Arsenic and lung disease mortality in bangladeshi adults

Maria Argos, Faruque Parvez, Mahfuzar Rahman, Muhammad Rakibuz-Zaman, Alauddin Ahmed, Samar Kumar Hore, Tariqul Islam, Yu Chen, Brandon L. Pierce, Vesna Slavkovich, Christopher Olopade, Muhammad Yunus, John A. Baron, Joseph H. Graziano, Habibul Ahsan

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Chronic arsenic exposure through drinking water is a public health problem affecting millions of people worldwide, including at least 30 million in Bangladesh. We prospectively investigated the associations of arsenic exposure and arsenical skin lesion status with lung disease mortality in Bangladeshi adults. METHODS: Data were collected from a population-based sample of 26,043 adults, with an average of 8.5 years of follow-up (220,157 total person-years). There were 156 nonmalignant lung disease deaths and 90 lung cancer deaths ascertained through October 2013. We used Cox proportional hazards models to estimate adjusted hazard ratios and 95% confidence intervals (CIs) for lung disease mortality. RESULTS: Creatinine-adjusted urinary total arsenic was associated with nonmalignant lung disease mortality, with persons in the highest tertile of exposure having a 75% increased risk for mortality (95% CI = 1.15-2.66) compared with those in the lowest tertile of exposure. Persons with arsenical skin lesions were at increased risk of lung cancer mortality (hazard ratio = 4.53 [95% CI = 2.82-7.29]) compared with those without skin lesions. CONCLUSIONS: This prospective investigation of lung disease mortality, using individual-level arsenic measures and skin lesion status, confirms a deleterious effect of ingested arsenic on mortality from lung disease. Further investigations should evaluate effects on the incidence of specific lung diseases, more fully characterize dose-response, and evaluate screening and biomedical interventions to prevent premature death among arsenic-exposed populations, particularly among those who may be most susceptible to arsenic toxicity.

Original languageEnglish (US)
Pages (from-to)536-543
Number of pages8
JournalEpidemiology
Volume25
Issue number4
DOIs
StatePublished - 2014

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Arsenic
Lung Diseases
Mortality
Arsenicals
Skin
Confidence Intervals
Lung Neoplasms
Premature Mortality
Bangladesh
Proportional Hazards Models
Drinking Water
Population
Creatinine
Public Health
Incidence

ASJC Scopus subject areas

  • Epidemiology

Cite this

Argos, M., Parvez, F., Rahman, M., Rakibuz-Zaman, M., Ahmed, A., Hore, S. K., ... Ahsan, H. (2014). Arsenic and lung disease mortality in bangladeshi adults. Epidemiology, 25(4), 536-543. https://doi.org/10.1097/EDE.0000000000000106

Arsenic and lung disease mortality in bangladeshi adults. / Argos, Maria; Parvez, Faruque; Rahman, Mahfuzar; Rakibuz-Zaman, Muhammad; Ahmed, Alauddin; Hore, Samar Kumar; Islam, Tariqul; Chen, Yu; Pierce, Brandon L.; Slavkovich, Vesna; Olopade, Christopher; Yunus, Muhammad; Baron, John A.; Graziano, Joseph H.; Ahsan, Habibul.

In: Epidemiology, Vol. 25, No. 4, 2014, p. 536-543.

