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Low-moderate arsenic exposure and respiratory in American Indian communities in the Strong Heart Study.
Environmental Health ( IF 6 ) Pub Date : 2019-11-28 , DOI: 10.1186/s12940-019-0539-6 Martha Powers 1 , Tiffany R Sanchez 2 , Maria Grau-Perez 1 , Fawn Yeh 3 , Kevin A Francesconi 4 , Walter Goessler 4 , Christine M George 5 , Christopher Heaney 1, 6 , Lyle G Best 7 , Jason G Umans 8 , Robert H Brown 1, 9 , Ana Navas-Acien 1, 2, 6
Environmental Health ( IF 6 ) Pub Date : 2019-11-28 , DOI: 10.1186/s12940-019-0539-6 Martha Powers 1 , Tiffany R Sanchez 2 , Maria Grau-Perez 1 , Fawn Yeh 3 , Kevin A Francesconi 4 , Walter Goessler 4 , Christine M George 5 , Christopher Heaney 1, 6 , Lyle G Best 7 , Jason G Umans 8 , Robert H Brown 1, 9 , Ana Navas-Acien 1, 2, 6
Affiliation
BACKGROUND
Arsenic exposure through drinking water is an established lung carcinogen. Evidence on non-malignant lung outcomes is less conclusive and suggests arsenic is associated with lower lung function. Studies examining low-moderate arsenic (< 50 μg/L), the level relevant for most populations, are limited. We evaluated the association of arsenic exposure with respiratory health in American Indians from the Northern Plains, the Southern Plains and the Southwest United States, communities with environmental exposure to inorganic arsenic through drinking water.
METHODS
The Strong Heart Study is a prospective study of American Indian adults. This analysis used urinary arsenic measurements at baseline (1989-1991) and spirometry at Visit 2 (1993-1995) from 2132 participants to evaluate associations of arsenic exposure with airflow obstruction, restrictive pattern, self-reported respiratory disease, and symptoms.
RESULTS
Airflow obstruction was present in 21.5% and restrictive pattern was present in 14.4%. The odds ratio (95% confidence interval) for obstruction and restrictive patterns, based on the fixed ratio definition, comparing the 75th to 25th percentile of arsenic, was 1.17 (0.99, 1.38) and 1.27 (1.01, 1.60), respectively, after adjustments, and 1.28 (1.02, 1.60) and 1.33 (0.90, 1.50), respectively, based on the lower limit of normal definition. Arsenic was associated with lower percent predicted FEV1 and FVC, self-reported emphysema and stopping for breath.
CONCLUSION
Low-moderate arsenic exposure was positively associated with restrictive pattern, airflow obstruction, lower lung function, self-reported emphysema and stopping for breath, independent of smoking and other lung disease risk factors. Findings suggest that low-moderate arsenic exposure may contribute to restrictive lung disease.
中文翻译:
强心研究中美洲印第安人社区的中低砷暴露和呼吸系统。
背景技术通过饮用水接触砷是一种已确定的肺癌致癌物。关于非恶性肺部结果的证据不太确凿,表明砷与肺功能较低有关。检测低中砷(< 50 μg/L)(与大多数人群相关的水平)的研究是有限的。我们评估了来自北部平原、南部平原和美国西南部的美洲印第安人的砷暴露与呼吸系统健康的关系,这些社区通过饮用水接触无机砷。方法 强心脏研究是一项针对美洲印第安成年人的前瞻性研究。该分析使用 2132 名参与者的基线(1989-1991)尿砷测量值和第 2 次访问(1993-1995)时的肺活量测定法来评估砷暴露与气流阻塞、限制性模式、自我报告的呼吸系统疾病和症状之间的关联。结果 21.5% 的患者存在气流阻塞,14.4% 的患者存在气流受限。根据固定比率定义,比较砷的第 75 个百分位数和第 25 个百分位数,调整后阻塞和限制模式的比值比(95% 置信区间)分别为 1.17 (0.99, 1.38) 和 1.27 (1.01, 1.60) 、 1.28 (1.02, 1.60) 和 1.33 (0.90, 1.50),分别基于正常清晰度的下限。砷与预测用力呼气量(FEV1)和用力肺活量(FVC)百分比较低、自我报告的肺气肿和停止呼吸有关。结论 低中度砷暴露与限制性模式、气流阻塞、肺功能降低、自我报告的肺气肿和停止呼吸呈正相关,与吸烟和其他肺部疾病危险因素无关。研究结果表明,低中度砷暴露可能导致限制性肺病。
更新日期:2019-11-28
中文翻译:
强心研究中美洲印第安人社区的中低砷暴露和呼吸系统。
背景技术通过饮用水接触砷是一种已确定的肺癌致癌物。关于非恶性肺部结果的证据不太确凿,表明砷与肺功能较低有关。检测低中砷(< 50 μg/L)(与大多数人群相关的水平)的研究是有限的。我们评估了来自北部平原、南部平原和美国西南部的美洲印第安人的砷暴露与呼吸系统健康的关系,这些社区通过饮用水接触无机砷。方法 强心脏研究是一项针对美洲印第安成年人的前瞻性研究。该分析使用 2132 名参与者的基线(1989-1991)尿砷测量值和第 2 次访问(1993-1995)时的肺活量测定法来评估砷暴露与气流阻塞、限制性模式、自我报告的呼吸系统疾病和症状之间的关联。结果 21.5% 的患者存在气流阻塞,14.4% 的患者存在气流受限。根据固定比率定义,比较砷的第 75 个百分位数和第 25 个百分位数,调整后阻塞和限制模式的比值比(95% 置信区间)分别为 1.17 (0.99, 1.38) 和 1.27 (1.01, 1.60) 、 1.28 (1.02, 1.60) 和 1.33 (0.90, 1.50),分别基于正常清晰度的下限。砷与预测用力呼气量(FEV1)和用力肺活量(FVC)百分比较低、自我报告的肺气肿和停止呼吸有关。结论 低中度砷暴露与限制性模式、气流阻塞、肺功能降低、自我报告的肺气肿和停止呼吸呈正相关,与吸烟和其他肺部疾病危险因素无关。研究结果表明,低中度砷暴露可能导致限制性肺病。