Lung cancer and arsenic concentrations in drinking water in Chile

Benchmark dose modeling for epidemiological dose-response assessment using case-control studies

Following a previous article that focused on integrating epidemiological data from prospective cohort studies into toxicological risk assessment, this paper shifts the focus to case-control studies. Specifically, it utilizes the odds ratio (OR) as the main epidemiological measure, aligning it with the benchmark dose (BMD) methodology as the standard dose-response modeling approach to determine chemical toxicity values for regulatory risk assessment. A standardized BMD analysis framework has been established for toxicological data, including input data requirements, dose-response models, definitions of benchmark response, and consideration of model uncertainty. This framework has been enhanced by recent methods capable of handling both cohort and case-control studies using summary data that have been adjusted for confounders. The present study aims to investigate and compare the "effective count" based BMD modeling approach, merged with an algorithm used for converting odds ratio to relative risk in cohort studies with partial data information (i.e., the Wang algorithm), with the adjusted OR-based BMD analysis approach. The goal is to develop an adequate BMD modeling framework that can be generalized for analyzing published case-control study data. As in the previous study, these methods were applied to a database examining the association between bladder and lung cancer and inorganic arsenic exposure. The results indicate that estimated BMDs and BMDLs are relatively consistent across both methods. However, modeling adjusted OR values as continuous data for BMD estimation aligns better with established practices in toxicological BMD analysis, making it a more generalizable approach.

Gestational arsenite exposure alters maternal postpartum heart size and induces Ca 2+ handling dysregulation in cardiomyocytes

Cardiovascular disease is the leading cause of mortality in the US. Studies suggest a role for environmental exposures in the etiology of cardiovascular disease, including exposure to arsenic through drinking water. Arsenic exposure during pregnancy has been shown to have effects on offspring, but few studies have examined impacts on maternal cardiovascular health. While our prior work documented the detrimental effect of arsenic on the maternal heart during pregnancy, our current study examines the effect of gestational arsenic exposure on the maternal heart postpartum. Timed-pregnant wild-type (C57BL/6J) mice were exposed to 0, 100 or 1000 µg/L sodium arsenite (NaAsO2) via drinking water from embryonic day 2.5 (E2.5) until parturition. Postpartum heart structure and function was assessed via transthoracic echocardiography and gravimetric measurement. Hypertrophic markers were probed via qRT-PCR and western blot. Isolated cardiomyocyte Ca 2+ -handling and contraction were also assessed, and expression of proteins associated with Ca 2+ handling and contraction. Interestingly, we found that exposure to either 100 or 1000 µg/L sodium arsenite increased postpartum heart size at P12 vs. non-exposed postpartum controls. At the cellular level, we found altered cardiomyocyte Ca 2+ -handling and contraction. We also found altered expression of key contractile proteins, including α-Actin and cardiac myosin binding protein C (cMyBP-c). Together, these findings suggest that gestational arsenic exposure impacts the postpartum maternal heart, possibly inducing long-term cardiovascular changes. Furthermore, these findings highlight the importance of reducing arsenic exposure during pregnancy, and the need for more research on the impact of arsenic and other environmental exposures on maternal heart health and adverse pregnancy events.

New & Noteworthy

Gestational exposure to sodium arsenite at environmentally relevant doses (100 and 1000 µg/L) increases postpartum heart size, and induces dysregulated Ca 2+ homeostasis and impaired shortening in isolated cardiomyocytes. This is the first study to demonstrate that gestational arsenic exposure impacts postpartum heart structure and function beyond the exposure period.

Biomonitoring Study of Toxic Metal(loid)s: Levels in Lung Adenocarcinoma Patients

Lung cancer is a leading cause of cancer deaths worldwide. The aim of this study was to investigate heavy metal(loid)s (Cd, Pb, Hg, Cr, Mn, Mo, Ni, and As) in lung cancer patients in order to elucidate their role as lung cancer environmental risk factors. Sixty-three patients of both sexes with adenocarcinoma stage IIIB or IV were enrolled in this research. The heavy metal(loid) urine concentrations were measured using ICP-MS. Arsenic was quantified above 10 μg/L in 44.44% of the samples. Nickel urinary concentrations above the ToxGuide reference levels were found in 50.79% of the samples, while lead was quantified in 9.52% of the urine samples. The urinary chromium levels were above the mean ToxGuide levels in 41.27% of the patients and were significantly higher in men in comparison with women (p = 0.035). The chromium urinary concentrations were positively associated with the CRP serum levels (p = 0.037). Cadmium was quantified in 61.90% of the samples with levels significantly higher in females than in males (p = 0.023), which was associated with smoking habits. Mercury was measured above the limit of quantification in 63.49% of the samples and was not associated with amalgam dental fillings. However, the Hg urinary concentrations were correlated positively with the ALT (p = 0.02), AST (p < 0.001), and GGT (p < 0.001) serum levels. In 46.03% of the samples, the Mo concentrations were above 32 μg/L, the mean value for healthy adults according to the ToxGuide, and 9.52% of the patients had Mn levels higher than 8 μg/L, the reference value for healthy adults based on ToxGuide data. The obtained results are preliminary, and further studies are needed to have a deeper insight into metal(loid) exposure's association with lung cancer development, progression, and survival prediction.

