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

Author

Listed:
  • Giuseppina Folesani

    (Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL-Italian Workers’ Compensation Authority, Via Fontana Candida 1, Monte Porzio Catone, 00078 Rome, Italy
    These authors contributed equally to the study.)

  • Maricla Galetti

    (Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL-Italian Workers’ Compensation Authority, Via Fontana Candida 1, Monte Porzio Catone, 00078 Rome, Italy
    These authors contributed equally to the study.)

  • Pier Giorgio Petronini

    (Department of Medicine and Surgery, University of Parma, Viale Gramsci 14, 43126 Parma, Italy)

  • Paola Mozzoni

    (Department of Medicine and Surgery, University of Parma, Viale Gramsci 14, 43126 Parma, Italy
    Center of Excellence for Toxicological Research (CERT), University of Parma, Viale Gramsci 14, 43126 Parma, Italy)

  • Silvia La Monica

    (Department of Medicine and Surgery, University of Parma, Viale Gramsci 14, 43126 Parma, Italy)

  • Delia Cavallo

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

  • Massimo Corradi

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

Suggested Citation

  • Giuseppina Folesani & Maricla Galetti & Pier Giorgio Petronini & Paola Mozzoni & Silvia La Monica & Delia Cavallo & Massimo Corradi, 2023. "Interaction between Occupational and Non-Occupational Arsenic Exposure and Tobacco Smoke on Lung Cancerogenesis: A Systematic Review," IJERPH, MDPI, vol. 20(5), pages 1-24, February.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:5:p:4167-:d:1080672
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    References listed on IDEAS

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    1. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    2. Louis Anthony Cox, 2009. "Predicting the Effects of Changes: Could Removing Arsenic from Tobacco Smoke Significantly Reduce Smoker Risks of Lung Cancer?," International Series in Operations Research & Management Science, in: Risk Analysis of Complex and Uncertain Systems, chapter 0, pages 283-302, Springer.
    3. David C. Dauphiné & Allan H. Smith & Yan Yuan & John R. Balmes & Michael N. Bates & Craig Steinmaus, 2013. "Case-Control Study of Arsenic in Drinking Water and Lung Cancer in California and Nevada," IJERPH, MDPI, vol. 10(8), pages 1-15, August.
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