Mortality in Young Adults following in Utero and Childhood Exposure to Arsenic in Drinking Water

Allan H. Smith,¹ Guillermo Marshall,^2,3 Jane Liaw,¹ Yan Yuan,¹ Catterina Ferreccio,² and Craig Steinmaus^1,4

¹Arsenic Health Effects Research Program, School of Public Health, University of California, Berkeley, Berkeley, California, USA; ²Departamento de Salud Pública, Escuela de Medicina, and ³Departamento de Estadística, Facultad de Matemáticas, Universidad Católica de Chile, Santiago, Chile; ⁴Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, California, USA


Abstract

Background: Beginning in 1958, the city of Antofagasta in northern Chile was exposed to high arsenic concentrations (870 µg/L) when it switched water sources. The exposure abruptly stopped in 1970 when an arsenic-removal plant commenced operations. A unique exposure scenario like this—with an abrupt start, clear end, and large population (125,000 in 1970), all with essentially the same exposure—is rare in environmental epidemiology. Evidence of increased mortality from lung cancer, bronchiectasis, myocardial infarction, and kidney cancer has been reported among young adults who were in utero or children during the high-exposure period. 


Objective: We investigated other causes of mortality in Antofagasta among 30‑ to 49‑year-old adults who were in utero or ≤ 18 years of age during the high-exposure period. 


Methods: We compared mortality data between Antofagasta and the rest of Chile for people 30–49 years of age during 1989–2000. We estimated expected deaths from mortality rates in all of Chile, excluding Region II where Antofagasta is located, and calculated standardized mortality ratios (SMRs).


Results: We found evidence of increased mortality from bladder cancer [SMR = 18.1; 95% confidence interval (CI): 11.3, 27.4], laryngeal cancer (SMR = 8.1; 95% CI: 3.5, 16.0), liver cancer (SMR = 2.5; 95% CI: 1.6, 3.7), and chronic renal disease (SMR = 2.0; 95% CI: 1.5, 2.8).


Conclusions: Taking together our findings in the present study and previous evidence of increased mortality from other causes of death, we conclude that arsenic in Antofagasta drinking water has resulted in the greatest increases in mortality in adults < 50 years of age ever associated with early-life environmental exposure. 


Key words: arsenic, childhood exposure, Chile, drinking water, environmental exposure, in utero, mortality. 


Environ Health Perspect 120:1527–1531 (2012). http://dx.doi.org/10.1289/ehp.1104867 [Online 4 September 2012]


Address correspondence to A.H. Smith, Arsenic Health Effects Research Program, School of Public Health, University of California, Berkeley, 50 University Hall, MC 7360, Berkeley, CA 94720-7360 USA. Telephone: (510) 843-1736. E-mail: ahsmith@berkeley.edu


The authors gratefully acknowledge the assistance of C. Alston in preparing this paper.


This work was supported by National Institutes of Health grants P42-ES04705 and R01-ES010033. 


The authors declare they have no actual or potential competing financial interests.


Received 16 December 2011; Accepted 4 September 2012; Online 4 September 2012.