Research output: Contribution to journalArticle

Argos, M, Parvez, F, Rahman, M, Rakibuz-Zaman, M, Ahmed, A, Hore, SK, Islam, T, Chen, Y, Pierce, BL, Slavkovich, V, Olopade, C, Yunus, M, Baron, JA, Graziano, JH & Ahsan, H 2014, 'Arsenic and lung disease mortality in bangladeshi adults', Epidemiology, vol. 25, no. 4, pp. 536-543. https://doi.org/10.1097/EDE.0000000000000106
Argos M, Parvez F, Rahman M, Rakibuz-Zaman M, Ahmed A, Hore SK et al. Arsenic and lung disease mortality in bangladeshi adults. Epidemiology. 2014;25(4):536-543. https://doi.org/10.1097/EDE.0000000000000106
Argos, Maria ; Parvez, Faruque ; Rahman, Mahfuzar ; Rakibuz-Zaman, Muhammad ; Ahmed, Alauddin ; Hore, Samar Kumar ; Islam, Tariqul ; Chen, Yu ; Pierce, Brandon L. ; Slavkovich, Vesna ; Olopade, Christopher ; Yunus, Muhammad ; Baron, John A. ; Graziano, Joseph H. ; Ahsan, Habibul. / Arsenic and lung disease mortality in bangladeshi adults. In: Epidemiology. 2014 ; Vol. 25, No. 4. pp. 536-543.
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abstract = "BACKGROUND: Chronic arsenic exposure through drinking water is a public health problem affecting millions of people worldwide, including at least 30 million in Bangladesh. We prospectively investigated the associations of arsenic exposure and arsenical skin lesion status with lung disease mortality in Bangladeshi adults. METHODS: Data were collected from a population-based sample of 26,043 adults, with an average of 8.5 years of follow-up (220,157 total person-years). There were 156 nonmalignant lung disease deaths and 90 lung cancer deaths ascertained through October 2013. We used Cox proportional hazards models to estimate adjusted hazard ratios and 95{\%} confidence intervals (CIs) for lung disease mortality. RESULTS: Creatinine-adjusted urinary total arsenic was associated with nonmalignant lung disease mortality, with persons in the highest tertile of exposure having a 75{\%} increased risk for mortality (95{\%} CI = 1.15-2.66) compared with those in the lowest tertile of exposure. Persons with arsenical skin lesions were at increased risk of lung cancer mortality (hazard ratio = 4.53 [95{\%} CI = 2.82-7.29]) compared with those without skin lesions. CONCLUSIONS: This prospective investigation of lung disease mortality, using individual-level arsenic measures and skin lesion status, confirms a deleterious effect of ingested arsenic on mortality from lung disease. Further investigations should evaluate effects on the incidence of specific lung diseases, more fully characterize dose-response, and evaluate screening and biomedical interventions to prevent premature death among arsenic-exposed populations, particularly among those who may be most susceptible to arsenic toxicity.",
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AU - Parvez, Faruque

AU - Rahman, Mahfuzar

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AU - Ahmed, Alauddin

AU - Hore, Samar Kumar

AU - Islam, Tariqul

AU - Chen, Yu

AU - Pierce, Brandon L.

AU - Slavkovich, Vesna

AU - Olopade, Christopher

AU - Yunus, Muhammad

AU - Baron, John A.

AU - Graziano, Joseph H.

AU - Ahsan, Habibul

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N2 - BACKGROUND: Chronic arsenic exposure through drinking water is a public health problem affecting millions of people worldwide, including at least 30 million in Bangladesh. We prospectively investigated the associations of arsenic exposure and arsenical skin lesion status with lung disease mortality in Bangladeshi adults. METHODS: Data were collected from a population-based sample of 26,043 adults, with an average of 8.5 years of follow-up (220,157 total person-years). There were 156 nonmalignant lung disease deaths and 90 lung cancer deaths ascertained through October 2013. We used Cox proportional hazards models to estimate adjusted hazard ratios and 95% confidence intervals (CIs) for lung disease mortality. RESULTS: Creatinine-adjusted urinary total arsenic was associated with nonmalignant lung disease mortality, with persons in the highest tertile of exposure having a 75% increased risk for mortality (95% CI = 1.15-2.66) compared with those in the lowest tertile of exposure. Persons with arsenical skin lesions were at increased risk of lung cancer mortality (hazard ratio = 4.53 [95% CI = 2.82-7.29]) compared with those without skin lesions. CONCLUSIONS: This prospective investigation of lung disease mortality, using individual-level arsenic measures and skin lesion status, confirms a deleterious effect of ingested arsenic on mortality from lung disease. Further investigations should evaluate effects on the incidence of specific lung diseases, more fully characterize dose-response, and evaluate screening and biomedical interventions to prevent premature death among arsenic-exposed populations, particularly among those who may be most susceptible to arsenic toxicity.

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