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  • Original Article
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Relationships between arsenic concentrations in drinking water and lung and bladder cancer incidence in U.S. counties


Increased risks of lung and bladder cancer have been observed in populations exposed to high levels of inorganic arsenic. However, studies at lower exposures (i.e., less than 100 μg/l in water) have shown inconsistent results. We therefore conducted an ecological analysis of the association between historical drinking water arsenic concentrations and lung and bladder cancer incidence in U.S. counties. We used drinking water arsenic concentrations measured by the U.S. Geological Survey and state agencies in the 1980s and 1990s as proxies for historical exposures in counties where public groundwater systems and private wells are important sources of drinking water. Relationships between arsenic levels and cancer incidence in 2006–2010 were explored by Poisson regression analyses, adjusted for groundwater dependence and important demographic covariates. The median and 95th percentile county mean arsenic concentrations were 1.5 and 15.4 μg/l, respectively. Water arsenic concentrations were significant and positively associated with female and male bladder cancer, and with female lung cancer. Our findings support an association between low water arsenic concentrations and lung and bladder cancer incidence in the United States. However, the limitations of the ecological study design suggest caution in interpreting these results.

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We thank Tim Wade and Elizabeth Doyle of EPA, and Prof. Dale Hattis of Clark University for their helpful comments on drafts of this manuscript. This worked was funded in part under U.S. EPA Contract EP-C-09-009.

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Correspondence to William M Mendez Jr..

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The study was reviewed by the National Center for Environmental Assessment of the U.S. Environmental Protection Agency and approved for publication. Mention of trade names or commercial products does not constitute endorsement or recommendation for use. Views expressed in this article are the authors’ and do not necessarily reflect the US EPA’s views or policies. All analyses are based on public release files from U.S National Cancer Institute (NCI) State Cancer Profiles website; thus, informed consent requirements have been met.

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Mendez, W., Eftim, S., Cohen, J. et al. Relationships between arsenic concentrations in drinking water and lung and bladder cancer incidence in U.S. counties. J Expo Sci Environ Epidemiol 27, 235–243 (2017).

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