Probabilistic health risk assessment of nitrosamines in drinking water of Shaoxing, Zhejiang, China

Volatile N-nitrosamines in processed meat products: An approach for monitoring dietary exposure, assessing human risk, and evaluating variable correlations by principal component analysis and heat map

Several epidemiological studies have reported a positive association between the consumption of processed meats containing N-nitrosamines (NAs) and the incidence of hepatocellular and colon cancer. The health risk assessment in this investigation was based on the concentration of six volatile N-nitrosamines (VNAs) (N-nitrosodimethylamine, N-nitrosodiethylamine, N-nitrosomethylethylamine, N-nitrosopiperidine, N-nitrosodibutylamine, and N-nitrosodi-n-propylamine) found in processed meat products (sausage and kielbasa) in the Iranian market. Direct supported liquid membrane two-phase hollow fiber electromembrane extraction coupled to gas chromatography/mass spectrometry was used to analyse six VNAs. The mean concentration of the six VNAs in sausages and kielbasa was 38.677 ± 27.56 and 48.383 ± 35.76 μg/kg, respectively. The 95th percentile for the chronic daily intake of total VNAs for children (3-14 years) and adults (15-70 years) were calculated to be 5.06 × 10-4 and 1.09 × 10-4 mg/kg bw/day, respectively. The cancer risk assessment showed that the risk associated with NDEA was the highest among the other VNAs studied in Iranian processed meat, with a 95th percentile for the child and adult groups. Based on an incremental lifetime cancer risk (ILCR) value of ≤10-4 for the carcinogenic effects of exposure to a total of six VNAs, it indicates low concern for all age groups.

Compromised very-low density lipoprotein induced polyunsaturated triglyceride accumulation in N-nitrosodiethylamine-induced hepatic steatosis

N-Nitrosodiethylamine (NDEA), a carcinogen in some foods and medications, is linked to liver damage similar to non-alcoholic fatty liver disease (NAFLD). This study explores how NDEA disrupts liver lipid metabolism. Sprague-Dawley rats were given two doses of NDEA (100 mg/kg) orally, 24 h apart. Liver response was assessed through tissue staining, blood tests, and biochemical markers, including fatty acids, lipid peroxidation, and serum very-low density lipoprotein (VLDL) levels. Additionally, lipidomic analysis of liver tissues and serum was performed. The results indicated significant hepatic steatosis (fat accumulation in the liver) following NDEA exposure. Blood analysis showed signs of inflammation and liver damage. Biochemical tests revealed decreased liver protein synthesis and specific enzyme alterations, suggesting liver cell injury but maintaining mitochondrial function. Increased fatty acid levels without a rise in lipid peroxidation were observed, indicating fat accumulation. Lipidomic analysis showed increased polyunsaturated triglycerides in the liver and decreased serum VLDL, implicating impaired VLDL transport in liver dysfunction. In conclusion, NDEA exposure disrupts liver lipid metabolism, primarily through the accumulation of polyunsaturated triglycerides and impaired fat transport. These findings provide insight into the mechanisms of NDEA-induced liver injury and its progression to hepatic steatosis.

The association between perchlorate in drinking water and height and weight of children and adolescents in Southwest China: a retrospective cross-sectional study

Objective

To investigate the association between the concentration of perchlorate in drinking water and the height and weight of children and adolescents in Sichuan Province.

Methods

Perchlorate in the drinking water of 24 counties in Sichuan Province from 2021 to 2022 was detected and analyzed, 66 drinking water samples were collected, and the content of perchlorate in drinking water during the wet season and dry season was detected by ultra-high performance liquid chromatography in series. The linear mixed effect model was used to estimate the relationship between perchlorate in drinking water and the height and weight of 144,644 children and adolescents, and 33 pieces of local average wage data were used as confounding factors for quality control.

Results

After controlling the age, gender, and local economic situation, we found that the concentration of perchlorate in drinking water increased by 10 μg/L is associated with a 1.0 cm decrease in height and a 1.6 kg decrease in weight in children and adolescents (p < 0.05).

Conclusion

The concentration of perchlorate in drinking water may be negatively correlated with the height and weight of children.

