Age-sex specific disability-adjusted life years (DALYs) attributable to elevated levels of fluoride in drinking water: A national and subnational study in Iran, 2017

Evaluation of fluoride exposure using disability-adjusted life years and health risk assessment in south-western Iran: A novel Monte Carlo simulation

Consumption of fluoride-contaminated water is a worldwide concern, especially in developing countries, including Iran. However, there are restricted studies of non-single-value health risk assessment and the disease burden regarding fluoride intake nationwide. Prolonged exposure to excessive fluoride has been linked to adverse health effects such as dental and skeletal fluorosis. This can lead to under-mineralization of hard tissues, causing aesthetic concerns for teeth and changes in bone structure, increasing the risk of fractures. As such, we aimed to implement probability-based frameworks using Monte Carlo methods to explore the potential adverse effects of fluoride via the ingestion route. This platform consists of two sectors: 1) health risk assessment of various age categories coupled with a variance decomposition technique to measure the contributions of predictor variables in the outcome of the health risk model, and 2) implementing Monte Carlo methods in dose-response curves to explore the fluoride-induced burden of diseases of dental fluorosis and skeletal fractures in terms of disability-adjusted life years (DALYs). For this purpose, total water samples of 8053 (N=8053) from 57 sites were analyzed in Fars and Bushehr Provinces. The mean fluoride concentrations were 0.75 mg/L and 1.09 mg/L, with maximum fluoride contents of 6.5 mg/L and 3.22 mg/L for the Fars and Bushehr provinces, respectively. The hazard quotient of the 95th percentile (HQ>1) revealed that all infants and children in the study area were potentially vulnerable to over-receiving fluoride. Sobol' sensitivity analysis indices, including first-order, second-order, and total order, disclosed that fluoride concentration (Cw), ingestion rate (IRw), and their mutual interactions were the most influential factors in the health risk model. DALYs rate of dental fluorosis was as high as 981.45 (uncertainty interval: UI 95 % 353.23-1618.40) in Lamerd, and maximum DALYs of skeletal fractures occurred in Mohr 71.61(49.75-92.71), in Fars Province, indicated severe dental fluorosis but mild hazard regarding fractures. Residents of the Tang-e Eram in Bushehr Province with a DALYs rate of 3609.40 (1296.68-5993.73) for dental fluorosis and a DALYs rate of 284.67 (199.11-367.99) for skeletal fractures were the most potentially endangered population. By evaluating the outputs of the DALYs model, the gap in scenarios of central tendency exposure and reasonable maximum exposure highlights the role of food source intake in over-receiving fluoride. This research insists on implementing defluoridation programs in fluoride-endemic zones to combat the undesirable effects of fluoride. The global measures presented in this research aim to address the root causes of contamination and help policymakers and authorities mitigate fluoride's harmful impacts on the environment and public health.

Assessing drinking water quality based on water quality indices, human health risk, and burden of disease attributable to heavy metals in rural communities of Yazd County, Iran, 2015-2021

The water quality indices, health risk, and burden of disease attributable to heavy metals in rural communities of Yazd County, Iran during 2015-2021 were studied. The drinking water quality index (DWQI) based on 27 parameters (including heavy metals) and heavy metal pollution index (HPI) were used for assessing drinking water quality. The health risk and burden of disease from heavy metals in drinking water were estimated in terms of hazard quotient (HQ), hazard index (HI), incremental lifetime cancer risk (ILCR), and disability-adjusted life year (DALY). Based on the DWQI scores by community, the drinking water quality in rural communities of Yazd County was characterized as good for 61 %, fair for 25 %, marginal for 2 %, and poor for 12 %. The distribution of the rural communities into the HPI categories was as follows: 43 % for excellent, 36 % for good, 14 % for poor, and 7 % for unsuitable. In about 20 % of the rural communities, the average HI level of heavy metals was higher than the boundary limit of one. The highest average HQ level at the county level was related to arsenic (As) to be 0.44. In all the communities, the total ILCR values of the heavy metals were in the category of significant increased cancer risk (10-6 to 10-4). At the county level, As and cadmium (Cd) exhibited the two highest cancer risk levels to be 1.96 × 10-4 and 1.87 × 10-4 for ILCR, respectively. The DALY rate (per 100,000 people) induced by exposure to the heavy metals via drinking water was 13.9, which was considered relatively high as compared to that of other drinking water pollutants obtained in the previous studies. The drinking water quality improvement through decreasing Cd and As levels below the standard values can drastically reduce the attributable burden of disease and promote the public health in the rural communities.

