Estimating the risk of bladder and kidney cancer from exposure to low-levels of arsenic in drinking water, Nova Scotia, Canada

Electrochemical arsenite oxidation for drinking water treatment: Mechanisms, by-product formation and energy consumption

The mechanisms and by-product formation of electrochemical oxidation (EO) for As(III) oxidation in drinking water treatment using groundwater was investigated. Experiments were carried out using a flowthrough system, with an RuO2/IrO2 MMO Ti anode electrode, fed with synthetic and natural groundwater containing As(III) concentrations in a range of around 75 and 2 µg/L, respectively. Oxidation was dependent on charge dosage (CD) [C/L] and current density [A/m2], with the latter showing plateau behaviour for increasing intensity. As(III) concentrations of <0.3 µg/L were obtained, indicating oxidation of 99.9 % of influent As(III). Achieving this required a higher charge dosage for the natural groundwater (>40 C/L) compared to the oxidation in the synthetic water matrix (20 C/L), indicating reaction with natural organic matter or other compounds. As(III) oxidation in groundwater required an energy consumption of 0.09 and 0.21 kWh/m3, for current densities of 20 and 60 A/m2, respectively. At EO settings relevant for As(III) oxidation, in the 30-100 C/L CD range, the formation of anodic by-products, as trihalomethanes (THMs) (0.11-0.75 µg/L) and bromate (<0.2 µg/L) was investigated. Interestingly, concentrations of the formed by-products did not exceed strictest regulatory standards of 1 µg/L, applicable to Dutch tap water. This study showed the promising perspective of EO as electrochemical advanced oxidation process (eAOP) in drinking water treatment as alternative for the conventional use of strong oxidizing chemicals.

Rural communities experience higher radon exposure versus urban areas, potentially due to drilled groundwater well annuli acting as unintended radon gas migration conduits

Repetitive, long-term inhalation of radioactive radon gas is one of the leading causes of lung cancer, with exposure differences being a function of geographic location, built environment, personal demographics, activity patterns, and decision-making. Here, we examine radon exposure disparities across the urban-to-rural landscape, based on 42,051 Canadian residential properties in 2034 distinct communities. People living in rural, lower population density communities experience as much as 31.2% greater average residential radon levels relative to urban equivalents, equating to an additional 26.7 Bq/m3 excess in geometric mean indoor air radon, and an additional 1 mSv/year in excess alpha radiation exposure dose rate to the lungs for occupants. Pairwise and multivariate analyses indicate that community-based radon exposure disparities are, in part, explained by increased prevalence of larger floorplan bungalows in rural areas, but that a majority of the effect is attributed to proximity to, but not water use from, drilled groundwater wells. We propose that unintended radon gas migration in the annulus of drilled groundwater wells provides radon migration pathways from the deeper subsurface into near-surface materials. Our findings highlight a previously under-appreciated determinant of radon-induced lung cancer risk, and support a need for targeted radon testing and reduction in rural communities.

Deep-dive into iron-based co-precipitation of arsenic: A review of mechanisms derived from synchrotron techniques and implications for groundwater treatment

The co-precipitation of Fe(III) (oxyhydr)oxides with arsenic (As) is one of the most widespread approaches to treat As-contaminated groundwater in both low- and high-income settings. Fe-based co-precipitation of As occurs in a variety of conventional and decentralized treatment schemes, including aeration and sand filtration, ferric chloride addition and technologies based on controlled corrosion of Fe(0) (i.e., electrocoagulation). Despite its ease of deployment, Fe-based co-precipitation of As entails a complex series of chemical reactions that often occur simultaneously, including electron-transfer reactions, mineral nucleation, crystal growth, and As sorption. In recent years, the growing use of sophisticated synchrotron-based characterization techniques in water treatment research has generated new detailed and mechanistic insights into the reactions that govern As removal efficiency. The purpose of this critical review is to synthesize the current understanding of the molecular-scale reaction pathways of As co-precipitation with Fe(III), where the source of Fe(III) can be ferric chloride solutions or oxidized Fe(II) sourced from natural Fe(II) in groundwater, ferrous salts or controlled Fe(0) corrosion. We draw primarily on the mechanistic knowledge gained from spectroscopic and nano-scale investigations. We begin by describing the least complex reactions relevant in these conditions (Fe(II) oxidation, Fe(III) polymerization, As sorption in single-solute systems) and build to multi-solute systems containing common groundwater ions that can alter the pathways of As uptake during Fe(III) co-precipitation (Ca, Mg bivalent cations; P, Si oxyanions). We conclude the review by providing a perspective on critical knowledge gaps remaining in this field and new research directions that can further improve the understanding of As removal via Fe(III) co-precipitation.

Update of the risk assessment of inorganic arsenic in food

The European Commission asked EFSA to update its 2009 risk assessment on arsenic in food carrying out a hazard assessment of inorganic arsenic (iAs) and using the revised exposure assessment issued by EFSA in 2021. Epidemiological studies show that the chronic intake of iAs via diet and/or drinking water is associated with increased risk of several adverse outcomes including cancers of the skin, bladder and lung. The CONTAM Panel used the benchmark dose lower confidence limit based on a benchmark response (BMR) of 5% (relative increase of the background incidence after adjustment for confounders, BMDL05) of 0.06 μg iAs/kg bw per day obtained from a study on skin cancer as a Reference Point (RP). Inorganic As is a genotoxic carcinogen with additional epigenetic effects and the CONTAM Panel applied a margin of exposure (MOE) approach for the risk characterisation. In adults, the MOEs are low (range between 2 and 0.4 for mean consumers and between 0.9 and 0.2 at the 95th percentile exposure, respectively) and as such raise a health concern despite the uncertainties.

The association of arsenic exposure with mortality due to cancer, diabetes, Alzheimer's and congenital anomalies using Poisson regression

The present study aims to determine the relationship between the concentration of arsenic in the groundwater of Hamadan province and the mortality rate due to various types of malignancies, congenital anomalies, diabetes mellitus and Alzheimer's. Mortality data due to various causes of death in Hamadan province were collected for five years (2016-2020). Sampling of drinking water was determined in the reference laboratory using polarography method. Poisson regression was used to investigate the relationship between arsenic level and the death rate due to various types of disease, at a significant level (p value < 0.05). According to the results of Poisson regression, among the various causes of death (N = 8042), Alzheimer's 5.94 (3.67-9.61), diabetes mellitus 4.05 (3.5-5.37), congenital malformations 2.98 (1.88-4.72), breast cancer 2.72 (1.56-4.71), leukemia 1.90 (1.24-2.92), stomach cancer 1.64 (1.28-2.10), Liver cancer 1.58 (1.58-2.30), other digestive organs 5.86 (3.38-10.16), meninges and brain cancer 1.57 (1.02-2.41) showed the highest relationship with arsenic contamination. The results of this study could be evidence for a positive and significant relationship between arsenic concentrations and mortality rates due to cancers, diabetes mellitus, Alzheimer disease, and congenital malformations. Therefore, it's necessary to use appropriate water treatment methods to remove arsenic at the source in contaminated areas.

SLC1A5 regulates cell proliferation and self-renewal through β-catenin pathway mediated by redox signaling in arsenic-treated uroepithelial cells

Arsenic exposure increases the risk of bladder cancer in humans, but its underlying mechanisms remain elusive. The alanine, serine, cysteine-preferring transporter 2 (ASCT2, SLC1A5) is frequently overexpressed in cancer cells. The aim of this study was to evaluate the effects of arsenic on SLC1A5, and to determine the role of SLC1A5 in the proliferation and self-renewal of uroepithelial cells. F344 rats were exposed to 87 mg/L NaAsO₂ or 200 mg/L DMA^V for 12 weeks. The SV-40 immortalized human uroepithelial (SV-HUC-1) cells were cultured in medium containing 0.5 μM NaAsO₂ for 40 weeks. Arsenic increased the expression levels of SLC1A5 and β-catenin both in vivo and in vitro. SLC1A5 promoted cell proliferation and self-renewal by activating β-catenin, which in turn was dependent on maintaining GSH/ROS homeostasis. Our results suggest that SLC1A5 is a potential therapeutic target for arsenic-induced proliferation and self-renewal of uroepithelial cells.

Arsenic in drinking water and kidney cancer: a systematic review

OBJECT

Arsenic as a chemical is found in rock, soil, air and used in various industries and their products, such as colors, hairs, and fertilizers. Humans may be exposed to arsenic mainly through food and drinking water. Due to its adverse health effects, its presence in drinking water has become a public health concern.

