Dose-Response Relationship Between Ischemic Heart Disease Mortality and Long-term Arsenic Exposure

Abstract

The cardiovascular effects of inorganic arsenic have been documented, but the dose-response relationship between ischemic heart disease (ISHD) and long-term arsenic exposure remains to be elucidated. Mortality rates from ISHD among residents in 60 villages of the area in Taiwan with endemic arseniasis from 1973 through 1986 were analyzed to examine their association with arsenic concentration in drinking water. Based on 1 355 915 person-years and 217 ISHD deaths, the cumulative ISHD mortalities from birth to age 79 years were 3.4%, 3.5%, 4.7%, and 6.6%, respectively, for residents who lived in villages in which the median arsenic concentrations in drinking water were <0.1, 0.1 to 0.34, 0.35 to 0.59, and > or = 0.6 mg/L. A cohort of 263 patients affected with blackfoot disease (BFD), a unique arsenic-related peripheral vascular disease, and 2293 non-BFD residents in the endemic area of arseniasis were recruited and followed up for an average period of 5.0 years. There was a monotonous biological gradient relationship between cumulative arsenic exposure through drinking artesian well water and ISHD mortality. The relative risks were 2.5, 4.0 and 6.5, respectively, for those who had a cumulative arsenic exposure of 0.1 to 9.9, 10.0 to 19.9, and > or = 20.0 mg/L-years compared with those without the arsenic exposure after adjustment for age, sex, cigarette smoking, body mass index, serum cholesterol and triglyceride levels, and disease status for hypertension and diabetes through proportional-hazards regression analysis. BFD patients were found to have a significantly higher ISHD mortality that non-BFD residents, showing a multivariate-adjusted relative risk of 2.5 (95% CI, 1.1 to 5.4).

Association of Clinical Complications with Nutritional Status and the Prevalence of Leukopenia among Arsenic Patients in Bangladesh

“…The duration of exposure has been found directly related to the severity of clinical disease. Similar dose-response relationships have been reported in long-term arsenic exposure with ischemic heart disease mortality in Taiwan [23], and with skin lesions in Bangladesh [3]. The calorie consumption per day values indicated that the patients have been nutritionally compromised and represented the common lower-middle class Bangladeshi populations; the control subjects from the same area showed similar data but have been in relatively better shape.…”

Understanding the human health effects of chemical mixtures.

“…For metals, we have good evidence for increased risk of ischemic heart disease from arsenic exposure (145), and the elevated risk (2.5-fold) remains after adjustment for several other factors including hypertension and diabetes. This effect also appears to be independent of the peripheral artery disease seen in arsenic poisoning.…”

Examination of the effects of arsenic on glucose homeostasis in cell culture and animal studies: Development of a mouse model for arsenic-induced diabetes

“…Previous research of the effects of chronic exposure to iAs has focused primarily on its carcinogenic potential. However, chronic exposures to iAs from the environment or in occupational settings have also been linked to non-carcinogenic diseases, including peripheral vascular disease, cardiovascular and cerebrovascular diseases Chen et al, 1996;Chiou et al, 1997;Engel et al, 1994;Thomas and Goyer, 1995;Tseng et al, 1995;Tseng et al, 1997), hypertension , goiter (Chang et al, 1991), hepatomegaly (Santra et al, 1999), respiratory system dysfunction (Mazumder et al, 2000), nervous system dysfunction (Bencko et al, 1977;Chisolm Jr. and Thomas, 1983;Masahiko and Hideyasu, 1973), and diabetes mellitus (Lai et al, 1994;Rahman et al, 1998;Rahman et al, 1999;Tseng et al, 2000).…”