Arsenic: Association of regional concentrations in drinking water with suicide and natural causes of death in Italy.
Arsenic, as a toxin, may be associated with higher mortality rates, although its relationship to suicide is not clear. Given this uncertainty, we evaluated associations between local arsenic concentrations in tapwater and mortality in regions of Italy, to test the hypothesis that both natural-cause and suicide death rates would be higher with greater trace concentrations of arsenic. Arsenic concentrations in drinking-water samples from 145 sites were assayed by mass spectrometry, and correlated with local rates of mortality due to suicide and natural causes between 1980 and 2011, using weighted, least-squares univariate and multivariate regression modeling. Arsenic concentrations averaged 0.969 (CI: 0.543-1.396) µg/L, well below an accepted safe maximum of 10µg/L. Arsenic levels were negatively associated with corresponding suicide rates, consistently among both men and women in all three study-decades, whereas mortality from natural causes increased with arsenic levels. Contrary to an hypothesized greater risk of suicide with higher concentrations of arsenic, we found a negative association, suggesting a possible protective effect, whereas mortality from natural causes was increased, in accord with known toxic effects of arsenic. The unexpected inverse association between arsenic and suicide requires further study.
Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Italy. Electronic address: maurizio.pompili@uniroma1.it.
Maurizio
M
Pompili
National Institute of Health, Rome, Italy.
Monica
M
Vichi
Department of Biological, Geological and Environmental Sciences, University of Bologna, Bologna, Italy.
Enrico
E
Dinelli
Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Italy.
Denise
D
Erbuto
Department of Psychiatry, Brunico, Italy.
Roger
R
Pycha
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.
Gianluca
G
Serafini
Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Italy.
Gloria
G
Giordano
Department of Civil-Environmental Engineering and Architecture, University of Cagliari, Cagliari, Italy.
Paolo
P
Valera
Department of Earth Sciences, Environment and Resources,University of Naples, Naples, Italy.
Stefano
S
Albanese
Department of Earth Sciences, Environment and Resources,University of Naples, Naples, Italy.
Annamaria
A
Lima
Department of Earth Sciences, Environment and Resources,University of Naples, Naples, Italy.
Benedetto
B
De Vivo
Department of Science and Technology, University of Sannio, Benevento, Italy.
Domenico
D
Cicchella
Department of Clinical and Theoretical Mental Health, Kútvölgyi Clinical Center, Semmelweis University, Budapest, Hungary; National Institute of Psychiatry and Addictions, Budapest, Hungary.
Zoltan
Z
Rihmer
Department of Psychiatry, University of Naples SUN, Naples, Italy.
Andrea
A
Fiorillo
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.
Mario
M
Amore
Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Italy.
Paolo
P
Girardi
Department of Psychiatry, McLean & Massachusetts General Hospitals; Harvard Medical School, Boston, MA, USA.
Ross J
RJ
Baldessarini
D000328:Adult; D001151:Arsenic / Q000009:adverse effects* / Q000032:analysis*; D002423:Cause of Death / Q000639:trends; D060766:Drinking Water / Q000009:adverse effects* / Q000032:analysis*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D009026:Mortality / Q000639:trends; D012307:Risk Factors; D013405:Suicide / Q000523:psychology* / Q000639:trends; D014881:Water Supply / Q000592:standards
D060766:Drinking Water; D001151:Arsenic
Arsenic; Drinking water; Italy; Mortality rates; Suicide