The burden of disease attributable to exposure to heavy metals via drinking water in Iran (2019) was assessed at the national and regional levels. The non-carcinogenic risk, carcinogenic risk, and attributable burden of disease of heavy metals in drinking water were estimated in terms of hazard quotient (HQ), incremental lifetime cancer risk (ILCR), and disability-adjusted life year (DALY), respectively. The average drinking water concentrations of arsenic (As), cadmium (Cd), chromium (Cr), lead (Pb), mercury (Hg), and nickel (Ni) in Iran were determined to be 2.3, 0.4, 12.1, 2.5, 0.7, and 19.7 μg/L, respectively, which were much lower than the standard values. The total average HQs of heavy metals in drinking water in the entire country, rural, and urban communities were 0.48, 0.65 and 0.45, respectively. At the national level, the average ILCRs of heavy metal in the entire country were in the following order: 1.06 × 10⁻⁴ for As, 5.89 × 10⁻⁵ for Cd, 2.05 × 10⁻⁵ for Cr, and 3.76 × 10⁻⁷ for Pb. The cancer cases, deaths, death rate (per 100,000 people), DALYs, and DALY rate (per 100,000 people) attributed to exposure to heavy metals in drinking water at the national level were estimated to be 213 (95% uncertainty interval: 180 to 254), 87 (73–104), 0.11 (0.09–0.13), 4642 (3793–5489), and 5.81 (4.75–6.87), respectively. The contributions of exposure to As, Cd, Cr, and Pb in the attributable burden of disease were 14.7%, 65.7%, 19.3%, and 0.2%, respectively. The regional distribution of the total attributable DALY rate for all heavy metals was as follows: Region 5> Region 4> Region 1> Region 3> Region 2. The investigation and improvement of relatively high exceedance of As levels in drinking water from the standard value, especially in Regions 5 and 3 as well as biomonitoring of heavy metals throughout the country were recommended.

在国家和地区层面评估了伊朗（2019 年）通过饮用水接触重金属引起的疾病负担。饮用水中重金属的非致癌风险、致癌风险和归因疾病负担分别用危害商（HQ）、增加的终生癌症风险（ILCR）和伤残调整生命年（DALY）来估计. 伊朗饮用水中砷 (As)、镉 (Cd)、铬 (Cr)、铅 (Pb)、汞 (Hg) 和镍 (Ni) 的平均浓度分别为 2.3、0.4、12.1、2.5、分别为 0.7 和 19.7 μg/L，远低于标准值。全国、农村和城市社区饮用水中重金属总平均HQ分别为0.48、0.65和0.45。在国家层面，^{As -4}，Cd 5.89 × 10 ^-5，Cr 2.05 × 10 ^{-5，3.76 × 10 -7}对于铅。在全国范围内，因饮用水中重金属暴露而导致的癌症病例、死亡、死亡率（每 10 万人）、DALY 和 DALY 率（每 10 万人）估计为 213 例（95% 的不确定区间：180 至254)、87 (73–104)、0.11 (0.09–0.13)、4642 (3793–5489) 和 5.81 (4.75–6.87)。As、Cd、Cr 和 Pb 暴露在归因疾病负担中的贡献分别为 14.7%、65.7%、19.3% 和 0.2%。所有重金属的总归属DALY率区域分布如下：5区>4区>1区>3区>2区。饮用水中As超标率较高的调查和改进,