Early Life Arsenic Exposure and Non-Malignant Respiratory Illnesses among Adolescents in Rural Bangladesh

Abstract

Background/Aim: Evidence suggests that exposure to arsenic through drinking water increases the risk of non-malignant respiratory illnesses including impairment of lung function in adults. However, early life arsenic exposure and subsequent respiratory system effects in adolescents have not been reported so far. Methods: The study was conducted in rural Bangladesh, Matlab. A cohort of 200 children now aged 11-22 years were enrolled of which 107 had in utero and early childhood (first five years) exposure to drinking water arsenic concentration over 400µg/L (exposed group) and 93 had less than 10 µg/L (unexposed group). Histories of respiratory symptoms were collected through a validated structured questionnaire (ISAAC). Lung function (FEV1, FVC) was tested by EasyOne spirometry following the standard American Thoracic Society criteria. Water arsenic concentrations were measured by hydride generation atomic absorption spectrophotometry. Results: The mean age was 15 years. Chronic respiratory symptoms were evident in male participants in the exposed group. In an adjusted model, boys with in early life arsenic exposure (>400 µg/L) were more likely to report wheezing attacks 1-3 times/week (Prevalence Odds Ratio (POR): 4.99, 95% Confidence Interval (CI): 1.00-24.9), wheezing after exercise (POR: 4.14, 95% CI: 1.05-16.4) and waking up with chest tightness (POR: 5.01, 95% CI: 1.00-25.0). Decrease in FEV1 (-117.3 ml, CI: -246.5, 11.8) and FVC (-135.2 ml, CI: -269.9, -0.37) were observed in male respondents in the exposed group compared to the unexposed. No respiratory impairment was observed among exposed girls. Conclusions: High exposure to arsenic in utero and early childhood may result in increased risk of chronic respiratory symptoms and decrements in lung function in adolescent males. We plan to follow this unique cohort further to see if early life arsenic exposure respiratory effects persist in males as they grow older, and remain absent in females.