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Denise Riedel Lewis,¹ J. Wanless Southwick,² Rita Ouellet-Hellstrom,² Jerry Rench,² and Rebecca L. Calderon¹

¹U.S. Environmental Protection Agency, National Health and Environmental Effects Research Laboratory, Human Studies Division, Research Triangle Park, NC 27711 USA
²SRA Technologies, Inc., Falls Church, VA 22042 USA

Abstract

The association of drinking water arsenic and mortality outcome was investigated in a cohort of residents from Millard County, Utah. Median drinking water arsenic concentrations for selected study towns ranged from 14 to 166 ppb and were from public and private samples collected and analyzed under the auspices of the State of Utah Department of Environmental Quality, Division of Drinking Water. Cohort members were assembled using historical documents of the Church of Jesus Christ of Latter-day Saints. Standard mortality ratios (SMRs) were calculated. Using residence history and median drinking water arsenic concentration, a matrix for cumulative arsenic exposure was created. Without regard to specific exposure levels, statistically significant findings include increased mortality from hypertensive heart disease [SMR = 2.20 ; 95% confidence interval (CI) , 1.36-3.36], nephritis and nephrosis (SMR = 1.72 ; CI, 1.13-2.50) , and prostate cancer (SMR = 1.45 ; CI, 1.07-1.91) among cohort males. Among cohort females, statistically significant increased mortality was found for hypertensive heart disease (SMR = 1.73 ; CI, 1.11-2.58) and for the category of all other heart disease, which includes pulmonary heart disease, pericarditis, and other diseases of the pericardium (SMR = 1.43 ; CI, 1.11-1.80) . SMR analysis by low, medium, and high arsenic exposure groups hinted at a dose relationship for prostate cancer. Although the SMRs by exposure category were elevated for hypertensive heart disease for both males and females, the increases were not sequential from low to high groups. Because the relationship between health effects and exposure to drinking water arsenic is not well established in U.S. populations, further evaluation of effects in low-exposure populations is warranted. Key words: arsenic, cancer, cohort studies, drinking water, epidemiologic studies, mortality, noncancer, standardized mortality ratio, United States, Utah. Environ Health Perspect 107:359-365 (1999) . [Online 26 March 1999]

http://ehpnet1.niehs.nih.gov/docs/1999/107p359-365lewis/ abstract.html

Address correspondence to D.R. Lewis, U.S. Environmental Protection Agency, NHEERL, Human Studies Division, MD-58A, Research Triangle Park, NC 27711 USA. J. Rench is currently with RTI, Inc., Rockville, MD 20852 USA.

The further study of this population was a direct recommendation of panelists from the EPA-sponsored workshop "Arsenic in Drinking Water" held on 8 March 1994 in Research Triangle Park, North Carolina. Panel members were Carol Angle, Dennis Clifford, Gunther Craun, Phil Enterline, Floyd Frost, and Craig Schnell. We thank David Thomas, Elaina Kenyon, and Larry Scanlan for their contributions.

The views expressed in this article are those of the individual authors and do not necessarily reflect the views and policies of the EPA. The research described in this article has been supported by the EPA through contract 68-D2-0187. It has been subject to the agency's peer and administrative review, and it has been approved for publication. Mention of trade names or commercial products does not constitute endorsement or recommendation for use.

Received 27 October 1998 ; accepted 15 January 1999.