Percent predicted FEV1 Percent predicted FVC FEV1 residual (ml) FVC residual (ml) Percent predicted FEV1 Percent predicted FVC FEV1 residual (ml) FVC residual (ml) Peak arsenic before age 10 \50 lg/l (n = 45) 98.2 ± 14.6 103.6 ± 16.7 -63 ± 443 103 ± 584 50–250 compared to \50 lg/l [800 compared to \50 lg/l Crude Diff. -7.0 -5.3 -208 -157 P value 0.03 0.10 0.03 0.14 Adjusteda Diff. -4.6 -2.7 -152 -52 P value 0.18 0.32 0.16 0.40 Crude Diff. -10.0 -8.8 -312 -329 Adjusteda Diff. -11.5 -12.2 -335 -429 P value 0.04 0.04 0.06 0.04 Diff. difference, FEV1 forced expiratory volume in 1 s, FVC forced vital capacity a Adjusted for smoking, childhood secondhand smoke, wood, charcoal, or kerosene fuel use in childhood home, occupational air pollution, and education b Highest known arsenic concentration before age 10 was entered as a continuous variable in linear models Table 4 Prevalence odds ratios (PORs) and 95% conﬁdence intervals (CIs) for respiratory symptoms Peak arsenic before age 10 0–250 lg/l (n = 65) [ 800lg/l (n = 32) 596 Int Arch Occup Environ Health (2011) 84:591–600 Table 3 Exposure response between early-life arsenic and lung function residuals (observed minus predicted) and percent of age-, sex-, and height-predicted values (mean ± SD) Chronic cough Chronic phlegm Chronic bronchitis Trouble breathing Rarely Often Breathlessness walking Fast/uphill At group pace At own pace Any respiratory symptom 7 (11%) 5 (7%) 2 (3%) 16 (25%) 2 (3%) 15 (23%) 9 (14%) 7 (11%) 20 (31%) 5 (16%) 2 (6%) 1 (3%) 4 (13%) 2 (6%) 13 (41%) 12 (38%) 10 (31%) 14 (44%) not available (adjustment variables missing for 1 ‘‘yes’’ respondent) a Adjusted for age, sex, smoking, childhood secondhand smoke, wood, charcoal, or kerosene fuel use in childhood home, occupational air pollution, and education were also stratiﬁed into 3 groups based on highest early-life arsenic concentration: \50, 50–250, and [800 lg/l. Sub- jects exposed to 50–250 lg/l and [800 lg/l had 4.6% (P = 0.18) and 11.5% (P = 0.04) lower FEV1, respec- tively, than those exposed to \50 lg/l. A similar pattern was seen for FVC. Effect estimates were similar when 8 subjects exposed to[800 lg/l only after age 10 were put in the intermediate group or excluded entirely. Table 4 shows prevalence of respiratory symptoms. Thirty-eight percent of exposed subjects reported breathless- ness walking at a group pace compared to 14% of unexposed (POR = 5.94, 95% conﬁdence interval (CI) 1.36–26.02). The POR for reporting any breathlessness was 2.53 (95% CI 0.68–9.45). There was little evidence of associations with chronic cough, phlegm, chronic bronchitis, or ‘‘trouble breathing,’’ although few subjects reported these symptoms. 123 50–250 lg/l (n = 20) [800 lg/l (n = 32) 91.2 ± 11.0 98.2 ± 10.0 -270 ± 314 -54 ± 380 P value 0.005 0.01 0.006 0.01 88.1 ± 18.3 94.7 ± 15.3 -375 ± 611 -226 ± 614 P trendb Crude 0.005 0.008 0.005 0.006 Adjusteda 0.03 0.03 0.03 0.02 Crude POR 1.53 0.80 1.02 0.44 2.10 2.28 3.73 3.77 1.75 95% CI 0.45–5.28 0.15–4.37 0.09–11.6 0.13–1.44 0.28–15.6 0.92–5.67 1.37–10.2 1.27–11.1 0.73–4.20 P value 0.26 0.38 0.49 0.08 0.23 0.04 0.004 0.006 0.11 Adjusteda POR 1.30 0.93 1.20 1.01 2.53 5.94 3.89 2.63 95% CI 0.22–7.80 0.10–9.01 0.25–5.73 0.06–17.2 0.68–9.45 1.36–26.0 0.90–16.8 0.78–8.92 P value 0.39 0.48 0.41 0.49 0.08 0.009 0.03 0.06