N-nitrosamines in drinking water and beer: Detection and risk assessment

Mutagenic drinking water and different levels of emerging micropollutants in Southern Brazil: A new challenge

This study investigated the presence of mutagenic compounds in raw and treated waters at four water treatment plants (WTP01 to WTP04), in southern Brazil. Samples were concentrated using Amberlite XAD4 resin and the acidic and neutral pH fractions tested by mutagenesis in Salmonella/microsome assay, using TA98, TA100 and YG7108 strains in presence and absence of metabolic activation (in vitro human S9). Mutagenesis in raw water was found only by strain TA98 at WTP03, with and without S9. In treated water, significant results were found for TA98 and TA100 strains, the latter being the most sensitive, with prevalence in acidic extract tests without S9. A chemical analysis was performed in the water samples, prioritizing the investigation of the presence and concentration of globally used Emerging Micropollutants (EMs). These compounds in water sources have the potential to contaminate drinking water due to the inefficiency of the conventional treatment employed and can generate disinfection by-products. WTP04 site had the highest total EMs in raw and treated waters, followed by WTP03 in treated water. These WTPs expressed an EMs removal capacity of 45% and only 23%, respectively. Some pharmaceuticals and caffeine showed the highest concentrations, and the latter was directly related to the disposal of domestic sewage in the aquatic ecosystem. The presence of EMs in water after treatment for all WTPs investigated suggests the importance of expanding guidelines that include EMs to establish better standards for the protection of aquatic life and better quality of the drinking water supplies.

To Drink or Not to Drink? Investigating Alcohol's Impact on Prostate Cancer Risk

BACKGROUND/OBJECTIVES

Prostate cancer (PCa) is a significant global health issue. The relationship between alcohol consumption and PCa risk has been the subject of extensive research, yet findings remain inconsistent. This review aims to clarify the association between alcohol intake and PCa risk, its aggressiveness, and the potential metabolic pathways involved in PCa onset.

METHODS

A comprehensive literature search was conducted across multiple databases, including PubMed and MEDLINE, focusing on epidemiological studies, meta-analyses, cohort studies, and case-control studies. Studies evaluating alcohol consumption, prostate-specific antigen (PSA) levels, and PCa risk were included. The review also explored the roles of alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) in alcohol metabolism.

RESULTS

The analysis reveals a complex relationship between alcohol consumption and PCa. Heavy alcohol intake is associated with an increased risk of PCa, particularly more aggressive forms, and higher mortality rates. However, studies also show weak or no association between moderate alcohol consumption and PCa. The variability in findings may be attributed to differences in alcohol types, regional factors, and study methodologies.

CONCLUSIONS

The link between alcohol consumption and PCa risk is multifaceted. While heavy drinking appears to increase the risk of aggressive PCa, the overall relationship remains unclear. Further research is needed to better understand these associations and inform public health recommendations and cancer prevention strategies.

Development of a sensitive LC-MS/MS method for determination of N-nitrosopiperazine in levocetirizine

Levocetirizine is one of the widely used antihistamines and has the potential to form N-nitrosopiperazine (NPZ) during drug synthesis, manufacturing, or storage. NPZ classified as a nitrosamine is a genotoxic impurity with carcinogenic properties. Controlling the presence of NPZ in the active pharmaceutical ingredient (API) and drug products is crucial with levels ideally maintained below 80 ppm. Herein, we developed a highly sensitive liquid chromatography-tandem mass spectrometry (LC-MS/MS) technique to analyze NPZ levels in levocetirizine API and various formulations. Chromatographic separation was carried out using an F5 column with mobile phases consisting of 2 mM ammonium formate in water and acetonitrile, employing gradient elution mode at a flow rate of 0.2 mL min-1. The column oven temperature was set at 30 °C, and the injection volume was 2 μL. NPZ quantification was achieved using positive electrospray ionization (ESI) in the multiple reaction monitoring (MRM) mode. The developed method underwent rigorous validation according to regulatory guidelines. The limit of quantification (LOQ) was established at 1 ng mL-1 within the range of 1-50 ng mL-1, covering 10-500% of the specified NPZ limit in drugs. The effectiveness of the method was shown by utilizing it to analyze the NPZ impurity in both levocetirizine API and various drug products, including tablets, capsules, chewables, and syrups. The proposed method and the resulting data would be valuable for determining potentially present impurities in drug substances or products for quality assessment.

Analytical Methodologies to Detect N-Nitrosamine Impurities in Active Pharmaceutical Ingredients, Drug Products and Other Matrices

Since 2018, N-nitrosamine impurities have become a widespread concern in the global regulatory landscape of pharmaceutical products. This concern arises due to their potential for contamination, toxicity, carcinogenicity, and mutagenicity and their presence in many active pharmaceutical ingredients, drug products, and other matrices. N-Nitrosamine impurities in humans can lead to severe chemical toxicity effects. These include carcinogenic effects, metabolic disruptions, reproductive harm, liver diseases, obesity, DNA damage, cell death, chromosomal alterations, birth defects, and pregnancy loss. They are particularly known to cause cancer (tumors) in various organs and tissues such as the liver, lungs, nasal cavity, esophagus, pancreas, stomach, urinary bladder, colon, kidneys, and central nervous system. Additionally, N-nitrosamine impurities may contribute to the development of Alzheimer's and Parkinson's diseases and type-2 diabetes. Therefore, it is very important to control or avoid them by enhancing effective analytical methodologies using cutting-edge analytical techniques such as LC-MS, GC-MS, CE-MS, SFC, etc. Moreover, these analytical methods need to be sensitive and selective with suitable precision and accuracy, so that the actual amounts of N-nitrosamine impurities can be detected and quantified appropriately in drugs. Regulatory agencies such as the US FDA, EMA, ICH, WHO, etc. need to focus more on the hazards of N-nitrosamine impurities by providing guidance and regular updates to drug manufacturers and applicants. Similarly, drug manufacturers should be more vigilant to avoid nitrosating agents and secondary amines during the manufacturing processes. Numerous review articles have been published recently by various researchers, focusing on N-nitrosamine impurities found in previously notified products, including sartans, metformin, and ranitidine. These impurities have also been detected in a wide range of other products. Consequently, this review aims to concentrate on products recently reported to contain N-nitrosamine impurities. These products include rifampicin, champix, famotidine, nizatidine, atorvastatin, bumetanide, itraconazole, diovan, enalapril, propranolol, lisinopril, duloxetine, rivaroxaban, pioglitazones, glifizones, cilostazol, and sunitinib.

