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Related Experiment Video

Updated: Apr 23, 2026

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Inorganic arsenic exposure and modifying factors: a systematic evidence map.

Janice S Lee1, Delia Fleming2, Suryanarayana V Vulimiri1

  • 1US EPA, Office of Research and Development, Center for Public Health and Environmental Assessment, Research Triangle Park, NC 27711 USA.

Human and Ecological Risk Assessment : HERA
|April 22, 2026
PubMed
Summary

Systematic evidence maps (SEM) effectively identified factors modifying inorganic arsenic (iAs) health risks. This approach aids understanding of iAs susceptibility, crucial for public health assessments.

Keywords:
evidence mapinorganic arsenicmodifying factorsrisk assessmentsusceptibilitysystematic review

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Area of Science:

  • Environmental Health
  • Toxicology
  • Epidemiology

Background:

  • Inorganic arsenic (iAs) is a widespread environmental toxicant linked to various human health outcomes, including cancer.
  • Individual susceptibility to iAs-related diseases is influenced by both intrinsic and extrinsic factors.
  • Systematic review screening tools are valuable for organizing chemical-specific scientific literature.

Purpose of the Study:

  • To assess the feasibility and utility of the systematic evidence map (SEM) approach for characterizing literature on factors modifying inorganic arsenic (iAs) health effects.
  • To provide a comprehensive overview of identified modifying factors influencing the relationship between iAs exposure and health outcomes.
  • To explore the breadth of research on iAs exposure and its interaction with various biological and environmental elements.

Main Methods:

  • Conducted a systematic literature search from 2014-2022 across PubMed, Web of Science, and Toxnet.
  • Utilized Populations, Exposures, Comparators, Outcomes (PECO) criteria to identify studies on modifying factors of iAs health effects.
  • Categorized identified studies based on specific modifying factors and, where applicable, health effects.

Main Results:

  • Identified 584 studies meeting the PECO criteria for modifying factors of iAs health effects.
  • Key modifying factors investigated include genetic polymorphisms (n=172), lifestages (n=228), nutritional deficiencies (n=150), and chemical co-exposure (n=104).
  • Other significant factors explored encompass sex, smoking, alcohol consumption, pre-existing conditions, microbiome, and arsenic metabolism.

Conclusions:

  • The systematic evidence map (SEM) method is an effective tool for identifying and categorizing research on factors that modify inorganic arsenic (iAs) health impacts.
  • This approach facilitates a clearer understanding of the complex interactions influencing iAs toxicity.
  • The findings highlight the diverse range of factors that contribute to differential susceptibility to inorganic arsenic, informing future research and risk assessment strategies.