Association of low-level inorganic arsenic exposure from rice with age-standardized mortality risk of cardiovascular disease (CVD) in England and Wales

Eliminating the stabilizer antagonistic effects for efficiently stabilizing Pb and As co-contaminated soil by innovative stepwise steam flash heating

Chemical stabilization is frequently used to stabilize lead (Pb) or arsenate (As), but faces challenges in Pb-As co-contaminated soils because of the antagonistic reactions between chemical stabilizers and contaminants. In this work, we innovated an effective and cost-efficient stepwise steam flash heating (SSFH) strategy to simultaneously immobilize Pb and As, and unraveled the underlying mechanisms. The combination of 1.5% Ca(H2PO4)2 and 2% Fe2(SO4)3 only decreased 1.99% Pb by toxicity characteristic leaching procedure (TCLP-Pb) but increased 17.8% of TCLP-As due to the antagonistic effects. SSFH with Ca(H2PO4)2 in the first step and Fe2(SO4)3 in the second step achieved the minimal TCLP-Pb and TCLP-As of 0.778 and 0.327 mg/L, respectively. It also reduced 69.8% of leachable As in 100-year acid rain simulation, indicating a favorable long-term stabilization performance. Additionally, SSFH approach reduced 43.2% stabilizer dosage and 14.9% cost. X-ray absorption near edge structure (XANES) documented that the stepwise SFH promoted the transformation of Pb(NO3)2 and NaAsO2/NaAsO3/As2O3/As2O5 into stable Pb3(PO4)2 and FeAsO4, preventing the formation of AsO43- and FePO4. Our findings proved the state-of-the-art SSFH approach and unraveled its mechanisms to stabilize Pb and As co-contamination in soils, offering a green and sustainable remediation alternative for the management of heavy metal contaminated sites. ENVIRONMENTAL IMPLICATION: A novel stepwise SFH approach can be applied to overcome the stabilizer antagonist effects by separately immobilizing Pb and As in two sequential steps. It also decreased 43.2% of stabilizer dosage and 14.9% of cost comparing to conventional chemical stabilization. This approach can be used for other metal co-contaminated soils facing similar antagonistic challenges, and our work raises a state-of-the-art solution for cost-effective, green and sustainable remediation practices.

Simultaneous removal of Cd(II) and As(V) by ferrihydrite-biochar composite: Enhanced effects of As(V) on Cd(II) adsorption

The coexistence of cadmium (Cd(II)) and arsenate (As(V)) pollution has long been an environmental problem. Biochar, a porous carbonaceous material with tunable functionality, has been used for the remediation of contaminated soils. However, it is still challenging for the dynamic quantification and mechanistic understanding of the simultaneous sequestration of multi-metals in biochar-engineered environment, especially in the presence of anions. In this study, ferrihydrite was coprecipitated with biochar to investigate how ferrihydrite-biochar composite affects the fate of heavy metals, especially in the coexistence of Cd(II) and As(V). In the solution system containing both Cd(II) and As(V), the maximum adsorption capacities of ferrihydrite-biochar composite for Cd(II) and As(V) reached 82.03 µmol/g and 531.53 µmol/g, respectively, much higher than those of the pure biochar (26.90 µmol/g for Cd(II), and 40.24 µmol/g for As(V)) and ferrihydrite (42.26 µmol/g for Cd(II), and 248.25 µmol/g for As(V)). Cd(II) adsorption increased in the presence of As(V), possibly due to the changes in composite surface charge in the presence of As(V), and the increased dispersion of ferrihydrite by biochar. Further microscopic and mechanistic results showed that Cd(II) complexed with both biochar and ferrihydrite, while As(V) was mainly complexed by ferrihydrite in the Cd(II) and As(V) coexistence system. Ferrihydrite posed vital importance for the co-adsorption of Cd(II) and As(V). The different distribution patterns revealed by this study help to a deeper understanding of the behaviors of cations and anions in the natural environment.

