Low-level arsenic in drinking water and risk of incident myocardial infarction: A cohort study

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.

A Clinical Perspective on Arsenic Exposure and Development of Atherosclerotic Cardiovascular Disease

Cardiovascular risk has traditionally been defined by modifiable and non-modifiable risk factors, such as tobacco use, hyperlipidemia, and family history. However, chemicals and pollutants may also play a role in cardiovascular disease (CVD) risk. Arsenic is a naturally occurring element that is widely distributed in the Earth's crust. Inorganic arsenic (iAs) has been implicated in the pathogenesis of atherosclerosis, with chronic high-dose exposure to iAs (> 100 µg/L) being linked to CVD; however, whether low-to-moderate dose exposures of iAs (< 100 µg/L) are associated with the development of CVD is unclear. Due to limitations of the existing literature, it is difficult to define a threshold for iAs toxicity. Studies demonstrate that the effect of iAs on CVD is far more complex with influences from several factors, including diet, genetics, metabolism, and traditional risk factors such as hypertension and smoking. In this article, we review the existing data of low-to-moderate dose iAs exposure and its effect on CVD, along with highlighting the potential mechanisms of action.

First assessment of atmospheric pollution by trace elements and particulate matter after a severe collapse of a tailings dam, Minas Gerais, Brazil: An insight into biomonitoring with Tillandsia usneoides and a public health dataset

In this study, samples of bromeliad Tillandsia usneoides (n = 70) were transplanted and exposed for 15 and 45 days in 35 outdoor residential areas in Brumadinho (Minas Gerais state, Brazil) after one of the most severe mining dam collapses in the world. Trace elements aluminum (Al), arsenic (As), chromium (Cr), copper (Cu), iron (Fe), mercury (Hg), manganese (Mn), nickel (Ni) and zinc (Zn) were quantified by atomic absorption spectrometry. Scanning electron microscope generated surface images of T. usneoides fragments and particulate matter (PM2.5, PM10 and PM > 10). Aluminum, Fe and Mn stood out from the other elements reflecting the regional geological background. Median concentrations in mg kg-1 increased (p < 0.05) between 15 and 45 days for Cr (0.75), Cu (1.23), Fe (474) and Mn (38.1), while Hg (0.18) was higher at 15 days. The exposed-to-control ratio revealed that As and Hg increased 18.1 and 9.4-fold, respectively, not showing a pattern associated only with the most impacted sites. The PM analysis points to a possible influence of the prevailing west wind on the increase of total particles, PM2.5 and PM10 in transplant sites located to the east. Brazilian public health dataset revealed increase in cases of some cardiovascular and respiratory diseases/symptoms in Brumadinho in the year of the dam collapse (1.38 cases per 1000 inhabitants), while Belo Horizonte capital and its metropolitan region recorded 0.97 and 0.37 cases, respectively. Although many studies have been carried out to assess the consequences of the tailings dam failure, until now atmospheric pollution had not yet been evaluated. Furthermore, based on our exploratory analysis of human health dataset, epidemiological studies are required to verify possible risk factors associated with the increase in hospital admissions in the study area.

The Development of Fe3O4-Monolithic Resorcinol-Formaldehyde Carbon Xerogels Using Ultrasonic-Assisted Synthesis for Arsenic Removal of Drinking Water

Inorganic arsenic in drinking water from groundwater sources is one of the potential causes of arsenic-contaminated environments, and it is highly toxic to human health even at low concentrations. The purpose of this study was to develop a magnetic adsorbent capable of removing arsenic from water. Fe3O4-monolithic resorcinol-formaldehyde carbon xerogels are a type of porous material that forms when resorcinol and formaldehyde (RF) react to form a polymer network, which is then cross-linked with magnetite. Sonication-assisted direct and indirect methods were investigated for loading Fe3O4 and achieving optimal mixing and dispersion of Fe3O4 in the RF solution. Variations of the molar ratios of the catalyst (R/C = 50, 100, 150, and 200), water (R/W = 0.04 and 0.05), and Fe3O4 (M/R = 0.01, 0.03, 0.05, 0.1, 0.15, and 0.2), and thermal treatment were applied to evaluate their textural properties and adsorption capacities. Magnetic carbon xerogel monoliths (MXRF600) using indirect sonication were pyrolyzed at 600 °C for 6 h with a nitrogen gas flow in the tube furnace. Nanoporous carbon xerogels with a high surface area (292 m2/g) and magnetic properties were obtained. The maximum monolayer adsorption capacity of As(III) and As(V) was 694.3 µg/g and 1720.3 µg/g, respectively. The incorporation of magnetite in the xerogel structure was physical, without participation in the polycondensation reaction, as confirmed by XRD, FTIR, and SEM analysis. Therefore, Fe3O4-monolithic resorcinol-formaldehyde carbon xerogels were developed as a potential adsorbent for the effective removal of arsenic with low and high ranges of As(III) and As(V) concentrations from groundwater.

Arsenic Contents, Speciation and Toxicity in Germinated Rice Alleviated by Selenium

Rice can accumulate more organic and inorganic arsenic (iAs) than other crop plants. In this study, the localization of As in rice grains was investigated using High Performance Liquid Chromatography-Inductively Coupled Plasma Mass Spectrometry (HPLC-ICP-MS) based on 26 rice varieties collected from two provinces. In all the samples, the total As contents in polished rice were 0.03-0.37 mg/kg, with average values of 0.28 and 0.21 mg/kg for two sample sets. The results of the determination of arsenic speciation in different components of rice grain showed that in the polished and brown rice the mean value of arsenite (As(III)) was nearly twice than that of arsenate (As(V)). The regional difference was observed in both total As contents and As speciation. The reason may be that As(III) is more mobile than As(V) in a dissociated form and because of soil properties, rice varieties, and the growing environment. The proportion of iAs and the total As in rice bran was higher than that in polished rice, and this is because As tends accumulate between the husk and the endosperm. In our study, selenium could alleviate the risk of arsenic toxicity at the primary stage of rice growth. Co-exposure to As and Se in germinated rice indicated that the reduction in As accumulation in polished rice reached 73.8%, 76.8%, and 78.3% for total As, As(III), and As(V) when compared with rice treated with As alone. The addition of Se (0.3 mg/kg) along with As significantly reduced the As amount in different parts of germinated rice. Our results indicated that Se biofortification could alleviate the As accumulation and toxicity in rice crops.

