oral ingestion of hexavalent chromium through drinking water and cancer mortality in an industrial area of greece - an ecological study口服摄入六价铬通过饮用水和癌症死亡率在一个工业区的希腊u2014u2014生态研究.pdf

Linos et al. Environmental Health 2011, 10:50 /content/10/1/50 RESEARCH Open Access Oral ingestion of hexavalent chromium through drinking water and cancer mortality in an industrial area of Greece - An ecological study 1,2* 1,2,3 4,5,6 1 1 Athena Linos , Athanassios Petralias , Costas A Christophi , Eleni Christoforidou , Paraskevi Kouroutou , 1 1,2 7 4,5 8 Melina Stoltidis , Afroditi Veloudaki , Evangelia Tzala , Konstantinos C Makris and Margaret R Karagas Abstract Background: Hexavalent chromium is a known carcinogen when inhaled, but its carcinogenic potential when orally ingested remains controversial. Water contaminated with hexavalent chromium is a worldwide problem, making this a question of significant public health importance. Methods: We conducted an ecological mortality study within the Oinofita region of Greece, where water has been contaminated with hexavalent chromium. We calculated gender, age, and period standardized mortality ratios (SMRs) for all deaths, cancer deaths, and specific cancer types of Oinofita residents over an 11-year period (1999 - 2009), using the greater prefecture of Voiotia as the standard population. Results: A total of 474 deaths were observed. The SMR for all cause mortality was 98 (95% CI 89-107) and for all cancer mortality 114 (95% CI 94-136). The SMR for primary liver cancer was 1104 (95% CI 405-2403, p-value 0.001). Furthermore, statistically significantly higher SMRs were identified for lung cancer (SMR = 145, 95% CI 100- 203, p-value = 0.047) and cancer of the kidney and other genitourin