Arsenic in public water supplies and cardiovascular mortality in Spain
| Autor: | Raquel Boix, Margarita Palau, José Luis del Barrio, Roberto Pastor-Barriuso, Ana Navas-Acien, Javier Damián, M.J. Medrano, Rebeca Ramis |
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| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Population Drinking chemistry.chemical_element Water supply Biochemistry Arsenic Risk Factors Water Supply Environmental health Epidemiology Water Pollution Chemical medicine Humans education Aged General Environmental Science education.field_of_study business.industry Public health Ecological study Environmental Exposure Standardized mortality ratio chemistry Cardiovascular Diseases Spain Epidemiological Monitoring Female business Water Pollutants Chemical Environmental Monitoring Cohort study |
| Zdroj: | Environmental Research. 110:448-454 |
| ISSN: | 0013-9351 |
| DOI: | 10.1016/j.envres.2009.10.002 |
| Popis: | High-chronic arsenic exposure in drinking water is associated with increased cardiovascular disease risk. At low-chronic levels, as those present in Spain, evidence is scarce. In this ecological study, we evaluated the association of municipal drinking water arsenic concentrations during the period 1998-2002 with cardiovascular mortality in the population of Spain.Arsenic concentrations in drinking water were available for 1721 municipalities, covering 24.8 million people. Standardized mortality ratios (SMRs) for cardiovascular (361,750 deaths), coronary (113,000 deaths), and cerebrovascular (103,590 deaths) disease were analyzed for the period 1999-2003. Two-level hierarchical Poisson models were used to evaluate the association of municipal drinking water arsenic concentrations with mortality adjusting for social determinants, cardiovascular risk factors, diet, and water characteristics at municipal or provincial level in 651 municipalities (200,376 cardiovascular deaths) with complete covariate information.Mean municipal drinking water arsenic concentrations ranged from1 to 118 microg/L. Compared to the overall Spanish population, sex- and age-adjusted mortality rates for cardiovascular (SMR 1.10), coronary (SMR 1.18), and cerebrovascular (SMR 1.04) disease were increased in municipalities with arsenic concentrations in drinking water10 microg/L. Compared to municipalities with arsenic concentrations1 microg/L, fully adjusted cardiovascular mortality rates were increased by 2.2% (-0.9% to 5.5%) and 2.6% (-2.0% to 7.5%) in municipalities with arsenic concentrations between 1-10 and10 microg/L, respectively (P-value for trend 0.032). The corresponding figures were 5.2% (0.8% to 9.8%) and 1.5% (-4.5% to 7.9%) for coronary heart disease mortality, and 0.3% (-4.1% to 4.9%) and 1.7% (-4.9% to 8.8%) for cerebrovascular disease mortality.In this ecological study, elevated low-to-moderate arsenic concentrations in drinking water were associated with increased cardiovascular mortality at the municipal level. Prospective cohort studies with individual measures of arsenic exposure, standardized cardiovascular outcomes, and adequate adjustment for confounders are needed to confirm these ecological findings. Our study, however, reinforces the need to implement arsenic remediation treatments in water supply systems above the World Health Organization safety standard of 10 microg/L. |
| Databáze: | OpenAIRE |
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