Biological Trace Element Research

, Volume 144, Issue 1–3, pp 86–96 | Cite as

Comparative Study of Liver Cancer Patients in Arsenic Exposed and Non-exposed Areas of Pakistan

  • Sham Kumar Wadhwa
  • Tasneem Gul KaziEmail author
  • Akhtar Ali Chandio
  • Hassan Imran Afridi
  • Nida Fatima Kolachi
  • Sumaira Khan
  • Ghulam Abbas Kandhro
  • Syeda Nasreen
  • Abdul Qadir Shah
  • Jameel Ahmed Baig


The investigated data shows that arsenic (As) in drinking water is associated with increased mortality from different types of cancers including liver cancer. In this study, blood and scalp hair samples of male liver cancer patients and healthy referents belonging to As exposed areas of Sindh Pakistan were analyzed for As contents. The As levels in drinking water of understudy area showed that sections of this population was exposed to 3–15-folds higher concentrations of As than permissible limit. For comparative purposes, blood and scalp hair samples of matched cancerous patient as referent patients belonging to big city (Hyderabad) who have used municipal treated water with low As levels <10 μg/L were also collected. The results of this study showed that the average As concentration was higher in the blood and scalp hair of exposed and non-exposed referent cancer patients as compared to referents (p < 001). The exposed cancerous patients have twofolds higher As level in both biological samples as related to non-exposed case matched cancerous male subjects.


