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Toxicol Appl Pharmacol. 2014 Apr 1;276(1):21-7. doi: 10.1016/j.taap.2014.01.015. Epub 2014 Jan 28.

Association between arsenic exposure from drinking water and hematuria: results from the Health Effects of Arsenic Longitudinal Study.

Author information

1
Department of Population Health, New York University School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA; Department of Urology, New York University School of Medicine, New York, NY, USA.
2
Department of Population Health, New York University School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA. Electronic address: yu.chen@nyumc.org.
3
Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
4
Department of Urology, New York University School of Medicine, New York, NY, USA; Robert F. Wagner Graduate School of Public Service, New York University, New York, NY, USA; United States Department of Veterans Affairs Harbor Healthcare System, New York, NY, USA; New York University Cancer Institute, New York, NY, USA.
5
Department of Population Health, New York University School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA.
6
U-Chicago Research Bangladesh, Ltd., Dhaka, Bangladesh.
7
Department of Urology, New York University School of Medicine, New York, NY, USA.
8
Department of Health Studies, The University of Chicago, Chicago, IL, USA; Department of Medicine, The University of Chicago, Chicago, IL, USA; Department of Human Genetics, The University of Chicago, Chicago, IL, USA; Comprehensive Cancer Center, The University of Chicago, Chicago, IL, USA. Electronic address: habib@uchicago.edu.

Abstract

Arsenic (As) exposure has been associated with both urologic malignancy and renal dysfunction; however, its association with hematuria is unknown. We evaluated the association between drinking water As exposure and hematuria in 7843 men enrolled in the Health Effects of Arsenic Longitudinal Study (HEALS). Cross-sectional analysis of baseline data was conducted with As exposure assessed in both well water and urinary As measurements, while hematuria was measured using urine dipstick. Prospective analyses with Cox proportional regression models were based on urinary As and dipstick measurements obtained biannually since baseline up to six years. At baseline, urinary As was significantly related to prevalence of hematuria (P-trend<0.01), with increasing quintiles of exposure corresponding with respective prevalence odds ratios of 1.00 (reference), 1.29 (95% CI: 1.04-1.59), 1.41 (95% CI: 1.15-1.74), 1.46 (95% CI: 1.19-1.79), and 1.56 (95% CI: 1.27-1.91). Compared to those with relatively little absolute urinary As change during follow-up (-10.40 to 41.17 μg/l), hazard ratios for hematuria were 0.99 (95% CI: 0.80-1.22) and 0.80 (95% CI: 0.65-0.99) for those whose urinary As decreased by >47.49 μg/l and 10.87 to 47.49 μg/l since last visit, respectively, and 1.17 (95% CI: 0.94-1.45) and 1.36 (95% CI: 1.10-1.66) for those with between-visit increases of 10.40 to 41.17 μg/l and >41.17 μg/l, respectively. These data indicate a positive association of As exposure with both prevalence and incidence of dipstick hematuria. This exposure effect appears modifiable by relatively short-term changes in drinking water As.

KEYWORDS:

Arsenic; Bangladesh; Environmental epidemiology; Hematuria; Mass screening; Urologic neoplasms

PMID:
24486435
PMCID:
PMC3959280
DOI:
10.1016/j.taap.2014.01.015
[Indexed for MEDLINE]
Free PMC Article

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