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匈牙利饮用水中的砷与先天性心脏异常

Arsenic in drinking water and congenital heart anomalies in Hungary.

作者信息

Rudnai Tamás, Sándor János, Kádár Mihály, Borsányi Mátyás, Béres Judit, Métneki Júlia, Maráczi Gabriella, Rudnai Péter

机构信息

National Institute of Environmental Health, Budapest, Hungary.

University of Debrecen, Institute of Preventive Medicine, Debrecen, Hungary.

出版信息

Int J Hyg Environ Health. 2014 Nov;217(8):813-8. doi: 10.1016/j.ijheh.2014.05.002. Epub 2014 May 22.

Abstract

Inorganic arsenic can get easily through the placenta however there are very few human data on congenital anomalies related to arsenic exposure. Objective of our study was to explore the associations between arsenic content of drinking water and prevalence of some congenital anomalies. Four anomalies reported to the Hungarian Congenital Anomalies Registry between 1987 and 2003 were chosen to be analysed in relation to arsenic exposure: congenital anomalies of the circulatory system (n=9734) were considered as cases, while Down syndrome, club foot and multiple congenital malformations were used as controls (n=5880). Arsenic exposure of the mothers during pregnancy was estimated by using archive measurement data for each year and for each settlement where the mothers lived. Analysis of the associations between the prevalence of congenital heart anomalies and arsenic exposure during pregnancy was performed by logistic regression. The child's gender and age of the mother were adjusted for. The associations were evaluated by using the present EU health limit value of 10.0 μg/L arsenic concentration as a cut-off point. Regular consumption of drinking water with arsenic concentration above 10 μg/L during pregnancy was associated with an increased risk of congenital heart anomalies in general (adjusted OR=1.41; 95% C.I.: 1.28-1.56), and especially that of ductus Botalli persistens (adjusted OR=1.81, 95%C.I.: 1.54-2.11) and atrial septal defect (adjusted OR=1.79; 95%C.I.: 1.59-2.01). The presented results showed an increased risk of congenital heart anomalies among infants whose mothers were exposed to drinking water with arsenic content above 10 μg/L during pregnancy. Further studies of possible similar effects of concentrations below 10 μg/L are warranted.

摘要

无机砷能够轻易穿过胎盘,然而,关于砷暴露与先天性异常相关的人类数据非常少。我们研究的目的是探讨饮用水中的砷含量与某些先天性异常患病率之间的关联。选取了1987年至2003年间向匈牙利先天性异常登记处报告的四种异常情况,分析其与砷暴露的关系:将循环系统先天性异常(n = 9734)视为病例,而将唐氏综合征、马蹄内翻足和多发性先天性畸形用作对照(n = 5880)。通过使用每位母亲居住的每年和每个定居点的存档测量数据来估计母亲孕期的砷暴露情况。采用逻辑回归分析先天性心脏异常患病率与孕期砷暴露之间的关联。对孩子的性别和母亲的年龄进行了校正。以目前欧盟10.0 μg/L的砷浓度健康限值作为分界点来评估这些关联。孕期经常饮用砷浓度高于10 μg/L的饮用水总体上与先天性心脏异常风险增加相关(校正比值比=1.41;95%置信区间:1.28 - 1.56),尤其是动脉导管未闭(校正比值比=1.81,95%置信区间:1.54 - 2.11)和房间隔缺损(校正比值比=1.79;95%置信区间:1.59 - 2.01)。研究结果表明,母亲在孕期饮用砷含量高于10 μg/L的饮用水的婴儿患先天性心脏异常的风险增加。有必要进一步研究浓度低于10 μg/L时可能产生的类似影响。

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