Arsenic Liver cancer Blood Scalp hair Tobacco Water 


  1. 1.
    Morales KH, Ryan L, Kuo TL, Wu MM, Chen CJ (2000) Risk of internal cancers from arsenic in drinking water. Environ Health Perspect 108:655–661PubMedCrossRefGoogle Scholar
  2. 2.
    Tuzen M, Ozlem SK, Karaman I, Soylak M (2010) Selective speciation and determination of inorganic arsenic in water, food and biological samples. Food Chem Toxicol 48:41–46PubMedCrossRefGoogle Scholar
  3. 3.
    Guo HR, Chiang HS, Hu H, Lipsitz SR, Monson RR (1997) Arsenic in drinking water and incidence of urinary cancers. Epidemiology 8:545–550PubMedCrossRefGoogle Scholar
  4. 4.
    Chiou HY, Chiuo ST, Hsu YH, Chou YL, Tseng CH, Wei ML et al (2001) Incidence of transitional cell carcinoma and arsenic in drinking water: a follow-up of 8102 residents in an arseniasis-endemic area in northeastern Taiwan. Am J Epidemiol 153:411–418PubMedCrossRefGoogle Scholar
  5. 5.
    Guo HR, Yu HS, Hu H, Monson RR (2001) Arsenic in drinking water and skin cancer: cell-type specificity. Cancer Cause Control 12:909–916CrossRefGoogle Scholar
  6. 6.
    Benbrahim-Tallaa L, Waalkes MP (2008) Inorganic arsenic and human prostate cancer. Environ Health Perspect 116:158–164PubMedCrossRefGoogle Scholar
  7. 7.
    Navas-Acien A, Sharrett AR, Silbergeld EK, Schwartz BS, Nachman KE, Burke TA, Guallar E (2005) Arsenic exposure and cardiovascular disease: a systematic review of the epidemiologic evidence. Am J Epidemiol 162:1037–1049PubMedCrossRefGoogle Scholar
  8. 8.
    Navas-Acien A, Silbergeld EK, Streeter RA, Clark JM, Burke TA, Guallar E (2006) Arsenic exposure and type 2 diabetes: a systematic review of the experimental and epidemiological evidence. Environ Health Perspect 114:641–648PubMedCrossRefGoogle Scholar
  9. 9.
    Tuzen M, Demirhan Ç, Mendil D, Soylak M (2009) Arsenic speciation in natural water samples by coprecipitation-hydride generation atomic absorption spectrometry combination. Talanta 78:52–56PubMedCrossRefGoogle Scholar
  10. 10.
    Uluozlu OD, Tuzen M, Mendil D, Soylak M (2010) Determination of As(III) and As(V) species in some natural water and food samples by solid-phase extraction on Streptococcus pyogenes immobilized on Sepabeads SP 70 and hydride generation atomic absorption spectrometry. Food Chem Toxicol 48:1393–1398PubMedCrossRefGoogle Scholar
  11. 11.
    Chen CL, Hsu LI, Chiou HY, Hsueh YM, Chen SY, Wu MM, Chen CJ (2004) Ingested arsenic, cigarette smoking, and lung cancer risk: a follow-up study in arseniasis-endemic areas in Taiwan. JAMA 292:2984–2990PubMedCrossRefGoogle Scholar
  12. 12.
    Yuan Y, Bates MN, Smith AH (2003) Case–control study of bladder cancer and drinking water arsenic in the western United States. Am J Epidemiol 158:1193–1201PubMedCrossRefGoogle Scholar
  13. 13.
    Bates MN, Rey OA, Biggs ML, Hopenhayn C, Moore LE, Kalman D, Steinmaus C, Smith AH (2004) Case–control study of bladder cancer and exposure to arsenic in Argentina. Am J Epidemiol 159:381–389PubMedCrossRefGoogle Scholar
  14. 14.
    Ferreccio C, González C, Milosavjlevic V, Marshall G, Sancha AM, Smith AH (2000) Lung cancer and arsenic concentrations in drinking water in Chile. Epidemiology 11(6):673–679PubMedCrossRefGoogle Scholar
  15. 15.
    Ahmet S, Tuzen M (2009) Biosorption of As(III) and As(V) from aqueous solution by macrofungus (Inonotus hispidus) biomass: equilibrium and kinetic studies. J Hazard Mater 164:1372–1378CrossRefGoogle Scholar
  16. 16.
    Grimmer G, Dettbarn G, Seidel A, Jacob J (2000) Detection of carcinogenic aromatic amines in the urine of non-smokers. Sci Total Environ 247(1):81–90PubMedCrossRefGoogle Scholar
  17. 17.
    Tanaka K, Tsuji I, Wakai K, Nagata C, Mizoue T, Inoue M, Tsugane S (2006) Cigarette smoking and liver cancer risk: an evaluation based on a systematic review of epidemiologic evidence among Japanese. Jpn J Clin Oncol 36(7):445–456PubMedCrossRefGoogle Scholar
  18. 18.
    Sarkar D, Datta R (2004) Arsenic fate and bioavailability in two soils contaminated with sodium arsenate pesticide: an incubation study. Bull Environ Contam Toxicol 72:240–247PubMedCrossRefGoogle Scholar
  19. 19.
    Shrestha, (2002) Drinking water quality: future directions for UNICEF in Pakistan. Consultancy Report 2 of 3, Water Quality, SWEET Project, UNICEF Pakistan, IslamabadGoogle Scholar
