Ultrahivenaine arsenikki ja vahingolliset määrät

Ultrahivenaineeksi mainittu arsenikki on tunnettu toksiini suuremmissa määrissä. Lansetti esittää artikkelissa näitä rajoja mortaliteetin ja morbiditeetin suhteen.
Kohorttitutkimukseen otettiin 11 746 vuosina 2000 - 2002 BanglaDeshissa. kontrolliryhmän juomavedessä oli arsenikkia alle 10 ug litrassa, siis veden käytön olless esim 2-3 litraa, olisi henkilöön tullut päivässä korkeintaan 20- 30 ug arseenia vedestä, mikä on vielä ultahivenaineen aluetta.
Tätä ryhmää verrattiin niihin joiden juoma vedessä oli 150- 864 ug arseenia litrassa.

The Lancet, Volume 376, Issue 9753, Page 1641, 13 November 2010

doi:10.1016/S0140-6736(10)62089-2Cite or Link Using DOI Arsenic exposure from drinking water and mortality in Bangladesh

Original Text

Marie Vahter, Nazmul Sohel c, Kim Streatfield b, Lars Åke Persson c

Maria Argos and co-workers (July 24, p 252)1 assess the association between arsenic in drinking water and mortality in rural Bangladesh. A cohort of 11 746 was recruited between 2000 and 2002 and followed up biennially. Compared with individuals with less than 10 μg/L arsenic in the main drinking water source used at baseline, those with 150—864 μg/L showed an increased risk of all-cause mortality (adjusted hazard ratio 1·68, 95% CI 1·26—2·23). This association was similar when exposure was expressed as creatinine-adjusted total arsenic in urine. This might, however, be biased owing to low creatinine excretion in malnourished people and co-excretion of creatinine and arsenic.2

Argos and colleagues also claim that the association between arsenic exposure and mortality has not been prospectively investigated by use of individual-level data. However, we published results of a population-based cohort study in Bangladesh a year ago.3 Our study assessed mortality data collected prospectively during 1991—2000 in an established health and demographic surveillance system in the rural region of Matlab (population size 115 903). This study was erroneously cited by Argos and colleagues as a retrospective study based on group-level data. In fact, data on individual long-term arsenic exposure through drinking water were based on personal interviews about historic water use (for each calendar year 1970—90) and arsenic in all 13 286 tubewells. Because the deceased people could not be interviewed, we used household long-term average arsenic concentration in drinking water as an exposure estimate, which in a subsample of 1000 living individuals was found to correlate with individual long-term average exposure (r=0·94).

The results showed that even low concentrations of arsenic in water (10—49 μg/L) were associated with a significantly increased risk of all non-accidental mortality (adjusted hazard ratio 1·16, 95% CI 1·06—1·26).3 Additionally, we found an increased risk of death due to cancer (1·44, 1·06—1·95) and infectious diseases (1·30, 1·13—1·49) at arsenic concentrations of 50—149 μg/L, and increased risk of cardiovascular death from 150 μg/L and above (1·51, 1·31—1·75).

We declare that we have no conflicts of interest.