Relations between personal exposure to elevated concentrations of arsenic in water and soil and blood arsenic levels amongst people living in rural areas in Limpopo, South Africa

Exposure to arsenic even at low levels can lead to adverse health outcomes, however, there is a paucity of research from South Africa in relation to human exposure to arsenic. We investigated long-term exposure of residents in Limpopo province, South Africa, in a cross-sectional study by analysing water, soil and blood arsenic concentrations from two arsenic-exposed (high and medium-low exposure) villages and one non-exposed (control) village. There were statistically significant differences in the distribution of arsenic in water, soil and blood amongst the three sites. The median drinking water arsenic concentration in the high-exposure village was 1.75 µg/L (range = 0.02 to 81.30 µg/L), 0.45 µg/L (range = 0.100 to 6.00 µg/L) in the medium- / low-exposure village and 0.15 µg/L (range =  < limit of detection (LOD) to 29.30 µg/L) in the control site. The median soil arsenic concentration in the high-exposure village was 23.91 mg/kg (range =  < LOD to 92.10 mg/kg) whilst arsenic concentrations were below the limit of detection in all soil samples collected from the medium-/low-exposure and control villages. In the high-exposure village, the median blood arsenic concentration was 1.6 µg/L (range = 0.7 to 4.2 µg/L); 0.90 µg/L (range =  < LOD to 2.5 µg/L) in the medium-/low-exposure village and 0.6 µg/L (range =  < LOD to 3.3 µg/L) in the control village. Significant percentages of drinking water, soil and blood samples from the exposed sites were above the internationally recommended guidelines (namely, 10 µg/L, 20 mg/kg and 1 µg/L, respectively). Majority of participants (86%) relied on borehole water for drinking and there was a significant positive correlation between arsenic in blood and borehole water (p-value = 0.031). There was also a statistically significant correlation between arsenic concentrations in participants' blood and soil samples collected from gardens (p-value = 0.051). Univariate quantile regression found that blood arsenic concentrations increased by 0.034 µg/L (95% CI = 0.02-0.05) for each one unit increase in water arsenic concentrations (p < 0.001). After adjusting for age, water source and homegrown vegetable consumption in multivariate quantile regression, participants from the high-exposure site had significantly higher blood concentrations than those in the control site (coefficient: 1.00; 95% CI = 0.25-1.74; p-value = 0.009) demonstrating that blood arsenic is a good biomarker of arsenic exposure. Our findings also provide new evidence for South Africa on the association between drinking water and arsenic exposure, emphasising the need for the provision of potable water for human consumption in areas with high environmental arsenic concentrations.

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.

Elevated Adsorption of Lead and Arsenic over Silver Nanoparticles Deposited on Poly(amidoamine) Grafted Carbon Nanotubes

An efficient adsorbent, CNTs-PAMAM-Ag, was prepared by grafting fourth-generation aromatic poly(amidoamine) (PAMAM) to carbon nanotubes (CNTs) and successive deposition of Ag nanoparticles. The FT-IR, XRD, TEM and XPS results confirmed the successful grafting of PAMAM onto CNTs and deposition of Ag nanoparticles. The absorption efficiency of CNTs-PAMAM-Ag was evaluated by estimating the adsorption of two toxic contaminants in water, viz., Pb(II) and As(III). Using CNTs-PAMAM-Ag, about 99 and 76% of Pb(II) and As(III) adsorption, respectively, were attained within 15 min. The controlling mechanisms for Pb(II) and As(III) adsorption dynamics were revealed by applying pseudo-first and second-order kinetic models. The pseudo-second-order kinetic model followed the adsorption of Pb(II) and As(III). Therefore, the incidence of chemisorption through sharing or exchanging electrons between Pb(II) or As(III) ions and CNTs-PAMAM-Ag could be the rate-controlling step in the adsorption process. Further, the Weber-Morris intraparticle pore diffusion model was employed to find the reaction pathways and the rate-controlling step in the adsorption. It revealed that intraparticle diffusion was not a rate-controlling step in the adsorption of Pb(II) and As(III); instead, it was controlled by both intraparticle diffusion and the boundary layer effect. The adsorption equilibrium was evaluated using the Langmuir, Freundlich, and Temkin isotherm models. The kinetic data of Pb(II) and As(III) adsorption was adequately fitted to the Langmuir isotherm model compared to the Freundlich and Temkin models.

Arsenic Exposure, Blood DNA Methylation, and Cardiovascular Disease

BACKGROUND

Epigenetic dysregulation has been proposed as a key mechanism for arsenic-related cardiovascular disease (CVD). We evaluated differentially methylated positions (DMPs) as potential mediators on the association between arsenic and CVD.

METHODS

Blood DNA methylation was measured in 2321 participants (mean age 56.2, 58.6% women) of the Strong Heart Study, a prospective cohort of American Indians. Urinary arsenic species were measured using high-performance liquid chromatography coupled to inductively coupled plasma mass spectrometry. We identified DMPs that are potential mediators between arsenic and CVD. In a cross-species analysis, we compared those DMPs with differential liver DNA methylation following early-life arsenic exposure in the apoE knockout (apoE-/-) mouse model of atherosclerosis.

RESULTS

A total of 20 and 13 DMPs were potential mediators for CVD incidence and mortality, respectively, several of them annotated to genes related to diabetes. Eleven of these DMPs were similarly associated with incident CVD in 3 diverse prospective cohorts (Framingham Heart Study, Women's Health Initiative, and Multi-Ethnic Study of Atherosclerosis). In the mouse model, differentially methylated regions in 20 of those genes and DMPs in 10 genes were associated with arsenic.

CONCLUSIONS

Differential DNA methylation might be part of the biological link between arsenic and CVD. The gene functions suggest that diabetes might represent a relevant mechanism for arsenic-related cardiovascular risk in populations with a high burden of diabetes.

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.

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

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

Associations of total urinary arsenic with total cholesterol and high-density lipoprotein among 12-17-year-old participants from the 2009-2016 NHANES cycles: A cross-sectional study

INTRODUCTION

Hypertension and diabetes are highly prevalent among US adults. Arsenic exposure is associated with these cardiometabolic morbidities but the relationship between arsenic exposure and cholesterol markers of cardiometabolic disease has not been elucidated, especially at younger ages, when many chronic diseases may initiate. This study examined the association of total urinary arsenic with total cholesterol (TC) and high-density lipoprotein cholesterol (HDL) and explored effect modification by weight status.

METHODS

The study sample consisted of 12-17-year-old participants with complete data from the 2009-2016 National Health and Nutrition Examination Survey cycles. The cross-sectional associations of creatinine-adjusted total urinary arsenic with TC and HDL were assessed using multivariable linear regression models with survey weights. Three models were built, adjusting for varying combinations of age, gender, race/ethnicity, weight status, survey cycle, family income to poverty ratio, reference person education level, arsenobetaine, and dimethylarsinic acid (DMA). Model adjustments for arsenobetaine approximated inorganic arsenic exposure, and further adjustment for DMA approximated unmethylated inorganic arsenic exposure. We also explored weight status (underweight/healthy, overweight, and obese) as a potential effect modifier of these relationships using stratified analyses and interaction tests.

RESULTS

The final analytical sample consisted of 1,177 12-17-year-old participants. After adjusting for covariates and arsenobetaine, creatinine-adjusted arsenic was positively associated with HDL levels (β = 0.063; 95% CI: 0.007, 0.119). Upon further adjustment for DMA, creatinine-adjusted arsenic was positively associated with HDL levels (β = 0.079; 95% CI: 0.015, 0.143) and TC levels (β = 0.258; 95% CI: 0.002, 0.515). No effect modification by weight status was observed.

