| Abstract | Cilj istraživanja Cilj ovog istraživanja je utvrditi jesu li stanovnici županije Osječko-baranjske i Vukovarsko-srijemske izloženi povišenim koncentracijama arsena u vodi za piće i u kojoj mjeri, te jesu li i u kojoj mjeri povišene koncentracije anorganskog arsena utjecale na zdravstveno stanje izložene populacije u pogledu incidencije i smrtnosti od karcinoma mokraćnog mjehura, incidencije karcinoma pluća, te pojavnosti nepovoljnih ishoda trudnoće, mrtvorođenja i spontanih pobačaja. Ispitanici, materijal i metode Uzorkovana je i na osnovne parametre zdravstvene ispravnosti i koncentraciju arsena analizirana voda za piće iz vodoopskrbnih objekata Vukovarsko-srijemske i Osječko-baranjske županije. Sukladno rezultatima vodoopskrbni objekti i pripadajuće stanovništvo je podijeljeno u skupinu neizloženih arsenu (<10 μg/L) i izloženih arsenu (10-50 i >50 μg/L). Podaci o pobolu dobiveni su iz javnozdravstvenih baza podataka Hrvatskog zavoda za javno zdravstvo, registra za rak, baze umrlih, baze poroda i baze prekida trudnoće. Rezultati Od 116 pregledanih uzoraka vode za piće 66 (56,8%) nije odgovaralo standardima. Arsen je u 45 uzoraka bio viši od 10 μg/L, a u 19 uzoraka viši od 50 μg/L. Razinama arsena u vodi za piće iznad 10 μg/L izloženo je ukupno 220074, a razinama iznad 50 μg/L 25283 stanovnika obje županije. Incidencija i smrtnost od karcinoma mokraćnog mjehura su bile više u ispitanika koji su izloženi arsenu, od onih u neizloženih ispitanika, a rezultati logističke regresije upućuju na viši rizik od karcinoma u izloženih i statistički su značajni za incidenciju u dobnim skupinama 60-79 godina, a za smrtnost u žena i ukupno za oba spola u razinama izloženosti 10-50 μg/L i u ukupno izloženih >10 μg/L.Također je prisutan i rast stopa incidencije i smrtnosti s rastom razine izloženosti arsenu. Razlike u incidenciji karcinoma traheje, bronha i pluća u desetgodišnjem periodu između ispitanika izloženih arsenu u vodi za piće i neizloženih ispitanika su prisutne, ali su male, a rast stopa s rastom izloženosti nekonzistentan. Omjeri šansi za ukupno izložene su, iako u dvije trećine podgrupa veći od 1, niskih vrijednosti (0,96-1,25) i nisu dosegli statističku značajnost niti u jednoj podgrupi. U izloženoj populaciji je također bio i viši rizik od nepovoljnih ishoda trudnoće, mrtvorođenja i spontanih abortusa, no omjer šansi nije dosegnuo statističku značajnost, a gradijent rasta stopa s rastom razine izloženosti je prisutan za niže razine izloženosti, a u najvišim razinama je izostao. IVZaključak Izloženost arsenu u vodi za piće stanovnika Istočne Hrvatske čije se koncentracije kreću do maksimalnih 197 μg/L, a u uzorcima koji prekoračuju 10 μg/L srednja vrijednost je 56,3 μg/L,povezana je s povećanom pojavnosti i smrtnosti od karcinoma mokraćnog mjehura, te pojavnosti nepovoljnih ishoda trudnoće, mrtvorođenja i spontanih pobačaja. U ovom istraživanju nije dokazan utjecaj arsena u vodi za piće na incidenciju karcinoma pluća. |
| Abstract (english) | The aim of the study The aim of this study was to determine whether residents of the County of Osijek –Baranja and Vukovar -Syrmia are exposed to elevated concentrations of arsenic in drinking water and to what extent, and whether and to what extent elevated concentrations of inorganic arsenic affected the health of exposed population in terms of incidence and mortality from urinary bladder cancer, lung cancer and the prevalence of adverse outcomes of pregnancy, stillbirths and miscarriages. Subjects, materials and methods Drinking water samples from water supply facilities of Vukovar –Syrmia and Osijek –Baranja County were taken and analyzed for basic health safety parameters and arsenic concentrations. According to the results obtained, water supply facilities and pertaining population were divided into two groups: subjects unexposed to arsenic (<10 μg/L) and those exposed to arsenic (10-50 and >50 μg/L). Morbidity and mortality data were obtained from public health databases of the Croatian National Institute of Public Health: National Cancer Registry, mortality database, birth database and database on abortions. Results Sixty six (56.8%) samples of the total of 116 samples examined did not correspond to health safety standards. In 45 samples arsenic concentration was higher than 10μg/L and in 19 samples higher than 50μg/L, with total population of 222 074 and 25 283 from both counties being exposed to those concentrations respectively. Urinary bladder incidence and mortality were higher in subjects exposed to arsenic compared to those unexposed, with logistic regression results indicating higher risk of cancer in exposed population with statistical significance for incidence in the age group 60-79 years, as well as for mortality in women and for both genders exposed to arsenic concentration of 10-50 μg/L and the total number of population exposed to arsenic levels in drinking water higher than 10 μg/L. Furthermore, an increase in incidence and mortality rate correlating the increasing level of exposure to arsenic is found. Differences in the incidence of tracheal, bronchial and lung cancer during ten-year period between subjects exposed to arsenic in drinking water and those unexposed were present, but were not statistically significant, and the increase in rate was inconsistent with the increase of arsenic exposure level. Odds ratio values for total exposed population, although in two-thirds of sub-groups higher than 1, were low (0.96 -1.25) and did not reach statistical significance in any subgroup. Furthermore, in the exposed population a higher risk of adverse VIpregnancy outcomes, stillbirths and spontaneous abortions was found, but odds ratio not reaching statistical significance; a gradient in increase in rate in reference to the increased exposure level is recorded for the lower levels of exposure, while in the highest exposure levels such gradient was lacking. ConclusionEastern Croatian population exposure to arsenic in drinking water, whose concentrations range up to a maximum of 197 μg/L, with mean value of 56.3 μg/L for all samples exceeding 10 μg/L, is linked with the increased urinary bladder cancer incidence and mortality, as well as incidence of adverse outcomes of pregnancy, stillbirths and spontaneous abortions. Present study, however, did not find the impact of arsenic in drinking water on the incidence of lung cancer. |
