It was expected that the incidence of skin cancer would be related to the known high arsenic levels in water supplies of Lane County, Oregon. Incidence rates were based on all histopathologically confirmed cases among Lane County residents diagnosed during 1958-1971 and were compared to mean water arsenic levels measured during 1968-1974. Basal cell carcinoma had a mean annual incidence rate of 88 per 100,000, a 5:4::M:F sex ratio, and an increasing risk for both sexes in urban areas. Squamous cell carcinoma incidence was 50 per 100,000 and showed 2:1:M:F sex ratio but no urban predilection. Neither type of skin cancer was directly related to the arsenic levels as expected, although sporadic individuals with sufficient exposure could manifest the relationship. Fewer than expected drinking water sources were found to contain high arsenic content, so that the Lane County data do not necessarily contradict previous reports of positive correlation. The basal cell carcinoma pattern suggested that this disease might be potentiated by urban air pollutants.
A case of acute arsenical intoxication arising from ingested well water containing only 1.2 ppm of arsenic is reported. After a latent period of 14 years, multiple cutaneous basal cell carcinomas developed. The water was analyzed for a variety of other trace elements and compounds and no evidence for the existence of other carcinogens was found. This study strengthens the concept that arsenic is a carcinogen. The role of a possible selenium deficiency is also discussed.
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