ASSOCIATIONS BETWEEN DRINKING WATRR AND URINARY ARSKNIC
LEVELS AND SKIN LESIONS IN BANGLADESH
Habibul Ahsan, MD, Atiqur Rahmug MBBS, Mary Pemn, MPH, Faruque Parvez,
MPH, Martin Stute, PhD, Abul Hasaat, MBBS, Yan Zheng, PhD, Paul Brandt-Rauf,
PhD, Alexaader van Geen, PhD, Joseph Graziano, PhD
Although health effects of arsenic (As) exposure from driaking water have been
examined ia many countries, very little systematic research has been conducted in
Baagladesh, where ground watec has beea found to be contaminated with high levels As
sinoe the 1970s. The preseat study utilized a cross-sectional design to examine the
associations betweea dxinking water and uriaary As levels and skin lesioas among 168
resideats of three coatiguous villages of Bangladesh. Subjects eere recruited through
house-to-house survey who underwent a complete physical examination and provided
question~ data, drhdang water aad urine samples. Thirty six (or 21.6%) subjects had any
skin lesions (melaoosis and/or hyperkeratosis) with an age-adjusted prevalence rate of
skin lesions in the study population being 19.4%. A substantial proportion (13 out of 36
or 36.1%) of the skin lesions occurred in subjects who drank water containiag As level
<50 pg/L. The risks for skin lesions in relation to the exposure measures based oa urinary
As were more than 3 times elevated with the odds ratios (OR) for the highest vs the
lowest quartiles of exposure beieg 3.6 [95/o con6dence interval (CI) 1.2-12.2] for urinary
total As aad 3.2 [95% CI 1.1-10.0] for creatinine-adjusted uriaary total As. The risks for
skin lesions in relation to the exposure measures based on driaking water As were
however, less strongly elevated with the ORs for the highest vs the lowest quartiles of
exposure being 1.6 [9S’Jo CI 0.6-4.9] for drinking water As and 1.4 [95% CI 0.9-2.0] for
lifetime As. The study provides evidence of occurrence of skia lesions among subjects
exposed to curreatly allowable As in drinking water. It also suggests tbat exposure
measures based on uriaary As are more strongly related to the risk of skin lesions than
the exposure measures based on drinking water As. These findings bave important public
health implicatiyns.
CORRESPONDING AUTHOR: Habibul Ahsan, MD, MMedSc, Division of
Epidemiology, PH-18, Joseph L. Mailman School of Public Health, Columbia
University, 622 West 168~ Street, New York, N, Y. 10032. E-Mail:
ha37@columbia.edu.