Hotspot mapping and risk prediction of fluoride in natural waters across the Tibetan Plateau

Intake of high fluoride concentrations through water affects up to 1 billion people worldwide, and the Tibetan Plateau (TP) is one of the most severely affected areas. Knowledge regarding the high fluoride risk areas, the driving factors, and at-risk populations on the TP remains fragmented. We collected 1581 natural water samples from the TP to model surface water and groundwater fluoride hazard maps using machine learning. The geomean concentrations of surface water and groundwater were 0.26 mg/L and 0.92 mg/L, respectively. Surface water fluoride hazard hotspots were concentrated in the north-central region; high fluoride risk areas of groundwater were mainly concentrated in the southern TP. Hazard maps showed a maximum estimate of 15% of the total population in the TP (approximately 1.47 million people) at risk, and 500,000 people considered the most reasonable estimate. Critical environment driving factors were identified, in which climate condition was taken for the vital one. Under the moderate climate change scenario (SSP2.45) for 2089-2099, the high fluoride risk change rate differed inside the TP (surface water -24%-55% and groundwater -56%-50%), and the overall risk increased in natural waters throughout the TP, particularly in the southeastern TP.

Prediction of human health risk and disability-adjusted life years induced by heavy metals exposure through drinking water in Fars Province, Iran

Exposure to heavy metals in contaminated drinking water is strongly correlated with various cancers, highlighting the burden of disease. This study aimed to assess the non-carcinogenic and carcinogenic risks associated with exposure to heavy metals (As, Pb, Cd, and Cr) in drinking water of Fars province and evaluate the attributed burden of disease. Non-carcinogenic risk assessment was performed using the hazard quotient (HQ) method, while the carcinogenic risk assessment utilized the excess lifetime cancer risk approach. The burden of disease was evaluated in terms of years of life lost, years lived with disability, and disability-adjusted life years (DALY) for three specific cancers: skin, lung, and kidney cancer. The average drinking water concentrations of arsenic (As), cadmium (Cd), chromium (Cr) and lead (Pb) were determined to be 0.72, 0.4, 1.10 and 0.72 μg/L, respectively. The total average HQ of heavy metals in drinking water in the study area were 0.127, 0.0047, 0.0009 and 0.0069, respectively. The average ILCRs of heavy metal in the entire country were in the following order: 1.15 × 10-5 for As, 2.22 × 10-7 for Cd and 3.41 × 10-7 for Cr. The results also indicated that among the various counties analyzed, Fasa experiences the greatest burden of disease in terms of DALYs, with a value of 87.56, specifically attributed to cancers caused by exposure to arsenic. Generally, it can be said that the burden of disease is a critical aspect of public health that requires comprehensive understanding and effective intervention.

Burden of disease from contaminated drinking water in countries with high access to safely managed water: A systematic review

The vast majority of residents of high-income countries (≥90%) reportedly have high access to safely managed drinking water. Owing perhaps to the widely held perception of near universal access to high-quality water services in these countries, the burden of waterborne disease in these contexts is understudied. This systematic review aimed to: identify population-scale estimates of waterborne disease in countries with high access to safely managed drinking water, compare methods to quantify disease burden, and identify gaps in available burden estimates. We conducted a systematic review of population-scale disease burden estimates attributed to drinking water in countries where ≥90% of the population has access to safely managed drinking water per official United Nations monitoring. We identified 24 studies reporting estimates for disease burden attributable to microbial contaminants. Across these studies, the median burden of gastrointestinal illness risks attributed to drinking water was ∼2,720 annual cases per 100,000 population. Beyond exposure to infectious agents, we identified 10 studies reporting disease burden-predominantly, cancer risks-associated with chemical contaminants. Across these studies, the median excess cancer cases attributable to drinking water was 1.2 annual cancer cases per 100,000 population. These median estimates slightly exceed WHO-recommended normative targets for disease burden attributable to drinking water and these results highlight that there remains important preventable disease burden in these contexts, particularly among marginalized populations. However, the available literature was scant and limited in geographic scope, disease outcomes, range of microbial and chemical contaminants, and inclusion of subpopulations (rural, low-income communities; Indigenous or Aboriginal peoples; and populations marginalized due to discrimination by race, ethnicity, or socioeconomic status) that could most benefit from water infrastructure investments. Studies quantifying drinking water-associated disease burden in countries with reportedly high access to safe drinking water, focusing on specific subpopulations lacking access to safe water supplies and promoting environmental justice, are needed.

