1 Facultad de Ciencias de la Salud, Universidad de Tarapacá, Arica, Chile

2 Departamento de Química. Universidad de Tarapacá, Arica, Chile

3 Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile. Santiago, Chile


Carcinogenic and systemic health effects of arsenic exposure in drinking water are well documented. This study estimated the risk associated with chronic consumption of water with high concentrations of arsenic in children and adults living in six Andean locations, in Chile. Concentrations of arsenic in the drinking water were analyzed between 2014 and 2017 based on health authority reports and data collected during this study. Average daily arsenic intake was estimated, and systemic (HQ) and deterministic carcinogenic risk (CR) indices were calculated using U.S. Environmental Protection Agency methodology. Threshold values ​​of HQ>1 and CR> 1 x 10–4 were considered to indicate high risk of adverse health effects. Four of the locations (Chucuyo > Putre > Humapalca = Visviri) had high concentrations of arsenic in the water, at levels 6.3–57.6 times the norm of 0.01 mg/L, Zapahuira and Belén, had values just below the threshold. Extremely high HQ values were estimated in children, at 1.3–119.8 times the threshold. Furthermore, CR values were several orders of magnitude (3.06–10790.6) above the tolerable value among all age strata. The locations studied have a high risk of adverse health effects from exposure to arsenic in drinking water. It is urgent to implement mitigation measures to improve water quality in these communities and to carry out probabilistic studies to provide more accurate assessment of exposure.

Graphical Abstract


  • The current study is one of the first health risk assessment for people living in the Chilean Altiplano who are exposed to high concentrations of inorganic arsenic in drinking water;
  • Systemic and carcinogenic deterministic risks, as estimated by the U.S. EPA methodology, are high in all the studied localities, especially in children;
  • This novel study adds further evidence that these localities of the Chilean Altiplano need urgently to improve the management of the drinking water quality.


Main Subjects

Amaro, A.; Herrera, B.; Lictevout. E., (2014). Spatial distribution of arsenic in the region of Tarapacá, northern Chile: Proceedings of the 5th International Congress on Arsenic in the Environment, May 11-16, 2014, Buenos Aires, Argentina. 54-55 (2 pages).

APHA, (2012). Standard methods for the examination of water and wastewater. 22st edition. American Public Health Association, American Water Works Association, Water Environment Federation, Washington D.C., USA (724 pages).

Arriaza, B.; Amarasiriwardena, D.; Standen, V.; Yanez, J.; Van Hoesen, J.; Figueroa, L., (2018). Living in poisoning environments: Invisible risks and human adaptation. Evol. Anthropol., 27:  188-196 (9 pages).

Asante-Duah, K., (2017). Public health risk assessment for human exposure to chemicals, Published, Springer Netherlands (600 pages). 

Bailey, K.; Fry, R.C., (2014). Long-term health consequences of prenatal arsenic exposure: links to the genome and the epigenome. Rev. Environ. Health, 29:  9-12 (4 pages).

Bjorklund, G.; Aaseth, J.; Chirumbolo, S.; Urbina, M. A.; Uddin, R., (2018). Effects of arsenic toxicity beyond epigenetic modifications. Environ. Geochem. Health. 40: 955-965 (11 pages).

Bloom, M.S.; Surdu, S.; Neamtiu, I.A.; Gurzau, E.S., (2014). Maternal arsenic exposure and birth outcomes: a comprehensive review of the epidemiologic literature focused on drinking water. Int. J. Hygiene Environ. Health. 217:  709-719 (11 pages).

Bundschuh, J.; Litter, M.; Nicoli, H.; Hoinkis, J.; Bhattacharya, P., (2010). Arsenic in the environment, Arsenic in geosphere and human disease, Published, London-UK. Tylor and Francis Group (652 pages).

Bundschuh, J.; Litter, M.I.; Parvez, F.; Roman-Ross, G.; Nicolli, H.B.; Jean, J.S.; Liu, C.W.; Lopez, D.; Armienta, M.A.; Guilherme, L.R.; Cuevas, A.G.; Cornejo, L.; Cumbal, L.;  Toujaguez, R., (2012a). One century of arsenic exposure in Latin America: a review of history and occurrence from 14 countries. Sci. Total Environ., 429: 2-35 (34 pages).

