Quantification of arsenic (As) exposure by drinking water in Auvergne (France) in the cardiotox cohort

The role of Arsenic in drinking water (As-DW) has been demonstrated in cancer diseases, and recently in cardiovascular diseases, after prolonged exposure to concentrations above 100 µg As/L.  Cardiotox study is a cohort study performed in the Puy de Dôme (France), a French department characterized by a high rate of mortality and coronary heart diseases (CHD), and also by As-DW above the WHO-Guidelines Value (10 µgAs/L). In 2001, 245 subjects with CHD have been included in this study. The follow-up of Cardiotox has been monitoring over 7 years (2001-2008), Data about the CHD, and also cardiovascular risk factors, dietary habits (specially drinking water), lifestyle, occupation, have been collected by interviews with standardized questionnaires.
Subjects (N = 245 - 57.0 ± 7.3 yrs old) are divided in exposed-group to As-DW (As-aN – n = 57 -  57.6 ± 7.1 yrs old) and in non-exposed to As-DW (As-N : n = 188 - 56.9 ± 7.4 yrs old ) on geographical basis and As-concentration of the water supply. Exposure to As-DW has been assessed for each subject by calculation of the amount provided by the real volumes of water consumed (cold and warm), at home and at work, over the total period of life in the specific areas.
The As-aN group ingested more tap water (cold and hot) and less bottled water, as well at home than at work, than the As-N group, despite warning-messages published by the Public Health Authority. Significant cumulative exposures linked to As-DW are shown (between 294.5 and 354.3 mg As in As-aN group and 16.1 to 19.4 mg in As-N group). In As-aN group, cumulative-exposure to As-DW exceeds significantly the theoretical cumulative-exposure to As linked to food and observed in the French population.