METHODS

In this systematic review, we investigated the relationship between arsenic concentration in drinking water and the risk of kidney cancer in humans. For this reason, various electronic databases were searched from 1992 February to November 2021. In this review, three ecological studies, two case-control studies, and four cohort studies were investigated.

RESULTS

High levels of arsenic (100 μg/L) have been reported in many countries such as southwest Taiwan, Niigata, Argentine, and northern Chile. A significant relationship was observed between kidney cancer incidence and its mortality rate with high arsenic levels in drinking water.

CONCLUSIONS

Despite the limitations in some previous studies, reviewing and comparing the data of different regions indicates a scientific relationship between kidney cancer incidence and high concentrations of arsenic in drinking water.

The Nova Scotia Community Cancer Matrix: A geospatial tool to support cancer prevention

Globally, cancer is a leading cause of death and morbidity and its burden is increasing worldwide. It is established that medical approaches alone will not solve this cancer crisis. Moreover, while cancer treatment can be effective, it is costly and access to treatment and health care is vastly inequitable. However, almost 50% of cancers are caused by potentially avoidable risk factors and are thus preventable. Cancer prevention represents the most cost-effective, feasible and sustainable pathway towards global cancer control. While much is known about cancer risk factors, prevention programs often lack consideration of how place impacts cancer risk over time. Maximizing cancer prevention investment requires an understanding of the geographic context for why some people develop cancer while others do not. Data on how community and individual level risk factors interact is therefore required. The Nova Scotia Community Cancer Matrix (NS-Matrix) study was established in Nova Scotia (NS), a small province in Eastern Canada with a population of 1 million. The study integrates small-area profiles of cancer incidence with cancer risk factors and socioeconomic conditions, to inform locally relevant and equitable cancer prevention strategies. The NS-Matrix Study includes over 99,000 incident cancers diagnosed in NS between 2001 and 2017, georeferenced to small-area communities. In this analysis we used Bayesian inference to identify communities with high and low risk for lung and bladder cancer: two highly preventable cancers with rates in NS exceeding the Canadian average, and for which key risk factors are high. We report significant spatial heterogeneity in lung and bladder cancer risk. The identification of spatial disparities relating to a community's socioeconomic profile and other spatially varying factors, such as environmental exposures, can inform prevention. Adopting Bayesian spatial analysis methods and utilizing high quality cancer registry data provides a model to support geographically-focused cancer prevention efforts, tailored to local community needs.

Urinary microbiota and metabolic signatures associated with inorganic arsenic-induced early bladder lesions

Inorganic arsenic (iAs) contamination in drinking water is a global public health problem, and exposure to iAs is a known risk factor for bladder cancer. Perturbation of urinary microbiome and metabolome induced by iAs exposure may have a more direct effect on the development of bladder cancer. The aim of this study was to determine the impact of iAs exposure on urinary microbiome and metabolome, and to identify microbiota and metabolic signatures that are associated with iAs-induced bladder lesions. We evaluated and quantified the pathological changes of bladder, and performed 16S rDNA sequencing and mass spectrometry-based metabolomics profiling on urine samples from rats exposed to low (30 mg/L NaAsO₂) or high (100 mg/L NaAsO₂) iAs from early life (in utero and childhood) to puberty. Our results showed that iAs induced pathological bladder lesions, and more severe effects were noticed in the high-iAs group and male rats. Furthermore, six and seven featured urinary bacteria genera were identified in female and male offspring rats, respectively. Several characteristic urinary metabolites, including Menadione, Pilocarpine, N-Acetylornithine, Prostaglandin B1, Deoxyinosine, Biopterin, and 1-Methyluric acid, were identified significantly higher in the high-iAs groups. In addition, the correlation analysis demonstrated that the differential bacteria genera were highly correlated with the featured urinary metabolites. Collectively, these results suggest that exposure to iAs in early life not only causes bladder lesions, but also perturbs urinary microbiome composition and associated metabolic profiles, which shows a strong correlation. Those differential urinary genera and metabolites may contribute to bladder lesions, suggesting a potential for development of urinary biomarkers for iAs-induced bladder cancer.

Chronic environmental inorganic arsenic exposure causes social behavioral changes in juvenile zebrafish (Danio rerio)

Arsenic (As) is a metalloid commonly found worldwide. Environmental As exposure may cause potential health hazards and behavioral changes in humans and animals. However, the effects of environmental As concentrations on social behavior, especially during the juvenile stage, are unclear. In this study, we observed behavioral changes in juvenile zebrafish after 28 days of exposure to inorganic As (NaAsO₂ 100 and 500 ppb) in water, especially anxiety and social deficits. Additionally, the level of oxidative stress in the zebrafish brain after As treatment increased, the content of dopamine (DA) decreased, and the transcription level of genes involved in DA metabolism with the activity of monoamine oxidase (MAO) increased. Oxidative stress is a recognized mechanism of nerve damage induced by As exposure. The zebrafish were exposed to N-acetylcysteine (NAC) to reduce As exposure-induced oxidative stress. The results showed improvements in social behavior, DA content, MAO activity, and gene transcription in zebrafish. In conclusion, environmental As exposure can induce behavioral abnormalities, such as anxiety and social deficits in zebrafish, which may be caused by As-induced oxidative stress altering gene transcription levels, causing an increase in MAO activity and a decrease in DA.

A Current Review of Water Pollutants in American Continent: Trends and Perspectives in Detection, Health Risks, and Treatment Technologies

Currently, water pollution represents a serious environmental threat, causing an impact not only to fauna and flora but also to human health. Among these pollutants, inorganic and organic pollutants are predominantly important representing high toxicity and persistence and being difficult to treat using current methodologies. For this reason, several research groups are searching for strategies to detect and remedy contaminated water bodies and effluents. Due to the above, a current review of the state of the situation has been carried out. The results obtained show that in the American continent a high diversity of contaminants is present in the water bodies affecting several aspects, in which in some cases, there exists alternatives to realize the remediation of contaminated water. It is concluded that the actual challenge is to establish sanitation measures at the local level based on the specific needs of the geographical area of interest. Therefore, water treatment plants must be designed according to the contaminants present in the water of the region and tailored to the needs of the population of interest.

Evaluation of heavy metals in water and sediments, pollution, and risk indices of Naltar Lakes, Pakistan

This study examined the physicochemical parameters of water and sediments in the Naltar Lakes, northern Pakistan. Water and sediments were sampled and analyzed for physicochemical parameters. Heavy metals such as iron (Fe, 11% and 12%), nickel (Ni, 100% and 88%), chromium (Cr, 22% and 12%), and arsenic (As, 0% and 12%) of sampling sites had surpassed the threshold of drinking water set by world health organization (WHO) in the Naltar Lake I (Naltar I) and Naltar Lake II (Naltar II), respectively. Water quality parameters were evaluated for the drinking and irrigation water quality indices (WQI). Drinking WQI values were found within the excellent category for Naltar I and Naltar II, except for the 6% of sampling sites observed in the good category. Toxic parameter concentrations were used for the risk indices, which revealed the highest average daily dose (ADD) values of 138 µg/kg-day and hazard quotient (HQ) 1.8 for children through nitrate (NO₃) and As consumption in drinking water from the Naltar I and Naltar II, respectively. Water of the Naltar Lakes were characterized by rock weathering dominance. Heavy metal concentrations of sediments showed a moderate level of contamination that poses a low risk to the Naltar Lake ecosystem.

Juvenile arsenic exposure aggravates goblet cell hyperplasia and airway mucus secretion in ovalbumin-sensitized mice

Gestational arsenic (As) exposure has been associated with adverse developmental outcomes. The purpose of this study was to explore the impacts of As exposure in different periods on susceptibility to allergic asthma. In model 1, dams were administered with NaAsO₂ (0.1 or 1 ppm) by drinking water throughout pregnancy and lactation. In model 2, newly weaned pups were exposed to NaAsO₂ (1 ppm) through drinking water. Pups were sensitized and challenged with ovalbumin (OVA). Inflammatory cell infiltration and pulmonary T helper 2 (Th2) cytokine upregulation were shown in OVA-sensitized and challenged pups. Goblet cell hyperplasia and airway mucus secretion were observed in OVA-sensitized and challenged pups. Maternal As exposure throughout pregnancy and lactation did not aggravate inflammatory cell infiltration, airway mucus secretion and pulmonary Th2 cytokine upregulation in OVA-sensitized and challenged pups. Although airway hyperreactivity, inflammatory cell infiltration and Th2 cytokine weren't influenced, OVA-evoked Goblet cell hyperplasia and airway mucus secretion were aggravated in pups who were exposed to NaAsO₂ after weaning. In conclusion, juvenile As exposure increases susceptibility to allergic asthma through aggravating Goblet cell hyperplasia and airway mucus secretion. The impacts of maternal As exposure during pregnancy and lactation on susceptibility to allergic asthma needs to be further evaluated in other animal experiments.

