Low-level exposure to arsenic in drinking water and incidence rate of stroke: A cohort study in Denmark

Perspectives on environment and health research in Denmark

AIMS

We provide an overview of nationwide environmental data available for Denmark and its linkage potentials to individual-level records with the aim of promoting research on the potential impact of the local surrounding environment on human health.

BACKGROUND

Researchers in Denmark have unique opportunities for conducting large population-based studies treating the entire Danish population as one big, open and dynamic cohort based on nationally complete population and health registries. So far, most research in this area has utilised individual- and family-level information to study the clustering of disease in families, comorbidities, risk of, and prognosis after, disease onset, and social gradients in disease risk. Linking environmental data in time and space to individuals enables novel possibilities for studying the health effects of the social, built and physical environment.

METHODS

We describe the possible linkage between individuals and their local surrounding environment to establish the exposome - that is, the total environmental exposure of an individual over their life course.

CONCLUSIONS

The currently available nationwide longitudinal environmental data in Denmark constitutes a valuable and globally rare asset that can help explore the impact of the exposome on human health.

Exposure to Environmental Toxins: Potential Implications for Stroke Risk via the Gut- and Lung-Brain Axis

Recent evidence indicates that exposure to environmental toxins, both short-term and long-term, can increase the risk of developing neurological disorders, including neurodegenerative diseases (i.e., Alzheimer's disease and other dementias) and acute brain injury (i.e., stroke). For stroke, the latest systematic analysis revealed that exposure to ambient particulate matter is the second most frequent stroke risk after high blood pressure. However, preclinical and clinical stroke investigations on the deleterious consequences of environmental pollutants are scarce. This review examines recent evidence of how environmental toxins, absorbed along the digestive tract or inhaled through the lungs, affect the host cellular response. We particularly address the consequences of environmental toxins on the immune response and the microbiome at the gut and lung barrier sites. Additionally, this review highlights findings showing the potential contribution of environmental toxins to an increased risk of stroke. A better understanding of the biological mechanisms underlying exposure to environmental toxins has the potential to mitigate stroke risk and other neurological disorders.

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.

Environmental factors and stroke: Risk and prevention

Stroke is a leading cause of death and adult disability globally. In addition to traditional risk factors, environmental risk factors have emerged over the recent past and are becoming increasingly important. The disproportionate rise of stroke incidence in low- and middle-income countries has been attributed, at least in part, to environmental factors. This narrative review provides details on the interplay between the environment and health generally and stroke specifically, covering topics including air pollution, atmospheric brown clouds, desert dust storms, giant wildfires, chemical contamination, biological aggressors, urbanization, and climate change. It also covers some beneficial environmental effects such as can be harnessed from the exposure to green spaces. It concludes with a summary of pragmatic actions that can be taken to help address some of these challenges at individual, community, and political advocacy levels.

Molecular-scale characterization of groundwater treatment sludge from around the world: Implications for potential arsenic recovery

Iron (Fe)-based treatment methods are widely applied to remove carcinogenic arsenic (As) from drinking water, but generate toxic As-laden Fe (oxyhydr)oxide waste that has traditionally been ignored for resource recovery by the water sector. However, the European Commission recently classified As as a Critical Raw Material (CRM), thus providing new incentives to re-think As-laden groundwater treatment sludge. Before As recovery techniques can be developed for groundwater treatment waste, detailed information on its structure and composition is essential. To this end, we comprehensively characterized sludge generated from a variety of As-rich groundwater treatment plants in different geographic regions by combining a suite of macroscopic measurements, such as total digestions, leaching tests and BET surface area with molecular-scale solid-phase analysis by Fe and As K-edge X-ray absorption spectroscopy (XAS). We found that the As mass fraction of all samples ranged from ∼200-1200 mg As/kg (dry weight) and the phosphorous (P) content reached ∼0.5-2 mass%. Notably, our results indicated that the influent As level was a poor predictor of the As sludge content, with the highest As mass fractions (940-1200 mg As/kg) measured in sludge generated from treating low groundwater As levels (1.1-22 µg/L). The Fe K-edge XAS data revealed that all samples consisted of nanoscale Fe(III) precipitates with less structural order than ferrihydrite, which is consistent with their high BET surface area (up to >250 m2/g) and large As and P mass fractions. The As K-edge XAS data indicated As was present in all samples predominantly as As(V) bound to Fe(III) precipitates in the binuclear-corner sharing (2C) geometry. Overall, the similar structure and composition of all samples implies that As recovery methods optimized for one type of Fe-based treatment sludge can be applied to many groundwater treatment sludges. Our work provides a critical foundation for further research to develop resource recovery methods for As-rich waste.

