Department of Earth and Environmental Sciences, Williamson Research Centre for Molecular Environmental Science, University of Manchester, Manchester M13 9PL, UK.
Department of Earth and Environmental Sciences, Williamson Research Centre for Molecular Environmental Science, University of Manchester, Manchester M13 9PL, UK.
Sci Total Environ. 2020 Nov 15;743:140534. doi: 10.1016/j.scitotenv.2020.140534. Epub 2020 Jun 29.
Adverse health outcomes, including death from cardiovascular disease (CVD), arising from chronic exposure to inorganic arsenic (iAs) are well documented. Consumption of rice is a major iAs exposure route for over 3 billion people, however, there is still a lack of epidemiological evidence demonstrating the association between iAs exposure from rice intake and CVD risks. We explored this potential association through an ecological study using data at local authority level across England and Wales. Local authority level daily per capita iAs exposure from rice (E-iAs) was estimated using ethnicity as a proxy for class of rice consumption. A series of linear and non-linear models were applied to estimate the association between E-iAs and CVD age-standardized mortality rate (ASMR), using Akaike's Information Criterion as the principle model selection criterion. When adjusted for significant confounders, notably smoking prevalence, education level, employment rate, overweight percentage, PM2.5, female percentage and medical and care establishments, the preferred non-linear model indicated that CVD risks increased with iAs exposure from rice at exposures above 0.3 μg/person/day. Also, the best-fitted linear model indicated that CVD ASMR in the highest quartile of iAs exposure (0.375-2.71 μg/person/day) was 1.06 (1.02, 1.11; p-trend <0.001) times higher than that in the lowest quartile (<0.265 μg/person/day). Notwithstanding the well-known limitations of ecological studies, this study further suggests exposure to iAs, including from rice intake, as a potentially important confounder for studies of the factors controlling CVD risks.
慢性接触无机砷（iAs）会对健康产生不良后果，包括心血管疾病（CVD）导致的死亡，这一点已有充分的文献记载。食用大米是超过 30 亿人摄入 iAs 的主要途径，然而，仍然缺乏流行病学证据表明摄入大米导致的 iAs 暴露与 CVD 风险之间存在关联。我们通过在英格兰和威尔士的地方当局层面进行的一项生态学研究来探索这种潜在的关联。使用种族作为大米消费阶层的代表来估计地方当局层面上的大米摄入 iAs 每日人均暴露量（E-iAs）。使用赤池信息量准则作为主要模型选择标准，应用一系列线性和非线性模型来估计 E-iAs 与 CVD 年龄标准化死亡率（ASMR）之间的关联。在调整了显著的混杂因素后，特别是吸烟率、教育水平、就业率、超重率、PM2.5、女性比例以及医疗和护理机构，首选的非线性模型表明，在暴露量超过 0.3μg/人/天时，CVD 风险随大米摄入 iAs 而增加。此外，拟合度最佳的线性模型表明，iAs 暴露量最高四分位数（0.375-2.71μg/人/天）的 CVD ASMR 比最低四分位数（<0.265μg/人/天）高 1.06 倍（1.02，1.11；p 趋势<0.001）。尽管生态学研究存在众所周知的局限性，但本研究进一步表明，iAs 暴露，包括摄入大米，可能是控制 CVD 风险因素研究的一个重要混杂因素。
