Low-level Arsenic Exposure in Drinking Water and Diabetes Mellitus in Cyprus: Preliminary Findings

Abstract

O-29C8-5 Background/Aims: Arsenic (As) carcinogenicity to living organisms, including humans has well been established. Non-carcinogenic effects of As, such as, adverse pregnancy outcomes, hypertension, endocrine disruption, and diabetes mellitus have recently attracted attention by the scientific community. Although dose response relationships for these end points seem to be clearly defined for relatively high As exposures, that is, >100 ppb, the shape and magnitude of the effect for low-level exposures (>10–100 ppb) is still unclear. This is also the case for diabetes mellitus where low-level As effects on the prevalence of diabetes mellitus have yet to be confirmed. Methods: This study was undertaken in a community of Cyprus where elevated As concentrations (median: 40 ppb; range: <10–100 ppb) were recently detected in the groundwater that was chronically used to satisfy their potable needs. A detailed questionnaire was filled out by 430 residents asking general, water use habits, and medical history questions. Cumulative lifetime As exposure was calculated using median As concentrations in water, individual water consumption rates, and individual exposure duration to that specific contaminated source of drinking-water. Results: A logistic regression model for the presence of diabetes mellitus was developed, and logarithmically transformed As exposures were analyzed both as a continuous variable and also by comparing their 20th and 80th percentiles. Odd ratios were calculated both in a univariate analysis as well as in a multivariate model adjusting for age, sex, smoking status, and educational level. Water use habits, such as, use of As-contaminated well water, bottled water, and use of As-contaminated water for cooking were included in the regression models and their effect sizes were calculated. Conclusion: Results from this study are expected to assess the relationship between low-level As exposures and the cases of diabetes mellitus recorded in this As-affected community of Cyprus.