Long term exposure to air pollution and kidney parenchyma cancer - Effects of low-level air pollution: a Study in Europe (ELAPSE)

BACKGROUND

Particulate matter (PM) is classified as a group 1 human carcinogen. Previous experimental studies suggest that particles in diesel exhaust induce oxidative stress, inflammation and DNA damage in kidney cells, but the evidence from population studies linking air pollution to kidney cancer is limited.

METHODS

We pooled six European cohorts (N = 302,493) to assess the association of residential exposure to fine particles (PM2.5), nitrogen dioxide (NO2), black carbon (BC), warm season ozone (O3) and eight elemental components of PM2.5 (copper, iron, potassium, nickel, sulfur, silicon, vanadium, and zinc) with cancer of the kidney parenchyma. The main exposure model was developed for year 2010. We defined kidney parenchyma cancer according to the International Classification of Diseases 9th and 10th Revision codes 189.0 and C64. We applied Cox proportional hazards models adjusting for potential confounders at the individual and area-level.

RESULTS

The participants were followed from baseline (1985-2005) to 2011-2015. A total of 847 cases occurred during 5,497,514 person-years of follow-up (average 18.2 years). Median (5-95%) exposure levels of NO2, PM2.5, BC and O3 were 24.1 μg/m3 (12.8-39.2), 15.3 μg/m3 (8.6-19.2), 1.6 10-5 m-1 (0.7-2.1), and 87.0 μg/m3 (70.3-97.4), respectively. The results of the fully adjusted linear analyses showed a hazard ratio (HR) of 1.03 (95% confidence interval [CI]: 0.92, 1.15) per 10 μg/m³ NO2, 1.04 (95% CI: 0.88, 1.21) per 5 μg/m³ PM2.5, 0.99 (95% CI: 0.89, 1.11) per 0.5 10-5 m-1 BCE, and 0.88 (95% CI: 0.76, 1.02) per 10 μg/m³ O3. We did not find associations between any of the elemental components of PM2.5 and cancer of the kidney parenchyma.

CONCLUSION

We did not observe an association between long-term ambient air pollution exposure and incidence of kidney parenchyma cancer.

Small area disease mapping of cancer incidence in British Columbia using Bayesian spatial models and the smallareamapp R Package

INTRODUCTION

There is an increasing interest in small area analyses in cancer surveillance; however, technical capacity is limited and accessible analytical approaches remain to be determined. This study demonstrates an accessible approach for small area cancer risk estimation using Bayesian hierarchical models and data visualization through the smallareamapp R package.

MATERIALS AND METHODS

Incident lung (N = 26,448), female breast (N = 28,466), cervical (N = 1,478), and colorectal (N = 25,457) cancers diagnosed among British Columbia (BC) residents between 2011 and 2018 were obtained from the BC Cancer Registry. Indirect age-standardization was used to derive age-adjusted expected counts and standardized incidence ratios (SIRs) relative to provincial rates. Moran's I was used to assess the strength and direction of spatial autocorrelation. A modified Besag, York and Mollie model (BYM2) was used for model incidence counts to calculate posterior median relative risks (RR) by Community Health Service Areas (CHSA; N = 218), adjusting for spatial dependencies. Integrated Nested Laplace Approximation (INLA) was used for Bayesian model implementation. Areas with exceedance probabilities (above a threshold RR = 1.1) greater or equal to 80% were considered to have an elevated risk. The posterior median and 95% credible intervals (CrI) for the spatially structured effect were reported. Predictive posterior checks were conducted through predictive integral transformation values and observed versus fitted values.

RESULTS

The proportion of variance in the RR explained by a spatial effect ranged from 4.4% (male colorectal) to 19.2% (female breast). Lung cancer showed the greatest number of CHSAs with elevated risk (Nwomen = 50/218, Nmen = 44/218), representing 2357 total excess cases. The largest lung cancer RRs were 1.67 (95% CrI = 1.06-2.50; exceedance probability = 96%; cases = 13) among women and 2.49 (95% CrI = 2.14-2.88; exceedance probability = 100%; cases = 174) among men. Areas with small population sizes and extreme SIRs were generally smoothed towards the null (RR = 1.0).

DISCUSSION

We present a ready-to-use approach for small area cancer risk estimation and disease mapping using BYM2 and exceedance probabilities. We developed the smallareamapp R package, which provides a user-friendly interface through an R-Shiny application, for epidemiologists and surveillance experts to examine geographic variation in risk. These methods and tools can be used to estimate risk, generate hypotheses, and examine ecologic associations while adjusting for spatial dependency.

Quantitative Assessment of Arsenite-Induced Perturbation of Ubiquitinated Proteome

Arsenic contamination in food and groundwater constitutes a public health concern for more than 200 million people worldwide. Individuals chronically exposed to arsenic through drinking and ingestion exhibit a higher risk of developing cancers and cardiovascular diseases. Nevertheless, the underlying mechanisms of arsenic toxicity are not fully understood. Arsenite is known to bind to and deactivate RING finger E3 ubiquitin ligases; thus, we reason that a systematic interrogation about how arsenite exposure modulates global protein ubiquitination may reveal novel molecular targets for arsenic toxicity. By employing liquid chromatography-tandem mass spectrometry, in combination with stable isotope labeling by amino acids in cell culture (SILAC) and immunoprecipitation of di-glycine-conjugated lysine-containing tryptic peptides, we assessed the alterations in protein ubiquitination in GM00637 human skin fibroblast cells upon arsenite exposure at the entire proteome level. We observed that arsenite exposure led to altered ubiquitination of many proteins, where the alterations in a large majority of ubiquitination events are negatively correlated with changes in expression of the corresponding proteins, suggesting their modulation by the ubiquitin-proteasomal pathway. Moreover, we observed that arsenite exposure confers diminished ubiquitination of a rate-limiting enzyme in cholesterol biosynthesis, HMGCR, at Lys248. We also revealed that TRC8 is the major E3 ubiquitin ligase for HMGCR ubiquitination in HEK293T cells, and the arsenite-induced diminution of HMGCR ubiquitination is abrogated upon genetic depletion of TRC8. In summary, we systematically characterized arsenite-induced perturbations in a ubiquitinated proteome in human cells and found that the arsenite-elicited attenuation of HMGCR ubiquitination in HEK293T cells involves TRC8.

Health impacts of water and sanitation insecurity in the Global North: a scoping literature review for U.S. colonias on the Mexico border

U.S. border colonias are peri-urban settlements along the U.S.-Mexico border. Residents often face substandard housing, inadequate septic and sewer systems, and unsafe or inadequate household water. As of 2015, an estimated 30% of over 5 million U.S. colonia residents lacked access to clean drinking water, suggesting health complications. This scoping review identifies a very limited existing set of research on water and sanitation insecurity in U.S.-Mexico border colonias, and suggests value in additional focused research in this specific context to address health challenges. Preliminary health data indicates that due to water insecurity, colonia residents are more likely to contract gastrointestinal diseases, be exposed to carcinogenic compounds from contaminated water, and experience psychosocial distress. These widespread health issues in colonias are exacerbated by historical and ongoing socioenvironmental injustices in the U.S.-Mexico border region and their relation to the poor health outcomes.

