All-cause and cause-specific mortality and long-term exposure to arsenic in drinking water: A prospective cohort study in northeastern Taiwan

摘要

The association of low-to-moderate arsenic exposure with cause-specific mortality has never been reported in Taiwan. This study aimed to elucidate the dose-response relation of mortality from various causes of death with the arsenic concentration in drinking water and cumulative arsenic exposure. A total of 8,088 residents from northeastern Taiwan were followed from 1991 to 2011. Cox regression analysis was used to determine the hazard ratio of cause-specific mortality associated with two indices of arsenic exposure. A total of 3,106 deaths were ascertained during the follow-up period of 120,768 person-years. The multivariate-adjusted hazard ratio (95% confidence interval) was 1.25 (1.04-1.50), 1.32 (0.96-1.81), 2.41 (1.43-4.05), 4.00 (1.17-13.70), 3.58 (0.92-13.93) and 2.31 (1.43-3.75), respectively, for mortality from all-causes, all cancers, lung cancer, urinary cancer, occlusive stroke, and respiratory disease for arsenic level in drinking water >500.0 μg/L compared to <10.0 μg/L after adjustment of age, sex, educational level, and cigarette smoking status.