Elevated childhood exposure to arsenic despite reduced drinking water concentrations--A longitudinal cohort study in rural Bangladesh

Arsenic exposure and increased C-reactive protein are independently associated with lower erythrocyte glutathione peroxidase activity in Bangladeshi children

Toxic metal contaminants present in food and water have widespread effects on health and disease. Chalcophiles, such as arsenic, cadmium, and mercury, show a high affinity to selenium and exposure to these metals could have a modulating effect on enzymes dependent on selenocysteine in their active sites. The aim of this study was to assess the influence of these metals on the activity of the selenoprotein glutathione peroxidase 1 (GPX1) in erythrocytes of 100 children residing in rural Bangladesh, where drinking water often contains arsenic. GPX1 expression, as measured using high-throughput immunoblotting, showed little correlation with GPX activity (rs = 0.02, p = 0.87) in blood samples. Toxic metals and selenium measured in erythrocytes using inductively coupled plasma mass spectrometry (ICP-MS) and C-reactive protein (CRP) measured in plasma, were all considered as effectors of this divergence in GPX enzymatic activity. Arsenic concentrations in erythrocytes were most influential for GPX1 activity (rs = -0.395, p < 0.0001), and CRP levels also negatively impacted GPX1 activity (rs = -0.443, p < 0.0001). These effects appear independent of each other as arsenic concentrations and CRP showed no correlation (rs = 0.124, p = 0.2204). Erythrocyte selenium, cadmium, and mercury did not show any correlation with GPX1 activity, nor with CRP or arsenic. Our findings suggest that childhood exposure to inorganic arsenic, as well as inflammation triggering the release of CRP, may negatively affect GPX1 activity in erythrocytes.

Early Life Environmental Exposure to Cadmium, Lead, and Arsenic and Age at Menarche: A Longitudinal Mother-Child Cohort Study in Bangladesh

BACKGROUND

Several metals act as endocrine disruptors, but there are few large longitudinal studies about associations with puberty onset.

OBJECTIVES

We evaluated whether early life cadmium, lead, and arsenic exposure was associated with timing of menarche.

METHODS

In a mother-child cohort in rural Bangladesh (n=935), the exposure was assessed by concentrations in maternal erythrocytes in early pregnancy and in girls' urine at 5 and 10 years of age using inductively coupled plasma mass spectrometry. The girls were interviewed twice, at average ages 13.3 [standard deviation (SD)=0.43] and 13.8 (SD=0.43) y, and the date of menarche, if present, was recorded. Associations were assessed using Kaplan-Meier analysis and multivariable-adjusted Cox regression.

RESULTS

In total, 77% of the girls (n=717) had reached menarche by the second follow-up. The median age of menarche among all girls was 13.0 y (25th-75th percentiles: 12.4-13.7 y). At 10 years of age, median urinary cadmium was 0.25μg/L (5th-95th percentiles: 0.087-0.72μg/L), lead 1.6μg/L (0.70-4.2μg/L), and arsenic 54μg/L (19-395μg/L). Given the same age, girls in the highest quartile of urinary cadmium at 5 and 10 years of age had a lower rate of menarche than girls in the lowest quartile, with an adjusted hazard ratio of (HR) 0.80 (95% CI: 0.62, 1.01) at 5 years of age, and 0.77 (95% CI: 0.60, 0.98) at 10 years of age. This implies that girls in the highest cadmium exposure quartile during childhood had a higher age at menarche. Comparing girls in the highest to the lowest quartile of urinary lead at 10 years of age, the former had a higher rate of menarche [adjusted HR = 1.23 (95% CI: 0.97, 1.56)], implying lower age at menarche, whereas there was no association with urinary lead at 5 years of age. Girls born to mothers in the highest quartile of erythrocyte arsenic during pregnancy were less likely to have attained menarche than girls born to mothers in the lowest quartile [adjusted HR= 0.79 (95% CI: 0.62, 0.99)]. No association was found with girls' urinary arsenic exposure.

DISCUSSION

Long-term childhood cadmium exposure was associated with later menarche, whereas the associations with child lead exposure were inconclusive. Maternal exposure to arsenic, but not cadmium or lead, was associated with later menarche. https://doi.org/10.1289/EHP11121.

Arsenic exposure promotes the emergence of cardiovascular diseases

A large number of studies conducted in the past decade 2010-2020 refer to the impact of arsenic (As) exposure on cardiovascular risk factors. The arsenic effect on humans is complex and mainly depends on the varying individual susceptibilities, its numerous toxic expressions and the variation in arsenic metabolism between individuals. In this review we present relevant data from studies which document the association of arsenic exposure with various biomarkers, the effect of several genome polymorphisms on arsenic methylation and the underling molecular mechanisms influencing the cardiovascular pathology. The corresponding results provide strong evidence that high and moderate-high As intake induce oxidative stress, inflammation and vessel endothelial dysfunction that are associated with increased risk for cardiovascular diseases (CVDs) and in particular hypertension, myocardial infarction, carotid intima-media thickness and stroke, ventricular arrhythmias and peripheral arterial disease. In addition, As exposure during pregnancy implies risks for blood pressure abnormalities among infants and increased mortality rates from acute myocardial infarction during early adulthood. Low water As concentrations are associated with increased systolic, diastolic and pulse pressure, coronary heart disease and incident stroke. For very low As concentrations the relevant studies are few. They predict a risk for myocardial infarction, stroke and ischemic stroke and incident CVD, but they are not in agreement regarding the risk magnitude.

Gestational and childhood urinary iodine concentrations and children's cognitive function in a longitudinal mother-child cohort in rural Bangladesh

BACKGROUND

Severe iodine deficiency adversely affects neurodevelopment; however, evidence regarding the association of non-severe deficiency and child cognitive functioning is inconclusive.

METHODS

This prospective mother-child cohort study was nested in a population-based nutritional supplementation trial in Bangladesh (Maternal and Infant Nutrition Interventions in Matlab [MINIMat]). Participants with data on cognitive abilities at 5 and 10 years of age (n = 1530) and at least one measurement of urinary iodine concentration (UIC) (gestational week 8, 5, and 10 years) were selected. Cognitive abilities were assessed using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III) and Wechsler Intelligence Scale for Children (WISC-IV). UICs were measured with inductively coupled plasma mass spectrometry and thereafter adjusted for specific gravity.

RESULTS

Median UICs in our population: (282 μg/L [pregnancy]; 406 μg/L [5 years]; 294 μg/L [10 years]) indicated that iodine intake corresponded to above 'adequate' or even 'excessive', according to the WHO classification. Maternal 'UIC <150 μg/L' was associated with lower full-scale and verbal scores at 5 and 10 years, although the associations were weakened in the fully adjusted models. A tendency of decreased verbal scores was also observed for maternal 'UIC ≥500 μg/L' but not for the corresponding child iodine category (≥300 μg/L). Child 'UIC <100 μg/L' was associated with lower processing speed (B=-3.1, 95% CI [-6.2, -0.1]; P-value = 0.041) compared with the reference group (100 μg/L≤ UIC <300 μg/L).

CONCLUSIONS

Current findings add to the growing evidence of a causal association of early-life iodine intake with cognitive development, indicating that low iodine intake during childhood is associated with reduced processing speed and non-optimal gestational iodine intake is weakly associated with slightly poorer verbal development outcomes.

Assessing the Association of Element Imbalances With Arsenism and the Potential Application Value of Rosa roxburghii Tratt Juice

Endemic arsenism caused by coal burning is a unique type of biogeochemical disease that only exists in China, and it is also a disease of element imbalances. Previous studies have shown that element imbalances are involved in the pathogenesis of arsenic; however, the interaction between the various elements and effective preventive measures have not been fully studied. This study first conducted a cross-sectional study of a total of 365 participants. The results showed that arsenic exposure can increase the content of elements (Al, As, Fe, Hg, K, and Na) in the hair (p < 0.05), but the content of other elements (Ca, Co, Cu, Mn, Mo, P, Se, Sr, V, and Zn) was significantly decreased (p < 0.05). Also, the high level of As, Fe, and Pb and the low level of Se can increase the risk of arsenism (p < 0.05). Further study found that the combined exposure of Fe–As and Pb–As can increase the risk of arsenism, but the combined exposure of Se–As can reduce the risk of arsenism (p < 0.05). In particular, a randomized, controlled, double-blind intervention study reveals that Rosa roxburghii Tratt juice (RRT) can reverse the abovementioned element imbalances (the high level of Al, As, and Fe and the low level of Cu, Mn, Se, Sr, and Zn) caused by arsenic (p < 0.05). Our study provides some limited evidence that the element imbalances (the high level of As, Fe, and Pb and the low level of Se) are the risk factors for the occurrences of arsenism. The second major finding was that RRT can regulate the element imbalances, which is expected to improve arsenism. This study provides a scientific basis for further understanding a possible traditional Chinese health food, RRT, as a more effective detoxication of arsenism.

Association of selenium, arsenic, and other trace elements in drinking water and urine in residents of the plateau region in China

Drinking water is considered to be an important exposure pathway for humans to ingest trace elements; human urine samples are widely accepted as biometric substrates that can reflect human exposure to trace elements. The current study aimed at investigating the concentrations of trace elements including selenium (Se), arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), manganese (Mn), nickel (Ni), lead (Pb), and zinc (Zn) in drinking water and human urine in plateau region of China, determining the association among trace elements in drinking water and urine, and analyzing their associations with age and gender. The results showed that the majority of trace element concentrations were in the range of the World Health Organization (WHO 2011) guideline values, in both urine samples of male and female, and the median values were descending in the order: Zn > Cu > As > Se > Cr > Ni > Mn > Pb > Cd > Co. Selenium contributed to the excretion of As, Cr, Cu, Cd, and Zn in human body, group of 31-40 years appeared to present the greatest excretion ability in most of the trace elements. Weak positive correlations were observed between age and Mn in female urine samples, and negative correlations were observed between age and Se, As, Co, and Cu in male urine samples and between age and Co in female urine samples, respectively. Significant positive correlation was observed in As between drinking water and the whole human urine. In the same family, female seemed to show higher proportions of urinary As levels than male. This study will provide elementary information regarding trace element levels in drinking water and human urine in residents in plateau region of China and is helpful to provide reference for dietary nutrient trace element intake and effective control for local resident.

Contribution of household drinking water intake to arsenic and lead exposure among Uruguayan schoolchildren

BACKGROUND

Food and water are common exposure sources of arsenic and lead among children. Whereas dietary sources of these toxicants are fairly well-studied, the contribution of drinking water to toxicant exposures is not well characterized in many populations, particularly in the Global South.