Arsenic and adipose tissue: an unexplored pathway for toxicity and metabolic dysfunction

Arsenic-contaminated drinking water can induce various disorders by disrupting lipid and glucose metabolism in adipose tissue, leading to insulin resistance. It inhibits adipocyte development and exacerbates insulin resistance, though the precise impact on lipid synthesis and lipolysis remains unclear. This review aims to explore the processes and pathways involved in adipogenesis and lipolysis within adipose tissue concerning arsenic-induced diabetes. Although arsenic exposure is linked to type 2 diabetes, the specific role of adipose tissue in its pathogenesis remains uncertain. The review delves into arsenic's effects on adipose tissue and related signaling pathways, such as SIRT3-FOXO3a, Ras-MAP-AP-1, PI(3)-K-Akt, endoplasmic reticulum stress proteins, CHOP10, and GPCR pathways, emphasizing the role of adipokines. This analysis relies on existing literature, striving to offer a comprehensive understanding of different adipokine categories contributing to arsenic-induced diabetes. The findings reveal that arsenic detrimentally impacts white adipose tissue (WAT) by reducing adipogenesis and promoting lipolysis. Epidemiological studies have hinted at a potential link between arsenic exposure and obesity development, with limited research suggesting a connection to lipodystrophy. Further investigations are needed to elucidate the mechanistic association between arsenic exposure and impaired adipose tissue function, ultimately leading to insulin resistance.

Multifaceted response mechanisms of Oryza sativa L. 'KDML105' to high arsenite and arsenate stress levels

Toxicity resulting from high levels of inorganic arsenic (iAs), specifically arsenite (AsIII) and arsenate (AsV), significantly induces oxidative stress and inhibits the growth of rice plants in various ways. Despite its economic importance and significance as a potent elite trait donor in rice breeding programmes, Khao Dawk Mali 105 (KDML105) has received limited attention regarding its responses to As stress. Therefore, this study aimed to comprehensively investigate how KDML105 responds to elevated AsIII and AsV stress levels. In this study, the growth, physiology, biochemical attributes and levels of As stress-associated transcripts were analysed in 45-day-old rice plants after exposing them to media containing 0, 75, 150, 300 and 600 µM AsIII or AsV for 1 and 7 days, respectively. The results revealed that AsIII had a more pronounced impact on the growth and physiological responses of KDML105 compared to AsV at equivalent concentrations. Under elevated AsIII treatment, there was a reduction in growth and photosynthetic efficiency, accompanied by increased levels of hydrogen peroxide (H2O2) and malondialdehyde (MDA). Notably, the total contents of antioxidants, such as proline, phenolics and flavonoids in the shoot, increased by 8.1-fold, 1.4-fold and 1.6-fold, respectively. Additionally, the expression of the OsABCC1 gene in the roots increased by 9.5-fold after exposure to 150 µM AsIII for 1 day. These findings suggest that KDML105's prominent responses to As stress involve sequestering AsIII in vacuoles through the up-regulation of the OsABCC1 gene in the roots, along with detoxifying excessive stress in the leaves through proline accumulation. These responses could serve as valuable traits for selecting As-tolerant rice varieties.

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.

Arsenic pollution cycle, toxicity and sustainable remediation technologies: A comprehensive review and bibliometric analysis

Arsenic pollution and its allied impacts on health are widely reported and have gained global attention in the last few decades. Although the natural distribution of arsenic is limited, anthropogenic activities have increased its mobility to distant locations, thereby increasing the number of people affected by arsenic pollution. Arsenic has a complex biogeochemical cycle which has a significant role in pollution. Therefore, this review paper has comprehensively analysed the biogeochemical cycle of arsenic which can dictate the occurrence of arsenic pollution. Considering the toxicity and nature of arsenic, the present work has also analysed the current status of arsenic pollution around the world. It is noted that the south of Asia, West-central Africa, west of Europe and Latin America are major hot spots of arsenic pollution. Bibliometric analysis was performed by using scopus database with specific search for keywords such as arsenic pollution, health hazards to obtain the relevant data. Scopus database was searched for the period of 20 years from year 2003-2023 and total of 1839 articles were finally selected for further analysis using VOS viewer. Bibliometric analysis of arsenic pollution and its health hazards has revealed that arsenic pollution is primarily caused by anthropogenic sources and the key sources of arsenic exposure are drinking water, sea food and agricultural produces. Arsenic pollution was found to be associated with severe health hazards such as cancer and other health issues. Thus considering the severity of the issue, few sustainable remediation technologies such as adsorption using microbes, biological waste material, nanomaterial, constructed wetland, phytoremediation and microorganism bioremediation are proposed for treating arsenic pollution. These approaches are environmentally friendly and highly sustainable, thus making them suitable for the current scenario of environmental crisis.

