| Summary: | 碩士 === 中山醫學大學 === 營養學研究所 === 93 === Blackfoot disease is an endemic peripheral vascular disease in the southwest coast of Taiwan. Previous studies have shown that blackfoot disease was associated with arsenic in artesian well water. The arsenic concentration of artesian well water ranged from 0.35 to 1.14 ppm and the residents drank high amounts of arsenic for more than 50 years. Arsenic is a carcinogen and related with non-cancer disease, such as diabetes mellitus, hypertension and vascular diseases. The service of tap-water supply system was provided in the early 1960s in the blackfoot disease endemic area of southwestern Taiwan. Until the mid 1970s, the tap-water supply system was almost completely available in the blackfoot disease endemic area. We, therefore, used the natural difference of drinking water history to investigate the mortality trend of 23 cancers and 5 non-cancer diseases in the periods of 1973-1982, 1983-1992 and 1993-2002 after the service of tap-water supply system in the blackfoot disease endemic area of the southwestern Taiwan. To further control the influence of period and cohort effect, an extension of age-period-cohort analysis which including of 5 age groups, 3 periods and 7 cohorts was used.
The decreasing period effect for mortality was found in the blackfoot disease endemic area of the southwestern Taiwan after stop drinking artesian wellwater; however, the increasing period effect for mortality were observed in male lung, kidney and prostate cancer and lung cancer and diabetes mellitus in other areas of Taiwan.
The period effect for mortality decreased more in the blackfoot disease endemic area of the southwestern Taiwan than in the other areas of Taiwan, including of nasal cavity, bladder and bone cancer, peripheral vascular disease in both males and females, liver, larynx and skin cancer in women. The period effect for liver cancer mortality in male increased more in the other areas of Taiwan than in the blackfoot disease endemic area of the southwestern Taiwan. Our results might support the causal relationship between disease and arsenic exposure.
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