Arsenic exposure is associated with elevated sweat chloride concentration and airflow obstruction among adults in Bangladesh: A cross-sectional study

Authors

Mi-Sun S. Lee, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.
Crystal M. North, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.
Irada Choudhuri, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States of America.
Subrata K. Biswas, Department of Molecular and Cell Biology, University of Connecticut, Storrs, Connecticut, United States of America.
Abby F. Fleisch, Center for Interdisciplinary Population Health Research, MaineHealth, Portland, Maine, United States of America.
Afifah Farooque, Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, United States of America.
Diane Bao, Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, United States of America.
Sakila Afroz, Dhaka Community Hospital Trust, Dhaka Bangladesh.
Sadia Mow, Dhaka Community Hospital Trust, Dhaka Bangladesh.
Nazmul Husain, Dhaka Community Hospital Trust, Dhaka Bangladesh.
Fuadul Islam, Dhaka Community Hospital Trust, Dhaka Bangladesh.
Md Golam Mostofa, Dhaka Community Hospital Trust, Dhaka Bangladesh.
Partha Pratim Biswas, Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
David S. Ludwig, New Balance Obesity Prevention Center, Boston Children's Hospital, Boston, Massachusetts, United States of America.

Document Type

Article

Publication Date

5-7-2025

Institution/Department

Center for Interdisciplinary Population Health Research

Journal Title

PloS one

MeSH Headings

Humans; Male; Female; Bangladesh (epidemiology); Adult; Cross-Sectional Studies; Arsenic (toxicity, analysis); Chlorides (metabolism, analysis); Sweat (chemistry); Middle Aged; Environmental Exposure (adverse effects); Nails (chemistry); Cystic Fibrosis Transmembrane Conductance Regulator (metabolism)

Abstract

Arsenic is associated with lung disease and experimental models suggest that arsenic-induced degradation of the chloride channel CFTR (cystic fibrosis transmembrane conductance regulator) is a mechanism of arsenic toxicity. We examined associations between arsenic exposure, sweat chloride concentration (measure of CFTR function), and pulmonary function among 269 adults in Bangladesh. Participants with sweat chloride ≥ 60 mmol/L had higher arsenic exposures than those with sweat chloride <  60 mmol/L (water: median 77.5 µg/L versus 34.0 µg/L, p = 0.025; toenails: median 4.8 µg/g versus 3.7 µg/g, p = 0.024). In linear regression models, a one-unit µg/g increment in toenail arsenic was associated with a 0.59 mmol/L higher sweat chloride concentration, p <  0.001. Among the entire study population, after adjusting for covariates including age, sex, smoking, education, and height, toenail arsenic concentration was associated with increased odds of airway obstruction (OR: 1.97, 95%: 1.06, 3.67, p = 0.03); however, sweat chloride concentration did not mediate this association. Our findings suggest that sweat chloride concentration may serve as novel biomarker for arsenic exposure, warranting further investigation in diverse populations, and that arsenic likely acts on the lung through mechanisms other than inducing CFTR dysfunction. Alternative mechanisms by which environmental arsenic exposure may lead to obstructive lung disease, such as arsenic-induced direct lung injury and/or increase lung proteinase activity, require additional exploration in future work.

First Page

e0311711

Recommended Citation

Lee MS, North CM, Choudhuri I, et al. Arsenic exposure is associated with elevated sweat chloride concentration and airflow obstruction among adults in Bangladesh: A cross-sectional study. PLoS One. 2025;20(5):e0311711. Published 2025 May 7. doi:10.1371/journal.pone.0311711