CONCLUSIONS

We found a positive association of approximated unmethylated inorganic arsenic exposure with TC, and contrary to our expectation, with HDL. There was no effect modification by weight status. Our findings should be confirmed by conducting longitudinal studies among adolescents exposed to low-level arsenic and focusing specifically on urinary inorganic arsenic concentrations.

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.

Impacts of Environmental Insults on Cardiovascular Aging

PURPOSE OF REVIEW

With cardiovascular disease (CVD) being the top cause of deaths worldwide, it is important to ensure healthy cardiovascular aging through enhanced understanding and prevention of adverse health effects exerted by external factors. This review aims to provide an updated understanding of environmental influences on cardiovascular aging, by summarizing epidemiological and mechanistic evidence for the cardiovascular health impact of major environmental stressors, including air pollution, endocrine-disrupting chemicals (EDCs), metals, and climate change.

RECENT FINDINGS

Recent studies generally support positive associations of exposure to multiple chemical environmental stressors (air pollution, EDCs, toxic metals) and extreme temperatures with increased risks of cardiovascular mortality and morbidity in the population. Environmental stressors have also been associated with a number of cardiovascular aging-related subclinical changes including biomarkers in the population, which are supported by evidence from relevant experimental studies. The elderly and patients are the most vulnerable demographic groups to majority environmental stressors. Future studies should account for the totality of individuals' exposome in addition to single chemical pollutants or environmental factors. Specific factors most responsible for the observed health effects related to cardiovascular aging remain to be elucidated.

Months-long spike in aqueous arsenic following domestic well installation and disinfection: Short- and long-term drinking water quality implications

Exposure to high concentration geogenic arsenic via groundwater is a worldwide health concern. Well installation introduces oxic drilling fluids and hypochlorite (a strong oxidant) for disinfection, thus inducing geochemical disequilibrium. Well installation causes changes in geochemistry lasting 12 + months, as illustrated in a recent study of 250 new domestic wells in Minnesota, north-central United States. One study well had extremely high initial arsenic (1550 µg/L) that substantially decreased after 15 months (5.2 µg/L). The drilling and development of the study well were typical and ordinary; nothing observable indicated the very high initial arsenic concentration. We hypothesized that oxidation of arsenic-containing sulfides (which lowers pH) combined with low pH dissolution of arsenic-bearing Fe (oxyhydr)oxides caused the very high arsenic concentration. Geochemical equilibrium considerations and modeling supported our hypothesis. Groundwater equilibrium redox conditions are poised at the Fe(III)_(s)/Fe(II)_(aq) stability boundary, indicating arsenic-bearing Fe (oxyhydr)oxide mineral sensitivity to pH and redox changes. Changing groundwater geochemistry can have negative implications for home water treatment (e.g., reduced arsenic removal efficiency, iron fouling), which can lead to ongoing but unrecognized hazard of arsenic exposure from domestic well water. Our results may inform arsenic mobilization processes and geochemical sensitivity in similarly complex aquifers in Southeast Asia and elsewhere.

Geostatistical model of the spatial distribution of arsenic in groundwaters in Gujarat State, India

Geogenic arsenic contamination in groundwaters poses a severe health risk to hundreds of millions of people globally. Notwithstanding the particular risks to exposed populations in the Indian sub-continent, at the time of writing, there was a paucity of geostatistically based models of the spatial distribution of groundwater hazard in India. In this study, we used logistic regression models of secondary groundwater arsenic data with research-informed secondary soil, climate and topographic variables as principal predictors generate hazard and risk maps of groundwater arsenic at a resolution of 1 km across Gujarat State. By combining models based on different arsenic concentrations, we have generated a pseudo-contour map of groundwater arsenic concentrations, which indicates greater arsenic hazard (> 10 μg/L) in the northwest, northeast and south-east parts of Kachchh District as well as northwest and southwest Banas Kantha District. The total number of people living in areas in Gujarat with groundwater arsenic concentration exceeding 10 μg/L is estimated to be around 122,000, of which we estimate approximately 49,000 people consume groundwater exceeding 10 µg/L. Using simple previously published dose-response relationships, this is estimated to have given rise to 700 (prevalence) cases of skin cancer and around 10 cases of premature avoidable mortality/annum from internal (lung, liver, bladder) cancers-that latter value is on the order of just 0.001% of internal cancers in Gujarat, reflecting the relative low groundwater arsenic hazard in Gujarat State.

Persistence and reversibility of arsenic-induced gut microbiome and metabolome shifts in male rats after 30-days recovery duration

The metabolites of gut microbiome are important host-health regulating factors and can be interrupted when the host is exposed to environmental pollutant via ingestion route. Arsenic contaminated drinking water is one of the most serious environmental health problems worldwide. Therefore, the arsenic-induced alterations of gut microbiome and metabolome, especially the persistence and reversibility of the alterations after the long-term arsenic exposure will be interesting to know. In this study, we investigated the relationship between gut microbiota and metabolites in male rats both after the 30-days arsenic treatment and 30-days recovery duration. The composition and diversity of gut microbiota were affected significantly by the treatment, but they presented partial improvement in recovery duration. Moreover, arsenic exposure induced the significant changes of 73 metabolites, which involved in the metabolism of glycerophospholipid, linoleic acid, as well as the biosynthesis of phenylalanine, tyrosine and tryptophan. Although it had a persistent effect, the restoration of glycerophospholipid metabolism was observed in the 30-days recovery. Integration analysis further correlated the arsenic impacting microbes with some important differential metabolites. Lactobacillus associated with the decreases of phosphatidylethanolamine(34:1), 16alpha-hydroxydehydroepiandrosterone 3-sulfate, seryltryptophan and alanyltyrosine in recovery duration. Lactobacillus strains have potential to work as protective agents against arsenic toxicity by restoring perturbed glycerophospholipid metabolism. In summary, arsenic significantly disrupted gut microbiome and metabolome, but the disruptions are reversible to some extent after a 30-days recovery.

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.

Urine cadmium and acute myocardial infarction among never smokers in the Danish Diet, Cancer and Health cohort

Cadmium exposure has been associated with cardiovascular disease. Cigarette smoking is a key source of cadmium exposure and thus a potential confounder in observational studies of environmental cadmium and cardiovascular disease that include tobacco smokers. We leveraged up to 20 years of follow-up in the Danish Diet, Cancer and Health cohort to test the hypothesis that cadmium exposure is associated with acute myocardial infarction (AMI) among people who never smoked. Between 1993 and 1997, 19,394 never-smoking participants (ages 50-64 years) were enrolled and provided a urine sample. From this sample, we randomly selected a subcohort of 600 males and 600 females. We identified 809 AMI cases occurring between baseline and the end of 2015 using the Danish National Patient Registry. We quantified cadmium, creatinine, and osmolality in baseline urine samples. Using an unweighted case-cohort approach, we estimated adjusted hazard ratios (aHR) for AMI in Cox proportional hazards models with age as the time axis. Participants had relatively low concentrations of urinary cadmium, as expected for never smokers (median = 0.20; 25th, 75th = 0.13, 0.32 μg cadmium/g creatinine). We did not find strong evidence to support an association between higher urinary cadmium and AMI when comparing the highest versus lowest quartile (aHR = 1.16; 95% CI: 0.86 - 1.56) and per IQR increment in cadmium concentration (aHR = 1.02; 95% CI: 0.93 - 1.12). Results were not materially different across strata defined by sex. Results were generally similar using creatinine or osmolality to account for differences in urine dilution. While cadmium exposure has been identified as a risk factor for cardiovascular disease, we did not find strong evidence that urinary cadmium at relatively low-levels is associated with AMI among people who have never smoked.

