Monrad Maria, Ersbøll Annette Kjær, Sørensen Mette, Baastrup Rikke, Hansen Birgitte, Gammelmark Anders, Tjønneland Anne, Overvad Kim, Raaschou-Nielsen Ole
Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark.
National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
Environ Res. 2017 Apr;154:318-324. doi: 10.1016/j.envres.2017.01.028. Epub 2017 Jan 31.
Epidemiological studies have shown that intake of drinking water with high levels of arsenic (>100μg/L) is associated with risk for cardiovascular diseases, but studies on lower levels of arsenic show inconsistent results.
The aim of this study was to investigate the relationship between exposure to low level arsenic in drinking water and risk of myocardial infarction in Denmark.
From the Danish Diet, Cancer and Health cohort of 57,053 people aged 50-64 years at enrolment in 1993-1997, we identified 2707 cases of incident myocardial infarction from enrolment to end of follow-up in February 2012. Cohort participants were enrolled in the Copenhagen and Aarhus areas. We geocoded residential addresses of the cohort members and used a geographic information system to link addresses with water supply areas. Arsenic in tap water at each cohort members address from 1973 to 2012 was estimated for all cohort members. Poisson regression was used to estimate incidence rate ratios (IRRs) for myocardial infarction after adjustment for lifestyle factors and educational level.
Arsenic levels in drinking water at baseline addresses ranged from 0.03 to 25.34μg/L, with the highest concentrations in the Aarhus area. We found no overall association between 20-years average concentration of arsenic and risk of myocardial infarction. However, in the Aarhus area, fourth arsenic quartile (2.21-25.34μg/L) was associated with an IRR of 1.48 (95% confidence interval (CI): 1.19-1.83) when compared with first quartile (0.05-1.83μg/L). An IRR of 1.26 (95% CI: 0.89-1.79) was found for ever (versus never) having lived at an address with 10μg/L or more arsenic in the drinking water.
This study provides some support for an association between low levels of arsenic in drinking water and the risk of myocardial infarction.
流行病学研究表明，摄入高砷含量（>100μg/L）的饮用水与心血管疾病风险相关，但关于低砷水平的研究结果并不一致。
本研究旨在调查丹麦饮用水中低水平砷暴露与心肌梗死风险之间的关系。
从1993 - 1997年入组时年龄为50 - 64岁的57053人的丹麦饮食、癌症与健康队列中，我们确定了从入组到2012年2月随访结束时的2707例新发心肌梗死病例。队列参与者来自哥本哈根和奥胡斯地区。我们对队列成员的居住地址进行地理编码，并使用地理信息系统将地址与供水区域相联系。估算了所有队列成员1973年至2012年在其各自地址的自来水中的砷含量。采用泊松回归在调整生活方式因素和教育水平后估计心肌梗死的发病率比（IRR）。
基线地址的饮用水中砷含量范围为0.03至25.34μg/L，奥胡斯地区浓度最高。我们发现砷的20年平均浓度与心肌梗死风险之间无总体关联。然而，在奥胡斯地区，与第一四分位数（0.05 - 1.83μg/L）相比，第四砷四分位数（2.21 - 25.34μg/L）的发病率比为1.48（95%置信区间（CI）：1.19 - 1.83）。对于曾（相对于从未）居住在饮用水中砷含量为10μg/L或更高地址的情况，发病率比为1.26（95%CI：0.89 - 1.79）。
本研究为饮用水中低水平砷与心肌梗死风险之间的关联提供了一些支持。