Ultrasound-assisted matrix solid-phase extraction based on deep eutectic solvents and zinc oxide: Extraction and determination of six active ingredients in Ligustri Lucidi Fructus

In this study, we propose a novel strategy utilizing deep eutectic solvents (DESs) as both the extraction solvent and dispersing liquid, with nanometer zinc oxide (ZnO) serving as the adsorbent. This method incorporates ultrasound-assisted matrix solid phase dispersion (UA-MSPD) for the extraction of six active components (salidroside, echinacoside, acteoside, specnuezhenide, nuezhenoside G13, and oleanolic acid) from Ligustri Lucidi Fructus samples. The extracts were then analyzed using high-performance liquid chromatography equipped with a diode array detector. The effects of various parameters such as dispersant dosage, DESs volume, grinding time, ultrasonication duration, and eluent volume on extraction recovery were investigated and optimized using a central composite design under response surface methodology. The optimized conditions yielded detection limits ranging from 0.003 to 0.01 mg/g and relative standard deviations of 8.7% or lower. Extraction recoveries varied between 93% and 98%. The method demonstrated excellent linearity for the analytes (R2 ≥ 0.9997). The simple, green, and efficient DESs/ZnO-UA-MSPD technique proved to be rapid, accurate, and reliable for extracting and analyzing the six active ingredients in Ligustri Lucidi Fructus samples.

Industrial effluents and N-nitrosamines in karst aquatic systems: a study on distribution and ecological implications

The discharge of electroplating wastewater, containing high concentrations of N-nitrosamines, poses significant risks to human health and aquatic ecosystems. Karst aquatic environment is easily impacted by N-nitrosamines due to the fragile surface ecosystem. However, it's still unclear in understanding N-nitrosamine transformation in karst water systems. To explore the response and transport of nine N-nitrosamines in electroplating effluent within both karst surface water and groundwater, different river and groundwater samples were collected from both the upper and lower reaches of the effluent discharge areas in a typical karst industrial catchment in Southwest China. Results showed that the total average concentrations of N-nitrosamines (∑NAs) in electroplating effluent (1800 ng/L) was significantly higher than that in the receiving river water (130 ng/L) and groundwater (70 ng/L). The dynamic nature of karst aquifers resulted in comparable average concentrations of ∑NAs in groundwater (70 ng/L) and river water (79 ng/L) at this catchment. Based on the principal component analysis and multiple linear regression analysis, the electroplating effluent contributed 89% and 53% of N-nitrosamines to the river water and groundwater, respectively. The results based on the species sensitivity distribution model revealed N-nitrosodibutylamine as a particularly toxic compound to aquatic organisms. Furthermore, the average N-nitrosamine carcinogenic risk was significantly higher in lower groundwater reaches compared to upper reaches. This study represents a pioneering effort in considering specific N-nitrosamine properties in evaluating their toxicity and constructing species sensitivity curves. It underscores the significance of electroplating effluent as a primary N-nitrosamine source in aquatic environments, emphasizing their swift dissemination and significant accumulation in karst groundwater.

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.

Understanding How Chemical Pollutants Arise and Evolve in the Brewing Supply Chain: A Scoping Review

In this study, a critical review was carried out using the Web of ScienceTM Core Collection database to analyse the scientific literature published to date to identify lines of research and future perspectives on the presence of chemical pollutants in beer brewing. Beer is one of the world's most popular drinks and the most consumed alcoholic beverage. However, a widespread challenge with potential implications for human and animal health is the presence of physical, chemical, and/or microbiological contaminants in beer. Biogenic amines, heavy metals, mycotoxins, nitrosamines, pesticides, acrylamide, phthalates, bisphenols, microplastics, and, to a lesser extent, hydrocarbons (aliphatic chlorinated and polycyclic aromatic), carbonyls, furan-derivatives, polychlorinated biphenyls, and trihalomethanes are the main chemical pollutants found during the beer brewing process. Pollution sources include raw materials, technological process steps, the brewery environment, and packaging materials. Different chemical pollutants have been found during the beer brewing process, from barley to beer. Brewing steps such as steeping, kilning, mashing, boiling, fermentation, and clarification are critical in reducing the levels of many of these pollutants. As a result, their residual levels are usually below the maximum levels allowed by international regulations. Therefore, this work was aimed at assessing how chemical pollutants appear and evolve in the brewing process, according to research developed in the last few decades.

Testosterone Exacerbates the Formation of Liver Cancer Induced by Environmental N-Nitrosamines Exposure: Potential Mechanisms and Implications for Human Health

Background

Humans are frequently exposed to N-nitrosamines through various sources, including diet, cigarette smoking, contaminated water, the atmosphere, and endogenous nitrosation. Exposure to these carcinogens may also contribute to the gender-specific incidence of liver cancer, which is significantly higher in males than in females, possibly due to the influence of endogenous hormones such as testosterone. However, the effect of testosterone on N-nitrosamine-induced liver cancer and its underlying mechanism remains unclear.

Purpose

To investigate the effect of testosterone on the development of liver cancer induced by N-nitrosamines exposure.

Patients and Methods

Histopathological and immunohistochemical staining techniques were employed to analyze the expression levels and nuclear localizations of key signaling molecules, including androgen receptor (AR), β-catenin, and HMGB1, in both tumor and non-tumor regions of liver samples obtained from human patients and mice.

Results

The findings demonstrated a strong correlation between AR and β-catenin in the nuclear region of tumor areas. AR also showed a significant correlation with HMGB1 in the cytoplasmic region of non-tumor areas in both human and mice samples. The study further analyzed the expression levels and patterns of these three proteins during the progression of liver tumors.

Conclusion

This study confirms that AR has the ability to modulate the expression levels and patterns of β-catenin and HMGB1 in vivo, thereby exacerbating the progression of liver cancer induced by environmental N-nitrosamines exposure. Importantly, the effect of testosterone on the formation of liver cancer induced by environmental N-nitrosamine exposure intensifies this progression. These findings have important implications for drug safety in clinical practice and emphasize the significance of reducing N-nitrosamines exposure through conscious choices regarding diet and lifestyle to ensure environmental safety.

Impact of agricultural activities on the occurrence of N-nitrosamines in an aquatic environment

N-Nitrosamines, nitroso compounds with strong carcinogenic effects on humans, have been frequently detected in natural waters. In agricultural areas, there is typically a lack of drinking water treatment processes and distribution systems. As a result, residents often consume groundwater as drinking water which may contain N-nitrosamines, necessitating the investigation of the occurrence, sources, and carcinogenic risk of N-nitrosamines within the groundwater of agricultural areas. This study identified eight N-nitrosamines in groundwater and river water in the Jianghan Plain, a famous agricultural region in central China. N-Nitrosodimethylamine (NDMA), N-nitrosodiethylamine (NDEA), N-nitrosomorpholine (NMOR), N-nitrosopyrrolidine (NPYR), and N-nitrosodi-n-butylamine (NDBA) were detected in groundwater, with NDMA being the main compound detected (up to 52 ng L-1). Comparable concentrations of these N-nitrosamines were also found in river water. From laboratory experiments, we found a tremendous potential for the formation of N-nitrosamines in groundwater. Principal component analysis and multiple linear regression analysis results showed that the primary sources of N-nitrosamines in groundwater were the uses of nitrogen fertilizers and pesticides carrying specific N-nitrosamines such as NPYR. The average total carcinogenic risk values of detected N-nitrosamines were higher than the acceptable risk level (10-5), suggesting a potential carcinogenic risk of groundwater. Further research is urgently needed to minimize N-nitrosamine levels in the groundwater of agricultural areas, particularly in those where pesticides and fertilizers are heavily used.

