Unidad de Epidemiología de la Nutrición, Universidad Miguel Hernández, Alicante, Spain.
CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
PLoS One. 2022 Sep 9;17(9):e0274215. doi: 10.1371/journal.pone.0274215. eCollection 2022.
Ingested inorganic arsenic (iAs) is a human carcinogen that is also linked to other adverse health effects, such as respiratory outcomes. Yet, among populations consuming low-arsenic drinking water, the impact of iAs exposure on childhood respiratory health is still uncertain. For a Spanish child study cohort (INfancia y Medio Ambiente-INMA), low-arsenic drinking water is usually available and ingestion of iAs from food is considered the major source of exposure. Here, we explored the association between iAs exposure and children's respiratory outcomes assessed at 4 and 7 years of age (n = 400). The summation of 4-year-old children's urinary iAs, monomethylarsonic acid (MMA), and dimethylarsinic acid (DMA) was used as a biomarker of iAs exposure (∑As) (median of 4.92 μg/L). Children's occurrence of asthma, eczema, sneeze, wheeze, and medication for asthma and wheeze at each assessment time point (i.e., 4- and 7-year) was assessed with maternal interviewer-led questionnaires. Crude and adjusted Poisson regression models using Generalized Estimating Equation (GEE) were performed to account for the association between natural logarithm transformed (ln) urinary ∑As in μg/L at 4 years and repeated assessments of respiratory symptoms at 4 and 7 years of age. The covariates included in the models were child sex, maternal smoking status, maternal level of education, sub-cohort, and children's consumption of vegetables, fruits, and fish/seafood. The GEE-splines function using Poisson regression showed an increased trend of the overall expected counts of respiratory symptoms with high urinary ∑As. The adjusted expected counts (95% confidence intervals) at ln-transformed urinary ∑As 1.57 (average concentration) and 4.00 (99th percentile concentration) were 0.63 (0.36, 1.10) and 1.33 (0.61, 2.89), respectively. These exploratory findings suggest that even relatively low-iAs exposure levels, relevant to the Spanish and other populations, may relate to an increased number of respiratory symptoms during childhood.
摄入无机砷（iAs）是一种人类致癌物，也与其他健康影响有关，例如呼吸道疾病。然而，在摄入低砷饮用水的人群中，iAs 暴露对儿童呼吸道健康的影响仍不确定。在西班牙儿童研究队列（INfancia y Medio Ambiente-INMA）中，通常可以获得低砷饮用水，并且认为从食物中摄入 iAs 是主要的暴露源。在这里，我们探讨了 iAs 暴露与 4 岁和 7 岁儿童呼吸道疾病的相关性（n=400）。将 4 岁儿童尿液中 iAs、一甲基砷酸（MMA）和二甲基砷酸（DMA）的总和作为 iAs 暴露的生物标志物（∑As）（中位数为 4.92μg/L）。通过母亲主导的问卷调查，评估每个评估时间点（即 4 岁和 7 岁）儿童哮喘、湿疹、打喷嚏、喘息和哮喘和喘息药物的发生情况。使用广义估计方程（GEE）的未调整和调整泊松回归模型来解释 4 岁时尿液中自然对数转换（ln）∑As 与 4 岁和 7 岁时呼吸道症状的重复评估之间的关联。纳入模型的协变量包括儿童性别、母亲吸烟状况、母亲教育程度、子队列以及儿童蔬菜、水果和鱼类/海鲜的摄入量。使用泊松回归的 GEE 样条函数显示，随着尿液中∑As 的增加，呼吸道症状的总预期计数呈上升趋势。ln 转化后尿液∑As 为 1.57（平均浓度）和 4.00（99 百分位浓度）时的调整预期计数（95%置信区间）分别为 0.63（0.36，1.10）和 1.33（0.61，2.89）。这些探索性发现表明，即使是与西班牙和其他人群相关的相对较低的 iAs 暴露水平，也可能与儿童期呼吸道症状的增加有关。
