A prospective study of arsenic exposure from drinking water and incidence of skin lesions in Bangladesh

Maria Argos, Tara Kalra, Brandon L. Pierce, Yu Chen, Faruque Parvez, Tariqul Islam, Alauddin Ahmed, Rabiul Hasan, Khaled Hasan, Golam Sarwar, Diane Levy, Vesna Slavkovich, Joseph H. Graziano, Paul J. Rathouz, Habibul Ahsan

Research output: Contribution to journalArticlepeer-review


Elevated concentrations of arsenic in groundwater pose a public health threat to millions of people worldwide. The authors aimed to evaluate the association between arsenic exposure and skin lesion incidence among participants in the Health Effects of Arsenic Longitudinal Study (HEALS). The analyses used data on 10,182 adults free of skin lesions at baseline through the third biennial follow-up of the cohort (2000-2009). Discrete-time hazard regression models were used to estimate hazard ratios and 95% confidence intervals for incident skin lesions. Multivariate-adjusted hazard ratios for incident skin lesions comparing 10.1-50.0, 50.1-100.0, 100.1-200.0, and ≥200.1 μg/L with ≤10.0 μg/L of well water arsenic exposure were 1.17 (95% confidence interval (CI): 0.92, 1.49), 1.69 (95% CI: 1.33, 2.14), 1.97 (95% CI: 1.58, 2.46), and 2.98 (95% CI: 2.40, 3.71), respectively (Ptrend = 0.0001). Results were similar for the other measures of arsenic exposure, and the increased risks remained unchanged with changes in exposure in recent years. Dose-dependent associations were more pronounced in females, but the incidence of skin lesions was greater in males and older individuals. Chronic arsenic exposure from drinking water was associated with increased incidence of skin lesions, even at low levels of arsenic exposure (<100 μg/L).

Original languageEnglish (US)
Pages (from-to)185-194
Number of pages10
JournalAmerican Journal of Epidemiology
Issue number2
StatePublished - Jul 15 2011


  • Bangladesh
  • arsenic
  • cohort studies
  • environmental exposure
  • keratosis
  • melanosis

ASJC Scopus subject areas

  • General Medicine


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