OBJECTIVE

To assess the extent to which consumption of household drinking water contributes to arsenic and lead exposure among Uruguayan schoolchildren with low-level exposure.

METHODS

Children, aged 5-8 years, were enrolled into the Salud Ambiental Montevideo study during 2009-2013 from schools in Montevideo, Uruguay. Participants reported water intake as part of two 24-h dietary recalls. Concentrations of arsenic were measured in first morning void urine samples, and adjusted for urinary specific gravity. Lead concentrations were measured in venous blood samples. Drinking water samples were collected from participants' homes and toxicant concentrations measured. Data analyses involved a triangulation approach. First, multivariable linear regressions estimated the associations between toxicant exposure through drinking water, calculated for each child as the product of water intake and water toxicant concentration, and the respective toxicant biomarker concentrations among children with complete data on all variables (Sample A; n = 40). Second, regressions were repeated for participants with complete data on all variables except water intakes (Sample B; n = 195), after water intakes were imputed. Finally, models were constructed for participants of Sample B (n = 195) based on drinking water intakes assumed to be fixed at 25th, 50th, 75th percentile intakes of participants in sample A.

RESULTS

Toxicant exposure via drinking water intake was low. The triangulation approach revealed no associations between toxicant exposure through household water intake and the respective toxicant biomarker concentrations.

CONCLUSION

Studies with larger samples and repeated measures are needed to confirm these findings. Nevertheless, it appears that at low water toxicant concentrations, typical water consumption is not a major contributor to children's exposure.

Genomic DNA hydroxymethylation reveals potential role in identification of lung injury in coal-burning arsenicosis populations

Arsenic (As) is a toxic metalloid element that causes lung cancer and multiple non-malignant respiratory diseases. The toxicity of arsenic is mediated in part by epigenetic mechanisms, such as alterations in DNA methylation. While increasing studies have highlighted the potential importance of arsenic exposure to DNA methylation patterns and the subsequent risks for arsenic toxicity, there has been little focus on DNA hydroxymethylation-a negative regulation mechanism of DNA methylation. Therefore, this study aimed to investigate the relationship between genomic DNA methylation/hydroxymethylation and lung injury in arsenicosis populations. First, an increased risk of lung injury and exacerbation of lung function impairment in the arsenicosis population was confirmed. Levels of 5-methylcytosine/deoxycytidine (5 mC/dC), 5-hydroxymethylcytosine/deoxycytidine (5 hmC/dC) and 5 hmC/5 mC in genomic DNA of peripheral blood were decreased in the arsenicosis population compared to in the control. Additionally, multivariate logistic regression models showed an increased risk of chest digital radiography (DR) abnormalities when 5 hmC/dC and 5 hmC/5 mC levels were lower (OR = 3.12 and 3.96, all P < 0.001). For 3 years follow-up, regression analysis showed that a decline in 5 hmC/dC was significantly associated with the decline of lung function parameters [forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and maximal mid-expiratory flow (MMEF); β = 0.167, 0.122 and 0.073, respectively; all P < 0.05]. Using the receiver operating characteristic (ROC) curve, a combination of 5 hmC/5 dC and 5 hmC/5 mC obtained the highest value for distinguishing lung injury in all subjects (AUC = 0.82, P < 0.01). In contrast, in arsenicosis subjects, 5 hmC/dC was better at distinguishing lung injury (AUC = 0.84, P < 0.01). Together, the results revealed that a decrease in genomic DNA hydroxymethylation markers was associated with lung injury in coal-burning arsenicosis populations. Genomic DNA hydroxymethylation could be a novel biomarker for identifying the risk of lung injury caused by coal-burning arsenicosis.

Nanomaterials as adsorbents for As(III) and As(V) removal from water: A review

Freshwater demand will rise in the next couple of decades, with an increase in worldwide population growth and industrial development. The development activities, on one side, have increased the freshwater demand. However, the ground water has been degraded. Among the various organic and inorganic contaminants, arsenic is one of the most toxic elements. Arsenic contamination in ground waters is a major issue worldwide, especially in South and Southeast Asia. Various methods have been applied to provide a remedy to arsenic contamination, including adsorption, ion exchange, oxidation, coagulation-precipitation and filtration, and membrane filtration. Out of these methods, adsorption of As(III)/As(V) using nanomaterials and biopolymers has been used on a wide scale. The present review focuses on recently used nanomaterials and biopolymer composites for As(III)/As(V) sorptive removal. As(III)/As(V) adsorption mechanisms have been explored for various sorbents. The impacts of environmental factors such as pH and co-existing ions on As(III)/As(V) removal, have been discussed. Comparison of various nanosorbents and biopolymer composites for As(III)/As(V) adsorption and regeneration of exhausted materials has been included. Overall, this review will be useful to understand the sorption mechanisms involved in As(III)/As(V) removal by nanomaterials and biopolymer composites and their comparative sorption performances.

Environmental metal exposure and growth to 10 years of age in a longitudinal mother-child cohort in rural Bangladesh

BACKGROUND

Early-life exposure to arsenic (As), cadmium (Cd), and lead (Pb) has been linked to smaller birth and early childhood anthropometry, but little is known beyond the first years in life.

OBJECTIVES

To evaluate the impact of gestational and childhood exposures to As, Cd, and Pb on growth up to 10 years of age.

METHODS

We studied 1530 mother-child dyads from a nested sub-cohort of the MINIMat trial in rural Matlab, Bangladesh. Metal concentrations in maternal erythrocytes during pregnancy and in children's urine at 10y were measured by inductively coupled plasma mass spectroscopy. Child height and weight were measured at 19 occasions from birth until 10y and converted to height-for-age Z-scores (HAZ) and weight-for-age Z-scores (WAZ). Associations between log₂-transformed metal concentrations and growth parameters were assessed with multivariable-adjusted regression models.

RESULTS

Children's concurrent urinary Cd (median 0.24 µg/L), reflecting long-term exposure, was inversely associated with WAZ (B: -0.072; 95% confidence interval (CI): -0.12, -0.020; p = 0.007), and possibly HAZ (B: -0.046; 95% CI: -0.096, 0.0014; p = 0.057), at 10y. The association with WAZ was stronger in boys than in girls. Maternal erythrocyte Cd (median 0.90 µg/kg) during pregnancy was inversely associated with WAZ during childhood only in boys (B: -0.071, 95% CI: -0.14, -0.0047, p = 0.036). Concurrent urinary Pb (median 1.6 µg/L) was inversely associated with WAZ (B: -0.084; 95% CI: -0.16, -0.0085; p = 0.029) and HAZ (B: -0.087; 95% CI: -0.15, -0.021; p = 0.010) in boys, but not in girls. Neither gestational nor childhood As exposure (median maternal erythrocyte As 4.3 µg/kg and children's urinary As 57 µg/L) was associated with growth up to 10y.

CONCLUSIONS

While all effect estimates were small, environmental exposure to Cd and Pb is common and impaired growth is of public health concern, especially for children already at risk of reduced growth due to malnutrition. Gender differences in susceptibility need further investigation.

Provision of folic acid for reducing arsenic toxicity in arsenic-exposed children and adults

BACKGROUND

Arsenic is a common environmental toxin. Exposure to arsenic (particularly its inorganic form) through contaminated food and drinking water is an important public health burden worldwide, and is associated with increased risk of neurotoxicity, congenital anomalies, cancer, and adverse neurodevelopment in children. Arsenic is excreted following methylation reactions, which are mediated by folate. Provision of folate through folic acid supplements could facilitate arsenic methylation and excretion, thereby reducing arsenic toxicity.

OBJECTIVES

To assess the effects of provision of folic acid (through fortified foods or supplements), alone or in combination with other nutrients, in lessening the burden of arsenic-related health outcomes and reducing arsenic toxicity in arsenic-exposed populations.

SEARCH METHODS

In September 2020, we searched CENTRAL, MEDLINE, Embase, 10 other international databases, nine regional databases, and two trials registers.

SELECTION CRITERIA

Randomised controlled trials (RCTs) and quasi-RCTs comparing the provision of folic acid (at any dose or duration), alone or in combination with other nutrients or nutrient supplements, with no intervention, placebo, unfortified food, or the same nutrient or supplements without folic acid, in arsenic-exposed populations of all ages and genders.

DATA COLLECTION AND ANALYSIS

We used standard methodological procedures expected by Cochrane.

