Betel-Quid and Areca-Nut Chew

296 Pages·2012·18 MB·English

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WORLD HEAL TH ORGANIZA nON
INTERNATIONAL AGENCY FOR RESEARCH ON CANCER
IARC MONOGRAPHS
ON THE
EVALUATION OF THE
CARCINOGENIC RISK
OF CHEMICALS TO HUMANS
Tobacco Habits Other than Smoking;
Betel-Quid and Areca-Nut Chewing;
and Sorne Related Nitrosamines
VOLUME 37
publication represents the views and expert opinions
This
of an IARC W orking Group on the
Evaluation of the Carcinogenic Risk of Chemicals to Humans
which met in Lyon,
23-30 October 1984
September 1985
IARC MONOGRAPHS
ln 19'69, the International Agency for Research on Cancer (IARC) initiated a programme
on the evaluation of the carcinogenic risk of chemicals to humans involving the production
of critically evaluated monographs on individual chemicals, ln 1980, the programme was
expanded to include the evaluation of the carcinogenic risk associated with exposures
to complex mixtures,
The objective of the programme is to elaborate and publish in the form of monographs cri-
tical reviews of data on carcinogenicity for chemicals and complex mixtures to which humans
are known to be exposed, and on specifie occupational exposures, to evaluate these data
in terms of human risk with the help of international working groups of experts in chemical
carcinogenesis and related fields, and to indicate where additional research efforts are nee-
ded.
This project was supported by PHS Grant No. 1 U01 CA33193-03 awarded by the US
National Cancer Institute, Department of Health and Human Services.
(£ International Agency for Research on Cancer 1985
ISBN 92 832 1237 1 (soft-cover edition)
ISBN 92 832 1537 0 (hard-cover edition)
ISSN 0250-9555
Distributed for the International Agency for Research on Cancer by the Secretariat of the
World Health Organization
PRINTED lN FRANCE
CONTENTS
NOTE TO TH E READER ........ ......... .... ......... ..... ...................... ............... .... .................. 5
LIST OF P ARTICI P ANTS ................ .......... ............. ........................ ....... ... ............. ....... 7
PREAM BLE .. ............... ...........:............... ........... ........................... ........... .... ................. 11
Background .......... .................... ............... ........ .............. ...... ................... ........... ...... 11
Objective and Scope ........................................ ................ ............ ......... ......... .... ..... 11
Selection of Chemicals and Complex Exposures for Monographs ...................... 12
Working Procedures ................. ....................... ................... .................... .... ............. 12
Data for Evaluations ... ........................................ ............ ...... ............... ............... ..... 13
The Working Group .................................................................. ............. ............ ...... 13
General Principles .. ...................... ........................................ ................. ............. ..... 13
Explanatory Notes on the Monograph Contents ................................................... 20
GENERAL REMARKS ON THE HABITS AND SUBSTANCES CONSIDERED .....;..... 31
THE MONOGRAPHS
Tobacco habits other than smoking ...................................................................... 37
Betel-quid and areca-nut chewing .................. ............ ....... ......... .......... ..... ............. 141
Glossary ........................................ ............... ..................... .... .................. ................. 201
Sorne related nitrosamines
4-(Methylnitrosarnino )-4-(3-pyridyl)butanal (NNA) ........ ..................................... 205
4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) ..................................... 209
N' -Nitrosoanabasine (NAB) ....... ..................... ....... ........ .... ....... ...... ....... ............. 225
N' -Nitrosoanatabine (NAT) '" ............................ .......... ..... ................ ........ ........... 233
N' -Nitrosonornicotine (N N N) .......... ....... ...... ............. ......... ....... ....... ......... .......... 241
Sorne N-nitrosamines derived from areca-nut alkaloids................................... 263
3-Methylnitrosaminopropionaldehyde (M NP A)
3-Methylnitrosaminopropionitrile (MNPN)
N-Nitrosoguvacine (NGC)
N-Nitrosoguvacoline (NGL)
SUPPLEMENTARY CORRIGENDA TO VOLUMES 1-36 ..........................................269
CUMULATIVE INDEX TO THE MONOGRAPH SERIES .............................................. 271

NOTE TO THE READER
The term 'carcinogenic risk' in the IARC Monographs series is taken to me an the proba-
bility that exposure to the chernical will lead to cancer in humans.
Inclusion of a chemical in the rnonographs does not imply that it is a carcinogen, only
that the published data have been examined. Equally, the fact that a chemical has notyet
been evaluated in a monograph does not mean that it is not carcinogenic.
Anyone who is aware of published data that may alter the evaluation of the carcinogenic
risk of a chemical to humans is encouraged to make this information available to the Unit
of Carcinogen Identification and Evaluation, Division of Environmental Carcinogenesis, Inter-
national Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 08,
France, in order that the chemical may be considered for re-evaluation by a future Working
Group.
Although every effort is made to prepare the monographs as accurately as possible, mis-
takes may occur. Readers are requested to communicate any errors to the Unit of Carcino-
gen Identification and Evaluation, so that corrections can be reported in future volumes.
-5-

