Low-level exposure to arsenic in drinking water and incidence rate of stroke: A cohort study in Denmark
Introduction: High arsenic concentration in drinking water is associated with a higher incidence rate of stroke, but only few studies have investigated an association with arsenic in drinking water at low concentration (<50 μg/L). Objective: To examine if arsenic in drinking water at low concentr...
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| Format: | Article |
| Language: | English |
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Elsevier
2018-11-01
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| Series: | Environment International |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0160412018306226 |
| _version_ | 1819208376958058496 |
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| author | Annette Kjær Ersbøll Maria Monrad Mette Sørensen Rikke Baastrup Birgitte Hansen Flemming Winther Bach Anne Tjønneland Kim Overvad Ole Raaschou-Nielsen |
| author_facet | Annette Kjær Ersbøll Maria Monrad Mette Sørensen Rikke Baastrup Birgitte Hansen Flemming Winther Bach Anne Tjønneland Kim Overvad Ole Raaschou-Nielsen |
| author_sort | Annette Kjær Ersbøll |
| collection | DOAJ |
| description | Introduction: High arsenic concentration in drinking water is associated with a higher incidence rate of stroke, but only few studies have investigated an association with arsenic in drinking water at low concentration (<50 μg/L). Objective: To examine if arsenic in drinking water at low concentration was associated with higher incidence rate of stroke in Denmark. Methods: A total of 57,053 individuals from the Danish Diet, Cancer, and Health cohort was included in the study (enrolment in 1993–1997, age 50–64 years), of which 2195 individuals had incident stroke between enrolment and November 2009. Individuals were enrolled in two major cities (Copenhagen and Aarhus). Residential addresses in the period 1973–2009 were geocoded and arsenic concentration in drinking water at each address was estimated by linking addresses with water supply areas. Associations between arsenic concentration and incidence rate of stroke were analysed using a generalized linear model with a Poisson distribution. Incidence rate ratios (IRR) were adjusted for differences in age, sex, calendar-year, lifestyle factors, and educational level. Results: Median arsenic concentration in drinking water was 0.7 μg/L at enrolment addresses (range: 0.03 to 25 μg/L), with highest concentrations in the Aarhus area. The adjusted IRRs were 1.17 (95% CI: 1.04–1.32) for the highest arsenic quartile (1.93–25.3 μg/L) when compared with the lowest quartile (0.049–0.57 μg/L), but the highest IRR was seen in the second quartile (0.57–0.76 μg/L) (IRR = 1.21; 95% CI: 1.07–1.36). The highest IRR in the upper quartile was seen in the Aarhus area (IRR = 1.79; 95% CI: 1.41–2.26). Having ever been exposed to10 μg/L or more arsenic in drinking water resulted in an IRR at 1.44 (95% CI: 1.00–2.08) for all strokes and 1.63 (95% CI: 1.11–2.39) for ischemic strokes. Conclusion: The results indicate that arsenic in drinking water even at low concentration is associated with higher incidence rate of stroke. Keywords: Stroke, Cerebrovascular disease, Epidemiology, Cohort, Drinking water, Arsenic |
| first_indexed | 2024-12-23T05:38:25Z |
| format | Article |
| id | doaj.art-66c9393ee5f3469e97a7b45c19d6401a |
| institution | Directory Open Access Journal |
| issn | 0160-4120 |
| language | English |
| last_indexed | 2024-12-23T05:38:25Z |
| publishDate | 2018-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Environment International |