The impact of water pollution on the health of older people

Water pollution exerts a negative impact on the health of both women and men, inducing hormonal changes, accelerating aging, and consequently leading to the premature onset of age-related health problems. Water pollutants can in general be classified as chemical (both organic and inorganic), physical, and biological agents. Certain chemical pollutants have been found to disrupt hormonal balance by blocking, mimicking, or disrupting functions within the intricate homeostasis of the human body. Moreover, certain water pollutants, including specific pesticides and industrial chemicals, have been associated with neurological and psychiatric disorders, such as mood swings, depression, cognitive decline, and anxiety, impacting both women and men. Water pollution is also associated with physical ailments, such as diarrhea, skin diseases, malnutrition, and cancer. Exposure to specific pollutants may promote premature menopause and vasomotor symptoms, elevate the risk of cardiovascular disease, and reduce bone density. In men, exposure to water pollution has been shown to reduce LH, FSH, and testosterone serum levels. The oxidative stress induced by pollutants prompts apoptosis of Sertoli and germ cells, inhibiting spermatogenesis and altering the normal morphology and concentration of sperm. Environmental estrogens further contribute to reduced sperm counts, reproductive system disruptions, and the feminization of male traits. Studies affirm that men generally exhibit a lower susceptibility than women to hormonal changes and health issues attributed to water pollutants. This discrepancy may be attributed to the varied water-related activities which have traditionally been undertaken by women, as well as differences in immune responses between genders. The implementation of effective measures to control water pollution and interventions aimed at safeguarding and enhancing the well-being of the aging population is imperative. The improvement of drinking water quality has emerged as a potential public health effort with the capacity to curtail the onset of cognitive impairment and dementia in an aging population.

Oral arsenite exposure induces inflammation and apoptosis in pulmonary tissue: acute and chronic evaluation in young and adult mice

Inorganic arsenic is a well-known environmental toxicant, and exposure to this metalloid is strongly linked with severe and extensive toxic effects in various organs including the lungs. In the present study, we aimed to investigate the acute and chronic effects of arsenite exposure on pulmonary tissue in young and adult mice. In brief, young and adult female Balb/C mice were exposed to 3 and 30 ppm arsenite daily via drinking water for 30 and 90 days. Subsequently, the animals were sacrificed and various histological and immunohistochemistry (IHC) analyses were performed using lung tissues. Our findings showed arsenite was found to cause dose-dependent pathological changes such as thickening of the alveolar septum, inflammatory cell infiltrations and lung fibrosis in young and adult mice. In addition, arsenite exposure significantly increased the expression of inflammatory markers NF-κB and TNF-α, indicating that arsenite-exposed mice suffered from severe lung inflammation. Moreover, the IHC analysis of fibrotic proteins demonstrated an increased expression of TGF-β1, α-SMA, vimentin and collagen-I in the arsenite-exposed mice compared to the control mice. This was accompanied by apoptosis, which was indicated by the upregulated expression of caspase-3 in arsenite-exposed mice compared to the control. Adult mice were generally found to be more prone to arsenite toxicity during chronic exposure relative to their younger counterparts. Overall, our findings suggest that arsenite in drinking water may induce dose-dependent and age-dependent structural and functional impairment in the lungs through elevating inflammation and fibrotic proteins.

Inorganic arsenic in seaweed: a fast HPLC-ICP-MS method without coelution of arsenosugars

Seaweed is becoming increasingly popular in the Western diet as consumers opt for more sustainable food sources. However, seaweed is known to accumulate high levels of arsenic-which may be in the form of carcinogenic inorganic arsenic (iAs). Here we propose a fast method for the routine measurement of iAs in seaweed using HPLC-ICP-MS without coelution of arsenosugars that may complicate quantification. The developed method was optimised using design of experiments (DOE) and tested on a range of reference materials including TORT-3 (0.36 ± 0.03 mg kg-1), DORM-5 (0.02 ± 0.003 mg kg-1), and DOLT-5 (0.07 ± 0.007 mg kg-1). The use of nitric acid in the extraction solution allowed for the successful removal of interferences from arsenosugars by causing degradation to an unretained arsenosugar species, and a recovery of 99 ± 9% was obtained for iAs in Hijiki 7405-b when compared with the certified value. The method was found to be suitable for high-throughput analysis of iAs in a range of food and feed matrices including Asparagopsis taxiformis seaweed, grass silage, and insect proteins, and offers a cost-effective, fast, and robust option for routine analysis that requires minimal sample preparation. The method may be limited with regards to the quantification of dimethylarsenate (DMA) in seaweed, as the acidic extraction may lead to overestimation of this analyte by causing degradation of lipid species that are typically more abundant in seaweed than other marine matrices (i.e. arsenophospholipids). However, the concentrations of DMA quantified using this method may provide a better estimation with regard to exposure after ingestion and subsequent digestion of seaweed.

