Exposure to arsenic, polycyclic aromatic hydrocarbons, metals, and association with skin cancers in the US adults.

Worldwide, skin cancer affects millions of people yearly and is broadly classified into melanoma and nonmelanoma types of skin cancer. The toxicity of metals to human health is a public and clinical health problem due to their widespread use in tools, machinery, and appliances as well as their widespread distribution in the air, water, and soil. Arsenic is a carcinogenic metalloid and available in the Earth's crust. Polycyclic aromatic hydrocarbons (PAHs) are toxic to humans, and incomplete combustion of fossil fuels is the main source of PAHs. Human populations exposed to metals from various sources can lead to various diseases including cancer. Limited studies are conducted to simultaneously assess the correlation of multiple arsenic, PAHs, metals with the occurrence of skin cancer. This study aimed to analyze the association between six PAHs compounds, seven types of arsenic, and fourteen metals from urine specimen with skin cancer in US adults. We performed a cross-sectional analysis using data from a total of 14,716 adults from the National Health Examination and Nutrition Survey (NHANES) database for three cycles ranging from 2011-2012 to 2015-2016. Specialized weighted complex survey logit regressions were conducted. Linear logit regression models using only main effects were performed first to identify the correlation between the selected demographic and lifestyle variables and melanoma, nonmelanoma, and unknown types of skin cancer. A second set of linear, main-effects logit regression models were constructed to examine the correlation between melanoma, nonmelanoma, and other types of skin cancers and seven types of arsenic (arsenous acid, arsenic acid, arsenobetaine, arsenocholine, dimethylarsinic acid, monomethylacrsonic acid, and total arsenic), six PAHs (1-hydroxynaphthalene, 2-hydroxynaphthalene, 3-hydroxyfluorene, 2-hydroxyfluorene, 1-hydroxyphenathrene, and 1-hydroxypyrene), and fourteen metals (barium, cadmium, cobalt, cesium, molybdenum, manganese, lead, antimony, tin, strontium, thallium, tungsten, uranium, and mercury) when adjusted for the selected covariates. The statistical analysis was conducted using R software, version 4.0.4. A marginal positive significant correlation between total arsenic and nonmelanoma was observed. This study identified a significant positive association between barium, cadmium, cesium, mercury, tin, and melanoma development. Cesium showed a significant positive statistical association for nonmelanoma, and thallium showed a borderline significant statistical association for nonmelanoma. A statistically significant positive association was found between cadmium and an unknown type of skin cancer. The findings of this study indicated a statistically significant positive association between skin cancer and barium, cadmium, cesium, tin, mercury, and thallium. Further studies are recommended in humans to refute or confirm these findings.