Bayesian inference of heavy metals exposure in crayfish for assessing human non-carcinogenic health risk

Contaminant concentrations often presented left censorship that below the limit of detection (LOD), which may contain true zero values because of no residue. In this study, we analyzed the concentrations of lead (Pb), cadmium (Cd), mercury (Hg), arsenic (As), and chromium (Cr) in 391 crayfish samples collected from 24 provinces of China, modelled the concentrations with two different models in a Bayesian framework, and evaluated health risk by estimating the target hazard quotient (THQ). The highest concentration was associated with Cr in Northwest China (0.1753 ± 0.1520 mg/kg w. w.), and the minimum concentration was Cd in Southwest China (0.0052 ± 0.0144 mg/kg w. w.), all heavy metal concentrations were below their safety limits. The posterior means of not detect rates P₀ of Pb, Cd, Hg, As, and Cr obtained with two models were both nearly equal to the observed not detect rates (51.15%, 36.83%, 27.37%, 64.71%, and 43.73%, respectively). The posterior probabilistic density lines for Pb, Hg, and Cd concentrations obtained with two models were similar, and fitted the empirical distributions well. The posterior density lines of THQs showed that the non-carcinogenic risk of As and Hg were significant high. Moreover, Bayesian approach presented a better understanding of the percentage of population exposed to potential risk.

Seasonal variability, predictive modeling and health risks of N-nitrosamines in drinking water of Shanghai

The prevalence of carcinogenic N-nitrosamines in drinking water is of significant concern. In the present study, eight N-nitrosamines from three representative drinking water treatment plants (DWTPs) in Shanghai, China were monitored for an entire year to evaluate their seasonal variability, probabilistic cancer risk and the resulting disease burden. The possibility of employing routinely monitored water quality parameters as predictors of N-nitrosamines was also examined. The results showed that the Taipu River-fed reservoir suffered more serious N-nitrosamine contamination than the Yangtze River-fed reservoirs. Winter witnessed higher levels of N-nitrosamines in both source and finished water. N-nitrosamine concentrations increased from source water to finished water in autumn or winter, but no spatial variations were observed in summer. The total lifetime cancer risk (LCR) posed by N-nitrosamines in finished water was within the acceptable range (1.00 × 10^-6 to 1.00 × 10^-4), with N-nitrosodimethylamine (NDMA) and N-nitrosodiethylamine (NDEA) being the main contributors. Winter and autumn were found to have higher total LCR values. The average individual disability-adjusted life years (DALYs) lost was 4.43 × 10^-6 per person-year (ppy), exceeding the reference risk level (1.00 × 10^-6 ppy). Liver cancer accounted for 97.1 % of the total disease burden, while bladder and esophagus cancers made a little contribution (2.9 %). A multiple regression model was developed to estimate the total N-nitrosamines in finished water as a function of water quality parameters, and the R² value was 0.735. This study not only provides fundamental data for public health policy development, but also reveals the necessity to incorporate a seasonal control strategy in DWTPs to minimize the associated health risks induced by N-nitrosamines.

Development of multi-residue gas chromatography coupled with mass spectrometry methodologies for the measurement of 15 chemically different disinfection by-products (DBPs) of emerging concern in drinking water from two different Portuguese water treatment plants

In water treatment plants (WTPs), chemical agents, such as chlorine and ozone, might react with organic matter and anthropogenic contaminants, forming a high diversity of disinfection by-products (DBPs). Due to the potential toxicological effects, the identification of unregulated DBPs (UR-DBPs) is critical to help water managers in the selection of effective water treatment processes, contributing to improving water safety plans. Given the limited validated analytical methods to detect UR-DBPs, here we developed new multi-residue gas chromatography coupled with mass spectrometry methodologies for the detection and quantification of 15 UR-DBPs, including aldehydes, haloketones (HKs), nitrosamines and alcohols, in drinking water matrices. Solid-phase extraction (SPE), for the nitrosamine group, and solid-phase micro extraction (SPME), for the remaining DBPs, were used as sample preparation methods. The developed methodologies allowed the quantification of target UR-DBPs at trace concentration levels (ng L^-1), with method quantification limits (MQLs) ranging from 14.4 ng L^-1 to 26.0 ng L^-1 (SPE-GC-MS) and 2.3 ng L^-1 and 1596 ng L^-1 (SPME-GC-MS). The methods were applied to different drinking water matrices, considering distinct delivery points of EPAL - Empresa Portuguesa das Águas Livres WTPs. Overall, the aldehyde group, represented by decanal, nonanal and 2-ethylheaxanal, showed the highest occurrence, followed by HKs and nitrosamines. The results of this study suggested that the formation of these UR-DBPs should be further monitored in WTPs.

