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      Water Arsenic Exposure and Children’s Intellectual Function in Araihazar, Bangladesh

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          Abstract

          Exposure to arsenic has long been known to have neurologic consequences in adults, but to date there are no well-controlled studies in children. We report results of a cross-sectional investigation of intellectual function in 201 children 10 years of age whose parents participate in our ongoing prospective cohort study examining health effects of As exposure in 12,000 residents of Araihazar, Bangladesh. Water As and manganese concentrations of tube wells at each child’s home were obtained by surveying all wells in the study region. Children and mothers came to our field clinic, where children received a medical examination in which weight, height, and head circumference were measured. Children’s intellectual function on tests drawn from the Wechsler Intelligence Scale for Children, version III, was assessed by summing weighted items across domains to create Verbal, Performance, and Full-Scale raw scores. Children provided urine specimens for measuring urinary As and creatinine and were asked to provide blood samples for measuring blood lead and hemoglobin concentrations. Exposure to As from drinking water was associated with reduced intellectual function after adjustment for sociodemographic covariates and water Mn. Water As was associated with reduced intellectual function, in a dose–response manner, such that children with water As levels > 50 μg/L achieved significantly lower Performance and Full-Scale scores than did children with water As levels < 5.5 μg/L. The association was generally stronger for well-water As than for urinary As.

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          Most cited references27

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          Exposure to arsenic and lead and neuropsychological development in Mexican children.

          This cross-sectional study examined the effects of chronic exposure to lead (Pb), arsenic (AS) and undernutrition on the neuropsychological development of children. Two populations chronically exposed to either high (41 children) or low (39 children) levels of As and Pb were analyzed using the Wechsler Intelligence Scale for Children, Revised Version, for México (WISC-RM). Geometric means of urinary arsenic (AsU) and lead in blood (PbB) were 62.9+/-0.03 (microgAs/g creatinine) and 8.9+/-0.03 (microg/dl) for the exposed group and 40.2+/-0.03 (microgAs/g creatinine) and 9.7+/-0.02 (microg/dl) for the reference group. The height for age index (HAI) was used as an indicator of chronic malnutrition and sociodemographic information was obtained with a questionnaire. Lead and arsenic were measured by atomic absorption spectrophotometry. Data on full, verbal, and performance intelligence quotients (IQ) scores, long-term memory, linguistic abstraction, attention span, and visuospatial organization were obtained through the WISC-RM. After controlling for significant potential confounders verbal IQ (P<0.01) decreased with increasing concentrations of AsU. The HAI correlated positively with full-scale and performance IQ (P<0.01). Higher levels of AsU were significantly related to poorer performance on WISC-RM factors examining long-term memory and linguistic abstraction, while lower scores in WISC-RM factors measuring attention were obtained at increasing values of PbB. Our results suggest that exposure to As and chronic malnutrition could have an influence on verbal abilities and long-term memory, while Pb exposure could affect the attention process even at low levels. Copyright 2001 Academic Press.
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            Spatial variability of arsenic in 6000 tube wells in a 25 km2area of Bangladesh

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              The effects of chronic arsenic exposure from drinking water on the neurobehavioral development in adolescence.

              This cross-sectional study examined the possible influence on the development of cognitive function among adolescents due to long-term arsenic exposure. Forty-nine junior school students drinking arsenic-containing well water and 60 controls matched with age, sex, education, body height, body weight, body mass index, and socioeconomic status were compared. The former was divided into two groups: high and low exposure, with mean cumulative arsenic levels of 520629.0+/-605824.2 and 13782.2+/-12886.0 ppm, respectively. Four neurobehavioral tests including continuous performance test (CPT), symbol digit (SD), pattern memory (PM) and switching attention (SA) were applied. A strong correlation between age and education caused collinearity in the multiple regression model (r=0.84, P<0.0001). Only education and sex, excluding age, were entered into the model as covariates. Pattern memory and switching attention were significantly affected by long-term cumulative exposure to arsenic after adjusting for education and sex. It is suggested that the arsenic levels in the well water may be monitored extensively, but if there is no intervention, then neurobehavioral function will not be protected. Limitations of the current study require replication of this effect in other studies to confirm this conclusion.
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                Author and article information

                Journal
                Environ Health Perspect
                Environmental Health Perspectives
                National Institue of Environmental Health Sciences
                0091-6765
                September 2004
                28 April 2004
                : 112
                : 13
                : 1329-1333
                Affiliations
                1Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, USA
                2New York State Psychiatric Institute, New York, New York, USA
                3Mailman School of Public Health and
                4Lamont-Doherty Earth Observatory, Columbia University, New York, New York, USA
                5National Institute of Preventive and Social Medicine, Dhaka, Bangladesh
                6Columbia University Bangladesh Arsenic Project, New York, New York, USA
                Author notes
                Address correspondence to G.A. Wasserman, New York State Psychiatric Institute, 1051 Riverside Dr., Unit 78, New York, NY 10032 USA. Telephone (212) 543-5296. Fax (212) 543-1000. E-mail: wassermg@childpsych.columbia.edu

                We thank J. Kline for her epidemiologic contributions. We also acknowledge our Bangladeshi field staff and the people of Araihazar.

                This work was supported by National Institute of Environmental Health Sciences grants P42 ES 10349, P30 ES 09089, the Mailman School of Public Health, and the Earth Institute at Columbia University.

                The authors declare they have no competing financial interests.

                Article
                ehp0112-001329
                10.1289/ehp.6964
                1247525
                15345348
                5a7f2f70-4b77-4d3e-b48c-d61474bec5d0
                This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original DOI.
                History
                : 14 January 2004
                : 28 April 2004
                Categories
                Children's Health
                Articles

                Public health
                arsenic,children,iq
                Public health
                arsenic, children, iq

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