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Arsenic Exposure and Oral Cavity Lesions in Bangladesh

Syed, Emdadul H. PhD; Melkonian, Stephanie MS; Poudel, Krishna C. PhD; Yasuoka, Junko PhD; Otsuka, Keiko MD; Ahmed, Alauddin MBBS; Islam, Tariqul MBBS, MPH; Parvez, Faruque PhD; Slavkovich, Vesna MS; Graziano, Joseph H. PhD; Ahsan, Habibul MD, MMedSc; Jimba, Masamine MD, PhD

Journal of Occupational and Environmental Medicine: January 2013 - Volume 55 - Issue 1 - p 59–66
doi: 10.1097/JOM.0b013e31826bb686
Original Articles

Objective: To evaluate the relationship between arsenic exposure and oral cavity lesions among an arsenic-exposed population in Bangladesh.

Methods: We carried out an analysis utilizing the baseline data of the Health Effects of Arsenic Exposure Longitudinal Study, which is an ongoing population-based cohort study to investigate health outcomes associated with arsenic exposure via drinking water in Araihazar, Bangladesh. We used multinomial regression models to estimate the risk of oral cavity lesions.

Results: Participants with high urinary arsenic levels (286.1 to 5000.0 μg/g) were more likely to develop arsenical lesions of the gums (multinomial odds ratio = 2.90; 95% confidence interval, 1.11 to 7.54), and tongue (multinomial odds ratio = 2.79; 95% confidence interval, 1.51 to 5.15), compared with those with urinary arsenic levels of 7.0 to 134.0 μg/g.

Conclusions: Higher level of arsenic exposure was positively associated with increased arsenical lesions of the gums and tongue.

From the Department of Community and Global Health (Drs Syed, Poudel, Yasuoka, Otsuka, and Jimba), Graduate School of Medicine, University of Tokyo, Tokyo, Japan; Department of Health Studies (Ms Melkonian and Dr Ahsan), Department of Medicine (Dr Ahsan), Department of Human Genetics (Dr Ahsan), and Cancer Research Center (Dr Ahsan), University of Chicago, Chicago, Ill; Mailman School of Public Health (Drs Parvez and Graziano and Ms Slavkovich), Columbia University, New York, NY; Columbia University and University of Chicago Research Office in Bangladesh (Drs Ahmed and Islam), Mohakhali, Dhaka, Bangladesh.

Address correspondence to: Prof. Masamine Jimba, MD, PhD, Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan (

This research was supported by grants P42ES10349, P30ES09089, and ES000260 from the National Institute of Environmental Health Sciences, and grants R01CA107431, R01CA102484, and CA016087 from the National Institutes of Health.

The authors declare that they have no competing financial interests.

Copyright © 2013 by the American College of Occupational and Environmental Medicine