Skin lesions associated with chronic exposure to arsenic in drinking water in rural Western Iran.

Chronic exposure to arsenic through drinking water is a major public health concern and is associated with a wide range of adverse health effects, including dermatological lesions, cardiovascular disorders, and increased cancer risk. In this cross-sectional study, the prevalence of arsenic-related skin problems, i.e., hyperpigmentation and keratosis, in relation to arsenic level in drinking water in rural regions in northwest Hamadan Province, Iran, was investigated. Arsenic levels in drinking water during 2022–2023 were obtained from the Hamadan University of Medical Sciences Health Department. Three villages with arsenic levels above 50 µg/L in Kabudarahang County were selected as exposure sites, and two villages with low arsenic levels (< 2 µg/L) were selected as controls. 189 individuals from the exposed village residents and 223 from control village residents were interviewed with medical screenings. Demographic and health-related variables, including age, BMI, blood pressure, and skin lesion history, were recorded. Skin symptoms were significantly more prevalent among the exposure group: keratosis (adjusted OR = 10.18, 95% CI: 1.28–80.75, p = 0.028), hyperpigmentation (adjusted OR  3.94, 95% CI 1.05–14.67, p = 0.041), and other cutaneous complications (adjusted OR 5.05, 95% CI 1.66–15.33, p = 0.004). Age was a risk factor per se with each additional year having a 2–4% increased risk of skin lesions. Systolic blood pressure differed between groups (p < 0.001), suggesting possible interactions with cutaneous manifestations. Arsenic in drinking water at high levels has strong association with elevated prevalence of skin lesions, and therefore a requirement for systematic waters monitoring and mitigation processes.