Shadassa Ourshalimian1, Abu Mohd Naser1, Mahbubur Rahman2, Solaiman Doza2, Jennifer Stowell1, K M Venkat Narayan3, Mohammad Shamsudduha4, Matthew O Gribble5. 1. Department of Environmental Health, Emory University, Atlanta, GA, USA. 2. International Centre for Diarrhoeal Disease Research, Bangladesh, GPO Box 128, Dhaka 1000, Bangladesh. 3. Emory Global Diabetes Research Center, Hubert Department of Global Health, Emory University, Atlanta, GA, USA. 4. Institute for Risk and Disaster Reduction, University College London, London, UK. 5. Department of Environmental Health, Emory University, Atlanta, GA, USA; Department of Epidemiology, Emory University, Atlanta, GA, USA. Electronic address: matt.gribble@emory.edu.
Abstract
GOAL: The goal of this study was to evaluate the association between groundwater arsenic and fasting blood glucose in the context of other groundwater chemicals, in Bangladesh. METHODS: Fasting blood glucose, gender, body mass index, sociodemographic variables, and diabetes medication use were measured among adults ≥ 35 years of age (n = 6587) participating in the Bangladesh Demographic and Health Survey (BDHS) 2011. Groundwater chemicals in 3534 well water samples were measured in the British Geological Survey (BGS) and Department of Public Health Engineering (DPHE) 1998-99 survey. We assigned the nearest BGS-DPHE well's chemical exposure to each BDHS participant. We used survey-estimation linear regression methods to model natural log-transformed fasting blood glucose, among those using groundwater as their primary drinking-water source, as a function of groundwater arsenic. We considered possible interactions between categorical arsenic exposure and each of 14 other groundwater chemicals dichotomized at their medians. The chemicals considered as possible effect modifiers included: aluminum, barium, calcium, iron, potassium, lithium, magnesium, manganese, sodium, phosphorous, silicon, sulfate, strontium, and zinc. RESULTS: Compared to persons exposed to groundwater arsenic ≤ 10 μg/L, the adjusted geometric mean ratio (GMR) of fasting blood glucose was 1.01 (95% confidence interval: 0.98, 1.04) for individuals exposed to groundwater arsenic concentrations > 10 μg/L and ≤ 50 μg/L, and was 1.01 (0.97, 1.03) for those with > 50 μg/L arsenic. There were no Bonferroni-significant interactions with other chemicals, after accounting for the large number of chemicals tested as modifiers. CONCLUSIONS: In our analysis of groundwater chemistry data from 1998/99 and fasting blood glucose outcomes measured in nearby populations approximately a decade later, there was no overall association of fasting blood glucose with nearby historical groundwater arsenic. This null association was not significantly modified by the historical levels of other groundwater chemicals. These null results are inconclusive regarding shorter-term potential toxicity of arsenic for glucose regulation, if there are differences between the historical concentrations measured in nearby groundwater and the actual drinking water chemical exposures in the population during the etiologically relevant period for more acute phenotypes like fasting blood glucose. Drinking water supply-relevant, longitudinal exposure assessment with less measurement error is needed to more precisely evaluate the joint impacts of drinking water chemicals and establish if there is a sensitive time window for glycemic outcomes.
GOAL: The goal of this study was to evaluate the association between groundwater arsenic and fasting blood glucose in the context of other groundwater chemicals, in Bangladesh. METHODS: Fasting blood glucose, gender, body mass index, sociodemographic variables, and diabetes medication use were measured among adults ≥ 35 years of age (n = 6587) participating in the Bangladesh Demographic and Health Survey (BDHS) 2011. Groundwater chemicals in 3534 well water samples were measured in the British Geological Survey (BGS) and Department of Public Health Engineering (DPHE) 1998-99 survey. We assigned the nearest BGS-DPHE well's chemical exposure to each BDHS participant. We used survey-estimation linear regression methods to model natural log-transformed fasting blood glucose, among those using groundwater as their primary drinking-water source, as a function of groundwater arsenic. We considered possible interactions between categorical arsenic exposure and each of 14 other groundwater chemicals dichotomized at their medians. The chemicals considered as possible effect modifiers included: aluminum, barium, calcium, iron, potassium, lithium, magnesium, manganese, sodium, phosphorous, silicon, sulfate, strontium, and zinc. RESULTS: Compared to persons exposed to groundwater arsenic ≤ 10 μg/L, the adjusted geometric mean ratio (GMR) of fasting blood glucose was 1.01 (95% confidence interval: 0.98, 1.04) for individuals exposed to groundwater arsenic concentrations > 10 μg/L and ≤ 50 μg/L, and was 1.01 (0.97, 1.03) for those with > 50 μg/L arsenic. There were no Bonferroni-significant interactions with other chemicals, after accounting for the large number of chemicals tested as modifiers. CONCLUSIONS: In our analysis of groundwater chemistry data from 1998/99 and fasting blood glucose outcomes measured in nearby populations approximately a decade later, there was no overall association of fasting blood glucose with nearby historical groundwater arsenic. This null association was not significantly modified by the historical levels of other groundwater chemicals. These null results are inconclusive regarding shorter-term potential toxicity of arsenic for glucose regulation, if there are differences between the historical concentrations measured in nearby groundwater and the actual drinking water chemical exposures in the population during the etiologically relevant period for more acute phenotypes like fasting blood glucose. Drinking water supply-relevant, longitudinal exposure assessment with less measurement error is needed to more precisely evaluate the joint impacts of drinking water chemicals and establish if there is a sensitive time window for glycemic outcomes.
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Authors: Matthew O Gribble; Ciprian M Crainiceanu; Barbara V Howard; Jason G Umans; Kevin A Francesconi; Walter Goessler; Ying Zhang; Ellen K Silbergeld; Eliseo Guallar; Ana Navas-Acien Journal: Environ Health Date: 2013-12-09 Impact factor: 5.984
Authors: Abu Mohd Naser; Thomas F Clasen; Stephen P Luby; Mahbubur Rahman; Leanne Unicomb; Kazi M Ahmed; Solaiman Doza; Shadassa Ourshalimian; Howard H Chang; Jennifer D Stowell; K M Venkat Narayan; Mohammad Shamsudduha; Shivani A Patel; Bethany O'Shea; Matthew O Gribble Journal: Int J Environ Res Public Health Date: 2019-06-28 Impact factor: 3.390