Established causes of diabetes do not fully explain the present epidemic. High-level arsenic exposure has been implicated in diabetes risk, but the effect of low-level arsenic exposure in drinking water remains unclear.
We sought to determine whether long-term exposure to low-level arsenic in drinking water in Denmark is associated with an increased risk of diabetes using a large prospective cohort.
During 1993-1997, we recruited 57,053 persons. We followed each cohort member for diabetes occurrence from enrollment until 31 December 2006. We traced and geocoded residential addresses of the cohort members and used a geographic information system to link addresses with water-supply areas. We estimated individual exposure to arsenic using all addresses from 1 January 1971 until the censoring date. Cox proportional hazards models were used to model the association between arsenic exposure and diabetes incidence, separately for two definitions of diabetes: all cases and a more strict definition in which cases of diabetes based solely on blood glucose results were excluded.
Over a mean follow-up period of 9.7 years for 52,931 eligible participants, there were a total of 4,304 (8.1%) diabetes cases, and 3,035 (5.8%) cases of diabetes based on the more strict definition. The adjusted incidence rate ratios (IRRs) per 1-µg/L increment in arsenic levels in drinking water were as follows: IRR = 1.03 (95% CI: 1.01, 1.06) and IRR = 1.02 (95% CI: 0.99, 1.05) for all and strict diabetes cases, respectively.
Long-term exposure to low-level arsenic in drinking water may contribute to the development of diabetes.
Cites: Environ Res. 2007 Jul;104(3):383-917475235
Cites: J Epidemiol Community Health. 2014 Feb;68(2):176-8424133074
Cites: Scand J Public Health. 2007;35(4):432-4117786808
Cites: Toxicol Appl Pharmacol. 2007 Dec 1;225(2):123-3317936320
Cites: Am J Epidemiol. 2013 May 1;177(9):962-923504692
Cites: Int J Epidemiol. 1991 Dec;20(4):906-121800429
Cites: Int J Epidemiol. 1991 Dec;20(4):900-51800428