Multilevel Regulation of Membrane Proteins in Response to Metal and Metalloid Stress: A Lesson from Yeast

In the face of flourishing industrialization and global trade, heavy metal and metalloid contamination of the environment is a growing concern throughout the world. The widespread presence of highly toxic compounds of arsenic, antimony, and cadmium in nature poses a particular threat to human health. Prolonged exposure to these toxins has been associated with severe human diseases, including cancer, diabetes, and neurodegenerative disorders. These toxins are known to induce analogous cellular stresses, such as DNA damage, disturbance of redox homeostasis, and proteotoxicity. To overcome these threats and improve or devise treatment methods, it is crucial to understand the mechanisms of cellular detoxification in metal and metalloid stress. Membrane proteins are key cellular components involved in the uptake, vacuolar/lysosomal sequestration, and efflux of these compounds; thus, deciphering the multilevel regulation of these proteins is of the utmost importance. In this review, we summarize data on the mechanisms of arsenic, antimony, and cadmium detoxification in the context of membrane proteome. We used yeast Saccharomyces cerevisiae as a eukaryotic model to elucidate the complex mechanisms of the production, regulation, and degradation of selected membrane transporters under metal(loid)-induced stress conditions. Additionally, we present data on orthologues membrane proteins involved in metal(loid)-associated diseases in humans.

Geographic differences in lung cancer: focus on carcinogens, genetic predisposition, and molecular epidemiology

Lung cancer poses a global health challenge and stands as the leading cause of cancer-related deaths worldwide. However, its incidence, mortality, and characteristics are not uniform across all regions worldwide. Understanding the factors contributing to this diversity is crucial in a prevalent disease where most cases are diagnosed in advanced stages. Hence, prevention and early diagnosis emerge as the most efficient strategies to enhance outcomes. In Western societies, tobacco consumption constitutes the primary risk factor for lung cancer, accounting for up to 90% of cases. In other geographic locations, different significant factors play a fundamental role in disease development, such as individual genetic predisposition, or exposure to other carcinogens such as radon gas, environmental pollution, occupational exposures, or specific infectious diseases. Comprehensive clinical and molecular characterization of lung cancer in recent decades has enabled us to distinguish different subtypes of lung cancer with distinct phenotypes, genotypes, immunogenicity, treatment responses, and survival rates. The ultimate goal is to prevent and individualize lung cancer management in each community and improve patient outcomes.

Arsenic in drinking water and lung cancer: A systematic review of 35 years of evidence

The association between higher arsenic concentrations in drinking water and lung cancer is well-established. However, the risk associated with lower levels of arsenic exposure remains uncertain. This systematic review and meta-analysis summarizes the evidence on the relationship between exposure to arsenic in drinking water and lung cancer outcomes as measured over a broad range of exposures, including lower levels. A total of 51 studies were included in the review and 15 met criteria for inclusion in meta-analysis. Risk estimates for lung cancer incidence and mortality were pooled and analyzed separately using Bayesian hierarchical random-effects models with a Gaussian observation submodel for log(Risk), computed using the "brms" R package. For lung cancer incidence, the predicted posterior mean relative risks (RRs) at arsenic concentrations of 10, 50 and 150 μg/L were 1.11 (0.86-1.43), 1.67 (1.27-2.17) and 2.21 (1.61-3.02), respectively, with posterior probabilities of 79%, 100% and 100%, respectively, for the RRs to be >1. The posterior mean mortality ratios at 20, 50 and 150 μg/L were 1.22 (0.83-1.78), 2.10 (1.62-2.71) and 2.41 (1.88-3.08), respectively, with posterior probabilities being above 80%. In addition to observing the dose-response relationship, these findings demonstrate that individuals exposed to low to moderate levels of arsenic (<150 μg/L) were at an elevated risk of developing or dying from lung cancer. Given the widespread exposure to lower levels of arsenic, there is an urgent need for vigilance and potential revisions to regulatory guidelines to protect people from the cancer risks associated with arsenic exposure.

Prenatal arsenite exposure alters maternal cardiac remodeling during late pregnancy

