Well water around the world can be contaminated with arsenic, a naturally occurring geological element that has been associated with myriad adverse health effects. Persons obtaining their drinking water from private wells are often responsible for well testing and water treatment. High levels of arsenic have been reported in well water-supplied areas of the United States. We quantified - in cases and dollars - the potential burden of disease associated with the ingestion of arsenic through private well drinking water supplies in the United States. To estimate cancer and cardiovascular disease burden, we developed a Monte Carlo model integrating three input streams: (1) regional concentrations of arsenic in drinking water wells across the United States; (2) dose-response relationships in the form of cancer slope factors and hazard ratios; and (3) economic cost estimates developed for morbidity endpoints using 'cost-of-illness' methods and for mortality using 'value per statistical life' estimates. Exposure to arsenic in drinking water from U.S. domestic wells is modeled to contribute 500 annual premature deaths from ischemic heart disease and 1,000 annual cancer cases (half of them fatal), monetized at $10.9 billion (2017 USD) annually. These considerable public health burden estimates can be compared with the burdens of other priority public health issues to assist in decision-making.

中文翻译：

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美国家庭水井中饮用水中砷的估计疾病负担。

全世界的井水都可能被砷污染，砷是一种自然发生的地质元素，与多种不良健康影响有关。从私人井中获得饮用水的人通常负责井的测试和水处理。据报道，在美国井水充足的地区，砷含量很高。我们以病例和美元为单位，量化了在美国通过私人井水供应而摄入砷所致疾病的潜在负担。为了估算癌症和心血管疾病的负担，我们开发了一个蒙特卡洛模型，该模型整合了三种输入流：（1）美国饮用水井中砷的区域浓度；（2）癌症斜率和危险比形式的剂量反应关系；（3）使用“疾病成本”方法为发病率终点制定经济成本估算，并使用“每统计生命值”估算死亡率。美国家庭井中饮用水中的砷暴露可导致每年因缺血性心脏病造成500例过早死亡和每年发生1000例癌症病例（其中一半是致命的），其货币化价值为每年109亿美元（2017年美元）。可以将这些可观的公共卫生负担估算值与其他优先公共卫生问题的负担进行比较，以协助决策。家用井的建模将导致每年因缺血性心脏病造成500例过早死亡和1000例年度癌症病例（其中一半是致命的），每年的货币化价值为109亿美元（2017年美元）。可以将这些可观的公共卫生负担估算值与其他优先公共卫生问题的负担进行比较，以协助决策。家用井的建模将导致每年因缺血性心脏病造成500例过早死亡和1000例年度癌症病例（其中一半是致命的），每年的货币化价值为109亿美元（2017年美元）。可以将这些可观的公共卫生负担估算值与其他优先公共卫生问题的负担进行比较，以协助决策。