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.

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.

A critical review on recent developments in MOF adsorbents for the elimination of toxic heavy metals from aqueous solutions

Effective and substantial remediation of contaminants especially heavy metals from water is still a big challenge in terms of both environmental and biological perspectives because of their adverse effects on the human health. Many techniques including adsorption, ion exchange, co-precipitation, chemical reduction, ultrafiltration, etc. are reported for eliminating heavy metal ions from the water. However, adsorption has preferred because of its simple and easy handlings. Several types of adsorbents are observed and documented well for the purpose. Recently, highly porous metal-organic frameworks (MOFs) were developed by incorporating metals and organic ligands together and claimed as potent adsorbents for the remediation of highly toxic heavy metals from the aqueous solutions due to their unique features like greater surface area, high chemical stability, green and reuse material, etc. In this review, the authors discussed systematically some recent developments about secure MOFs to eliminate the toxic metals such as arsenic (both arsenite and arsenate), chromium(VI), cadmium (Cd), mercury (Hg) and lead (Pb). MOFs are observed as the most efficient adsorbents with greater selectivity as well as high adsorption capacity for metallic contamination. Graphical abstract.

Association of arsenic exposure and cognitive impairment: A population-based cross-sectional study in China

BACKGROUND

The influence of chronic arsenic exposure on cognitive impairment has been explored broadly by previous studies. However, most of them focused mainly on children rather than adults. In addition, in China, studies in this field are not sufficient. To illustrate how long-term arsenic exposure affects cognitive function, we designed a cross-sectional study involving 1556 adults.

METHODS

All of them came from three locations around the Realgar Plant. The cognitive function of the participants was evaluated using a Chinese version of the Mini-mental state Examination (MMSE). The participants' internal arsenic exposure status (hair arsenic concentrations) and the external arsenic exposure status (the distance between the participants' location of residence and the Realgar Plant) were measured.

RESULTS

Our research revealed that both of hair arsenic concentrations and the prevalence of arsenicosis, two important indexes, were significantly higher in the cognitive-impaired (CI) group than in the cognitive-normal (CN) group (P < 0.05). In addition, distance from the Realgar Plant was positively correlated with the MMSE scores and was negatively correlated with the prevalence of cognitive impairment. Moreover, our results demonstrated that there was a negative correlation between hair arsenic concentrations and MMSE scores. We conducted a two-level Logistic regression analysis and further confirmed that even after adjusting for potential confounding variables, arsenicosis retained a risk factor for cognitive impairment (odds ratio (OR) = 1.84, P < 0.05).

CONCLUSIONS

Our results indicated that chronic arsenic exposure could impair adults' cognitive function in a dose-dependent manner. Additionally, arsenicosis could be an independent risk factor for cognitive impairment.

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.

Environmental heavy metals and cardiovascular diseases: Status and future direction

Cardiovascular disease (CVD) and environmental degradation are leading global health problems of our time. Recent studies have linked exposure to heavy metals to the risks of CVD and diabetes, particularly in populations from low- and middle-income countries, where concomitant rapid development occurs. In this review, we 1) assessed the totality, quantity, and consistency of the available epidemiological studies, linking heavy metal exposures to the risk of CVD (including stroke and coronary heart disease); 2) discussed the potential biological mechanisms underlying some tantalizing observations in humans; and 3) identified gaps in our knowledge base that must be investigated in future work. An accumulating body of evidence from both experimental and observational studies implicates exposure to heavy metals, in a dose-response manner, in the increased risk of CVD. The limitations of most existing studies include insufficient statistical power, lack of comprehensive assessment of exposure, and cross-sectional design. Given the widespread exposure to heavy metals, an urgent need has emerged to investigate these putative associations of environmental exposures, either independently or jointly, with incident CVD outcomes prospectively in well-characterized cohorts of diverse populations, and to determine potential strategies to prevent and control the impacts of heavy metal exposure on the cardiometabolic health outcomes of individuals and populations.

Arsenic concentration, speciation, and risk assessment in sediments of the Xijiang River basin, China

In order to acquire the spatial distribution, speciation, and risk assessment of arsenic (As), 18 sediment samples were collected in the middle and upper reaches (Nanpan River, Beipan River, Hongshui River, Diaojiang River, and Duliu River) of the Xijiang River basin, China. The chemical fractions of As in the collected sediments were mainly dominated by the residual fraction and the Fe (Mn, Al) oxide/oxyhydroxides fractions. The correlation analysis results showed that the chemical fraction of As in sediments had close correlations with Mn, good correlations with Fe and organic matter (OM), while weak correlations with Al and carbonate. In addition, it also showed that Diaojiang River basin was found to have an extremely high As pollution status and suffered from high ecological risk. Duliu River and Nanpan River had moderately polluted levels of As and showed a low ecological risk. The other sample sites of Xijiang River basin were uncontaminated of As. The assessment results from this study indicated that the different types of species present based on the chemical fractionation of As from the Xijiang River basin showed different risks. Graphical abstract.

Using the Apolipoprotein E Knock-Out Mouse Model to Define Atherosclerotic Plaque Changes Induced by Low Dose Arsenic

Arsenic exposure increases the risk of atherosclerosis, the gradual occlusion of the large arteries with fibro-fatty plaque. While epidemiologic data provide convincing evidence this is true at higher exposures, it is unclear whether this may occur at low arsenic exposures, near the maximum contaminant level of 10 ppb. We have previously shown that 200 ppb arsenite in the drinking water increased the atherosclerosis in apolipoprotein E knock-out (apoE-/-) mice after 13 weeks, but the effects of lower concentrations were unknown. Therefore, here, we analyzed the effects of oral exposure to arsenite from 10 to 200 ppb after 13 weeks. Importantly, we found that even at the lowest concentration of arsenite, there was a significant increase in atherosclerotic plaque size. In our previous studies, we found that arsenite exposure resulted in decreased smooth muscle cells (SMCs) and collagen within the plaque. This change is indicative of a less stable phenotype that could increase the risk of rupture and subsequently, myocardial infarct or stroke in humans. In addition, we observed that lipid increased within the plaque without concomitant increase in macrophage content, suggesting that the macrophages were retaining more lipid intracellularly. We also assessed these plaque components in apoE-/- mice exposed to 10-200 ppb arsenite. Interestingly, we observed that macrophage lipid accumulation occurred at lower concentrations than the decreased SMC/collagen content. Together these data suggest that in the apoE-/- model, low arsenite concentrations are pro-atherogenic and that macrophage lipid homeostasis is more sensitive to arsenite-induced perturbation than the SMCs.

