Chronic lung disease and detection of pulmonary artery dilatation in high resolution computerized tomography of chest in chronic arsenic exposure

Abstract

Lung affection in chronic arsenicosis developing from chronic ingestion of arsenic contaminated groundwater has been known but little is known on its effect on pulmonary arterial system. A cross sectional study was carried out at two geographically similar areas and demographically similar populations with or without evidence of chronic arsenic exposure in West Bengal, India. The willing participants in both the groups with chronic respiratory symptoms were evaluated with High Resolution Computerized Tomography (HRCT) of Chest. Evaluation of High Resolution Computerized Tomography of chest followed clinical assessment of lung disease in194 and 196 subjects from the arsenic exposed and unexposed people; the former had a higher prevalence of cough OR(Odds Ratio) 3.23 (95% CI(Confidence Interval): 1.72-6.07) and shortness of breath OR1.76 (95% CI: 0.84-3.71), respectively. The arsenic exposed individuals showed higher score for bronchiectasis [mean ± SD(Standard Deviation)] as 2.41 ± 2.32 vs. 1.22 ± 1.48 (P <0.001), pulmonary artery branch dilatation (PAD) as 2.48 ± 2.33 vs. 0.78 ± 1.56, (P <0.001) and pulmonary trunk dilatation as 0.26 ± 0.45 vs. nil. Age-adjusted prevalence odds ratio (POR) for Pulmonary Artery Dilatation Found in HRCT comparing those exposed to arsenic (Group 1) to unexposed participants (Group 2) was found to be 6.98 (CI: 2.26-16.48). There was a strong dose-response relationship between the PAD (Pulmonary Artery Dilatation) and cumulative arsenic exposure. Pulmonary trunk and branch dilatation in chronic arsenicosis is a frequent abnormality seen in HRCT Chest of arsenicosis patients. The significance of such finding needs further investigation.

Inorganic arsenic and respiratory health, from early life exposure to sex-specific effects: A systematic review

“…Overall, 25% of exposed (27/108) and 7% of unexposed (11/150) underwent CT-test. Bhattacharyya et al (2014) found a statistically significant increase in pulmonary artery dilatation (also determined by high-resolution computed tomography) among those with skin lesions; however, findings were not adjusted for potential confounders, including sex and smoking status.…”

“…Articles examined symptoms individually or combined, and reported on anywhere from one to nineteen different symptom-related endpoints. Of the 18 publications on InAs and respiratory symptoms, 11 reported a statistically significant positive association between InAs and at least one respiratory symptom (Das et al, 2014; Bhattacharyya et al, 2014; Paul et al, 2013; Smith et al, 2013; Pesola et al, 2012; Parvez et al, 2010; Ghosh et al, 2007; Mazumder et al, 2005; Guo et al, 2003; Milton et al, 2001; Mazumder et al, 2000). However seven did not find a significant association for any respiratory symptom assessed (Recio-Vega et al, 2014; Farzan et al, 2015, 2013; Amster et al, 2011; Dauphine et al, 2011; Nafees et al, 2011; von Ehrenstein et al, 2005).…”

“…Fourteen publications examined the relationship between InAs and cough (Farzan et al, 2015; Bhattacharyya et al, 2014; Das et al, 2014; Recio-Vega et al, 2014; Smith et al, 2013; Amster et al, 2011; Dauphine et al, 2011; Nafees et al, 2011; Parvez et al, 2010; Mazumder et al, 2005; von Ehrenstein et al, 2005; Guo et al, 2003; Milton et al, 2001; Mazumder et al, 2000). Publications commonly categorized cough by productive/non-productive and severity/frequency.…”

“…Eleven publications examined InAs and a symptom concerning shortness or breath/dyspnea/trouble breathing (Farzan et al, 2015; Bhattacharyya et al, 2014; Das et al, 2014; Recio-Vega et al, 2014; Smith et al, 2013; Pesola et al, 2012; Dauphine et al, 2011; Nafees et al, 2011; Parvez et al, 2010; von Ehrenstein et al, 2005; Mazumder et al, 2000). Overall, the direction of the association was consistently positive for all but one publication (Recio-Vega et al, 2014).…”

“…Four publications stratified their results by sex (Bhattacharyya et al, 2014; Mazumder et al, 2005; von Ehrenstein et al, 2005; Milton et al, 2001). In general, associations among males seemed to be stronger than associations among females.…”