MAIN RESULTS

We included two RCTs with 822 adults exposed to arsenic-contaminated drinking water in Bangladesh. The RCTs compared 400 µg/d (FA400) or 800 µg/d (FA800) folic acid supplements, given for 12 or 24 weeks, with placebo. One RCT, a multi-armed trial, compared FA400 plus creatine (3 g/d) to creatine alone. We judged both RCTs at low risk of bias in all domains. Due to differences in co-intervention, arsenic exposure, and participants' nutritional status, we could not conduct meta-analyses, and therefore, provide a narrative description of the data. Neither RCT reported on cancer, all-cause mortality, neurocognitive function, or congenital anomalies. Folic acid supplements alone versus placebo Blood arsenic. In arsenic-exposed individuals, FA likely reduces blood arsenic concentrations compared to placebo (2 studies, 536 participants; moderate-certainty evidence). For folate-deficient and folate-replete participants who received arsenic-removal water filters as a co-intervention, FA800 reduced blood arsenic levels more than placebo (percentage change (%change) in geometric mean (GM) FA800 -17.8%, 95% confidence intervals (CI) -25.0 to -9.8; placebo GM -9.5%, 95% CI -16.5 to -1.8; 1 study, 406 participants). In one study with 130 participants with low baseline plasma folate, FA400 reduced total blood arsenic (%change FA400 mean (M) -13.62%, standard error (SE) ± 2.87; placebo M -2.49%, SE ± 3.25), and monomethylarsonic acid (MMA) concentrations (%change FA400 M -22.24%, SE ± 2.86; placebo M -1.24%, SE ± 3.59) more than placebo. Inorganic arsenic (InAs) concentrations reduced in both groups (%change FA400 M -18.54%, SE ± 3.60; placebo M -10.61%, SE ± 3.38). There was little to no change in dimethylarsinic acid (DMA) in either group. Urinary arsenic. In arsenic-exposed individuals, FA likely reduces the proportion of total urinary arsenic excreted as InAs (%InAs) and MMA (%MMA) and increases the proportion excreted as DMA (%DMA) to a greater extent than placebo (2 studies, 546 participants; moderate-certainty evidence), suggesting that FA enhances arsenic methylation. In a mixed folate-deficient and folate-replete population (1 study, 352 participants) receiving arsenic-removal water filters as a co-intervention, groups receiving FA had a greater decrease in %InAs (within-person change FA400 M -0.09%, 95% CI -0.17 to -0.01; FA800 M -0.14%, 95% CI -0.21 to -0.06; placebo M 0.05%, 95% CI 0.00 to 0.10), a greater decrease in %MMA (within-person change FA400 M -1.80%, 95% CI -2.53 to -1.07; FA800 M -2.60%, 95% CI -3.35 to -1.85; placebo M 0.15%, 95% CI -0.37 to 0.68), and a greater increase in %DMA (within-person change FA400 M 3.25%, 95% CI 1.81 to 4.68; FA800 M 4.57%, 95% CI 3.20 to 5.95; placebo M -1.17%, 95% CI -2.18 to -0.17), compared to placebo. In 194 participants with low baseline plasma folate, FA reduced %InAs (%change FA400 M -0.31%, SE ± 0.04; placebo M -0.13%, SE ± 0.04) and %MMA (%change FA400 M -2.6%, SE ± 0.37; placebo M -0.71%, SE ± 0.43), and increased %DMA (%change FA400 M 5.9%, SE ± 0.82; placebo M 2.14%, SE ± 0.71), more than placebo. Plasma homocysteine: In arsenic-exposed individuals, FA400 likely reduces homocysteine concentrations to a greater extent than placebo (2 studies, 448 participants; moderate-certainty evidence), in the mixed folate-deficient and folate-replete population receiving arsenic-removal water filters as a co-intervention (%change in GM FA400 -23.4%, 95% CI -27.1 to -19.5; placebo -1.3%, 95% CI -5.3 to 3.1; 1 study, 254 participants), and participants with low baseline plasma folate (within-person change FA400 M -3.06 µmol/L, SE ± 3.51; placebo M -0.05 µmol/L, SE ± 4.31; 1 study, 194 participants). FA supplements plus other nutrient supplements versus nutrient supplements alone In arsenic-exposed individuals who received arsenic-removal water filters as a co-intervention, FA400 plus creatine may reduce blood arsenic concentrations more than creatine alone (%change in GM FA400 + creatine -14%, 95% CI -22.2 to -5.0; creatine -7.0%, 95% CI -14.8 to 1.5; 1 study, 204 participants; low-certainty evidence); may not change urinary arsenic methylation indices (FA400 + creatine: %InAs M 13.2%, SE ± 7.0; %MMA M 10.8, SE ± 4.1; %DMA M 76, SE ± 7.8; creatine: %InAs M 14.8, SE ± 5.5; %MMA M 12.8, SE ± 4.0; %DMA M 72.4, SE ±7.6; 1 study, 190 participants; low-certainty evidence); and may reduce homocysteine concentrations to a greater extent (%change in GM FA400 + creatinine -21%, 95% CI -25.2 to -16.4; creatine -4.3%, 95% CI -9.0 to 0.7; 1 study, 204 participants; low-certainty evidence) than creatine alone.

AUTHORS' CONCLUSIONS

There is moderate-certainty evidence that FA supplements may benefit blood arsenic concentration, urinary arsenic methylation profiles, and plasma homocysteine concentration versus placebo. There is low-certainty evidence that FA supplements plus other nutrients may benefit blood arsenic and plasma homocysteine concentrations versus nutrients alone. No studies reported on cancer, all-cause mortality, neurocognitive function, or congenital anomalies. Given the limited number of RCTs, more studies conducted in diverse settings are needed to assess the effects of FA on arsenic-related health outcomes and arsenic toxicity in arsenic-exposed adults and children.

A cohort study of the association between prenatal arsenic exposure and age at menarche in a rural area, Bangladesh

BACKGROUND

Millions of individuals worldwide, particularly in Bangladesh, are exposed to arsenic, mainly through drinking water from tube wells. Arsenic is a reproductive toxicant, but there is limited knowledge of whether it influences pubertal development.

OBJECTIVES

We evaluated the association between prenatal arsenic exposure and age at menarche.

METHODS

This prospective study was based on data from two studies conducted in Matlab, Bangladesh-the Maternal and Infant Nutrition Interventions in Matlab (MINIMat) trial and the Health Consequences of Arsenic in Matlab (AsMat) study. We included 809 MINIMat girls who participated in assessing age at menarche from July 2016 to June 2017 and had prenatal arsenic exposure data through the AsMat study via measurements in tube well water used by the mothers during pregnancy. The exposure was categorized into <10, 10-49, 50-99, 100-199, and ≥200 µg/L. We used Kaplan-Meier and Cox proportional hazards analyses with adjustment for potential confounders to evaluate the association between arsenic exposure and age at menarche. The results were presented by adjusted hazards ratio (aHR) with a 95% confidence interval (CI).

RESULTS

The median arsenic concentration in tube well water consumed by pregnant women was 80 µg/L (interquartile range 2-262 µg/L), and 55% drank water with concentrations above Bangladesh's acceptable value of 50 µg/L. The median age at menarche was 13.0 years. The unadjusted analysis revealed 3.2 months delay in menarche for girls exposed to arsenic concentrations ≥200 µg/L compared with the girl exposed to arsenic concentrations <10 µg/L. Girls exposed to the same higher arsenic concentrations were 23% (aHR 0.77, 95% CI: 0.63-0.95) less likely to have reached menarche than girls exposed to low arsenic concentrations.

CONCLUSIONS

Increased levels of prenatal arsenic exposure were associated with older age at menarche. This delay may indicate endocrine disruptions that could potentially result in adverse health consequences in later life. This finding, along with other severe adverse health reinforces the need for arsenic mitigation at the population level.

Health effect and risk assessment of the populations exposed to different arsenic levels in drinking water and foodstuffs from four villages in arsenic endemic Gaighata block, West Bengal, India

Health exposure and perception of risk assessment have been evaluated on the populations exposed to different arsenic levels in drinking water (615, 301, 48, 20 µg/l), rice grain (792, 487, 588, 569 µg/kg) and vegetables (283, 187, 238, 300 µg/kg) from four villages in arsenic endemic Gaighata block, West Bengal. Dietary arsenic intake rates for the studied populations from extremely highly, highly, moderately, and mild arsenic-exposed areas were 56.03, 28.73, 11.30, and 9.13 μg/kg bw/day, respectively. Acute and chronic effects of arsenic toxicity were observed in ascending order from mild to extremely highly exposed populations. Statistical interpretation using 'ANOVA' proves a significant relationship between drinking water and biomarkers, whereas "two-tailed paired t test" justifies that the consumption of arsenic-contaminated dietary intakes is the considerable pathway of health risk exposure. According to the risk thermometer (SAMOE), drinking water belongs to risk class 5 (extremely highly and highly exposed area) and 4 (moderately and mild exposed area) category, whereas rice grain and vegetables belong to risk class 5 and 4, respectively, for all the differently exposed populations. The carcinogenic (ILCR) and non-carcinogenic risks (HQ) through dietary intakes for adults were much higher than the recommended threshold level, compared to the children. Supplementation of arsenic-safe drinking water and nutritional food is strictly recommended to overcome the severe arsenic crisis.

Inflammation biomarkers associated with arsenic exposure by drinking water and respiratory outcomes in indigenous children from three Yaqui villages in southern Sonora, México

Environmental arsenic exposure in adults and children has been associated with a reduction in the expression of club cell secretory protein (CC16) and an increase in the expression of matrix metalloproteinase-9 (MMP-9), both biomarkers of lung inflammation and negative respiratory outcomes. The objectives of this study were to determine if the levels of serum CC16 and MMP-9 and subsequent respiratory infections in children are associated with the ingestion of arsenic by drinking water. This cross-sectional study included 216 children from three Yaqui villages, Potam, Vicam, and Cocorit, with levels of arsenic in their ground water of 70.01 ± 21.85, 23.3 ± 9.99, and 11.8 ± 4.42 μg/L respectively. Total arsenic in water and urine samples was determined by inductively coupled plasma/optical emission spectrometry. Serum was analyzed for CC16 and MMP-9 using ELISA. The children had an average urinary arsenic of 79.39 μg/L and 46.8 % had levels above of the national concern value of 50 μg/L. Increased arsenic concentrations in drinking water and average daily arsenic intake by water were associated with decreased serum CC16 levels (β = - 0.12, 95% CI - 0.20, - 0.04 and β = - 0.10, 95% CI - 0.18, - 0.03), and increased serum MMP-9 levels (β = 0.35, 95% CI 0.22, 0.48 and β = 0.29, 95% CI 0.18, 0.40) at significant levels (P < 0.05). However, no association was found between levels of these serum biomarkers and urinary arsenic concentrations. In these children, reduced serum CC16 levels were significantly associated with increased risk of respiratory infections (OR = 0.34, 95% CI 0.13, 0.90). In conclusion, altered levels of serum CC16 and MMP-9 in the children may be due to the toxic effects of arsenic exposure through drinking water.

Prenatal arsenic exposure interferes in postnatal immunocompetence despite an absence of ongoing arsenic exposure

Arsenic (As) readily crosses the placenta and exposure of the fetus may cause adverse consequences later in life, including immunomodulation. In the current study, the question was asked how the immune repertoire might respond in postnatal life when there is no further As exposure. Here, pregnant mice (Balb/c [H-2^d]) were exposed to arsenic trioxide (As₂O₃) through their drinking water from time of conception until parturition. Their offspring, 4-week-old mice who had not been exposed again to As, were used for functional analyses of innate, humoral and cellular immunity. Compared to cells from non-As-exposed dam offspring, isolated peritoneal macro-phages (Mϕ) displayed no differences in T-cell stimulating ability. Levels of circulating IgG_2a but not IgG₁ were decreased in As-exposed dam offspring as compared to control offspring counterparts. Mixed-leukocyte reactions (MLR) indicated that CD4⁺ T-cells from the prenatal As-exposed mice were significantly less responsive to allogenic stimulation as evidenced by decreases in interferon (IFN)-γ and IL-2 production and in expression of CD44 and CD69 (but not CD25) activation markers. Interestingly, the Mϕ from the prenatal As-exposed mice were capable of stimulating normal allogenic T-cells, indicating that T-cells from these mice were refractory to allogenic signals. There was also a significant decrease in absolute numbers of splenic CD4⁺ and CD8⁺ T-cells due to prenatal As exposure (as compared to control). Lastly, the impaired immune function of the prenatal As-exposed mice was correlated with a very strong susceptibility to Escherichia coli infection. Taken together, the data from this study clearly show that in utero As exposure may continue to perpetuate a dampening effect on the immune repertoire of offspring, even into the early stages of postnatal life.

