Increased Mortality Associated with Well-Water Arsenic Exposure in Inner Mongolia, China

Abstract

We conducted a retrospective mortality study in an Inner Mongolian village exposed to well water contaminated by arsenic since the 1980s. Deaths occurring between January 1, 1997 and December 1, 2004 were classified according to underlying cause and water samples from household wells were tested for total arsenic. Heart disease mortality was associated with arsenic exposure, and the association strengthened with time exposed to the water source. Cancer mortality and all-cause mortality were associated with well-water arsenic exposure among those exposed 10-20 years. This is the first study to document increased arsenic-associated mortality in the Bayingnormen region of Inner Mongolia.

Arsenic Exposure and Cardiovascular Disease:An Updated Systematic Review

“…Twelve studies were conducted in high arsenic exposure areas of Taiwan (5), Bangladesh (3), Chile (1), Inner Mongolia (2) and Pakistan (1), and six studies were conducted in low to moderate arsenic exposure areas in the U.S. (3), Japan (1), Slovakia (1), and Spain (1). Of 12 cohort studies, six used internal comparisons [27, 28••, 29•, 30, 31•, 33] and six used external comparisons [32•, 34, 37, 42–44]. Of the cohort studies with internal comparisons, four were prospective [27, 28••, 29•, 33] and two were retrospective [30, 31•].…”

“…Of 12 cohort studies, six used internal comparisons [27, 28••, 29•, 30, 31•, 33] and six used external comparisons [32•, 34, 37, 42–44]. Of the cohort studies with internal comparisons, four were prospective [27, 28••, 29•, 33] and two were retrospective [30, 31•]. The remaining six studies used case control [35, 39, 40] or cross-sectional designs [24, 36, 38, 41].…”

Mechanisms of action for arsenic in cardiovascular toxicity and implications for risk assessment

“…Later studies have suggested that exposure to drinking water with a high iAs concentration is an independent risk factor for developing the full spectrum of CVD, including hypertension (Chen et al, 1995;Rahman et al, 1999), carotid atherosclerosis (Wang et al, 2002), ischemic heart disease (Hsueh et al, 1998;Tseng et al, 2000) and even vascular disease mortality (Chen et al, 1996). More recent prospective cohort studies, retrospective cohort analyses, observational studies, and case-control studies from high exposure areas such as China (Wade et al, 2009), Taiwan (Hsieh et al, 2011;Wang et al, 2007;Wu et al, 2010), and Bangladesh (Chen et al, 2006(Chen et al, , 2011(Chen et al, , 2013aSohel et al, 2009) have further suggested a potential relationship between relatively high iAs levels (>100 mg/L) and the development of CVD. However, these epidemiologic studies did not consistently report a statistically significant association between arsenic concentrations below 100 mg/L and CVD associated morbidity or mortality.…”

Association Between Exposure to Low to Moderate Arsenic Levels and Incident Cardiovascular Disease

“…High arsenic levels in drinking water (>100μg/L) increased the risk of peripheral artery disease, coronary heart disease, stroke, and carotid atherosclerosis in studies conducted in Taiwan (2-4), Bangladesh (5, 6), Chile (7), Inner Mongolia (8, 9), and Pakistan (10, 11). Less is known about the cardiovascular effects of low to moderate arsenic levels (<100μg/L in drinking water) that affect most populations around the world due to a lack of prospective studies, limitations in exposure and outcome assessment, and inadequate information on cardiovascular risk factors (12, 13).…”