Genotoxicity and mutagenicity in blood and drinking water induced by arsenic in an impacted gold mining region in Colombia

Arsenic (As) is one of the most dangerous substances that can affect human health and long-term exposure to As in drinking water can even cause cancer. The objective of this study was to investigate the concentrations of total As in the blood of inhabitants of a Colombian region impacted by gold mining and to evaluate its genotoxic effect through DNA damage by means of the comet assay. Additionally, the concentration of As in the water consumed by the population as well as the mutagenic activity of drinking water (n = 34) in individuals were determined by hydride generator atomic absorption spectrometry and the Ames test, respectively. In the monitoring, the study population was made up of a group of 112 people, including inhabitants of four municipalities: Guaranda, Sucre, Majagual, and San Marcos from the Mojana region as the exposed group, and Montería as a control group. The results showed DNA damage related to the presence of As in blood (p < 0.05) in the exposed population, and blood As concentrations were above the maximum allowable limit of 1 μg/L established by the ATSDR. A mutagenic activity of the drinking water was observed, and regarding the concentrations of As in water, only one sample exceeded the maximum permissible value of 10 μg/L established by the WHO. The intake of water and/or food containing As is potentially generating DNA damage in the inhabitants of the Mojana region, which requires surveillance and control by health entities to mitigate these effects.

The Association Between Arsenic Levels and Oxidative Stress in Myocardial Infarction: A Case-Control Study

Cardiovascular diseases (CVDs) are known as the first causes of death throughout the world, and mainly myocardial infarction (MI), lead to 7.4 million deaths annually. Atherosclerosis is the major underlying cause of most CVDs. However, exposure to heavy metals, among other factors, deserves further attention as a risk factor for CVDs. This study was designed to evaluate the levels of arsenic (Ars) in myocardial infarction (MI) patients and healthy individuals as well as assess the association between the incidence of MI and Ars, total antioxidant capacity (TAC), and oxidative stress. This case-control study was conducted among patients with MI (n = 164) and normal individuals (n = 61) at Shafa Hospital in Kerman, Iran. Patients were classified into two groups, including coronary artery blocks above 50% (CAB > 50%, n = 83) and coronary artery blocks less than 50% (CAB < 50%, n = 83) based on their angiography findings. The demographic characteristics, clinical history, biochemical parameters, and serum Ars and TAC levels were evaluated. In the present study, both CAB groups had significantly reduced levels of TAC compared with the control. Furthermore, TAC was lower in the CAB > %50 group compared to the CAB < %50 group. Ars levels were significantly higher in both CAB groups compared with the control. There was a significant positive relationship between CAB and Ars, BG, HbA1c, urea, creatinine, TG, TC, and LDL-c, as well as a negative relationship between HDL-c and TAC. Moreover, TAC levels showed a significant inverse correlation with Ars, HbA1c, and creatinine, and a positive correlation with HDL-c. As risk factors, Ars, hs-CRP, TG, TC, and LDL-c enhance the severity of the disease, and HDL-c and TAC decrease the disease severity. Moreover, ROC curve analysis revealed that the highest AUC for the CAB > %50 (AUC = 78.29), and cytotoxic levels for both CAB groups (Ars ≥ 0.105 ppm), and no significant differences were found between the two groups. Our findings suggest that Ars at ≥ 0.105 ppm is able to increase the risk of MI through the increased OS and decreased TAC.

Overview of the cardiovascular effects of environmental metals: New preclinical and clinical insights