Assessing the potential value and mechanism of Ginkgo biloba L. On coal-fired arsenic-induced skin damage: In vitro and human evidence

Exposure through arsenic-contaminated air and food caused by the burning of coal is a major environmental public health concern in Guizhou Province of China. Previous studies have shown that immunological dysfunction is involved in the pathogenesis and carcinogenesis of arsenic; however, knowledge regarding effective prevention measures have not been fully examined. The effect of Ginkgo biloba extract (EGb761) on arsenic-induced skin damage of human immortalized keratinocyte cells (HaCaT) was first evaluated in this study. The results showed that 200 μg/mL EGb761 can reduce the expression of miR-155-5p, and the indicators reflecting arsenic-induced skin damage (Krt1, Krt6c and Krt10) in arsenic-exposed cells (P < 0.05), the expression levels of NF-AT1; the indicators reflecting arsenic-induced immunological dysfunction (IL-2, IFN-γ) in cells; and the levels of secreted IL-2 and IFN-γ in cell supernatants were significantly increased (P < 0.05). Further randomized controlled double-blind experiments showed that compared to the placebo control group, the expression level of miR-155-5p in the plasma of the Ginkgo biloba intervention group, the indicators in the serum reflecting arsenic-induced skin damage (Krt1, Krt6c, and Krt10) and the epithelial-mesenchymal transformation (EMT) vimentin were significantly reduced (P < 0.05), but the levels of NF-AT1 and the indicators reflecting arsenic-induced immunological dysfunction (IL-2, IFN-γ) and EMT (E-cadherin) in serum were significantly increased (P < 0.05). Our study provides some limited evidence that Ginkgo biloba L. can increase the expression of NF-AT1 by downregulating the level of miR-155-5p, alleviating immunological dysfunction, and decreasing the expression of EMT biomarkers, thus indirectly improving arsenic-induced skin damage.

A longitudinal study of rural Bangladeshi children with long-term arsenic and cadmium exposures and biomarkers of cardiometabolic diseases

There is growing interest in understanding the contribution of environmental toxicant exposure in early life to development of cardiometabolic diseases (CMD) in adulthood. We aimed to assess associations of early life exposure to arsenic and cadmium with biomarkers of CMD in children in rural Bangladesh. From a longitudinal mother-child cohort in Matlab, Bangladesh, we followed up 540 pairs. Exposure to arsenic (U-As) and cadmium (U-Cd) was assessed by concentrations in urine from mothers at gestational week 8 (GW8) and children at ages 4.5 and 9 years. Blood pressure and anthropometric indices were measured at 4.5 and 9 years. Metabolic markers (lipids, glucose, hemoglobin A1c, adipokines, estimated glomerular filtration rate (eGFR) were determined in plasma/blood of 9 years old children. In linear regression models, adjusted for child sex, age, height-for-age z score (HAZ), BMI-for-age z score (BAZ), socioeconomic status (SES) and maternal education, each doubling of maternal and early childhood U-Cd was associated with 0.73 and 0.82 mmHg increase in systolic blood pressure (SBP) respectively. Both early and concurrent childhood U-Cd was associated with diastolic (D)BP (β = 0.80 at 4.5 years; β = 0.75 at 9 years). Each doubling of U-Cd at 9 years was associated with decrements of 4.98 mg/dL of total cholesterol (TC), 1.75 mg/dL high-density lipoprotein (HDL), 3.85 mg/dL low-density lipoprotein (LDL), 0.43 mg/dL glucose and 4.29 units eGFR. Each doubling of maternal U-Cd was associated with a decrement of 1.23 mg/dL HDL. Both maternal and childhood U-As were associated with decrement in TC and HDL. Multiple comparisons were checked with family-wise error rate Bonferroni-type-approach. The negative associations of arsenic and cadmium with biomarkers of CMD in preadolescent children indicated influence of both metal(loid)s on fat and carbohydrate metabolism, while cadmium additionally influenced kidney function and BP. Thus, fewer outcomes were associated with U-As compared to U-Cd at preadolescence.

Arsenic exposure from food exceeds that from drinking water in endemic area of Bihar, India

Extensive evidence of elevated arsenic (As) in the food-chain, mainly rice, wheat and vegetables exists. Nevertheless, the importance of exposure from food towards total As exposure and associated health risks in areas with natural occurring As in drinking water is still often neglected, and accordingly mitigations are largely focused on drinking water only. In this study, the contribution of food over drinking water to overall As exposure was estimated for As exposed populations in Bihar, India. Increased lifetime cancer risk was predicted using probabilistic methods with input parameters based on detailed dietary assessment and estimation of As in drinking water, cooked rice, wheat flour and potato collected from 91 households covering 19 villages. Median total exposure was 0.83 μg/kgBW/day (5th and 95th percentiles were 0.21 and 11.1 μg/kgBW/day) and contribution of food (median = 49%) to overall exposure was almost equal to that from drinking water (median = 51%). More importantly and contrary to previous studies, food was found to contribute more than drinking water to As exposure, even when drinking water As was above the WHO provisional guide value of 10 μg/L. Median and 95th percentile excess lifetime cancer risks from food intake were 1.89 × 10^-4 and 7.32 × 10^-4 respectively when drinking water As was below 10 μg/L and 4.00 × 10^-4 and 1.83 × 10^-3 respectively when drinking water As was above 10 μg/L. Our results emphasise the importance of food related exposure in As-endemic areas, and, perhaps surprisingly, particularly in areas with high As concentrations in drinking water - this being partly ascribed to increases in food As due to cooking in high As water. These findings are timely to stress the importance of removing As from the food chain and not just drinking water in endemic areas.

ROS-mediated PERK-eIF2α-ATF4 pathway plays an important role in arsenite-induced L-02 cells apoptosis via regulating CHOP-DR5 signaling

Chronic exposure to arsenic remains a worldwide environmental health issue, affecting hundreds of millions of people. Although, arsenic-induced oxidative stress and apoptosis have been determined, the underlying apoptosis mechanism has not been fully elucidated yet. Oxidative stress integrated-ER stress plays an important role in Life-and-Death decision of cells. The current study was to investigate whether NaAsO₂ utilizes oxidative stress integrated-ER stress signaling to exert pro-apoptotic activity in L-02 cells. Results showed that death receptor 5 (DR5) was a mediator of NaAsO₂ -induced apoptosis by enhancing construction of the death-inducing signaling complex (DISC). NaAsO₂ -sensitized DR5 elevation required maintainable transcription and its transcription factor C/EBP homologous protein (CHOP). Further results showed that NaAsO₂ increased expression in biomarker of endoplasmic reticulum (ER) stress and activated the protein kinase R-like ER kinase (PERK)-eukaryotic translation initiation 2α (eIF2α)-activating transcription factor 4 (ATF4) pathway. PERK inhibitor and ATF4 siRNA significantly attenuated NaAsO₂ -induced CHOP and DR5 expressions. In addition, the antioxidant N-acetyl-l-cysteine (NAC) treatment led to amelioration of NaAsO₂ -induced production of reactive oxygen species (ROS) and some ER stress- and apoptosis- related protein levels and cell viability. Taken together, the results indicate that ROS-mediated PERK-eIF2α-ATF4 pathway activated by NaAsO₂ is the critical upstream event for subsequent apoptosis induction via regulating CHOP-DR5 signaling in L-02 cells when chronic exposure to arsenic, and support that antioxidants might be potential therapeutic agents for preventing or delaying the onset and progress of arsenic-induced hepatotoxicity.

Prenatal and childhood arsenic exposure through drinking water and food and cognitive abilities at 10 years of age: A prospective cohort study

BACKGROUND

Our studies of children in a rural Bangladeshi area, with varying concentrations of arsenic in well-water, indicated modest impact on child verbal cognitive function at 5 years of age.

OBJECTIVES

Follow-up of arsenic exposure and children's cognitive abilities at school-age.

METHODS

In a nested sub-cohort of the MINIMat supplementation trial, we assessed cognitive abilities at 10 years of age (n = 1523), using Wechsler Intelligence Scale for Children (WISC-IV). Arsenic in maternal urine and erythrocytes in early pregnancy, in child urine at 5 and 10 years, and in hair at 10 years, was measured using Inductively Coupled Plasma Mass Spectrometry.

RESULTS

Median urinary arsenic at 10 years was 58 µg/L (range 7.3-940 µg/L). Multivariable-adjusted regression analysis showed that, compared to the first urinary arsenic quintile at 10 years (<30 µg/L), the third and fourth quintiles (30-45 and 46-73 µg/L, respectively) had 6-7 points lower Full developmental raw scores (B: -7.23, 95% CI -11.3; -3.18, and B: -6.37, 95% CI -10.5; -2.22, respectively), corresponding to ~0.2 SD. Verbal comprehension and Perceptual reasoning seemed to be affected. Models with children's hair arsenic concentrations showed similar results. Maternal urinary arsenic in early pregnancy, but not late pregnancy, showed inverse associations with Full developmental scores (quintiles 2-4: B: -4.52, 95% CI -8.61; -0.43, B: -5.91, 95% CI -10.0; -1.77, and B: -5.98, 95%CI -10.2; -1.77, respectively, compared to first quintile), as well as with Verbal comprehension, Perceptual reasoning, and Processing speed, especially in girls (p < 0.05 for interaction of sex with Full developmental scores and Perceptual reasoning). In models with all exposure time points included, both concurrent exposure at 10 years and early prenatal exposure remained associated with cognitive abilities.

CONCLUSIONS

Both early prenatal and childhood arsenic exposure, even at low levels (about 50 µg/L in urine), was inversely associated with cognitive abilities at school-age, although the estimates were modest.

