Tondel M, Rahman M, Magnuson A, Chowdhury I A, Faruquee M H, Ahmad S A
Division of Occupational and Environmental Medicine, Department of Health and Environment, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
Environ Health Perspect. 1999 Sep;107(9):727-9. doi: 10.1289/ehp.99107727.
To determine the relationship of arsenic-associated skin lesions and degree of arsenic exposure, a cross-sectional study was conducted in Bangladesh, where a large part of the population is exposed through drinking water. Four villages in Bangladesh were identified as mainly dependent on wells contaminated with arsenic. We interviewed and examined 1,481 subjects [Greater/equal to] 30 years of age in these villages. A total of 430 subjects had skin lesions (keratosis, hyperpigmentation, or hypopigmentation). Individual exposure assessment could only be estimated by present levels and in terms of a dose index, i.e., arsenic levels divided by individual body weight. Arsenic water concentrations ranged from 10 to 2,040 microg/L, and the crude overall prevalence rate for skin lesions was 29/100. After age adjustment to the world population the prevalence rate was 30. 1/100 and 26.5/100 for males and females, respectively. There was a significant trend for the prevalence rate both in relation to exposure levels and to dose index (p < 0.05), regardless of sex. This study shows a higher prevalence rate of arsenic skin lesions in males than females, with clear dose-response relationship. The overall high prevalence rate in the studied villages is an alarming sign of arsenic exposure and requires an urgent remedy.
为确定砷相关皮肤损害与砷暴露程度之间的关系，在孟加拉国开展了一项横断面研究，该国大部分人口通过饮用水接触砷。孟加拉国的四个村庄被确定主要依赖受砷污染的水井。我们对这些村庄中1481名年龄≥30岁的受试者进行了访谈和检查。共有430名受试者有皮肤损害（角化病、色素沉着过度或色素沉着不足）。个体暴露评估只能根据当前水平并以剂量指数来估计，即砷水平除以个体体重。砷水浓度范围为10至2040微克/升，皮肤损害的总体粗患病率为29/100。根据世界人口年龄调整后，男性和女性的患病率分别为30.1/100和26.5/100。无论性别如何，患病率与暴露水平和剂量指数均呈显著趋势（p<0.05）。本研究表明，男性砷皮肤损害的患病率高于女性，且存在明确的剂量反应关系。所研究村庄总体患病率较高，这是砷暴露的一个警示信号，需要紧急补救。
