Arsenic reduction in drinking water and improvement in skin lesions: a follow-up study in Bangladesh.
Arsenic reduction in drinking water and improvement in skin lesions: a follow-up study in Bangladesh.
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DOI：
10.1289/ehp.1205381
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发表时间：
2012-12
影响因子：
10.4
通讯作者：
Christiani DC
中科院分区：
文献类型：
--
作者：
Seow WJ;Pan WC;Kile ML;Baccarelli AA;Quamruzzaman Q;Rahman M;Mahiuddin G;Mostofa G;Lin X;Christiani DC
背景：慢性砷暴露与皮肤损伤有关。然而，目前尚不清楚减少砷暴露是否会改善皮肤损伤。目的：我们评估了随着时间的推移，减少砷暴露与皮肤损伤恢复之间的关系。方法：在2009-2011年对550人进行了跟踪研究，以2001-2003年在孟加拉国登记的皮损病例(n=900)为基线人群。在基线和随访时，确定饮用水和脚趾甲中的砷，以及皮肤损害状况和严重程度。我们使用Logistic回归和广义估计方程(GEE)模型来评估log10转化砷暴露与皮肤病变持续性和严重性之间的关联。结果：在研究期间，这些人群中的水砷浓度总体上降低了41%，65名在基线水平有皮肤损害的人在随访中没有发现可识别的损害。在调整后的模型中，水砷和趾甲砷每降低log10，皮肤损伤恢复的相对增加分别为22%[优势比(OR)=1.22；95%CI：0.85，1.78]和4.5倍(OR=4.49；95%CI：1.94，11.1)。此外，较低的基线砷水平与康复几率的增加显著相关。从基线到随访，趾甲砷的log10降低也与随时间推移患者皮肤损害严重程度的降低显著相关(平均得分变化-5.22个单位；95%可信区间：-8.61，-1.82)。结论：减少砷暴露增加了皮肤损害的个体在10年内恢复或表现出不那么严重的损害的可能性。在孟加拉国和受砷污染水影响的其他地区，减少砷暴露必须仍然是公共卫生的优先事项。
Background: Chronic exposure to arsenic is associated with skin lesions. However, it is not known whether reducing arsenic exposure will improve skin lesions. Objective: We evaluated the association between reduced arsenic exposures and skin lesion recovery over time. Methods: A follow-up study of 550 individuals was conducted in 2009–2011 on a baseline population of skin lesion cases (n = 900) previously enrolled in Bangladesh in 2001–2003. Arsenic in drinking water and toenails, and skin lesion status and severity were ascertained at baseline and follow-up. We used logistic regression and generalized estimating equation (GEE) models to evaluate the association between log10-transformed arsenic exposure and skin lesion persistence and severity. Results: During the study period, water arsenic concentrations decreased in this population by 41% overall, and 65 individuals who had skin lesions at baseline had no identifiable lesions at follow-up. In the adjusted models, every log10 decrease in water arsenic and toenail arsenic was associated with 22% [odds ratio (OR) = 1.22; 95% CI: 0.85, 1.78] and 4.5 times (OR = 4.49; 95% CI: 1.94, 11.1) relative increase in skin lesion recovery, respectively. In addition, lower baseline arsenic levels were significantly associated with increased odds of recovery. A log10 decrease in toenail arsenic from baseline to follow-up was also significantly associated with reduced skin lesion severity in cases over time (mean score change of –5.22 units; 95% CI: –8.61, –1.82). Conclusions: Reducing arsenic exposure increased the odds that an individual with skin lesions would recover or show less severe lesions within 10 years. Reducing arsenic exposure must remain a public health priority in Bangladesh and in other regions affected by arsenic-contaminated water.
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影响因子：
5
作者：
Argos, Maria;Kalra, Tara;Ahsan, Habibul
通讯作者：
Ahsan, Habibul
影响因子：
5.4
作者：
Milton, AH;Smith, W;Ali, A
通讯作者：
Ali, A
影响因子：
6.6
作者：
Fernandez, Mario I.;Francisco Lopez, J.;Coz, Fernando
通讯作者：
Coz, Fernando
影响因子：
8.8
作者：
Cuzick, J;Evans, S;Gillman, M;Price Evans, D A
通讯作者：
Price Evans, D A
DOI：
10.1038/sj.jea.7500449
发表时间：
2006-03-01
影响因子：
4.5
作者：
Ahsan, H;Chen, Y;Graziano, J
通讯作者：
Graziano, J