IARC WORKING GROUP ON THE EVALUATION OF THE
CARCINOGENIC RISK OF CHEMICALS TO HUMANS:
TOBACCO HABITS OTHER THAN SMOKING;
BETEL-QUID AND ARECA-NUT CHEWING;
AND SOME RELATED NITROSAMINES
Lyon, 23-30 October 1984
Members1
S.V. Bhide, Head, Carcinogenesis Division, Cancer Research Institute, Tata Memorial
Centre, Parei, Bombay 400012, India
E. Boyland, TUC Centenary Institute of Occupational Health, London School of Hygiene and
Tropical Medicine, Keppel Street (Gower Street), London WCIE 7HT, UK
D.L. Davis, Director, Tobacco and Health Research Institute, University of Kentucky, Lexing-
ton, KY 40406, USA
P.C. Gupta, Tata Institute of Fundamental Research, Basic Dental Research Unit, Horni
Bhabha Road, Bombay 400005, India
S.S. Hecht, Chief, Division of Chernical Carcinogenesis, Naylor Dana Institute for Disease
Prevention, American Health Foundation, Dana Road, Val~alla, NY 10595, USA
J.M. Hirsch, Head, Public Dental Service, Oral Surgery, Emergency Clinic, Stampgatan 2,
411 01 Göteborg, Sweden
D. Hoffmann, Associate Director, Naylor Dana Institute for Disease Prevention, American
Health Foundation, Dana Road, Valhalla, NY 10595, USA
E. Huberman, Director, Division of Biological and Medical Research, Argonne National Labo-
ratory, 9700 South Case Avenue, Argonne, IL 60439, USA
lUnable to attend: N.A. Jafarey, Department of Pathology, Jinnah Postgraduate Medical Centre, Karachi, Pakistan
-7-
8 IARC MONOGRAPHS VOLUME 37
D.G. Kaufman, Department of Pathology, The University of North Carolina at Chapel Hil,
Preclinical Educational Building 228 H, Chapel Hill, NC 27514, USA
A. Knaap, Laboratory for Carcinogenesis and Mutagenesis, National Institute of Public
Health and Environmental Hygiene, PO Box 1, 3720 BA Bilthoven, The Netherlands
P.N. Magee, Director, Fels Research Institute, Temple University, School of Medicine, 3420
North Broad St, Philadelphia, PA 19140, USA (Chairman)
A.J. McMichael, CSIRO, Division of Hurnan Nutrition, Kintore Avenue, Adelaide, SA
5000, Australia
J.J. Pindborg, Professor of Oral Pathology, Royal Dental College, Blegdamsvej 3C, 2200
Copenhagen N, Denmark
J.M. Ratcliffe, National Institute for Occupational Safety and Health, R.A. Taft Laboratories,
4676 Columbia Parkway, Cincinnati, OH 45226, USA
J.K. Reddy, Department of Pathology, Northwestern University, The Medical School, Ward
Memorial Building, 303 East Chicago Avenue, Chicago, IL 60611, USA
H.F. Stich, Head, Environmental Carcinogenesis Unit, British Columbia Cancer Research
Centre, 601 West 10th Avenue, Vancouver BCV5Z IL3, Canada
P.F. Swann, Courtauld Institute of Biochemistry, Middlesex Hospital Medical SChool, Morti-
mer Street, London W1 P 7PN, UK
S.R. Tannenbaum, Massachusetts Institute of Technology, 56-311, Department of Nutrition
and Food Science, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
V. Turusov, Cancer Research Centre, USSR Academy of Medical Sciences, Karshirskoye
Shosse 24, 115478 Moscow, USSR (Vice-Chairman)
Representative of the National Cancer Institute
D.M. Winn, Environmental Epidemiology Branch, National Cancer Institute, Landow Building,
Room 3C16, Bethesda, MD 20205, USA
Representative of SRI International
K.E. McCaleb, Director, Chemical-Environmental Department, SRI International, 333
Ravenswood Avenue, Menlo Park, CA 94025, USA
PARTICIPANTS 9
Observers
A. Englund, Bygghalsän, Box 26055, 10041 Stockholrn, Sweden
B.H. MacGibbon, Senior Principal Medical Officer, Department of Health and Social Secu-
y, Hannibal House, Elephant and Castle, London SE1 6TE, UK
rit
S. Olin, Tracor Jitco, Inc., 1601 Research Boulevard, Rockville, MD 20850, USA
K. Stanley, Cancer Unit, WHO, 1211 Geneva 27, Switzerland
M.-Th. van der Venne, Health and Safety Directorate", Commission of the European Com-
rnunities, Bâtirnent Jean Monnet (C4/83), 2920 Luxembourg, Grand Duchy of Luxern-
bourg
Secretariat
H. Bartsch, Division of Environmental Carcinogenesis
J.R.P. Cabral, Division of Environmental Carcinogenesis
M. Friesen, Division of Environmental Carcinogenesis
L. Haroun, Division of Environmental Carcinogenesis (Secretary)
E. Heseltine, Editorial and Publications Services
J. Kaldor, Division of Epidemiology and Biostatistics
D. Mietton, Division of Environmental Carcinogenesis
R. Montesano, Division of Environmental Carcinogenesis
C.S. Muir, Division of Epidemiology and Biostatistics
J. Nair, Division of Environrnental Carcinogenesis
1. O'Neill, Division of Environmental Carcinogenesis
C. Partensky, Division of Environmental Carcinogenesis
1. Peterschmitt, Division of Environmental Carcinogenesis, Geneva, Switzerland
S. Poole, Birmingham, UK
E. Riboli, Division of Epidemiology and Biostatistics
L. Sirnonato, Division of Epidemiology and Biostatistics
L. Tomatis, Director
H. Vainio, Division of Environmental Carcinogenesis (Head of the Programme)
J. Wahrendorf, Division of Epidemiology and Biostatistics
J. Wilbourn, Division of Environmental Carcinogenesis
H. Y amasaki, Division of. Environmental Carcinogenesis
D. Zaridze, Division of Epidemiology and Biostatistics
Secretarial assistance
J. Cazeaux
M.-J. Ghess
M. Lézre
S. Reynaud
K. Zouhair