Impact of receipt of private well arsenic test results on maternal use of contaminated drinking water in a U.S. population

Abstract

Exposure to inorganic arsenic in drinking water has known cancer and non-cancer health effects. However, no prior studies have addressed response to well water testing for arsenic during pregnancy, a time of known heightened risk perception. Using a US pregnancy cohort, we assessed the impact of receiving well water arsenic test results on subsequent use of arsenic-contaminated tap water. Study participants were 24–28 weeks' gestation at study entry and reported living in a residence served by a private, unregulated well. Upon enrollment participants provided a tap water sample which was tested for arsenic using ICP-MS. During pregnancy and every four months after, participants were asked their extent of tap water use for drinking, cooking and mixing infant formula. Logistic regression was used to estimate the odds of tap water use at one year post-partum in relation to baseline tap water use and arsenic concentration. Compared to those who used tap water <50% of the time, mothers who reported using tap water for drinking and cooking >50% of time in their prenatal questionnaire had 8.54 times the odds of using their tap water at 1-year postpartum (95% CI: 5.37, 13.60). After adjusting for frequency of prenatal tap water use, mothers were less likely to use tap water for drinking and cooking (OR = 0.34, 95% CI: 0.19, 0.60) and for mixing formula (OR = 0.45, 95% CI: 0.24, 0.86) if the high arsenic concentration (>10 μg/L) was known to them. Our findings suggest that providing well water test results during pregnancy may reduce subsequent maternal use of iAs contaminated tap water for drinking, cooking, and mixing infant formula. Public health implications are discussed.