Positive association of Cardiovascular Disease (CVD) with chronic exposure to drinking water Arsenic (As) at concentrations below the WHO provisional guideline value : a systematic review and meta-analysis

Xu, L; Mondal, D; Polya, DA

Abstract

To the best of our knowledge, a dose-response meta-analysis of the relationship between cardiovascular disease (CVD) and arsenic (As) exposure at drinking water As concentrations lower than the WHO provisional guideline value (10 µg/L) has not been published yet. We conducted a systematic review and meta-analyses to estimate the pooled association between the relative risk of each CVD endpoint and low-level As concentration in drinking water both linearly and non-linearly using a random effects dose-response model. In this study, a significant positive association was found between the risks of most CVD outcomes and drinking water As concentration for both linear and non-linear models (p-value for trend < 0.05). Using the preferred linear model, we found significant increased risks of coronary heart disease (CHD) mortality and CVD mortality as well as combined fatal and non-fatal CHD, CVD, carotid atherosclerosis disease and hypertension in those exposed to drinking water with an As concentration of 10 µg/L compared to the referent (drinking water As concentration of 1 µg/L) population. Notwithstanding limitations included, the observed significant increased risks of CVD endpoints arising from As concentrations in drinking water between 1 µg/L and the 10 µg/L suggests further lowering of this guideline value should be considered.

Citation

Xu, L., Mondal, D., & Polya, D. (2020). Positive association of Cardiovascular Disease (CVD) with chronic exposure to drinking water Arsenic (As) at concentrations below the WHO provisional guideline value : a systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 17(7), 2536. https://doi.org/10.3390/ijerph17072536

• Journal Article Type: Article
• Acceptance Date: Apr 6, 2020
• Online Publication Date: Apr 7, 2020
• Publication Date: Apr 7, 2020
• Deposit Date: Apr 8, 2020
• Publicly Available Date: Apr 9, 2020
• Journal: International Journal of Environmental Research and Public Health
• Publisher: MDPI
• Volume: 17
• Issue: 7
• Pages: 2536
• DOI: https://doi.org/10.3390/ijerph17072536
• Publisher URL: https://doi.org/10.3390/ijerph17072536
• Related Public URLs: https://www.mdpi.com/journal/ijerph
• Additional Information: Access Information : A correction to this article can be accessed at https://doi.org/10.3390/ijerph17238947