eTABLE 1. Lung Disease Death Classification based on ICD-10 Codes from Verbal Autopsy Procedure
ICD-10
Codes
Name
N
C34
I27
J22
J41
J44
J45
J46
J69
J85
J95
Malignant neoplasm of bronchus and lung
Pulmonary heart disease
Unspecified acute lower respiratory infection
Simple and mucopurulent chronic bronchitis
Other chronic obstructive pulmonary disease
Bronchial asthma
Status asthmaticus
Pneumonitis due to aspiration of solids and liquids
Abscess of lung and mediastinum
Postprocedural respiratory disorders
90
16
3
1
99
22
8
4
1
2
Lung Disease
Mortality
(N=246)
x
x
x
x
x
x
x
x
x
x
Non-malignant
Lung Disease
Mortality
(N=156)
x
x
x
x
x
x
x
x
x
Lung Cancer
Mortality
(N=90)
x
eTABLE 2. Multivariate Adjusted Hazard Ratios and 95% CIs for Associations Between Arsenic Exposure and Lung Disease Mortality by Study Cohort
Outcome
Arsenic Exposure Tertiles
P for trend
Health Effects of Arsenic Longitudinal Study
≥83.0
Well water arsenic tertiles, μg/L
N
<14.0
N
14.0-82.9
N
0.060
Lung disease mortality
44
1.00
43
0.92 (0.60–1.40)
84
1.38 (0.95–2.00)
0.051
Non-malignant lung disease mortality
32
1.00
32
0.95 (0.58–1.55)
65
1.47 (0.96–2.27)
0.666
Lung cancer mortality
12
1.00
11
0.85 (0.38–1.93)
19
1.15 (0.55–2.38)
Cr-adjusted urinary total arsenic tertiles, μg/g
Lung disease mortality
Non-malignant lung disease mortality
Lung cancer mortality
N
43
32
11
<132.5
1.00
1.00
1.00
N
76
54
22
132.5-331.9
1.43 (0.98–2.08)
1.34 (0.86–2.08)
1.76 (0.85–3.66)
Bangladesh Vitamin E and Selenium Trial
Cr-adjusted urinary total arsenic tertiles, μg/g
N
<132.5
N
132.5-331.9
Lung disease mortality
15
1.00
19
1.39 (0.71–2.75)
Non-malignant lung disease mortality
3
1.00
5
2.18 (0.52–9.25)
Lung cancer mortality
12
1.00
14
1.30 (0.60–2.82)
HRs adjusted for sex, age, BMI, education, and smoking status.
N
52
43
9
≥332.0
1.63 (1.08–2.46)
1.74 (1.10–2.77)
1.33 (0.54–3.27)
0.019
0.019
0.438
N
41
19
22
≥332.0
1.22 (0.67–2.23)
2.95 (0.85–10.15)
0.86 (0.42–1.77)
0.627
0.080
0.561
eTABLE 3. Multivariate Adjusted Hazard Ratios and 95% CIs for Associations of Joint Effects Between Arsenic Exposure and Selected Characteristics in
relation to Lung Disease Mortality
Lung Disease Mortality
Additive Interaction:
Multiplicative
Creatinine-adjusted urinary arsenic, μg/g
Characteristic
Synergy Index
Interaction: Ratio of
N
<132.5
N
132.5-331.9
N
≥332.0
(95% CI)
HRs (95% CI)
Female
9
1.00
17 1.72 (0.77–3.87)
29 2.48 (1.17–5.26)
0.95 (0.70–1.29)
0.78 (0.53–1.16)
Male
49
2.15 (1.00–4.64)
78 2.99 (1.42–6.30)
64 3.20 (1.51–6.78)
Age <38 years
