Bronchiectasis in Persons With Skin Lesions Resulting From Arsenic in Drinking Water

Mazumder, D. N. Guha; Steinmaus, Craig; Bhattacharya, Partha Pratim; Ehrenstein, Ondine S. von; Ghosh, Nilima; Gotway, Michael B.; Sil, Arabinda; Balmes, John R.; Haque, Reina; Hira-Smith, Meera; Smith, Allan H.

doi:10.1097/01.ede.0000181637.10978.e6

Cited by 110 publications

(96 citation statements)

References 15 publications

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“…The facts that ingested arsenic is an established carcinogen at higher exposures (1), accumulates in the lungs (20,21), and has been linked to noncancer lung disease (22)(23)(24)(25) all support the biologic plausibility of these findings. This is one of the few low exposure-cancer studies with individual data on past arsenic exposure.…”

Section: Discussionmentioning

confidence: 96%

Elevated Lung Cancer in Younger Adults and Low Concentrations of Arsenic in Water

Steinmaus¹,

Ferreccio²,

Yuan³

et al. 2014

American Journal of Epidemiology

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Arsenic concentrations greater than 100 µg/L in drinking water are a known cause of cancer, but the risks associated with lower concentrations are less well understood. The unusual geology and good information on past exposure found in northern Chile are key advantages for investigating the potential long-term effects of arsenic. We performed a case-control study of lung cancer from 2007 to 2010 in areas of northern Chile that had a wide range of arsenic concentrations in drinking water. Previously, we reported evidence of elevated cancer risks at arsenic concentrations greater than 100 µg/L. In the present study, we restricted analyses to the 92 cases and 288 populationbased controls who were exposed to concentrations less than 100 µg/L. After adjustment for age, sex, and smoking behavior, these exposures from 40 or more years ago resulted in odds ratios for lung cancer of 1.00, 1.43 (90% confidence interval: 0.82, 2.52), and 2.01 (90% confidence interval: 1.14, 3.52) for increasing tertiles of arsenic exposure, respectively (P for trend = 0.02). Mean arsenic water concentrations in these tertiles were 6.5, 23.0, and 58.6 µg/L. For subjects younger than 65 years of age, the corresponding odds ratios were 1.00, 1.62 (90% confidence interval: 0.67, 3.90), and 3.41 (90% confidence interval: 1.51, 7.70). Adjustments for occupation, fruit and vegetable intake, and socioeconomic status had little impact on the results. These findings provide new evidence that arsenic water concentrations less than 100 µg/L are associated with higher risks of lung cancer.arsenic; case-control; drinking water; low exposure; lung cancer; northern Chile Abbreviation: CI, confidence interval.High concentrations of arsenic in drinking water (e.g., >100 µg/L) are known to cause cancer, but the risks associated with exposure to lower concentrations are unclear (1-3). One difficulty in studying low-level exposures is the prolonged latency of arsenic-caused cancer (2,(4)(5)(6). This long latency period means that exposure data must be available for a period of several decades or more in order to identify true overall risks. Another difficulty is that exposure in most arsenic-exposed areas comes from thousands of small private wells, for which historic records are frequently unavailable (7).Northern Chile is the driest habitable place on earth. There are few water sources, and almost everyone lives in a city and drinks water from municipal supplies. These supplies have had a wide range of arsenic concentrations, and historical records are available from 40 years ago or more (8). These factors mean that a person's lifetime exposure can be reliably estimated simply by knowing the cities in which the person lived.In 2007-2010, we performed a case-control study in northern Chile and identified high odds ratios for lung, bladder, and kidney cancers (6, 9). These results focused on cities in which arsenic concentrations in drinking water were greater than 800 µg/L. They also involved lifetime average and cumulative exposure metrics, in which short pe...

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Section: Discussionmentioning

confidence: 96%

Elevated Lung Cancer in Younger Adults and Low Concentrations of Arsenic in Water

Steinmaus¹,

Ferreccio²,

Yuan³

et al. 2014

American Journal of Epidemiology

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“…As is associated with skin, lung and bladder cancers [1,2], as well as vascular diseases, hepatotoxicity, neurotoxicity, diabetes, chronic cough and impaired fetal and child development [2][3][4]. One mechanism involved in various As-related toxic effects, including carcinogenesis, is the generation of reactive oxygen species (ROS) [5,6].…”

Section: Introductionmentioning

confidence: 99%

Low 8-oxo-7,8-dihydro-2′-deoxyguanosine levels and influence of genetic background in an Andean population exposed to high levels of arsenic

Engström

Vahter

Lindh

et al. 2010

Mutation Research/Fundamental and Molecular Mechanisms of Mutag

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“…Overall, subjects with arsenic-caused skin lesions had a 10-fold increased prevalence of bronchiectasis compared with subjects who did not have skin lesions. 98 Furthermore, in the same area, another study using a cohort of 287 participants who were exposed to 500 mgL À1 of arsenic, levels well above the current World Health Organization recommended maximum of 10 mgL À1 , reported a significant association between skin lesions and reduced lung function. 99 There is a growing body of evidence that shows that ingestion of arsenic through drinking contaminated water leads to significant chronic nonmalignant lung disease including obstructive and restrictive lung disease and bronchiectasis.…”

Section: Water Pollution Arsenicmentioning

confidence: 95%

“…In participants with arsenic-associated skin lesions, the age-adjusted prevalence odds ratio estimates for cough, crepitations and shortness of breath for females were 7.8, 9.6 and 23.2 and for males 5, 6.9 and 3.7, respectively. 98 To establish the risk of bronchiectasis in persons with arsenic-caused skin lesions, Mazumder and colleagues 98 recruited 108 participants with skin lesions and 150 participants with no skin lesions from a population survey in an arsenic-exposed region in West Bengal, India. Participants with a 2-year history of chronic cough (N ¼ 38) underwent high-resolution CT scan.…”

Section: Water Pollution Arsenicmentioning

confidence: 99%

Review Series: What goes around, comes around: childhood influences on later lung health?: Relationship between environmental exposures in children and adult lung disease: The case for outdoor exposures

Soto-Martinez

Sly

2009

Chron Respir Dis

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There is a growing understanding that chronic respiratory diseases in adults have their origins in early life. Adverse environmental exposures occurring in vulnerable periods during lung growth and development in the fetal period and in early childhood that alter lung structure and limit the growth in lung function may have lifelong consequences. Evidence is increasing that exposure to the ambient environment, including air pollutants, persistent toxic substances, water pollutants and respiratory viral infections, can inhibit lung function growth and predispose to chronic non-malignant lung diseases. These exposures generally interact with a genetic predisposition, and gene-environment interactions and epigenetic phenomena are attracting considerable study. An understanding of how ambient exposures impact on normal lung growth and development will aid in understanding of how chronic respiratory diseases of adults develop and may lead to new preventative strategies.

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Bronchiectasis in Persons With Skin Lesions Resulting From Arsenic in Drinking Water

Abstract: These results suggest that, in addition to being a cause of lung cancer, ingestion of high concentrations of arsenic in drinking water may be a cause of bronchiectasis.

Cited by 110 publications

References 15 publications

Elevated Lung Cancer in Younger Adults and Low Concentrations of Arsenic in Water

Elevated Lung Cancer in Younger Adults and Low Concentrations of Arsenic in Water

Low 8-oxo-7,8-dihydro-2′-deoxyguanosine levels and influence of genetic background in an Andean population exposed to high levels of arsenic

Review Series: What goes around, comes around: childhood influences on later lung health?: Relationship between environmental exposures in children and adult lung disease: The case for outdoor exposures

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