蓝藻普遍存在于水体中，它们产生的肝毒素可能导致肝脏损伤。然而，蓝藻暴露（CE）对人群健康的影响尚不清楚。我们的研究目标是确定长期接触高蓝藻含量水体对肝病和癌症发病率和死亡率的影响，并识别与地理位置有关的风险因素。通过卫星遥感数据，我们确定了美国连续的区域中蓝藻含量高的水体。该数据被地理空间映射到县界，并分析了疾病死亡率和发病率。我们找到了与CE和与肝病或癌症相关的独特空间聚类现象。CE和肝病、肝癌之间存在高度显著的空间关联，但CE与所有癌症之间没有关联。在墨西哥湾、德克萨斯东部、路易斯安那州和佛罗里达州沿海地区发现了CE和死亡的高度聚集区，阿巴拉契亚山脉地区则存在冷点。通过逻辑回归分析，社会脆弱指数被确定为重要的地理位置决定因素，第四或第五分位数的县具有CE和肝癌死亡的高聚集区的最高患病率。这些研究结果强调了环境暴露于蓝藻与肝癌死亡的地理位置决定因素的重要性。可以考虑采取公共卫生措施来减少死亡，特别是在社会脆弱地区。 版权所有 © 2023 美国肝脏疾病研究学会。

Cyanobacteria are commonly found in water bodies and their production of hepatotoxins can contribute to liver damage. However, the population health effects of cyanobacteria exposure (CE) are unknown. Our objectives were to determine the effect of chronic exposure to cyanobacteria through proximity to waterbodies with high cyanobacteria counts on the incidence and mortality of liver disease and cancers, as well as to identify location-based risk factors.Across the contiguous United States, regions with high cyanobacteria counts in waterbodies were identified using satellite remote sensing data. The data was geospatially mapped to county boundaries, and disease mortality and incidence rates analyzed. Distinctive spatial clusters of CE and mortality related to liver diseases or cancer were identified. There was a highly significant spatial association between CE and liver disease and liver cancer, but not between CE and all cancers. Hot spots of CE and mortality were identified along the Gulf of Mexico, eastern Texas, Louisiana, and Florida, and cold spots across the Appalachians. Social vulnerability index was identified as a major location-based determinant by logistic regression, with counties in the fourth or fifth quintiles having the highest prevalence of hot-spots of CE and mortality from liver cancer.These findings emphasize the importance of environmental exposure to cyanobacteria as a location-based determinant of mortality from liver cancer. Public health initiatives addressing CE may be considered to reduce mortality, particularly in areas of high social vulnerability.Copyright © 2023 American Association for the Study of Liver Diseases.