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.

Removal of arsenic from semiarid area groundwater using a biosorbent from watermelon peel waste

Groundwater is one of the most important reservoirs in semi-arid and arid zones of the world, particularly in Mexico. The aims of this work were to produce a biosorbent from watermelon peel waste and a biosorbent with citric acid treatment and to evaluate both biosorbents with different concentrations of arsenic in groundwater. The biosorbents were produced with watermelon peel residues, which were observed by SEM microscopy to evaluate their physical morphology. Its removal potential was tested at concentrations of 0, 1, 13, 22, and 65 μg/L of arsenic, and both adsorption capacity and removal percentage were analyzed by final measurement obtained by atomic absorption spectrometry. The pH was measured throughout the experimentation maintaining ranges between 5.5 and 7.5. The biosorbent without treatment presented clearer and more compact flakes. At the microscopic level, the biosorbent without treatment presented pores with a more circular shape, and the biosorbent with treatment was more polygonal, similar to a honeycomb. The highest removal percentage was 99.99%, for both treatments at 4 h. The biosorbent without treatment at 4 h with arsenic concentrations of 65 μg/L presented the highest adsorption capacity (2.42 μg/g). It is concluded that watermelon peel biosorbent is a material that has the potential to remove arsenic from groundwater. This type of biosorbent is effective to remove arsenic and could be used in the field, however, it still needs to be optimized to convert it into a material completely suitable for large-scale use.

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.

Synergy of arsenic with smoking in causing cardiovascular disease mortality: A cohort study with 27 follow-up years in China

Background

To explore the patterns of the exposure-response relationship between arsenic exposure and cardiovascular disease (CVD) mortality and investigate the effect of cigarette smoking on the association.

Methods

Seven thousand seven hundred thirty-five tin miners with at least 10 years of arsenic exposure were enrolled since 1992 and followed up for 27 years. Each individual's air arsenic exposure at workplace was calculated by time weighted average arsenic concentration × exposure months. Detailed information on smoking was collected at baseline, and information on smoking status was collected for five consecutive years from 1992 to 1996. Hazard ratio (HR) and 95% confidence interval (CI) for the risk of CVD were estimated using Cox proportional hazards models.

Results

A total of 1,046 CVD deaths occurred in this cohort over 142,287.7 person-years of follow up. We firstly reported that for equal cumulative exposure, participants exposed to higher concentrations over shorter duration had a higher risk of CVD mortality than those exposed to lower concentration over longer duration. The HR and 95% CI were 1.38 (95%CI: 1.03-1.85) in participants exposed to arsenic concentration (45.5-99.5 mg/m³), 1.29 (95%CI: 1.02-1.67) in 99.5-361.0 mg/m³. Further, participants with age at first exposure <18 years had a significantly higher risk of morality from CVD, cerebrovascular and heart diseases than those with ≥18 years. Finally, all synergy indices were greater than 1 (range, 1.11-2.39), indicating that the joint effect of arsenic exposure and cigarette smoking on CVD mortality was greater than the sum of their individual effect.

Conclusions

Exposure to air arsenic at workplace is adversely associated with mortality from CVD, especially among smokers younger than 18 years and smokers.

Analysis of the geological control on the spatial distribution of potentially toxic concentrations of As and F- in groundwater on a Pan-European scale

The distribution of the high concentrations of arsenic (As) and fluoride (F^-) in groundwater on a Pan-European scale could be explained by the geological European context (lithology and structural faults). To test this hypothesis, seventeen countries and eighteen geological survey organizations (GSOs) have participated in the dataset. The methodology has used the HydroGeoToxicity (HGT) and the Baseline Concentration (BLC) index. The results prove that most of the waters considered in this study are in good conditions for drinking water consumption, in terms of As and/or F^- content. A low proportion of the analysed samples present HGT≥ 1 levels (4% and 7% for As and F^-, respectively). The spatial distribution of the highest As and/or F^- concentrations (via BLC values) has been analysed using GIS tools. The highest values are identified associated with fissured hard rock outcrops (crystalline rocks) or Cenozoic sedimentary zones, where basement fractures seems to have an obvious control on the distribution of maximum concentrations of these elements in groundwaters.

