Association between drinking water uranium content and cancer risk in Bavaria, Germany

Uranium in Drinking Water and Bladder Cancer: A Case-control Study in Michigan

ABSTRACT

Uranium is naturally occurring in groundwater used for drinking; however, health risks from naturally occurring concentrations are uncertain. Uranium can cause both radiological and chemical toxicity following ingestion. Bladder and kidneys receive a dose when uranium is excreted into the urine. Investigate the association between uranium in drinking water and bladder cancer risk in a case-control study. A population-based bladder cancer case-control study was conducted in 11 counties of southeastern Michigan. A total of 411 cases and 566 controls provided drinking water and toenail samples and answered questions about lifestyle and residential history. Uranium was measured in drinking water and toenails, and its association with bladder cancer was assessed via unconditional logistic regression models. Median uranium concentration in water was 0.12 μg L -1 , with a maximum of 4.99 μg L -1 , and median uranium concentration in toenails was 0.0031 μg g -1 . In adjusted regression models, there was a suggestion of a protective effect among those exposed to the upper quartile of uranium in drinking water (HR = 0.64, 95% CI: 0.43, 0.96) and toenails (HR 0.66; 95% CI 0.45, 0.96) compared to those in the lowest quartile. Our objective is to investigate additional adjustment of drinking water source at home residence at time of recruitment to address potential selection bias and confounding attenuated results toward the null for drinking water uranium (HR = 0.68, 95% CI: 0.44, 1.05) and toenail uranium (HR = 0.80, 95% CI: 0.53, 1.20). This case-control study showed no increased risk of bladder cancer associated with uranium found in drinking water or toenails.

Uranium and Radium in Groundwater and Incidence of Colorectal Cancer in Georgia Counties, USA: An Ecologic Study

Colorectal cancer (CRC) is the third most commonly occurring cancer in the United States, with higher incidence rates among Black populations. Groundwater concentrations of natural radionuclides uranium and radium have seldom been investigated in relation to CRC despite their known carcinogenicity. We investigate spatial patterns of CRC by race, and in relation to groundwater concentrations of uranium and radium, testing the hypothesis that uranium and radium in groundwater might differentially contribute to incident CRC in Black and White populations in counties of Georgia, USA. Black populations showed a higher incidence of CRC than White populations; the median incident rate difference was 9.23 cases per 100,000 (95% CI: 2.14, 19.40). Spatial cluster analysis showed high incidence clusters of CRC in similar regions for Black and White populations. Linear regression indicated there are, on average, 1-2 additional cases of colorectal cancer in counties with higher levels of radium in their groundwater, irrespective of race. Uranium was not associated with CRC. This ecologic study suggests that radium in groundwater may be linked with increased incidence of CRC, although it did not explain higher CRC incidence rates in Black populations. Further studies are needed to verify this association given the inherent limitations in the ecologic study design and the crude exposure assessment.

Early diagenesis of anthropogenic uranium in lakes receiving deep groundwater from the Kiruna mine, northern Sweden

The uranium (U) concentrations and isotopic composition of waters and sediment cores were used to investigate the transport and accumulation of U in a water system (tailings pond, two lakes, and the Kalix River) receiving mine waters from the Kiruna mine. Concentrations of dissolved U decrease two orders of magnitude between the inflow of mine waters and in the Kalix River, while the concentration of the element bound to particulate matter increases, most likely due to sorption on iron‑manganese hydroxides and organic matter. The vertical distribution of U in the water column differs between two polluted lakes with a potential indication of dissolved U supply from sediment's pore waters at anoxic conditions. Since the beginning of exposure in the 1950s, U concentrations in lake sediments have increased >20-fold, reaching concentrations above 50 μg g-1. The distribution of anthropogenic U between the lakes does not follow the distribution of other mine water contaminants, with a higher relative proportion of U accumulating in the sediments of the second lake. Concentrations of redox-sensitive elements in the sediment core as well as Fe isotopic composition were used to re-construct past redox-conditions potentially controlling early diagenesis of U in surface sediments. Two analytical techniques (ICP-SFMS and MC-ICP-MS) were used for the determination of U isotopic composition, providing an extra dimension in the understanding of processes in the system. The (234 U)/(238 U) activity ratio (AR) is rather uniform in the tailings pond but varies considerably in water and lake sediments providing a potential tracer for U transport from the Kiruna mine through the water system, and U immobilization in sediments. The U mass balance in the Rakkurijoki system as well as the amount of anthropogenic U accumulated in lake sediments were evaluated, indicating the immobilization in the two lakes of 170 kg and 285 kg U, respectively.

