Burden of Coronary Heart Disease and Cancer from Dietary Exposure to Inorganic Arsenic in Adults in China, 2016

BACKGROUND AND OBJECTIVES: Inorganic arsenic (iAs) can cause a wide range of health problems, including coronary heart disease (CHD) and lung, bladder, and skin cancer. Although dietary iAs intake is the primary source of iAs, the burden of CHD and cancers from dietary iAs exposure in Chinese adults has not been well known. METHODS: To estimate the iAs exposure level in Chinese adults’ diet, we systematically collected food-specific iAs concentrations in China from Chinese and English literature databases during 2000-2020. Food consumption was extracted from two nationwide food and nutrition surveys in China. The population attributable fraction was calculated based on the dose-response relationship between iAs and CHD risk. Combining the 2016 Chinese tumor registry data, we calculated the annual incidence of cancer from dietary iAs exposure to measure the disability-adjusted life year (DALY) in 2016. FINDINGS: The total amount of daily foodborne iAs intake was 0.55 μg/kg bw/day among Chinese adults. The DALY of foodborne iAs-associated CHD was 3,017,510, which accounted for 10.18% of total CHD DALY in Chinese adults in 2016. Moreover, the carcinogenic DALY for lung cancer, bladder cancer, and skin cancer of Chinese residents in 2016 related to dietary iAs was 314.24, 9.89, and 167.32 thousand, accounting for 2.05%, 1.70%, and 35.5% of the total cancer burden, respectively. CONCLUSIONS: Our findings suggested that dietary iAs exposure causes a substantial disease burden in Chinese adults. More efforts for foodborne iAs control are critical to reducing the disease burden of CHD and cancer in China and other countries with similar dietary patterns.