Interaction between Occupational and Non-Occupational Arsenic Exposure and Tobacco Smoke on Lung Cancerogenesis: A Systematic Review

Author:

Folesani Giuseppina1ORCID,Galetti Maricla1ORCID,Petronini Pier Giorgio2,Mozzoni Paola23ORCID,La Monica Silvia2ORCID,Cavallo Delia1ORCID,Corradi Massimo23ORCID

Affiliation:

1. Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL-Italian Workers’ Compensation Authority, Via Fontana Candida 1, Monte Porzio Catone, 00078 Rome, Italy

2. Department of Medicine and Surgery, University of Parma, Viale Gramsci 14, 43126 Parma, Italy

3. Center of Excellence for Toxicological Research (CERT), University of Parma, Viale Gramsci 14, 43126 Parma, Italy

Abstract

Although a higher lung cancer risk has been already associated with arsenic exposure, the contribution of arsenic and its compounds to the carcinogenic effects of other agents, such as tobacco smoke, is not well characterized. This systematic review examined the relationship between occupational and non-occupational arsenic exposure and tobacco smoking on lung cancer risk using papers published from 2010 to 2022. Two databases, PUBMED and Scifinder, were used for the searches. Among the sixteen human studies included, four were about occupational exposure, and the others were about arsenic in drinking water. Furthermore, only three case-control studies and two cohort studies evaluated an additive or multiplicative interaction. The interaction between arsenic exposure and tobacco smoke seems to be negligible at low arsenic concentrations (<100 μg/L), while there is a synergistic effect at higher concentrations. Finally, it is not yet possible to assess whether a linear no-threshold (LNT) model for lung cancer risk can be applied to the co-exposure to arsenic and tobacco smoke. Although the methodological quality of the included studies is good, these findings suggest that rigorous and accurate prospective studies on this topic are highly needed.

Publisher

MDPI AG

Subject

Health, Toxicology and Mutagenesis,Public Health, Environmental and Occupational Health

Reference56 articles.

1. Kuivenhoven, M., and Mason, K. (2022). Arsenic Toxicity, StatPearls Publishing.

2. Howard, G. (2022, December 02). Arsenic, Drinking-water and Health Risk Substitution in Arsenic Mitigation: A Discussion Paper. Available online: http://www.who.int/mediacentre/factsheets/fs372/en/.

3. Arsenic round the world: A review;Mandal;Talanta,2002

4. IARC monographs on the evaluation of carcinogenic risks to humans (2012). A Review of Human Carcinogens, International Agency for Research on Cancer.

5. EUR-Lex (2019). Directive. (EU) 2019/983 of the European Parliament and of the Council of 5 June 2019 Amending Directive 2004/37/EC on the Protection of Workers from the Risks Related to Exposure to Carcinogens or Mutagens at Work, European Union.

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