Assessment of health risk and burden of disease induced by exposure to benzene, toluene, ethylbenzene, and xylene in the outdoor air in Tehran, Iran

The health risk and burden of disease induced by exposure to benzene, toluene, ethylbenzene, and xylene (BTEX) in the outdoor air in Tehran, 2019 were assessed based on the data of five fixed stations with weekly BTEX measurements. The non-carcinogenic risk, carcinogenic risk, and disease burden from exposure to BTEX compounds were determined by hazard index (HI), incremental lifetime cancer risk (ILCR), and disability-adjusted life year (DALY), respectively. The average annual concentrations of benzene, toluene, ethylbenzene, and xylene in the outdoor air in Tehran were 6.59, 21.62, 4.68, and 20.88 μg/m³, respectively. The lowest seasonal BTEX concentrations were observed in spring and the highest ones occurred in summer. The HI values of BTEX in the outdoor air in Tehran by district ranged from 0.34 to 0.58 (less than one). The average ILCR values of benzene and ethylbenzene were 5.37 × 10^-5 and 1.23 × 10^-5, respectively (in the range of probable increased cancer risk). The DALYs, death, DALY rate (per 100,000 people) and death rate (per 100,000 people) induced by BTEX exposure in the outdoor air in Tehran were determined to be 180.21, 3.51, 2.07, and 0.04, respectively. The five highest attributable DALY rates in Tehran by district were observed in the districts 10 (2.60), 11 (2.43), 17 (2.41), 20 (2.32), and 9 (2.32), respectively. The corrective measures such as controlling road traffic and improving the quality of vehicles and gasoline in Tehran could reduce the burden of disease from BTEX along with the health effects of other outdoor air pollutants.

Drinking hot beverages from paper cups: Lifetime intake of microplastics

Microplastics (MPs) have been found in many packaged food products such as salt, tea bags, milk, and fish. In a previous study by this group, MPs were found to leach into hot water from the plastic lining of disposable paper cups. No studies were found in the literature quantifying health risks or lifetime intake of MPs. At present, it is not possible to quantify health risks due to MPs because dose-response and toxicity assessments are not available. Therefore, the objective of the current study was to assess the intake of MPs and associated contaminants like fluoride that are released into these hot beverages. MPs in the previous study were quantified in terms of particle counts only and a simple method was adopted in the present study to convert the microplastics count into its respective mass. Chronic daily intake (CDI) and lifetime intake (LTI) of MPs through the ingestion pathway were calculated. CDI and Hazard Quotient (HQ) due to fluoride ingestion were also estimated following USEPA guidelines. Monte Carlo (MC) simulations were used to account for the variability in input variables such as concentration of MPs, body weight, averaging time, exposure duration, exposure frequency and ingestion rate to evaluate the impact on CDI and LTI values. The CDI was used to estimate the LTI of MPs and HQ for fluoride ingestion. MC simulations with 100,000 iterations resulted in an average CDI of 0.03 ± 0.025 mg of microplastic per kg of body weight per day and 7.04 ± 8.8 μg fluoride per kg body weight per day. This study takes us one step closer to estimating the human health risk due to the ingestion of microplastics and other contaminants through food items.