  20. 20.
    Ahmad T, Kahlown MA, Tahir A, Rashid H (2004) Arsenic an emerging issue: experiences from Pakistan. 30th WEDC International Conference Vientiane Lao PDR, Public Health National Institute of Preventive and SocialGoogle Scholar
  21. 21.
    Arain MB, Kazi TG, Baig JA, Jamali MK, Afridi HI, Shah AQ, Jalbani N, Sarfraz RA (2009) Determination of arsenic levels in lake water, sediment, and foodstuff from selected area of Sindh, Pakistan: estimation of daily dietary intake. Food Chem Toxicol 47(1):242–248PubMedCrossRefGoogle Scholar
  22. 22.
    Arain MB, Kazi TG, Baig JA, Jamali MK, Afridi HI, Jalbani N, Sarfraz RA, Kandhro GA (2009) Respiratory effects in people exposed to arsenic via the drinking water and tobacco smoking in southern part of Pakistan. Sci Total Environ 407(21):5524–5530PubMedCrossRefGoogle Scholar
  23. 23.
    Kazi TG, Arain MB, Baig JA, Jamali MK, Afridi HI, Shah AQ, Jalbani N, Sarfraz RA (2009) The correlation of arsenic levels in drinking water with the biological samples of skin disorders. Sci Total Environ 407:1019–1026PubMedGoogle Scholar
  24. 24.
    WHO (2001) Worldhealth Organization fact sheet no. 210. Arsenic in drinking water. Bulletin of the 78(9):1096Google Scholar
  25. 25.
    Pandey PK, Yadav S, Pandey M (2007) Human arsenic poisoning issues in Central-East Indian locations: biomarkers and biochemical monitoring. Int J Environ Res Public Health 4(1):15–22PubMedCrossRefGoogle Scholar
  26. 26.
    Hutchinson J (1987) Arsenic cancer. Br Med J 2:1280–1281Google Scholar
  27. 27.
    Neubauer O (1947) Arsenical cancer: a review. Br J Cancer 1:192–251PubMedCrossRefGoogle Scholar
  28. 28.
    Yeh S (1963) Relative incidence of skin cancer in Chinese in Taiwan: with special reference to arsenical cancer. Monogr Natl Cancer Inst 10:81–107Google Scholar
  29. 29.
    Chen KP, Wu HY, Yeh CC, Cheng YJ (1976) Color atlas of cancer mortality by administrative and other classified districts in Taiwan area. NSC Special Publication No. 2:1979. National Science Council, Taipei, TaiwanGoogle Scholar
  30. 30.
    Sommers SC, McManus RG (1952) Multiple arsenical cancers of skin and internal organs. Cancer 6:347–359CrossRefGoogle Scholar
  31. 31.
    Regelson W, Kim U, Ospina J, Holland JF (1968) Hemangioendothelial sarcoma of liver from chronic arsenic intoxication by Fowler's solution. Cancer 21:145–152CrossRefGoogle Scholar
  32. 32.
    Lander JJ, Stanley RJ, Sumner HW, Boswell DC, Aach RD (1975) Angiosarcoma of the liver associated with Fowler's solution (potassium arsenite). Gastroenterology 68:1582–1586PubMedGoogle Scholar
  33. 33.
    Dalderup LM, Freni SC, Bras G, Bronckhorst FB (1976) Angiosarcoma of the liver in Netherlands. J Occup Med 18:444PubMedCrossRefGoogle Scholar
  34. 34.
    Cowlishaw JL, Pollard EJ, Cowen AE, Powell LW (1979) Liver disease associated with chronic arsenic ingestion. Aust N Z Med 9:310–313CrossRefGoogle Scholar
  35. 35.
    Roat JW, Wald A, Mendelow H, Pataki KI (1982) Hepatic angiosarcoma associated with short-term arsenic ingestion. Am J Med 73:933–936PubMedCrossRefGoogle Scholar
  36. 36.
    Kasper ML, Schoenfield L, Strom RL, Theologides A (1984) Hepatic angiosarcoma and bronchioloaveolar carcinoma induced by Fowler's solution. J Am Med Assoc 252:3407–3408CrossRefGoogle Scholar
  37. 37.
    Lüchtrath H (1983) The consequences of chronic arsenic poisoning among Moselle wine growers. J Cancer Res Clin Oncol 105:173–182PubMedCrossRefGoogle Scholar
  38. 38.
    Tsuda T, Babazono A, Yamamoto E, Kuruamtani N, Mino Y, Ogawa T et al (1995) Ingested arsenic and internal cancer. Am J Epidemiol 141:198–209PubMedGoogle Scholar
  39. 39.
    Hopenhayn-Rich C, Biggs MK, Smith AH (1998) Lung and kidney cancer mortality associated with arsenic in drinking water in Cordoba, Argentina. Int J Epidemiol 27:561–569PubMedCrossRefGoogle Scholar
  40. 40.
    Cuzick J, Sasieni P, Evans S (1992) Ingested arsenic, keratoses, and bladder cancer. Am J Epidemiol 136:417–421PubMedGoogle Scholar
  41. 41.
    Smith AH, Goycolea M, Haque R, Biggs ML (1998) Marked increase in bladder and lung cancer mortality in a region of northern Chile due to arsenic in drinking water. Am J Epidemiol 147:660–669PubMedCrossRefGoogle Scholar
