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Prevalence and factors associated with high arsenic exposure in the adult population of Chumbivilcas in Cusco, Peru 2024

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This cross-sectional study determined the prevalence and factors associated with high arsenic exposure in 370 adults from Chumbivilcas province, Cusco, Peru during 2024. Chumbivilcas is at approximately 3,660 m above sea level in a region with mining, livestock farming, and agriculture. Urinary arsenic concentration was measured by ICP-MS at the Chemical Toxicology Laboratory of CENSOPAS in Lima.

Key numbers

  • n = 370 participants; 327 had quantifiable urinary arsenic concentrations.
  • Mean urinary arsenic: 39.30 µg/g creatinine (SD 24.40); median 29.02 µg/g (IQR 20.44-44.75).
  • Weighted prevalence of high arsenic exposure (urinary arsenic 20 µg/g creatinine or above): 68.2% (95% CI: 61.9-73.9).
  • Prevalence by district ranged from 56.9% (Santo Tomas) to 86.7% (Capacmarca and Chamaca).
  • Occupational exposure at work was associated with higher prevalence of high arsenic (adjusted prevalence ratio [aPR] = 1.29; 95% CI: 1.07-1.56).
  • Spring water consumption was associated with higher prevalence (aPR = 1.19; 95% CI: 1.01-1.40).
  • Respiratory route of exposure was associated with lower prevalence (aPR = 0.82; 95% CI: 0.72-0.92).
  • No significant associations found for sociodemographic characteristics (age, sex, educational level) in the multivariable models.
  • LOD/LOQ: Arsenic quantifiable in 327 of 370 participants (88.4%).
  • High exposure defined as urinary arsenic 20 µg/g creatinine or above (WHO provisional guideline and Peru Ministry of Health Technical Guide threshold).

Methods (brief)

Analytical cross-sectional study. Two-stage cluster probability sampling stratified by district. Fieldwork: July 22-28, 2024. Spot urine samples collected at home; preserved at 2-8 degrees C; transported by air to Lima. ICP-MS method: MET-CENSO-PAS-017 (determination of arsenic and cadmium in human urine). Results normalized to µg arsenic (As)/g creatinine. Statistical analysis: Poisson regression models with log link; sample design weights incorporated; Stata 4.5.2 for R.

Evidence fitness

Supports: establishing prevalence and risk factors for high arsenic exposure in a high-altitude Andean mining region in Peru; confirms occupational (mining-related) and environmental (spring water) exposure sources. This study measures urinary arsenic as a biomarker; it does not measure respiratory outcomes or lung function, and it does not measure arsenic in food. It is contextual evidence for high-endemic-area exposure characterization.

Limitations

Cross-sectional design; no prospective follow-up; arsenic exposure via water and occupational inhalation not separated by biomarker; food arsenic contribution not measured; self-reported route of exposure (questionnaire); no measurement of environmental arsenic in air, water, or soil.

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