Groundwater Arsenic-Attributable Cardiovascular Disease (CVD) Mortality Risks in India

Cardiovascular diseases (CVDs) have been recognized as the most serious non-carcinogenic detrimental health outcome arising from chronic exposure to arsenic. Drinking arsenic contaminated groundwaters is a critical and common exposure pathway for arsenic, notably in India and other countries in the circum-Himalayan region. Notwithstanding this, there has hitherto been a dearth of data on the likely impacts of this exposure on CVD in India. In this study, CVD mortality risks arising from drinking groundwater with high arsenic (>

10 μg/L) in India and its constituent states, territories, and districts were quantified using the population-attributable fraction (PAF) approach. Using a novel pseudo-contouring approach, we estimate that between 58 and 64 million people are exposed to arsenic exceeding 10 μg/L in groundwater-derived drinking water in India. On an all-India basis, we estimate that 0.3–0.6% of CVD mortality is attributable to exposure to high arsenic groundwaters, corresponding to annual avoidable premature CVD-related deaths attributable to chronic exposure to groundwater arsenic in India of between around 6500 and 13,000. Based on the reported reduction in life of 12 to 28 years per death due to heart disease, we calculate value of statistical life (VSL) based annual costs to India of arsenic-attributable CVD mortality of between USD 750 million and USD 3400 million.