title: Arsenic in drinking water and congenital heart anomalies in Hungary.
abstract: Inorganic arsenic can get easily through the placenta however there are very few human data on congenital anomalies related to arsenic exposure. Objective of our study was to explore the associations between arsenic content of drinking water and prevalence of some congenital anomalies. Four anomalies reported to the Hungarian Congenital Anomalies Registry between 1987 and 2003 were chosen to be analysed in relation to arsenic exposure: congenital anomalies of the circulatory system (n=9734) were considered as cases, while Down syndrome, club foot and multiple congenital malformations were used as controls (n=5880). Arsenic exposure of the mothers during pregnancy was estimated by using archive measurement data for each year and for each settlement where the mothers lived. Analysis of the associations between the prevalence of congenital heart anomalies and arsenic exposure during pregnancy was performed by logistic regression. The child's gender and age of the mother were adjusted for. The associations were evaluated by using the present EU health limit value of 10.0 μg/L arsenic concentration as a cut-off point. Regular consumption of drinking water with arsenic concentration above 10 μg/L during pregnancy was associated with an increased risk of congenital heart anomalies in general (adjusted OR=1.41; 95% C.I.: 1.28-1.56), and especially that of ductus Botalli persistens (adjusted OR=1.81, 95%C.I.: 1.54-2.11) and atrial septal defect (adjusted OR=1.79; 95%C.I.: 1.59-2.01). The presented results showed an increased risk of congenital heart anomalies among infants whose mothers were exposed to drinking water with arsenic content above 10 μg/L during pregnancy. Further studies of possible similar effects of concentrations below 10 μg/L are warranted.
authors.affiliation: National Institute of Environmental Health, Budapest, Hungary. Electronic address: rudnai.tamas@oki.antsz.hu.
authors.forename: Tamás
authors.initials: T
authors.lastname: Rudnai
authors.affiliation: University of Debrecen, Institute of Preventive Medicine, Debrecen, Hungary.
authors.forename: János
authors.initials: J
authors.lastname: Sándor
authors.affiliation: National Institute of Environmental Health, Budapest, Hungary.
authors.forename: Mihály
authors.initials: M
authors.lastname: Kádár
authors.affiliation: National Institute of Environmental Health, Budapest, Hungary.
authors.forename: Mátyás
authors.initials: M
authors.lastname: Borsányi
authors.affiliation: National Institute for Health Development, Budapest, Hungary.
authors.forename: Judit
authors.initials: J
authors.lastname: Béres
authors.affiliation: National Institute for Health Development, Budapest, Hungary.
authors.forename: Júlia
authors.initials: J
authors.lastname: Métneki
authors.affiliation: Békés County Public Health Institute, Békéscsaba, Hungary.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Maráczi
authors.affiliation: National Institute of Environmental Health, Budapest, Hungary.
authors.forename: Péter
authors.initials: P
authors.lastname: Rudnai
mesh_terms: D000328:Adult; D001151:Arsenic / Q000009:adverse effects* / Q000032:analysis; D060766:Drinking Water / Q000737:chemistry*; D005260:Female; D006330:Heart Defects, Congenital / Q000139:chemically induced*; D006344:Heart Septal Defects, Atrial / Q000139:chemically induced; D006801:Humans; D006814:Hungary; D007223:Infant; D016015:Logistic Models; D018811:Maternal Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D011247:Pregnancy; D014874:Water Pollutants, Chemical / Q000009:adverse effects* / Q000032:analysis; D055815:Young Adult
chemical_list: D060766:Drinking Water; D014874:Water Pollutants, Chemical; D001151:Arsenic
keywords: Arsenic; Birth defects; Congenital heart anomalies; Drinking water; Teratogenicity