Khan Md Alfazal, Hira-Smith Meera, Ahmed Syed Imran, Yunus Mohammad, Hasan S M Tafsir, Liaw Jane, Balmes John, Raqib Rubhana, Yuan Yan, Kalman David, Roh Taehyun, Steinmaus Craig, Smith Allan H
Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
Arsenic Health Effects Research Program, School of Public Health, University of California, Berkeley, California.
Environ Epidemiol. 2020 Apr 9;4(2):e089. doi: 10.1097/EE9.0000000000000089. eCollection 2020 Apr.
We previously reported chronic respiratory effects in children who were then 7-17 years of age in Matlab, Bangladesh. One group of children had been exposed to high concentrations of arsenic in drinking water in utero and early childhood (average 436 µg/L), and the other group of children were never known to have been exposed to >10 µg/L. The exposed children, both males and females, had marked increases in chronic respiratory symptoms.
The current study involves a further follow-up of these children now 14-26 years of age with 463 located and agreeing to participate. They were interviewed for respiratory symptoms and lung function was measured. Data were collected on smoking, body mass index (BMI), and number of rooms in the house as a measure of socioeconomic status.
Respiratory effects were still present in males but not females. In the high exposure group (>400 µg/L in early life) the odds ratio (OR) among male participants for dry cough in the last 12 months was 2.36 (95% confidence interval [CI] = 1.21, 4.63, = 0.006) and for asthma OR = 2.51 (95% CI = 1.19, 5.29, = 0.008). Forced vital capacity (FVC) was reduced in males in the early life high-exposure group compared with those never exposed (-95ml, = 0.04), but not in female participants.
By the age range 14-26, there was little remaining evidence of chronic respiratory effects in females but pronounced effects persisted in males. Mechanisms for the marked male female differences warrant further investigation along with further follow-up to see if respiratory effects continue in males.
我们之前报道过孟加拉国马特拉布7至17岁儿童的慢性呼吸道影响。一组儿童在子宫内和幼儿期接触了高浓度的饮用水砷（平均436微克/升），另一组儿童从未接触过超过10微克/升的砷。暴露组的儿童，无论男女，慢性呼吸道症状均显著增加。
本研究对这些现已14至26岁的儿童进行了进一步随访，找到463名同意参与的儿童。对他们进行了呼吸道症状访谈并测量了肺功能。收集了关于吸烟、体重指数（BMI）以及房屋房间数量的数据，以此作为社会经济地位的衡量指标。
呼吸道影响在男性中依然存在，但在女性中不存在。在高暴露组（早年>400微克/升）中，男性参与者在过去12个月干咳的优势比（OR）为2.36（95%置信区间[CI]=1.21，4.63，P=0.006），哮喘的OR=2.51（95%CI=1.19，5.29，P=0.008）。早年高暴露组的男性用力肺活量（FVC）与未暴露者相比有所降低（-95毫升，P=0.04），但女性参与者中没有这种情况。
到14至26岁这个年龄段，女性几乎没有慢性呼吸道影响的证据留存，但男性中仍存在明显影响。男女之间显著差异的机制值得进一步研究，同时需要进一步随访以观察男性的呼吸道影响是否持续存在。
