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Table 4 Associations between exposure to arsenic concentrations in drinking water > 10 µg/l and health outcomes

From: Long-term exposure to low-level arsenic in drinking water is associated with cause-specific mortality and hospitalization in the Mt. Amiata area (Tuscany, Italy)

 

MORTALITY 1998–2016

HOSPITALIZATION 1998–2019

WOMEN

MEN

TOTAL

WOMEN

MEN

TOTAL

Ref.a

N

TWAb > 10 µg/l

N

HR (95%CI)c

Ref N

TWA > 10 µg/l

N

HR (95%CI)

Ref

N

TWA > 10 µg/l

N

HR (95%CI)

Ref

N

TWA > 10 µg/l

N

HR (95%CI)

Ref

N

TWA > 10 µg/l

N

HR (95%CI)

Ref

N

TWA > 10 µg/l

N

HR (95%CI)

Non-accidental causes

1367

1401

1.10 (1.02–1.19)

1401

1198

1.04 (0.95–1.12)

2768

2599

1.07 (1.01–1.13)

5530

4574

1.07 (1.03–1.12)

4811

3717

1.05 (1.01–1.10)

10,341

8291

1.06 (1.03–1.09)

Malignant neoplasms

309

304

1.14 (0.97–1.35)

501

421

1.00 (0.88–1.15)

819

725

1.06 (0.95–1.17)

747

700

1.19 (1.07–1.32)

936

749

1.03 (0.93–1.14)

1683

1449

1.10 (1.02–1.19)

Lung

25

28

1.42 (0.81–2.47)

119

109

1.08 (0.82–1.42)

144

137

1.14 (0.89–1.46)

32

43

1.85 (1.14–3.02)

145

125

1.05 (0.81–1.35)

177

168

1.18 (0.95–1.48)

Colon-rectum

51

39

0.87 (0.56–1.35)

64

50

0.91 (0.62–1.35)

115

89

0.90 (0.67–1.20)

102

92

1.14 (0.85–1.53)

143

99

0.89 0.67–1.16)

245

191

0.99 (0.81–1.21)

Kidney

 

n.d.d

 

n.d

 

n.d

25

21

0.99 (0.53–1.82)

48

30

0.87 (0.54–1.41)

73

51

0.91 (0.62–1.33)

Breast

36

31

1.03 (0.62–1.71)

 

n.d

 

n.d

199

191

1.23 (0.99–1.51)

 

n.d

0

n.d

Bladder

6

5

0.67 (0.19–2.39)

32

29

1.01 (0.59–1.72)

38

34

0.94 (0.58–1.55)

20

28

1.50 (0.81–2.77)

107

102

1.19 (0.89–1.58)

127

130

1.23 (0.95–1.60)

Stomach

32

42

1.51 (0.93–2.46)

56

41

0.93 (0.61–1.43)

88

83

1.14 (0.83–1.57)

51

52

1.16 (0.77–1.75)

88

66

0.98 (0.69–1.37)

139

118

1.05 (0.81–1.36)

Liver

23

20

0.99 (0.52–1.85)

53

27

0.69 (0.42–1.12)

76

47

0.78 (0.53–1.15)

33

26

0.96 (0.56–1.66)

76

47

0.81 (0.55–1.19)

109

73

0.86 (0.63–1.17)

Ovary

15

16

1.16 (0.55–2.45)

 

-

 

-

32

29

1.22 (0.72–2.07)

 

-

0

-

Prostate

 

-

37

39

1.19 (0.74–1.90)

 

-

 

-

119

112

1.27 (0.97–1.66)

0

-

Lymphatic and haematopoietic tissue

27

30

1.25 (0.73–2.14)

27

28

1.28 (0.73–2.25)

54

58

1.27 (0.86–1.88)

61

54

1.11 (0.75–1.63)

57

50

1.22 (0.81–1.84)

118

104

1.16 (0.88–1.54)

