Exploring the Association of low-level inorganic arsenic (iAs) exposure from rice with age-standardized mortality risk from cardiovascular disease (CVD) in England and Wales
PHE ePoster Library. Xu L. Sep 10, 2018; 221305; 99
Lingqian Xu
Lingqian Xu
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Abstract Adverse health outcomes, including death from cardiovascular disease (CVD), arising from chronic exposure to inorganic arsenic (iAs) are well documented. Consumption of rice is a major iAs exposure route for over 3,000,000,000 people. However, there is a lack of epidemiological evidence demonstrating such mortality due to CVD from rice consumption.We explored this potential association through an ecological study using health and social data at the local authority level across England and Wales. Age-standardised mortality rates (ASMR) from CVD were calculated with reference to the European Standard Population. iAs exposure from rice (iAsRICE) was estimated using ONS reported ethnicity as a proxy for class of rice consumption. The utility of both generalized linear and least-squared non-linear models were explored categorically and continuously, using AICc as the principle model selection criterion.No simple direct significant association was found between CVD ASMR and iAsRICE. However, high rice consumption rates and hence high iAsRICE were associated with trends in behavioural and socioeconomic characteristics known to be protective against CVD, viz. lower smoking prevalence, lower obesity, higher economic and higher educational status. When corrected for such significant confounders, we observed a significant positive association between CVD ASMR and iAsRICE. In this model, CVD ASMR in the highest quartile of exposure (1.3-9.5 µg/day) was found to be 1.06 (1.02, 1.10; p-trend<0.001) times higher than that in the lowest quartile (< 0.9 µg/day). This is somewhat higher than expected from studies of CVD mortalities arising from iAs exposure from water, suggesting further model exploration is indicated. External funding details LX acknowledges with thanks funding from a University of Manchester President Doctoral Scholarship (October 2017 - September 2020).
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