | 0.90 (0.78–1.04) | ||||
20.0–49.9 | SMRwhite_male | 3 | 0.80 (0.54–1.17) | ||||
50.0–59.9 | SMRwhite_male | 2 | 0.73 (0.41–1.27) | ||||
[Median arsenic concentration ranged between 3–60 (μg˙•L-1), with 65% of the counties and 82% of the population in the range of 3–5 (μg˙•L-1).] | |||||||
Marshall et al. 2007 [50] (Table Three) | Chile | Mortality 1950-2000 | Northern Chile (Region II) with population weighted average arsenic concentration in drinking water up to 569 μg˙•L-1 vs Region V which is otherwise similar to Region II but not exposed to arsenic. Between 1958–1970, arsenic concentration in water supply of Antofagasta and nearby Mejillones (Region II) averaged 870 μg˙•L-1 and declined in the 1970s when water treatment plants were installed. | ICD 188 | |||
RRmale-1971–73 | 9 | 1.71 (0.80–3.69) | |||||
RRmale-1974–75 | 9 | 5.95 (2.22–16.0) | |||||
RRmale-1977–79 | 17 | 2.10 (1.19–3.72) | |||||
RRmale-1980–82 | 35 | 5.04 (3.13–8.10) | |||||
RRmale-1983–85 | 41 | 5.77 (3.66–9.09) | |||||
RRmale-1986–88 | 47 | 6.10 (3.97–9.39) | |||||
RRmale-1989–91 | 52 | 4.73 (3.23–6.94) | |||||
RRmale-1992–94 | 62 | 4.95 (3.47–7.06) | |||||
RRmale-1995–97 | 56 | 4.43 (3.07–6.38) | |||||
RRmale-1998–2000 | 58 | 4.27 (2.98–6.11) | |||||
RRfemale-1971–73 | 7 | 3.45 (1.34–8.91) | |||||
RRfemale-1974–75 | 4 | 3.09 (0.90–10.6) | |||||
RRfemale-1977–79 | 10 | 5.39 (2.24–13.0) | |||||
RRfemale-1980–82 | 22 | 9.10 (4.59–18.1) | |||||
RRfemale-1983–85 | 22 | 8.41 (4.30–16.4) | |||||
RRfemale-1986–88 | 37 | 7.28 (4.44–12.0) | |||||
RRfemale-1989–91 | 35 | 6.61 (4.02–10.9) | |||||
RRfemale-1992–94 | 42 | 13.8 (7.74–24.5) | |||||
RRfemale-1995–97 | 44 | 7.60 (4.78–12.1) | |||||
RRfemale-1998–2000 | 50 | 9.16 (5.76–14.5) | |||||
*†Meliker et al. 2007 [90] (Table Two) | 6 counties, Southeastern Michigan, USA | Mortality 1979-97 | Population weighted median arsenic concentration in water of 7.58 μg˙•L-1. Data from 9,251 well water samples collected between 1983–2002. | ICD9 188 | SMRmale | 348 | 0.94 (0.82–1.08) |
SMRfemale | 171 | 0.98 (0.80–1.19) | |||||
*†Pou et al. 201112[63] (Table Two) | 26 counties in province of Cordoba, Argentina | Mortality 1986-2006 | Arsenic drinking water concentration ( μg˙•L-1). Period of samples collection not reported. | ICD10 C67 | |||
Low (0–40) | SMRmale | – | 3.14 (2.9–3.4) | ||||
Medium (40–320) | – | 4.0 (3.6–4.5) | |||||
High (320–1,800) | – | 4.7 (4.1–5.4) | |||||
Low (0–40) | SMRfemale | – | 1.0 (reference) | ||||
Medium (40–320) | – | 0.94 (0.84–1.1) | |||||
High (320–1,800) [Arsenic measurements from many surveys, one dating 50 years prior to study publication but with arsenic levels showing high degree of consistency with a more recent survey with no exact date detailed.] | – | 1.2 (1.04–1.4) | |||||
*†Su et al. 2011 [64] (Table Two) | BFD endemic area, Taiwan | Mortality 1979-2003 | Median arsenic content of artesian well: 780 μg˙•L-1 (range: 350–1,140). [Period of samples collection not reported. Artesian wells in the region were dug in the 1920s but no longer used by mid-1970s. Results show a comparison of mortality in BFD endemic area with that of Taiwan.] | ICD9 188 | SMR | 785 | 5.3 (4.9–5.6) |
†Aballay et al. 201211[62] (Table Two) | 123 districts in province of Cordoba, Argentina | Incidence 2004 | Arsenic water samples from 3 aquifers: (1) Rjojan plain (concentration ranged 0–40 μg˙•L-1 - 23 wells), (2) Pampean mountains (0–320 μg˙•L-1- 114 wells) and (3) Chaco-Pampean plain (0–1,800 μg˙•L-1 - 301 wells). In 80 wells, arsenic was undetected. | N/A | RRmale | – | 13.8 (6.80–28.0) |
RRfemale | – | 12.7 (2.51–63.9) | |||||
†Fernández et al. 2012 [55] | Antofagasta, Chile | Mortality 1983-2009 | Arsenic drinking water concentration ranging 800–900 μg˙•L-1. [Arsenic levels based on the last 60 years and obtained from the local tap water company in Antofagasta. Results compares mortality rate in Antofagasta with the rest of Chile.] | ICD10 C67 | RRmale | – | 5.3 (4.8–5.8) |
RRfemale | – | 7.8 (7.0–8.7) | |||||
RRboth_sex | – | 6.1 (5.7–6.6) |