In Situ Measurements of Domestic Water Quality and Health Risks by Elevated Concentration of Heavy Metals and Metalloids Using Monte Carlo and MLGI Methods

The domestic water (DW) quality of an island province in the Philippines that experienced two major mining disasters in the 1990s was assessed and evaluated in 2021 utilizing the heavy metals pollution index (MPI), Nemerow’s pollution index (NPI), and the total carcinogenic risk (TCR) index. The island province sources its DW supply from groundwater (GW), surface water (SW), tap water (TP), and water refilling stations (WRS). This DW supply is used for drinking and cooking by the population. In situ analyses were carried out using an Olympus Vanta X-ray fluorescence spectrometer (XRF) and Accusensing Metals Analysis System (MAS) G1 and the target heavy metals and metalloids (HMM) were arsenic (As), barium (Ba), copper (Cu), iron (Fe), lead (Pb), manganese (Mn), nickel (Ni), and zinc (Zn). The carcinogenic risk was evaluated using the Monte Carlo (MC) method while a machine learning geostatistical interpolation (MLGI) technique was employed to create spatial maps of the metal concentrations and health risk indices. The MPI values calculated at all sampling locations for all water samples indicated a high pollution. Additionally, the NPI values computed at all sampling locations for all DW samples were categorized as “highly polluted”. The results showed that the health quotient indices (HQI) for As and Pb were significantly greater than 1 in all water sources, indicating a probable significant health risk (HR) to the population of the island province. Additionally, As exhibited the highest carcinogenic risk (CR), which was observed in TW samples. This accounted for 89.7% of the total CR observed in TW. Furthermore, all sampling locations exceeded the recommended maximum threshold level of 1.0 × 10⁻⁴ by the USEPA. Spatial distribution maps of the contaminant concentrations and health risks provide valuable information to households and guide local government units as well as regional and national agencies in developing strategic interventions to improve DW quality in the island province.

Arsenic Exposure via Contaminated Water and Food Sources

Arsenic poisoning constitutes a major threat to humans, causing various health problems. Almost everywhere across the world certain “hotspots” have been detected, putting in danger the local populations, due to the potential consumption of water or food contaminated with elevated concentrations of arsenic. According to the relevant studies, Asia shows the highest percentage of significantly contaminated sites, followed by North America, Europe, Africa, South America and Oceania. The presence of arsenic in ecosystems can originate from several natural or anthropogenic activities. Arsenic can be then gradually accumulated in different food sources, such as vegetables, rice and other crops, but also in seafood, etc., and in water sources (mainly in groundwater, but also to a lesser extent in surface water), potentially used as drinking-water supplies, provoking their contamination and therefore potential health problems to the consumers. This review reports the major areas worldwide that present elevated arsenic concentrations in food and water sources. Furthermore, it also discusses the sources of arsenic contamination at these sites, as well as selected treatment technologies, aiming to remove this pollutant mainly from the contaminated waters and thus the reduction and prevention of population towards arsenic exposure.

Pedo-geochemical background and sediment contamination of metal(loid)s in the old mining-district of Salsigne (Orbiel valley, France)

The mining district of Salsigne in the Orbiel valley (Aude, France) was at one time the first gold mine in Europe and the first arsenic mine in the world. However, no scientific studies have evaluated the magnitude of its environmental impact. In this study, the pedo-geochemical background (PGB) was determined for 14 metal (loid) elements, including As. It appears that the PGB values for As and Sb are relatively high with 44±12 and 0.9±1.2 mg kg^-1, respectively, because of the geological particularities of this area. In a second step, these PGB values (normalized with Ti concentrations) were used as local references to determine enrichment factors (EFs) of bed river sediments for the Orbiel River and two of its major tributaries (Gresillou and Russec rivers) collected between November 2018 and July 2020. Results showed that riverine sediments are contaminated by past mining activity and/or current storage areas. If we except the major elements (Fe, Ti and at a lesser extent Mn), we observed that As, Cu, Sb, Pb present the highest concentrations relative to the remaining elements (Cd, Co, V, Ni and Cr). In the case of As, EFs can reach 74 in the Orbiel River, 1000 in the Gresillou River and 27 in the Russec River. These calculations were also performed for sediments transported by the extreme flood of October 14, 2018, that killed 15 people and potentially remobilized contamination in the valley. We observed that the As concentrations of suspended samples from Grésillou and Russec rivers have reached 870 mg kg^-1. Finally, the As concentrations measured in the river sediments of this valley are of the same order of magnitude than those published in the literature for environments strongly impacted by mining or mineral processing activities.

Potential value and mechanism of Rosa roxburghii tratt juice on pro-inflammatory responses in peripheral blood of patients with arsenic poisoning

Increasing evidence supports the role of arsenic in dysregulated immune and inflammation responses, while, safe and effective treatments have not been fully examined. Rosa roxburghii Tratt (RRT), a traditional Chinese edible fruit with potential immunoregulatory activities, was considered as a dietary supplement to explore its protective effects and possible mechanism in arsenic-induced dysregulated inflammation responses. We enrolled 209 arsenicosis patients and 41 controls to obtain baseline data, including the degree of arsenic poisoning prior to the RRT juice (RRTJ) intervention. Then, based on criteria of inclusion and exclusion and the principle of voluntary participation, 106 arsenicosis patients who volunteered to receive treatment were divided into RRTJ (n = 53) and placebo (n = 53) groups randomly. After three months follow-up, 89 subjects (46 and 43 of the RRTJ and placebo groups, respectively) completed the study and were examined for the effects and possible mechanisms of RRTJ on the Th17 cells-related pro-inflammatory responses in peripheral blood mononuclear cells (PBMCs). The PBMCs had higher levels of Th17 and Th17-related inflammatory cytokines IL-17, IL-6, and RORγt. Furthermore, the gene expressions of STAT3 and SOCS3 in PBMCs increased and decreased, respectively. Conversely, RRTJ decreased the number of Th17 cells, secretion of IL-17, IL-6, RORγt, and relative mRNA levels of STAT3, and increased the transcript levels of SOCS3. This study provides limited evidence that possible immunomodulatory effects of RRTJ on the critical regulators, IL-6 and STAT3, of the Th17 cells in arsenicosis patients, which indicated that IL-6/STAT3 pathway might appear as a potential therapeutic target in arsenicosis.

Guilty by association: Assessment of environmental loadings on arsenic distribution in two Pacific Island rivers

This work evaluates the immediate risk of arsenic toxicity in two major river systems located in Western Viti Levu, Fiji and Guadalcanal, the Solomon Islands. Using principal component analysis, the associations between the major inorganic arsenic species, As (V) and As(III) and those of the controlling parameters, pH, dissolved oxygen and temperature were investigated in these aquatic systems. As(III) was found to be the dominant form of total inorganic As concentrations in five of the thirteen sites studied. There remains a high risk of As(III) exposure from these sites in the rivers. The study also examined the potential role of mine adits in influencing the distinct water chemistry at the sites. Over 50% of As was found to exist as the more toxic As(III) species at some sites (with higher levels near the gold mines) in both river systems. This finding implies that there may be health risk to populations relying on the river waters for agriculture. As(V) at most sites across both rivers exceeded 13 μg/L, defined as a trigger value for aquatic ecosystems by Australia and New Zealand standards. The PCA indicated that spatial variations play a significant role in water chemistries between sites further from the mine adit location in the Metapona River. In the Sabeto River system, there was also considerable intra-variability in the water chemistries between sites. Further detailed studies are necessary to determine a complete profile of As species and associated biogeochemical processes in these rivers which could lead on to identify appropriate containment or mitigation measures.

Arsenic co-carcinogenesis: Inhibition of DNA repair and interaction with zinc finger proteins

Arsenic is widely present in the environment and is associated with various population health risks including cancers. Arsenic exposure at environmentally relevant levels enhances the mutagenic effect of other carcinogens such as ultraviolet radiation. Investigation on the molecular mechanisms could inform the prevention and intervention strategies of arsenic carcinogenesis and co-carcinogenesis. Arsenic inhibition of DNA repair has been demonstrated to be an important mechanism, and certain DNA repair proteins have been identified to be extremely sensitive to arsenic exposure. This review will summarize the recent advances in understanding the mechanisms of arsenic carcinogenesis and co-carcinogenesis, including DNA damage induction and ROS generation, particularly how arsenic inhibits DNA repair through an integrated molecular mechanism which includes its interactions with sensitive zinc finger DNA repair proteins.

Aggregated cumulative county arsenic in drinking water and associations with bladder, colorectal, and kidney cancers, accounting for population served

BACKGROUND

Many studies neglect to account for variation in population served by community water systems (CWSs) when aggregating CWS-level contaminant concentrations to county level.

OBJECTIVE

In an ecological epidemiologic analysis, we explored two methods-unweighted and weighted (proportion of CWS population served by county population)-to account for population served by CWS in association between arsenic and three cancers to determine the impact of population served on aggregated measures of exposure.

