title: Arsenic exposure and impaired lung function. Findings from a large population-based prospective cohort study.
abstract: BACKGROUND
  Exposure to arsenic through drinking water has been linked to respiratory symptoms, obstructive lung diseases, and mortality from respiratory diseases. Limited evidence for the deleterious effects on lung function exists among individuals exposed to a high dose of arsenic.
  
  
  OBJECTIVE
  To determine the deleterious effects on lung function that exist among individuals exposed to a high dose of arsenic.
  
  
  METHODS
  In 950 individuals who presented with any respiratory symptom among a population-based cohort of 20,033 adults, we evaluated the association between arsenic exposure, measured by well water and urinary arsenic concentrations measured at baseline, and post-bronchodilator-administered pulmonary function assessed during follow-up.
  
  
  RESULTS
  For every one SD increase in baseline water arsenic exposure, we observed a lower level of FEV1 (-46.5 ml; P < 0.0005) and FVC (-53.1 ml; P < 0.01) in regression models adjusted for age, sex, body mass index, smoking, socioeconomic status, betel nut use, and arsenical skin lesions status. Similar inverse relationships were observed between baseline urinary arsenic and FEV1 (-48.3 ml; P < 0.005) and FVC (-55.2 ml; P < 0.01) in adjusted models. Our analyses also demonstrated a dose-related decrease in lung function with increasing levels of baseline water and urinary arsenic. This association remained significant in never-smokers and individuals without skin lesions, and was stronger in male smokers. Among male smokers and individuals with skin lesions, every one SD increase in water arsenic was related to a significant reduction of FEV1 (-74.4 ml, P < 0.01; and -116.1 ml, P < 0.05) and FVC (-72.8 ml, P = 0.02; and -146.9 ml, P = 0.004), respectively.
  
  
  CONCLUSIONS
  This large population-based study confirms that arsenic exposure is associated with impaired lung function and the deleterious effect is evident at low- to moderate-dose range.
authors.affiliation: 1 Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York.
authors.forename: Faruque
authors.initials: F
authors.lastname: Parvez
authors.forename: Yu
authors.initials: Y
authors.lastname: Chen
authors.forename: Mahbub
authors.initials: M
authors.lastname: Yunus
authors.forename: Christopher
authors.initials: C
authors.lastname: Olopade
authors.forename: Stephanie
authors.initials: S
authors.lastname: Segers
authors.forename: Vesna
authors.initials: V
authors.lastname: Slavkovich
authors.forename: Maria
authors.initials: M
authors.lastname: Argos
authors.forename: Rabiul
authors.initials: R
authors.lastname: Hasan
authors.forename: Alauddin
authors.initials: A
authors.lastname: Ahmed
authors.forename: Tariqul
authors.initials: T
authors.lastname: Islam
authors.forename: Mahmud M
authors.initials: MM
authors.lastname: Akter
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Graziano
authors.forename: Habibul
authors.initials: H
authors.lastname: Ahsan
mesh_terms: D000328:Adult; D001114:Areca / Q000009:adverse effects; D001151:Arsenic / Q000032:analysis / Q000652:urine; D020261:Arsenic Poisoning / Q000150:complications* / Q000209:etiology / Q000652:urine; D001459:Bangladesh; D004305:Dose-Response Relationship, Drug; D060766:Drinking Water / Q000009:adverse effects / Q000032:analysis*; D005260:Female; D006801:Humans; D008168:Lung / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012120:Respiration Disorders / Q000139:chemically induced*; D012129:Respiratory Function Tests; D012907:Smoking / Q000009:adverse effects; D014874:Water Pollutants, Chemical / Q000032:analysis / Q000506:poisoning*
chemical_list: D060766:Drinking Water; D014874:Water Pollutants, Chemical; D001151:Arsenic