Why We Will Continue to Lose Our Battle with Cancers If We Do Not Stop Their Triggers from Environmental Pollution

Besides our current health concerns due to COVID-19, cancer is a longer-lasting and even more dramatic pandemic that affects almost a third of the human population worldwide. Most of the emphasis on its causes has been posed on genetic predisposition, chance, and wrong lifestyles (mainly, obesity and smoking). Moreover, our medical weapons against cancers have not improved too much during the last century, although research is in progress. Once diagnosed with a malignant tumour, we still rely on surgery, radiotherapy, and chemotherapy. The main problem is that we have focused on fighting a difficult battle instead of preventing it by controlling its triggers. Quite the opposite, our knowledge of the links between environmental pollution and cancer has surged from the 1980s. Carcinogens in water, air, and soil have continued to accumulate disproportionally and grow in number and dose, bringing us to today's carnage. Here, a synthesis and critical review of the state of the knowledge of the links between cancer and environmental pollution in the three environmental compartments is provided, research gaps are briefly discussed, and some future directions are indicated. New evidence suggests that it is relevant to take into account not only the dose but also the time when we are exposed to carcinogens. The review ends by stressing that more dedication should be put into studying the environmental causes of cancers to prevent and avoid curing them, that the precautionary approach towards environmental pollutants must be much more reactionary, and that there is an urgent need to leave behind the outdated petrochemical-based industry and goods production.

Uranium Exposure in American Indian Communities: Health, Policy, and the Way Forward

BACKGROUND

Uranium contamination of drinking-water sources on American Indian (AI) reservations in the United States is a largely ignored and underfunded public health crisis. With an estimated 40% of the headwaters in the western U.S. watershed, home to many AI reservation communities, being contaminated with untreated mine waste, the potential health effects have largely been unexplored. With AI populations already facing continued and progressive economic and social marginalization, higher prevalence of chronic disease, and systemic discrimination, associations between various toxicant exposures, including uranium, and various chronic conditions, need further examination.

OBJECTIVES

Uranium's health effects, in addition to considerations for uranium drinking-water testing, reporting, and mitigation in reference to AI communities through the lens of water quality, is reviewed.

DISCUSSION

A series of environmental health policy recommendations are described with the intent to proactively improve responsiveness to the water quality crisis in AI reservation communities in the United States specific to uranium. There is a serious and immediate need for better coordination of uranium-related drinking-water testing and reporting on reservations in the United States that will better support and guide best practices for uranium mitigation efforts. https://doi.org/10.1289/EHP7537.

Spatial distribution of uranium and basic water quality parameter in the capital of Bihar and consequent ingestion dose

Investigation of presence of Uranium (U) in groundwater/drinking water is an active are of research due to its chemical and radiological toxicity as well as long-term health effects. The current study had the objective of estimating U as a naturally occurring radioactive element in groundwater samples and assessment of ingestion dose, when groundwater is the source of drinking water. The random sampling method was chosen for the collection of samples based on population density. The estimation of U was done using LED fluorimeter. Statistical tools were applied to analyze the data and its spatial distribution. The U concentrations in three blocks of urban Patna were well below the permissible limits suggested by different health agencies of the world. A correlation test was performed to analyze the association of U with other physiochemical parameters of water samples. It was found that the sulfate, chloride, calcium, hardness, alkalinity, TDS, salinity, and ORP were positively correlated, whereas fluoride, phosphate, magnesium, dissolved oxygen, and pH were negatively correlated with U concentrations. The ingestion dose due to U, occurring in groundwater, was found to vary from 0.2-27.0 μSv y^-1 with a mean of 4.2 μSv y^-1, which was well below the recommended limit of 0.1 mSv (WHO WHO Chron 38:104-108, 2012).Therefore, the water in this region is fit for drinking purposes.

Drinking Water Uranium and Potential Health Effects in the German Federal State of Bavaria

Mainly due to its nephrotoxic and osteotoxic potential, uranium (U) increasingly finds itself in the spotlight of environmental and health-related research. Germany decided on a binding U guideline value in drinking water of 10 µg/L, valid since 2011. It is yet widely unknown if and how public health was affected by elevated U concentrations before that. In this ecological study we summarized available drinking water U data for the German federal state of Bavaria (703 analyses in total for 553 different municipalities) at county level (for 76 out of 96 Bavarian counties, representing about 83% of Bavaria's and about 13% of Germany's total population) in terms of mean and maximum U concentration. Bavaria is known to regionally exhibit mainly geogenically elevated groundwater U with a maximum value of 40 µg/L in the database used here. Public health data were obtained from federal statistical authorities at county resolution. These included incidence rates of diagnosed diseases suspected to be potentially associated with chronic U uptake, e.g., diseases of the skeleton, the liver or the thyroid as well as tumor and genito-urinary diseases. The datasets were analyzed for interrelations and mutual spatial occurrence using statistical approaches and GIS as well as odds ratios and relative risks calculations. Weak but significant positive associations between maximum U concentrations and aggregated ICD-10 diagnose groups for growths/tumors as well as liver diseases were observed, elevated incidence rates of thyroid diseases seem to occur where mean drinking water U concentrations exceed 2 µg/L. Here, we discuss obtained results and their implications for potential impacts of hydrochemistry on public health in southeast Germany.