LCA of Disposal Practices for Arsenic-Bearing Iron Oxides Reveals the Need for Advanced Arsenic Recovery

Iron (Fe)-based groundwater treatment removes carcinogenic arsenic (As) effectively but generates toxic As-rich Fe oxide water treatment residuals (As WTRs) that must be managed appropriately to prevent environmental contamination. In this study, we apply life cycle assessment (LCA) to compare the toxicity impacts of four common As WTR disposal strategies that have different infrastructure requirements and waste control: (i) landfilling, (ii) brick stabilization, (iii) mixture with organic waste, and (iv) open disposal. The As disposal toxicity impacts (functional unit = 1.0 kg As) are compared and benchmarked against impacts of current methods to produce marketable As compounds via As mining and concentrate processing. Landfilling had the lowest non-carcinogen toxicity (2.0 × 10-3 CTUh), carcinogen toxicity (3.8 × 10-5 CTUh), and ecotoxicity (4.6 × 103 CTUe) impacts of the four disposal strategies, with the largest toxicity source being As emission via sewer discharge of treated landfill leachate. Although landfilling had the lowest toxicity impacts, the stored toxicity of this strategy was substantial (ratio of stored toxicity/emitted As = 13), suggesting that landfill disposal simply converts direct As emissions to an impending As toxicity problem for future generations. The remaining disposal strategies, which are frequently practiced in low-income rural As-affected areas, performed poorly. These strategies yielded ∼3-10 times greater human toxicity and ecotoxicity impacts than landfilling. The significant drawbacks of each disposal strategy indicated by the LCA highlight the urgent need for new methods to recover As from WTRs and convert it into valuable As compounds. Such advanced As recovery technologies, which have not been documented previously, would decrease the stored As toxicity and As emissions from both WTR disposal and from mining As ore.

Environmental toxic metal contaminants and risk of stroke: a systematic review and meta-analysis

The relationship between toxic metals in the environment and clinical stroke risk remains unclear, although their role as immunotoxicants and carcinogens has been well established. We conducted a systematic review of the relationship between five metals (arsenic, mercury, copper, cadmium, and lead) and stroke. First, we comprehensively searched 3 databases (Pubmed, EMBASE, and Cochrane) from inception until June 2021. Random-effects meta-analyses, pooled relative risks (RR) and 95% confidence intervals (CI) were applied to evaluate the effect value. We finally identified 38 studies involving 642,014 non-overlapping participants. Comparing the highest vs. lowest baseline levels, chronic exposure to lead (RR = 1.07; 95%CI,1.00-1.14), cadmium (RR = 1.30; 95%CI,1.13-1.48), and copper (RR = 1.19; 95%CI,1.04-1.36) were significantly associated with stroke risks. However, the other two metals (arsenic and mercury) had less effect on stroke risk. Further analysis indicated that the association was likely in a metal dose-dependent manner. The results may further support the possibility that environmental toxic metal contaminants in recent years are associated with the increased risk of stroke.

Maternal exposure to arsenic in drinking water and risk of congenital heart disease in the offspring

INTRODUCTION

Prenatal exposure to arsenic is suspected to impair fetal health, including congenital malformations. Few studies investigated an association between maternal exposure to arsenic and congenital heart disease.

OBJECTIVE

To examine the association between maternal exposure to arsenic through drinking water and congenital heart disease among offspring.

METHODS

This nationwide cohort study included all liveborn children in Denmark, 1997-2014. Maternal addresses at fetal age 4 weeks were linked to drinking water supply areas. Exposure was arsenic concentration in drinking water in first trimester in four categories (<0.5 μg/L, 0.5-0.9 μg/L, 1.0-4.9 μg/L, ≥5.0 μg/L). Outcomes were defined as congenital heart disease diagnosed within the first year of life, with sub-categorization of severe, septal defects and valvular heart defect. Associations between arsenic levels and congenital heart disease were analysed using logistic regression, presented as odds ratios (OR) with 95% confidence interval (CI), and adjusted for year of birth, mother's educational level and ethnicity.