Assessment of cause-specific mortality and disability-adjusted life years (DALYs) induced by exposure to inorganic arsenic through drinking water and foodstuffs in Iran

The health risk and burden of disease induced by exposure to inorganic arsenic (iAs) through drinking water and foodstuffs in Iran were assessed. The iAs levels in drinking water and foodstuffs (15 food groups) in the country were determined through systematic review of three international databases (PubMed, Scopus, and Web of Science) and meta-analysis. Based on the results of the systematic review and meta-analysis, the average iAs levels in drinking water and all the food groups at the national level were lower than the maximum permissible levels. The total average non-carcinogenic risk of dietary exposure to iAs in terms of hazard index (HI) was 3.4. The average incremental lifetime cancer risk (ILCR) values of dietary exposure to iAs were determined to be 1.5 × 10^-3 for skin cancer, 1.0 × 10^-3 for lung cancer, and 4.0 × 10^-4 for bladder cancer. Over two-thirds of the non-carcinogenic and carcinogenic risk of dietary exposure to iAs was attributed to bread and cereals, drinking water, and rice. The total annual cancer incidence, deaths, disability-adjusted life years (DALYs), death rate, and DALY rate (per 100,000 people) were assessed to be 3347 (95 % uncertainty interval: 1791 to 5999), 1302 (697 to 2336), 72,606 (38,833 to 130,228), 1.6 (0.87 to 2.9), and 91 (49 to 160). The contribution of mortality in the attributable burden of disease was 95.1 %. The contributions of the causes in the attributable burden of disease were 72 % for lung cancer, 16 % for bladder cancer, and 12 % for skin cancer. Due to the significant attributable burden of disease, national and subnational action plans consisting of multi-disciplinary approaches for risk management of dietary exposure to iAs, especially for the higher arsenic-affected areas and high-risk population groups in the country are recommended.

Vitamin D deficiency in patients with diabetes and its correlation with water fluoride levels

Chronic exposure to fluoride through drinking water has been linked to insulin resistance and resulting type 2 diabetes mellitus (T2DM). Here, we aim to study the impact of water fluoride levels on blood glucose and vitamin D levels. A hospital-based study was conducted on diabetic patients (n = 303) at All India Institute of Medical Sciences (AIIMS), Raebareli outstation patient department (OPD). The relationship between vitamin D or fasting blood glucose levels (BGLs) with water fluoride levels was estimated through Spearman's rank correlation. We found a significant negative correlation between water fluoride and vitamin D levels [r_s = -0.777, p-value < 0.001] and a positive correlation between water fluoride and fasting BGLs [r_s = 0.178, p-value <0.05]. The participants residing in fluoride-endemic areas (F > 1.5 mg/L) had higher odds of severe vitamin D deficiency (odds ratio: 5.07, 95% CI: 1.9-13.2, p-value = 0.0009). The results demonstrate that vitamin D deficiency and fasting BGLs are significantly associated with water fluoride levels. This study signifies the role of fluoride toxicity in poor glycemic control and derived vitamin D deficiency. Vitamin D supplementation and the application of standard household water purification devices are recommended to tackle vitamin D deficiency in fluoride-endemic areas.

Structural modification of aluminum oxides for removing fluoride in water: crystal forms and metal ion doping

In this paper, the effect of different crystal forms of Al₂O₃ on fluoride removal was studied. All crystal forms of Al₂O₃ were based on the same boehmite precursor and were obtained using a hydrothermal and calcination method. γ-Al₂O₃ had higher fluoride removal performance (52.15 mg/g) compared with θ-Al₂O₃ and α-Al₂O₃. Density functional theory (DFT) calculations confirmed that fluoride removal was greatest for γ-Al₂O₃, followed by θ-Al₂O₃ and α-Al₂O₃, and γ-Al₂O₃ possessed the strongest fluoride binding energy (-3.93 eV). The typical adsorption behaviour was consistent with the Langmuir model and pseudo-second-order model, indicating chemical and monolayer adsorption. Different metal ions were used to modify γ-Al₂O₃, and lanthanum had the best effect. Lanthanum oxide was shown to play an important role in fluoride removal. The best La/Al doping ratio was 20 At%. The adsorption process of the composite was also consistent with chemical and monolayer adsorption. When the La/Al doping rate was 20%, the adsorption capacity reached 94.64 mg/g. Compared with γ-Al₂O₃ (1.39 × 10^-7 m/s), the adsorption rate of 20La-Al₂O₃ was 3.93 × 10^-7 m/s according to the mass transfer model. Furthermore, DFT was used to provide insight into the adsorption mechanism, which was mainly driven by electrostatic attraction and ion exchange.