Exposure to inorganic arsenic through drinking water is widespread and has been linked to many chronic diseases, including cardiovascular disease. Arsenic exposure has been shown to alter hypertrophic signaling in the adult heart, as well as in utero offspring development. However, the effect of arsenic on maternal cardiac remodeling during pregnancy has not been studied. As such, there is a need to understand how environmental exposure contributes to adverse pregnancy-related cardiovascular events. This study seeks to understand the impact of trivalent inorganic arsenic exposure during gestation on maternal cardiac remodeling in late pregnancy, as well as offspring outcomes. C57BL/6 J mice were exposed to 0 (control), 100 or 1000 μg/L sodium arsenite (NaAsO2) beginning at embryonic day (E) 2.5 and continuing through E17.5. Maternal heart function and size were assessed via transthoracic echocardiography, gravimetric measurement, and histology. Transcript levels of hypertrophic markers were probed via qRT-PCR and confirmed by western blot. Offspring outcomes were assessed through echocardiography and gravimetric measurement. We found that maternal heart size was smaller and transcript levels of Esr1 (estrogen receptor alpha), Pgrmc1 (progesterone receptor membrane component 1) and Pgrmc2 (progesterone receptor membrane component 2) reduced during late pregnancy with exposure to 1000 μg/L iAs vs. non-exposed pregnant controls. Both 100 and 1000 μg/L iAs also reduced transcription of Nppa (atrial natriuretic peptide). Akt protein expression was also significantly reduced after 1000 μg/L iAs exposure in the maternal heart with no change in activating phosphorylation. This significant abrogation of maternal cardiac hypertrophy suggests that arsenic exposure during pregnancy can potentially contribute to cardiovascular disease. Taken together, our findings further underscore the importance of reducing arsenic exposure during pregnancy and indicate that more research is needed to assess the impact of arsenic and other environmental exposures on the maternal heart and adverse pregnancy events.

Micro-distribution of arsenic in toenail clippings using laser ablation inductively coupled plasma mass spectrometry: implications for biomonitoring

Toenails are a common monitoring tool for arsenic exposure, but the risk of external contamination of toenails has cast doubt on its usefulness. The main objective of this study is to investigate the micro-distribution of arsenic through the dorsoventral plane of nail clippings to understand endogenous vs exogenous sources. We used laser-ablation inductively coupled plasma mass spectrometry to measure arsenic through a dorsoventral cross-section of the nail plate collected from reference (N = 17) and exposed individuals (N = 35). Our main results showed (1) bulk toenail concentrations measured using ICP-MS in this study ranged from 0.54 to 4.35 µg/g; (2) there was a double-hump pattern in arsenic concentrations, i.e., dorsal and ventral layers had higher arsenic than the inner layer; (3) the double-hump was more pronounced in the exposed group (ventral: 6.25 μg/g; inner: 0.75 μg/g; dorsal: 0.95 μg/g) than the reference group (ventral: 0.58 μg/g; inner: 0.15 μg/g; dorsal: 0.29 μg/g) on average; (4) the distribution was, in part, associated with different binding affinity of nail layers (i.e., ventral > dorsal > inner); (5) most individuals in the higher exposure group showed > 25% contamination in ventral and dorsal nail layers; and (6) there were no statistically significant correlations between LA-ICP-MS arsenic with either bulk toenail arsenic or urine arsenic from the same individuals. Our results on micro-distribution and binding affinity provide insight into the impact of external contamination on arsenic concentrations and show how LA-ICP-MS can access the protected inner nail layer to provide a more accurate result.

Arsenic and UVR co-exposure results in unique gene expression profile identifying key co-carcinogenic mechanisms

Changes in gene expression underlie many pathogenic endpoints including carcinogenesis. Metals, like arsenic, alter gene expression; however, the consequences of co-exposures of metals with other stressors are less understood. Although arsenic acts as a co-carcinogen by enhancing the development of UVR skin cancers, changes in gene expression in arsenic UVR co-carcinogenesis have not been investigated. We performed RNA-sequencing analysis to profile changes in gene expression distinct from arsenic or UVR exposures alone. A large number of differentially expressed genes (DEGs) were identified after arsenic exposure alone, while after UVR exposure alone fewer genes were changed. A distinct increase in the number of DEGs was identified after exposure to combined arsenic and UVR exposure that was synergistic rather than additive. In addition, a majority of these DEGs were unique from arsenic or UVR alone suggesting a distinct response to combined arsenic-UVR exposure. Globally, arsenic alone and arsenic plus UVR exposure caused a global downregulation of genes while fewer genes were upregulated. Gene Ontology analysis using the DEGs revealed cellular processes related to chromosome instability, cell cycle, cellular transformation, and signaling were targeted by combined arsenic and UVR exposure, distinct from UVR alone and arsenic alone, while others were related to epigenetic mechanisms such as the modification of histones. This result suggests the cellular functions we identified in this study may be key in understanding how arsenic enhances UVR carcinogenesis and that arsenic-enhanced gene expression changes may drive co-carcinogenesis of UVR exposure.

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.

