Burden of Coronary Heart Disease and Cancer from Dietary Exposure to Inorganic Arsenic in Adults in China, 2016

Abstract

Background and Objectives: Inorganic arsenic (iAs) can cause a wide range of health problems, including coronary heart disease (CHD) and lung, bladder, and skin cancer. Although dietary iAs intake is the primary source of iAs, the burden of CHD and cancers from dietary iAs exposure in Chinese adults has not been well known. Methods: To estimate the iAs exposure level in Chinese adults’ diet, we systematically collected food-specific iAs concentrations in China from Chinese and English literature databases during 2000-2020. Food consumption was extracted from two nationwide food and nutrition surveys in China. The population attributable fraction was calculated based on the dose-response relationship between iAs and CHD risk. Combining the 2016 Chinese tumor registry data, we calculated the annual incidence of cancer from dietary iAs exposure to measure the disability-adjusted life year (DALY) in 2016. Findings: The total amount of daily foodborne iAs intake was 0.55 μg/kg bw/day among Chinese adults. The DALY of foodborne iAs-associated CHD was 3,017,510, which accounted for 10.18% of total CHD DALY in Chinese adults in 2016. Moreover, the carcinogenic DALY for lung cancer, bladder cancer, and skin cancer of Chinese residents in 2016 related to dietary iAs was 314.24, 9.89, and 167.32 thousand, accounting for 2.05%, 1.70%, and 35.5% of the total cancer burden, respectively. Conclusions: Our findings suggested that dietary iAs exposure causes a substantial disease burden in Chinese adults. More efforts for foodborne iAs control are critical to reducing the disease burden of CHD and cancer in China and other countries with similar dietary patterns.

Hospitalization expenses of coronary heart disease inpatients in China: evidence from two hospitals in Ningxia Hui autonomous region

“…The average direct CHD hospitalization costs were RMB30998.26 (US$4976.92) before applying for reimbursement from medical insurance. Although average CHD hospitalization costs were lower than other regions in China ( 20 ) and other countries ( 21 ), it imposed a heavy burden on CHD patients and their families in one of the least development regions in China. Given CHD hospital expenses as a proportion of the average yearly income, we recommend improving national insurance cover, catastrophe insurance and income safety nets to shield individuals and families from financial stress.…”

Update of the risk assessment of inorganic arsenic in food

“…For the present Opinion, the CONTAM Panel identified 87 additional studies from a literature search and from nine systematic reviews (Abhyankar et al, 2012;Bao et al, 2022;Chowdhury et al, 2018;Karachaliou et al, 2021;Moon et al, 2012Moon et al, , 2017Tsuji et al, 2014;Zhao et al, 2021). Out of these, 53 studies (Afridi et al, 2011;Ameer et al, 2015;Castiello et al, 2020;Cheng et al, 2021;Dastgiri et al, 2010;Desai et al, 2021;Dong et al, 2022;Gong & O'Bryant, 2012;Guha Mazumder et al, 2012;Gunduz et al, 2015;Guo et al, 2007;Hall et al, 2017;Jovanović et al, 2012;Liao et al, 2012;Lin, Hsu, et al, 2018;Lisabeth et al, 2010;Liu et al, 2022;McLeod et al, 2018;Meliker et al, 2007;Merrill et al, 2017;Nong et al, 2016;Nunes et al, 2022;Pichler et al, 2019;Qu et al, 2022;Rahman et al, 1999Rahman et al, , 2014Rahman, Niemann, & Munson-McGee, 2022c;Shiue, 2014;Sohel et al, 2009;Soria et al, 2021;Stea et al, 2016;Tang et al, 2022;Wang et al, 2002;…”

An analysis of arsenic toxicity's origins, manifestations, and remediation

“…No health risks associated with As have been identified from exposure to fruit or vegetable products (roots or legumes). Overall, the noncancer and cancer risks of As are determined by the presence of As in cereal products (Liu et al, 2022). It was found in the Netherland and Portugal that an increase in the levels of intake of seaweed increased the risk of exposure to As (Vellinga et al, 2021).…”