Evaluation of occurrence of organic, inorganic, and microbial contaminants in bottled drinking water and comparison with international guidelines: a worldwide review

The aim of this study was to evaluate the levels of inorganic and organic substances as well as microbial contaminants in bottled drinking water on a global scale. The findings were compared to WHO guidelines, EPA standards, European Union (EU) directive, and standards drafted by International Bottled Water Association (IBWA). Our review showed that 46% of studies focused on the organic contaminants, 25% on physicochemical parameters, 12% on trace elements, 7% on the microbial quality, and 10% on microplastics (MPs) and radionuclides elements. Overall, from the 54 studies focusing on organic contaminants (OCs) compounds, 11% of studies had higher OCs concentrations than the standard permissible limit. According to the obtained results from this review, several OCs, inorganic contaminants (IOCs), including CHCl3, CHBrCl2, DEHP, benzene, styrene, Ba, As, Hg, pb, Ag, F, NO3, and SO4 in bottled drinking water of some countries were higher than the international guidelines values that may cause risks for human health in a long period of time. Furthermore, some problematic contaminants with known or unknown health effects such as EDCs, DBP, AA, MPs, and some radionuclides (40K and 222Rn) lack maximum permissible values in bottled drinking water as stipulated by international guidelines. The risk index (HI) for OCs and IOCs (CHBrCl2, Ba, As, and Hg) was higher than 1 in adults and children, and the value of HI for CHCl3 in children was more than 1. Thus, further studies are required to have a better understanding of all contaminants levels in bottled drinking water.

Assessment of burden of disease induced by exposure to heavy metals through drinking water at national and subnational levels in Iran, 2019

The burden of disease attributable to exposure to heavy metals via drinking water in Iran (2019) was assessed at the national and regional levels. The non-carcinogenic risk, carcinogenic risk, and attributable burden of disease of heavy metals in drinking water were estimated in terms of hazard quotient (HQ), incremental lifetime cancer risk (ILCR), and disability-adjusted life year (DALY), respectively. The average drinking water concentrations of arsenic (As), cadmium (Cd), chromium (Cr), lead (Pb), mercury (Hg), and nickel (Ni) in Iran were determined to be 2.3, 0.4, 12.1, 2.5, 0.7, and 19.7 μg/L, respectively, which were much lower than the standard values. The total average HQs of heavy metals in drinking water in the entire country, rural, and urban communities were 0.48, 0.65 and 0.45, respectively. At the national level, the average ILCRs of heavy metal in the entire country were in the following order: 1.06 × 10^-4 for As, 5.89 × 10^-5 for Cd, 2.05 × 10^-5 for Cr, and 3.76 × 10^-7 for Pb. The cancer cases, deaths, death rate (per 100,000 people), DALYs, and DALY rate (per 100,000 people) attributed to exposure to heavy metals in drinking water at the national level were estimated to be 213 (95% uncertainty interval: 180 to 254), 87 (73-104), 0.11 (0.09-0.13), 4642 (3793-5489), and 5.81 (4.75-6.87), respectively. The contributions of exposure to As, Cd, Cr, and Pb in the attributable burden of disease were 14.7%, 65.7%, 19.3%, and 0.2%, respectively. The regional distribution of the total attributable DALY rate for all heavy metals was as follows: Region 5> Region 4> Region 1> Region 3> Region 2. The investigation and improvement of relatively high exceedance of As levels in drinking water from the standard value, especially in Regions 5 and 3 as well as biomonitoring of heavy metals throughout the country were recommended.