Using disability-adjusted life years to estimate the cancer risks of low-level arsenic in drinking water

Recent studies have shown that long-term exposure to low-level arsenic (<10 μg/L) may cause human health problems. However, the induced cancer risks and differences among multisite cancers have not been well-understood. In this study, the concentrations of low-level arsenic in drinking water in XP city, Northwest China were investigated. A health risk assessment was carried out for different age groups and exposure pathways based on Monte Carlo simulations and disability-adjusted life years (DALYs). The measured arsenic levels were in the range of 7.61-9.25 μg/L with a mean of 8.23 μg/L. For the public, the average total lifetime cancer risk was 3.87 × 10^-4, and the total DALYs estimation for all age groups was 20.58 person-year. The average individual DALYs lost was 3.35 × 10^-5 per person-year (ppy), which was 33.5 times the reference value (1.00 × 10^-6 ppy). The mortality burden had a considerably larger contribution (97.31%) to the total disease burden, and the 60-65-year age group exhibited the largest DALYs lost. Skin cancer exhibited the largest burden of 2.15 × 10^-5 ppy, followed by lung cancer (1.20 × 10^-5 ppy). This study might be useful for potential strategies of risk control and management in XP drinking water.

Semi-volatile organic compounds in tap water from Hangzhou, China: Influence of pipe material and implication for human exposure

Investigations on environmental behaviors of SVOCs have recently received great attention. However, the SVOC occurrence and influence of pipe materials on SVOC levels in the tap water have received little attention. Herein, we collected tap water samples from 25 households constructed at different ages in Hangzhou, China. Concentrations of 61 SVOCs, including phthalate esters (PAEs), organochlorine pesticides (OCPs), polycyclic aromatic hydrocarbons (PAHs), and polychlorinated biphenyls (PCBs), were simultaneously determined in these collected samples. The potential human exposure risks were evaluated via the hazard index calculation. Our results showed that the total concentration of detected SVOCs (∑SVOCs) ranged from 110 to 289 μg/L (mean, 179 μg/L), and the SVOCs were dominated by PAHs (mean, 116 ng/L) and PAEs (mean, 55 ng/L) in Hangzhou tap water. 12 PCB congeners were detected in Hangzhou tap water samples, with hepta-CBs (68% of samples) as the most frequently detected PCBs. Nearly all tap water samples contained measurable o, p'-DDE, p, p'-DDT, and p, p'-DDD, and ∑DDTs had significantly (p < 0.05) higher concentrations than ∑HCHs. All target PAHs had high detection frequencies (>72%) in tap water samples, with their mean concentrations in the range of 2.1-41 ng/L. Tap water from steel pipes had relatively lower SVOC concentrations than that from either reinforced concrete, gray cast iron, or ductile iron pipes. Although no carcinogenic risks originating from exposure to SVOCs through ingestion and bathing were observed, the tap water from steel pipes showed relatively low exposure risks than that from other materials. Data provided here, for the first, are helpful in understanding the influence of pipe materials on human SVOC exposure risks through tap water intake.

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.

Adsorption of Aqueous As (III) in Presence of Coexisting Ions by a Green Fe-Modified W Zeolite

The high toxicity of arsenite and the difficulty to remove it is one of the main challenges for water treatment. In the present work the surface of a low cost zeolite was modified by chemical treatment with a ferrous chloride to enhance its arsenite adsorption capacity. The effect of pH, ions coexistence, concentration, temperature and dosage was studied on the adsorption process. Additionally, the Fe-modified W zeolite was aged by an accelerated procedure and the regeneration of the exhausted zeolite was demonstrated. The Fe-modified W zeolite was stable in the pH range of 3 to 8 and no detriment to its arsenite removal capacity was observed in the presence of coexisting ions commonly found in underground water. The studies showed that the adsorption of As (III) on Fe-modified W zeolite is a feasible, spontaneous and endothermic process and it takes place by chemical bonding. The exhausting process proved the adsorption of 0.20 mg g−1 of As (III) by the Fe-modified W zeolite and this withstand at least five aging cycles without significant changes of its arsenite adsorption capacity. Fe-modified W zeolite prepared from fly ash might be a green and low-cost alternative for removal of As (III) from groundwater.

A critical review on arsenic removal from water using iron-based adsorbents

Intensive research efforts have been pursued to remove arsenic (As) contamination from water with an intention to provide potable water to millions of people living in different countries. Recent studies have revealed that iron-based adsorbents, which are non-toxic, low cost, and easily accessible in large quantities, offer promising results for arsenic removal from water. This review is focused on the removal of arsenic from water using iron-based materials such as iron-based nanoparticles, iron-based layered double hydroxides (LDHs), zero-valent iron (ZVI), iron-doped activated carbon, iron-doped polymer/biomass materials, iron-doped inorganic minerals, and iron-containing combined metal oxides. This review also discusses readily available low-cost adsorbents such as natural cellulose materials, bio-wastes, and soils enriched with iron. Details on mathematical models dealing with adsorption, including thermodynamics, kinetics, and mass transfer process, are also discussed. For elucidating the adsorption mechanisms of specific adsorption of arsenic on the iron-based adsorbent, X-ray photoelectron spectroscopy (XPS) and X-ray absorption spectroscopy (XAS) are frequently used. Overall, iron-based adsorbents offer significant potential towards developing adsorbents for arsenic removal from water.

Estimating and comparing the cancer risks from THMs and low-level arsenic in drinking water based on disability-adjusted life years

To determine the priority hazard in drinking water, disability-adjusted life years (DALYs) method was used to evaluate the disease burden induced by trihalomethanes (THMs) and low-level arsenic through multiple exposure routes based on the two-year sampling from drinking water in Xi'an city, Northwest China. The average concentrations of chloroform (TCM), bromodichloromethane (BDCM), dibromochloromethane (DBCM), bromoform (TBM) and arsenic were 12.67 μg/L, 1.42 μg/L, 0.60 μg/L, 0.13 μg/L and 1.00 μg/L, respectively, and the total lifetime cancer risks for all THMs and arsenic were 8.54 × 10^-6 and 4.02 × 10^-5, which were 8.54 and 40.2 times of the negligible risk level (1.00 × 10^-6), respectively. The DALYs estimation showed that the total DALYs lost for all age groups was 32.62 person-year, and the average individual DALYs lost was 4.77 × 10^-6 per person-year (ppy), which was 4.77 times of the reference level (1.00 × 10^-6 ppy). About 72.07% of the total disease burden was due to arsenic, which was considered to be the priority hazard in Xi'an drinking water. The age group of 75-80 years was found to be most vulnerable to the induced cancer risk, and skin cancer had the highest disease burden (2.24 × 10^-6 ppy). Due to the relatively high incidence rates of lung cancer and skin cancer, most DALYs lost for males were 2-4 times to that for females in the same age group. Oral ingestion made the most contribution (88.58%) to the total disease burden, followed by inhalation of THMs (11.30%), whereas dermal absorption showed negligible risk (0.12%). As the first to compare the cancer risks of arsenic and THMs to the public in DALYs in China, this study might be useful for potential strategies of risk control and management of hazardous agents in drinking water.