Bundschuh, J.; Nath, B.; Bhattacharya, P.; Liu, C.W.; Armienta, M. A.; Moreno Lopez, M.V.; Lopez, D.L.; Jean, J.S.; Cornejo, L.; Lauer Macedo, L.F.;  Filho, A.T., (2012b). Arsenic in the human food chain: the Latin American perspective. Sci. Total Environ., 429: 92-106 (15 pages).

Castriota, F.; Acevedo, J.; Ferreccio, C.; Smith, A. H.; Liaw, J.; Smith, M.T.;  Steinmaus, C., (2018). Obesity and increased susceptibility to arsenic-related type 2 diabetes in Northern Chile. Environ. Res., 167: 248-254 (7 pages).

De Loma, J.; Tirado, N.; Ascui, F.; Levi, M.; Vahter, M.; Broberg, K.;  Gardon, J., (2019). Elevated arsenic exposure and efficient arsenic metabolism in indigenous women around Lake Poopo, Bolivia. Sci. Total Environ., 657: 179-186 (8 pages).

de la Rosa, R.; Steinmaus, C.; Akers, N.K.; Conde, L.; Ferreccio, C.; Kalman, D.; Zhang, K.R.; Skibola, C.F.; Smith, A.H.; Zhang, L.; Smith, M.T. (2017). Associations between arsenic (+3 oxidation state) methyltransferase (AS3MT) and N-6 adenine-specific DNA methyltransferase 1 (N6AMT1) polymorphisms, arsenic metabolism, and cancer risk in a chilean population. Environ. Mol. Mutagen. 58: 411-422 (12 pages).

ERD, (2018). Estrategia Regional de Desarrollo. Arica y Parinacota 2017-2030. Enfoque basado en el desarrollo humano. Gobierno Regional de Arica y Parinacota, Chile.

Fernandez, M.I.; Valdebenito, P.; Delgado, I.; Segebre, J.; Chaparro, E.; Fuentealba, D.; Castillo, M.; Vial, C.; Barroso, J.P.; Ziegler, A.; Bustamante, A., (2019). Impact of arsenic exposure on clinicopathological characteristics of bladder cancer: A comparative study between patients from an arsenic-exposed region and nonexposed reference sites. Urol Oncol.

Fernandez, M.I.; Lopez, J.F.; Vivaldi, B.; Coz, F., (2012). Long-term impact of arsenic in drinking water on bladder cancer health care and mortality rates 20 years after end of exposure. J. Urol., 187: 856-861 (6 pages).

Ferreccio, C.; Smith, A.H.; Duran, V.; Barlaro, T.; Benitez, H.; Valdes, R.; Aguirre, J.J.; Moore, L.E.; Acevedo, J.; Vasquez, M.I.; Perez, L.; Yuan, Y.; Liaw, J.; Cantor, K.P.; Steinmaus, C., (2013). Case-control study of arsenic in drinking water and kidney cancer in uniquely exposed Northern Chile. Am. J. Epidemiol., 178: 813-818 (6 pages).

Garcia, M.; Riquelme, R.; Farias, M.; Herail, G.; Charrier, R., (2011). Late Miocene-Holocene canyon incision in the western Altiplano, northern Chile: Tectonic or climatic forcing? J. Geol. Soc., 168: 1047-1060 (14 pages).

Hall, E.M.; Acevedo, J.; Lopez, F.G.; Cortes, S.; Ferreccio, C.; Smith, A.H.;  Steinmaus, C.M., (2017). Hypertension among adults exposed to drinking water arsenic in Northern Chile. Environ. Res., 153: 99-105 (7 pages).

Huang, L.; Wu, H.; van der Kuijp, T.J., (2015). The health effects of exposure to arsenic-contaminated drinking water: a review by global geographical distribution. Int. J. Environ. Health Res., 25:  432-452 (20 pages).

Leith Sly, J.; Carpenter, D.O., (2012). Special vulnerability of children to environmental exposures. Rev. Environ. Health. 27:  151-157 (7 pages).

Ratnaike, R.N., (2003). Acute and chronic arsenic toxicity. Postgrad Med. J., 79:  391-6 (6 pages). Ravenscroft, P.; Brammer, H.; Richards, K., (2009). Arsenic Pollution: A Global Synthesis, Published, Chichester, UK: Wiley-Blackwell. Place.

Roh, T.; Steinmaus, C.; Marshall, G.; Ferreccio, C.; Liaw, J.; Smith, A.H., (2018). Age at exposure to arsenic in water and mortality 30-40 years after exposure Cessation. Am J Epidemiol., 187: 2297-2305 (9 pages).