METHODS

CWS arsenic concentration data for 19 states were obtained from Centers for Disease Control and Prevention (CDC) National Environmental Public Health Tracking Network for 2000-10, aggregated to county level, and linked to county-level cancer data for 2011-5 from National Cancer Institute and CDC State Cancer Profiles. Negative binomial regression models estimated adjusted risk ratios (aRR) and 95% confidence intervals (CI) between county-level bladder, colorectal, and kidney cancers and quartiles of aggregated cumulative county-level arsenic concentration (ppb-years).

RESULTS

We observed positive associations between the highest quartile of exposure, compared to the lowest, of aggregated cumulative county-level arsenic concentration (ppb-year) for bladder [weighted aRR: 1.89(1.53, 2.35)], colorectal [1.64(1.33, 2.01)], and kidney [1.69(1.37, 2.09)] cancers. We observed stronger associations utilizing the weighted exposure assessment method. However, inferences from this study are limited due to the ecologic nature of the analyses and different analytic study designs are needed to assess the utility that the weighted by CWS population served metric has for exposure assessment.

SIGNIFICANCE

Weighting by CWS population served accounts for some potential exposure assignment error in epidemiologic analysis.

Imbalanced inflammatory response in subchronic arsenic-induced liver injury and the protective effects of Ginkgo biloba extract in rats: Potential role of cytokines mediated cell-cell interactions

Arsenic is a well-known environmental toxicant and carcinogen, which has been epidemiologically proved related to the increased hepatic disorders. Researches have shown that aseptic inflammation and abnormal immune response are associated with arsenic-induced liver injury. However, the immunotoxic effects of liver have not been extensively characterized. Ginkgo biloba extract (GBE), a natural products of G. biloba leaves with proven anti-inflammatory and potential immunoregulatory activities, was used as intervention agent to explore its protective effects on arsenic-induced hepatotoxicity. Thus, the underlying mechanism of the immunotoxic effects on arsenic-induced liver injury were investigated in 2.5, 5.0, and 10.0 mg/kg NaAsO₂ of Wistar rats for 16 weeks. Subsequently, GBE was used as intervention agent in 50 mg/kg for 6 weeks after cessation of arsenic exposure. The ratio of Th17 to Treg cells in peripheral blood as well as the secretion of inflammatory cytokines IL-17A, IL-6, TGF-β1, and IL-10 in serum and liver were detected. Meanwhile, the notable activation of aseptic inflammation-related molecule TLR4 and its downstream targets MyD88 and NF-κB in the liver were observed. In this work, we confirmed that subchronic exposed to arsenic triggered the infiltration of inflammatory cells in rat liver, coupled with obvious histopathological changes and aberrant hepatic serum biochemical parameters. Meanwhile, imbalanced immune response was verified by the notable abnormal ratio of Th17 to Treg cells in peripheral blood as well as the secretion of inflammatory cytokines IL-17A, IL-6, TGF-β1, and IL-10 in serum and liver of arsenic exposed rats. Further, the level of TLR4, MyD88, and NF-κB in liver both transcription and translation activity were raised. Subsequently, GBE markedly mitigated arsenic-induced liver injury, most impressively, post treatment with GBE prominently suppressed the overactivated inflammatory-related TLR4-MyD88-NF-κB pathway and evidently decreased the secretion of inflammation cytokines. Meanwhile, the disturbance of pro- and anti-inflammatory response was reversed. We concluded that the disruption of pro- and anti-inflammatory T-cells balance caused by cytokines mediated cell-cell interactions may be one of the mechanisms underlying arsenic-induced liver injury and that GBE intervention exerts an evidence protective effects, which might be closely associated with the suppression of inflammatory-related TLR4 pathway.

Arsenic: Various species with different effects on cytochrome P450 regulation in humans

Arsenic is well-recognized as one of the most hazardous elements which is characterized by its omnipresence throughout the environment in various chemical forms. From the simple inorganic arsenite (iAsIII) and arsenate (iAsV) molecules, a multitude of more complex organic species are biologically produced through a process of metabolic transformation with biomethylation being the core of this process. Because of their differential toxicity, speciation of arsenic-based compounds is necessary for assessing health risks posed by exposure to individual species or co-exposure to several species. In this regard, exposure assessment is another pivotal factor that includes identification of the potential sources as well as routes of exposure. Identification of arsenic impact on different physiological organ systems, through understanding its behavior in the human body that leads to homeostatic derangements, is the key for developing strategies to mitigate its toxicity. Metabolic machinery is one of the sophisticated body systems targeted by arsenic. The prominent role of cytochrome P450 enzymes (CYPs) in the metabolism of both endobiotics and xenobiotics necessitates paying a great deal of attention to the possible effects of arsenic compounds on this superfamily of enzymes. Here we highlight the toxicologically relevant arsenic species with a detailed description of the different environmental sources as well as the possible routes of human exposure to these species. We also summarize the reported findings of experimental investigations evaluating the influence of various arsenicals on different members of CYP superfamily using human-based models.

Use of the alkaline comet assay for monitoring genotoxic effects of arsenic in human populations

The alkaline comet assay has been widely used to determine genotoxicity in human populations exposed to arsenic. The sample sizes of earlier studies were usually small, and inconsistent results were found. Meta-analyses can merge the results of multiple studies of the same type and increase the credibility of the conclusion by increasing the sample size. Thus, to investigate the monitoring effect of alkaline comet assay on genotoxicity for arsenic exposed population, meta-analyses were performed. Thirteen studies were found to meet the inclusion criteria and were included in this study; of them, twelve articles were of medium quality (15-20 points), only one study was of high quality (21-27 points). Meta-analyses showed that the overall estimates of Mean Ratio (MR, defined as the mean value of the response in the exposed group divided by that in the reference group) were 2.81(95 % confidence interval (CI) 1.93-4.10); 2.37(95 % CI, 1.73-3.26), and 1.69(95 %CI, 1.29-2.20) for comet tail length, % tail DNA, and tail moment, respectively. This shows that the level of DNA damage in arsenic exposed population is significantly higher than that in control populations. A meta-analysis of the correlation coefficients showed that the overall estimate was 0.52 (95 %CI, 0.48∼0.56, P<0.05) with all correlation coefficients included, but it changed to 0.24 (95 %CI, 0.17∼0.28, P<0.05) when two abnormal correlation coefficients were excluded, suggesting there was a positive correlation between arsenic load in vivo and DNA damage, but the overall estimate value of coefficients was unstable. Therefore, we conclude that the alkaline comet assay can be used as an effective genotoxic biomonitoring tool for arsenic-exposed populations. However, more and higher-quality studies are still needed to verify its actual application value.

The role of autophagy in metal-induced urogenital carcinogenesis

Environmental and/or occupational exposure to metals such as Arsenic (As), Cadmium (Cd), and Chromium (Cr) have been shown to induce carcinogenesis in various organs, including the urogenital system. However, the mechanisms responsible for metal-induced carcinogenesis remain elusive. We and others have shown that metals are potent inducers of autophagy, which has been suggested to be an adaptive stress response to allow metal-exposed cells to survive in hostile environments. Albeit few, recent experimental studies have shown that As and Cd promote tumorigenesis via autophagy and that inhibition of autophagic signaling suppressed metal-induced carcinogenesis. In light of the newly emerging role of autophagic involvement in metal-induced carcinogenesis, the present review focuses explicitly on the mechanistic role of autophagy and potential signaling pathways involved in As-, Cd-, and Cr-induced urogenital carcinogenesis.

Arsenic level in bladder tumor of patients from an exposed population: association with progression and prognosis

Aims: To elucidate the impact of arsenic on progression and prognosis of bladder cancer. Patients & methods: Total arsenic in 145 tumors (80 non-muscle-invasive [NMIBC] and 65 muscle-invasive bladder cancer [MIBC]) was measured and associated with Ki67 expression, tumor-clinicopathological parameters and patient outcome. Results: Tumor arsenic concentration was higher in exposed than unexposed patients (256 μg/kg vs 77 μg/kg; p < 0.0001) and positively correlated (r = 0.65; p < 0.0001) with arsenic content of patient's drinking water. Arsenic concentration showed significant association with Ki67-overexpression (p = 0.001) and advanced tumor stages (NMIBC vs MIBC; p = 0.0009). In NMIBC, high tumor arsenic (>100 μg/kg) and Ki67 overexpression was established as predictors for recurrence (hazard ratio [HR]: 4.68; p = 0.005 and HR: 3.91; p = 0.018) and progression (HR: 6.04; p = 0.023 and HR: 6.87; p = 0.013). In MIBC, association of high arsenic remained significant with increased risk of recurrence (HR: 4.58; p = 0.04). Conclusion: In NMIBC, high arsenic and Ki67 overexpression and in MIBC, only high arsenic showed prognostic importance in predicting poor patient outcome.