Preparation of metal-organic framework @molecularly imprinted polymers for extracting N-nitrosamines in salted vegetables

In this paper, the novel metal-organic framework @molecularly imprinted polymers were prepared and applied in extracting N-nitrosamines from salted vegetables. The imprinted polymers were coated on the surface of MIL-101 using multi-dummy template molecules (5-nonanol, benzhydrol and N-formylpyrrolidine). The characterization and adsorbing experiments showed that the hybrid imprinted polymers presented spherical particles with typically core-shell structure, and exhibited high adsorption capacity (maximum capacity: 46.85 mg/g) and fast equilibrium rate (only 5 min) for N-nitrosamines. Various parameters (sample loading solvent, pH, washing solvent, elution solvent and elution volume) affecting solid-phase extraction were optimized. Under the optimum conditions, the solid-phase extraction process based on the hybrid polymers combined with high performance liquid chromatography-ultraviolet detection method was established and applied to analyze N-nitrosamines in different salted vegetables. The results showed that the developed method produced the linear relationship between the peak areas versus the N-nitrosamines concentrations of 0.2-10 µg/g with limit of detections from 20.6 to 76.1 ng/g. The spiked recovery of N-nitrosamines in the salted vegetable samples was in the range of 66-100.5 % with relative standard deviation from 0.1 to 3.4 %. Those results demonstrated that the established method was sensitive and efficient for directly enriching and analyzing trace N-nitrosamines in salted vegetables.

Occurrence of N-nitrosodimethylamine in roasted Alaska pollock fillets during processing and storage and preliminary cancer risk assessment

BACKGROUND

Dried and salt-fermented fish products are important sources of N-nitrosodimethylamine (NDMA) exposure for human. As a potent carcinogen, NDMA was frequently detected in roasted Alaska pollock fillet products (RPFs), which is among the most common fish products in China. Until now, the occurrence and development of NDMA and its precursors (nitrites, nitrates and dimethylamine) in RPFs during processing and storage were not well elucidated, and safety evaluation of this fish product is also urgently needed.

RESULTS

The presence of precursors in the raw material was verified and significant increase of nitrates and nitrites during processing was observed. NDMA was found generated during pre-drying (3.7 μg kg-1 dry basis) and roasting (14.6 μg kg-1 dry basis) process. Continuous increase in NDMA content can also be found during storage, especially at higher storage temperature. The 95th percentile of Monte Carlo simulated cancer risk (3.73 × 10-5 ) surpassed the WHO threshold (1.00 × 10-5 ) and sensitivity analysis implies the risk was mainly attributable to NDMA level in RPFs.

CONCLUSION

The occurrence of NDMA in RFPs was mainly a result of endogenous factors originating in Alaska pollock during processing and storage rather than exogenous contamination, and temperature played a pivotal role. The preliminary risk assessment results suggest that long-term consumption of RPFs would impose potential health risks for consumers. © 2023 Society of Chemical Industry.

Dispersant-First Dispersive Liquid-Liquid Microextraction (DF-DLLME), a Novel Sample Preparation Procedure for NDMA Determination in Metformin Products

Since December 2019, global batch recalls of metformin pharmaceutical products have highlighted an urgent need to control N-nitrosodimethylamine (NDMA) contamination to demonstrate patient safety and maintain supply of this essential medicine. Due to their formulation, the metformin extended-release products present difficult analytical challenges for conventional sample preparation procedures, such as artefactual (in-situ) NDMA formation, gelling, and precipitation. To overcome these challenges, a new version of dispersive liquid-liquid microextraction (DLLME) termed dispersant-first DLLME (DF-DLLME) was developed and optimized for the analysis of NDMA in metformin extended-release products using a detailed Design of Experiments (DoE) to optimize sample preparation. Gas chromatography-high resolution accurate mass-mass spectrometry (GC-HRAM-MS) combined with automated DF-DLLME were successfully applied to monitor the NDMA levels of two different metformin extended-release AstraZeneca products to ultra-trace levels (parts per billion). The additional benefits associated with DF-DLLME, which include automation, time/costs saving, and greener sample preparation, make this novel technique easier to transfer from a development to Quality Control (QC) environment. In addition, this also offers an attractive candidate for the wider platform analysis of N-nitrosamines in pharmaceutical drug products.

Rapid screening of high-priority N-nitrosamines in pharmaceutical, forensic, and environmental samples with paper spray ionization and filter cone spray ionization-mass spectrometry

RATIONALE

The burgeoning concern of N-nitrosamine (NAM) contamination found in various pharmaceutical compositions has increased the demand for rapid and reliable screening methods to better assess the breadth of the problem. These carcinogenic compounds are also found in food, water, and soil, and they have been used in poison-related homicides.

METHODS

A combination of complementary, ambient ionization methods, paper spray ionization (PSI) and filter cone spray ionization (FCSI)-mass spectrometry (MS), was characterized towards trace-level residue screening of select NAMs (e.g., N-nitrosodimethylamine, N-nitrosodiethylamine, N-nitrosodibutylamine) directly from complex and problematic matrices of interest, including prescription and over-the-counter tablets, drinking water, soil, and consumable goods. Spectral data for analyte confirmation and detection limit studies were collected using a Thermo LCQ Fleet ion trap mass spectrometer.

RESULTS

PSI-MS and FCSI-MS readily produced mass spectral data marked by their simplicity (e.g., predominantly protonated molecular ions observed) and congruence with traditional electrospray ionization mass spectra in under 2 min. per sample. Both methods proved robust to the complex matrices tested, yielding ion signatures for target NAMs, as well as active pharmaceutical ingredients for analyzed tablets, flavorants inherent to food products, etc. Low part-per-million detection limits were observed but were shown dependent on sample composition.

CONCLUSIONS

PSI-MS and FCSI-MS were successful in detecting trace-level NAMS in complex liquid- and solid-phase matrices with little to no prior preparation. This work suggests that these methodologies can provide a means for assessing problematic pharmaceutical adulterants/degradants for expedited quality control, as well as enhancing environmental stewardship efforts and forensic investigations.

