title: Low-level arsenic exposure via drinking water consumption and female fecundity - A preliminary investigation.
abstract: High level arsenic exposure is associated with reproductive toxicity in experimental and observational studies; however, few data exist to assess risks at low levels. Even less data are available to evaluate the impact of low level arsenic exposure on human fecundity. Our aim in this pilot study was a preliminary evaluation of associations between low level drinking water arsenic contamination and female fecundity. This retrospective study was conducted among women previously recruited to a hospital-based case-control study of spontaneous pregnancy loss in Timiṣ County, Romania. Women (n=94) with planned pregnancies of 5-20 weeks gestation completed a comprehensive physician-administered study questionnaire and reported the number of menstrual cycles attempting to conceive as the time to pregnancy (TTP). Drinking water samples were collected from residential drinking water sources and we determined arsenic levels using hydride generation-atomic absorption spectrometry (HG-AAS). Multivariable Cox-proportional hazards regression with Efron approximation was employed to evaluate TTP as a function of drinking water arsenic concentrations among planned pregnancies, adjusted for covariates. There was no main effect for drinking water arsenic exposure, yet the conditional probability for pregnancy was modestly lower among arsenic exposed women with longer TTPs, relative to women with shorter TTPs, and relative to unexposed women. For example, 1µg/L average drinking water arsenic conferred 5%, 8%, and 10% lower likelihoods for pregnancy in the 6th, 9th, and 12th cycles, respectively (P=0.01). While preliminary, our results suggest that low level arsenic contamination in residential drinking water sources may further impair fecundity among women with longer waiting times; however, this hypothesis requires confirmation by a future, more definitive study.
authors.affiliation: Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, New York, United States.
authors.forename: Michele L
authors.initials: ML
authors.lastname: Susko
authors.affiliation: Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, New York, United States; Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, New York, United States. Electronic address: mbloom@albany.edu.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Bloom
authors.affiliation: Health Department, Environmental Health Center, Cluj-Napoca, Romania; IMOGEN Research Institute, Cluj-Napoca, Romania.
authors.forename: Iulia A
authors.initials: IA
authors.lastname: Neamtiu
authors.affiliation: Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, New York, United States.
authors.forename: Allison A
authors.initials: AA
authors.lastname: Appleton
authors.affiliation: Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, New York, United States.
authors.forename: Simona
authors.initials: S
authors.lastname: Surdu
authors.affiliation: Physico-chemical and Biotoxicological Analysis Laboratory, Environmental Health Center, Cluj-Napoca, Romania; Cluj School of Public Health - College of Political, Administrative and Communication Sciences, Babeṣ-Bolyai University, Cluj-Napoca, Romania; Faculty of Environmental Science and Engineering, Babeṣ-Bolyai University, Cluj-Napoca, Romania.
authors.forename: Cristian
authors.initials: C
authors.lastname: Pop
authors.affiliation: Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, New York, United States; Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, New York, United States.
authors.forename: Edward F
authors.initials: EF
authors.lastname: Fitzgerald
authors.affiliation: University of Medicine and Pharmacy "Victor Babeṣ", Timiṣoara, Romania; Obstetrics and Gynecology Department of the Emergency County Hospital, Timiṣoara, Romania.
authors.forename: Doru
authors.initials: D
authors.lastname: Anastasiu
authors.affiliation: Health Department, Environmental Health Center, Cluj-Napoca, Romania; IMOGEN Research Institute, Cluj-Napoca, Romania; University of Medicine and Pharmacy "Iuliu Haṭieganu", Cluj-Napoca, Romania.
authors.forename: Eugen S
authors.initials: ES
authors.lastname: Gurzau
mesh_terms: D000328:Adult; D001151:Arsenic / Q000633:toxicity*; D015331:Cohort Studies; D060766:Drinking Water / Q000009:adverse effects* / Q000032:analysis / Q000737:chemistry; D005260:Female; D005298:Fertility; D006801:Humans; D008423:Maternal Age; D010865:Pilot Projects; D011247:Pregnancy / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012383:Romania; D012959:Socioeconomic Factors; D013997:Time Factors; D061685:Time-to-Pregnancy; D014874:Water Pollutants, Chemical / Q000633:toxicity*
chemical_list: D060766:Drinking Water; D014874:Water Pollutants, Chemical; D001151:Arsenic
keywords: Arsenic; Fecundity; Pregnancy; Reproduction; Romania; Water