2007). An ecologic study comparing the arsenic-exposed city of

Antofagasta to other regions of Chile found that those exposed in early life had higher death rates from lung cancer (standardized mortality ratio (SMR) = 6.1, 95% CI 3.5–9.9), bronchiectasis (SMR = 46.2, 95% CI 21.1–87.7), and other COPD (SMR = 7.6, 95% CI 3.1–15.6) in adulthood (Smith et al. 2006). These learn more studies all support our results linking early-life arsenic ingestion to long-term respiratory effects. Our results are consistent with the 2 previously published studies of ingested arsenic and lung function in people with probable adult exposures. In a study involving 31 subjects in Bangladesh, urinary arsenic concentration (indicative of current exposure) was inversely associated with percent predicted FEV1 and FVC (Parvez et al. 2008). In 287 subjects from West Bengal, India, men with arsenic-caused skin lesions had 256 selleck inhibitor and 288 ml lower FEV1 and FVC, respectively, than those without skin lesions or known high arsenic exposures (von Ehrenstein et al. 2005). The FEV1 deficits were much smaller in women (64 ml). We also found much smaller effects in women (17-ml FEV1 reduction

versus 440 ml for men). Other studies have reported greater arsenic-associated health effects in men (Marshall et al. 2007; Rahman et al. 2006), perhaps due to sex-related differences in arsenic metabolism, water intake, occupational and other exposures (Hertz-Picciotto et al. 1992; Lindberg et al. 2010; Vahter 2009). selleck kinase inhibitor The greater effects observed in men in Dolutegravir mw this study were not

likely due to interactions with smoking since larger arsenic-associated lung function deficits were seen in never smokers, yet men smoked more than women in terms of the proportion of ever smokers (71% vs. 63%), pack-years (5.2 vs. 4.0), and cigarettes per day (4.2 vs. 3.4). Strengths of our study include the accuracy of data on past arsenic exposure. In other places with widespread exposure, the abundance of private wells and other water sources, coupled with a lack of historical arsenic records, makes studies of long-term health effects much more difficult. By contrast, northern Chile has limited water sources and has arsenic records dating back more than 50 years, providing a unique opportunity to study the long-term impacts of exposure. The main limitation of this study is the convenience method of participant recruitment, raising concerns about inference and interpretation of results. Although the problem of arsenic in drinking water in northern Chile has been publicized, most information has been on cancer. Our experience is that very few people in the study cities know about the possible role of arsenic in non-malignant respiratory disease.