Characteristics and health risk assessment of volatile N-nitrosamines in the plasma of adults in Guangdong Province, China

N-nitrosamines are strong carcinogens that are widely present in the environment. This study developed a method, and analyzed the concentrations of volatile N-nitrosamines (VNAs) in the plasma of adults in Guangdong Province, China. Finally, the health risks to adults in Guangdong Province, China, with dietary exposure to VNAs were assessed. Gas chromatography/mass spectrometry (GC/MS) in electron impact (EI) ionization source mode was used to quantitatively analyze VNAs, and to perform accurate mass determination. The lower limit of detection (LOD) of nine nitrosamines are ranged from 0.01 to 2.14 ng/mL. The recovery rate ranged from 83 % to 116 %, and the relative standard deviation (RSD) was < 10 %. The method developed is simple, rapid, and provides good reproducibility and high sensitivity. N-nitrosodimethylamine (NDMA), N-nitrosomethylethylamine (NMEA), N-nitrosodinbutylamine (NDBA), N-nitrosopiperidine (NPIP), N-nitrosopyrrolidine (NPYR), N-nitrosomorpholine (NMOR) and N-nitrosodiphenylamine (NDPhA) were detected in 92 adult plasma samples. NDMA and NMEA were detected in 56.5 % and 44.6 % of the samples, followed by NPIP (34.8 %). NDMA had the highest median concentration (43.7 ng/mL) in the total samples. There were gender-related differences found in the concentrations of NDBA and NDPhA. The exposure risk assessment results showed that the two highest daily dietary intakes of VNAs were N-nitrosodi-n-propylamine (NDPA) and NDMA, and aquatic products and pickled vegetables contributed the most total nitrosamine intake. The lifetime cancer risk of adults ranged from 2.88 × 10^-10 to 7.46 × 10^-5, and the risk associated with NDMA, NDPA, N-nitrosodiethylamine (NDEA), NMEA and NPIP are important and should attract more attention. This study aimed to explore the exposure levels of VNAs in the plasma of adults in Guangdong Province, China, and to assess the health risks of dietary intake of VNAs, which provides a basis of the effect of VNAs exposure on human health.

Occurrence and mass loads of N-nitrosamines discharged from different anthropogenic activities in Desheng River, South China

N-nitrosamines are widespread in various bodies of water, which is of great concern due to their carcinogenic risks and harmful mutagenic effects. Livestock rearing, domestic, agricultural, and industrial wastewaters are the main sources of N-nitrosamines in environmental water. However, information on the amount of N-nitrosamines these different wastewaters contribute to environmental water is scarce. Here, we investigated eight N-nitrosamines and assessed their mass loadings in the Desheng River to quantify the contributions discharged from different anthropogenic activities. N-nitrosodimethylamine (NDMA) (< 1.6-18 ng/L), N-nitrosomethylethylamine (NMEA) (< 2.2 ng/L), N-nitrosodiethylamine (NDEA) (< 1.7-2.4 ng/L), N-nitrosopyrrolidine (NPYR) (< 1.8-18 ng/L), N-nitrosomorpholine (NMOR) (< 2.0-3.5 ng/L), N-nitrosopiperidine (NPIP) (< 2.2-2.5 ng/L), and N-nitrosodi-n-butylamine (NDBA) (< 3.3-16 ng/L) were detected. NDMA and NDBA were the dominant compounds contributing 89% and 92% to the total N-nitrosamine concentrations. The mean cumulative concentrations of N-nitrosamines in the livestock rearing area (26 ± 11 ng/L) and industrial area (24 ± 4.8 ng/L) were higher than those in the residential area (16 ± 6.3 ng/L) and farmland area (15 ± 5.1 ng/L). The mean concentration of N-nitrosamines in the tributaries (22 ng/L) was slightly higher than that in the mainstem (17 ng/L), probably due to the dilution effect of the mainstem. However, the mass loading assessment based on the river's flow and water concentrations suggested the negligible mass emission of N-nitrosamines into the mainstem from tributaries, which could be due to the small water flow of tributaries. The average mass loads of N-nitrosamines discharged into the mainstem were ranked as the livestock rearing area (742.7 g/d), industrial area (558.6 g/d), farmland area (93.9 g/d), and residential areas (83.2 g/d). In the livestock rearing, residential, and industrial area, NDMA (60.9%, 53.6%, and 46.7%) and NDBA (34.6%, 33.3%, and 44.9%) contributed the most mass loads; NDMA (23.4%), NDEA (15.8%), NPYR (10.1%), NPIP (12.8%), and NDBA (37.8%) contributed almost all the mass loads in the farmland area. Photodegradation amounts of NDMA (0.65 ~ 5.25 µg/(m³·day)), NDBA (0.37 ~ 0.91 µg/(m³·day)), and NDEA (0 ~ 0.66 µg/(m³·day)) were also calculated according to the mass loading. Quantifying the contribution of different anthropogenic activities to the river will provide important information for regional river water quality protection. Risk quotient (RQ) values showed the negligible ecological risks for fish, daphnid, and green algae.

NDMA formation Due to Active Ingredient Degradation and Nitrite Traces in Drug Product

N-nitrosamines are genotoxic compounds which can be found as impurities in drug substances and drug products used in the pharmaceutical industry. To date, several possible nitrosamine sources in drug products have been reported and this study aims to illuminate another one. A case of afatinib drug product was investigated, in which up to 50 ppb N-nitrosodimethylamine (NDMA) traces were detected. Afatinib was found to degrade to the secondary amine dimethylamine (DMA), forming NDMA with traces of nitrite in crospovidone. Two series of film-coated tablets were prepared with crospovidone from two different manufacturers, containing different levels of nitrites. Tablets were subjected to an accelerated stability study (40 °C/75% relative humidity) or stored at room temperature and levels of NDMA, DMA and nitrite in tablets were monitored. NDMA and nitrite were found on ppb levels, whereas DMA was detected on ppm levels. NDMA formation in the drug product was found to be time, temperature and nitrite dependent and it was emphasized that DMA and nitrite should be reduced. The accelerated stability study proved to be a useful tool for predicting nitrosamine formation in the drug product.

Risk assessment of N-nitrosamines in food

EFSA was asked for a scientific opinion on the risks to public health related to the presence of N-nitrosamines (N-NAs) in food. The risk assessment was confined to those 10 carcinogenic N-NAs occurring in food (TCNAs), i.e. NDMA, NMEA, NDEA, NDPA, NDBA, NMA, NSAR, NMOR, NPIP and NPYR. N-NAs are genotoxic and induce liver tumours in rodents. The in vivo data available to derive potency factors are limited, and therefore, equal potency of TCNAs was assumed. The lower confidence limit of the benchmark dose at 10% (BMDL10) was 10 μg/kg body weight (bw) per day, derived from the incidence of rat liver tumours (benign and malignant) induced by NDEA and used in a margin of exposure (MOE) approach. Analytical results on the occurrence of N-NAs were extracted from the EFSA occurrence database (n = 2,817) and the literature (n = 4,003). Occurrence data were available for five food categories across TCNAs. Dietary exposure was assessed for two scenarios, excluding (scenario 1) and including (scenario 2) cooked unprocessed meat and fish. TCNAs exposure ranged from 0 to 208.9 ng/kg bw per day across surveys, age groups and scenarios. 'Meat and meat products' is the main food category contributing to TCNA exposure. MOEs ranged from 3,337 to 48 at the P95 exposure excluding some infant surveys with P95 exposure equal to zero. Two major uncertainties were (i) the high number of left censored data and (ii) the lack of data on important food categories. The CONTAM Panel concluded that the MOE for TCNAs at the P95 exposure is highly likely (98-100% certain) to be less than 10,000 for all age groups, which raises a health concern.

