Susko Michele L, Bloom Michael S, Neamtiu Iulia A, Appleton Allison A, Surdu Simona, Pop Cristian, Fitzgerald Edward F, Anastasiu Doru, Gurzau Eugen S
Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, New York, United States.
Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, New York, United States; Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, New York, United States.
Environ Res. 2017 Apr;154:120-125. doi: 10.1016/j.envres.2016.12.030. Epub 2017 Jan 3.
High level arsenic exposure is associated with reproductive toxicity in experimental and observational studies; however, few data exist to assess risks at low levels. Even less data are available to evaluate the impact of low level arsenic exposure on human fecundity. Our aim in this pilot study was a preliminary evaluation of associations between low level drinking water arsenic contamination and female fecundity. This retrospective study was conducted among women previously recruited to a hospital-based case-control study of spontaneous pregnancy loss in Timiṣ County, Romania. Women (n=94) with planned pregnancies of 5-20 weeks gestation completed a comprehensive physician-administered study questionnaire and reported the number of menstrual cycles attempting to conceive as the time to pregnancy (TTP). Drinking water samples were collected from residential drinking water sources and we determined arsenic levels using hydride generation-atomic absorption spectrometry (HG-AAS). Multivariable Cox-proportional hazards regression with Efron approximation was employed to evaluate TTP as a function of drinking water arsenic concentrations among planned pregnancies, adjusted for covariates. There was no main effect for drinking water arsenic exposure, yet the conditional probability for pregnancy was modestly lower among arsenic exposed women with longer TTPs, relative to women with shorter TTPs, and relative to unexposed women. For example, 1µg/L average drinking water arsenic conferred 5%, 8%, and 10% lower likelihoods for pregnancy in the 6th, 9th, and 12th cycles, respectively (P=0.01). While preliminary, our results suggest that low level arsenic contamination in residential drinking water sources may further impair fecundity among women with longer waiting times; however, this hypothesis requires confirmation by a future, more definitive study.
在实验研究和观察性研究中，高剂量砷暴露与生殖毒性有关；然而，几乎没有数据可用于评估低剂量砷暴露的风险。关于评估低剂量砷暴露对人类生育能力影响的数据更是少之又少。我们这项初步研究的目的是对低剂量饮用水砷污染与女性生育能力之间的关联进行初步评估。这项回顾性研究是在罗马尼亚蒂米什县之前招募到的、参与一项基于医院的自然流产病例对照研究的女性中进行的。怀孕5至20周且有计划妊娠的女性（n = 94）完成了一份由医生全面管理的研究问卷，并报告了尝试受孕的月经周期数作为受孕时间（TTP）。从住宅饮用水源采集饮用水样本，我们使用氢化物发生原子吸收光谱法（HG - AAS）测定砷含量。采用带有埃弗龙近似法的多变量Cox比例风险回归来评估计划妊娠中TTP作为饮用水砷浓度的函数，并对协变量进行了调整。饮用水砷暴露没有主要影响，但与TTP较短的女性以及未暴露女性相比，TTP较长的砷暴露女性怀孕的条件概率略低。例如，饮用水中平均砷含量为1μg/L时，在第6、9和12个周期怀孕的可能性分别降低5%、8%和10%（P = 0.01）。虽然是初步结果，但我们的研究结果表明，住宅饮用水源中的低剂量砷污染可能会进一步损害等待时间较长女性的生育能力；然而，这一假设需要未来更明确的研究加以证实。
