Arsenic Exposure from Drinking Water and QT-Interval Prolongation: Results from the Health Effects of Arsenic Longitudinal Study

Yu Chen¹, Fen Wu¹, Faruque Parvez², Alauddin Ahmed³, Mahbub Eunus³, Tyler R. McClintock⁴, Tazul Islam Patwary³, Tariqul Islam³, Anajan Kumar Ghosal³, Shahidul Islam³, Rabiul Hasan³, Diane Levy², Golam Sarwar³, Vesna Slavkovich², Alexander van Geen⁵, Joseph H. Graziano², and Habibul Ahsan⁶

¹Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, New York, USA; ²Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, New York, USA; ³U-Chicago Research Bangladesh, Ltd., Dhaka, Bangladesh; ⁴New York University School of Medicine, New York University, New York, New York, USA; ⁵Lamont-Doherty Earth Observatory of Columbia University, Palisades, New York, USA; ⁶Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, The University of Chicago, Chicago, Illinois, USA

Advance Publication

Abstract

Background: Arsenic exposure from drinking water has been associated with heart disease, but underlying mechanisms are uncertain.

Objective: To evaluate the association between history of arsenic exposure from drinking water and prolongation of heart rate-corrected QT (QTc), PR, and QRS intervals.

Method: We conducted a study of 1,715 participants enrolled at baseline from the Health Effects of Arsenic Longitudinal Study. Arsenic exposure was measured in baseline well water and urine samples, and in urine samples collected during follow-up. Electrocardiogram evaluations were performed during 2005-2010, with an average time since baseline of 5.9 years.

Results: The adjusted odds ratio [95% confidence interval (CI)] for QTc prolongation, defined as a QTc ≥ 450 ms in men and ≥ 460 ms in women, was 1.17 (1.01, 1.35) for a 1-standard deviation (SD) increase in well water arsenic (108.7 µg/L). The positive association appeared to be limited to women, with adjusted odds ratios of 1.24 (95% CI: 1.05, 1.47) and 1.24 (95% CI: 1.01, 1.53) for a 1-SD increases in baseline well water and urinary arsenic, respectively, compared with 0.99 (95% CI: 0.73, 1.33) and 0.86 (95% CI: 049, 1.51) in men. There were no apparent associations of baseline well water arsenic or urinary arsenic with PR or QRS prolongation in women or men.

Conclusions: Long-term arsenic exposure from drinking water (average 95 µg/L; range, 0.1-790 µg/L) was associated with subsequent QT-interval prolongation in women. Future longitudinal studies with repeated ECG measurements would be valuable to assess the influence of changes in exposure.

Citation: Chen Y, Wu F, Parvez F, Ahmed A, Eunus M, McClintock TR, Patwary TI, Islam T, Ghosal AK, Islam S, Hasan R, Levy D, Sarwar G, Slavkovich V, van Geen A, Graziano JH, Ahsan H. Environ Health Perspect (): .doi:10.1289/ehp.1205197

Received: March 11, 2012; Accepted: January 31, 2013; Published: February 5, 2013

Advance Publication

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