Prospective cohort study of respiratory effects at ages 14 to 26 following early life exposure to arsenic in drinking water

Md Alfazal Khan, Meera Hira-Smith, Syed Imran Ahmed, Mohammad Yunus, S. M.Tafsir Hasan, Jane Liaw, John Balmes, Rubhana Raqib, Yan Yuan, David Kalman, Taehyun Roh, Craig Steinmaus, Allan H. Smith

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Background: We previously reported chronic respiratory effects in children who were then 7-17 years of age in Matlab, Bangladesh. One group of children had been exposed to high concentrations of arsenic in drinking water in utero and early childhood (average 436 g/L), and the other group of children were never known to have been exposed to >10 g/L. The exposed children, both males and females, had marked increases in chronic respiratory symptoms. Methods: The current study involves a further follow-up of these children now 14-26 years of age with 463 located and agreeing to participate. They were interviewed for respiratory symptoms and lung function was measured. Data were collected on smoking, body mass index (BMI), and number of rooms in the house as a measure of socioeconomic status. Results: Respiratory effects were still present in males but not females. In the high exposure group (>400 g/L in early life) the odds ratio (OR) among male participants for dry cough in the last 12 months was 2.36 (95% confidence interval [CI] = 1.21, 4.63, P = 0.006) and for asthma OR = 2.51 (95% CI = 1.19, 5.29, P = 0.008). Forced vital capacity (FVC) was reduced in males in the early life high-exposure group compared with those never exposed (-95ml, P = 0.04), but not in female participants. Conclusions: By the age range 14-26, there was little remaining evidence of chronic respiratory effects in females but pronounced effects persisted in males. Mechanisms for the marked male female differences warrant further investigation along with further follow-up to see if respiratory effects continue in males.

Original languageEnglish (US)
Article number00007
JournalEnvironmental Epidemiology
Issue number2
StatePublished - 2020


  • Arsenic
  • Children
  • Early life exposure
  • In utero
  • Lung function
  • Pulmonary
  • Respiratory

ASJC Scopus subject areas

  • Epidemiology
  • Global and Planetary Change
  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


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