Prenatal Arsenite Exposure Alters Maternal Cardiac Remodeling During Late Pregnancy

Exposure to inorganic arsenic through drinking water is widespread and has been linked to many chronic diseases, including cardiovascular disease. Arsenic exposure has been shown to alter hypertrophic signaling in the adult heart, as well as in-utero offspring development. However, the effect of arsenic on maternal cardiac remodeling during pregnancy has not been studied. As such, there is a need to understand how environmental exposure contributes to adverse pregnancy-related cardiovascular events. This study seeks to understand the impact of trivalent inorganic arsenic exposure during gestation on maternal cardiac remodeling in late pregnancy, as well as offspring outcomes. C57BL/6J mice were exposed to 0 (control), 100 or 1000 µg/L sodium arsenite (NaAsO 2 ) beginning at embryonic day (E) 2.5 and continuing through E17.5. Maternal heart function and size were assessed via transthoracic echocardiography, gravimetric measurement, and histology. Transcript levels of hypertrophic markers were probed via qRT-PCR and confirmed by western blot. Offspring outcomes were assessed through echocardiography and gravimetric measurement. We found that exposure to 1000 µg/L iAs abrogated normal physiologic growth of the maternal heart during late pregnancy and reduced transcript levels of estrogen receptor alpha (ERα), progesterone receptor membrane component 1 (Pgrmc1) and progesterone receptor membrane component 2 (Pgrmc2). Both 100 and 1000 µg/L iAs also reduced transcription of protein kinase B (Akt) and atrial natriuretic peptide (ANP). Akt protein expression was also significantly reduced after 1000 µg/L iAs exposure in the maternal heart with no change in activating phosphorylation. This significant abrogation of maternal cardiac hypertrophy suggests that arsenic exposure during pregnancy can potentially contribute to cardiovascular disease. Taken together, our findings further underscore the importance of reducing arsenic exposure during pregnancy and indicate that more research is needed to assess the impact of arsenic and other environmental exposures on the maternal heart and adverse pregnancy events.

Groundwater arsenic contamination: impacts on human health and agriculture, ex situ treatment techniques and alleviation

Groundwater is consumed by a large number of people as their primary source of drinking water globally. Among all the countries worldwide, nations in South Asia, particularly India and Bangladesh, have severe problem of groundwater arsenic (As) contamination so are on our primary focus in this study. The objective of this review study is to provide a viewpoint about the source of As, the effect of As on human health and agriculture, and available treatment technologies for the removal of As from water. The source of As can be either natural or anthropogenic and exposure mediums can either be air, drinking water, or food. As-polluted groundwater may lead to a reduction in crop yield and quality as As enters the food chain and disrupts it. Chronic As exposure through drinking water is highly associated with the disruption of many internal systems and organs in the human body including cardiovascular, respiratory, nervous, and endocrine systems, soft organs, and skin. We have critically reviewed a complete spectrum of the available ex situ technologies for As removal including oxidation, coagulation-flocculation, adsorption, ion exchange, and membrane process. Along with that, pros and cons of different techniques have also been scrutinized on the basis of past literatures reported. Among all the conventional techniques, coagulation is the most efficient technique, and considering the advanced and emerging techniques, electrocoagulation is the most prominent option to be adopted. At last, we have proposed some mitigation strategies to be followed with few long and short-term ideas which can be adopted to overcome this epidemic.

Use of Microbial Consortia in Bioremediation of Metalloid Polluted Environments

Metalloids are released into the environment due to the erosion of the rocks or anthropogenic activities, causing problems for human health in different world regions. Meanwhile, microorganisms with different mechanisms to tolerate and detoxify metalloid contaminants have an essential role in reducing risks. In this review, we first define metalloids and bioremediation methods and examine the ecology and biodiversity of microorganisms in areas contaminated with these metalloids. Then we studied the genes and proteins involved in the tolerance, transport, uptake, and reduction of these metalloids. Most of these studies focused on a single metalloid and co-contamination of multiple pollutants were poorly discussed in the literature. Furthermore, microbial communication within consortia was rarely explored. Finally, we summarized the microbial relationships between microorganisms in consortia and biofilms to remove one or more contaminants. Therefore, this review article contains valuable information about microbial consortia and their mechanisms in the bioremediation of metalloids.

Arsenic causing gallbladder cancer disease in Bihar

In recent times Gallbladder cancer (GBC) incidences increased many folds in India and are being reported from arsenic hotspots identified in Bihar. The study aims to establish association between arsenic exposure and gallbladder carcinogenesis. In the present study, n = 200 were control volunteers and n = 152 confirmed gallbladder cancer cases. The studied GBC patient's biological samples-gallbladder tissue, gallbladder stone, bile, blood and hair samples were collected for arsenic estimation. Moreover, n = 512 gallbladder cancer patients blood samples were also evaluated for the presence of arsenic to understand exposure level in the population. A significantly high arsenic concentration (p < 0.05) was detected in the blood samples with maximum concentration 389 µg/L in GBC cases in comparison to control. Similarly, in the gallbladder cancer patients, there was significantly high arsenic concentration observed in gallbladder tissue with highest concentration of 2166 µg/kg, in gallbladder stones 635 µg/kg, in bile samples 483 µg/L and in hair samples 6980 µg/kg respectively. Moreover, the n = 512 gallbladder cancer patient's blood samples study revealed very significant arsenic concentration in the population of Bihar with maximum arsenic concentration as 746 µg/L. The raised arsenic concentration in the gallbladder cancer patients' biological samples-gallbladder tissue, gallbladder stone, bile, blood, and hair samples was significantly very high in the arsenic exposed area. The study denotes that the gallbladder disease burden is very high in the arsenic exposed area of Bihar. The findings do provide a strong link between arsenic contamination and increased gallbladder carcinogenesis.

