Association between Arsenic in Drinking Water and Cerebral Ischemic Stroke in Blackfoot Disease Endemic Area

• Main Authors: Tain-Junn Cheng, 鄭天浚
• Other Authors: How-Ran Guo
• Format: Others
• Language: zh-TW
• Published: 2003
• Online Access: http://ndltd.ncl.edu.tw/handle/08290184744567139230

碩士 === 國立成功大學 === 環境醫學研究所 === 91 === Stroke was the second leading cause of death in Taiwan in 2000 and can be caused by cerebral atherosclerosis. As we know, long-term exposure to arsenic can cause atheroscleoris and lead to peripheral vascular disease such as blackfoot disease (BFD), which is an unique endemic peripheral vascular occlusive disease developed in the southwestern coast of Taiwan. Residents who lived in this so called〝blackfoot disease (BFD) endemic area〞were exposed to drinking water from wells with high arsenic concentration before. The association of high concentration of arsenic in well water and cancers including bladder, skin, and lung cancers were documented; however, previous studies on the association between arsenic and stroke showed controversial results. To evaluate the association between arsenic and ischemic stroke, we conducted a hospital-based case-control study from April 2002 to November 2002. One hundred acute ischemic stroke patients, including 36 patients from BFD endemic area as cases and 64 matched patients from outside the BFD endemic area as internal controls, were enrolled; and 71 matched persons free of stroke were also as external controls. Participants received questionnaire interview on drinking water history, tests on serum level of epidermal growth factor receptor (EGFR), and determination of arsenic species in urine as indicators of methylation capacity. Data of arsenic level in well water from a previous survey were used to estimate the arsenic exposure of each individual. The results showed all the individuals had low total arsenic concentration in urine and there were no statistical differences in arsenic methylation capacity between case and external control groups. There were statistically significant differences in EGFR concentrations among the three groups, but all the levels were less than 15 fm/mL. In conclusion, the association between high arsenic exposure and ischemic stroke should be further explored, and EGFR overexpression was not a biomarker for ischemic stroke.