Uncertainty health risk assessment and regional control of drinking water: a case study of Hanyuan County, southwest mountainous area, China

To evaluate the health risks of drinking water in Hanyuan County, 96 samples of peripheral drinking water were collected from 30 sites in the area. The samples were then analyzed for chemical properties including Fe, Mn, NH₃-N, [Formula: see text], F^-, Pb, Hg, As, Cr(VI), Cd, and so on. The health risks of ten trace elements in drinking water were probabilistically assessed using the health risk assessment model and Monte Carlo simulation. On this basis, sequential indicator simulations were used to classify the health risk levels of drinking water in the region, to conduct hierarchical management and control. The results showed that except for [Formula: see text], all other indicators met World Health Organization standards and China's drinking water sanitation standards. Drinking water presents a specific carcinogenic risk to adults, and the cumulative contribution of As and Cr(VI) exceeds 95%, and has a specific non-carcinogenic risk to children if the cumulative contribution of F^-, [Formula: see text], and As exceeds 90%. Grade I, II, and III non-carcinogenic risk areas accounted for 0.89%, 24.72%, and 74.39% of the total area of Hanyuan County, respectively, while grade I, II, and III carcinogenic risk areas accounted for 27.71%, 45.56%, and 26.73% of the total Hanyuan County area, respectively. Finally, according to the health risk characteristics of each control area, corresponding zoning control suggestions were proposed.

Metabolomics-based molecular signatures reveal the toxic effect of co-exposure to nitrosamines in drinking water

Nitrosamines, a group of emerging nitrogenous pollutants, are ubiquitously found in the drinking water system. However, less is known about how systemic biological responses resist or tolerate nitrosamines, especially long-term co-exposure at low concentrations. In this study, untargeted metabolomics was used to investigate the metabolic perturbations in human esophageal epithelial Het-1A cells induced by a mixture of nine common nitrosamines in drinking water at environmentally relevant, human-internal-exposure, and genotoxic concentrations. Generally, the disrupted metabolic spectrum became complicated with nitrosamines dose increasing. Notably, two inflammation-associated pathways, namely, cysteine (Cys) and methionine (MET) metabolism, and nicotinate and nicotinamide metabolism, changed significantly under the action of nitrosamines, even at the environmentally relevant level. Furthermore, targeted metabolomics and molecular biology indicators in cells were identified in mice synchronously. For one thing, the up-regulated Cys and MET metabolism provided methyl donors for histone methylation in the context of pro-inflammatory response. For another, the down-regulated NAD⁺/NADH ratio inhibited the deacetylation of NF-кB p65 and eventually activated the NF-кB signaling pathway. Taken collectively, the metabolomics molecular signatures were important indicative markers for nitrosamines-induced inflammation. The potential crosstalk between the inflammatory cascade and metabolic regulation also requires further studies. These findings suggest that more attention should be paid to long-term co-exposure at low concentrations in the control of nitrosamines pollution in drinking water. Additionally, this study also highlights a good prospect of the combined metabolomic-molecular biology approach in environmental toxicology.

