Ahmed Sharia M, Branscum Adam, Welch Barrett M, Megowan Meghan, Bethel Jeffrey W, Odden Michelle C, Joya Sakila Afroz, Ibn Hasan M Omar Sharif, Lin Pi-I, Mostofa Golam, Quamruzzaman Quazi, Rahman Mahmudur, Christiani David C, Kile Molly L
Oregon State University, Corvallis, Oregon, USA.
Stanford University, Stanford, California, USA.
Environ Epidemiol. 2020 Apr 9;4(2):e086. doi: 10.1097/EE9.0000000000000086. eCollection 2020 Apr.
Previous research found that infants who were exposed to high levels of arsenic in utero had an increased risk of infectious disease in the first year of life. This prospective study examined the association between arsenic exposures during gestation, and respiratory, diarrheal, and febrile morbidity in children 4-5 years of age.
A cohort of pregnant women was recruited in 2008-2011 in Bangladesh. Their children (N = 989) were followed, and household drinking water samples were collected during pregnancy, toddlerhood (12-40 months of age), and childhood (4-5 years of age). We actively surveyed mothers every 2 weeks regarding their children's infectious diseases symptoms from 4 to 5 years of age. Poisson regression models were used to estimate the association between arsenic exposure and respiratory and febrile illness.
Median drinking water arsenic was 4.6, 8.8, and 4.2 µg/L in pregnancy, toddlerhood, and childhood, respectively. We observed 0.01, 1.2, and 1.0 cases per 100 person-days of diarrhea, respiratory, and febrile illness, respectively. The incident rate ratios (IRRs) for each doubling of drinking water arsenic during pregnancy were 1.10 (95% confidence interval [CI] = 1.00, 1.22) and 0.93 (95% CI = 0.82, 1.05) for respiratory and febrile illness, respectively, after adjusting for covariates. The association between arsenic exposure measured during toddlerhood and childhood was attenuated and not significantly associated with either outcome. Diarrheal disease was too infrequent to assess.
Drinking water arsenic exposure during pregnancy was associated with a higher risk of acute respiratory infections in children 4-5 years old in Bangladesh.
先前的研究发现，子宫内接触高浓度砷的婴儿在出生后第一年患传染病的风险增加。这项前瞻性研究调查了孕期砷暴露与4至5岁儿童呼吸道、腹泻和发热性疾病之间的关联。
2008年至2011年在孟加拉国招募了一组孕妇。对她们的孩子（N = 989）进行随访，并在孕期、幼儿期（12至40个月龄）和儿童期（4至5岁）采集家庭饮用水样本。我们每两周积极调查一次母亲，了解她们孩子4至5岁时的传染病症状。采用泊松回归模型估计砷暴露与呼吸道和发热性疾病之间的关联。
孕期、幼儿期和儿童期饮用水中砷的中位数分别为4.6、8.8和4.2μg/L。腹泻、呼吸道和发热性疾病的发病率分别为每100人日0.01、1.2和1.0例。在调整协变量后，孕期饮用水砷每增加一倍，呼吸道疾病和发热性疾病的发病率比（IRR）分别为1.10（95%置信区间[CI]=1.00，1.22）和0.93（95%CI = 0.82，1.05）。幼儿期和儿童期测量的砷暴露与这两种结果之间的关联减弱，且无显著相关性。腹泻病发生频率过低，无法进行评估。
在孟加拉国，孕期饮用水砷暴露与4至5岁儿童患急性呼吸道感染的较高风险相关。