RESULTS

A total of 1,042,413 liveborn children were included of whom 1.0% had a congenital heart disease. The OR of congenital heart disease was higher among children exposed to all levels of arsenic above 0.5 μg/L; the OR was 1.13 (95% CI: 1.08-1.19) for exposure of 0.5-0.9 μg/L, 1.33 (95% CI: 1.27-1.39) for 1.0-4.9 μg/L and 1.42 (95% CI: 1.24-1.63) for ≥5.0 μg/L. Similar associations were observed for congenital septal defects. The OR was also higher for severe congenital heart disease but at the same level among all exposure levels ≥0.5 μg/L. The OR of congenital valvular heart defects was only higher among children with maternal exposure to arsenic in drinking water ≥5.0 μg/L. The associations were similar for boys and girls.

CONCLUSION

The findings indicate that maternal exposure to arsenic in drinking water even at low concentrations (i.e., 0.5-0.9 μg/L) increased the risk of congenital heart disease in the offspring.

Seven potential sources of arsenic pollution in Latin America and their environmental and health impacts

This review presents a holistic overview of the occurrence, mobilization, and pathways of arsenic (As) from predominantly geogenic sources into different near-surface environmental compartments, together with the respective reported or potential impacts on human health in Latin America. The main sources and pathways of As pollution in this region include: (i) volcanism and geothermalism: (a) volcanic rocks, fluids (e.g., gases) and ash, including large-scale transport of the latter through different mechanisms, (b) geothermal fluids and their exploitation; (ii) natural lixiviation and accelerated mobilization from (mostly sulfidic) metal ore deposits by mining and related activities; (iii) coal deposits and their exploitation; (iv) hydrocarbon reservoirs and co-produced water during exploitation; (v) solute and sediment transport through rivers to the sea; (vi) atmospheric As (dust and aerosol); and (vii) As exposure through geophagy and involuntary ingestion. The two most important and well-recognized sources and mechanisms for As release into the Latin American population's environments are: (i) volcanism and geothermalism, and (ii) strongly accelerated As release from geogenic sources by mining and related activities. Several new analyses from As-endemic areas of Latin America emphasize that As-related mortality and morbidity continue to rise even after decadal efforts towards lowering As exposure. Several public health regulatory institutions have classified As and its compounds as carcinogenic chemicals, as As uptake can affect several organ systems, viz. dermal, gastrointestinal, peptic, neurological, respiratory, reproductive, following exposure. Accordingly, ingesting large amounts of As can damage the stomach, kidneys, liver, heart, and nervous system; and, in severe cases, may cause death. Moreover, breathing air with high As levels can cause lung damage, shortness of breath, chest pain, and cough. Further, As compounds, being corrosive, can also cause skin lesions or damage eyes, and long-term exposure to As can lead to cancer development in several organs.

Evaluation of Groundwater Quality for Human Consumption and Irrigation in Relation to Arsenic Concentration in Flow Systems in a Semi-Arid Mexican Region

The supply of drinking water to the population is an important challenge facing humanity, since both surface and underground sources present a great variability of water storage with respect to space and time. This problem is further aggravated in arid and semi-arid areas where rainfall is low and torrential, which makes groundwater the main source of supply; therefore, it is necessary to carry out studies that allow evaluating the evolution of the quantity and quality of water. This study addresses the behavior of groundwater in a semi-arid region, considering the theory of flow systems to identify movement as well as water quality, es determined by a water quality index (WQI), calculated considering arsenic and fluorine. In addition, a quality irrigation classification is used, employing the norms in accordance with international standards and the Mexican Norm, which allows for a comparison. Local, regional, intermediate and mixed flow systems are identified, and the evolution of cations and anions in addition to temperature is examined. It is observed that the drinking water quality index classifies them as excellent in most of the monitored wells (<50), but with a negative evolution. Regarding irrigation, most of the water samples are classified without restriction for the establishment of any type II crop (C₂S₁) and with restrictions for horticultural crops. It is observed that arsenic had values between 0.49 and 61.40 (µg/L) in 2005, while in 2015 they were between 0.10 and 241.30 (µg/L). In addition, fluoride presented values between 0.00 and 2.6 (mg/L) in 2005, while in 2015 they were between 0.28 and 5.40 (mg/L). The correlations between arsenic and fluorine are noted as well as WQI and SAR. A finding in this research was to include arsenic and fluorine in the calculation of the WQI allowing a better interpretation of the quality of water for both human consumption and for agricultural use to based on this make the best decision to control any harmful effects for the population, in addition to identifying the appropriate purification treatment required to control pollutants. It is concluded that arsenic is an element of utmost importance when considering water quality, so it is necessary to examine its evolution and continue to monitor its levels constantly.