Environmental causes of cardiovascular diseases (CVDs) are global health issues. In particular, an association between metal exposure and CVDs has become evident but causal evidence still lacks. Therefore, this symposium at the Society of Toxicology 2022 annual meeting addressed epidemiological, clinical, pre-clinical animal model-derived and mechanism-based evidence by five presentations: 1) An epidemiologic study on potential CVD risks of individuals exposed occupationally and environmentally to heavy metals; 2) Both presentations of the second and third were clinical studies focusing on the potential link between heavy metals and pulmonary arterial hypertension (PAH), by presenting altered blood metal concentrations of both non-essential and essential metals in the patients with PAH and potential therapeutic approaches; 3) Arsenic-induced atherosclerosis via inflammatory cells in mouse model; 4) Pathogenic effects on the heart by adult chronic exposure to very low-dose cadmium via epigenetic mechanisms and whole life exposure to low dose cadmium via exacerbating high-fat-diet-lipotoxicity. This symposium has brought epidemiologists, therapeutic industry, physicians, and translational scientists together to discuss the health risks of occupational and environmental exposure to heavy metals through direct cardiotoxicity and indirect disruption of homeostatic mechanisms regulating essential metals, as well as lipid levels. The data summarized by the presenters infers a potential causal link between multiple metals and CVDs and defines differences and commonalities. Therefore, summary of these presentations may accelerate the development of efficient preventive and therapeutic strategies by facilitating collaborations among multidisciplinary investigators.

Household and community systems for groundwater remediation in Bihar, India: Arsenic and inorganic contaminant removal, controls and implications for remediation selection

The presence of arsenic (As) and other inorganic contaminants in groundwater is a key public health issue in India and many other parts of the world. Whilst a broad range of remediation technologies exist, performance can be highly variable, and appropriate selection and management of remediation approaches remains challenging. Here, we have identified and tested the performance of a range of small-scale remediation technologies (e.g. sand filters, multi-stage filtration and reverse osmosis (RO)-based systems; n = 38) which have been implemented in Bihar, India. We have undertaken spot-assessments of system performance under typical operating conditions in household and non-household (e.g. community, hospital, hostel/hotel) settings. The removal of As and other inorganic contaminants varied widely (ranging from ~0-100%), with some solutes generally more challenging to remove than others. We have evaluated the relative importance of technology type (e.g. RO-based versus non-RO systems), implementation setting (e.g. household versus non-household) and source water geochemistry (particularly concentrations and ratios of As, Fe, P, Si and Ca), as potential controls on remediation effectiveness. Source water composition, particularly the ratio ([Fe] - 1.8[P])/[As], is a statistically significant control on As removal (p < 0.01), with higher ratios associated with higher removal, regardless of technology type (under the site-specific conditions observed). This ratio provides a theoretical input which could be used to identify the extent to which natural groundwater composition may be geochemically compatible with higher levels of As removal. In Bihar, we illustrate how this ratio could be used to identify spatial patterns in theoretical geochemical compatibility for As removal, and to identify where additional Fe may theoretically facilitate improved remediation. This geochemical approach could be used to inform optimal selection of groundwater remediation approaches, when considered alongside other important considerations (e.g. technical, managerial and socio-economic) known to impact the effective implementation and sustainability of successful groundwater remediation approaches.

Arsenic Exposure through Dietary Intake and Associated Health Hazards in the Middle East

Dietary arsenic (As) contamination is a major public health issue. In the Middle East, the food supply relies primarily on the import of food commodities. Among different age groups the main source of As exposure is grains and grain-based food products, particularly rice and rice-based dietary products. Rice and rice products are a rich source of core macronutrients and act as a chief energy source across the world. The rate of rice consumption ranges from 250 to 650 g per day per person in South East Asian countries. The source of carbohydrates through rice is one of the leading causes of human As exposure. The Gulf population consumes primarily rice and ready-to-eat cereals as a large proportion of their meals. Exposure to arsenic leads to an increased risk of non-communicable diseases such as dysbiosis, obesity, metabolic syndrome, diabetes, chronic kidney disease, chronic heart disease, cancer, and maternal and fetal complications. The impact of arsenic-containing food items and their exposure on health outcomes are different among different age groups. In the Middle East countries, neurological deficit disorder (NDD) and autism spectrum disorder (ASD) cases are alarming issues. Arsenic exposure might be a causative factor that should be assessed by screening the population and regulatory bodies rechecking the limits of As among all age groups. Our goals for this review are to outline the source and distribution of arsenic in various foods and water and summarize the health complications linked with arsenic toxicity along with identified modifiers that add heterogeneity in biological responses and suggest improvements for multi-disciplinary interventions to minimize the global influence of arsenic. The development and validation of diverse analytical techniques to evaluate the toxic levels of different As contaminants in our food products is the need of the hour. Furthermore, standard parameters and guidelines for As-containing foods should be developed and implemented.

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.