Arsenic in a groundwater environment in Bangladesh: Occurrence and mobilization

Groundwater with an excessive level of Arsenic (As) is a threat to human health. In Bangladesh, out of 64 districts, the groundwater of 50 and 59 districts contains As exceeding the Bangladesh (50 μg/L) and WHO (10 μg/L) standards for potable water. This review focuses on the occurrence, origin, plausible sources, and mobilization mechanisms of As in the groundwater of Bangladesh to better understand its environmental as well as public health consequences. High As concentrations mainly was mainly occur from the natural origin of the Himalayan orogenic tract. Consequently, sedimentary processes transport the As-loaded sediments from the orogenic tract to the marginal foreland of Bangladesh, and under the favorable biogeochemical circumstances, As is discharged from the sediment to the groundwater. Rock weathering, regular floods, volcanic movement, deposition of hydrochemical ore, and leaching of geological formations in the Himalayan range cause As occurrence in the groundwater of Bangladesh. Redox and desorption processes along with microbe-related reduction are the key geochemical processes for As enrichment. Under reducing conditions, both reductive dissolution of Fe-oxides and desorption of As are the root causes of As mobilization. A medium alkaline and reductive environment, resulting from biochemical reactions, is the major factor mobilizing As in groundwater. An elevated pH value along with decoupling of As and HCO₃^- plays a vital role in mobilizing As. The As mobilization process is related to the reductive solution of metal oxides as well as hydroxides that exists in sporadic sediments in Bangladesh. Other mechanisms, such as pyrite oxidation, redox cycling, and competitive ion exchange processes, are also postulated as probable mechanisms of As mobilization. The reductive dissolution of MnOOH adds dissolved As and redox-sensitive components such as SO₄^2- and oxidized pyrite, which act as the major mechanisms to mobilize As. The reductive suspension of Mn(IV)-oxyhydroxides has also accelerated the As mobilization process in the groundwater of Bangladesh. Infiltration from the irrigation return flow and surface-wash water are also potential factors to remobilize As. Over-exploitation of groundwater and the competitive ion exchange process are also responsible for releasing As into the aquifers of Bangladesh.

Evaluating the effects between metal mixtures and serum vaccine antibody concentrations in children: a prospective birth cohort study

BACKGROUND

Many populations are exposed to arsenic, lead, and manganese. These metals influence immune function. We evaluated the association between exposure to single and multiple metals, including arsenic, lead, and manganese, to humoral immunity as measured by antibody concentrations to diphtheria and tetanus toxoid among vaccinated Bangladeshi children. Additionally, we examined if this association was potentially mediated by nutritional status.

METHODS

Antibody concentrations to diphtheria and tetanus were measured in children's serum at age 5 (n = 502). Household drinking water was sampled to quantify arsenic (W-As) and manganese (W-Mn), whereas lead was measured in blood (B-Pb). Exposure samples were taken during pregnancy, toddlerhood, and early childhood. Multiple linear regression models (MLRs) with single or combined metal predictors were used to determine the association with antibody outcomes. MLR results were transformed to units of percent change in outcome per doubling of exposure to improve interpretability. Structural equation models (SEMs) were used to further assess exposure to metal mixtures. SEMs regressed a latent exposure variable (Metals), informed by all measured metal variables (W-As, W-Mn, and B-Pb), on a latent outcome variable (Antibody), informed by measured antibody variables (diphtheria and tetanus). Weight-for-age z-score (WFA) at age 5 was evaluated as a mediator.

RESULTS

Diphtheria antibody was negatively associated with W-As during pregnancy in MLR, but associations were attenuated after adjusting for W-Mn and B-Pb (- 2.9% change in diphtheria antibody per doubling in W-As, 95% confidence interval [CI]: - 7%, 1.5%). Conversely, pregnancy levels of B-Pb were positively associated with tetanus antibody, even after adjusting for W-As and W-Mn (13.3%, 95% CI: 1.7%, 26.3%). Overall, null associations were observed between W-Mn and antibody outcomes. Analysis by SEMs showed that the latent Metals mixture was significantly associated with the latent Antibody outcome (β = - 0.16, 95% CI: - 0.26, - 0.05), but the Metals variable was characterized by positive and negative loadings of W-As and B-Pb, respectively. Sex-stratified MLR and SEM analyses showed W-As and B-Pb associations were exclusive to females. Mediation by WFA was null, indicating Metals only had direct effects on Antibody.

CONCLUSIONS

We observed significant modulation of vaccine antibody concentrations among children with pregnancy and early life exposures to drinking water arsenic and blood lead. We found distinct differences by child sex, as only females were susceptible to metal-related modulations in antibody levels. Weight-for-age, a nutritional status proxy, did not mediate the association between the metal mixture and vaccine antibody.

hOGG1 promoter methylation, hOGG1 genetic variants and their interactions for risk of coal-borne arsenicosis: A case-control study

To identify the effect of hOGG1 methylation, Ser326Cys polymorphism and their interactions on the risk of coal-borne arsenicosis, 113 coal-borne arsenicosis subjects and 55 reference subjects were recruited. Urinary arsenic contents were analyzed with ICP-MS. hOGG1 methylation and Ser326Cys polymorphism was measured by mehtylation-specific PCR and restriction fragment length polymorphism PCR in PBLCs, respectively. The results showed that the prevalence of methylated hOGG1 and variation genotype (326 ^Ser/Cys & 326 ^Cys/Cys) were increased with raised levels of urinary arsenic in arsenicosis subjects. Increased prevalence of methylated hOGG1 and variation genotype were associated with raised risk of arsenicosis. Moreover, the results revealed that variant genotype might increase the susceptibility to hOGG1 methylation. The interactions of methylated hOGG1 and variation genotype were also found to contribute to increased risk of arsenicosis. Taken together, hOGG1 hypermethylation, hOGG1 variants and their interactions might be potential biomarkers for evaluating risk of coal-borne arsenicosis.

Arsenic exposure and perception of health risk due to groundwater contamination in Majuli (river island), Assam, India

Island populations are rarely studied for risk of arsenic (As) poisoning. As poisoning, multimetal contamination and people's perceptions of health risks were assessed on India's Majuli Island, the largest inhabited river island in the world. This holistic approach illustrated the association of groundwater contamination status with consequent health risk by measuring levels of inorganic arsenic (iAs) in groundwater, borehole sediment and biological samples (hair, nails and urine). Piper and Gibbs's plots discerned the underlying hydrogeochemical processes in the aquifer. Demographic data and qualitative factors were evaluated to assess the risks and uncertainties of exposure. The results exhibited significant enrichment of groundwater with As, Mn and Fe along with significant body burden. Maximum Hazard Index values indicated severe non-carcinogenic health impacts as well as a significantly elevated risk of cancer for both adults and children. Most (99%) of the locally affected population did not know about the adverse health impacts of metal contamination, and only 15% understood bodily ailments and health issues. Various aspects of the island environment were used to elucidate the status of contamination and future risk of disease. A projection showed adverse health outcomes rising significantly, especially among the young population of Majuli, due to overexposure to not only As but also Ba, Mn and Fe.

miR-191 is involved in renal dysfunction in arsenic-exposed populations by regulating inflammatory response caused by arsenic from burning arsenic-contaminated coal

Chronic exposure to arsenic may result in the manifestation of damage in multiple organs or systems of the body. Arsenic-induced renal dysfunction has been determined, but their pathogenesis has not been fully examined. In this study, we measured the expression levels of miR-191 in plasma, the contents of pro-inflammatory (interleukin (IL)-6 and tumor necrosis factor alpha) and anti-inflammatory (IL-2 and transforming growth factor beta) cytokines, and renal dysfunction indicators (blood urea nitrogen, blood creatinine, uric acid, and cystatin C) in serum from control and arsenic poisoning populations and analyzed the relationship between the miR-191, cytokines, and renal dysfunction indicators. The results clearly show the alteration of miR-191 expression was significantly associated with arsenic-induced renal dysfunction. Overall, the association of miR-191, inflammatory response and renal dysfunction, is clearly supported by the current findings. In other words, miR-191 is involved in renal dysfunction in exposed populations by regulating inflammatory response caused by coal-burning arsenic. The study provides a scientific basis for further studies of the causes of the arsenic-induced renal dysfunction, the biological role of miR-191, and targeted prevention strategies.

Association and risk of five miRNAs with arsenic-induced multiorgan damage

Chronic exposure to arsenic remains a major environmental public health concern worldwide, affecting hundreds of millions of people. Arsenic-induced multiorgan damage and miRNA expression changes after arsenic exposure have been determined, but their associations and risks have not been fully examined. In this study, we measured the expression levels of five miRNAs in plasma from control and arsenic poisoned populations, and we analyzed the relationship between miRNAs and multiorgan damage. The results clearly show that the upregulation of miR-155 expression can increase the risk of arsenic induced skin damage (OR = 10.55; 95% CI: 6.02, 18.47); further, there is a link between the expression of miR-21 (OR = 11.84; 95% CI: 5.34, 26.28) and miR-145 (OR = 2.39; 95% CI: 1.61, 3.55) and liver damage, and miR-191 and kidney damage (OR = 3.65; 95% CI: 1.49, 8.93). In addition, we analyzed the diagnostic value of miRNAs associated with specific organ damage in arsenic-induced multiorgan damage. It was found that the miR-155 has a certain diagnostic value in arsenic-induced skin damage (AUC = 0.83), miR-21 and miR-145 have diagnostic value for liver damage (AUC = 0.80, 0.81) and miR-191 has diagnostic value for kidney damage (AUC = 0.83). This study provides the first comprehensive assessment of the association and risk of five miRNAs with arsenic-induced multiorgan damage. The study can provide a scientific basis for further understanding the causes of arsenic-induced multiorgan damage, identification of possible biological markers, and improvement of targeted prevention and control strategies.

Thyroid hormones and neurobehavioral functions among adolescents chronically exposed to groundwater with geogenic arsenic in Bangladesh

Groundwater, the major source of drinking water in Bengal Delta Plain, is contaminated with geogenic arsenic (As) enrichment affecting millions of people. Children exposed to tubewell water containing As may be associated with thyroid dysfunction, which in turn may impact neurodevelopmental outcomes. However, data to support such relationship is sparse. The purpose of this study was to examine if chronic water As (WAs) from Holocene alluvial aquifers in this region was associated with serum thyroid hormone (TH) and if TH biomarkers were related to neurobehavioral (NB) performance in a group of adolescents. A sample of 32 healthy adolescents were randomly drawn from a child cohort in the Health Effects of Arsenic Longitudinal Study (HEALS) in Araihazar, Bangladesh. Half of these participants were consistently exposed to low WAs (<10 μg/L) and the remaining half had high WAs exposure (≥10 μg/L) since birth. Measurements included serum total triiodothyronine (tT₃), free thyroxine (fT₄), thyrotropin (TSH) and thyroperoxidase antibodies (TPOAb); concurrent WAs and urinary arsenic (UAs); and adolescents' NB performance. WAs and UAs were positively and significantly correlated with TPOAb but were not correlated with TSH, tT₃ and fT₄. After accounting for covariates, both WAs and UAs demonstrated positive but non-significant relationships with TSH and TPOAb and negative but non-significant relationships with tT₃ and fT₄. TPOAb was significantly associated with reduced NB performance indicated by positive associations with latencies in simple reaction time (b = 82.58; p < 0.001) and symbol digit (b = 276.85; p = 0.005) tests. TSH was significantly and negatively associated with match-to-sample correct count (b = -0.95; p = 0.05). Overall, we did not observe significant associations between arsenic exposure and TH biomarkers although the relationships were in the expected directions. We observed TH biomarkers to be related to reduced NB performance as hypothesized. Our study indicated a possible mechanism of As-induced neurotoxicity, which requires further investigations for confirmatory findings.