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

INTRODUCTION

High arsenic concentration in drinking water is associated with a higher incidence rate of stroke, but only few studies have investigated an association with arsenic in drinking water at low concentration (<50 μg/L).

OBJECTIVE

To examine if arsenic in drinking water at low concentration was associated with higher incidence rate of stroke in Denmark.

METHODS

A total of 57,053 individuals from the Danish Diet, Cancer, and Health cohort was included in the study (enrolment in 1993-1997, age 50-64 years), of which 2195 individuals had incident stroke between enrolment and November 2009. Individuals were enrolled in two major cities (Copenhagen and Aarhus). Residential addresses in the period 1973-2009 were geocoded and arsenic concentration in drinking water at each address was estimated by linking addresses with water supply areas. Associations between arsenic concentration and incidence rate of stroke were analysed using a generalized linear model with a Poisson distribution. Incidence rate ratios (IRR) were adjusted for differences in age, sex, calendar-year, lifestyle factors, and educational level.

RESULTS

Median arsenic concentration in drinking water was 0.7 μg/L at enrolment addresses (range: 0.03 to 25 μg/L), with highest concentrations in the Aarhus area. The adjusted IRRs were 1.17 (95% CI: 1.04-1.32) for the highest arsenic quartile (1.93-25.3 μg/L) when compared with the lowest quartile (0.049-0.57 μg/L), but the highest IRR was seen in the second quartile (0.57-0.76 μg/L) (IRR = 1.21; 95% CI: 1.07-1.36). The highest IRR in the upper quartile was seen in the Aarhus area (IRR = 1.79; 95% CI: 1.41-2.26). Having ever been exposed to10 μg/L or more arsenic in drinking water resulted in an IRR at 1.44 (95% CI: 1.00-2.08) for all strokes and 1.63 (95% CI: 1.11-2.39) for ischemic strokes.

CONCLUSION

The results indicate that arsenic in drinking water even at low concentration is associated with higher incidence rate of stroke.

Bioelectrochemical Systems for Removal of Selected Metals and Perchlorate from Groundwater: A Review

Groundwater contamination is a major issue for human health, due to its largely diffused exploitation for water supply. Several pollutants have been detected in groundwater; amongst them arsenic, cadmium, chromium, vanadium, and perchlorate. Various technologies have been applied for groundwater remediation, involving physical, chemical, and biological processes. Bioelectrochemical systems (BES) have emerged over the last 15 years as an alternative to conventional treatments for a wide variety of wastewater, and have been proposed as a feasible option for groundwater remediation due to the nature of the technology: the presence of two different redox environments, the use of electrodes as virtually inexhaustible electron acceptor/donor (anode and cathode, respectively), and the possibility of microbial catalysis enhance their possibility to achieve complete remediation of contaminants, even in combination. Arsenic and organic matter can be oxidized at the bioanode, while vanadium, perchlorate, chromium, and cadmium can be reduced at the cathode, which can be biotic or abiotic. Additionally, BES has been shown to produce bioenergy while performing organic contaminants removal, lowering the overall energy balance. This review examines the application of BES for groundwater remediation of arsenic, cadmium, chromium, vanadium, and perchlorate, focusing also on the perspectives of the technology in the groundwater treatment field.

Quantification and feed to food transfer of total and inorganic arsenic from a commercial seaweed feed

Seaweed has a long-associated history of use as a supplemented livestock feed, providing nutrients and vitamins essential to maintaining animal health. Some species of seaweed, particularly the fucoids, are well-known accumulators of the metalloid arsenic (As). Arsenic toxicity to humans is well established even at low exposure levels and is considered a class 1 human carcinogen. As mankind's appetite for livestock produce continues to grow unabated, there is a concern that consumption of livestock produce reared on a diet supplemented with seaweed animal feed (SAF) may pose a threat to the human population due to potentially high levels of As present in seaweed. To address this concern and provide end users, including industry, consumers, policymakers and regulators with information on the exposure associated with As in commercial seaweed animal feed, the estimated daily intake (EDI) of As was calculated to evaluate potential human exposure levels. Using As data from a commercially available seaweed meal over a five-year period (2012-2017) a population exposure assessment was carried out. A Monte Carlo simulation model was developed to characterise the feed to food transfer of As from animal feed to animal produce such as beef, milk, chicken, and eggs. The model examined initial levels in seaweed, inclusion rate in animal feed, animal feeding rates and potential transfer to food produced from a supplemented diet of SAF. The analysis of seaweed animal feed showed that inorganic As was a small fraction of the total As found in seaweed meal (80:1). Statistical analysis found significant differences in the concentration of As in seaweed animal feed depending on the grain size (p < 0.001), with higher As concentrations in smaller sized grain fractions. Due to several detoxification steps and subsequent rapid excretion from the bodies of livestock, a very low carryover rate of As compounds from seaweed animal feed into livestock produce was observed. The EDI calculated in this study for the livestock produce evaluated at the 95th confidence interval was <0.01% of suggested safe levels of inorganic As intake. The threat to the general population as a result of consumption of livestock products reared on a diet consisting of SAF is found to be negligible.

Early-life arsenic exposure promotes atherogenic lipid metabolism in adolescence: A 15-year birth cohort follow-up study in central Taiwan

BACKGROUND

Inorganic arsenic (iAs) exposure potentially causes diabetes and cardiovascular diseases in adults. However, its effect on glucose and lipid metabolism in early life remains unknown.

OBJECTIVE

We evaluated the associations between early-life arsenic exposure and profiles of glucose and lipids in a 15-year birth cohort in central Taiwan.

METHODS

We studied 237 adolescents through 5 waves of follow-up interviews and examinations at ages of approximately 2, 5, 8, 11, and 14 y. We obtained at least one follow-up urine measurement for arsenic species and blood sample collection up to 14 y of age and identified group-based trajectories of serial iAs by semiparametric mixture modeling. Multiple linear and logistic regressions were performed to assess the effect of the arsenic exposure trajectory on serum fasting glucose, total cholesterol (TCHO), triglycerides (TGs), low-density lipoprotein cholesterol (LDL), and high-density lipoprotein cholesterol (HDL).

RESULTS

Three trajectories of postnatal arsenic exposure were identified, namely stable-low (31.4%), stable-high (48.2%), and rising-high (20.4%) groups. Compared with the stable-low trajectory group, the percent changes in TCHO and LDL was 14% (95% confidence interval 4-24%) and 23% (9-38%) for the group with "rising-high" trajectory and was 8% (-1-16%) and 16% (4-29%) for the group with "stable-high" trajectory. The rising-high group was also associated with an increase in the TCHO/HDL ratio by 14% (95% CI 3%-25%). The adjusted odds ratios of high developmental trajectories of TCHO, TG, LDL, and non-HDL levels were 4.0 (95% CI 1.2-13.7), 12.2 (2.2-67), 7.3 (1.8-30), and 3.6 (0.9-14.6), respectively, in the rising-high group (reference: stable-low group).

CONCLUSION

Our findings suggest that conversion to an atherogenic lipid profile in adolescents may be associated with early-life exposure to environmental arsenic, particularly during the pre-adolescent period. An environmental modification approach for preventing As-related cardiovascular disease is recommended to begin early in life.

