Intended for healthcare professionals


Arsenic in drinking water

BMJ 2011; 342 doi: (Published 05 May 2011) Cite this as: BMJ 2011;342:d2248
  1. Allan H Smith, professor of epidemiology1,
  2. Craig M Steinmaus, public health medical officer2
  1. 1University of California, Berkeley, School of Public Health, Berkeley, CA 94720, USA
  2. 2California Office of Environmental Health Hazard Assessment, Oakland, California, USA
  1. ahsmith{at}

Increases mortality from cardiovascular disease

Arsenic has more effects on health than any other toxicant, and the list continues to grow, along with evidence that exposure is widespread throughout the world. Ingestion of inorganic arsenic in drinking water causes cancer of the skin, bladder, lung, liver, and kidney.1 2 Mounting evidence suggests that arsenic is also a cause of chronic respiratory disease,3 4 and adverse effects on reproductive outcomes and child development have also been reported.5 6 In the linked cohort study (doi:10.1136/bmj.d2431), Yu Chen and colleagues add to the evidence that arsenic in water increases mortality from cardiovascular disease with the findings of their prospective cohort study in Bangladesh.7

The first evidence of a link between cardiovascular disease and arsenic in drinking water came in 1980 from Antofagasta, Chile, with a report of 17 deaths from myocardial infarction in people under the age of 40.8 Later, a comprehensive body of evidence from a series of studies in Taiwan starting in 1988 found that arsenic in water …

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