Drinking water treatment and associated toxic byproducts: Concurrence and urgence

Reclaimed water is highly required for environmental sustainability and to meet sustainable development goals (SDGs). Chemical processes are frequently associated with highly hazardous and toxic by-products, like nitrosamines, trihalomethanes, haloaldehydes, haloketones, and haloacetic acids. In this context, we aim to summarize the formation of various commonly produced disinfection by-products (DBPs) during wastewater treatment and their treatment approaches. Owing to DBPs formation, we discussed permissible limits, concentrations in various water systems reported globally, and their consequences on humans. While most reviews focus on DBPs detection methods, this review discusses factors affecting DBPs formation and critically reviews various remediation approaches, such as adsorption, reverse osmosis, nano/micro-filtration, UV treatment, ozonation, and advanced oxidation process. However, research in the detection of hazardous DBPs and their removal is quite at an early and initial stage, and therefore, numerous advancements are required prior to scale-up at commercial level. DBPs abatement in wastewater treatment approach should be considered. This review provides the baseline for optimizing DBPs formation and advancements in the remediation process, efficiently reducing their production and providing safe, clean drinking water. Future studies should focus on a more efficient and rigorous understanding of DBPs properties and degradation of hazardous pollutants using low-cost techniques in wastewater treatment.

N-nitrosamines in Qingdao dried aquatic products and dietary risk assessment

N-nitrosamines are human carcinogens commonly present in dried aquatic products. A method of gas chromatography - mass spectrometry combined with steam distillation was developed for the determination of 9 N-nitrosamines in dried aquatic products in Qingdao, China, with which 300 samples of fish, squid, shrimp and sea cucumber collected from Qingdao were analysed. A health risk assessment was conducted based on determined levels of N-nitrosamines by using estimated daily intake and slope factors. Results showed that fish products was the category with the highest content of N-nitrosamines, whereas squid and shrimp products were the categories with the highest frequency of presence of N-nitrosamines. The average estimated cancer risk of N-nitrosamines in dried aquatic products in Qingdao ranged from 3.57 × 10^-8 to 3.53 × 10^-5. Nitrosodimethylamine, N-Nitrosodiethylamine and N-Nitrosodibutylamine could be considered to pose a potential cancer risk to residents in Qingdao.

Fluorescent paper-based sensor integrated with headspace thin-film microextraction for the detection of acyclic N-nitrosamines following in situ photocatalytic decomposition

BACKGROUND

In this work, a novel analytical approach based on the photocatalytic decomposition of N-nitrosamines combined with headspace thin-film microextraction of the generated nitrogen oxides such as NO has been developed for the determination of the acyclic N-nitrosamine fraction in drinking water samples. A hydrophilic cellulose substrate modified with fluorescent silver nanoclusters (Ag NCs) was used both as extractant and sensing platform. A quenching effect of Ag NCs fluorescence occurs as the concentration of N-nitrosamines increases. Front-face fluorescence spectroscopy with a solid sample holder was employed for directly measuring the fluorescence quenching onto the cellulose substrate.

RESULTS

In order to achieve an optimal analytical response, different parameters involved in the photocatalytic reaction as well as those concerning the microextraction step were fully investigated. It is demonstrated that the photodegradation rate of cyclic N-nitrosamines at acidic pH is much lower than that of acyclic ones, which can be the basis for the determination of the later fraction in waters. Under optimal conditions, a detection limit for the acyclic N-nitrosamine fraction around 0.08 μg L^-1 using N-nitrosodimethylamine (NDMA) as model compound for calibration was obtained. Several drinking waters were spiked with acyclic N-nitrosamines showing recoveries in the range of 98-102% with a relative standard deviation of 3-4% (N = 3).

SIGNIFICANCE AND NOVELTY

N-nitrosamines generated as by-products during disinfection processes applied to water cause multiple adverse effects on human health being classified as potential human carcinogens. This study highlights the suitability of a fluorescent paper-based sensor for the rapid analysis of the acyclic N-nitrosamine fraction (i.e. the most abundant fraction) as a total index in drinking water, being useful as screening tool before exhaustive chromatographic analysis, which saves costs, time and reduces waste generation.

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.

Beer Safety: New Challenges and Future Trends within Craft and Large-Scale Production

The presence of physical, chemical, or microbiological contaminants in beer represents a broad and worthy problem with potential implications for human health. The expansion of beer types makes it more and more appreciated for the sensorial properties and health benefits of fermentation and functional ingredients, leading to significant consumed quantities. Contaminant sources are the raw materials, risks that may occur in the production processes (poor sanitation, incorrect pasteurisation), the factory environment (air pollution), or inadequate (ethanol) consumption. We evaluated the presence of these contaminants in different beer types. This review covers publications that discuss the presence of bacteria (Lactobacillus, Pediococcus), yeasts (Saccharomyces, Candida), moulds (Fusarium, Aspergillus), mycotoxins, heavy metals, biogenic amines, and micro- and nano-plastic in beer products, ending with a discussion regarding the identified gaps in current risk reduction or elimination strategies.

A Genetic Toxicology Study of the Rapid Detection of Nitrosamine Compounds by the rpsL Gene Mutation Assay

In a rpsL gene mutation experiment, the mutagenicity of the nitrosamine compounds N-diethylnitrosamine (NDEA) and N-dipropylnitrosamine (NDPA) was investigated at the cellular level, as well as with PCR (polymerase chain reaction) and RCA (rolling-circle amplification) amplification systems. The experiments were set up with 10 ppm, 100 ppm, and 1000 ppm concentration gradients of NDEA and NDPA, and ethidium bromide (EB) was used as a positive control group. The results demonstrated that the mutagenic frequency of NDEA and NDPA was significantly higher than the spontaneous mutation frequency of the rpsL gene under the same conditions, but lower than the mutagenic rate of EB in the positive control, and there was a dose-effect relationship, indicating that NDEA and NDPA could induce rpsL gene mutation. The rpsL mutation system has a low spontaneous mutation background and high sensitivity, thus the system is expected to become an effective tool for the rapid detection of carcinogens in the field of food.

