Arsenic exposure from drinking water and risk of premalignant skin lesions in Bangladesh: baseline results from the Health Effects of Arsenic Longitudinal Study

Am J Epidemiol. 2006 Jun 15;163(12):1138-48. doi: 10.1093/aje/kwj154. Epub 2006 Apr 19.


Millions of persons around the world are exposed to low doses of arsenic through drinking water. However, estimates of health effects associated with low-dose arsenic exposure have been extrapolated from high-dose studies. In Bangladesh, many persons have been exposed to a wide range of doses of arsenic from drinking water over a significant period of time. The authors evaluated dose-response relations between arsenic exposure from drinking water and premalignant skin lesions by using baseline data on 11,746 participants recruited in 2000-2002 for the Health Effects of Arsenic Longitudinal Study in Araihazar, Bangladesh. Several measures of arsenic exposure were estimated for each participant based on well-water arsenic concentration and usage pattern of the wells and on urinary arsenic concentration. In different regression models, consistent dose-response effects were observed for all arsenic exposure measures. Compared with drinking water containing <8.1 microg/liter of arsenic, drinking water containing 8.1-40.0, 40.1-91.0, 91.1-175.0, and 175.1-864.0 microg/liter of arsenic was associated with adjusted prevalence odds ratios of skin lesions of 1.91 (95% confidence interval (CI): 1.26, 2.89), 3.03 (95% CI: 2.05, 4.50), 3.71 (95% CI: 2.53, 5.44), and 5.39 (95% CI: 3.69, 7.86), respectively. The effect seemed to be influenced by gender, age, and body mass index. These findings provide information that should be considered in future research and policy decisions.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Arsenic / adverse effects*
  • Arsenic / analysis
  • Bangladesh / epidemiology
  • Cross-Sectional Studies
  • Dose-Response Relationship, Drug
  • Environmental Exposure / adverse effects*
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Precancerous Conditions / chemically induced*
  • Precancerous Conditions / epidemiology
  • Regression Analysis
  • Risk Factors
  • Skin Diseases / chemically induced*
  • Skin Diseases / epidemiology
  • Water Supply*


  • Arsenic