A Cross-Sectional Analysis of Health Impacts of Inorganic Arsenic in Chemical Mixtures

• Main Author: Hargarten, Paul
• Format: Others
• Published: VCU Scholars Compass 2015
• Subjects: inorganic arsenic; hypertension; weighted quantile sum regression; logistic regression; National Health and Examination Survey; NHANES; toxicology
• Online Access: http://scholarscompass.vcu.edu/etd/3788; http://scholarscompass.vcu.edu/cgi/viewcontent.cgi?article=4831&context=etd

Drinking groundwater is the primary way humans accumulate arsenic. Chronic exposure to inorganic arsenic (iAs) (over decades) has been shown to be associated with multiple health effects at low levels (5-10 ppb) including: cancer, elevated blood pressure and cardiovascular disease, skin lesions, renal failure, and peripheral neuropathy. Using hypertension (or high blood pressure) as a surrogate marker for cardiovascular disease, we examined the effect of iAs alone and in a mixture with other metals using a cross-sectional study of adults in United States (National Health and Examination Survey, NHANES, 2005-2010) adjusting for covariates: urinary creatinine level (mg/dL), poverty index ratio (PIR, measure of socioeconomic status, 1 to 5), age, smoking (yes/no), alcohol usage, gender, non-Hispanic Black, and overweight (BMI>=25). A logistic regression model suggests that a one-unit increase in log of inorganic arsenic increases the odds of hypertension by a factor of 1.093 (95% Confidence Interval=0.935, 1.277) adjusted for these covariates , which indicates that there was not significant evidence to claim that inorganic arsenic is a risk factor for hypertension. Biomonitoring data provides evidence that humans are not only exposed to inorganic arsenic but also to mixtures of chemicals including inorganic arsenic, total mercury, cadmium, and lead. We tested for a mixture effect of these four environmental chemicals using weighted quantile sum (WQS) regression, which takes into account the correlation among the chemicals and with the outcome. For one-unit increase in the weighted sum, the adjusted odds of developing hypertension increases by a factor of 1.027 (95% CI=0.882,1.196), which is also not significant after taking into account the same covariates. The insignificant finding may be due to the low inorganic arsenic concentration (8-620 μg /L) in US drinking water, compared to those in countries like Bangladesh where the concentrations are much higher. Literature provides conflicting evidence of the association of inorganic arsenic and hypertension in low/moderate regions; future studies, especially a large cohort study, are needed to confirm if inorganic arsenic alone or with other metals is associated with hypertension in the United States.