Abstract
BackgroundMillions of people are at risk from the adverse effects of arsenic exposure through drinking water. Increasingly, non-cancer effects such as cardiovascular disease have been associated with drinking water arsenic exposures. However, most studies have been conducted in highly exposed populations and lacked individual measurements.ObjectiveTo evaluate the association between cardiovascular disease and well-water arsenic exposure.MethodsWe conducted a hospital based case control study in Inner Mongolia, China. Cases and controls were prospectively identified and enrolled from a large hospital in the Hangjin Hou area. Cases were patients diagnosed with cardiovascular disease and controls were patients free from cardiovascular disease, admitted for conditions unrelated to arsenic exposure. Water from the primary water source and toenail samples were collected from each subject and tested for inorganic arsenic.ResultsArsenic exposures were moderate with mean and median arsenic exposures of 8.9 μg/L and 13.1 μg/L, respectively. A total of 298 cases and 275 controls were enrolled. The adjusted odds ratio (AOR) and corresponding 95% confidence interval (95% CI) for a 10 μg/L increase in water arsenic were 1.19 (95% CI: 1.03, 1.38). Compared to exposures less than 10 μg/L, the AOR for water arsenic exposures above 40 μg/L was 4.05 (95% CI: 1.1-14.99, p = 0.04). Nail arsenic above 1.38 μg/g was also associated with an increased risk of cardiovascular disease.ConclusionsBy using standardized case definitions and collecting individual measurements of arsenic, this study addressed several limitations of previous studies. The results provide further evidence of the association between cardiovascular disease and arsenic at moderate exposures.Electronic supplementary materialThe online version of this article (doi:10.1186/s12940-015-0022-y) contains supplementary material, which is available to authorized users.
Highlights
Millions of people are at risk from the adverse effects of arsenic exposure through drinking water
The adjusted odds ratio (AOR) and corresponding 95% confidence interval for a 10 μg/L increase in water arsenic were 1.19
Compared to exposures less than 10 μg/L, the AOR for water arsenic exposures above 40 μg/L was 4.05
Summary
Millions of people are at risk from the adverse effects of arsenic exposure through drinking water. Epidemiological studies have associated arsenic exposures with cardiovascular and peripheral vascular health effects including Blackfoot disease, hypertension, atherosclerosis, ischemic heart disease, vascular disease mortality, Increased cardiovascular mortality was observed in populations in Taiwan exposed to extremely high levels of arsenic in well water [6,13,16,22,23]. Most of these studies, were retrospective, lacked individual measures of arsenic or cardiovascular disease (CVD), and were conducted in populations with high arsenic exposures (e.g., >600 μg/L).
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