Environmental, biochemical and genetic risk factors in thyroid tumors and endocrine-related cancer.

Doctoral Dissertation uoadl:2778896 355 Read counter

Unit:
Τομέας Κοινωνικής Ιατρικής - Ψυχιατρικής και Νευρολογίας
Library of the School of Health Sciences
Deposit date:
2018-07-01
Year:
2018
Author:
Alatsathianos Ioannis
Dissertation committee:
Δημήτριος Λινός, Καθηγητής, Ιατρική, ΕΚΠΑ
Αθηνά Λινού, Καθηγήτρια, Ιατρική, ΕΚΠΑ
Μαρία Καντζανού, Καθηγήτρια, Ιατρική, ΕΚΠΑ
Γεώργιος Χρούσος, Καθηγητής, Ιατρική, ΕΚΠΑ
Γεώργιος Ζωγράφος, Καθηγητής, Ιατρική, ΕΚΠΑ
Θεοδώρα Ψαλτοπούλου, Αναπληρώτρια Καθηγήτρια, Ιατρική, ΕΚΠΑ
Βασιλική Μπενέτου, Αναπληρώτρια Καθηγήτρια, Ιατρική, ΕΚΠΑ
Original Title:
Περιβαλλοντικοί, βιοχημικοί και γενετικοί παράγοντες κινδύνου στην ανάπτυξη καρκίνου του θυρεοειδούς και άλλων ενδοκρινών όγκων
Languages:
Greek
Translated title:
Environmental, biochemical and genetic risk factors in thyroid tumors and endocrine-related cancer.
Summary:
Introduction: Many chemicals may be harmless or even beneficial to human health. However, a few of them pose threats to public health and the environment. In tandem with the increase in the production of chemical substances the probability of humans being exposed to chemicals is also on the increase. Surface water interacts with humans across a variety of routes. Surface water may be utilized directly but also, after being mixed with the water supply network of wells, it may end up as water for domestic use, personal hygiene and as potable water. Surface water contamination poses a direct threat to humans as they experience its toxic effects when contaminated water is consumed, inhaled and comes into contact with the skin.
Purpose: The purpose of this study was to investigate the impact of water contaminated with hexavalent chromium (Cr[VI]) on human health by comparing mortality rates amongst polluted places, namely, the districts of Oenophyta, Dilessi and Schematari, and non-polluted districts such as Tanagra initially and then the whole territory of Greece. The first four municipal units belong to the same municipality, are adjacent, have similar demographic and socio-economic characteristics while the first district, serving as criterion, the municipal unit of Tanagra, is characterized by intense industrial activity but its water-bearing strata has not been affected by hexavalent chromium. In respect with the whole territory of Greece, according to measurements by the Institute of Geology and Mineral Exploration (I.G.M.E.), every locally increased occurrence of hexavalent chromium appears insignificant due to the vastness of the territory of the whole country. This study focused on the examination of the role of hexavalent chromium as a contributing factor to cancer mortality rates initially and to thyroid cancer and other endocrine tumours subsequently. The impact of inhabiting areas marked by high levels of hexavalent chromium on their water-bearing strata was investigated in relation to total cancer mortality and mortality rates classified by type of cancer.
Materials and methods: A study of mortality rates was conducted including the citizens of the municipal units and the totality of the population of Greece during the years 2013-2016. Thus, the indices of mortality by type of neoplasm and by all types of neoplasm were formulated. By employing the method of direct standardization, the standardized rates of mortality were constructed (ASRs) and the standardized quotients of mortality (SRRs) weighted according to gender, age and calendar year for the municipal units of Tanagra. In addition, the entire weighted (aged-standardized) greek rates of neoplasm mortality were utilized. The wider estimated population of Greece at the midpoint of each year (2013-2016) was used as standard population. In parallel, all the existing estimates of physicochemical parametres of water by the Institute of Geology and Mineral Exploration (I.G.M.E.), the Geological University of Athens, the technical reports by Dr. Dermatas of the National Polytechnic in the context of the European programme “life-charm Asopos” and of by the ex-municipality of Oenophyta on potable water were investigated and juxtaposed against the indices of rough and weighted yearly mortality rates.
Results: A total of 76 deaths due to neoplasm out of the aggregate of the 13,736 citizens and a total of 6 deaths due to neoplasm diseases out of the aggregate of the 3,827 citizens of the municipal unit of Tanagra were observed in these two areas respectively. In the area with high concentrations of chromium in comparison with the municipal unit of Tanagra, the indices of mortality rates due to all neoplasm causes were found to be significantly higher statistically. These indices of mortality rates are higher in the municipal units of Oenophyta, Schematari and Dilessi separately in comparison with the municipal unit of Tanagra just as much as in their totality in relation to the mortality rates in Greece. Furthermore, increased indices of mortality, statistically significant, were found from all neoplasm diseases, such as neoplasm of the lungs, the breasts, the liver and neoplasm of unspecified location in comparison with the Greek indices of mortality rates due to neoplasm diseases.
Conclusions: The increased indices of mortality in the areas being characterized by high levels of hexavalent chromium (Cr[VI]) in potable water, groundwater and surface water in relation to the wider Greek indices, suggest that the hexavalent chromium (Cr[VI]) is as risk factor for the development of cancer in general while the statistically significant differences in mortality rates due to cancer in women and breast cancer for both genders in relation to the wider Greek indices of mortality, imply a possible involvement of hexavalent chromium (Cr[VI]) in estrogen receptors. It is imperative, therefore, that the implementation of safe permissible limits of hexavalent chromium (Cr[VI]) in potable water, through regulations in the health sector founded on the results of ecological and epidemiological research.
Main subject category:
Health Sciences
Keywords:
Cr(VI), Malignant tumors, Mortality, Morbidity
Index:
No
Number of index pages:
0
Contains images:
Yes
Number of references:
291
Number of pages:
217
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