American Journal of Epidemiology Vol. 151, No. 2: 174-181
Copyright © 2000 by The Johns Hopkins University School of Hygiene and Public Health
other |
Does Arsenic Exposure Increase the Risk for Circulatory Disease?
1Department of Epidemiology, University of North Carolina Chapel Hill, NC
Reprint requests to Dr. Irva Hertz-Picciotto, CB 
7400, Department of Epidemiology, University of North Carolina, Chapel Hill, NC 27599–7400
2 Present address: Amgen, Thousand Oaks, CA.
Studies of residents in communities with high endemic concentrations of arsenic in drinking water suggest a deleterious effect on the circulatory system; however, studies among workers with high occupational exposures generally have shown either no or weak associations. This discrepancy could be a result of the healthy worker effect, including the healthy hire component and the healthy worker survivor effect (HWSE). Therefore, the authors conducted analyses of arsenic exposure in relation to circulatory disease mortality among 2,802 Tacoma, Washington, smelter workers by using 1) internal comparisons to control for the healthy hire effect and 2) the lagging method, adjustment for employment status, and the G-null test to control for the HWSE. Both lagging and adjustment for work status increased circulatory mortality rate ratios at all exposure levels, as compared with a baseline Poisson model. This excess mortality was limited to cardiovascular disease; no excess was observed for cerebrovascular disease. G-null analyses suggested no adverse effect, but power was very limited for this analysis. Overall, these results may indicate that the HWSE obscures an effect of arsenic on circulatory disease. Since cardiovascular deaths constitute about one-third of total mortality, small rate ratios translate into large numbers of excess deaths and, if causal, could be of wide public health significance. Further studies of arsenic exposure and cardiovascular disease are needed, and those conducted in occupational cohorts must control for the HWSE. Am J Epidemiol 2000; 151:174-81.
arsenic; cardiovascular diseases; epidemiologic methods; healthy worker effect; occupational medicine
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  C J Sakr, J M Symons, K H Kreckmann, and R C Leonard Ischaemic heart disease mortality study among workers with occupational exposure to ammonium perfluorooctanoate Occup. Environ. Med., October 1, 2009; 66(10): 699 - 703. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Yuan, G. Marshall, C. Ferreccio, C. Steinmaus, S. Selvin, J. Liaw, M. N. Bates, and A. H. Smith Acute Myocardial Infarction Mortality in Comparison with Lung and Bladder Cancer Mortality in Arsenic-exposed Region II of Chile from 1950 to 2000 Am. J. Epidemiol., December 15, 2007; 166(12): 1381 - 1391. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Navas-Acien, A. R. Sharrett, E. K. Silbergeld, B. S. Schwartz, K. E. Nachman, T. A. Burke, and E. Guallar Arsenic Exposure and Cardiovascular Disease: A Systematic Review of the Epidemiologic Evidence Am. J. Epidemiol., December 1, 2005; 162(11): 1037 - 1049. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. M. Zierold, L. Knobeloch, and H. Anderson Prevalence of Chronic Diseases in Adults Exposed to Arsenic-Contaminated Drinking Water Am J Public Health, November 1, 2004; 94(11): 1936 - 1937. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. R. Smith, L. R. Klei, and A. Barchowsky Arsenite stimulates plasma membrane NADPH oxidase in vascular endothelial cells Am J Physiol Lung Cell Mol Physiol, March 1, 2001; 280(3): L442 - L449. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. H. Lubin, J. F. Fraumeni Jr., I. Hertz-Picciotto, S.-W. Hu, and H. M. Arrighi RE: "DOES ARSENIC EXPOSURE INCREASE THE RISK FOR CIRCULATORY DISEASE?" Am. J. Epidemiol., August 1, 2000; 152(3): 290 - 293. [Full Text] [PDF]
|
|