EXPOSURE TO ARSENIC IN DRINKING WATER AND RISK OF BLADDER CANCER

The municipality of Bogatić, part of Mačva District, belongs to the Pannonian Basin, where high concentrations of arsenic in artesian wells were detected. Numerous epidemiological studies have confirmed the association of exposure to arsenic in drinking water and bladder cancer (C67). This retrospective ten-year analysis included age-standardized incidence rates (ASRs) and age-specific incidence rates of C67 in the municipality of Bogatić and rural municipalities of Mačva District. The concentration of arsenic in drinking water was determined at Šabac Public Health Institute (PHI) laboratories in 2015. ASRs were estimated using data from regional cancer registries at Šabac PHI and compared by use of the Mann-Whitney U test. Control population was recruited from an area where there were no artesian wells or hydrogeological conditions that would indicate elevated concentrations of arsenic in drinking water. Arsenic levels in all artesian wells in Bogatić municipality were 1.4 to 41 times higher than the maximum permissible concentration (mean 120 µg/L±165). Female subjects from Bogatić municipality had higher ASRs of C67 compared with the populations in rural municipalities of Mačva District (p<0.01), while the incidence of bladder cancer was by 13% greater than that in central Serbia (standardized incidence ratio, 113; 95% CI 96.97-131.35). Male subjects from Bogatić municipality had higher ASRs of C67 but the difference was not statistically significant (p>0.05). Our analyses suggested that exposure to arsenic in drinking water could triple the risk of bladder cancer. These results support the conclusions of previous studies that there may be an association between higher concentrations of arsenic in drinking water and higher ASRs of bladder cancer in both male and female subjects.