Machine-Learning Predictions of High Arsenic and High Manganese at Drinking Water Depths of the Glacial Aquifer System, Northern Continental United States

Globally, over 200 million people are chronically exposed to arsenic (As) and/or manganese (Mn) from drinking water. We used machine-learning (ML) boosted regression tree (BRT) models to predict high As (>10 μg/L) and Mn (>300 μg/L) in groundwater from the glacial aquifer system (GLAC), which spans 25 states in the northern United States and provides drinking water to 30 million people. Our BRT models' predictor variables (PVs) included recently developed three-dimensional estimates of a suite of groundwater age metrics, redox condition, and pH. We also demonstrated a successful approach to significantly improve ML prediction sensitivity for imbalanced data sets (small percentage of high values). We present predictions of the probability of high As and high Mn concentrations in groundwater, and uncertainty, at two nonuniform depth surfaces that represent moving median depths of GLAC domestic and public supply wells within the three-dimensional model domain. Predicted high likelihood of anoxic condition (high iron or low dissolved oxygen), predicted pH, relative well depth, several modeled groundwater age metrics, and hydrologic position were all PVs retained in both models; however, PV importance and influence differed between the models. High-As and high-Mn groundwater was predicted with high likelihood over large portions of the central part of the GLAC.

Overlapping redox zones control arsenic pollution in Pleistocene multi-layer aquifers, the Po Plain (Italy)

Understanding the factors that control As concentrations in groundwater is vital for supplying safe groundwater in regions with As-polluted aquifers. Despite much research, mainly addressing Holocene aquifers hosting young (<100 yrs) groundwater, the source, transport, and fate of As in Pleistocene aquifers with fossil (>12,000 yrs) groundwaters are not yet fully understood and so are assessed here through an evaluation of the redox properties of the system in a type locality, the Po Plain (Italy). Analyses of redox-sensitive species and major ions on 22 groundwater samples from the Pleistocene arsenic-affected aquifer in the Po Plain shows that groundwater concentrations of As are controlled by the simultaneous operation of several terminal electron accepters. Organic matter, present as peat, is abundant in the aquifer, allowing groundwater to reach a quasi-steady-state of highly reducing conditions close to thermodynamic equilibrium. In this system, simultaneous reduction of Fe-oxide and sulfate results in low concentrations of As (median 7 μg/L) whereas As reaches higher concentrations (median of 82 μg/L) during simultaneous methanogenesis and Fe-reduction. The position of well-screens is an additional controlling factor on groundwater As: short screens that overlap confining aquitards generate higher As concentrations than long screens placed away from them. A conceptual model for groundwater As, applicable worldwide in other Pleistocene aquifers with reducible Fe-oxides and abundant organic matter is proposed: As may have two concentration peaks, the first after prolonged Fe-oxide reduction and until sulfate reduction takes place, the second during simultaneous Fe-reduction and methanogenesis.

Application of the in vivo oxidative stress reporter Hmox1 as mechanistic biomarker of arsenic toxicity

Inorganic arsenic (iAs) is a naturally occurring metalloid present in drinking water and polluted air exposing millions of people globally. Epidemiological studies have linked iAs exposure to the development of numerous diseases including cognitive impairment, cardiovascular failure and cancer. Despite intense research, an effective therapy for chronic arsenicosis has yet to be developed. Laboratory studies have been of great benefit in establishing the pathways involved in iAs toxicity and providing insights into its mechanism of action. However, the in vivo analysis of arsenic toxicity mechanisms has been difficult by the lack of reliable in vivo biomarkers of iAs's effects. To address this issue we have applied the use of our recently developed stress reporter models to study iAs toxicity. The reporter mice Hmox1 (oxidative stress/inflammation; HOTT) and p21 (DNA damage) were exposed to iAs at acute and chronic, environmentally relevant, doses. We observed induction of the oxidative stress reporters in several cell types and tissues, which was largely dependent on the activation of transcription factor NRF2. We propose that our HOTT reporter model can be used as a surrogate biomarker of iAs-induced oxidative stress, and it constitutes a first-in-class platform to develop treatments aimed to counteract the role of oxidative stress in arsenicosis. Indeed, in a proof of concept experiment, the HOTT reporter mice were able to predict the therapeutic utility of the antioxidant N-acetyl cysteine in the prevention of iAs associated toxicity.

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).