Burden of disease induced by public overexposure to solar ultraviolet radiation (SUVR) at the national and subnational levels in Iran, 2005-2019

Estimating the burden of diseases induced by overexposure to solar ultraviolet radiation (SUVR) can help to prioritize environmental health interventions. The age-sex specific and cause-specific mortality and disability-adjusted life years (DALYs) attributable to overexposure to SUVR at the national and subnational levels in Iran, 2005-2019 were estimated. The burden of disease induced by overexposure to SUVR was quantified in four steps as follows: (1) estimating exposure to SUVR, (2) estimating total incidences and deaths of target causes, (3) assessing population attributable fractions of the target causes for the SUVR, and (4) calculating the attributable burden of disease. The attributable DALYs, deaths, age-standardized DALY rate, and age-standardized death rate at the national level were determined to be respectively 21896, 252, 42.59, and 0.56 in 2005 and were respectively changed to 28665, 377, 38.76, and 0.53 in 2019. The contributions of causes in the attributable DALYs at the national level were different by year and sex and for both sexes in 2019 were as follows: 46.15% for cataract, 20.36% for malignant skin melanoma, 16.07% for sunburn, 12.41% for squamous-cell carcinoma, and 5.01% for the other five causes. The contributions of population growth, population ageing, risk exposure, and risk-deleted DALY rate in the temporal variations of the attributable burden of disease in the country were +20.73%, +20.68%, +2.01%, and -12.51%. The highest and lowest provincial attributable age-standardized DALY rates in 2019 were observed in Fars (46.8) and Ardebil (32.7), respectively. The burden of disease induced by exposure to SUVR caused relatively low geographical inequality in health status in Iran. Due to increasing trends of the SUVR as well as the attributable burden of disease, the preventive interventions against the SUVR overexposure should be considered in the public health action plan all across the country.

Spatiotemporal analysis of solar ultraviolet radiation based on Ozone Monitoring Instrument dataset in Iran, 2005-2019

The solar ultraviolet radiation (UVR) at national, provincial and county levels in Iran during 2005-2019 were determined based on Ozone Monitoring Instrument (OMI) dataset. The temporal (annual and monthly) trends and spatial distributions of the UVR in terms of erythemally weighted daily dose (EDD), erythemally weighted irradiance at local solar noon time (EDR), and UV index and the major factors influencing the spatiotemporal trends were analyzed. The population-weighted average values of EDD, EDR, and UV index in Iran were respectively 3631 J/m², 176.3 mW/m², 7.1 in 2005 and rose by 0.22% per year to 3744 J/m², 181.7 mW/m², and 7.3, respectively in 2019, but the annual trend was not statistically significant. The EDD in Iran during the study period exhibited the highest monthly average value in June (6339 J/m²) and the lowest one in December (1263 J/m²). The solar UVA/UVB ratios at the national level during 2005-2019 were considerably lower in summer. The EDD provincial average values in the study period were in the range of 2717 (Gilan) to 4424 J/m² (Fars). The spatiotemporal variations of the solar UVR parameters were well described by the linear models as a function of cloud optical thickness (COT), ozone column amount, surface albedo, latitude, and altitude (R² > 0.961, p value < 0.001) and the temporal changes of the solar UVR parameters were mainly caused by the COT. The results indicated that non-burning exposure to solar UVR in summer can be more efficient for vitamin D synthesis due to higher contribution of UVB in the solar UVR. The spatial distributions and temporal trends should be considered to determine the optimal duration, time and condition of exposure to the solar UVR for the public and occupational training and public health measures.

Removal of fluoride from industrial wastewater by using different adsorbents: A review

Many industries such as iron and steel metallurgy, copper and zinc smelting, the battery industry, and cement manufacturing industries discharge high concentrations of fluoride-containing wastewater into the environment. Subsequently, the discharge of high fluoride effluent serves as a threat to human life as well as the ecological ability to sustain life. This article analyses the advantages and drawbacks of some fluoride remediation technologies such as precipitation and flocculation, membrane technology, ion exchange technology, and adsorption technology. Among them, adsorption technology is considered the obvious choice and the best applicable technology. As such, several adsorbents with high fluoride adsorption capacity such as modified alumina, metal oxides, biomass, carbon-based materials, metal-organic frameworks, and other adsorption materials including their characteristics have been comprehensively summarized. Additionally, different adsorption conditions of the various adsorbents, such as pH, temperature, initial fluoride concentration, and contact time have been discussed in detail. The study found out that the composite synergy between different materials, morphological and structural control, and the strengthening of their functional groups can effectively improve the ability of the adsorbents for removing fluoride. This study has prospected the direction of various adsorbents for removing fluoride in wastewater, which would serve as guiding significance for future research in the field.