High arsenic contamination and presence of other trace metals in drinking water of Kushtia district, Bangladesh

Drinking water with excessive concentration levels of arsenic (As) is a great threat to human health. A hydrochemical approach was employed in 50 drinking water samples (collected from Kushtia district, Bangladesh) to examine the occurrence of geogenic As and the presence of trace metals (TMs), as well as the factors controlling As release in aquifers. The results reveal that the drinking water of shallow aquifers is highly contaminated by As (6.05-590.7 μg/L); 82% of samples were found to exceed the WHO recommended limit (10 μg/L) for potable water, but the concentrations of Si, B, Mn, Sr, Se, Ba, Fe, Cd, Pb, F, U, Ni, Li, and Cr were within safe limits. The Ca-HCO₃-type drinking water was identified as having high contents of As, pH and HCO₃^-, a medium-high content EC, and low concentrations of NO₃^-, SO₄^2-, K⁺, and Cl^-. The significant correlation between As and NO₃^- indicates that NO₃^- might be attributed to the use of phosphate fertilizers and a factor responsible for enhancing As in aquifers. The study also reports that the occurrence of high As and the presence of TMs in drinking water may be a result of local anthropogenic activities, such as irrigation, intensive land use and the application of agrochemicals. The insignificant correlation between As and SO₄^2- demonstrated that As is released from SO₄^2- minerals under reducing conditions. An elevated pH value along with decoupling of As and HCO₃^- plays a vital role in mobilizing As to aquifer systems. Moreover, the positive relationship between As and Si indicated that As is transported in the biogeochemical environment. The reductive suspension of Mn(IV)-oxyhydroxides also accelerated the As mobilization process. Over exploitation of tube-well water and the competitive ion exchange process are also responsible for the release of As in aquifers.

Inorganic arsenic in food products on the Swedish market and a risk-based intake assessment

Inorganic arsenic (iAs) and total arsenic (tAs) were determined in common food from the Swedish market. Special focus was on rice, fish and shellfish products. For the speciation of iAs the European standard EN:16802 based on anion exchange chromatography coupled to ICP-MS was used. The two market basket food groups cereals (including rice), and sweets and condiments (a mixed group of sugar, sweets, tomato ketchup and dressings), contained the highest iAs levels (means 9 and 7 μg iAs/kg), whereas other food groups, including fish, did not exceed 2 μg iAs/kg. Varying levels of iAs were found in separate samples of tomato ketchup, 2.4-26 μg/kg, and is suggested to be one reason of the rather high average level of iAs in the food group sweets and condiments. Some specific food products revealed iAs levels much higher, i.e. rice crackers 152 and Norway lobster 89 μg iAs/kg. The intake of iAs via food was estimated by data from two national consumption surveys, performed in 2010-11 (1797 adults) and 2003 (2259 children). The estimated median iAs intakes in adults and children were 0.047 and 0.095 μg/kg body weight and day, respectively. The iAs intake for rice eaters was about 1.4 times higher than for non-rice eaters. Validation of the consumption survey-based iAs intake, using food purchase and market basket data mainly from 2015, resulted in a per capita intake of a similar magnitude, i.e. 0.056 μg/kg body weight and day. The estimated cancer risk for adults using low-dose linear extrapolation is <1 per 100,000 per year.

Changes in arsenic exposure in Araihazar, Bangladesh from 2001 through 2015 following a blanket well testing and education campaign

BACKGROUND

Concentrations of arsenic (As) are elevated in a large proportion of wells in Bangladesh but are spatially variable even within a village. This heterogeneity can enable exposed households to switch to a nearby well lower in As in response to blanket (area-wide) well As testing.

OBJECTIVES

We document the evolution of As exposure in Araihazar, Bangladesh following a blanket well testing and education campaign, as well as the installation of a considerable number of low As community wells.

METHODS

We use well water and urinary As data collected between 2000 and 2008, along with household interviews extending through 2016, within a 25 km2 area of Araihazar upazila for nearly 12,000 participants enrolled in the Health Effects of Arsenic Longitudinal Study (HEALS). We observe changes in participants' well water and urinary As concentrations following interventions to lower their exposure and use logistic regression to determine the factors associated with participants' decisions to switch primary household wells.

RESULTS

Urinary As for participants drinking from wells with >100 μg/L As at baseline declined from a mean of 226 μg/L at baseline to 173 μg/L two years later, and further declined to 139 μg/L over 8 years. For comparison, urinary As concentrations for participants drinking from wells with ≤10 μg/L As remained close to 50 μg/L throughout. Whereas the interventions only partially reduced exposure, well status with respect to As was predictive of well-switching decisions for at least a decade after the initial testing. Participants with high-As wells were 7 times more likely to switch wells over the first two years and 1.4-1.8 times more likely to switch wells over the ensuing decade.

CONCLUSIONS

Arsenic exposure gradually declined following blanket well testing, an education campaign, and the installation of community wells but remained almost three times higher than for a subgroup of the participants drinking from wells with ≤10 μg/L. In addition, the number of participants with unknown As concentrations in their primary household wells increased substantially over time, indicating the importance of additional well testing as new wells continue to be installed, in addition to other means of reducing As exposure.

Early-Life Cadmium Exposure and Bone-Related Biomarkers: A Longitudinal Study in Children

BACKGROUND

Chronic cadmium exposure has been associated with osteotoxicity in adults, but little is known concerning its effects on early growth, which has been shown to be impaired by cadmium.

OBJECTIVES

Our objective was to assess the impact of early-life cadmium exposure on bone-related biomarkers and anthropometry at 9 y of age.

METHODS

For 504 children in a mother-child cohort in Bangladesh, cadmium exposure was assessed by concentrations in urine (U-Cd, long-term exposure) and erythrocytes (Ery-Cd, ongoing exposure) at 9 and 4.5 y of age, and in their mothers during pregnancy. Biomarkers of bone remodeling [urinary deoxypyridinoline (DPD), urinary calcium, plasma parathyroid hormone, osteocalcin, vitamin D3, insulin-like growth factor (IGF) 1, IGF binding protein 3, thyroid stimulating hormone] were measured at 9 y of age.

RESULTS

In multivariable-adjusted linear models, a doubling of concurrent U-Cd was associated with a mean increase in osteocalcin of [Formula: see text] (95% CI: 0.042, 5.9) and in urinary DPD of [Formula: see text] (95% CI: 12, 32). In a combined exposure model, a doubling of maternal Ery-Cd was associated with a mean increase in urinary DPD of [Formula: see text] (95% CI: [Formula: see text], 30). Stratifying the osteocalcin model by gender ([Formula: see text] 0.001), a doubling of concurrent U-Cd was associated with a mean decrease in osteocalcin of [Formula: see text] (95% CI: [Formula: see text], [Formula: see text]) in boys and a mean increase of [Formula: see text] (95% CI: 5.4, 13) in girls. The same pattern was seen with U-Cd at 4.5 y of age ([Formula: see text] 0.016). Children's U-Cd and Ery-Cd, concurrent and at 4.5 y of age, were inversely associated with vitamin D3.

CONCLUSIONS

Childhood cadmium exposure was associated with several bone-related biomarkers and some of the associations differed by gender. https://doi.org/10.1289/EHP3655.

Predictors of selenium biomarker kinetics in 4-9-year-old Bangladeshi children

BACKGROUND

Biomarker selenium concentrations vary greatly between studies. Concentrations in erythrocytes, urine, and hair vary even at similar plasma concentrations, suggesting that unknown factors influence the distribution of selenium between body compartments.

OBJECTIVE

To assess predictors of the different selenium biomarkers in children.

DESIGN

We used a mother-child cohort, nested in a population-based supplementation trial in rural Bangladesh (MINIMat), established for evaluation of arsenic toxicity. Selenium was measured in plasma (n = 223), erythrocytes, urine, and hair at 9 years (n = 395) and in erythrocytes and urine at 4.5 years (n = 259) using inductively coupled plasma mass spectrometry. We also measured concentrations of arsenic (all biospecimen) and cadmium (erythrocytes and urine). Genotyping for INMT, a methyltransferase involved in selenium metabolism, was performed using TaqMan probes.

RESULTS

At 9 years, the selenium concentrations ranged 51-139 μg/L in plasma, 128-281 μg/L in erythrocytes, 2.2-55 μg/L in urine, and 258-723 μg/kg in hair. Correlations (r_S) between biomarkers ranged 0.12-0.37, and were strongest between blood compartments and between erythrocytes and hair (long-term markers). In multivariable-adjusted linear regression analyses, plasma selenium differed by sampling season (highest in food-secure pre-monsoon season) and was inversely associated with plasma arsenic (range < 0.0080-20 μg/L; B = -1.1, 95% CI: -1.8, -0.41). In contrast, erythrocyte selenium was positively associated with erythrocyte arsenic (range 0.95-50 μg/L; B = 0.58, 95% CI: 0.26, 0.91) and inversely associated with erythrocyte cadmium (range 0.27-3.1 μg/L; B = -12, 95% CI: -17, -6.9). These associations were similar at 4.5 years. Only selenium in hair and urine were influenced by INMT polymorphisms. Finally, chronic malnutrition seemed to increase selenium retention, measured as the ratio plasma/urinary selenium.

CONCLUSIONS

Selenium biomarkers seem to be influenced by malnutrition, genetics, and exposure to metal pro-oxidants. This might affect the evaluation of deficiency/sufficiency, normally assessed by selenium in plasma/serum.

