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Natural occurrence of arsenic in groundwater is found in the Americas, European, Western Africa, and Asia including Taiwan, Japan, southern Thailand and China where in some areas, drinking water supplies are primarily based on groundwater resources 2. For general population in southwestern coast Taiwan, the major arsenic exposure resource is the ingestion of arsenic contaminated groundwater. The residents have used high-arsenic contaminated well water for drinking and cooking for many decades since early 1910s. The tap water supply system was implemented in the early 1960s, however artesian well water has not been used for drinking or cooking until mid-1970s 3. Because arsenic toxicity operates in a highly nonlinear manner and different levels of exposure measurements applied result in large discrepancy across studies and made it difficult to come up a reliable dose-response relationship for arsenic hazard. There is a long-standing observation of individual variability in susceptibility to arsenic toxicity 4 and this variation may be partly due to differences in age and sex distribution across areas, and also individual arsenic metabolism capabilities 5,6. Inter-individual differences in the speciation and amounts of arsenic metabolites have been reported among subjects chronically exposed to arsenic 7 and significant genetic determinants of arsenic metabolism was supported by epidemiological study 8. Toenail and hair arsenic has been reported to provided an integrated measure of internal arsenic exposure 9. However epidemiologic studies showed that external contamination lead to overestimation of internal dose and urinary arsenic concentration seems to be a better marker than concentrations in drinking water10. Growing epidemiological evidence also suggests that some factors such as age, sex and genetic susceptibility are related to its metabolism and can be important predictors for arsenic-related health hazard 11,12.

intech ebooks

Electrocardiogram (ECG) Abnormality Among Residents in Arseniasis-Endemic and Non-Endemic Areas of Southwestern Taiwan – A Study of Gene-Gene and Gene-Environment Interactions