Effects of seasons and parts on volatile N-nitrosamines and their exposure and risk assessment in raw chicken and duck meats

The N-nitrosamine (NA) concentrations and types in raw chicken and duck meats of different parts and seasons were estimated by headspace solid-phase micro-extraction with gas chromatography-mass spectrometry (HS-SPME-GC-MS). The exposure level and hazard quotient of each detected volatile N-nitrosamine (VNA) were conducted. The selected chicken and duck samples were contaminated by VNAs to some extent. The major types and contents of VNAs in different parts of chicken and duck meats varied seasonally. For chicken samples, the order of the total VNA concentrations was as follows: autumn > spring > winter > summer. For duck samples, the order was changed as follows: winter > autumn > summer > spring (thigh samples) and autumn > spring > winter > summer (breast samples). The estimated exposure levels for adults caused by duck consumption were slightly higher than those by chickens, which was consistent with the tendency in 2-3 years old children. According to the linear regression correlation between the 10% benchmark dose limit (BMDL₁₀) and subtriplicate of median lethal dose (LD₅₀), BMDL₁₀ values of each VNA were calculated. Due to this hypothesis, the risk assessments of each detected VNA and total VNAs posed by consuming chicken and duck meats in Tianjin, China were of low concern.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13197-021-05195-1.

The genotoxic potential of mixed nitrosamines in drinking water involves oxidative stress and Nrf2 activation

Nitrosamine by-products in drinking water are designated as probable human carcinogens by the IARC, but the health effects of simultaneous exposure to multiple nitrosamines in drinking water remain unknown. Genotoxicity assays were used to assess the effects of both individual and mixed nitrosamines in finished drinking water produced by a large water treatment plant in Shanghai, China. Cytotoxicity and genotoxicity were measured at 1, 10-, 100- and 1000-fold actual concentrations by the Ames test, Comet assay, γ-H2AX assay, and the cytokinesis-block micronuclei assay; oxidative stress and the Nrf2 pathway were also assessed. Nitrosamines detected in drinking water included NDMA (36.45 ng/L), NDPA (44.68 ng/L), and NEMA (37.27 ng/L). Treatment with a mixture of the three nitrosamines at 1000-fold actual drinking-water concentration induced a doubling of revertants in Salmonella typhimurium strain TA100, DNA and chromosome damage in HepG2 cells, while 1-1000-fold concentrations of compounds applied singly lacked these effects. Treatment with 100- and 1000-fold concentrations increased ROS, GSH, and MDA and decreased SOD activity. Thus, nitrosamine mixtures showed greater genotoxic potential than that of the individual compounds. N-Acetylcysteine protected against the nitrosamine-induced chromosome damage, and Nrf2 pathway activation suggested that oxidative stress played pivotal roles in the genotoxic property of the nitrosamine mixtures.

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.

Long-term monitoring and risk assessment of N-nitrosamines in the finished water of drinking water treatment plants in South Korea

Approximately 99.1% of South Koreans have access to drinkable tap water from river basins. Due to such a high access rate, the South Korean government has been running, since 2013, a long-term program for monitoring the quality of tap water for drinking. Under this program, the maximum allowed concentrations of N-nitroso-di-n-methylamine (NDMA) and N-nitrosomethylethylamine (NMEA) are defined and applied. In this study, the data from this monitoring program were used to investigate the changes in six N-nitrosamine substances in the finished water of 33 drinking water treatment plants (DWTPs) in South Korea from 2013 to 2020, based on time and location. The effect of the applied water treatment steps on the appearance of N-nitrosamines was analyzed. The excess cancer risk (ECR) due to the oral intake of these substances was assessed. The results before the maximum allowed concentrations of NDMA and NMEA were defined showed that the oral intake ECR of these substances exceeded the carcinogenesis risk of one per one million people per year. After the maximum allowed concentrations of the substances were applied, the concentrations of the substances in the finished water of the DWTPs significantly dropped. The drinking water treated through sand filtration, and then with granular activated carbon, showed the highest efficiency in preventing the appearance of NDMA. Considering the potency of N-nitrosamines in tap water for drinking, the levels of these substances in the finished water of DWTPs in South Korea should be continuously monitored.

Preparation of flower-like molybdenum disulfide for solid-phase extraction of N-nitrosoamines in environmental water samples

In this paper, a flower-like molybdenum disulfide material was prepared by hydrothermal method and was first used as adsorbents in the solid-phase extraction process for enriching N-nitrosoamines. Molybdenum disulfide exhibited three-dimensional petal-like microspheres with about 500 nm in diameter. The relevant analyte extraction and elution parameters (sample volumes, solution pH, washing solvents, elution solvents, and elution volumes) were optimized to improve the solid-phase extraction efficiency. The solid-phase extraction process coupled with high-performance liquid chromatography-tandem mass spectrometry for determining N-nitrosoamines in environmental water samples was established. The limits of detection were in the range of 0.01-0.05 ng/mL. The satisfactory recoveries (68.9-106.1%) were obtained at three different spiked concentrations (2, 5, and 8 ng/mL) in water samples, and the relative standard deviations were between 1.96 and 8.38%. This proposed method not only showed high sensitivity and good reusability but also provided a new adsorbent for enriching trace N-nitrosoamines in environmental water samples.

Ultrasound Assisted Extraction Approach to Test the Effect of Elastic Rubber Nettings on the N-Nitrosamines Content of Ham Meat Samples

Nitrosamines (NAs), which are catalogued as carcinogenic compounds, may be present in meat products due to the conversion of nitrites and as result of migration from elastic rubber nettings used. A method based on ultrasonic assisted extraction coupled with dispersive liquid–liquid microextraction as sample treatment and gas chromatography-mass spectrometry as separation and detection technique was proposed for the determination of twelve NAs in cooked ham samples. The method was validated by evaluating linearity (0.5–1000 ng g⁻¹), matrix effect, sensitivity (detection limits were between 0.15 and 1.4 ng g⁻¹) and precision, which was below 12%. Five NAs were found in the samples with levels ranging from not quantifiable to 40 ng g⁻¹. The effect of the elastic rubber nettings on the nitrosamine content of meat was evaluated by comparing the levels found in products made with several plastics or thread in the presence of additives.

Betulinic acid abates N-nitrosodimethylamine-induced changes in lipid metabolism, oxidative stress, and inflammation in the liver and kidney of Wistar rats

N-nitrosamines have been linked with cancer in humans due to their presence in drinking water and diets. This study evaluated the role of betulinic acid (BA) in abating oxidative stress, inflammation, and hyperlipidemia in rats treated with N-nitrosodimethylamine (NDMA). Twenty-four male rats were assigned into four equal groups. Group I served as the control, Group II received BA (25 mg/kg), Group III received NDMA (5 mg/kg) and, Group IV received BA (25 mg/kg) and NDMA (5 mg/kg). Results showed that the administration of NDMA significantly (p < 0.05) elevated malondialdehyde in the liver and kidney relative to controls. Activities of superoxide dismutase, catalase, glutathione peroxidase, and glutathione-S-transferase, and the level of glutathione were significantly (p < 0.05) decreased by NDMA, while treatment with BA elevated the activities of these enzymes in the liver and kidney. The BA lowered serum interleukin-6 and tumor necrosis factor-alpha levels against the NDMA effect. Furthermore, NDMA increased hepatic and renal triglyceride while phospholipids levels were decreased. NDMA significantly modulated the activities of drug-metabolizing enzymes (aniline hydroxylase, aminopyrine-N-demethylase, and uridyldiphosphoglucuronyltransferase), while BA was able to restore these enzymes to values close to controls. Histology revealed the presence of infiltration and fibroplasia in the liver, while cortical degeneration was noticed in the kidney in NDMA-administered rats. These lesions were reduced in the NDMA rats treated with BA. The findings suggest that BA improves NDMA-induced damage in the liver and kidney of rats through reactions that can be linked with antioxidant, anti-inflammatory, and lipid-lowering pathways.

