000			03107nam a22004697a 4500
008			220124s20212021 xxu||||| |||| 00| 0 eng d
022			_a0160-4120
024			_a10.1016/j.envint.2021.107029 [doi]
024			_aS0160-4120(21)00654-1 [pii]
040			_aOvid MEDLINE(R)
099			_a34890900
245			_aThe association of arsenic exposure and arsenic metabolism with all-cause, cardiovascular and cancer mortality in the Strong Heart Study.
251			_aEnvironment International. 159:107029, 2022 01 15.
252			_aEnviron Int. 159:107029, 2022 01 15.
252			_zEnviron Int. 159:107029, 2021 Dec 07.
253			_aEnvironment international
260			_c2022
260			_fFY2022
260			_p2021 Dec 07
265			_sppublish
266			_d2022-01-25
268			_aEnvironment International. 159:107029, 2021 Dec 07.
520			_aThe effect of low-moderate levels of arsenic exposure and of arsenic metabolism on mortality remains uncertain. We used data from a prospective cohort study in 3600 men and women aged 45 to 75 years living in Arizona, Oklahoma, and North and South Dakota. The biomarker of inorganic arsenic exposure was the sum of urine inorganic (iAs), monomethylated (MMA) and dimethylated (DMA) arsenic compounds (As) at baseline. The proportions of urine iAs, MMA and DMA over the iAs, expressed as iAs%, MMA%, and DMA%, respectively, were used as biomarkers of arsenic metabolism. Arsenic exposure and arsenic metabolism were associated with all-cause, cardiovascular, and cancer mortality. For each interquartile range (IQR) increase in As (12.5 mug/L, overall range 0.7-194.1 mug/L), the adjusted hazard ratios (aHRs) were 1.28 (95% CI 1.16-1.41) for all-cause mortality, 1.28 (1.08-1.52) for cardiovascular mortality and 1.15 (0.92-1.44) for cancer mortality. The aHR for mortality for each IQR increase in MMA%, when iAs% is decreasing, was 1.52 (95% CI 1.16-1.99) for cardiovascular disease, 0.73 (0.55-0.98) for cancer, and 1.03 (0.90-1.19) for all-cause mortality. These findings at low-moderate levels of arsenic exposure highlight the need to implement public health measures to protect populations from involuntary arsenic exposure and for research to advance the biological and clinical understanding of arsenic-related health effects in general populations. Copyright (c) 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.
546			_aEnglish
650			_a*Arsenic
650			_a*Arsenicals
650			_a*Neoplasms
650			_aAged
650			_aArsenic/an [Analysis]
650			_aEnvironmental Exposure/ae [Adverse Effects]
650			_aFemale
650			_aHumans
650			_aMale
650			_aMiddle Aged
650			_aProspective Studies
651			_aMedStar Health Research Institute
657			_aJournal Article
700			_aUmans, Jason G
790			_aBalakrishnan P, Best LG, Goessler W, Gribble MO, Kuo CC, Navas-Acien A, Umans JG
856			_uhttps://dx.doi.org/10.1016/j.envint.2021.107029 _zhttps://dx.doi.org/10.1016/j.envint.2021.107029
942			_cART _dArticle
999			_c954 _d954