Prospective cohort study of association of arsenic exposure reduction and chronic disease mortality in Bangladesh

Chronic exposure to arsenic in drinking water has been associated with increased chronic disease mortality, including cancer mortality. A prospective cohort of 11,746 adults was enrolled between 2000 and 2002 in Araihazar, Bangladesh, with levels of well-water arsenic ranging from less than 1 μg/L to 864 μg/L (mean 102 μg/L). Arsenic levels declined over time as a result of community mitigation. Mean urinary arsenic levels declined from 283 (SD 314) to 132 (SD 161) μg/g creatinine. Mortality was tracked through 2022. Each IQR decrease in urinary arsenic (197 μg/g creatinine) was associated with 22% lower chronic disease mortality (aHR 0.78; 95% CI 0.75-0.82), 20% lower cancer mortality (0.80; 0.73-0.87), and 23% lower CVD mortality (0.77; 0.73-0.81). The authors conclude that reduced arsenic exposure is associated with lower mortality from chronic diseases, including cancer.