  42. 42.
    Lewis DR, Southwick JW, Ouellet-Hellstrom R, Rench J, Calderon RL (1999) Comments on “Drinking water arsenic in Utah: a cohort mortality study”. Environ Health Perspect 107(11):A544–A546CrossRefGoogle Scholar
  43. 43.
    Chen CJ, Chuang YC, Lin TM, Wu HY (1985) Malignant neoplasms among residents of a black foot disease endemic area in Taiwan: high-arsenic artisan well water and cancers. Cancer Res 45:5895–5899PubMedGoogle Scholar
  44. 44.
    Vahter M (1983) Metabolism of arsenic. In: Fowler BA (ed) Biological and environmental effects of arsenic. Elsevier Science, Amsterdam, pp 171–198Google Scholar
  45. 45.
    Hall M, Chen Y, Ahsan H, Slavkovich V, Van Geen A, Parvez F et al (2006) Blood arsenic as a biomarker of arsenic exposure: results from a prospective study. Toxicology 225:225–233PubMedCrossRefGoogle Scholar
  46. 46.
    Samanta G, Sharma R, Roychowdhury T, Chakrabortic D (2004) Arsenic and other elements in hair, nails, and skin-scales of arsenic victims in West Bengal. India Sci Total Environ 326:33–47CrossRefGoogle Scholar
  47. 47.
    Klaassen CD (ed) (2001) Casarett and Doull's toxicology: the basic science of poisons, Sixthth edn. McGraw-Hill, New York, p 114Google Scholar
  48. 48.
    Elci L, Divrikli U, Soylak M (2008) Inorganic arsenic speciation in various water samples with GF-AAS using coprecipitation. Int J Environ Anal Chem 88:711–723CrossRefGoogle Scholar
  49. 49.
    Rodrıguez VM, Jimenez-Capdeville ME, Giordano M (2003) The effects of arsenic exposure on the nervous system. Toxicol Lett 145:1–18PubMedCrossRefGoogle Scholar
  50. 50.
    Santra A, Gupta JD, De BK, Roy B, Guha Mazumder DN (1999) Hepatic manifestations in chronic arsenic toxicity. Indian J Gastroenterol 18:152–155PubMedGoogle Scholar
  51. 51.
    Guha Mazumder DN (2001) Arsenic and liver disease. J Indian Med Assoc 99:318–320Google Scholar
  52. 52.
    IARC (International Agency for Research on Cancer) (2004) Tobacco smoke and involuntary smoking. IARC monographs on the evaluation of the carcinogenic risk of chemicals to humans, Lyon, France. IARC 83:1005–1178Google Scholar
  53. 53.
    WHO (2002) The world health report: reducing risks. Promoting Healthy Life, GenevaGoogle Scholar
  54. 54.
    Mackay JE (2002) The tobacco atlas. World Health Organization, GenevaGoogle Scholar
  55. 55.
    IARC (1986) Tobacco smoking. Monographs on the evaluation of the carcinogenic risk of chemicals to humans. Lyon: IARC Scientific Publications 38:270–303Google Scholar
  56. 56.
    Bernhard A, Rossmann A, Wick G (2005) Metals in cigarette smoke. Life 57:805–809PubMedGoogle Scholar
  57. 57.
    Landsberger S, Wu D (1995) The impact of heavy metals from environmental tobacco smoke on indoor air quality as determined by Compton suppression neutron activation analysis. Sci Total Environ 173–174:323–337PubMedCrossRefGoogle Scholar
  58. 58.
    Celik J, Gallicchio L, Boyd K, Lam TK, Matanoski G, Tao X, Shiels M, Hammond E, Chen L, Robinson KA, Caulfield LE, Herman JG, Guallar E, Alberg AJ (2008) Arsenic in drinking water and lung cancer: a systematic review. Environ Res 108:48–55PubMedCrossRefGoogle Scholar
  59. 59.
    NRC, Board on Environmental Studies and Toxicology, Committee on Toxicology, Subcommittee on Arsenic in Drinking Water (1999) Arsenic in drinking water. National Academy Press, WashingtonGoogle Scholar
  60. 60.
    NTP (1998) Arsenic and certain arsenic compounds. In: Eighth report on carcinogens: summary. US Public Health Service, US DHHS, Atlanta, GA, 1999, 17–19Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Sham Kumar Wadhwa
    • 1
  • Tasneem Gul Kazi
    • 1
    Email author
  • Akhtar Ali Chandio
    • 2
  • Hassan Imran Afridi
    • 1
  • Nida Fatima Kolachi
    • 1
  • Sumaira Khan
    • 1
  • Ghulam Abbas Kandhro
    • 1
  • Syeda Nasreen
    • 3
  • Abdul Qadir Shah
    • 1
  • Jameel Ahmed Baig
    • 1
  1. 1.National Center of Excellence in Analytical ChemistryUniversity of SindhJamshoroPakistan
  2. 2.Larkana Institute of Nuclear Medicine and Radiotherapy, (LINAR)LarkanaPakistan
  3. 3.Nuclear Institute of Medicine and Radiotherapy (NIMRA)JamshoroPakistan

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