Epigenetic modifications from arsenic exposure: A comprehensive review

Arsenic is a notorious element with the potential to harm exposed individuals in ways that include cancerous and non-cancerous health complications. Millions of people across the globe (especially in South and Southeast Asian countries including China, Vietnam, India and Bangladesh) are currently being unknowingly exposed to precarious levels of arsenic. Among the diverse effects associated with such arsenic levels of exposure is the propensity to alter the epigenome. Although a large volume of literature exists on arsenic-induced genotoxicity, cytotoxicity, and inter-individual susceptibility due to active research on these subject areas from the last millennial, it is only recently that attention has turned on the ramifications and mechanisms of arsenic-induced epigenetic changes. The present review summarizes the possible mechanisms involved in arsenic induced epigenetic alterations. It focuses on the mechanisms underlying epigenome reprogramming from arsenic exposure that result in improper cell signaling and dysfunction of various epigenetic components. The mechanistic information articulated from the review is used to propose a number of novel therapeutic strategies with a potential for ameliorating the burden of worldwide arsenic poisoning.

OUP accepted manuscript

Healthy soil is foundational to human health. Healthy soil is needed to grow crops, provides food, and sustains populations. It supports diverse ecosystems and critical ecological services such as pollination. It stores water and prevents floods. It captures carbon and slows global climate change. Soil pollution is a great and growing threat to human health. Soil may be polluted by heavy metals, organic chemicals such as pesticides, biological pathogens, and micro/nanoplastic particles. Pollution reduces soil's ability to yield food. It results in food crop contamination and disease. Soil pollutants wash into rivers causing water pollution. Deforestation causes soil erosion, liberates sequestered pollutants, and generates airborne dust. Pollution of air, water, and soil is responsible for at least 9 million deaths each year. More than 60% of pollution-related disease and death is due to cardiovascular disease. Recognizing the importance of pollution to human health, the European Commission and the EU Action Plan for 2050: A Healthy Planet for All, have determined that air, water, and soil pollution must be reduced to levels that cause no harm to human or ecosystem health. We are thus required to create a toxic-free environment, respect the concept of a safe operating space for humanity, and sustain the health of our planet for future generations. This review article summarizes current knowledge of the links between soil health and human health and discusses the more important soil pollutants and their health effects.

Is Arsenic Exposure a Risk Factor for Metabolic Syndrome? A Review of the Potential Mechanisms

Exposure to arsenic in drinking water is a worldwide health problem. This pollutant is associated with increased risk of developing chronic diseases, including metabolic diseases. Metabolic syndrome (MS) is a complex pathology that results from the interaction between environmental and genetic factors. This condition increases the risk of developing type 2 diabetes, cardiovascular diseases, and cancer. The MS includes at least three of the following signs, central obesity, impaired fasting glucose, insulin resistance, dyslipidemias, and hypertension. Here, we summarize the existing evidence of the multiple mechanisms triggered by arsenic to developing the cardinal signs of MS, showing that this pollutant could contribute to the multifactorial origin of this pathology.

Ultra-Performance Liquid Chromatography-Tandem Mass Spectrometry for the Analysis of Complex Compounds in Serum and Its Application in Accurate Detection of Early Arsenic Exposure

With the acceleration of industrialization, environmental arsenic pollution is threatening human health. However, by the time clinical symptoms appear, arsenic toxicity has usually caused irreversible damage to the body, so it is important to establish a rapid and accurate screening method for early arsenic exposure. In this work, 32 female C57BL/6 mice were exposed to different concentrations of inorganic arsenic in drinking water for a week. By analyzing the changes in serum, more than 20 compounds were detected to increase or decrease with the increase of arsenic intake. The abnormal increase in inosine, xanthine, xanthosine, and hypoxanthine and the abnormal purine pathway were found at the same time. Dimethylarsenic acid, an important inorganic arsenic metabolite in the body, was also found in serum. Combined with statistical analysis, early arsenic exposure can be easily and quickly detected, and the potential health risks of short-term exposure can be revealed simultaneously.