Association between arsenic exposure, DNA damage, and urological cancers incidence: A long-term follow-up study of residents in an arseniasis endemic area of northeastern Taiwan

Arsenic is a well-established human carcinogen and is considered a health risk worldwide, especially where groundwater is consumed as drinking water. In 2018, bladder and kidney cancers were the 14th and 17th leading causes of global cancer mortality, respectively. Our aim was to investigate the association between arsenic exposure, DNA damage, and the incidence of bladder and kidney cancers. A total of 788 participants aged ≥40 years were enrolled in a prospective cohort study in Taiwan between 1991 and 1994, with follow-up between 2011 and 2014. Well-water and first-morning spot urine samples were collected between 1991 and 1994 to estimate arsenic exposure, and the baseline urinary levels of 8-Oxo-2'-deoxyguanosine (8-OHdG) and N7-methylguanine (N7-MeG) were quantified to assess DNA lesions. The Cox proportional hazard model was used to estimate the effects of arsenic exposure and DNA adduct levels on the risk of bladder or kidney cancer. Urinary arsenic species were associated with significantly increased 8-OHdG and N7-MeG after adjusting for age, sex, and cigarette smoking. Only non-statistically significant mediation effects of 8-OHdG were observed. In a fully adjusted Cox model, participants with arsenic exposure and urinary 8-OHdG levels higher than the median had a higher risk of bladder cancer (HR = 4.60, confidence interval: 1.43-14.85). Overall, the combined effects of high cumulative arsenic exposure from artesian well-water and advanced DNA damage predicted the risk of bladder cancer.

Carcinogenic and non-carcinogenic health risk of arsenic ingestion via drinking water in Langat River Basin, Malaysia

The prolonged persistence of toxic arsenic (As) in environment is due to its non-biodegradable characteristic. Meanwhile, several studies have reported higher concentrations of As in Langat River. However, it is the first study in Langat River Basin, Malaysia, that As concentrations in drinking water supply chain were determined simultaneously to predict the health risks of As ingestion. Water samples collected in 2015 from the four stages of drinking water supply chain were analysed for As concentration by inductively coupled plasma mass spectrometry. Determined As concentrations along with the time series data (2004-2015) were significantly within the maximum limit 0.01 mg/L of drinking water quality standard set by World Health Organization. The predicted As concentration by auto-regression moving average was 3.45E-03 mg/L in 2020 at 95% level based on time series data including climatic control variables. Long-term As ingestion via household filtration water at Langat Basin showed no potential lifetime cancer risk (LCR) 9.7E-06 (t = 6.68; p = 3.37E-08) as well as non-carcinogenic hazard quotient (HQ) 4.8E-02 (t = 6.68; p = 3.37E-08) risk at 95% level. However, the changing landscape, ex-mining ponds and extensive use of pesticides for palm oil plantation at Langat Basin are considered as the major sources of increased As concentration in Langat River. Therefore, a two-layer water filtration system at Langat Basin should be introduced to accelerate the achievement of sustainable development goal of getting safe drinking water supply.

Urinary leucine aminopeptidase 3 in population environmentally exposed to airborne arsenic

INTRODUCTION

Environmental arsenic contamination is a major toxicological problem worldwide due to its carcinogenic and nephrotoxic potential.

AIM

The purpose of this observational study was to determine the suspected association between urinary arsenic (uAs) and urinary leucine (or leucyl) aminopeptidase 3 (uLAP₃) to evaluate uLAP₃ as a candidate biomarker of exposure to airborne arsenic.

MATERIALS AND METHODS

A total of 918 adults occupationally and/or environmentally exposed to airborne arsenic were enrolled in the study. Baseline information (age; sex; history of smoking; alcohol, fish and seafood consumption) was gathered. Total uAs concentrations [μg/L] of 918 subjects, as well as the sum of arsenic species (ΣiAs) in 259 subjects, were obtained. Urinary LAP₃ was measured by an immune-enzymatic assay using an ELISA kit. Urinary creatinine concentration was assessed with the IB/lAB/1289 research protocol (version II, 2015-09-17). The values of uAs and uLAP₃ were recalculated per unit of creatinine. The association between uAs and uLAP₃ was assessed using a logistic regression model adjusted for confounders.

RESULTS

The study identified a positive correlation between the logarithm of uAs and the logarithm of uLAP₃ in the study population (r = 0.1737, p < 0.0000) and between urinary creatinine and uLAP₃ concentration not adjusted for creatinine level (r = 0.1871, p < 0.001). In the logistic regression model, there was also an association between increased (≥15 µg/L) uAs and decreased (below the 25th quartile) uLAP₃ [OR uLAP₃ = 1.22 (95% CI 1.03 to 1.44, p < 0.02)].

CONCLUSIONS

These data suggest that urinary LAP₃ may be a potential biomarker of arsenic exposure, which warrants further study.

Arsenic-induced HER2 promotes proliferation, migration and angiogenesis of bladder epithelial cells via activation of multiple signaling pathways in vitro and in vivo

Arsenic (As) is a known human carcinogen with a hitherto unknown mechanism of action. Dimethylarsinic acid (DMA^V) is a methylated metabolite of arsenicals found in most mammals, and long-term exposure to DMA^V can lead to bladder cancer in rats. Human epidermal growth factor receptor 2 (HER2) is an oncogenic factor that is overexpressed in bladder cancer, but its role in the initiation and progression of As-induced bladder cancer has not been elucidated. We found that HER2 was up-regulated in human uroepithelial cells treated with arsenite as well as in the bladder tissues of DMA^V-exposed rats. HER2 overexpression correlated to increased cell proliferation, epithelial-to-mesenchymal transition (EMT), migration and angiogenesis in vitro. The anti-HER2 monoclonal antibody trastuzumab significantly decreased serum vascular endothelial-derived growth factor (VEGF) levels and that of proliferation-related proteins in the bladder tissues of DMA^V-exposed rats. Furthermore, inhibition of HER2, as well as that of the MAPK, AKT and STAT3 pathways, attenuated arsenite-induced proliferation, migration and angiogenesis of human uroepithelial cells, and increased apoptosis rates in vitro. These findings indicate that HER2 mediates the oncogenic effects of As on bladder epithelial cells by activating the MAPK, PI3K/AKT and Src/STAT3 signaling pathways, and is therefore a promising biomarker.

HER2 overexpression triggers the IL-8 to promote arsenic-induced EMT and stem cell-like phenotypes in human bladder epithelial cells

Arsenic is a natural chemical element that is strongly associated with bladder cancer. Understanding the underlying mechanisms behind the association between arsenic and bladder cancer as well as identifying effective preventive interventions will help reduce the incidence and mortality of this disease. The epithelial-mesenchymal transition (EMT) and cancer stem cell (CSC) properties play key roles in cancer development and progression. Here, we reported that chronic exposure to arsenic resulted in EMT and increased levels of the CSC marker CD44 in human uroepithelial cells. Furthermore, IL-8 promoted a mesenchymal phenotype and upregulated CD44 by activating the ERK, AKT and STAT3 signaling. Phosphorylation of the human epidermal growth factor receptor 2 (HER2) was key for arsenic-induced IL-8 overexpression and depended on the simultaneous activation of the MAPK, JNK, PI3K/AKT and GSK3β signaling pathways. We also found that genistein inhibited arsenic-induced HER2 phosphorylation and downregulated its downstream signaling pathways, thereby inhibiting progression of EMT, and reducing CD44 expression levels. These results demonstrate that the HER2/IL-8 axis is related to the acquisition of an EMT phenotype and CSCs in arsenic-treated cells. The inhibitory effects of genistein on EMT and CSCs provide a new perspective for the intervention and potential chemotherapy against arsenic-induced bladder cancer.