Roman, D.A.; Pizarro, I.; Rivera, L.; Camara, C.; Palacios, M.A.; Gomez, M.M.; Solar, C., (2011). An approach to the arsenic status in cardiovascular tissues of patients with coronary heart disease. Hum. Exp. Toxicol., 30: 1150-1164 (15 pages).

Smith, A.H.; Marshall, G.; Yuan, Y.; Steinmaus, C.; Liaw, J.; Smith, M.T.; Wood, L.; Heirich, M.; Fritzemeier, R.M.; Pegram, M.D.; Ferreccio, C., (2014). Rapid reduction in breast cancer mortality with inorganic arsenic in drinking water. Ebiol. Medicine. 1: 58-63 (6 pages).

Steinmaus, C.; Ferreccio, C.; Acevedo, J.; Yuan, Y.; Liaw, J.; Duran, V.; Cuevas, S.; Garcia, J.; Meza, R.; Valdes, R.; Valdes, G.; Benitez, H.; VanderLinde, V.; Villagra, V.; Cantor, K.P.; Moore, L.E.; Perez, S.G.; Steinmaus, S.; Smith, A.H., (2014). Increased lung and bladder cancer incidence in adults after in utero and early-life arsenic exposure. Cancer Epidemiol Biomarkers Prev., 23: 1529-1538 (10 pages).

Soza-Ried, C.; Bustamante, E.; Caglevic, C.; Rolfo, C.; Sirera, R.; Marsiglia, H., (2019). Oncogenic role of arsenic exposure in lung cancer: A forgotten risk factor. Crit. Rev. Oncol. Hematol. 139: 128-133 (6 pages).

Steinmaus, C.M.; Ferreccio, C.; Romo, J.A.; Yuan, Y.; Cortes, S.; Marshall, G.; Moore, L.E.; Balmes, J.R.; Liaw, J.; Golden, T.;  Smith, A.H., (2013). Drinking water arsenic in northern Chile: high cancer risks 40 years after exposure cessation. Cancer Epidemiol. Biomarkers Prev., 22: 623-630 (8 pages).

Tapia, J.; Murray, J.; Ormachea, M.; Tirado, N.; Nordstrom, D.K., (2019). Origin, distribution, and geochemistry of arsenic in the Altiplano-Puna plateau of Argentina, Bolivia, Chile, and Peru. Sci. Total Environ., 678: 309-325 (44 pages).

USEPA, (1989). Risk assessment guidance for Superfund. Human health evaluation manual, (part A) [R]. Published.

USEPA, (2011). Age dependent adjustment factor (ADAF) application published. U.S. Environmental Protection Agency (21 pages).

Valdes Salgado, M.A.; Schisterman, E.; Pino, P.; Bangdiwala, S.; Munoz, M.P.;  Iglesias, V., (2019). Is prenatal arsenic exposure associated with salivary cortisol in infants in Arica, Chile? An exploratory cohort study. Ann. Agric. Environ. Med., 26: 266-272 (7 pages).

Vicuna, L.; Fernandez, M.I.; Vial, C.; Valdebenito, P.; Chaparro, E.; Espinoza, K.; Ziegler, A.; Bustamante, A.;  Eyheramendy, S., (2019). Adaptation to extreme environments in an admixed human population from the Atacama Desert. Genome Biol. Evol., 11: 9: 2468-2479 (12 pages).

WHO, (1993). Guidelines for Drinking Water Quality. Vol. 1: World Health Organization Recommendations. 2d ed. Geneva (202 pages).

Yuan, Y.; Marshall, G.; Ferreccio, C.; Steinmaus, C.; Liaw, J.; Bates, M.; Smith, A.H., (2010). Kidney cancer mortality: fifty-year latency patterns related to arsenic exposure. Epidemiology. 21:103-108 (6 pages).

Young, J.L.; Cai, L.; States, J.C., (2018). Impact of prenatal arsenic exposure on chronic adult diseases. Syst. Biol. Reprod. Med., 64:  469-483 (15 pages).

Yu, S.; Liao, W.T.; Lee, C.H.; Chai, C.Y.; Yu, C.L.; Yu, H.S., (2018). Immunological dysfunction in chronic arsenic exposure: From subclinical condition to skin cancer. J. Dermatol., 45: 1271-1277 (7 pages).

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