{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T09:51:42Z","timestamp":1780048302057,"version":"3.53.1"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2010,11]]},"abstract":"<jats:p>\n            <jats:bold>\n              <jats:italic>Background and Purpose\u2014<\/jats:italic>\n            <\/jats:bold>\n            Mechanistic and human studies suggest a role for arsenic in ischemic stroke; however, risks from chronic, low-level exposures are uncertain and US studies are lacking. The objective was to investigate the association between low-level arsenic exposure in drinking water and ischemic stroke hospital admissions in Michigan.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Methods\u2014<\/jats:italic>\n            <\/jats:bold>\n            Ischemic stroke hospital admissions among those aged \u226545 years were identified (1994 to 2006). Population-weighted average arsenic concentrations were estimated for each Michigan county (n=83) and for zip codes in Genesee County (n=27) where there is greater variation in arsenic concentrations. US Census data provided age- and sex-specific population counts and other county- and zip code-level variables (race, income), which were adjusted for in multilevel negative binomial regression models of arsenic and stroke admissions. Hospital admissions for duodenal ulcer and hernia, not hypothesized to be associated with arsenic, were also evaluated.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Results\u2014<\/jats:italic>\n            <\/jats:bold>\n            Adjusted county-level analyses suggested a relationship between arsenic and ischemic stroke hospital admissions, although similar associations were observed for duodenal ulcer and hernia. In zip code-level analysis, arsenic was associated with an increased risk of stroke admission (relative risk, 1.03; 95% CI, 1.01 to 1.05 per \u03bcg\/L increase in arsenic) after adjustment for confounders, and null or negative associations were found between arsenic and nonvascular outcomes.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Conclusions\u2014<\/jats:italic>\n            <\/jats:bold>\n            Findings from this study suggest that exposure to even low levels of arsenic in drinking water may be associated with a higher risk of incident stroke. Given the ecological nature of the analysis, further epidemiological study with individual-level data on arsenic exposure and incident stroke is warranted.\n          <\/jats:p>","DOI":"10.1161\/strokeaha.110.585281","type":"journal-article","created":{"date-parts":[[2010,10,15]],"date-time":"2010-10-15T02:56:24Z","timestamp":1287111384000},"page":"2499-2504","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":47,"title":["Arsenic in Drinking Water and Stroke Hospitalizations in Michigan"],"prefix":"10.1161","volume":"41","author":[{"given":"Lynda D.","family":"Lisabeth","sequence":"first","affiliation":[{"name":"From the Department of Epidemiology (L.D.L., S.S.-J.), University of Michigan School of Public Health, Ann Arbor, Mich; the Stroke Program (L.D.L., J.F.B.), University of Michigan, Ann Arbor, Mich; the Department of Preventive Medicine (H.J.A., J.J.C., J.R.M.), Stony Brook University, NY; and the Graduate Program in Public Health (J.R.M.), Stony Brook University, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyeong Jun","family":"Ahn","sequence":"additional","affiliation":[{"name":"From the Department of Epidemiology (L.D.L., S.S.-J.), University of Michigan School of Public Health, Ann Arbor, Mich; the Stroke Program (L.D.L., J.F.B.), University of Michigan, Ann Arbor, Mich; the Department of Preventive Medicine (H.J.A., J.J.C., J.R.M.), Stony Brook University, NY; and the Graduate Program in Public Health (J.R.M.), Stony Brook University, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J.","family":"Chen","sequence":"additional","affiliation":[{"name":"From the Department of Epidemiology (L.D.L., S.S.-J.), University of Michigan School of Public Health, Ann Arbor, Mich; the Stroke Program (L.D.L., J.F.B.), University of Michigan, Ann Arbor, Mich; the Department of Preventive Medicine (H.J.A., J.J.C., J.R.M.), Stony Brook University, NY; and the Graduate Program in Public Health (J.R.M.), Stony Brook University, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawnita","family":"Sealy-Jefferson","sequence":"additional","affiliation":[{"name":"From the Department of Epidemiology (L.D.L., S.S.-J.), University of Michigan School of Public Health, Ann Arbor, Mich; the Stroke Program (L.D.L., J.F.B.), University of Michigan, Ann Arbor, Mich; the Department of Preventive Medicine (H.J.A., J.J.C., J.R.M.), Stony Brook University, NY; and the Graduate Program in Public Health (J.R.M.), Stony Brook University, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James F.","family":"Burke","sequence":"additional","affiliation":[{"name":"From the Department of Epidemiology (L.D.L., S.S.-J.), University of Michigan School of Public Health, Ann Arbor, Mich; the Stroke Program (L.D.L., J.F.B.), University of Michigan, Ann Arbor, Mich; the Department of Preventive Medicine (H.J.A., J.J.C., J.R.M.), Stony Brook University, NY; and the Graduate Program in Public Health (J.R.M.), Stony Brook University, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaymie R.","family":"Meliker","sequence":"additional","affiliation":[{"name":"From the Department of Epidemiology (L.D.L., S.S.-J.), University of Michigan School of Public Health, Ann Arbor, Mich; the Stroke Program (L.D.L., J.F.B.), University of Michigan, Ann Arbor, Mich; the Department of Preventive Medicine (H.J.A., J.J.C., J.R.M.), Stony Brook University, NY; and the Graduate Program in Public Health (J.R.M.), Stony Brook University, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0883-2927(02)00018-5"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwj154"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mrrev.2006.02.001"},{"key":"e_1_3_2_4_2","unstructured":"International Agency for Research on Cancer. Monographs on the Evaluation of Carcinogenic Risks to Humans: Some Drinking-Water Disinfectants and Contaminants Including Arsenic vol 84. IARC; 2002."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.8551"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwi330"},{"key":"e_1_3_2_7_2","unstructured":"National Research Council. Arsenic in Drinking Water: 2001 Update. Washington DC: National Academy of Sciences Press; 2001."},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/0192623308323919"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1006\/taap.2001.9356"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.taap.2006.12.035"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000015862.64816.b2"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.108.841403"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/1476-069X-6-4"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1080\/00039896.1994.9954996"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.94.11.1936"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.99107359"},{"key":"e_1_3_2_17_2","unstructured":"Michigan Department of Public Health. Arsenic in Drinking Water\u2014A Study of Exposure and Clinical Survey. Michigan Department of Public Health Michigan. 1982."},{"key":"e_1_3_2_18_2","doi-asserted-by":"crossref","unstructured":"Kolker A Haack S Cannon W Westjohn DB Kim MJ Nriagu J Woodruff LG. Arsenic in southeast Michigan. In: Welch AH Stollenwerk KG eds. Arsenic in Ground Water. Norwell MA: Kluwer Academic Publishers; 2003: 281\u2013294.","DOI":"10.1007\/0-306-47956-7_10"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10653-008-9173-x"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00420-006-0119-2"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2006.04.021"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/73.1.13"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.0006-341X.2001.00120.x"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.publhealth.29.020907.090821"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.10817"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(06)70351-9"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.28.9.1717"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0891-5849(99)00186-0"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.taap.2004.04.008"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/hyp.33.1.74"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.5916"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.8000"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.110.585281","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T14:19:19Z","timestamp":1715609959000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.110.585281"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,11]]},"references-count":32,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2010,11]]}},"alternative-id":["10.1161\/STROKEAHA.110.585281"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.110.585281","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,11]]},"assertion":[{"value":"2010-03-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2010-06-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2010-10-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}