| spelling | doaj.art-66c9393ee5f3469e97a7b45c19d6401a2022-12-21T17:58:15ZengElsevierEnvironment International0160-41202018-11-011207280Low-level exposure to arsenic in drinking water and incidence rate of stroke: A cohort study in DenmarkAnnette Kjær Ersbøll0Maria Monrad1Mette Sørensen2Rikke Baastrup3Birgitte Hansen4Flemming Winther Bach5Anne Tjønneland6Kim Overvad7Ole Raaschou-Nielsen8National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark; Corresponding author at: National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 København K, Denmark.Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, DenmarkDiet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, DenmarkDiet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, DenmarkDanish Ministry for Energy, Utilities and Climate, Geological Survey of Denmark and Greenland, GEUS Department of Groundwater and Quaternary Geology Mapping C.F. Aarhus, DenmarkDepartment of Neurology, Aarhus University Hospital, Aarhus, DenmarkDiet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, DenmarkDepartment of Cardiology, Aalborg University Hospital, Aalborg, Denmark; Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, DenmarkDiet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Roskilde, DenmarkIntroduction: High arsenic concentration in drinking water is associated with a higher incidence rate of stroke, but only few studies have investigated an association with arsenic in drinking water at low concentration (<50 μg/L). Objective: To examine if arsenic in drinking water at low concentration was associated with higher incidence rate of stroke in Denmark. Methods: A total of 57,053 individuals from the Danish Diet, Cancer, and Health cohort was included in the study (enrolment in 1993–1997, age 50–64 years), of which 2195 individuals had incident stroke between enrolment and November 2009. Individuals were enrolled in two major cities (Copenhagen and Aarhus). Residential addresses in the period 1973–2009 were geocoded and arsenic concentration in drinking water at each address was estimated by linking addresses with water supply areas. Associations between arsenic concentration and incidence rate of stroke were analysed using a generalized linear model with a Poisson distribution. Incidence rate ratios (IRR) were adjusted for differences in age, sex, calendar-year, lifestyle factors, and educational level. Results: Median arsenic concentration in drinking water was 0.7 μg/L at enrolment addresses (range: 0.03 to 25 μg/L), with highest concentrations in the Aarhus area. The adjusted IRRs were 1.17 (95% CI: 1.04–1.32) for the highest arsenic quartile (1.93–25.3 μg/L) when compared with the lowest quartile (0.049–0.57 μg/L), but the highest IRR was seen in the second quartile (0.57–0.76 μg/L) (IRR = 1.21; 95% CI: 1.07–1.36). The highest IRR in the upper quartile was seen in the Aarhus area (IRR = 1.79; 95% CI: 1.41–2.26). Having ever been exposed to10 μg/L or more arsenic in drinking water resulted in an IRR at 1.44 (95% CI: 1.00–2.08) for all strokes and 1.63 (95% CI: 1.11–2.39) for ischemic strokes. Conclusion: The results indicate that arsenic in drinking water even at low concentration is associated with higher incidence rate of stroke. Keywords: Stroke, Cerebrovascular disease, Epidemiology, Cohort, Drinking water, Arsenichttp://www.sciencedirect.com/science/article/pii/S0160412018306226 |
| spellingShingle | Annette Kjær Ersbøll Maria Monrad Mette Sørensen Rikke Baastrup Birgitte Hansen Flemming Winther Bach Anne Tjønneland Kim Overvad Ole Raaschou-Nielsen Low-level exposure to arsenic in drinking water and incidence rate of stroke: A cohort study in Denmark Environment International |
| title | Low-level exposure to arsenic in drinking water and incidence rate of stroke: A cohort study in Denmark |
| title_full | Low-level exposure to arsenic in drinking water and incidence rate of stroke: A cohort study in Denmark |
| title_fullStr | Low-level exposure to arsenic in drinking water and incidence rate of stroke: A cohort study in Denmark |
| title_full_unstemmed | Low-level exposure to arsenic in drinking water and incidence rate of stroke: A cohort study in Denmark |
| title_short | Low-level exposure to arsenic in drinking water and incidence rate of stroke: A cohort study in Denmark |
| title_sort | low level exposure to arsenic in drinking water and incidence rate of stroke a cohort study in denmark |
| url | http://www.sciencedirect.com/science/article/pii/S0160412018306226 |
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