Interaction between Occupational and Non-Occupational Arsenic Exposure and Tobacco Smoke on Lung Cancerogenesis: A Systematic Review

Although a higher lung cancer risk has been already associated with arsenic exposure, the contribution of arsenic and its compounds to the carcinogenic effects of other agents, such as tobacco smoke, is not well characterized. This systematic review examined the relationship between occupational and non-occupational arsenic exposure and tobacco smoking on lung cancer risk using papers published from 2010 to 2022. Two databases, PUBMED and Scifinder, were used for the searches. Among the sixteen human studies included, four were about occupational exposure, and the others were about arsenic in drinking water. Furthermore, only three case-control studies and two cohort studies evaluated an additive or multiplicative interaction. The interaction between arsenic exposure and tobacco smoke seems to be negligible at low arsenic concentrations (<100 μg/L), while there is a synergistic effect at higher concentrations. Finally, it is not yet possible to assess whether a linear no-threshold (LNT) model for lung cancer risk can be applied to the co-exposure to arsenic and tobacco smoke. Although the methodological quality of the included studies is good, these findings suggest that rigorous and accurate prospective studies on this topic are highly needed.

Chronic dietary exposure to total arsenic, inorganic arsenic and water-soluble organic arsenic species based on results of the first German total diet study

For risk assessment purposes, the dietary exposure to total arsenic and inorganic arsenic was estimated within the first German total diet study (BfR MEAL Study) for the whole population in Germany. Therefore, occurrence data of 356 different foods from the BfR MEAL Study were combined with consumption data from German nutrition surveys. Due to the different toxicological potentials of other water-soluble organic arsenic species present in rice-based foods, fish and seafood, dietary exposure to dimethylarsinic acid, monomethylarsonic acid and arsenobetaine was assessed in consumers in Germany through such foods for the first time. Related to the bodyweight, dietary exposure to total arsenic and inorganic arsenic in infants and young children (0.5-<5 years) were higher than in adolescents/adults (≥14 years). The highest median exposure estimates to inorganic arsenic resulted for the age group of infants from 0.5 to <1 year under modified lower bound conditions and for young children from 1 to <2 years under upper bound conditions (0.17 μg kg^-1 bodyweight day^-1-0.24 μg kg^-1 bodyweight day^-1 and 0.26 μg kg^-1 bodyweight day^-1-0.34 μg kg^-1 bodyweight day^-1, respectively). 'Grains and grain-based products' (especially rice) were identified as the main contributors for dietary exposure to total arsenic and inorganic arsenic for all age classes. Especially, for infants and young children, high consumption of rice-based foods and fish fingers is driving the dietary exposure to dimethylarsinic acid. The dietary exposure calculations indicate that a further reduction of dietary exposure to inorganic arsenic and further investigations to water-soluble organic arsenic species are necessary.

The dark side of NRF2 in arsenic carcinogenesis

Arsenic is an environmental toxicant that significantly enhances the risk of developing disease, including several cancers. While the epidemiological evidence supporting increased cancer risk due to chronic arsenic exposure is strong, therapies tailored to treat exposed populations are lacking. This can be accredited in large part to the chronic nature and pleiotropic pathological effects associated with prolonged arsenic exposure. Despite this fact, several putative mediators of arsenic promotion of cancer have been identified. Among these, the critical transcription factor NRF2 has been shown to be a key mediator of arsenic's pro-carcinogenic effects. Importantly, the dependence of arsenic-transformed cancer cells on NRF2 upregulation exposes a targetable liability that could be utilized to treat arsenic-promoted cancers. In this chapter, we briefly introduce the "light" vs "dark" side of the NRF2 pathway. We then give a brief overview of arsenic metabolism, and discuss the epidemiological and experimental evidence that support arsenic promotion of different cancers, with a specific emphasis on mechanisms mediated by chronic, non-canonical activation of NRF2 (i.e., the "dark" side). Finally, we briefly highlight how the non-canonical NRF2 pathway plays a role in other arsenic-promoted diseases, as well as research directions that warrant further investigation.

Sustainable health-based soil standards for arsenic using epidemiological data and toxicokinetic/probabilistic modelling

This study presents an alternative method to the traditional reference dose approach for the determination of health risk-based soil standards for arsenic. The model combines multimedia equations for air, soil and dietary exposure, a toxicokinetic component, a probabilistic output, a reference distribution for urine arsenic in the general population and exposure parameters values traceable in US-EPA or EFSA reference studies. The model calculates a mean inorganic As urine concentration AsU (sum of inorganic arsenic Asi and its metabolites) from environmental data and exposure parameters, which is attributed to the central value of a lognormal distribution. Risk is assessed by comparing a high percentile of the modelled distribution to the target AsU attributed to the reference value of 10 µg/g_CREA (microgram As per gram of creatinine), the upper confidence interval of the 95^th percentile from the AsU distribution in the French population. A soil standard value of 40 mg/kg is determined as being the arsenic concentration in soil not giving rise to more than 5% probability of having a AsU concentration above the target value of 10 µg/g_CREA. Once soil As concentrations above 40 mg/kg are measured, further environmental investigations should be carried, involving an assessment of As bioaccessibility to address health risks and decide of regulatory measures in residential setting.

