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Correction published on 2 December 2020, see Int. J. Environ. Res. Public Health 2020, 17(23), 8947.
Review

Positive Association of Cardiovascular Disease (CVD) with Chronic Exposure to Drinking Water Arsenic (As) at Concentrations below the WHO Provisional Guideline Value: A Systematic Review and Meta-analysis

1
Department of Earth and Environmental Sciences and Williamson Research Centre for Molecular Environmental Science, University of Manchester, Manchester M13 9PL, UK
2
School of Science, Engineering and Environment, University of Salford, Salford M5 4WT, UK
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(7), 2536; https://doi.org/10.3390/ijerph17072536
Received: 19 March 2020 / Revised: 4 April 2020 / Accepted: 6 April 2020 / Published: 7 April 2020
(This article belongs to the Special Issue Arsenic Exposure in Environment and Human Health)
To the best of our knowledge, a dose-response meta-analysis of the relationship between cardiovascular disease (CVD) and arsenic (As) exposure at drinking water As concentrations lower than the WHO provisional guideline value (10 µg/L) has not been published yet. We conducted a systematic review and meta-analyses to estimate the pooled association between the relative risk of each CVD endpoint and low-level As concentration in drinking water both linearly and non-linearly using a random effects dose-response model. In this study, a significant positive association was found between the risks of most CVD outcomes and drinking water As concentration for both linear and non-linear models (p-value for trend < 0.05). Using the preferred linear model, we found significant increased risks of coronary heart disease (CHD) mortality and CVD mortality as well as combined fatal and non-fatal CHD, CVD, carotid atherosclerosis disease and hypertension in those exposed to drinking water with an As concentration of 10 µg/L compared to the referent (drinking water As concentration of 1 µg/L) population. Notwithstanding limitations included, the observed significant increased risks of CVD endpoints arising from As concentrations in drinking water between 1 µg/L and the 10 µg/L suggests further lowering of this guideline value should be considered. View Full-Text
Keywords: arsenic; low level; cardiovascular disease; dose-response; systematic review; meta-analysis arsenic; low level; cardiovascular disease; dose-response; systematic review; meta-analysis
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MDPI and ACS Style

Xu, L.; Mondal, D.; Polya, D.A. Positive Association of Cardiovascular Disease (CVD) with Chronic Exposure to Drinking Water Arsenic (As) at Concentrations below the WHO Provisional Guideline Value: A Systematic Review and Meta-analysis. Int. J. Environ. Res. Public Health 2020, 17, 2536. https://doi.org/10.3390/ijerph17072536

AMA Style

Xu L, Mondal D, Polya DA. Positive Association of Cardiovascular Disease (CVD) with Chronic Exposure to Drinking Water Arsenic (As) at Concentrations below the WHO Provisional Guideline Value: A Systematic Review and Meta-analysis. International Journal of Environmental Research and Public Health. 2020; 17(7):2536. https://doi.org/10.3390/ijerph17072536

Chicago/Turabian Style

Xu, Lingqian, Debapriya Mondal, and David A. Polya. 2020. "Positive Association of Cardiovascular Disease (CVD) with Chronic Exposure to Drinking Water Arsenic (As) at Concentrations below the WHO Provisional Guideline Value: A Systematic Review and Meta-analysis" International Journal of Environmental Research and Public Health 17, no. 7: 2536. https://doi.org/10.3390/ijerph17072536

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