A Prospective Study of Arsenic Exposure From Drinking Water and Incidence of Skin Lesions in Bangladesh

Abstract

Elevated concentrations of arsenic in groundwater pose a public health threat to millions of people worldwide. The authors aimed to evaluate the association between arsenic exposure and skin lesion incidence among participants in the Health Effects of Arsenic Longitudinal Study (HEALS). The analyses used data on 10,182 adults free of skin lesions at baseline through the third biennial follow-up of the cohort (2000-2009). Discrete-time hazard regression models were used to estimate hazard ratios and 95% confidence intervals for incident skin lesions. Multivariate-adjusted hazard ratios for incident skin lesions comparing 10.1-50.0, 50.1-100.0, 100.1-200.0, and ≥200.1 μg/L with ≤10.0 μg/L of well water arsenic exposure were 1.17 (95% confidence interval (CI): 0.92, 1.49), 1.69 (95% CI: 1.33, 2.14), 1.97 (95% CI: 1.58, 2.46), and 2.98 (95% CI: 2.40, 3.71), respectively (P(trend) = 0.0001). Results were similar for the other measures of arsenic exposure, and the increased risks remained unchanged with changes in exposure in recent years. Dose-dependent associations were more pronounced in females, but the incidence of skin lesions was greater in males and older individuals. Chronic arsenic exposure from drinking water was associated with increased incidence of skin lesions, even at low levels of arsenic exposure (<100 μg/L).

Epidemiology of chronic disease related to arsenic in Argentina: A systematic review

“…They were reported to occur from exposure to concentrations as low as 10 μg/L in prospective cohort studies (Argos et al, 2011). The median frequency of skin lesions in subjects chronically exposed to As was shown to be 32.43% in the province of Tucumán in 2009-2014.…”

Risk Assessment

“…the earliest, often FIGURE 4 Incidence of skin lesions (dotted line) and bladder cancer (unbroken line) in relation to exposure to arsenic in drinking water. Incidence (above-background incidence) of skin lesions (keratosis and melanosis) per 9 years of exposure is estimated from Argos et al (2011). Incidence of bladder cancer in life-long exposure is estimated from data by Chen et al (2010), modeled by Carrington et al (2013), and with background incidence subtracted.…”

Behavioral factors associated with the development of skin cancer in patients of arsenicosis

“…2 In this study, most of skin cancers were found both in the exposed and covered areas and the lesions in the covered areas outnumbered the sun-exposed areas. Arsenical basal cell carcinomas most often arise from the normal tissue, frequently occur on the trunk.…”

“…Arsenical basal cell carcinomas most often arise from the normal tissue, frequently occur on the trunk. 2 In this study, among the 3 basal cell carcinoma, 2 were found on the trunk and one in the palm.…”