Age ≥38 years
3
55
1.00
11.10 (3.46–35.61)
8
87
2.31 (0.61–8.72)
15.77 (4.97–50.08)
8
85
2.43 (0.64–9.15)
17.29 (5.44–54.95)
1.20 (0.99–1.45)
0.85 (0.46–1.56)
BMI ≥19.2
BMI <19.2
14
44
1.00
3.64 (1.98–6.71)
20
75
1.82 (0.92–3.60)
4.81 (2.69–8.60)
21
72
2.80 (1.42–5.53)
5.40 (3.02–9.67)
1.03 (0.82–1.29)
0.73 (0.50–1.01)
Education >3 years
Education ≤3 years
22
36
1.00
0.97 (0.57–1.66)
32
63
1.32 (0.77–2.28)
1.44 (0.88–2.36)
30
63
1.63 (0.93–2.83)
1.61 (0.98–2.65)
1.01 (0.33–3.06)
1.00 (0.71–1.39)
Arsenic study cohort
Vitamin trial cohort
43
15
1.00
2.39 (1.30–4.40)
76
19
1.44 (0.99–2.10)
3.29 (1.87–5.78)
53
40
1.68 (1.12–2.53)
2.82 (1.78–4.46)
0.88 (0.59–1.30)
0.80 (0.57–1.12)
Never smokera
Ever smoker
4
45
1.00
2.05 (0.73–5.76)
5
73
1.11 (0.30–4.13)
2.94 (1.06–8.14)
4
60
1.24 (0.31–4.98)
3.13 (1.12–8.74)
1.29 (0.63–2.66)
1.10 (0.53–2.26)
No skin lesionsb,c
40
1.00
61 1.38 (0.93–2.06)
Skin lesions
18
1.63 (0.91–2.92)
32 2.19 (1.36–3.53)
HRs adjusted for sex, age, BMI, education, smoking status, and study cohort.
a
Presented among males only.
b
Not adjusted for study cohort.
c
Missing for 121 participants.
41
51
1.75 (1.13–2.71)
2.06 (1.33–3.20)
0.85 (0.56–1.31)
0.83 (0.60–1.15)
eTABLE 4. Multivariate Adjusted Hazard Ratios and 95% CIs for Associations of Joint Effects Between Skin Lesion Status and Selected Characteristics in
relation to Lung Disease Mortality
Lung Disease Mortality
Additive Interaction:
Multiplicative
Skin
lesion
status
Characteristic
Synergy Index
Interaction: Ratio of
N
Absent
N
Present
(95% CI)
HRs (95% CI)
33
1.00
22
1.90 (1.07–3.36)
Female
0.91 (0.41–2.05)
0.80 (0.43–1.49)
109
1.52 (0.93–2.46)
79
2.29 (1.38–3.79)
Male
Age <38 years
Age ≥38 years
12
130
1.00
8.22 (4.50–15.01)
6
95
2.58 (0.95–6.95)
15.69 (8.43–29.19)
1.67 (1.15–2.43)
0.74 (0.27–2.05)
BMI ≥19.2
BMI <19.2
27
115
1.00
3.24 (2.10–4.98)
28
73
2.36 (1.37–4.07)
4.52 (2.82–7.25)
0.98 (0.63–1.52)
0.59 (0.32–1.09)
Education >3 years
Education ≤3 years
45
97
1.00
1.13 (0.79–1.62)
38
63
1.78 (1.13–2.79)
1.69 (1.12–2.54)
0.76 (0.30–1.93)
0.84 (0.49–1.44)
Never smokera
Ever smoker
5
104
1.00
3.43 (1.38–8.48)
8
71
2.98 (0.96–9.21)
5.17 (2.04–13.08)
0.95 (0.52–1.73)
0.51 (0.16–1.61)
75
1.00
34
1.74 (1.15–2.65)
Cr-adjusted urinary arsenic <208 μg/g
0.96 (0.39–2.38)
67
1.17 (0.84–1.64)
67
1.88 (1.34–2.65)
Cr-adjusted urinary arsenic ≥208 μg/g
HRs adjusted for sex, age, BMI, education, smoking status, and creatinine-adjusted urinary total arsenic concentration.
a
Presented among males only.
0.92 (0.54–1.56)