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Does Arsenic Exposure Increase the Risk for Circulatory Disease?

Citation

Hertz-Picciotto, Irva; Arrighi, H. Michael; & Hu, Suh-Woan (2000). Does Arsenic Exposure Increase the Risk for Circulatory Disease?. American Journal of Epidemiology, 151(2), 174-81.

Abstract

Studies of residents in communities with high endemic concentrations of arsenic in drinking water suggest a deleterious effect on the circulatory system; however, studies among workers with high occupational exposures generally have shown either no or weak associations. This discrepancy could be a result of the healthy worker effect, including the healthy hire component and the healthy worker survivor effect (HWSE). Therefore, the authors conducted analyses of arsenic exposure in relation to circulatory disease mortality among 2,802 Tacoma, Washington, smelter workers by using 1) internal comparisons to control for the healthy hire effect and 2) the lagging method, adjustment for employment status, and the G-null test to control for the HWSE. Both lagging and adjustment for work status increased circulatory mortality rate ratios at all exposure levels, as compared with a baseline Poisson model. This excess mortality was limited to cardiovascular disease; no excess was observed for cerebrovascular disease. G-null analyses suggested no adverse effect, but power was very limited for this analysis. Overall, these results may indicate that the HWSE obscures an effect of arsenic on circulatory disease. Since cardiovascular deaths constitute about one-third of total mortality, small rate ratios translate into large numbers of excess deaths and, if causal, could be of wide public health significance. Further studies of arsenic exposure and cardiovascular disease are needed, and those conducted in occupational cohorts must control for the HWSE.

URL

http://dx.doi.org/DOI: 10.1093/oxfordjournals.aje.a010185

Reference Type

Journal Article

Journal Title

American Journal of Epidemiology

Author(s)

Hertz-Picciotto, Irva
Arrighi, H. Michael
Hu, Suh-Woan

Year Published

2000

Volume Number

151

Issue Number

2

Pages

174-81

Reference ID

1536