Mutagenicity, health risk, and disease burden of exposure to organic micropollutants in water from a drinking water treatment plant in the Yangtze River Delta, China

A wide variety of organic micropollutants in drinking water pose a serious threat to human health. This study was aimed to reveal the characteristics of organic micropollution profiles in water from a drinking water treatment plant (DWTP) in the Yangtze River Delta, China and investigate the mutagenicity, health risk and disease burden through mixed exposure to micropollutants in water. The presence of organic micropollutants in seven categories in organic extracts (OEs) of water from the DWTP was determined, and Ames test was conducted to test the mutagenic effect of OEs. Meanwhile, health risk of exposure to organic micropollutants in finished water through three exposure routes (ingestion, dermal absorption and inhalation) was assessed with the method proposed by U.S. EPA, and disability-adjusted life years (DALYs) were combined to estimate the disease burden of cancer based on the carcinogenic risk (CR) assessment. The results showed that 28 organic micropollutants were detected in the raw and finished water at total concentrations of 967.28 ng/L and 1073.45 ng/L, respectively, of which phthalate esters (PAEs) were the dominant category (95.79% in the raw water and 96.61% in the finished water). Although the results of the Ames test for OEs were negative and the non-carcinogenic hazard index of the organic micropollutants in the finished water was less than 1 in all age groups, the total CR was 2.17 × 10^-5, higher than the negligible risk level (1.00 × 10^-6). The total DALYs caused by the organic micropollutants in the finished water was 2945.59 person-years, and the average individual DALYs was 2.21 × 10^-6 per person-year (ppy), which was 2.21 times the reference risk level (1.00 × 10^-6 ppy) defined by the WHO. Exposure to nitrosamines (NAms) was the major contributor to the total CR (92.06%) and average individual DALYs (94.58%). This study demonstrated that despite the negative result of the mutagenicity test with TA98 and TA100 strains, the health risk of exposure to organic micropollutants in drinking water should not be neglected.

Strontium in public drinking water and associated public health risks in Chinese cities

Due to the fact that strontium (Sr) is not involved in the scope of supervision of drinking water in China, the Sr concentration in public drinking water and its related health risks have been neglected for a long time. In this research, public drinking water samples were collected from 314 cities across the country to reveal the concentration and spatial distribution of Sr in public drinking water. In addition, the Monte Carlo method (a statistical simulation method) was applied to evaluate the Sr intake from drinking water and human health risks among different age groups and different regions. As shown in the results, the Sr was in the concentration range of 0.005-3.11 mg/L with a mean value of 0.360 mg/L. There were significant differences in the Sr concentration in different regions; in general, it was high in the north and low in the south. The Sr intakes of infants, children, teens, and adults from drinking water were 0.273, 0.503, 0.633, and 0.784 mg/day, respectively. There was a significant positive correlation between Sr concentration in drinking water and bone mineral density (BMD) in the elderly. Especially, the correlation coefficients (r) between Sr concentration and the BMD of the elderly whose age fell in the range of 60-70 years were 0.692 (male) and 0.483 (female). In addition, the Sr concentration in drinking water was positively correlated with the incidence of children's rickets (r = 0.411), while the Ca/Br ratio was negatively correlated with the incidence of children's rickets (r = - 0.410). According to the health risk assessment, among people of different ages, infants' hazard index (HI) value was the highest. The mean value and 95th percentile value were 0.066 and 0.247. Non-carcinogenic risk of Sr through drinking water among different people in different regions was less than 1, which meant no significant damage to human health. This study is the first time to systematically investigate Sr in public drinking water across the whole country. More importantly, the conclusions can be applied to risk control and management of public drinking water.

Intake of volatile nitrosamines by Chinese residents in different provinces via food and drinking water

