Superfund Research Program
Health Effects of Arsenic Longitudinal Study
Project Leader: Habibul Ahsan (University of Chicago)
Co-Investigators: Ana Navas-Acien, Muhammad G. Kibriya (University of Chicago), Farzana Jasmine (University of Chicago)
Grant Number: P42ES010349
Funding Period: 2000-2021
Final Progress Reports
This prospective cohort study recruited 11,746 men and women in Araihazar, Bangladesh, during 2000-2002 to investigate the health effects of arsenic exposure, with an initial focus on skin lesions and skin cancers. Between 2006 and 2008, the cohort was expanded to 20,033 individuals. Expansion participants were enrolled into the cohort through in-person interviews and had blood and urine samples collected in the same manner as the original cohort. The design of this multidisciplinary project and cohort description has been published (Ahsan et al., 2005). The researchers have numerous publications utilizing the baseline cross-sectional data on arsenic exposure and adverse health effects, including prevalent skin lesion cases, as well as longitudinal analyses of mortality, incident skin lesions, diabetes, and respiratory disease with the prospective data.
In-person interviews and clinical examinations of the cohort participants are conducted every 2 years. The 8-year follow-up visit of the original cohort and 4-year follow-up visit of the expansion cohort is currently underway, using the same study instrument. To date, the research group has completed laboratory measurement of urinary total arsenic concentration in all baseline, two-year follow-up, and four-year follow-up samples from the original HEALS cohort and all baseline and two-year follow-up samples of the expansion cohort.
Utilizing the data collected from the first three follow-up visits (2-, 4-, and 6-year visits) of the original cohort, the researchers' prospective analyses based on individual-level data clearly suggest increased mortality in relation to increases in arsenic exposure based on water and urinary arsenic. These findings were recently published in The Lancet They also have a manuscript under review, in which they observed an increased risk of cardiovascular disease mortality in relation to increases in arsenic exposure (Chen et al., under review). Additionally, the research group utilized the prospective data through six years of follow-up to assess skin lesion incidence and observed a clear dose-dependent association between arsenic exposure and skin-lesion risk, even at low exposure levels (water arsenic concentration <100 µg/L). This manuscript has been submitted for publication and currently is being revised (Argos et al., under review). Additionally, they have two publications in press reporting modification of the association between arsenic exposure and incident skin-lesion status by smoking status in men (Melkonian et al., in press) and dietary patterns (Pierce et al., in press).
The objectives of the current analyses and follow-up interviews are to specifically examine the original aims which have not been modified since the last progress report. Several other manuscripts are being drafted for publication, reporting results of the researchers' prospective cohort analyses of modification of the effects of arsenic on mortality and incidence of skin lesions.
In addition to the above-mentioned components, resources from this prospective cohort study have also yielded many other ancillary studies and publications, including three additional R01 grants from NIH to investigate the genetic and nutritional aspects, as well as chemoprevention, of arsenic health effects.