Health Effects of Arsenic Exposure Joseph Graziano, PhD Professor - - PowerPoint PPT Presentation

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Health Effects of Arsenic Exposure Joseph Graziano, PhD Professor - - PowerPoint PPT Presentation

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Health Effects of Arsenic Exposure Joseph Graziano, PhD Professor of Environmental Health Sciences And Pharmacology Director, The Columbia University Superfund Research Program September 14, 2017 Arsenic in Groundwater: An International

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Health Effects of Arsenic Exposure

Joseph Graziano, PhD Professor of Environmental Health Sciences And Pharmacology Director, The Columbia University Superfund Research Program

September 14, 2017

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Arsenic in Groundwater: An International Problem

  • Taiwan
  • China
  • Chile
  • Argentina
  • Mexico
  • United States
  • India
  • Bangladesh
  • Nepal
  • Vietnam
  • Cambodia
  • Mongolia
  • Myanmar
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Skin

Targets of Arsenic Toxicity

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Known Health Effects of Arsenic

  • “Early/Intermediate””

– Skin Lesions:

  • Melanosis
  • Keratosis
  • Other Conditions

– Diabetes mellitus – Non-malignant respiratory disease – Cognitive deficits – Black-foot Disease

  • “Late”

– Cancers:

  • Skin
  • Bladder
  • Lung
  • Liver

– Cardiovascular:

  • Hypertension
  • Ischemic Heart

Disease

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Arsenic in 5,966 wells

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Baseline

Cohort Recruitment and Follow-up: The HEALS Cohort

Follow-up 1

7/2000-5/2002 9/2002-11/2004 12/2004 - 9/2006 6/2007-1/2009

Follow-up 3

HEALS Original Cohort ~12,000 adults

6/2006-8/2008 11/2008-11/2009

Follow-up 2

Baseline

Follow-up 1

HEALS Expanded Cohort ~8,000 adults

2010-2012 ~35,000 adults: HEALS original and Expanded cohort

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Baseline

Cohort Recruitment and Follow-up

Follow-up 1

7/2000-5/2002 9/2002-11/2004 12/2004 - 9/2006 6/2007-1/2009

Follow-up 3

HEALS Original Cohort ~12,000 adults

6/2006-8/2008 11/2008-11/2009

Follow-up 2

Baseline

Follow-up 1

HEALS Expanded Cohort ~8,000 adults

2010-2012 ~35,000 adults: HEALS original and Expanded cohort

113 deaths 120 deaths 174 deaths

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Am J Respir Crit Care Med. 2013

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Maternal Blood As (g/L)

20 40 60 80

Umbilical Cord Blood As (g/L)

20 40 60 80

r=0.93 b=0.94

A

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Unusual Cancer Excess After Neonatal Arsenic Exposure From Contaminated Milk Powder

Takashi Yorifuji, Toshihide Tsuda and Philippe Grandjean

“During the summer of 1955, mass arsenic poisoning of bottle-fed infants occurred in the western part of Japan because of contaminated milk powder ( 2 ). Although the milk powder was distributed countrywide, Okayama was the most severely affected prefecture, with a consumption of at least 33 500 one-pound cans of milk powder ( 3 )…”

  • J. Natl. Cancer Inst. 102, 360-361.

Mortality data in the survivors later in life: Excess skin and liver cancer, as well as pancreatic cancer and leukemia.

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Environ Health Perspect 114:1293–1296 (2006). doi:10.1289/ehp.8832 available via http://dx.doi.org/

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Relationship Between Water Arsenic Concentrations and Intellectual Function

Wasserman et al, EHP, 2004

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Wasserman et al, EHP 2004

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Elevated groundwater arsenic from natural sources

USGS, 2003 About 30,000 monitoring wells

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Estimating IQ Points Lost Attributable to Water Arsenic (Maine): WAs > 5 ppb vs WAs <5ppb

Full Scale IQ was 4 points lower (p<0.01) in those children whose water arsenic was > 5 ppb!

Adjusted for HOME, number of children in the home, mother’s IQ

Wasserman et al, Environ Health, 2014

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So what to do…?

  • Test, Test, Test!