Associations of Arsenic Exposure With Impaired Lung Function and Mortality From Diseases of the Respiratory System: Findings From the Health Effects of Arsenic Longitudinal Study (HEALS)

Abstract

O-31C8-5 Background/Aims: Epidemiologic studies have reported a positive association between high levels of arsenic (As) exposure from drinking water (>500 μg/L) and respiratory disease. However, the effects of lower levels of As exposure on respiratory disease are unknown. Methods: We established the Health Effects of Arsenic Longitudinal Study, a cohort of 11,746 adults in Araihazar, Bangladesh. We measured pulmonary function with spirometry for 852 participants in a cross-sectional study. We also conducted cohort analyses using mortality data over the past 8 years. Results: In the cross-sectional study, individuals with skin lesions had a reduced level of FEV1 (P = 0.02) and FVC (P = 0.08). In the overall cohort, there were 43 deaths (9%) due to diseases of the respiratory system (ICD-10 J00-J99) of which 20 were due to other chronic obstructive pulmonary disease (J44). The hazard ratios of death from diseases of the respiratory system for increasing tertile of well water arsenic concentration (0–25, 25–114, and 114+ μg/L) were 1.0 (reference), 1.7 (95% CI: 0.7–3.9), and 2.2 (1.0–4.8) for death from disease of the respiratory system (P for trend = 0.02) adjusting for baseline age, sex, body mass index, cigarette smoking status, and educational attainment. The RRs for death from diseases of the respiratory system increasing quintiles of urinary arsenic were 1.00 (reference), 1.4 (95% CI: 0.7–3.9), and 2.0 (0.9–4.5) (P for trend = 0.04). Conclusion: The findings support that As is related to impaired lung functions and the risk of mortality from diseases of the respiratory system.