The global burden of disease for skin, lung and bladder cancer caused by arsenic in food.

Background: Arsenic is a ubiquitous, naturally occurring metalloid that poses a significant human cancer risk. While water consumption provides the majority of human exposure, millions of individuals worldwide are significantly exposed to arsenic through naturally occurring levels of arsenic in grains, vegetables, meats and fish, as well as through food processed with water containing arsenic. Thus, we estimated the global burdens of disease for bladder, lung and skin cancers attributable to inorganic arsenic in food. Methods: To determine foodborne inorganic arsenic exposures worldwide, we used World Health Organization estimates of food consumption in thirteen country clusters, in conjunction with reported measurements of total and inorganic arsenic in different foods. We estimated slope factors for arsenic related bladder and lung cancers, and used the US Environmental Protection Agency skin cancer slope factor, to calculate the annual risk of the cancer incidence in males and females within each country cluster. Results: We estimated that each year 9,129 to 119,176 additional cases of bladder cancer, 11,844 to 121,442 of lung cancer, and 10,729 to 110,015 of skin cancer worldwide are attributable to inorganic arsenic in food. Conclusions: These estimates indicate that foodborne arsenic exposure causes a significant global burden of human disease. Impact: Estimating the global cancer burden caused by arsenic exposure in food will support policies that reduce exposure to disease promoting environmental hazards.