Positive Association of Cardiovascular Disease (CVD) with Chronic Exposure to Drinking Water Arsenic (As) at Concentrations below the WHO Provisional Guideline Value: A Systematic Review and Meta-Analysis

To the best of our knowledge, a dose-response meta-analysis of the relationship between cardiovascular disease (CVD) and arsenic (As) exposure at drinking water As concentrations lower than the WHO provisional guideline value (10 µg/L) has not been published yet. We conducted a systematic review and meta-analyses to estimate the pooled association between the relative risk of each CVD endpoint and low-level As concentration in drinking water both linearly and non-linearly using a random effects dose-response model. In this study, a significant positive association was found between the risks of most CVD outcomes and drinking water As concentration for both linear and non-linear models (p-value for trend < 0.05). Using the preferred linear model, we found significant increased risks of coronary heart disease (CHD) mortality and CVD mortality as well as combined fatal and non-fatal CHD, CVD, carotid atherosclerosis disease and hypertension in those exposed to drinking water with an As concentration of 10 µg/L compared to the referent (drinking water As concentration of 1 µg/L) population. Notwithstanding limitations included, the observed significant increased risks of CVD endpoints arising from As concentrations in drinking water between 1 µg/L and the 10 µg/L suggests further lowering of this guideline value should be considered.

Direct Visualization of Arsenic Binding on Green Rust Sulfate

"Green rust" (GR), a redox-active Fe(II)-Fe(III) layered double hydroxide, is a potential environmentally relevant mineral substrate for arsenic (As) sequestration in reduced, subsurface environments. GR phases have high As uptake capacities at circum-neutral pH conditions, but the exact interaction mechanism between the GR phases and As species is still poorly understood. Here, we documented the bonding and interaction mechanisms between GR sulfate and As species [As(III) and As(V)] under anoxic and circum-neutral pH conditions through scanning transmission electron microscopy (STEM) coupled with energy-dispersive X-ray (EDX) spectroscopy and combined it with synchrotron-based X-ray total scattering, pair distribution function (PDF) analysis, and As K-edge X-ray absorption spectroscopy (XAS). Our highly spatially resolved STEM-EDX data revealed that the preferred adsorption sites of both As(III) and As(V) are at GR crystal edges. Combining this data with differential PDF and XAS allowed us to conclude that As adsorption occurs primarily as bidentate binuclear (²C) inner-sphere surface complexes. In the As(III)-reacted GR sulfate, no secondary Fe-As phases were observed. However, authigenic parasymplesite (ferrous arsenate nanophase), exhibiting a threadlike morphology, formed in the As(V)-reacted GR sulfate and acts as an additional immobilization pathway for As(V) (∼87% of immobilized As). We demonstrate that only by combining high-resolution STEM imaging and EDX mapping with the bulk (differential) PDF and extended X-ray absorption fine structure (EXAFS) data can one truly determine the de facto As binding nature on GR surfaces. More importantly, these new insights into As-GR interaction mechanisms highlight the impact of GR phases on As sequestration in anoxic subsurface environments.

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.

Health effects inflicted by chronic low-level arsenic contamination in groundwater: A global public health challenge

Groundwater arsenic (As) contamination is a global public health concern. The high level of As exposure (100-1000 μg/L or even higher) through groundwater has been frequently associated with serious public health hazards, e.g., skin disorders, cardiovascular diseases, respiratory problems, complications of gastrointestinal tract, liver and splenic ailments, kidney and bladder disorders, reproductive failure, neurotoxicity and cancer. However, reviews on low-level As exposure and the imperative health effects are far less documented. The World Health Organization (WHO) and the United States Environmental Protection Agency (USEPA) has set the permissible standard of As in drinking water at 10 μg/L. Considering the WHO and USEPA guidelines, most of the developed countries have established standards at or below this guideline. Worldwide many countries including India have millions of aquifers with low-level As contamination (≤50 μg/L). The exposed population of these areas might not show any As-related skin lesions (hallmark of As toxicity particularly in a population consuming As contaminated groundwater >300 μg/L) but might be subclinically affected. This review has attempted to encompass the wide range of health effects associated with chronic low-level As exposure ≤50 μg/L and the probable mechanisms that might provide a better insight regarding the underlying cause of these clinical manifestations. Therefore, there is an urgent need to create mass awareness about the health effects of chronic low-level As exposure and planning of proper mitigation strategies.