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A Case control study of cardiovascular disease and arsenic exposure in Inner Mongolia, China
Citation:
Wade, Tim, Y. Xia, K. Wu, J. Mumford, X. Le, E. Sams, AND W. Sanders. A Case control study of cardiovascular disease and arsenic exposure in Inner Mongolia, China. Presented at International Society for Environmental Epidemiology Annual Conference, Seattle, WA, August 23 - 29, 2014.
Impact/Purpose:
Investigate the cardiovascular effects of waterborne arsenic in the low to moderate exposure range
Description:
Background: Millions of people are at risk from the adverse effects of waterborne arsenic. Although the cardiovascular effects of high exposures to arsenic have been well documented, few individual level prospective studies have assessed cardiovascular risk at moderate exposures. Methods: We conducted a prospective, hospital based, case control study in Inner Mongolia, China of waterborne arsenic and cardiovascular disease. Enrollment took place at a regional hospital which served Hangjin Hou county. Cases were patients diagnosed with acute myocardial infarction, chest pain with evidence of previous myocardial infarction, or cardiomyopathy. Controls were frequency matched by age and sex to cases, free of cardiovascular disease and were admitted for conditions unrelated to arsenic exposure (e.g., injury, pregnancy). Inclusion criteria included residence in Hangjin Hou and age between 18 and 70 years. Water samples from each subject’s main water source and toenail samples were tested for inorganic arsenic. Health history, dietary habits, and residence history were obtained by structured interview. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using unconditional logistic regression, controlling for age, sex, smoking, occupation, diet, family history of heart disease and body mass index. Results: 298 cases and 275 controls were enrolled between 2006 and 2011. Water arsenic ranged from non-detect to 208 µg/L. Toenail arsenic ranged from non-detect to 34 mg/kg. Well-water arsenic was linearly associated with cardiovascular disease risk (OR per 10 µg/L =1.19, 95% CI=1.03-1.38). Cardiovascular disease was associated with well-water arsenic above 40 µg/L (OR=4.05, 95% CI=1.10-14.99). Cardiovascular disease was also associated with toenail arsenic above the 90th percentile (OR=2.48, 95% CI=1.18-5.20). Conclusions: Residents with well water arsenic above 40 µg/L had an increased risk of cardiovascular disease. This abstract does not reflect EPA policy.