Association between arsenic exposure from drinking water and hematuria: Results from the Health Effects of Arsenic Longitudinal Study

• Published in: Toxicology and applied pharmacology 2014-04, Vol.276 (1), p.21-27
• Main Authors: McClintock, Tyler R., Chen, Yu, Parvez, Faruque, Makarov, Danil V., Ge, Wenzhen, Islam, Tariqul, Ahmed, Alauddin, Rakibuz-Zaman, Muhammad, Hasan, Rabiul, Sarwar, Golam, Slavkovich, Vesna, Bjurlin, Marc A., Graziano, Joseph H., Ahsan, Habibul
• Format: Article
• Language: English
• Subjects: 60 APPLIED LIFE SCIENCES; Administration, Oral; Adult; ARSENIC; Arsenic - administration & dosage; Arsenic - analysis; Arsenic - toxicity; Arsenic - urine; Arsenic Poisoning - epidemiology; Arsenic Poisoning - etiology; Arsenic Poisoning - physiopathology; Arsenic Poisoning - urine; BANGLADESH; Bangladesh - epidemiology; Biological and medical sciences; Carcinogenesis, carcinogens and anticarcinogens; Chemical agents; Chemical and industrial products toxicology. Toxic occupational diseases; Cohort Studies; COMPARATIVE EVALUATIONS; Cross-Sectional Studies; DRINKING WATER; Drinking Water - adverse effects; Drinking Water - chemistry; Environmental epidemiology; EPIDEMIOLOGY; HAZARDS; Hematuria; Hematuria - etiology; Humans; Incidence; KIDNEYS; Longitudinal Studies; Male; Mass Screening; Medical sciences; MEN; Metals and various inorganic compounds; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); NEOPLASMS; Nephrology. Urinary tract diseases; Prevalence; Proportional Hazards Models; Prospective Studies; Reagent Strips; Rural Health; SYMPTOMS; Toxicology; Tumors; Urinary system involvement in other diseases. Miscellaneous; URINARY TRACT; Urinary tract. Prostate gland; URINE; Urologic neoplasms; Water Pollutants, Chemical - administration & dosage; Water Pollutants, Chemical - analysis; Water Pollutants, Chemical - toxicity; Water Pollutants, Chemical - urine; Water Quality; Water Wells - chemistry
• ISSN: 0041-008X; 1096-0333
• DOI: 10.1016/j.taap.2014.01.015

Arsenic (As) exposure has been associated with both urologic malignancy and renal dysfunction; however, its association with hematuria is unknown. We evaluated the association between drinking water As exposure and hematuria in 7843 men enrolled in the Health Effects of Arsenic Longitudinal Study (HEALS). Cross-sectional analysis of baseline data was conducted with As exposure assessed in both well water and urinary As measurements, while hematuria was measured using urine dipstick. Prospective analyses with Cox proportional regression models were based on urinary As and dipstick measurements obtained biannually since baseline up to six years. At baseline, urinary As was significantly related to prevalence of hematuria (P-trend47.49μg/l and 10.87 to 47.49μg/l since last visit, respectively, and 1.17 (95% CI: 0.94–1.45) and 1.36 (95% CI: 1.10–1.66) for those with between-visit increases of 10.40 to 41.17μg/l and >41.17μg/l, respectively. These data indicate a positive association of As exposure with both prevalence and incidence of dipstick hematuria. This exposure effect appears modifiable by relatively short-term changes in drinking water As. •Hematuria is the most common symptom of urinary tract disease.•Arsenic exposure is associated with renal dysfunction and urologic malignancy.•Water arsenic was positively associated with prevalence and incidence of hematuria.•Reduction in exposure lowered hematuria risk especially in low-to-moderate exposed.•Arsenic-related hematuria may represent nonmalignant or premalignant condition.