Heterotrophic nitrification and biomineralization potential of Pseudomonas sp. HXF1 for the simultaneous removal of ammonia nitrogen and fluoride from groundwater

Pseudomonas sp. HXF1, a strain capable of heterotrophic nitrification, aerobic denitrification (HNAD), and biomineralization was identified and employed for the simultaneous removal of ammonia nitrogen (NH₄⁺-N) and fluoride (F^-). It removed 99.2% of NH₄⁺-N without accumulation of nitrous nitrogen (NO₂^--N) and nitrate nitrogen (NO₃^--N), while removed 87.3% of F^-. Response surface methodology (RSM) was used to study the best removal conditions for NH₄⁺-N and F^-. The results of nitrogen balance experiments with NH₄Cl, NaNO₂, and NaNO₃ as single nitrogen sources and amplification experiments of denitrification genes proved that the bacterial strains may remove NH₄⁺-N through HNAD. The experimental results of Scanning electron microscope (SEM), X-ray photoelectron spectroscopy (XPS), and X-ray diffractometer (XRD) indicated that the way of F^- removal may be adsorption and co-precipitation. The results demonstrated that the strain HXF1 has great potential in the biological denitrification and F^- removal of groundwater.

Synthesis of hierarchical hollow MIL-53(Al)-NH2 as an adsorbent for removing fluoride: experimental and theoretical perspective

The MIL-53(Al)-NH₂ was designed to remove fluoride with hierarchical hollow morphology. It was used as an adsorbent for fluoride removal at a wide pH range (1-12) due to the positive zeta potential of MIL-53(Al)-NH₂. The pH did not significantly influence the fluoride adsorption into MIL-53(Al)-NH₂. However, the adsorbent indicated good adsorption capacity with maximum adsorption of 1070.6 mg g^-1. Different adsorption kinetic and thermodynamic models were investigated for MIL-53(Al)-NH₂. The adsorption of fluoride into MIL-53(Al)-NH₂ followed the pseudo-second-order model and a well-fitted Langmuir model indicating chemical and monolayer adsorption process. When mass transfer model was used at initial concentrations of 100 ppm and 1000 ppm, the rates of conversion were 8.4 × 10^-8 and 4.7 × 10^-8 m s^-1. Moreover, anions such as [Formula: see text], [Formula: see text], [Formula: see text], Cl^-, and Br^- also had less effect on the adsorption of fluoride. Also, experimental and theoretical calculations on adsorption mechanism of MIL-53(Al)-NH₂ revealed that the material had good stability and regenerative capacity using alum as regenerant. In a nutshell, the dominant crystal face (1 0 1) and adsorption sites Al, O, and N combined well with F^-, HF, and HF₂^- through density functional theory. It opens a good way of designing hollow MOFs for adsorbing contaminants in wastewater.

Experimental and modeling studies for adsorbing different species of fluoride using lanthanum-aluminum perovskite

We investigated the adsorption mechanisms for removing fluoride based on experimental and modeling studies. Lanthanum-aluminum perovskite was designed for treating wastewater contaminated by fluoride. A fluorine-species model was developed to calculate the concentrations of different species of fluorine: F^-, HF, HF₂^-. Multiple kinetic models were examined and the pseudo-second order model was found the best to fit the experimental data, implying fast-chemisorption. The thermodynamic data were fitted by the Langmuir model and Freundlich model at different temperatures, indicating heterogeneous adsorption at low temperature and homogeneous adsorption at high temperature. The La₂Al₄O₉ material had less influence from negative ions when adsorbing fluoride. The adsorption mechanisms were further studied using experiments and Density Functional Theory calculations. The adsorption experiments could be attributed to the lattice plane (1 2 1) and La, O, Al sites. More Al sites were required than La sites for the increase of fluoride concentration. By contrast, more La sites than Al sites were needed for increased pH.