Endocrine disorders

 

n.d

 

n.d

 

n.d

473

460

1.17 (1.02–1.35)

336

275

1.08 (0.91–1.28)

809

735

1.13 (1.02–1.26)

Diabetes

42

42

1.01 (0.64–1.58)

30

25

0.96 (0.55–1.68)

72

67

0.99 (0.70–1.40)

132

142

1.13 (0.82–1.56)

132

100

0.96 (0.66–1.39)

264

242

1.03 (0.81–1.30)

Circulatory system

622

595

0.98 (0.87–1.10)

478

401

0.99 (0.86–1.14)

1100

996

0.99 (0.90–1.08)

1654

1570

1.13 (1.05–1.22)

1762

1490

1.10 (1.03–1.19)

3416

3060

1.12 (1.06–1.18)

Ischaemic heart disease

125

128

1.03 (0.79–1.34)

135

127

1.05 (0.81–1.36)

260

255

1.04 (0.87–1.25)

274

263

1.11 (0.93–1.33)

441

385

1.10 (0.95–1.27)

715

648

1.11 (0.99–1.24)

Acute myocardial infarction

52

58

1.20 (0.81–1.79)

64

57

0.98 (0.67–1.44)

116

115

1.08 (0.82–1.42)

161

156

1.13 (0.89–1.42)

261

206

0.98 (0.81–1.19)

422

362

1.04 (0.90–1.21)

Hypertensive disease

 

n.d

 

n.d

 

n.d

145

166

1.19 (0.90–1.56)

134

152

1.22 (0.90–1.65)

279

318

1.21 (0.99–1.48)

Heart failure

16

25

1.52 (0.79–2.92)

20

17

0.93 (0.46–1.84)

36

42

1.21 (0.75–1.93)

309

340

1.17 (0.99–1.37)

290

271

1.11 (0.93–1.32)

599

611

1.14 (1.01–1.29)

Cerebrovascular diseases

206

186

0.92 (0.75–1.13)

131

104

0.96 (0.73–1.25)

337

290

0.93 (0.79–1.10)

549

546

1.09 (0.96–1.24)

535

453

1.05 (0.92–1.20)

1084

999

1.07 (0.98–1.17)

Respiratory system

85

78

0.94 (0.68–1.30)

150

126

1.05 (0.81–1.34)

235

204

1.01 (0.83–1.23)

937

837

1.11 (1.01–1.23)

1111

924

1.10 (1.00–1.20)

2048

1761

1.10 (1.03–1.18)

COPDe

27

30

1.20 (0.70–2.08)

55

52

1.07 (0.71–1.60)

82

82

1.13 (0.81–1.56)

128

135

1.23 (0.95–1.60)

191

164

1.03 (0.83–1.30)

319

299

1.12 (0.94–1.32)

Urinary system

23

23

0.95 (0.51–1.77)

29

25

1.02 (0.58–1.77)

52

48

0.98 (0.65–1.48)

364

333

1.10 (0.94–1.29)

501

378

0.99 (0.86–1.14)

865

711

1.04 (0.93–1.15)

Chronic kidney disease

20

23

1.09 (0.57–2.07)

25

24

1.11 (0.62–1.99)

45

47

1.09 (0.71–1.68)

98

121

1.28 (0.96–1.70)

150

117

0.93 (0.72–1.21)

248

238

1.07 (0.89–1.30)

Diseases of the skin

 

n.d

 

n.d

 

n.d

207

148

0.92 (0.73–1.16)

257

207

1.13 (0.93–1.38)

464

355

1.04 (0.89–1.20)

  1. aRef Reference class TWA ≤ 10 µg/l
  2. bTWA time-weighted average arsenic concentration in drinking water 2005–2010
  3. cHR Hazard ratios from Cox proportional hazard models, adjusted for gender, socio-economic status and calendar period
  4. dn.d. Not determined
  5. eCOPD Chronic obstructive pulmonary disease