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. 2013 Aug;42(4):1077-86.
doi: 10.1093/ije/dyt120.

Chronic respiratory symptoms in children following in utero and early life exposure to arsenic in drinking water in Bangladesh

Allan H Smith  1 , Mohammad Yunus, Al Fazal Khan, Ayse Ercumen, Yan Yuan, Meera Hira Smith, Jane Liaw, John Balmes, Ondine von Ehrenstein, Rubhana Raqib, David Kalman, Dewan S Alam, Peter K Streatfield, Craig Steinmaus
Affiliations

Chronic respiratory symptoms in children following in utero and early life exposure to arsenic in drinking water in Bangladesh

Allan H Smith et al. Int J Epidemiol. 2013 Aug.

Abstract

Background: Arsenic exposure via drinking water increases the risk of chronic respiratory disease in adults. However, information on pulmonary health effects in children after early life exposure is limited.

Methods: This population-based cohort study set in rural Matlab, Bangladesh, assessed lung function and respiratory symptoms of 650 children aged 7-17 years. Children with in utero and early life arsenic exposure were compared with children exposed to less than 10 µg/l in utero and throughout childhood. Because most children drank the same water as their mother had drunk during pregnancy, we could not assess only in utero or only childhood exposure.

Results: Children exposed in utero to more than 500 µg/l of arsenic were more than eight times more likely to report wheezing when not having a cold [odds ratio (OR) = 8.41, 95% confidence interval (CI): 1.66-42.6, P < 0.01] and more than three times more likely to report shortness of breath when walking on level ground (OR = 3.86, 95% CI: 1.09-13.7, P = 0.02) and when walking fast or climbing (OR = 3.19, 95% CI: 1.22-8.32, P < 0.01]. However, there was little evidence of reduced lung function in either exposure category.

Conclusions: Children with high in utero and early life arsenic exposure had marked increases in several chronic respiratory symptoms, which could be due to in utero exposure or to early life exposure, or to both. Our findings suggest that arsenic in water has early pulmonary effects and that respiratory symptoms are a better marker of early life arsenic toxicity than changes in lung function measured by spirometry.

Keywords: Arsenic; children; in utero; lung function; pulmonary; respiratory.

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Figures

Figure 1
Figure 1
Distribution of in utero drinking water arsenic exposure in study participants
Figure 2
Figure 2
Odds ratios for respiratory symptoms which exceeded 2.0, with P < 0.05, in the highest exposure category. Adjusted for age, gender, mother's education, father's education, father's smoking status and rooms in the house
See this image and copyright information in PMC

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