Effect of plasma selenium, red blood cell cadmium, total urinary arsenic levels, and eGFR on renal cell carcinoma

High total urinary arsenic concentrations and low estimated glomerular filtration rate (eGFR) increase the risk of renal cell carcinoma (RCC). This study aimed to determine whether other metals or metalloids can affect RCC. A total of 401 patients with RCC and 774 age- and sex-matched controls were recruited between November 2006 and December 2012 in Taiwan. Surgical resection or image-guided biopsy of renal tumors was performed to pathologically verify RCC. High-performance liquid chromatography linked to a hydride generator and atomic absorption spectrometer were used to measure the urinary arsenic species concentrations. Inductively coupled plasma mass spectrometry was used to determine plasma selenium and red blood cell cadmium and lead concentration. Plasma selenium levels were inversely related to RCC, whereas red blood cell cadmium levels were directly related to RCC. The odds ratio (OR) and 95% confidence interval (CI) were 0.14 (95% CI, 0.10-0.20) and 1.33 (95% CI, 1.03-1.72), respectively. A low plasma selenium level tended to interact with high total urinary arsenic levels or with high red blood cell cadmium concentration to increase the OR of RCC. In particular, low eGFR multiplicatively interacted with high red blood cell cadmium concentration to increase the OR of RCC (P_interaction=0.003). This study was the first to find a significant multiplicative interaction between eGFR and the red blood cell cadmium levels on the increased OR of RCC.

Water and Soil Pollution: Ecological Environmental Study Methodologies Useful for Public Health Projects. A Literature Review

Health risks at population level may be investigated with different types of environmental studies depending on access to data and funds. Options include ecological studies, case-control studies with individual interviews and human sample analysis, risk assessment or cohort studies. Most public health projects use data and methodologies already available due to the cost of ad-hoc data collection. The aim of the article is to perform a literature review of environmental exposure and health outcomes with main focus on methodologies for assessing an association between water and/or soil pollutants and cancer. A systematic literature search was performed in May 2019 using PubMed. Articles were assessed by four independent reviewers. Forty articles were identified and divided into four groups, according to the data and methods they used, i.e.: (1) regression models with data by geographical area; (2) regression models with data at individual level; (3) exposure intensity threshold values for evaluating health outcome trends; (4) analyses of distance between source of pollutant and health outcome clusters. The issue of exposure assessment has been investigated for over 40 years and the most important innovations regard technologies developed to measure pollutants, statistical methodologies to assess exposure, and software development. Thanks to these changes, it has been possible to develop and apply geo-coding and statistical methods to reduce the ecological bias when considering the relationship between humans, geographic areas, pollutants, and health outcomes. The results of the present review may contribute to optimize the use of public health resources.

Groundwater As Removal by As(III), Fe(II), and Mn(II) Co-Oxidation: Contrasting As Removal Pathways with O2, NaOCl, and KMnO4

Effective arsenic (As) removal from groundwater is a pressing need in view of increasingly stringent As drinking water limits in some US states and European countries. In this study, we compared the addition of weak (O₂), intermediate (NaOCl), and strong (KMnO₄) groundwater oxidants on the fate of As during As(III), Fe(II), and Mn(II) co-oxidation. Experiments were performed with 50 μg/L As(III), 5 mg/L Fe(II), and 0.5 mg/L Mn(II) in solutions containing relevant groundwater ions, with the reaction products characterized by As K-edge X-ray absorption spectroscopy (XAS). Adding O₂ by aeration was the least effective method, unable to decrease As to below 10 μg/L, which was attributed to inefficient As(III) oxidation. Dosing NaOCl (55 μM) consistently removed As to <10 μg/L (and often <5 μg/L). The As K-edge XAS data of the NaOCl samples indicated complete As(III) oxidation and As(V) sorption to coprecipitated hydrous ferric oxide (HFO) in the binuclear, bridging (²C) complex. The most effective As removal was observed with KMnO₄ (40 μM), which completely oxidized As(III) and yielded residual As concentrations that were less than (by as much as 50%) or equal to the NaOCl experiments. Furthermore, the average As-metal bond length of the KMnO₄ solids (R_As-Fe/Mn = 3.24 ± 0.02 Å) was systematically shorter than the NaOCl solids (R_As-Fe/Mn = 3.29 ± 0.02 Å), consistent with As(V) sorption to both MnO₂ and HFO. These findings can be used to optimize groundwater As treatment to meet relevant drinking water guidelines, while considering the As uptake mode and characteristics of the particle suspension (i.e., colloidal stability and filterability).

Mobility and redox transformation of arsenic during treatment of artificially recharged groundwater for drinking water production

In this study we investigate opportunities for reducing arsenic (As) to low levels, below 1 μg/L in produced drinking water from artificially infiltrated groundwater. We observe that rapid sand filtration is the most important treatment step for the oxidation and removal of As at water treatment plants which use artificially recharged groundwater as source. Removal of As is mainly due to As co-precipitation with Fe(III)(oxyhydr)oxides, which shows higher efficiency in rapid sand filter beds compared to aeration and supernatant storage. This is due to an accelerated oxidation of As(III) to As(V) in the filter bed which may be caused by the manganese oxides and/or As(III) oxidizing bacteria, as both are found in the coating of rapid sand filter media grains by chemical analysis and taxonomic profiling of the bacterial communities. Arsenic removal does not take place in treatment steps such as granular activated carbon filtration, ultrafiltration or slow sand filtration, due to a lack of hydrolyzing iron in their influent and a lack of adsorption affinity between As and the filtration surfaces. Further, we found that As reduction to below 1 μg/L can be effectively achieved at water treatment plants either by treating the influent of rapid sand filters by dosing potassium permanganate in combination with ferric chloride or by treating the effluent of rapid sand filters with ferric chloride dosing only. Finally, we observe that reducing the pH is an effective measure for increasing As co-precipitation with Fe(III)(oxyhydr)oxides, but only when the oxidized arsenic, As(V), is the predominant species in water.

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.

Current State of Geospatial Methodologic Approaches in Canadian Population Oncology Research

Geospatial analyses are increasingly used in population oncology. We provide a first review of geospatial analysis in Canadian population oncology research, compare to international peers, and identify future directions. Geospatial-focused peer-reviewed publications from 1992-2020 were compiled using PubMed, MEDLINE, Web of Science, and Google Scholar. Abstracts were screened for data derived from a Canadian cancer registry and use of geographic information systems. Studies were classified by geospatial methodology, geospatial unit, location, cancer site, and study year. Common limitations were documented from article discussion sections. Our search identified 71 publications using data from all provincial and national cancer registries. Thirty-nine percent (N = 28) were published in the most recent 5-year period (2016-2020). Geospatial methodologies included exposure assessment (32.4%), identifying spatial associations (21.1%), proximity analysis (16.9%), cluster detection (15.5%), and descriptive mapping (14.1%). Common limitations included confounding, ecologic fallacy, not accounting for residential mobility, and small case/population sizes. Geospatial analyses are increasingly used in Canadian population oncology; however, efforts are concentrated among a few provinces and common cancer sites, and data are over a decade old. Limitations were similar to those documented internationally, and more work is needed to address them. Organized efforts are needed to identify common challenges, develop leading practices, and identify shared priorities.

Arsenic Concentrations in Ground and Surface Waters across Arizona Including Native Lands

Parts of the Southwestern United States report arsenic levels in water resources that are above the United States Environmental Protection Agency's current drinking water limits. Prolonged exposure to arsenic through food and drinking water can contribute to significant health problems including cancer, developmental effects, cardiovascular disease, neurotoxicity, and diabetes. In order to understand exposure risks, water sampling and testing has been conducted throughout Arizona. This information is available to the public through often non-overlapping databases that are difficult to access and in impracticable formats. The current study utilized a systemic compilation of online databases to compile a spreadsheet containing over 33,000 water samples. The reported arsenic concentrations from these databases were collected from 1990-2017. Using ArcGIS software, these data were converted into a map shapefile and overlaid onto a map of Arizona. This visual representation shows that arsenic levels in surface and ground water exceed the United States Environmental Protection Agency's drinking water limits for many sites in several counties in Arizona, and there is an underrepresentation of sampling in several tribal jurisdictions. This information is useful for water managers and private well owners throughout the State for determining safe drinking water sources and limiting exposure to arsenic.