Lung cancer in never smokers: Tumor immunology and challenges for immunotherapy

Lung cancer is the second most common and the most lethal malignancy worldwide. It is estimated that lung cancer in never smokers (LCINS) accounts for 10-25% of cases, and its incidence is increasing according to recent data, although the reasons remain unclear. If considered alone, LCINS is the 7th most common cause of cancer death. These tumors occur more commonly in younger patients and females. LCINS tend to have a better prognosis, possibly due to a higher chance of bearing an actionable driver mutation, making them amenable to targeted therapy. Notwithstanding, these tumors respond poorly to immune checkpoint inhibitors (ICI). There are several putative explanations for the poor response to immunotherapy: low immunogenicity due to low tumor mutation burden and hence low MANA (mutation-associated neo-antigen) load, constitutive PD-L1 expression in response to driver mutated protein signaling, high expression of immunosuppressive factors by tumors cells (like CD39 and TGF-beta), non-permissive immune TME (tumor microenvironment), abnormal metabolism of amino acids and glucose, and impaired TLS (Tertiary Lymphoid Structures) organization. Finally, there is an increasing concern of offering ICI as first line therapy to these patients owing to several reports of severe toxicity when TKIs (tyrosine kinase inhibitors) are administered sequentially after ICI. Understanding the biology behind the immune response against these tumors is crucial to the development of better therapeutic strategies.

A Comprehensive Transcriptomic Analysis of Arsenic-Induced Bladder Carcinogenesis

Arsenic (sodium arsenite: NaAsO2) is a potent carcinogen and a known risk factor for the onset of bladder carcinogenesis. The molecular mechanisms that govern arsenic-induced bladder carcinogenesis remain unclear. We used a physiological concentration of NaAsO2 (250 nM: 33 µg/L) for the malignant transformation of normal bladder epithelial cells (TRT-HU1), exposed for over 12 months. The increased proliferation and colony-forming abilities of arsenic-exposed cells were seen after arsenic exposure from 4 months onwards. Differential gene expression (DEG) analysis revealed that a total of 1558 and 1943 (padj < 0.05) genes were deregulated in 6-month and 12-month arsenic-exposed TRT-HU1 cells. The gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis revealed that cell proliferation and survival pathways, such as the MAPK, PI3K/AKT, and Hippo signaling pathways, were significantly altered. Pathway analysis revealed that the enrichment of stem cell activators such as ALDH1A1, HNF1b, MAL, NR1H4, and CDH1 (p < 0.001) was significantly induced during the transformation compared to respective vehicle controls. Further, these results were validated by qPCR analysis, which corroborated the transcriptomic analysis. Overall, the results suggested that stem cell activators may play a significant role in facilitating the arsenic-exposed cells to gain a survival advantage, enabling the healthy epithelial cells to reprogram into a cancer stem cell phenotype, leading to malignant transformation.

Health risk assessment of As due to rice ingestion based on iAs distribution and actual consumption patterns for the residents in Beijing: a cross-sectional study

As a well-known human carcinogen, arsenic (As) could pose various detrimental health effects to humans mainly through the exposure pathway of food ingestion. In comparison with other foods, rice can accumulate more arsenic due to its tissue specificity. Thus, it is of great significance to assess the health risk of As due to rice ingestion. However, the study on risk assessment from exposure to As in rice is still in an early stage and lack accuracy to date. In this study, after obtaining the rice exposure behavior patterns based on a questionnaire survey, a total of 160 rice samples, which consisted of 4 types (i.e., japonica, indica, glutinous and brown rice), rice from 4 areas and consumed by most of the population in Beijing, were collected. On the basis of the actual intake rate and the species weighted average concentration of consumed rice, average daily exposure dose and health risks of inorganic As (iAs) from rice ingestion were assessed for the population among different genders and ages in Beijing. The results show that japonica rice and rice from Northeast China had higher As content, with the same value of 0.064 mg kg^-1. And, they were the most popular rice consumed by people, with the intake rates of 75.50 g d^-1, and 67.91 g d^-1, respectively. The proportion of iAs to total As (tAs) was 58.34%, with a range of 43.18-71.88%. The average daily dose of iAs for the population was 1.15 × 10^-4, which mainly came from japonica rice and the rice from Northeast China ingestion. In comparison with the acceptable non-cancer risk, which had a HQ value of 0.38, the carcinogenic risk of the population in Beijing was 1.73 × 10^-4 on average. Furthermore, males had higher carcinogenic risk (1.88 × 10^-4) than females (1.62 × 10^-4), and the people in the age of 45-55 suffered from the highest carcinogenic risk (2.22 × 10^-4), which mainly was attributed to the japonica rice and the rice from Northeast China. This study strengthened that appropriate dietary patterns should be paid more attention in order to control the health risk due to As exposure.

