Arsenic Exposure from Drinking Water and Risk of Premalignant Skin Lesions in Bangladesh: Baseline Results from the Health Effects of Arsenic Longitudinal Study

• Published in: American journal of epidemiology Vol. 163; no. 12; pp. 1138 - 1148
• Main Authors: Ahsan, Habibul, Chen, Yu, Parvez, Faruque, Zablotska, Lydia, Argos, Maria, Hussain, Iftikhar, Momotaj, Hassina, Levy, Diane, Cheng, Zhongqi, Slavkovich, Vesna, van Geen, Alexander, Howe, Geoffrey R., Graziano, Joseph H.
• Format: Journal Article
• Language: English
• Published: Cary, NC Oxford University Press 15.06.2006; Oxford Publishing Limited (England)
• Subjects: Adult; Age; Analysis. Health state; Arsenic; Arsenic - adverse effects; Arsenic - analysis; Bangladesh; Bangladesh - epidemiology; Biological and medical sciences; CAI; Cross-Sectional Studies; cumulative arsenic index; Dermatology; Dose-Response Relationship, Drug; Drinking water; environmental exposure; Environmental Exposure - adverse effects; Epidemiology; Female; Gender; General aspects; HEALS; Health Effects of Arsenic Longitudinal Study; Health risk assessment; Human exposure; Humans; keratosis; Longitudinal Studies; Male; Medical sciences; melanosis; Middle Aged; Miscellaneous; Pigmentary diseases of the skin; POR; Precancerous Conditions - chemically induced; Precancerous Conditions - epidemiology; prevalence odds ratio; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Regression Analysis; relative excess risk due to interaction; RERI; risk; Risk Factors; Skin; Skin Diseases - chemically induced; Skin Diseases - epidemiology; time-weighted arsenic concentration; TWA; Water Supply; Asia; Bangladesh; Human; Drinking water; Skin disease; Pigmentation disorder; Premalignant lesion; Arsenic; Exposure; Epidemiology; cross-sectional studies; Result; Bangladesh; Health and environment; Follow up study; Cross sectional study; environmental exposure; Risk factor; Melanosis; risk; Public health; Keratosis
• DOI: 10.1093/aje/kwj154
• ISSN: 0002-9262

Millions of persons around the world are exposed to low doses of arsenic through drinking water. However, estimates of health effects associated with low-dose arsenic exposure have been extrapolated from high-dose studies. In Bangladesh, many persons have been exposed to a wide range of doses of arsenic from drinking water over a significant period of time. The authors evaluated dose-response relations between arsenic exposure from drinking water and premalignant skin lesions by using baseline data on 11,746 participants recruited in 2000–2002 for the Health Effects of Arsenic Longitudinal Study in Araihazar, Bangladesh. Several measures of arsenic exposure were estimated for each participant based on well-water arsenic concentration and usage pattern of the wells and on urinary arsenic concentration. In different regression models, consistent dose-response effects were observed for all arsenic exposure measures. Compared with drinking water containing <8.1 μg/liter of arsenic, drinking water containing 8.1–40.0, 40.1–91.0, 91.1–175.0, and 175.1–864.0 μg/liter of arsenic was associated with adjusted prevalence odds ratios of skin lesions of 1.91 (95% confidence interval (CI): 1.26, 2.89), 3.03 (95% CI: 2.05, 4.50), 3.71 (95% CI: 2.53, 5.44), and 5.39 (95% CI: 3.69, 7.86), respectively. The effect seemed to be influenced by gender, age, and body mass index. These findings provide information that should be considered in future research and policy decisions.