Occurrence and fate of N-nitrosamines in three full-scale drinking water treatment systems with different treatment trains

The occurrence of mutagenic and carcinogenic N-nitrosamines in drinking water is of great concern. In this study, dynamics and removal of nine N-nitrosamines in three drinking water treatment systems of a southern city of China are monitored during one year of sampling. The impacts of physicochemical treatment units on the removal and generation of N-nitrosamines were evaluated. The O₃ and KMnO₄ based pre-oxidation units have caused an increase in N-nitrosamines concentration, with O₃ showing the substantial generation of N-nitrosamines. The carbon filter and ultrafiltration membrane units were found effective in removing N-nitrosamine precursors. These drinking water treatment systems have been useful in removing N-nitrosamine precursors; meanwhile, a slight decrease was found in already formed N-nitrosamines concentration. However, N-nitrosomorpholine (NMOR) and N-nitrosodiphenylamine (NDPhA) were found resistant toward all kinds of physicochemical treatments, and negligible changes in concentration were noted in all drinking water treatment systems. The distribution networks in the city provided an effective contact period to residual chlorine and precursors, which caused an increase in N-nitrosamines concentration. Overall, N-nitrosodimethylamine (NDMA) and N-nitroso-diethylamine (NDEA) have been found near the cancer risk threshold (10^-6) in all of the drinking water treatment systems, while the remaining seven N-nitrosamines were found below the risk level.

Low-Level Determination of Mutagenic Nitrosamine Impurities in Drug Substances by LC–MS/MS

Since the detection of N-nitrosodimethylamine (NDMA) in a batch of valsartan in 2018, at levels exceeding ICH acceptable intake limits for mutagenic impurities, the analysis of nitrosamines has become an intense focus point for the pharmaceutical industry. The identification and low-level determination of nitrosamines in potentially affected materials is challenging and requires the application of highly sensitive analytical techniques. This article reviews the chronological development of the story and the regulatory landscape that has evolved. It will then discuss the development of analytical methods for the determination of a series of nitrosamines referenced by regulatory authorities, demonstrating separation of these compounds from the active pharmaceutical ingredient (API) and looking at how mass spectrometry (MS) can be applied to ensure that the required detection limits can be reached.

Drinking water nitrosamines in a large metropolitan region in Brazil

Nitrosamines are a concerning group of carcinogens, which have gained increasing attention over the last years, frequently found in drinking and recycled water systems. In this work, an analytical method was developed for the detection and quantification of seven nitrosamines (NDMA, NMEA, NPYR, NDEA, NPIP, NDPA, and NDBA) in drinking water. The method is based on gas chromatography coupled with a single quadrupole mass spectrometer (GC-MS) with electron ionization (EI) mode. Sample enrichment and matrix cleanup by solid-phase extraction (SPE) were performed using the US EPA Method 521 cartridge packed with coconut-based charcoal. The simple method allowed reliable identification and quantification of nitrosamines in the water at nanogram per liter levels. The optimized method was validated at three concentration levels (20, 100, and 200 ng L-1) in ultrapure and drinking water samples. Average recoveries were 63-87% for ultrapure water and 38-79% for drinking water with relative standard deviations (RSD) below 10% for both matrices. Method detection limits were 1.23-3.14 ng L-1. The described method was applied to eighteen drinking water samples collected from 13 cities of the Metropolitan Region of Campinas (São Paulo, Brazil). NDMA was the most frequent nitrosamine detected (89% of samples) and had the highest concentration level found (67 ng L-1). The levels of nitrosamines found in drinking water samples are of considerable relevance since the selected area is a major urban center that has amply expanded industrial and agricultural activities over the last few decades. To the best of our knowledge, this is the first evaluation of nitrosamines in drinking water conducted in Brazil to date.

Risk of Cancer Following the Use of N-Nitrosodimethylamine (NDMA) Contaminated Ranitidine Products: A Nationwide Cohort Study in South Korea

N-nitrosodimethylamine (NDMA), a known carcinogenic agent, was recently detected in some products of ranitidine. Several studies have investigated the detectability of NDMA, in drugs and their risks. However, only a few epidemiological studies have evaluated cancer risk from the use of such individual drugs. This study investigates the risk of cancer in ranitidine users. We conducted an observational population-based cohort study using the Health Insurance Review and Assessment databases, which contain information about the use of medicines in South Korea. The primary study cohort consisted of ranitidine users (n = 88,416). For controls, we enrolled users of famotidine, another H2-receptor antagonist in which no NDMA has been detected. A 4:1 matched cohort was constructed to compare cancer outcomes of the two groups. Our matched cohort comprised of 40,488 ranitidine users and 10,122 famotidine users. There was no statistical difference in the overall cancer risk between the ranitidine and famotidine groups (7.45% vs. 7.56%, HR 0.99, 95% CI 0.91-1.07, p = 0.716). Additionally, no significant differences were observed in the analysis of 11 single cancer outcomes. We found no evidence that exposure to NDMA through ranitidine increases the risk of cancer.

Identification and quantification of contributions to karst groundwater using a triple stable isotope labeling and mass balance model

Although karst groundwater systems provide critical ecosystem services in many regions worldwide, anthropogenic contamination has seriously degraded groundwater quality. Properly elucidating geochemical processes, quantifying contributions of natural and anthropogenic end members, and then protecting karst aquifer systems remain challenging from scientific and engineering aspects. To identify the hydrochemical processes and quantifying contributions of end members (especially, contamination end members), 49 samples were collected from cave waters (CW), artesian springs (AS), and gravity springs (GS) in a karst watershed in Guiyang, China. With increased anthropogenic contamination, the CW, AS, and GS characterized by a Ca-Mg-SO₄^2--HCO₃^- composition often had pH and SO₄^2- concentrations exceeding USEPA secondary drinking water standards. That is attributed to the influence of water-rock interaction, rainfall, and anthropogenic sources (mainly, sewage and fertilizers), in agreement with the compositions of δ³⁴S_SO4, δ¹⁸O_SO4, and ⁸⁷Sr/⁸⁶Sr as well as the results of principal component analysis and correlation coefficients. Based on an end-member mixing model, contributions of rainfall and anthropogenic sources were 47% and 33% of GS, 52% and 41% of CW, and 58% and 35% of AS, respectively. It suggests that the karst groundwater quality is predominantly controlled by rainfall and anthropogenic sources (especially, land use). Results may be applied to properly evaluate the impacts of natural and anthropogenic sources on karst aquifers, coupled with actions to efficiently control potential contamination end members.

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.