N-nitrosamines are potent carcinogens, particularly N-nitrosodimethylamine (NDMA) and N-nitrosodiethylamine (NDEA), which are commonly found in a variety of foods and drinking water. We calculated the food and drinking water intakes of NDMA, NDEA, and total volatile nitrosamines (TVNA) by Chinese residents in different provinces by multiplying the reported total diet study results by the nitrosamine contents in food and drinking water. The weighted content of nitrosamines in each category of foods and the concentration of nitrosamines in drinking water was obtained through literature review. The exogenous NDMA, NDEA and TVNA intakes of adult residents in 20 provinces ranged from 171 to 425 ng/d, 41 to 140 ng/d and 373 to 1028 ng/d, respectively. The main contributors to NDMA and TVNA intakes were vegetables, cereals, aquatic products, and meats while the main sources of NDEA intake were vegetables and cereals. The average total NDMA intake per capita in China (251 ng/d) was similar to that in Germany in 1991 (231 ng/d) but higher than that in the United States (136 ng/d), Canada (87.6 ng/d) and France (188 ng/d). Large differences in nitrosamine intakes were observed between the coastal provinces and inland provinces. Drinking water was estimated to contribute 13.1%, 1.3% and 10.8% of the exogenous intakes of NDMA, NDEA and TVNA, respectively. Based on our results, we recommend setting the NDMA drinking water criterion of 40 ng/L. Overall, this study presents basic information regarding nitrosamines intake via food and drinking water in China that will facilitate risk assessment, generation of health advisories and policy making.

Challenges for Safe and Healthy Drinking Water in China

PURPOSE OF REVIEW

Rapid economic growth and its huge population are putting tremendous pressure on water sustainability in China. Ensuring clean drinking water is a great challenge for public health due to water shortage and pollution. This article reviews current scientific findings on health-related issues on drinking water and discusses the challenges for safe and healthy drinking water in China.

RECENT FINDINGS

From literature published since 2010, a variety of emerging contaminants were detected in drinking water, including disinfection byproducts (DBPs), pharmaceuticals and personal care products (PPCPs), endocrine-disrupting compounds (EDCs), antibiotic resistance genes, and pathogens. Arsenic and fluoride are still the two major contaminants in groundwater. Microcystins, toxins produced by cyanobacteria, were also frequently detected in surface water for drinking. Health effects of exposure to arsenic, fluoride, nitrates, DBPs, and noroviruses in drinking water have been reported in several epidemiological studies. According to literature, water scarcity is still a severe ongoing issue, and regional disparity affects the access to safe and healthy drinking water. In addition, urbanization and climate change have strong influences on drinking water quality and water quantity. Multiple classes of contaminants of emerging concern have been detected in drinking water, while epidemiological studies on their health effects are still inadequate. Water scarcity, regional disparity, urbanization, and climate change are the major challenges for safe and healthy drinking water in China.

Dietary intake and health risk assessment of nitrate, nitrite, and nitrosamines: a Bayesian analysis and Monte Carlo simulation

Nitrate, nitrite, and nitrosamines intake from the diet creates human health risks. In this study, nitrate/nitrite intake from diet and its association with nitric oxide (NO) level in humans have been surveyed. Besides nitrate/nitrite, nitrosamines risks were also determined from the diet. This study was conducted as a pilot study; 33 heathy adults participated in and completed the Food Frequency Questionnaire (FFQ) for 3 days. Then, concentrations of nitrate, nitrite, and nitrosamines were studied by the literature review. Also, the association between the intake of nitrate and nitrite with salivary and urinary NO was evaluated by Bayesian bi-variate analysis. Then, the health risk was assessed for nitrate/nitrite from food groups and drinking water, and nitrosamines from food groups based on hazard index (HI) and cancer risk with the Monte Carlo simulation. The nitrate/nitrite intakes had no association with NO level in the saliva and urine samples. The mean of HI value for the mean of 3 days was 3.57 and 0.32 from food groups and drinking water, respectively. The cancer risk amount of nitrosamines from food groups was (1.74 to 2.22) × 10^-3 based on 95% confidence interval (CI 95%) values. This study showed the Iranian diet had a high risk, but drinking water consumption was safe based on nitrate/nitrite and nitrosamines for humans. There is a need to determine the concentration of nitrosamines in drinking water in Iran and to recommend for decrease risk of nitrate, nitrite, and nitrosamines exposure by food groups.

Spatial, temporal variability and carcinogenic health risk assessment of nitrosamines in a drinking water system in China

Nitrosamines, as a class of emerging frequently detected nitrogenous disinfection byproducts (N-DBPs) in drinking water, have gained increasing attention due to their potentially high health risk. Few studies focus on the occurrence variation and carcinogenic health risk of nitrosamines in drinking water systems. Our study aimed to investigate the spatial and temporal variability of nitrosamines in a drinking water system and to conduct a carcinogenic health risk assessment. Three types of water samples, including influent water, treated water and tap water, were collected monthly during an entire year in a drinking water system utilizing a combination of chlorine dioxide and chlorine in central China, and 9 nitrosamines were measured. The nitrosamine formation potentials (FPs) in influent water were also determined. N-nitrosodimethylamine (NDMA) was the most prevalent compound and was dominant in the water samples with average concentrations ranging from 2.5 to 67.4 ng/L, followed by N-nitrosodiethylamine (NDEA) and N-nitrosopiperidine (NPIP). Nitrosamine occurrence varied monthly, and significant seasonal differences were observed in tap water (p < .05). There were decreasing mean NDMA, NDEA and NPIP concentrations from influent water to treated water to tap water, but no significant spatial variability was observed within the water distribution system (p > .05). The average and 95th percentile total lifetime cancer risks for the three main nitrosamines were 4.83 × 10^-5 and 4.48 × 10^-4, respectively, exceeding the negligible risk level (10^-6) proposed by the USEPA. Exposure to nitrosamines in drinking water posed a higher cancer risk for children than for adults, and children aged 0.75 to 1 years suffered the highest cancer risk. These results suggest that nitrosamine occurrence in tap water varied temporally but not spatially. Exposure to drinking water nitrosamines may pose a carcinogenic risk to human health, especially to children.

Ultrasound-assisted synthesis of clover-shaped nano-titania functionalized covalent organic frameworks for the dispersive solid phase extraction of N-nitrosamines in drinking water

In this study, three batches of nano-titania functionalized covalent organic frameworks were acquired depending on different solvothermal reaction stages (24 h, 48 h and 72 h), which were named as single roll-up shaped nano-titania functionalized COFs (SSTF-COFs), double roll-up shaped nano-titania functionalized COFs (DSTF-COFs) and clover-shaped nano-titania functionalized covalent organic framework (CSTF-COFs), respectively. After comparing their extraction performances, the more efficient and stable CSTF-COFs were selected as sorbent for the dispersive solid phase extraction (dSPE) of eight target N-nitrosamines in drinking water, followed by the determination with liquid chromatography-tandem quadrupole mass spectrometry (LC-MS/MS). Owing to the introduction of hydroxy groups, CSTF-COFs showed high extraction efficiency for N-nitrosamines with a wide range of polarities through hydrogen bonding interaction, hydrophobic interaction and hydrophilic interaction. Under optimum conditions, the developed method provided relatively low limits of detection (0.13-2.45 ng/L) and satisfactory recoveries (88.6-105.5%), with relative standard deviations (RSDs) less than 8.3%. Therefore, with the assistance of CSTF-COFs, trace levels of N-nitrosamines were quantitatively and sensitively determined in 31 out of 460 bottled drinking water samples in a sensitive and convenient way.

Distribution of N-nitrosamines in drinking water and human urinary excretions in high incidence area of esophageal cancer in Huai'an, China

The Huai'an area in Jiangsu Province of East China is an endemic region of esophageal cancer (EC). The regional heterogeneity of EC suggests that the levels of potential carcinogens might vary throughout the environment. It has been suggested that the most likely carcinogens related to EC are a group known as the N-nitrosamines. In this study, we measured the concentrations of nine nitrosamines in drinking water and human urine in two areas in China, one with a high incidence of EC (Huai'an) and one with a low incidence (Nanjing). Among the nine target analytes, N-nitrosodi-n-propylamine (NDPA), N-nitrosodibutylamine (NDBA), N-nitrosopyrrolidine (NPyr), N-nitrosodiethylamine (NDEA) and N-nitrosomorpholine (NMor) occurred at higher concentrations in drinking water in the high incidence area. Inhabitants from the high incidence area also had urinary excretions with significantly higher concentrations of NDEA, NDBA, N-nitrosopiperidine (NPip) and N-nitrosodiphenylamine (NDPhA). These findings indicated that people in the high EC incidence area were exposed to higher levels of nitrosamines. However, the association between the incidence of EC and nitrosamines exposure will need to be evaluated in more detail.