Associations of potentially toxic elements (PTEs) in drinking water and human biomarkers: a case study from five districts of Pakistan

Potentially toxic elements (PTEs) are hazardous contaminants with great global environmental/ecological concerns due to their toxic, persistence, and bio-accumulative nature. This study investigates the concentrations of PTEs (Cd, Co, Cu, Fe, Ni, Mn, Pb, and Zn) in drinking water sources and consumers' biomarkers such as hair, nails, urine, and blood. For this purpose, drinking water (n = 190) and consumer biomarker (n = 60) samples were collected from five districts of the Southern Khyber Pakhtunkhwa, Pakistan. Samples were extracted and analyzed for selected PTEs concentrations using an inductively coupled plasma mass spectrometer (ICP-MS, PerkinElmer Optima 7000 DV, USA). The concentrations of PTEs were observed within the drinking water guidelines set by the World Health Organization (WHO), except for Fe, Mn, and Pb. The determined concentrations of PTEs were used to evaluate the health risk through exposure, particularly hazard quotient (HQ) and hazard index (HI). The PTEs contamination of drinking water has led to the highest mean ADI values (39.0 and 91.8 μg/kg/day) and HQ values (0.306 and 0.130) for Zn in adults and children, respectively. The mean values of HQ and HI for selected PTEs were observed within the safe health limits (< 1). Among studied biomarkers, hair showed the highest concentrations for Mn, Zn, Cd, and Pb, plasma for Co and Cu, nails for Ni, and red blood cells (RBCs) for Fe only. This study concluded that chronic exposure of PTEs through drinking water consumption has led to their bioaccumulation in human biomarkers.

Cadmium exposure and cognitive abilities and behavior at 10 years of age: A prospective cohort study

BACKGROUND

We have previously reported inverse associations of prenatal and childhood cadmium exposure with cognition in 5-year-old Bangladeshi children.

OBJECTIVES

To assess if cadmium exposure affected cognition and behavior in the Bangladeshi children at 10 years.

METHODS

Cadmium exposure was assessed by urinary concentrations at 10 (n = 1498) and 5 years of age (n = 1453), and of the mothers in early pregnancy (n = 1299), measured by ICP-MS. Cognitive abilities were assessed with Wechsler Intelligence Scale for Children (4th edition) and behavior with the parent-rated Strengths and Difficulties Questionnaire.

RESULTS

In multivariable-adjusted models, urinary cadmium at 10 years was inversely associated with Full scale IQ and most of the sub-scales. Associations were mainly observed in boys, in whom the difference in Full scale IQ was 7.0 scores (95% CI: -11, -2.7), corresponding to 0.21 SD, when comparing those in the highest (range: 0.30-2.6 μg/L) and lowest tertile of urinary cadmium (0.036-0.18 μg/L). Urinary cadmium at 5 years was inversely, but not significantly, associated with IQ. Children in the highest exposure tertile at 10 years also had poorer Prosocial behavior scores. The association appeared strongest in girls, in whom the corresponding OR for Prosocial scores in relation to cadmium exposure at 10 years and prenatally was 0.58 (95% CI: 0.34, 0.99) and 0.48 (95% CI: 0.25, 0.93), respectively.

CONCLUSION

Childhood cadmium exposure was associated with lower intelligence in boys, and there were indications of altered behavior in girls for both prenatal and childhood exposures. Findings are of concern as similar exposure levels are common world-wide.

Associations between Methylated Metabolites of Arsenic and Selenium in Urine of Pregnant Bangladeshi Women and Interactions between the Main Genes Involved

BACKGROUND

It has been proposed that interactions between selenium and arsenic in the body may affect their kinetics and toxicity. However, it is unknown how the elements influence each other in humans.

OBJECTIVES

We aimed to investigate potential interactions in the methylation of selenium and arsenic.

METHODS

Urinary selenium (U-Se) and arsenic (U-As) were measured using inductively coupled plasma mass spectrometry (ICPMS) in samples collected from pregnant women (n=226) in rural Bangladesh at gestational weeks (GW) 8, 14, 19, and 30. Urinary concentrations of trimethyl selenonium ion (TMSe) were measured by HPLC-vapor generation-ICPMS, as were inorganic arsenic (iAs), methylarsonic acid (MMA), and dimethylarsinic acid (DMA). Methylation efficiency was assessed based on relative amounts (%) of arsenic and selenium metabolites in urine. Genotyping for the main arsenite and selenium methyltransferases, AS3MT and INMT, was performed using TaqMan probes or Sequenom.

RESULTS

Multivariable-adjusted linear regression analyses indicated that %TMSe (at GW8) was positively associated with %MMA (β=1.3, 95% CI: 0.56, 2.0) and U-As, and inversely associated with %DMA and U-Se in producers of TMSe (INMT rs6970396 AG+AA, n=74), who had a wide range of urinary TMSe (12-42%). Also, %TMSe decreased in parallel to %MMA during pregnancy, especially in the first trimester (-0.58 %TMSe per gestational week). We found a gene-gene interaction for %MMA (p-interaction=0.076 for haplotype 1). In analysis stratified by INMT genotype, the association between %MMA and both AS3MT haplotypes 1 and 3 was stronger in women with the INMT GG (TMSe nonproducers, 5th-95th percentile: 0.2-2%TMSe) vs. AG+AA genotype.

CONCLUSIONS

Our findings for Bangladeshi women suggest a positive association between urinary %MMA and %TMSe. Genes involved in the methylation of selenium and arsenic may interact on associations with urinary %MMA. https://doi.org/10.1289/EHP1912.

Arsenic in groundwater of West Bengal, India: A review of human health risks and assessment of possible intervention options

This paper reviews how active research in West Bengal has unmasked the endemic arsenism that has detrimental effects on the health of millions of people and their offspring. It documents how the pathways of exposure to this toxin/poison have been greatly expanded through intensive application of groundwater in agriculture in the region within the Green Revolution framework. A goal of this paper is to compare and contrast the similarities and differences in arsenic occurrence in West Bengal with those of other parts of the world and assess the unique socio-cultural factors that determine the risks of exposure to arsenic in local groundwater. Successful intervention options are also critically reviewed with emphasis on integrative strategies that ensure safe water to the population, proper nutrition, and effective ways to reduce the transfer of arsenic from soil to crops. While no universal model may be suited for the vast areas of the world affected with by natural contamination of groundwater with arsenic, we have emphasized community-specific sustainable options that can be adapted. Disseminating scientifically correct information among the population coupled with increased community level participation and education are recognized as necessary adjuncts for an engineering intervention to be successful and sustainable.

Quantification of health risks in Ecuadorian population due to dietary ingestion of arsenic in rice

In Ecuador alone, 500,000 people in rural areas are estimated to have been exposed to high concentrations of As from water and food, but no quantitative evaluation of health risk has yet been made. The present study quantifies exposure and health risk for the Ecuadorian population from the ingestion of arsenic in white rice. Estimated exposure is correlated with published data on tap water quality and biomarkers of exposure for the population of two towns in the metropolitan area of Quito. Estimated daily intake (EDI) of arsenic for infants living in urban areas of Ecuador is around four times that of European infants, being equal for those livings in rural areas. EDI for the population as a whole is almost twice that of Europe, but between a half and a third of that of Brazil, Bangladesh, and India. Estimated excess lifetime risk (ELTR) for adults is 3 per 10,000, while for infants varies between 10 per 10,000 in rural areas and 20 per 10,000 in urban areas. Future research on arsenic impacts on human health in Ecuador should consider in particular poor populations living in regions where environmental arsenic concentrations are highest, including cross-sectional and longitudinal epidemiologic studies.

Human health implications, risk assessment and remediation of As-contaminated water: A critical review

Arsenic (As) is a naturally occurring metalloid and Class-A human carcinogen. Exposure to As via direct intake of As-contaminated water or ingestion of As-contaminated edible crops is considered a life threatening problem around the globe. Arsenic-laced drinking water has affected the lives of over 200 million people in 105 countries worldwide. Limited data are available on various health risk assessment models/frameworks used to predict carcinogenic and non-carcinogenic health effects caused by As-contaminated water. Therefore, this discussion highlights the need for future research focusing on human health risk assessment of individual As species (both organic and inorganic) present in As-contaminated water. Various conventional and latest technologies for remediation of As-contaminated water are also reviewed along with a discussion of the fate of As-loaded waste and sludge.

Major Limitations in Using Element Concentrations in Hair as Biomarkers of Exposure to Toxic and Essential Trace Elements in Children

BACKGROUND

Hair is a commonly used exposure biomarker for metals and other trace elements, but concern has been raised regarding its appropriateness for assessing the internal dose.

OBJECTIVES

The aim of the present study was to evaluate children's hair as biomarker of internal dose for toxic (As, Mn, Cd, Pb) and essential elements (Mg, Ca, Fe, Co, Cu, Zn, Se, Mo).

METHODS

In 207 children (9-10 years of age), originating from a population-based cohort in rural Bangladesh, we measured concentrations of the selected elements in hair ( closest to the scalp) using ICP-MS. We compared these with previously measured concentrations in erythrocytes, urine, and water. For a subset of children (n=19), we analyzed four consecutive 2 cm pieces of hair.

RESULTS

There were strong associations between hair As and the other biomarkers (erythrocytes: r_s=0.73, p<0.001; urine: r_S=0.66, p<0.001); and water (r_s=0.60, p<0.001); and there were significant correlations between Se in hair and erythrocytes (overall r_s=0.38, p<0.001), and urine (r_s=0.29, p<0.001). Hair Co and Mo showed weak correlations with concentrations in erythrocytes. Hair Mn was not associated with Mn in erythrocytes, urine, or water, and the geometric mean concentration increased almost five times from the 2 cm closest to the head to the 7th–8th cm (p<0.001). Also Mg, Ca, Co, Cd, and Pb increased from the scalp outward (>50% higher in 7th–8th cm compared with 1st–2nd cm, p<0.001).

CONCLUSIONS

Hair was found to be a useful exposure biomarker of absorbed As and Se only. Of all measured elements, hair Mn seemed the least reflective of internal dose. https://doi.org/10.1289/EHP1239.

Manganese in Drinking Water and Cognitive Abilities and Behavior at 10 Years of Age: A Prospective Cohort Study

BACKGROUND

Cross-sectional studies have indicated impaired neurodevelopment with elevated drinking water manganese concentrations (W-Mn), but potential susceptible exposure windows are unknown.

OBJECTIVES

We prospectively evaluated the effects of W-Mn, from fetal life to school age, on children's cognitive abilities and behavior.

METHODS

We assessed cognitive abilities and behavior in 1,265 ten-year-old children in rural Bangladesh using the Wechsler Intelligence Scale for Children (WISC-IV) and the Strengths and Difficulties Questionnaire (SDQ), respectively. Manganese in drinking water used during pregnancy and by the children at 5 y and 10 y was measured using inductively coupled plasma mass spectrometry.