A mass-balance approach to evaluate arsenic intake and excretion in different populations

Unless a toxicant builds up in a deep compartment, intake by the human body must on average balance the amount that is lost. We apply this idea to assess arsenic (As) exposure misclassification in three previously studied populations in rural Bangladesh (n = 11,224), Navajo Nation in the Southwestern United States (n = 619), and northern Chile (n = 630), under varying assumptions about As sources. Relationships between As intake and excretion were simulated by taking into account additional sources, as well as variability in urine dilution inferred from urinary creatinine. The simulations bring As intake closer to As excretion but also indicate that some exposure misclassification remains. In rural Bangladesh, accounting for intake from more than one well and rice improved the alignment of intake and excretion, especially at low exposure. In Navajo Nation, comparing intake and excretion revealed home dust as an important source. Finally, in northern Chile, while food-frequency questionnaires and urinary As speciation indicate fish and shellfish sources, persistent imbalance of intake and excretion suggests imprecise measures of drinking water arsenic as a major cause of exposure misclassification. The mass-balance approach could prove to be useful for evaluating sources of exposure to toxicants in other settings.

Low-dose arsenic trioxide enhances membrane-GLUT1 expression and glucose uptake via AKT activation to support L-02 cell aberrant proliferation

Long term low dose exposure of arsenic has been reported to lead various cells proliferation and malignant transformation. GLUT1, as the key transporter of glucose, has been reported to have association with rapid proliferation of various cells or tumor cells. In our study, we found that low dose exposure to arsenic trioxide (0.1μmol/L As₂O₃) could induce an increase in glucose uptake and promote cell viability and DNA synthesis. And, 2-DG, a non-metabolized glucose analog, significantly decreased the glucose uptake and cell proliferation of 0.1μmol/L As₂O₃ treated L-02 cells. However, 4 mmol/L 2-DG was co-utilized with equal dose glucose had no significant effect on the cell proliferation of 0.1μmol/L As₂O₃ treated L-02 cells. Further studies showed that exposure to 0.1μmol/L As₂O₃ could promote the expression of GLUT1 on plasma membrane. Inhibition of GLUT1 expression by 5μmol/L BAY-876 significantly decreased the abilities of glucose uptake and cell proliferation in As₂O₃-treated L-02 cells. Moreover, 0.1μmol/L As₂O₃ induced the AKT activation indicated by increased the phospho-AKT (Ser473 and Thr308). Knockdown AKT by shRNA or inhibited AKT activation by LY294002 was followed by significantly decreased glucose uptake, GLUT1 plasma membrane expression and cell proliferation in As₂O₃-treated L-02 cells. All in all, these results demonstrated that arsenic trioxide-induced AKT activation contributed to the cells proliferation through upregulating expression of GLUT1 on plasma membrane that enhanced glucose uptake.

New bimetallic adsorbent material based on cerium-iron nanoparticles highly selective and affine for arsenic(V)

Bimetallic oxy(hydroxides) have gain great interest in water treatment systems based on adsorption processes. Their high OH groups density, in addition to inheriting the oxides properties make them highly promising adsorbents of anions. In this work, highly affine and selective bimetallic oxyhydroxides of cerium and iron (Ce:Fe-P's) for arsenic(V) were synthesized by implementing an assisted microwave methodology. The Ce:Fe-P's were characterized by various techniques (SEM, FTIR, XRD and XPS) and the As(V) adsorption capacity and kinetics as well as the effect of pH and the presence of coexisting anions were determined. The results showed that Ce:Fe-P's have an outstanding As(V) adsorption capacity (179.8 mg g^-1 at C_e = 3 mg L^-1) even at low concentrations (120 mg g^-1 at C_e = 37 μg L^-1). Moreover, the adsorption equilibrium was reached very fast, just in 3 min, with an adsorption rate of 0.123 mg min^-1, that is, 80% of the initial As(V) concentration of 5 mg L^-1 was removed in the first 3 min. The arsenic adsorption capacity decreased only up to 20% at pH above 7, attributed to electrostatic repulsions due to the adsorbent's pH_PZC, which was 6.8. On the other hand, the arsenic adsorption capacity of Ce:Fe-P's decreased just 21% in the presence of 10 mg L^-1 of each of the following competing anions: F^-, Cl^-, SO₄^2-, NO₃^-, PO₄^3- and CO₃^2-, which usually coincide in contaminated water with As(V). Ce:Fe-P's has proven to be one of the most promising As(V) adsorbent materials reported so far in the literature, because it presented an outstanding adsorption capacity and at the same time a very fast adsorption speed. Furthermore, the pH and the concentration of coexisting anions caused little interference in the adsorption processes. Due to the above, the Ce:Fe-P's is already in the process of intellectual protection.

Assessment of disease burden in the arsenic exposed population of Chapar village of Samastipur district, