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Reducción de la exposición al arsénico y mortalidad por enfermedades crónicas
Fen Wu1, Alexander van Geen2, Joseph Graziano3
1Department of Population Health, New York University Grossman School of Medicine, New York.
JAMA
|November 17, 2025
Resumen
La reducción de la exposición al arsénico del agua potable está relacionada con una menor mortalidad por enfermedades crónicas como el cáncer y las enfermedades cardiovasculares. Este estudio muestra que la disminución de los niveles de arsénico se correlaciona con mejores resultados de salud a largo plazo.
Área de la Ciencia:
- Salud del medio ambiente
- Toxicología
- Epidemiología
Sus antecedentes:
- La exposición crónica al arsénico a través del agua potable es una preocupación importante para la salud pública, relacionada con un aumento de la mortalidad por enfermedades crónicas.
- Existen pruebas limitadas sobre los beneficios para la salud de reducir la exposición al arsénico en las poblaciones afectadas.
Objetivo del estudio:
- Investigar la asociación entre la reducción de la exposición al arsénico, medida por los niveles de arsénico en la orina, y el riesgo de mortalidad por enfermedades crónicas, incluido el cáncer y las enfermedades cardiovasculares (ECV).
Principales métodos:
- Estudio de cohorte prospectivo en Bangladesh (n=10 977) con mediciones repetidas de los niveles de arsénico urinario a lo largo del tiempo (2000-2018).
- Los esfuerzos de mitigación a nivel comunitario redujeron la exposición al arsénico.
- Para evaluar el riesgo de mortalidad asociado a los cambios en la exposición al arsénico, se utilizaron análisis de regresión de Cox variables en el tiempo y análisis de espina cúbica restringida.
Principales resultados:
- Cada disminución del intervalo interquartil (IQR) en el arsénico urinario se asoció con una reducción del 22% en la mortalidad por enfermedades crónicas, del 20% en la mortalidad por cáncer y del 23% en la mortalidad por ECV.
- Los participantes cuyos niveles de arsénico urinario disminuyeron por debajo de la mediana mostraron tasas de mortalidad significativamente más bajas en comparación con aquellos con niveles consistentemente altos.
- Las reducciones en la exposición al arsénico se relacionaron constantemente con una menor mortalidad, mientras que los aumentos se asociaron con un mayor riesgo.
Conclusiones:
- La exposición reducida al arsénico, incluso después de la exposición crónica, se asocia con reducciones significativas en la mortalidad por enfermedades crónicas.
- Estos hallazgos ponen de relieve la importancia de las intervenciones de salud pública destinadas a reducir los niveles de arsénico en el agua potable para mejorar los resultados de salud de la población.
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