Uranium in groundwater--Fertilizers versus geogenic sources

Due to its radiological and toxicological properties even at low concentration levels, uranium is increasingly recognized as relevant contaminant in drinking water from aquifers. Uranium originates from different sources, including natural or geogenic, mining and industrial activities, and fertilizers in agriculture. The goal of this study was to obtain insights into the origin of uranium in groundwater while differentiating between geogenic sources and fertilizers. A literature review concerning the sources and geochemical processes affecting the occurrence and distribution of uranium in the lithosphere, pedosphere and hydrosphere provided the background for the evaluation of data on uranium in groundwater at regional scale. The state of Baden-Württemberg, Germany, was selected for this study, because of its hydrogeological and land-use diversity, and for reasons of data availability. Uranium and other parameters from N=1935 groundwater monitoring sites were analyzed statistically and geospatially. Results show that (i) 1.6% of all water samples exceed the German legal limit for drinking water (10 μg/L); (ii) The range and spatial distribution of uranium and occasional peak values seem to be related to geogenic sources; (iii) There is a clear relation between agricultural land-use and low-level uranium concentrations, indicating that fertilizers generate a measurable but low background of uranium in groundwater.

Novel drug delivery systems for actinides (uranium and plutonium) decontamination agents

The possibility of accidents in the nuclear industry or of nuclear terrorist attacks makes the development of new decontamination strategies crucial. Among radionuclides, actinides such as uranium and plutonium and their different isotopes are considered as the most dangerous contaminants, plutonium displaying mostly a radiological toxicity whereas uranium exhibits mainly a chemical toxicity. Contamination occurs through ingestion, skin or lung exposure with subsequent absorption and distribution of the radionuclides to different tissues where they induce damaging effects. Different chelating agents have been synthesized but their efficacy is limited by their low tissue specificity and high toxicity. For these reasons, several groups have developed smart delivery systems to increase the local concentration of the chelating agent or to improve its biodistribution. The aim of this review is to highlight these strategies.

Uranium in drinking-water: a unique case of guideline value increases and discrepancies between chemical and radiochemical guidelines

BACKGROUND

Uranium represents a unique case for an element naturally present in the environment, as its chemical guideline value in drinking water significantly increased from 2 μg/L in 1998 up to 15 μg/L in 2004 and then to 30 μg/L in 2011, to date corresponding to a multiplication factor of 15 within a period of just 13 years.

OBJECTIVES

In this commentary we summarize the evolution of uranium guideline values in drinking-water based on both radiological and chemical aspects, emphasizing the benefit of human studies and their contribution to recent recommendations. We also propose a simpler and better consistency between radiological and chemical values.

DISCUSSION

The current chemical guideline value of 30 μg/L is still designated as provisional because of scientific uncertainties regarding uranium toxicity. During the same period, the radiological guideline for (238)U increased from 4 Bq/L to 10 Bq/L while that for (234)U decreased from 4 Bq/L to 1 Bq/L. These discrepancies are discussed here, and a value of 1 Bq/L for all uranium isotopes is proposed to be more consistent with the current chemical value of 30 μg/L.

CONCLUSION

Continuous progress in the domains of toxicology and speciation should enable a better interpretation of the biological effects of uranium in correlation with epidemiological human studies. This will certainly aid future proposals for uranium guideline values.

Removal of fluoride and uranium by nanofiltration and reverse osmosis: a review

Inorganic contamination in drinking water, especially fluoride and uranium, has been recognized as a worldwide problem imposing a serious threat to human health. Among several treatment technologies applied for fluoride and uranium removal, nanofiltration (NF) and reverse osmosis (RO) have been studied extensively and proven to offer satisfactory results with high selectivity. In this review, a comprehensive summary and critical analysis of previous NF and RO applications on fluoride and uranium removal is presented. Fluoride retention is generally governed by size exclusion and charge interaction, while uranium retention is strongly affected by the speciation of uranium and size exclusion usually plays a predominant role for all species. Adsorption on the membrane occurs as some uranium species interact with membrane functional groups. The influence of operating conditions (pressure, crossflow velocity), water quality (concentration, solution pH), solute–solute interactions, membrane characteristics and membrane fouling on fluoride and uranium retention is critically reviewed.

A comparison of the Scottish Index of Multiple Deprivation (SIMD) 2004 with the 2009 + 1 SIMD: does choice of measure affect the interpretation of inequality in mortality?

Background

There is a growing international literature assessing inequalities in health and mortality by area based measures. However, there are few works comparing measures available to inform research design. The analysis here seeks to begin to address this issue by assessing whether there are important differences in the relationship between deprivation and inequalities in mortality when measures that have been constructed at different time points are compared.

Methods

We contrast whether the interpretation of inequalities in all-cause mortality between the years 2008-10 changes in Scotland if we apply the earliest (2004) and the 2009 + 1 releases of the Scottish Index of Multiple Deprivation (SIMD) to make this comparison. The 2004 release is based on data from 2001/2 and the 2009 + 1 release is based on data from 2008/9. The slope index of inequality (SII) and 1:10 ratio are used to summarise inequalities standardised by age/sex using population and mortality records.

Results

The 1:10 ratio suggests some differences in the magnitude of inequalities measured using SIMD at different time points. However, the SII shows much closer correspondence.

Conclusions

Overall the findings show that substantive conclusions in relation to inequalities in all-cause mortality are little changed by the updated measure. This information is beneficial to researchers as the most recent measures are not always available. This adds to the body of literature showing stability in inequalities in health and mortality by geographical deprivation over time.