Environmental toxic metal contaminants and risk of cardiovascular disease: systematic review and meta-analysis

OBJECTIVE

To conduct a systematic review and meta-analysis of epidemiological studies investigating the association of arsenic, lead, cadmium, mercury, and copper with cardiovascular disease.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

PubMed, Embase, and Web of Science searched up to December 2017.

REVIEW METHODS

Studies reporting risk estimates for total cardiovascular disease, coronary heart disease, and stroke for levels of arsenic, lead, cadmium, mercury, or copper were included. Two investigators independently extracted information on study characteristics and outcomes in accordance with PRISMA and MOOSE guidelines. Relative risks were standardised to a common scale and pooled across studies for each marker using random effects meta-analyses.

RESULTS

The review identified 37 unique studies comprising 348 259 non-overlapping participants, with 13 033 coronary heart disease, 4205 stroke, and 15 274 cardiovascular disease outcomes in aggregate. Comparing top versus bottom thirds of baseline levels, pooled relative risks for arsenic and lead were 1.30 (95% confidence interval 1.04 to 1.63) and 1.43 (1.16 to 1.76) for cardiovascular disease, 1.23 (1.04 to 1.45) and 1.85 (1.27 to 2.69) for coronary heart disease, and 1.15 (0.92 to 1.43) and 1.63 (1.14 to 2.34) for stroke. Relative risks for cadmium and copper were 1.33 (1.09 to 1.64) and 1.81 (1.05 to 3.11) for cardiovascular disease, 1.29 (0.98 to 1.71) and 2.22 (1.31 to 3.74) for coronary heart disease, and 1.72 (1.29 to 2.28) and 1.29 (0.77 to 2.17) for stroke. Mercury had no distinctive association with cardiovascular outcomes. There was a linear dose-response relation for arsenic, lead, and cadmium with cardiovascular disease outcomes.

CONCLUSION

Exposure to arsenic, lead, cadmium, and copper is associated with an increased risk of cardiovascular disease and coronary heart disease. Mercury is not associated with cardiovascular risk. These findings reinforce the importance of environmental toxic metals in cardiovascular risk, beyond the roles of conventional behavioural risk factors.

Predictors of Urinary Arsenic Levels among Postmenopausal Danish Women

Arsenic is a risk factor for several noncommunicable diseases, even at low doses. Urinary arsenic (UAs) concentration is a good biomarker for internal dose, and demographic, dietary, and lifestyle factors are proposed predictors in nonoccupationally exposed populations. However, most predictor studies are limited in terms of size and number of predictors. We investigated demographic, dietary, and lifestyle determinants of UAs concentrations in 744 postmenopausal Danish women who had UAs measurements and questionnaire data on potential predictors. UAs concentrations were determined using mass spectrometry (ICP-MS), and determinants of the concentration were investigated using univariate and multivariate regression models. We used a forward selection procedure for model optimization. In all models, fish, alcohol, and poultry intake were associated with higher UAs concentration, and tap water, fruit, potato, and dairy intake with lower concentration. A forward regression model explained 35% (R²) of the variation in concentrations. Age, smoking, education, and area of residence did not predict concentration. The results were relatively robust across sensitivity analyses. The study suggested that UAs concentration in postmenopausal women was primarily determined by dietary factors, with fish consumption showing the strongest direct association. However, the majority of variation in UAs concentration in this study population is still unexplained.

Stability of Major Geogenic Cations in Drinking Water-An Issue of Public Health Importance: A Danish Study, 1980⁻2017

Concentrations and spatial variations of the four cations Na, K, Mg and Ca are known to some extent for groundwater and to a lesser extent for drinking water. Using Denmark as case, the purpose of this study was to analyze the spatial and temporal variations in the major cations in drinking water. The results will contribute to a better exposure estimation in future studies of the association between cations and diseases. Spatial and temporal variations and the association with aquifer types, were analyzed with spatial scan statistics, linear regression and a multilevel mixed-effects linear regression model. About 65,000 water samples of each cation (1980–2017) were included in the study. Results of mean concentrations were 31.4 mg/L, 3.5 mg/L, 12.1 mg/L and 84.5 mg/L for 1980–2017 for Na, K, Mg and Ca, respectively. An expected west-east trend in concentrations were confirmed, mainly explained by variations in aquifer types. The trend in concentration was stable for about 31–45% of the public water supply areas. It is therefore recommended that the exposure estimate in future health related studies not only be based on a single mean value, but that temporal and spatial variations should also be included.

Ethnic, Geographic, and Genetic Differences in Arsenic Metabolism at Low Arsenic Exposure: A Preliminary Analysis in the Multi-Ethnic Study of Atherosclerosis (MESA)

We investigated the effect of candidate variants in AS3MT (arsenic (III) methyltransferase) with urinary arsenic metabolites and their principal components in a subset of 264 participants in the Multi-Ethnic Study of Atherosclerosis (MESA). Urinary arsenic species, including inorganic arsenic (iAs), monomethylarsonate (MMA), dimethylarsinate (DMA), and arsenobetaine (Ab), were measured using high performance liquid chromatography-inductively coupled plasma mass spectrometry (HPLC-ICPMS) and corrected for organic sources from seafood consumption by regressing Ab on arsenic species using a validated method. Principal components of arsenic metabolism were also used as independent phenotypes. We conducted linear regression of arsenic traits with allelic dosage of candidate single nucleotide polymorphisms (SNPs) rs12768205 (G > A), rs3740394 (A > G), and rs3740393 (G > C) measured using Illumina MetaboChip. Models were stratified by non-Hispanic white vs. all other race/ethnicity and adjusted for age, sex, arsenic exposure, study site, and population stratification. Consistent with previous studies, rs12768205 showed evidence for strongest association (non-Hispanic white: iAs% -0.14 (P 0.83), MMA% -0.66 (0.49), DMA% 0.81(0.49); other race/ethnicity: 0.13 (0.71), -1.21 (0.09), 1.08 (0.20)). No association, however, passed the strict Bonferroni p-value. This was a novel study among an ethnically diverse population exposed to low arsenic levels.

Assessment of trace elements in terminal tap water of Hunan Province, South China, and the potential health risks

A total of 116 terminal tap water (TTW) samples from Xiangjiang, Zijiang, Yuanjiang, and Lishui river basins of Hunan province were collected and concentrations of As, Cd, Cr, Pb, Mn, Zn, Fe, Al, and Cu were determined using inductively coupled plasma mass spectrometry. The results showed that 10% of the water samples exceeded the limit level of Cd established by World Health Organization (WHO) of 0.003 mg L^-1. Three percent of the samples had Fe level and 1% had As level above the WHO limits of 0.3 and 0.01 mg L^-1, respectively. Multivariate statistic approach (cluster analysis and principal component analysis) results revealed that anthropogenic activities and pipeline corrosion were major sources of TTW contamination in Hunan province. The individual and total hazard quotient values estimated by deterministic and probabilistic approaches were both less than 1. However, the mean cancer risk values of Cd were 2.2 × 10^-4 and 1.4 × 10^-4 for Xiangjiang and Yuanjiang river basin, respectively, both greater than 10^-4. The 95th percentile value of cancer risk for Cr was slightly greater than 10^-4 in Xiangjiang river basins. Long-term exposure to Cd and Cr through tap water consumption poses moderate carcinogenic health risks to the local residents.