Age-sex specific and cause-specific health risk and burden of disease induced by exposure to trihalomethanes (THMs) and haloacetic acids (HAAs) from drinking water: An assessment in four urban communities of Bushehr Province, Iran, 2017

Health risk and burden of disease induced by exposure to trihalomethanes (THMs, four compounds) and haloacetic acids (HAAs, 5 compounds) from drinking water through ingestion, dermal absorption, and inhalation routes were assessed based on one-year water quality monitoring in four urban communities (Bandar Deylam, Borazjan, Bushehr, and Choghadak) of Bushehr Province, Iran. The total average concentrations of THMs and HAAs at all the communities level were determined to be 92.9 ± 43.7 and 70.6 ± 26.5 μg/L, respectively. The dominant components of the THMs and HAAs were determined to be tribromomethane (TBM, 41.6%) and monobromoacetic acid (MBAA, 60.8%), respectively. The average contributions of ingestion, dermal absorption, and inhalation routes in exposure to the chlorination by-products (CBPs) were respectively 65.0, 15.4, and 19.6%. The total average non-carcinogenic risk as the hazard index (HI) and incremental lifetime cancer risk (ILCR) of the CBPs at all the communities level were found to be 4.03 × 10^-1 and 3.16 × 10^-4, respectively. The total attributable deaths, death rate (per 100,000 people), age-weighted disability-adjusted life years (DALYs), and age-weighted DALY rate for all ages both sexes combined at all the communities level were estimated to be 1.0 (uncertainty interval: UI 95% 0.3 to 2.8), 0.27 (0.08-0.75), 30.8 (11.3-100.1), and 8.1 (3.0-26.4), respectively. The average contribution of mortality (years of life lost due to premature mortality: YLLs) in the attributable burden of disease was 94.7% (94.4-95.6). Although in most of cases the average levels of the CBPs were in the permissible range of Iranian standards for drinking water quality, the average values of ILCRs as well as attributable burden of disease were not acceptable (the ILCRs were higher than the boundary limit of 10^-5); therefore, implementation of interventions for reducing exposure to CBPs through drinking water especially in Kowsar Dam Water Treatment Plant is strictly recommended.

The disease burden attributable to 18 occupational risks in China: an analysis for the global burden of disease study 2017

BACKGROUND

China has more than 18% of the global population and over 770 million workers. However, the burden of disease attributable to occupational risks is unavailable in China. We aimed to estimate the burden of disease attributable to occupational exposures at provincial levels from 1990 to 2017.

METHODS

We estimated the summary exposure values (SEVs), deaths and disability-adjusted life years (DALYs) attributable to occupational risk factors in China from 1990 to 2017, based on Global Burden of Disease Study (GBD) 2017. There were 18 occupational risks, 22 related causes, and 35 risk-outcome pairs included in this study. Meanwhile, we compared age-standardized death rates attributable to occupational risk factors in provinces of China by socio-demographic index (SDI).

RESULTS

The SEVs of most occupational risks increased from 1990 to 2017. There were 323,833 (95% UI 283,780 - 369,061) deaths and 14,060,210 (12,022,974 - 16,125,763) DALYs attributable to total occupational risks in China, which were 27.9 and 22.1% of corresponding global levels, respectively. For attributable deaths, major risks came from occupational particulate matter, gases, and fumes (PGFs), and for the attributable DALYs, from occupational injuries. The attributable burden was higher in males than in females. Compared with high SDI provinces, low SDI provinces, especially Western China, had higher death rates attributable to total occupational risks, occupational PGFs, and occupational injuries.

CONCLUSION

Occupational risks contribute to a huge disease burden in China. The attributable burden is higher in males, and in less developed provinces of Western China, reflecting differences in risk exposure, socioeconomic conditions, and type of jobs. Our study highlights the need for further research and focused policy interventions on the health of workers especially for less developed provinces in China to reduce occupational health losses effectively.