RESULTS

The median W-Mn was 0.20 mg/L (range 0.001–6.6) during pregnancy and 0.34mg/L (<0.001–8.7) at 10 y. In multivariable-adjusted linear regression analyses, restricted to children with low arsenic (As) exposure, none of the W-Mn exposures was associated with the children’s cognitive abilities. Stratifying by gender (p for interaction in general <0.081) showed that prenatal W-Mn (3 mg/L) was positively associated with cognitive ability measures in girls but not in boys. W-Mn at all time points was associated with an increased risk of conduct problems, particularly in boys (range 24–43% per mg/L). At the same time, the prenatal W-Mn was associated with a decreased risk of emotional problems [odds ratio (OR)=0.39 (95% CI: 0.19, 0.82)] in boys. In girls, W-Mn was mainly associated with low prosocial scores [prenatal W-Mn: OR=1.48 (95% CI: 1.06, 1.88)].

CONCLUSIONS

Elevated prenatal W-Mn exposure was positively associated with cognitive function in girls, whereas boys appeared to be unaffected. Early life W-Mn exposure appeared to adversely affect children's behavior. https://doi.org/10.1289/EHP631.

Methylmercury exposure and cognitive abilities and behavior at 10years of age

BACKGROUND

Methylmercury (MeHg) is a known developmental neurotoxicant present in fish, yet the impact of childhood exposure is uncertain, especially in children with poor nutrition.

OBJECTIVES

To evaluate associations of MeHg exposure with cognitive abilities and behavior in children from a poor rural area in Bangladesh.

METHODS

The MeHg exposure was assessed in 1434 ten-year-old children by measuring mercury concentrations in hair (hair-Hg), using inductively coupled plasma mass spectrometry. Cognitive abilities were assessed with the Wechsler Intelligence Scale for Children (4th edition), and behavior by the parent-report Strengths and Difficulties Questionnaire.

RESULTS

Children's median hair-Hg was 674μg/kg (range 70-17,561μg/kg). Concentrations did not differ by distance from scalp, indicating a similar exposure over time. No multivariable-adjusted associations were observed between the children's hair-Hg and their cognitive abilities. However, children in the highest tertile of hair-Hg had a lower prevalence of hyperactivity (OR: 0.61, 95% CI: 0.45-0.83) and peer relationship problems (OR: 0.58, 95% CI: 0.44-0.76), compared to children in the lowest tertile. The corresponding ORs were slightly stronger in children from families with lower socioeconomic status (OR: 0.56, 95% CI: 0.34-0.90 and OR: 0.48, 95% CI: 0.30-0.74) than in children from families with higher socioeconomic status (OR: 0.73, 95% CI: 0.49-1.08 and OR: 0.72, 95% CI: 0.51-1.02). Similar stronger ORs were observed in underweight children.

CONCLUSION

MeHg exposure was not associated with cognitive function, but inversely associated with certain adverse behavior. More studies are needed concerning the risk-benefit of different fish consumption in rural Bangladesh.

Arsenic exposure alters lung function and airway inflammation in children: A cohort study in rural Bangladesh

Exposure to arsenic has been associated with increased risk of reduced lung function in adults, but the adverse impacts in early life are unclear. We aim to examine whether prenatal and childhood arsenic exposure is associated with reduced lung function and increased airway inflammation in school-aged children. Children born in the MINIMat cohort in rural Bangladesh were evaluated at 9years of age (n=540). Arsenic exposure was assessed in urine (U-As) that was collected from mothers during early pregnancy and their children aged 4.5 and 9years. In the 9-year-old children, lung function was assessed using spirometry and airway inflammation was assessed by the NIOX MINO system. C-reactive protein (CRP) and Clara cell secretory protein (CC16) concentrations were measured in plasma by immunoassays. The U-As concentrations in 9-year-old children were lower (median 53μg/l) compared to their mothers (median 76μg/l). Maternal U-As (log₂ transformed) was inversely associated with forced vital capacity (FVC) and forced expiratory volume at 1s (FEV1) (β=-12; 95% CI: -22, -1.5; p=0.031 and β=-12; 95% CI: -22, -1.9; p=0.023, respectively) in all children, and the associations were stronger in boys and among children with adequate height and weight, as well as among those whose mothers had higher percentages of methylarsonic acid (MMA) and lower percentages of dimethylarsinic acid (DMA). U-As (log₂ transformed) at 4.5 and 9years was positively associated with fractional exhaled nitric oxide (FE_NO) concentrations in boys (β=0.89; 95% CI: 0.13, 1.66; p=0.022 and β=0.88; 95% CI: 0.16, 1.61; p=0.017, respectively) but not in girls. Increased CC16 concentrations were associated with higher lung function indices. In conclusion, our findings suggest that prenatal arsenic exposure is related to impaired lung function, while childhood exposure may increase airway inflammation, particularly in boys.

Widespread copper and lead contamination of household drinking water, New South Wales, Australia

This study examines arsenic, copper, lead and manganese drinking water contamination at the domestic consumer's kitchen tap in homes of New South Wales, Australia. Analysis of 212 first draw drinking water samples shows that almost 100% and 56% of samples contain detectable concentrations of copper and lead, respectively. Of these detectable concentrations, copper exceeds Australian Drinking Water Guidelines (ADWG) in 5% of samples and lead in 8%. By contrast, no samples contained arsenic and manganese water concentrations in excess of the ADWG. Analysis of household plumbing fittings (taps and connecting pipework) show that these are a significant source of drinking water lead contamination. Water lead concentrations derived for plumbing components range from 108µg/L to 1440µg/L (n=28, mean - 328µg/L, median - 225µg/L). Analysis of kitchen tap fittings demonstrates these are a primary source of drinking water lead contamination (n=9, mean - 63.4µg/L, median - 59.0µg/L). The results of this study demonstrate that along with other potential sources of contamination in households, plumbing products that contain detectable lead up to 2.84% are contributing to contamination of household drinking water. Given that both copper and lead are known to cause significant health detriments, products for use in contact with drinking water should be manufactured free from copper and lead.

Urinary Arsenic Speciation in Children and Pregnant Women from Spain

Inorganic arsenic (i-As) is a non-threshold human carcinogen that has been associated with several adverse health outcomes. Exposure to i-As is of particular concern among pregnant women, infants and children, as they are specifically vulnerable to the adverse health effects of i-As, and in utero and early-life exposure, even low to moderate levels of i-As, may have a marked effect throughout the lifespan. Ion chromatography-mass spectrometry detection (IC-ICP-MS) was used to analyse urinary arsenic speciation, as an exposure biomarker, in samples of 4-year-old children with relatively low-level arsenic exposure living in different regions in Spain including Asturias, Gipuzkoa, Sabadell and Valencia. The profile of arsenic metabolites in urine was also determined in samples taken during pregnancy (1st trimester) and in the children from Valencia of 7 years old. The median of the main arsenic species found in the 4-year-old children was 9.71 μg/l (arsenobetaine-AsB), 3.97 μg/l (dimethylarsinic acid-DMA), 0.44 μg/l (monomethylarsonic acid-MMA) and 0.35 μg/l (i-As). Statistically significant differences were found in urinary AsB, MMA and i-As according to the study regions in the 4-year-old, and also in DMA among pregnant women and their children. Spearman's correlation coefficient among urinary arsenic metabolites was calculated, and, in general, a strong methylation capacity to methylate i-As to MMA was observed.

Arsenic Metabolism in Children Differs From That in Adults

Arsenic toxicity in adults is associated with methylation efficiency, influenced by factors such as gender, genetics, and nutrition. The aim of this study was to evaluate influencing factors for arsenic metabolism in children. For 488 children (9 years), whose mothers participated in a study on arsenic exposure during pregnancy (nested into the MINIMat trial) in rural Bangladesh, we measured urinary concentrations of inorganic arsenic (iAs) and its metabolites methylarsonic acid (MMA) and dimethylarsinic acid (DMA) by HPLC-HG-ICPMS. Methylation efficiency was assessed by relative amounts (%) of the metabolites. We evaluated the impact of factors such as maternal urinary metabolite pattern, arsenic exposure, gender, socioeconomic status, season of sampling, and nutritional factors, including erythrocyte selenium (Ery-Se), and plasma folate and vitamin B12.

Children had higher %DMA and lower %iAs in urine compared to their mothers, unrelated to their lower exposure [median urinary arsenic (U-As) 53 vs 78 µg/l]. Surprisingly, selenium status (Ery-Se) was strongly associated with children’s arsenic methylation; an increase in Ery-Se from the 5–95th percentile was associated with: +1.8 percentage points (pp) for %iAs (P  =  .001), +1.4 pp for %MMA (P  =  .003), and −3.2 pp for %DMA (P  <  .001). Despite this, Ery-Se was positively associated with U-As (5–95th percentile: +41 µg/l, P  =  .026). As expected, plasma folate was inversely associated with %iAs (5–95th percentile: −1.9 pp, P  =  .001) and positively associated with %DMA (5–95th percentile: +2.2 pp, P  =  .008). Children methylated arsenic more efficiently than their mothers. Also influencing factors, mainly selenium and folate, differed. This warrants further research.

Total Arsenic, Cadmium, and Lead Determination in Brazilian Rice Samples Using ICP-MS

This study is aimed at investigating a suitable method for rice sample preparation as well as validating and applying the method for monitoring the concentration of total arsenic, cadmium, and lead in rice by using Inductively Coupled Plasma Mass Spectrometry (ICP-MS). Various rice sample preparation procedures were evaluated. The analytical method was validated by measuring several parameters including limit of detection (LOD), limit of quantification (LOQ), linearity, relative bias, and repeatability. Regarding the sample preparation, recoveries of spiked samples were within the acceptable range from 89.3 to 98.2% for muffle furnace, 94.2 to 103.3% for heating block, 81.0 to 115.0% for hot plate, and 92.8 to 108.2% for microwave. Validation parameters showed that the method fits for its purpose, being the total arsenic, cadmium, and lead within the Brazilian Legislation limits. The method was applied for analyzing 37 rice samples (including polished, brown, and parboiled), consumed by the Brazilian population. The total arsenic, cadmium, and lead contents were lower than the established legislative values, except for total arsenic in one brown rice sample. This study indicated the need to establish monitoring programs for emphasizing the study on this type of cereal, aiming at promoting the Public Health.