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Table 5 Associations between exposure to arsenic concentrations in drinking water below the regulatory limit (5–10 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

Ref.a

TWAb

5–10 µg/l

TWA

 > 10 µg/l

p-value trend

Ref

TWA

5–10 µg/l

TWA

 > 10 µg/l

p-value trend

N

N

HR (95%CI)c

N

HR (95%CI)

N

N

HR (95%CI)

N

HR (95%CI)

Non-accidental causes

400

2368

1.07

(0.96–1.20)

2599

1.13

(1.02–1.26)

0.009

1362

8979

1.03

(0.97–1.09)

8291

1.09

(1.03–1.15)

 < 0.001

Malignant neoplasms

130

689

0.90

(0.74–1.10)

725

0.97

(0.80–1.17)

0.604

253

1430

0.89

(0.78–1.03)

1449

1.01

(0.88–1.15)

0.094

Lung

32

112

0.57

(0.38–0.86)

137

0.74

(0.50–1.09)

0.930

33

144

0.70

(0.47–1.03)

168

0.89

(0.61–1.29)

0.524

Colon-rectum

22

93

0.77

(0.47–1.28)

89

0.73

(0.45–1.18)

0.274

43

202

0.72

(0.51–1.02)

191

0.76

(0.55–1.07)

0.413

Breast

5

31

0.99

(0.37–2.67)

31

1.02

(0.39–2.64)

0.932

26

173

1.01

(0.66–1.54)

191

1.23

(0.82–1.86)

0.082

Bladder

11

27

0.56

(0.26–1.24)

34

0.63

(0.31–1.29)

0.430

26

101

0.69

(0.44–1.10)

130

0.93

(0.60–1.43)

0.413

Stomach

10

78

1.34

(0.68–2.67)

83

1.46

(0.76–2.82)

0.276

19

120

1.12

(0.67–1.87)

118

1.15

(0.70–1.89)

0.626

Liver

9

67

1.19

(0.57–2.47)

47

0.90

(0.44–1.85)

0.346

13

96

1.16

(0.64–2.11)

73

0.97

(0.54–1.75)

0.494

Ovary

 < 3

n.d. d

n.d

n.d

n.d

n.d

5

27

0.73

(0.28–1.95)

29

0.94

(0.36–2.44)

0.665

Prostate

 < 3

n.d

n.d

n.d

n.d

n.d

12

107

1.47

(0.80–2.72)

112

1.76

(0.97–3.19)

0.041

Lymphatic and haematopoietic tissue

4

50

2.16

(0.76–6.13)

58

2.47

(0.89–6.82)

0.097

16

102

0.97

(0.56–1.67)

104

1.13

(0.67–1.92)

0.369

Endocrine disorders

11

87

1.46

(076–2.81)

89

1.38

(0.774–2.60)

0.583

99

710

1.11

(0.89–1.38)

735

1.23

(1.00–1.53)

0.015

Diabetes

9

63

1.39

(0.67–2.90)

67

1.29

(0.64–2.61)

0.761

32

232

1.07

(0.65–1.74)

242

1.09

(0.67–1.76)

0.764

Circulatory system

156

944

1.17

(0.98–1.41)

996

1.12

(0.94–1.33)

0.683

483

2933

1.03

(0.93–1.13)

3060

1.14

(1.04–1.26)

 < 0.001

Ischaemic heart disease

42

218

1.06

(0.74–1.50)

255

1.09

(0.78–1.51)

0.608

88

627

1.26

(1.00–1.59)

648

1.34

(1.07–1.67)

0.018

Acute myocardial infarction

18

98

1.07

(0.63–1.83)

115

1.14

(0.69–1.89)

0.537

53

369

1.21

(0.90–1.64)

362

1.22

(0.91–1.63)

0.331

Heart failure

4

32

1.78

(0.60–5.27)

42

1.93

(0.69–5.40)

0.264

87

512

1.13

(0.89–1.43)

611

1.26

(1.00–1.57)

0.019

Cerebrovascular diseases

53

284

1.00

(0.73–1.37)

290

0.93

(0.69–5.40)

0.441

170

914

0.96

(0.81–1.14)

999

1.04

(0.88–1.22)

0.250

Respiratory system

30

205

1.35

(0.89–2.05)

204

1.29

(0.87–1.92)

0.509

284

1764

0.97

(0.85–1.11)

1761

1.08

(0.95–1.22)

0.014

COPDe

10

72

1.64

(0.79–3.39)

82

1.68

(0.84–3.36)

0.242

41

278

1.26

(0.89–1.77)

299

1.34

(0.97–1.86)

0.094

Urinary system

5

47

2.09

(0.80–5.49)

48

1.79

(0.71–4.52)

0.601

113

752

1.09

(0.89–1.34)

711

1.11

(0.91–1.36)

0.356

Chronic kidney disease

4

41

2.41

(0.83–7.03)

47

2.24

(0.80–6.25)

0.312

35

213

1.24

(0.85–1.81)

238

1.27

(0.88–1.84)

0.270

Diseases of the skin

 < 3

n.d

n.d

n.d

n.d

n.d

54

410

1.06

(0.79–1.43)

355

1.09

(0.81–1.46)

0.563

  1. aRef Reference class TWA ≤ 5 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