Adaptation to Extreme Environments in an Admixed Human Population from the Atacama Desert

Inorganic arsenic (As) is a toxic xenobiotic and carcinogen associated with severe health conditions. The urban population from the Atacama Desert in northern Chile was exposed to extremely high As levels (up to 600 µg/l) in drinking water between 1958 and 1971, leading to increased incidence of urinary bladder cancer (BC), skin cancer, kidney cancer, and coronary thrombosis decades later. Besides, the Andean Native-American ancestors of the Atacama population were previously exposed for millennia to elevated As levels in water (∼120 µg/l) for at least 5,000 years, suggesting adaptation to this selective pressure. Here, we performed two genome-wide selection tests—PBS_n1 and an ancestry-enrichment test—in an admixed population from Atacama, to identify adaptation signatures to As exposure acquired before and after admixture with Europeans, respectively. The top second variant selected by PBS_n1 was associated with LCE4A-C1orf68, a gene that may be involved in the immune barrier of the epithelium during BC. We performed association tests between the top PBS_n1 hits and BC occurrence in our population. The strongest association (P = 0.012) was achieved by the LCE4A-C1orf68 variant. The ancestry-enrichment test detected highly significant signals (P = 1.3 × 10⁻⁹) mapping MAK16, a gene with important roles in ribosome biogenesis during the G1 phase of the cell cycle. Our results contribute to a better understanding of the genetic factors involved in adaptation to the pathophysiological consequences of As exposure.

Arsenic: Geochemical distribution and age-related health risk in Italy

This study is the first attempt to evaluate occurrence, distribution and potential health impacts of As at a national scale in Italy. In various environmental matrices, As geochemical distribution was investigated and carcinogenic and non-carcinogenic risks were assessed with respect to different exposure routes and age groups. Both deterministic and probabilistic methods were used to determine the health risks. Geochemical mapping at a sub-continental scale provided a useful tool to spatially represent As concentration and the critical areas posing a health threat to inhabitants. The results show that significant As concentrations in tap water and soil (up to 27.20 μg/l and 62.20 mg/kg, respectively) are mainly governed by geological features. In the central parts of Italy, where alkaline volcanic materials and consequently high levels of As occur, the residents are prone to health issues. Daily exposure to As in tap water is unparalleled playing an important role in the potential cancer and non-cancer risks. The Incremental Lifetime Cancer Risk for skin cancer and also lung and bladder cancer associated with tap water ingestion interestingly shows that (i) almost 80% of the computed values fall above the internationally accepted benchmark value of 1 × 10^-5; (ii) majority of the data exceed the acceptable risk proposed by most jurisdictions, such as that of Italian law (1 × 10^-6). Further, geographical variation of health risk highlights high carcinogenic and non-carcinogenic risk associated with water ingestion for those living in the northern Alps (including the city of Trento) and the central and southern Italy (including the capital Rome and the cities of Napoli and Catanzaro). According to the results, application of the probabilistic method which considers variability and uncertainty is preferred to the deterministic approach for risk assessment. The sensitivity analysis showed that As concentration in drinking water and exposure duration are the factors with the greatest impact on the outcome of risk assessment (for all age groups). The results of the current study may be a good starting point for authorities to urgently decide about the needed policy actions in order to prevent the adverse health effects and to reduce the human health risk due to As exposure.

Drug-Related Carcinogenesis: Risk Factors and Approaches for Its Prevention

The review summarizes the data on the role of metabolic and repair systems in the mechanisms of therapy-related carcinogenesis and the effect of their polymorphism on the cancer development risk. The carcinogenic activity of different types of drugs, from the anticancer agents to analgesics, antipyretics, immunomodulators, hormones, natural remedies, and non-cancer drugs, is described. Possible approaches for the prevention of drug-related cancer induction at the initiation and promotion stages are discussed.

Transcriptome responses in blood reveal distinct biological pathways associated with arsenic exposure through drinking water in rural settings of Punjab, Pakistan

BACKGROUND

Groundwater Arsenic (As) contamination is a global public health concern responsible for various health implications and a neglected area of environmental health research in Pakistan. Because of interindividual differences in genetic predisposition, As-related health issues may not be equally distributed among the As-exposed population. However, till date, no studies have been conducted including multiple SNPs involved in As metabolism and disease risk using a linear mixed effect model approach to analyze peripheral blood transcriptomics results.

OBJECTIVES

In order to detect early responses on the gene expression level and to evaluate the impact of selected SNPs inferring disease risks associated with As exposure, we designed a systematic study to investigate blood transcriptomics profiles of 57 differentially exposed rural subjects living in drinking water As-contaminated settings of Lahore and Kasur districts in Punjab Province in southeast Pakistan. Exposure among the subjects was correlated with individual transcriptome responses applying urinary As profiles as the main biomarker for risk stratification.

METHODS

We performed whole genome gene expression analysis in blood of subjects using microarrays. Linear effect mixed models were applied for evaluating the combined impact of SNPs hypothetically increasing the risk for As exposure-induced health effects (GSTM1, GSTT1, As3MT, DNMT1, MTHFR, ERCC2 and EGFR).

RESULTS

Our findings confirmed important signaling, growth factor, cancer and other disease related pathways known to be associated with increased As exposure levels. In addition, upon implementing our integrative SNPs-based genetic risk factor, pathways associated with an increased risk of NAFLD and diabetes appeared significantly enhanced by down-regulation of genes NDUFV3, IKBKB, IL6R, ADIPOR1, PPARA, OGT and FOXO1.

CONCLUSION

We report the first comprehensive study applying state-of-the-art bioinformatics approaches to address multiple SNP-based inter-individual variability in adverse molecular responses among subjects exposed to drinking water As contamination in Pakistan thereby providing strong evidence of various gene expression targets associated with development of known As-related diseases.

Arsenic reduction to <1 µg/L in Dutch drinking water

Arsenic (As) is a highly toxic element which naturally occurs in drinking water. In spite of substantial evidence on the association between many illnesses and chronic consumption of As, there is still a considerable uncertainty about the health risks due to low As concentrations in drinking water. In the Netherlands, drinking water companies aim to supply water with As concentration of <1 μg/L - a water quality goal which is tenfold more stringent than the current WHO guideline. This paper provides (i) an account on the assessed lung cancer risk for the Dutch population due to pertinent low-level As in drinking water and cost-comparison between health care provision and As removal from water, (ii) an overview of As occurrence and mobility in drinking water sources and water treatment systems in the Netherlands and (iii) insights into As removal methods that have been employed or under investigation to achieve As reduction to <1 µg/L at Dutch water treatment plants. Lowering of the average As concentration to <1μg/L in the Netherlands is shown to result in an annual benefit of 7.2-14 M€. This study has a global significance for setting drinking water As limits and provision of safe drinking water.

Achieving arsenic concentrations of <1 μg/L by Fe(0) electrolysis: The exceptional performance of magnetite

Consumption of drinking water containing arsenic at concentrations even below the World Health Organization provisional limit of 10 μg/L can still lead to unacceptable health risks. Consequently, the drinking water sector in the Netherlands has recently agreed to target 1 μg/L of arsenic in treated water. Unfortunately, in many poor, arsenic-affected countries, the costs and complexity of current methods that can achieve <1 μg/L are prohibitive, which highlights the need for innovative methods that can remove arsenic to <1 μg/L without costly support infrastructure and complicated supply chains. In this work, we used Fe(0) electrolysis, a low cost and scalable technology that is also known as Fe(0) electrocoagulation (EC), to achieve <1 μg/L residual dissolved arsenic. We compared the arsenic removal performance of green rust (GR), ferric (oxyhydr)oxides (Fe(III) oxides) and magnetite (Mag) generated by EC at different pH (7.5 and 9) in the presence of As(III) or As(V) (initial concentrations of 200-11,000 μg/L). Although GR and Fe(III) oxides removed up to 99% of initial arsenic, neither Fe phase could reliably meet the 1 μg/L target at both pH values. In contrast, EC-generated Mag consistently achieved <1 μg/L, regardless of the initial As(V) concentration and pH. Only solutions with initial As(III) concentrations ≥2200 μg/L resulted in residual arsenic >1 μg/L. As K-edge X-ray absorption spectroscopy showed that Mag also sorbed arsenic in a unique mode, consistent with partial arsenic incorporation near the particle surface. This sorption mode contrasts with the binuclear, corner sharing surface complex for GR and Fe(III) oxides, which could explain the difference in arsenic removal efficiency among the three Fe phases. Our results suggest that EC-generated Mag is an attractive method for achieving <1 μg/L particularly in decentralized water treatment.