Arsenic exposure is associated with alterations to multiple red blood cell parameters among adults in rural Bangladesh

Abstract

Chronic arsenic exposures are associated with multiple hematologic disturbances, including anemia. The goal of this study was to evaluate associations between arsenic exposures and hematological parameters among men and women who are chronically exposed to elevated levels of arsenic from drinking water. Hematologic analyses were performed on blood collected from 755 participants (45% male and 54% female) in the Health Effects of Arsenic Longitudinal Study (HEALS) cohort, Bangladesh. Herein, we used linear regression models to estimate associations between red blood cell (RBC) parameters (i.e., RBC counts, hematocrit (HCT), hemoglobin (Hgb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC)) and measurements of arsenic exposure (urinary arsenic and urinary arsenic metabolites). Arsenic exposures showed trending associations with decreased RBC counts in both men and women, a positive association with MCV in males, and an inverse association with MCHC among males, but not among non-smoking females. Among men, those who smoked had stronger associations between arsenic exposures and MCHC than non-smoking males. Collectively, our results show that arsenic exposures affect multiple RBC parameters and highlight potentially important sex differences in arsenic-induced hematotoxicity.

Keywords: Arsenic; Arsenic metabolites; Bangladesh; Drinking water; HEALS cohort; Smoking.

Fig. 1.

Plots showing β-coefficient (center dot and colored vertical line) and 95% confidence intervals for associations between MCV with (A) urinary As, (B) iAs (AsV + AsIII), (C) AsIII, (D) MMA, and (E) DMA among non-smoking women (n = 412), non-smoking men, (n = 93) and smoking (n = 250). Men. Parameter estimates are adjusted for age and BMI. *Statistically relevant associations were considered at a significance level of p < 0.05.

Fig. 2.

Plots showing β-coefficient (center dot and colored vertical line) and 95% confidence intervals for associations between MCHC with (A) urinary As, (B) iAs (AsV + AsIII), (C) AsIII, (D) MMA, and (E) DMA among non-smoking women (n = 412), non-smoking men, (n = 93) and smoking (n = 250). Men. Parameter estimates are adjusted for age and BMI. *Statistically relevant associations were considered at a significance level of p < 0.05.