A prospective cohort study of in utero and early childhood arsenic exposure and infectious disease in 4- to 5-year-old Bangladeshi children

2020  Journal Article

A prospective cohort study of in utero and early childhood arsenic exposure and infectious disease in 4- to 5-year-old Bangladeshi children

Pub TLDR

This study highlights the critical nature of prenatal exposure to arsenic and its potential long-term health impacts on respiratory health in children. The findings underscore the importance of ensuring safe drinking water, particularly for pregnant women, to prevent early-life exposure to arsenic. This research adds to the growing body of evidence suggesting that fetal development is a window of significant vulnerability to environmental toxins.

 

College of Health researcher(s)

Highlights

  • Children whose mothers had higher arsenic exposure during pregnancy had a 10% higher risk of respiratory infections compared to those with lower exposure, even after accounting for factors like household income, breastfeeding practices, and exposure to cooking fire smoke.
  • Arsenic exposure after birth during toddler and childhood years was not significantly linked to infection risk, suggesting the prenatal period may be an especially vulnerable time.
  • Arsenic did not appear to increase risk of childhood fevers or diarrheal disease.

Abstract

Background

Previous research found that infants who were exposed to high levels of arsenic in utero had an increased risk of infectious disease in the first year of life. This prospective study examined the association between arsenic exposures during gestation, and respiratory, diarrheal, and febrile morbidity in children 4–5 years of age.

Methods

A cohort of pregnant women was recruited in 2008–2011 in Bangladesh. Their children (N = 989) were followed, and household drinking water samples were collected during pregnancy, toddlerhood (12–40 months of age), and childhood (4–5 years of age). We actively surveyed mothers every 2 weeks regarding their children’s infectious diseases symptoms from 4 to 5 years of age. Poisson regression models were used to estimate the association between arsenic exposure and respiratory and febrile illness.

Results

Median drinking water arsenic was 4.6, 8.8, and 4.2 µg/L in pregnancy, toddlerhood, and childhood, respectively. We observed 0.01, 1.2, and 1.0 cases per 100 person-days of diarrhea, respiratory, and febrile illness, respectively. The incident rate ratios (IRRs) for each doubling of drinking water arsenic during pregnancy were 1.10 (95% confidence interval [CI] = 1.00, 1.22) and 0.93 (95% CI = 0.82, 1.05) for respiratory and febrile illness, respectively, after adjusting for covariates. The association between arsenic exposure measured during toddlerhood and childhood was attenuated and not significantly associated with either outcome. Diarrheal disease was too infrequent to assess.

Conclusions

Drinking water arsenic exposure during pregnancy was associated with a higher risk of acute respiratory infections in children 4–5 years old in Bangladesh.

Ahmed, S.M., Branscum, A.J., Welch, B.M., Megowan, M., Bethel, J.W., Odden, M.C., Joya, S.A., Ibn Hasan, M.O., Lin, P.D., Mostofa, G., Quamruzzaman, Q., Rahman, M., Christiani, D.C., Kile, M.L.(2020)A prospective cohort study of in utero and early childhood arsenic exposure and infectious disease in 4- to 5-year-old Bangladeshi childrenEnvironmental Epidemiology4(2)