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Pre- and Postnatal Arsenic Exposure and Body Size to 2 Years of Age: A Cohort Study in Rural Bangladesh

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      Background: Exposure to arsenic via drinking water has been associated with adverse pregnancy outcomes and infant morbidity and mortality. Little is known, however, about the effects of arsenic on child growth.Objective: We assessed potential effects of early-life arsenic exposure on weight and length of children from birth to 2 years of age.Methods: We followed 2,372 infants born in a population-based intervention trial in rural Bangladesh. Exposure was assessed by arsenic concentrations in urine (U-As) of mothers (gestational weeks 8 and 30) and children (18 months old). Child anthropometry was measured monthly in the first year and quarterly in the second. Linear regression models were used to examine associations of U-As (by quintiles) with child weight and length, adjusted for age, maternal body mass index, socioeconomic status, and sex (or stratified by sex).Results: Median (10th–90th percentiles) U-As concentrations were about 80 (25–400) µg/L in the mothers and 34 (12–159) µg/L in the children. Inverse associations of maternal U-As with child’s attained weight and length at 3–24 months were markedly attenuated after adjustment. However, associations of U-As at 18 months with weight and length at 18–24 months were more robust, particularly in girls. Compared with girls in the first quintile of U-As (< 16 µg/L), those in the fourth quintile (26–46 µg/L) were almost 300 g lighter and 0.7 cm shorter, and had adjusted odds ratios (95% confidence interval) for underweight and stunting of 1.57 (1.02–2.40) and 1.58 (1.05–2.37), respectively, at 21 months.Conclusions: Postnatal arsenic exposure was associated with lower body weight and length among girls, but not boys.

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      Most cited references 38

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      Developmental potential in the first 5 years for children in developing countries

      Summary Many children younger than 5 years in developing countries are exposed to multiple risks, including poverty, malnutrition, poor health, and unstimulating home environments, which detrimentally affect their cognitive, motor, and social-emotional development. There are few national statistics on the development of young children in developing countries. We therefore identified two factors with available worldwide data—the prevalence of early childhood stunting and the number of people living in absolute poverty—to use as indicators of poor development. We show that both indicators are closely associated with poor cognitive and educational performance in children and use them to estimate that over 200 million children under 5 years are not fulfilling their developmental potential. Most of these children live in south Asia and sub-Saharan Africa. These disadvantaged children are likely to do poorly in school and subsequently have low incomes, high fertility, and provide poor care for their children, thus contributing to the intergenerational transmission of poverty.
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        Water Arsenic Exposure and Intellectual Function in 6-Year-Old Children in Araihazar, Bangladesh

        Background We recently reported results of a cross-sectional investigation of intellectual function in 10-year-olds in Bangladesh, who had been exposed to arsenic from drinking water in their home wells. Objectives We present results of a similar investigation of 301 randomly selected 6-year-olds whose parents participated in our ongoing prospective study of the health effects of As exposure in 12,000 residents of Araihazar, Bangladesh. Methods Water As and manganese concentrations of tube wells at each home were obtained by surveying all study region wells. Children and mothers were first visited at home, where the quality of home stimulation was measured, and then seen in our field clinic, where children received a medical examination wherein weight, height, and head circumference were assessed. We assessed children’s intellectual function using subtests drawn from the Wechsler Preschool and Primary Scale of Intelligence, version III, by summing weighted items across domains to create Verbal, Performance, Processing Speed, and Full-Scale raw scores. Children provided urine specimens for measuring urinary As and were asked to provide blood samples for blood lead measurements. Results Exposure to As from drinking water was associated with reduced intellectual function before and after adjusting for water Mn, for blood lead levels, and for sociodemographic features known to contribute to intellectual function. With covariate adjustment, water As remained significantly negatively associated with both Performance and Processing Speed raw scores; associations were less strong than in our previously studied 10-year-olds. Conclusion This second cross-sectional study of As exposure expands our concerns about As neurotoxicity to a younger age group.
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          Urinary arsenic concentration adjustment factors and malnutrition.

          This study aims at evaluating the suitability of adjusting urinary concentrations of arsenic, or any other urinary biomarker, for variations in urine dilution by creatinine and specific gravity in a malnourished population. We measured the concentrations of metabolites of inorganic arsenic, creatinine and specific gravity in spot urine samples collected from 1466 individuals, 5-88 years of age, in Matlab, rural Bangladesh, where arsenic-contaminated drinking water and malnutrition are prevalent (about 30% of the adults had body mass index (BMI) below 18.5 kg/m(2)). The urinary concentrations of creatinine were low; on average 0.55 g/L in the adolescents and adults and about 0.35 g/L in the 5-12 years old children. Therefore, adjustment by creatinine gave much higher numerical values for the urinary arsenic concentrations than did the corresponding data expressed as microg/L, adjusted by specific gravity. As evaluated by multiple regression analyses, urinary creatinine, adjusted by specific gravity, was more affected by body size, age, gender and season than was specific gravity. Furthermore, urinary creatinine was found to be significantly associated with urinary arsenic, which further disqualifies the creatinine adjustment.

            Author and article information

            [1 ]International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
            [2 ]International Food Policy Research Institute, Washington, DC, USA
            [3 ]Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
            [4 ]Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
            Author notes
            Address correspondence to M. Vahter, Institute of Environmental Medicine, Karolinska Institutet, Box 210, S-171 77 Stockholm, Sweden. Telephone: 46 8 52487540. Fax: 46 8 336981. E-mail: Marie.Vahter@
            Environ Health Perspect
            Environ. Health Perspect
            Environmental Health Perspectives
            National Institute of Environmental Health Sciences
            13 April 2012
            August 2012
            : 120
            : 8
            : 1208-1214

            This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.



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