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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2005.078816v1 97/5/825    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Web of Science (7) Citing Articles via Google Scholar Google Scholar Articles by Argos, M. Articles by Ahsan, H. Search for Related Content PubMed PubMed Citation Articles by Argos, M. Articles by Ahsan, H. Related Collections Epidemiology Global Health Asians Cancer

Maria Argos, MPH, Faruque Parvez, MPH, Yu Chen, PhD, A.Z.M. Iftikhar Hussain, MD, MPH, Hassina Momotaj, MD, MPH, Geoffrey R. Howe, PhD, Joseph H. Graziano, PhD and Habibul Ahsan, MD, MMedSc

Maria Argos is with the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY. Faruque Parvez is with the Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York. At the time of the study, Yu Chen and Geoffrey R. Howe were with the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York. A.Z.M. Iftikhar Hussain and Hassina Momotaj were with the National Institute of Preventive and Social Medicine, Dhaka, Bangladesh. Joseph H. Graziano is with the Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, and the College of Physicians and Surgeons, Columbia University, New York. Habibul Ahsan is with the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, and the Herbert Irving Comprehensive Cancer Center, Columbia University, New York.

Correspondence: Requests for reprints should be sent to Habibul Ahsan, MD, MMedSc, Department of Health Studies, University of Chicago, 5841 S Maryland Ave, MC 2007, Chicago, IL 60637 (e-mail: habib{at}uchicago.edu).

Objectives. Arsenic contamination of groundwater is a severe public health crisis in Bangladesh, where the population is exposed to arsenic in drinking water through tube wells used for groundwater collection. In this study, we explored the association between socioeconomic status and arsenic toxicity.

Methods. We used baseline data from 11438 men and women who were recruited into the Health Effects of Arsenic Longitudinal Study (HEALS), a prospective cohort study on the health effects of arsenic exposure in Bangladesh. We conducted analyses with logistic regression and generalized estimating equations.

Results. We found a strong dose–response association with all measures of arsenic exposure and skin lesions. We also found that the effect of arsenic was modified by land ownership on a multiplicative scale, with an increased risk among non–land owners associated with well water arsenic (P=.04) and urinary total arsenic concentrations (P=.03).

Conclusions. Our study provides insight into potentially modifiable host characteristics and identifies factors that may effectively target susceptible population subgroups for appropriate interventions.