Urinary exposure of N-nitrosamines and associated risk of esophageal cancer in a high incidence area in China

Esophageal cancer (EC) is a deadly malignancy worldwide with a high incidence and exhibits unevenly geographic prevalence, which suggests that environmental factors are deeply involved in the development of EC. Although the carcinogenesis of nitrosamines in the esophagus has been identified by tremendous toxicological data, the role of nitrosamines in the genesis of human EC has so far proved inconclusive largely due to a lack of convincing evidences. In this study, urinary nitrosamines in population controls and cases with esophageal precancerous lesions, including reflux esophagitis (RE) accompanying with basal cell hyperplasia (BCH) and dysplasia (DYS), and esophageal squamous cell carcinoma (ESCC) were detected by a SPE-LC-MS/MS method and the associated risk was evaluated. Higher excretion concentrations of N-nitrosomethylethylamine (NMEA) in the RE/BCH patients, NMEA and N-nitrosodibutylamine (NDBA) in the DYS patients, and NMEA, NDBA, N-nitrosopyrrolidine (NPyr) and N-nitrosomorpholine (NMor) in the ESCC patients were observed compared with the controls (p < .05). And with the progression of esophageal lesion, the exposure complexity increased in terms of the categories of nitrosamines. Furthermore, the observed positive associations between the hazardous exposure of NMEA, NDBA and NPyr and the increased risk of ESCC, and between NMEA and NDBA and RE/BCH were established. These findings provided direct evidence to support the hypothesis that exposure to nitrosamines are involved in the carcinogenesis of esophageal epithelia in this high incidence area from the perspective of endogenous exposure assessment. However, discoveries in this study need to be confirmed by systematic researches in the future. And the dose-response relationships, the reference ranges or cutoff values to predict the risks of nitrosamines exposure also need to be defined.

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.

Seasonal occurrence of N-nitrosamines and their association with dissolved organic matter in full-scale drinking water systems: Determination by LC-MS and EEM-PARAFAC

N-nitrosamines have been identified as emerging contaminants with tremendous carcinogenic potential for human beings. This study examined the seasonal changes in the occurrence of N-nitrosamines and N-nitrosodimethylamine formation potential (NDMA-FP) in drinking water resources and potable water from 10 drinking water treatment plants in a southern city of China. The changes in N-nitrosamines are well correlated with dissolved organic matter (DOM), particularly fluorophores, which were measured and compared between traditional fluorescence indices and excitation-emission matrix coupled with parallel factor analysis (EEM-PARAFAC). Four of N-nitrosamine species including N-nitrosodimethylamine (NDMA), N-Nitrosodibutylamine (NDBA), N-Nitrosopyrrolidine (NPYR), and N-Nitrosodiphenylamine (NDPhA) are found to be abundant compounds with an average of 29.5% (26.7%), 20.0% (25.2%), 18.9% (16.0%), and 9.0% (9.9%) in the source (and treated) water, respectively. The sum of N-nitrosamines concentration is recorded to be low in the wet season (July-September), whereas the dry season (October-December) provided opposite impacts. EEM-PARAFAC modeling indicated the predominance of humic-like component (C1) in the wet season while in the dry season the water was dominant in protein-like component (C2). All the N-nitrosamines excluding NDPhA and N-Nitrosomorpholine (NMOR) showed a strong association with protein-like component (C2). In contrast, humic-like C1, which was directly influenced by rainfall, was found to be a suitable proxy for NMOR and NDPhA. The results of this study are valuable to understand the correlation between different N-nitrosamines and DOM through adopting fluorescence signatures.

Progress in the pretreatment and analysis of N-nitrosamines: an update since 2010

As highly toxic substances, N-nitrosamines (NAs) have been proved to cause carcinogenesis and mutagenesis in humans. Therefore, to carefully monitor safety and preserve human health, the development of rapid, accurate, and high-sensitivity determination methods of NAs is of substantial importance. This review provides a current-status comprehensive summary of the pretreatment and determination methods of NAs in various samples since 2010. Common pretreatment methods that have been used to extract and purify targets include solid-phase extraction, liquid-liquid extraction and various microextraction methods, such as solid-phase microextraction and liquid-phase microextraction, among others. Determination methods include liquid chromatography, gas chromatography, supercritical fluid chromatography and electrochemical methods, among others. In addition, we discuss and compare the advantages and disadvantages of various pretreatment and analytical methods and examine the prospects in this area.

Application of chromatographic techniques in the analysis of total nitrosamines in water

The use of ozone, chloramine and chlorine dioxide for water treatment results in the formation N-nitrosamines in the treated water. These groups of chemicals and other nitrogen-containing compounds have been described as disinfection by-products (DBPs) which are known for their toxicity. Nitrosamines are a potential source of nitric oxide (NO) which can bind with metals present in the sample matrix leading to formation of metal - nitrosyl complexes and dissolved metals have the potential to increase the total nitrosamines in water. This phenomenon has not received the desired attention and determination of metal-nitrosyl complexes lack standard analytical technique. Chromatography linked to various detectors is the commonest of the techniques for nitrosamine analysis but it is beset with reduced sensitivity as a result of inappropriate choice of the column. Incidentally, chromatographic techniques have not been really adapted for the analysis of metal-nitrosyl complexes. Therefore, there is need for the survey of existing techniques vis-à-vis metal-nitrosamine analysis and to suggest possible areas for method optimization.

Carcinogenic risk of N-Nitrosamines in Shanghai Drinking Water: Indications for the Use of Ozone Pretreatment

N-Nitrosamines are drinking water disinfection byproducts that pose a high carcinogenic risk. We hypothesized that raw water treatment processes influence the types and concentrations of nitrosamines in drinking water, thereby posing differential health risks. We compared the finished water of two water treatment plants (WTP-A, WTP-B) serving Shanghai, China. Both plants use the Qingcaosha reservoir as a water source to generate drinking water with conventional but distinct treatment processes, namely preoxidation with sodium hypochlorite (WTP-A) vs ozone (WTP-B). Average nitrosamine concentrations, especially that of the probable human carcinogen (2A) N-nitrosodimethylamine, were higher in finished (drinking) water from WTP-A (35.83 ng/L) than from WTP-B (5.07 ng/L). Other differences in mean nitrosamines in drinking water included N-nitrosodipropylamine (42.62 ng/L) and N-nitrosomethylethylamine (26.73 ng/L) in WTP-A in contrast to N-nitrosodiethylamine (7.26 ng/L) and N-nitrosopyrrolidine (59.12 ng/L) in WTP-B. The estimated adult cancer risk from exposure to mixed nitrosamines was 1.83 times higher from WTP-A than from WTP-B drinking water. Children exposed to nitrosamines had a significantly higher cancer risk than adults ( p < 0.05). Disease burden exceeded 10⁶ person-years. Taken together, these data suggest that use of ozone in the preoxidation step can reduce nitrosamine formation in drinking water and thereby lower the population cancer health risk.