title: Mortality in young adults following in utero and childhood exposure to arsenic in drinking water.
abstract: BACKGROUND
  Beginning in 1958, the city of Antofagasta in northern Chile was exposed to high arsenic concentrations (870 µg/L) when it switched water sources. The exposure abruptly stopped in 1970 when an arsenic-removal plant commenced operations. A unique exposure scenario like this--with an abrupt start, clear end, and large population (125,000 in 1970), all with essentially the same exposure--is rare in environmental epidemiology. Evidence of increased mortality from lung cancer, bronchiectasis, myocardial infarction, and kidney cancer has been reported among young adults who were in utero or children during the high-exposure period.
  
  
  OBJECTIVE
  We investigated other causes of mortality in Antofagasta among 30- to 49-year-old adults who were in utero or ≤ 18 years of age during the high-exposure period.
  
  
  METHODS
  We compared mortality data between Antofagasta and the rest of Chile for people 30-49 years of age during 1989-2000. We estimated expected deaths from mortality rates in all of Chile, excluding Region II where Antofagasta is located, and calculated standardized mortality ratios (SMRs).
  
  
  RESULTS
  We found evidence of increased mortality from bladder cancer [SMR = 18.1; 95% confidence interval (CI): 11.3, 27.4], laryngeal cancer (SMR = 8.1; 95% CI: 3.5, 16.0), liver cancer (SMR = 2.5; 95% CI: 1.6, 3.7), and chronic renal disease (SMR = 2.0; 95% CI: 1.5, 2.8).
  
  
  CONCLUSIONS
  Taking together our findings in the present study and previous evidence of increased mortality from other causes of death, we conclude that arsenic in Antofagasta drinking water has resulted in the greatest increases in mortality in adults < 50 years of age ever associated with early-life environmental exposure.
authors.affiliation: Arsenic Health Effects Research Program, School of Public Health, University of California, Berkeley, Berkeley, California 94720-7360, USA. ahsmith@berkeley.edu
authors.forename: Allan H
authors.initials: AH
authors.lastname: Smith
authors.forename: Guillermo
authors.initials: G
authors.lastname: Marshall
authors.forename: Jane
authors.initials: J
authors.lastname: Liaw
authors.forename: Yan
authors.initials: Y
authors.lastname: Yuan
authors.forename: Catterina
authors.initials: C
authors.lastname: Ferreccio
authors.forename: Craig
authors.initials: C
authors.lastname: Steinmaus
mesh_terms: D000293:Adolescent; D000328:Adult; D001151:Arsenic / Q000633:toxicity*; D002648:Child; D002677:Chile / Q000453:epidemiology; D015331:Cohort Studies; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000139:chemically induced / Q000453:epidemiology / Q000401:mortality*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced / Q000453:epidemiology / Q000401:mortality*; D051436:Renal Insufficiency, Chronic / Q000139:chemically induced / Q000453:epidemiology / Q000401:mortality*; D012189:Retrospective Studies; D014874:Water Pollutants, Chemical / Q000633:toxicity*; D014881:Water Supply
chemical_list: D014874:Water Pollutants, Chemical; D001151:Arsenic