Maria Argos and co-workers (July 24, p 252)1 assess the association between arsenic in drinking water and mortality in rural Bangladesh. A cohort of 11746 was recruited between 2000 and 2002 and followed up biennially. Compared with individuals with less than 10 mug/L arsenic in the main drinking water source used at baseline, those with 150-864 mug/L showed an increased risk of all-cause mortality (adjusted hazard ratio 1.68, 95% Cl 1.26-2.23). This association was similar when exposure was expressed as creatinine-adjusted total arsenic in urine. This might, however, be biased owing to low creatinine excretion in malnourished people and co-excretion of creatinine and arsenic.
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