American Journal of Epidemiology Advance Access originally published online on August 10, 2005
American Journal of Epidemiology 2005 162(6):533-541; doi:10.1093/aje/kwi236
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ORIGINAL CONTRIBUTIONS |
Decrements in Lung Function Related to Arsenic in Drinking Water in West Bengal, India
1 Arsenic Health Effects Research Program, School of Public Health, University of California, Berkeley, CA
2 Institute of Post Graduate Medical Education and Research, Kolkata, India
3 Division of Occupational and Environmental Medicine, University of California, San Francisco, CA
4 Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
Reprint requests to Dr. Allan H. Smith, Arsenic Health Effects Research Program, School of Public Health, 140 Warren Hall, University of California, Berkeley, CA 94720-7360 (e-mail: ahsmith{at}berkeley.edu).
During 1998–2000, the authors investigated relations between lung function, respiratory symptoms, and arsenic in drinking water among 287 study participants, including 132 with arsenic-caused skin lesions, in West Bengal, India. The source population involved 7,683 participants who had been surveyed for arsenic-related skin lesions in 1995–1996. Respiratory symptoms were increased among men with arsenic-caused skin lesions (versus those without lesions), particularly "shortness of breath at night" (odds ratio (OR) = 2.8, 95% confidence interval (CI): 1.1, 7.6) and "morning cough" (OR = 2.8, 95% CI: 1.2, 6.6) in smokers and "shortness of breath ever" (OR = 3.8, 95% CI: 0.7, 20.6) in nonsmokers. Among men with skin lesions, the average adjusted forced expiratory volume in 1 second (FEV1) was reduced by 256.2 ml (95% CI: 113.9, 398.4; p < 0.001) and the average adjusted forced vital capacity (FVC) was reduced by 287.8 ml (95% CI: 134.9, 440.8; p < 0.001). In men, a 100-µg/liter increase in arsenic level was associated with a 45.0-ml decrease (95% CI: 6.2, 83.9) in FEV1 (p = 0.02) and a 41.4-ml decrease (95% CI: –0.7, 83.5) in FVC (p = 0.054). Women had lower risks than men of developing skin lesions and showed little evidence of respiratory effects. In this study, consumption of arsenic-contaminated water was associated with respiratory symptoms and reduced lung function in men, especially among those with arsenic-related skin lesions.
arsenic; India; respiratory function tests; signs and symptoms, respiratory; water; water pollutants
Abbreviations: CI, confidence interval; FEF25–75, forced expiratory flow between 25 and 75 percent of forced vital capacity; FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity; OR, odds ratio; SMR, standardized mortality ratio
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