Urinary Arsenic in Human Samples from Areas Characterized by Natural or Anthropogenic Pollution in Italy

Arsenic is ubiquitous and has a potentially adverse impact on human health. We compared the distribution of concentrations of urinary inorganic arsenic plus methylated forms (uc(iAs+MMA+DMA)) in four Italian areas with other international studies, and we assessed the relationship between uc(iAs+MMA+DMA) and various exposure factors. We conducted a human biomonitoring study on 271 subjects (132 men) aged 20-44, randomly sampled and stratified by area, gender, and age. Data on environmental and occupational exposure and dietary habits were collected through a questionnaire. Arsenic was speciated using chromatographic separation and inductively coupled mass spectrometry. Associations between uc(iAs+MMA+DMA) and exposure factors were evaluated using the geometric mean ratio (GMR) with a 90% confidence interval by stepwise multiple regression analysis. The 95th percentile value of uc(iAs+MMA+DMA) for the whole sample (86.28 µg/L) was higher than other national studies worldwide. A statistical significant correlation was found between uc(iAs+MMA+DMA) and occupational exposure (GMR: 2.68 [1.79-4.00]), GSTT gene (GMR: 0.68 [0.52-0.80]), consumption of tap water (GMR: 1.35 [1.02-1.77]), seafood (GMR: 1.44 [1.11-1.88]), whole milk (GMR: 1.34 [1.04-1.73]), and fruit/vegetables (GMR: 1.37 [1.03-1.82]). This study demonstrated the utility of uc(iAs+MMA+DMA) as a biomarker to assess environmental exposure. In a public health context, this information could be used to support remedial action, to prevent individuals from being further exposed to environmental arsenic sources.

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

Arsenic in drinking water impacts health. Highest levels of arsenic have been historically observed in Taiwan and Bangladesh but the contaminant has been affecting the health of people globally. Strong associations have been confirmed between exposure to high-levels of arsenic in drinking water and a wide range of diseases, including cancer. However, at lower levels of exposure, especially near the current World Health Organization regulatory limit (10μg/L), this association is inconsistent as the effects are mostly extrapolated from high exposure studies. This ecological study used Bayesian inference to model the relative risk of bladder and kidney cancer at these lower concentrations-0-2μg/L; 2-5μg/L and; ≥5μg/L of arsenic-in 864 bladder and 525 kidney cancers diagnosed in the study area, Nova Scotia, Canada between 1998 and 2010. The model included proxy measures of lifestyle (e.g. smoking) and accounted for spatial dependencies. Overall, bladder cancer risk was 16% (2-5μg/L) and 18% (≥5μg/L) greater than that of the referent group (<2μg/L), with posterior probabilities of 88% and 93% for these risks being above 1. Effect sizes for kidney cancer were 5% (2-5μg/L) and 14% (≥5μg/L) above that of the referent group (<2μg/L), with probabilities of 61% and 84%. High-risk areas were common in southwestern areas, where higher arsenic-levels are associated with the local geology. The study suggests an increased bladder cancer, and potentially kidney cancer, risk from exposure to drinking water arsenic-levels within the current the World Health Organization maximum acceptable concentration.

Urine Arsenic and Arsenic Metabolites in U.S. Adults and Biomarkers of Inflammation, Oxidative Stress, and Endothelial Dysfunction: A Cross-Sectional Study

BACKGROUND

Arsenic (As) exposure has been associated with increased risk for cardiovascular disease (CVD) and with biomarkers of potential CVD risk and inflammatory processes. However, few studies have evaluated the effects of As on such biomarkers in U.S. populations, which are typically exposed to low to moderate As concentrations.

OBJECTIVES

We investigated associations between As exposures and biomarkers relevant to inflammation, oxidative stress, and CVD risk in a subset of participants from the New Hampshire Health Study, a population with low to moderate As exposure (n=418).

METHODS

Associations between toenail As, total urine As (uAs), and %uAs metabolites [monomethyl (%uMMA^V), dimethyl (%uDMA^V), and inorganic (%iAs) species] and plasma biomarkers, including soluble plasma vascular and cellular adhesion molecules (VCAM-1 and ICAM-1, respectively), matrix metalloproteinase-9 (MMP-9), tumor necrosis factor-α, plasminogen activator inhibitor-1 (PAI-1), and urinary oxidative stress marker 15-F_2t-isoprostane (15-F_2t-IsoP), were evaluated using linear regression models.

RESULTS

Covariate-adjusted estimates of associations with a doubling of urinary As suggested an 8.8% increase in 15-F_2t-IsoP (95% CI: 3.2, 14.7), and a doubling of toenail As was associated with a 1.7% increase in VCAM-1 (95% CI: 0.2, 3.2). Additionally, a 5% increase in %uMMA was associated with a 7.9% increase in 15-F_2t-IsoP (95% CI: 2.1, 14.1), and a 5% increase in %uDMA was associated with a 2.98% decrease in 15-F_2t-IsoP [(95% CI: -6.1, 0.21); p=0.07]. However, in contrast with expectations, a doubling of toenail As was associated with a 2.3% decrease (95% CI: -4.3, -0.3) in MMP-9, and a 5% increase in %uMMA was associated with a 7.7% decrease (95% CI: -12.6, -2.5) in PAI-1.

CONCLUSION

In a cross-sectional study of U.S. adults, we observed some positive associations of uAs and toenail As concentrations with biomarkers potentially relevant to CVD pathogenesis and inflammation, and evidence of a higher capacity to metabolize inorganic As was negatively associated with a marker of oxidative stress. https://doi.org/10.1289/EHP2062.

Health risk assessment of arsenic from blended water in distribution systems

In a water distribution system with different sources, water blending occurs, causing specific variations of the arsenic level. This study was undertaken to investigate the concentration and cancer risk of arsenic in blended water in Xi'an city. A total of 672 tap water samples were collected from eight sampling points in the blending zones for arsenic determination. The risk was evaluated through oral ingestion and dermal absorption, separately for males and females, as well as with respect to seasons and blending zones. Although the arsenic concentrations always fulfilled the requirements of the World Health Organization (WHO) (≤10 μg L^-1), the total cancer risk value was higher than the general guidance risk value of 1.00 × 10^-6. In the blending zone of the Qujiang and No.3 WTPs (Z2), the total cancer risk value was over 1.00 × 10^-5, indicating that public health would be affected to some extent. More than 99% of the total cancer risk was from oral ingestion, and dermal absorption had a little contribution. With higher exposure duration and lower body weight, women had a higher cancer risk. In addition, due to several influential factors, the total cancer risk in the four blending zones reached the maximum in different seasons. The sensitivity analysis by the tornado chart proved that body weight, arsenic concentration and ingestion rate significantly contributed to cancer risk. This study suggests the regular monitoring of water blending zones for improving risk management.