Low-moderate arsenic exposure and respiratory in American Indian communities in the Strong Heart Study

Table 4 Weighted Odds Ratio (95% Confidence Interval) of Airflow Obstruction and Restrictive Pattern, Defined Based on the Lower Limit of Normal (LLN), by Urinary Arsenic Concentration (N = 2132)

	Inorganic Plus Methylated Arsenic Species μg/g creatinine				P-trend^d
	Tertile 1 ≤7.0^e	Tertile 2 7.1–13.9^e	Tertile 3 ≥14.0^e	75th vs. 25th Percentile^f	P-trend^d
Airflow obstruction^a/Healthy^c	47/773	57/626	47/435	151/1834
Model 1	1.00 (Ref)	1.15 (0.84, 1.58)	1.64 (1.16, 2.34)	1.47 (1.17, 1.88)	0.001
Model 2	1.00 (Ref)	1.11 (0.80, 1.53)	1.50 (1.05, 2.15)	1.38 (1.09, 1.76)	0.007
Model 3	1.00 (Ref)	1.08 (0.78, 1.50)	1.36 (0.94, 1.97)	1.28 (1.02, 1.60)	0.03
Model 4	1.00 (Ref)	1.07 (0.78, 1.49)	1.33 (0.92, 1.93)	1.26 (1.01, 1.59)	0.04
Restrictive pattern^b/ Healthy^c	62/773	42/626	43/435	147/1834
Model 1	1.00 (Ref)	0.85 (0.58, 1.26)	1.45 (0.91, 2.30)	1.33 (1.00, 1.76)	0.05
Model 2	1.00 (Ref)	0.85 (0.58, 1.26)	1.41 (0.88, 2.25)	1.30 (0.98, 1.74)	0.07
Model 3	1.00 (Ref)	0.86 (0.58, 1.28)	1.42 (0.88, 2.28)	1.33 (0.90, 1.50)	0.06
Model 4	1.00 (Ref)	0.83 (0.56, 1.23)	1.23 (0.76, 2.00)	1.21 (0.90, 1.64)	0.22

Model 1: adjusted for age, sex, education, site
Model 2: further adjusted for smoking status and smoking pack-year
Model 3: further adjusted for eGFR, tuberculosis, and BMI
Model 4: sensitivity analysis: further adjusted for diabetes
^aAirflow obstruction: FEV1/FVC < LLN
^bRestrictive pattern: FEV1/FVC > LLN & FVC < LLN
^cHealthy: FEV1/FVC > LLN and FVC > LLN
^dP-trend calculated modeling log-arsenic as continuous
^eTertiles are range; calculated based on overall population; sum of iAs, MMA, DMA μg/g creatinine
^fComparison of the 75th and 25th percentiles (interquartile range) of urinary arsenic concentrations (16.7 vs. 5.8 μg/g creatinine)

ISSN: 1476-069X