Assessment of hypertension association with arsenic exposure from food and drinking water in Bihar, India

Epidemiological studies have associated chronic exposure to arsenic (As) from drinking water with increased risk of hypertension. However, evidence of an association between As exposure from food and hypertension risks is sparse. To quantify the association between daily As intake from both food (rice, wheat and potatoes) and drinking water (As_water) along with total exposure (As_total) and hypertension risks in a study population in Bihar, India, we conducted an individual level cross-sectional analysis between 2017 and 2019 involving 150 participants. Arsenic intake variables and three indicators of hypertension risks (general hypertension, low-density lipoprotein (LDL) and high-density lipoprotein (HDL)) were derived, and any relationship was quantified using a series of crude and multivariable log-linear or logistic regression models. The prevalence of general hypertension was 40% for the studied population. The median level of HDL was 45 mg/dL while median value of LDL was 114 mg/dL. Apart from a marginally significant positive relationship between As intake from rice and the changes of LDL (p-value = 0.032), no significant positive association between As intake and hypertension risks could be ascertained. In fact, As_total was found to be associated with lower risks of general hypertension and higher levels of HDL (p-value = 0.020 and 0.010 respectively) whilst general hypertension was marginally associated with lower As_water (p-value = 0.043). Due to limitations regarding study design and residual confounding, all observed marginal associations should be treated with caution.

Living with arsenic in the environment: An examination of current awareness of farmers in the Bengal basin using hybrid feature selection and machine learning

High levels of arsenic in drinking water and food materials continue to pose a global health challenge. Over 127 million people alone in Bangladesh (BD) and West Bengal (WB) state of India are exposed to elevated levels of arsenic in drinking water. Despite decades of research and outreach, arsenic awareness in communities continue to be low. Specifically, very few studies reported arsenic awareness among low-income farming communities. A comprehensive approach to assess arsenic awareness is a key step in identifying research and development priorities so that appropriate stakeholder engagement may be designed to tackle arsenic menace. In this study, we developed a comprehensive arsenic awareness index (CAAI) and identified key awareness drivers (KADs) of arsenic to help evaluate farmers' preferences in dealing with arsenic in the environment. The CAAI and KADs were developed using a questionnaire survey in conjunction with ten machine learning (ML) models coupled with a hybrid feature selection approach. Two questionnaire surveys comprising of 73 questions covering health, water and community, and food were conducted in arsenic-affected areas of WB and BD. Comparison of CAAIs showed that the BD farmers were generally more arsenic-aware (CAAI = 7.7) than WB farmers (CAAI = 6.8). Interestingly, the reverse was true for the awareness linked to arsenic in the food chain. Application of hybrid feature selection identified 15 KADs, which included factors related to stakeholder interventions and cropping practices instead of commonly perceived factors such as age, gender and income. Among ML algorithms, classification and regression trees and single C5.0 tree could estimate CAAIs with an average accuracy of 84%. Both communities agreed on policy changes on water testing and clean water supply. The CAAI and KADs combination revealed a contrasting arsenic awareness between the two farming communities, albeit their cultural similarities. Specifically, our study shows the need for increasing awareness of risks through the food chain in BD, whereas awareness campaigns should be strengthened to raise overall awareness in WB possibly through media channels as deemed effective in BD.

The burden of disease of three food-associated heavy metals in clusters in the Danish population - Towards targeted public health strategies

Lifestyle and sociodemographics are likely to influence dietary patterns, and, as a result, human exposure to chemical contaminants in foods and their associated health impact. We aimed to characterize subgroups of the Danish population based on diet and sociodemographic indicators, and identify those bearing a higher disease burden due to exposure to methylmercury (MeHg), cadmium (Cd) and inorganic arsenic (i-As). We collected dietary, lifestyle, and sociodemographic data on the occurrence of chemical contaminants in foods from Danish surveys. We grouped participants according to similarities in diet, lifestyle, and sociodemographics using Self-Organizing Maps (SOM), and estimated disease burden in disability-adjusted life years (DALY). SOM clustering resulted in 12 population groups with distinct characteristics. Exposure to contaminants varied between clusters and was largely driven by intake of fish, seafood and cereal products. Five clusters had an estimated annual burden >20 DALY/100,000. The cluster with the highest burden had a high proportion of women of childbearing age, with most of the burden attributed to MeHg. Individuals belonging to the top three clusters had higher education and physical activity, were mainly non-smokers and lived in urban areas. Our findings may facilitate the development of preventive strategies targeted to the most affected subgroups.