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Journal of Environmental Pathology, Toxicology and Oncology

Impact factor: 1.154

ISSN Print: 0731-8898
ISSN Online: 2162-6537

Journal of Environmental Pathology, Toxicology and Oncology

DOI: 10.1615/JEnvironPatholToxicolOncol.v30.i3.40
pages 213-223

Concentrations of Arsenic, Chromium, and Nickel in Toenail Samples From Appalachian Kentucky Residents

Xianglin Shi
Center for Research on Environmental Disease and Graduate Center for Toxicology, University of Kentucky, Lexington, Kentucky
Nancy Johnson
University of Kentucky
Brent J. Shelton
College of Public Health, Markey Cancer Control Program, University of Kentucky, Lexington, Kentucky
Claudia Hopenhayn
College of Public Health, Markey Cancer Control Program, University of Kentucky, Lexington, Kentucky
Thomas T. Tucker
College of Public Health, Markey Cancer Control Program, University of Kentucky, Lexington, Kentucky
Jason M. Unrine
Department of Plant and Soil Sciences, University of Kentucky, Lexington, Kentucky
Bin Huang
College of Public Health, Markey Cancer Control Program, University of Kentucky, Lexington, Kentucky
W. Jay Christian
Markey Cancer Control Program, University of Kentucky, Lexington, Kentucky
Zhuo Zhang
Center for Research on Environmental Disease and Graduate Center for Toxicology, University of Kentucky, Lexington, Kentucky
Li Li
Departments of Family Medicine, Epidemiology, and Biostatistics, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio

ABSTRACT

Lung cancer rates in Appalachian Kentucky are almost twice national rates; colorectal cancer rates are also elevated. Although smoking prevalence is high, it does not explain all excess risk. The area is characterized by poverty, low educational attainment, and unemployment. Coal production is a major industry. Pyrite contaminants of coal contain established human carcinogens, arsenic (As), chromium (Cr), and nickel (Ni). We compared biological exposure to As, Cr, and Ni for adults living in Appalachian Kentucky with residents of Jefferson, a non-Appalachian, urban county. We further compared lung and colon cancer rates, demographics, and smoking prevalence across the study areas. Toenail clipping analysis measured As, Cr, and Ni for residents of 23 rural Appalachian Kentucky counties and for Jefferson County. Reverse Kaplan-Meier statistical methodology addressed left-censored data. Appalachian residents were exposed to higher concentrations of As, Cr, and Ni than Jefferson County residents. Lung cancer incidence and mortality rates in Appalachia are higher than Jefferson County and elsewhere in the state, as are colorectal mortality rates. Environmental factors may contribute to the increased concentration of trace elements measured in residents of the Appalachian region. Routes of human exposure need to be determined.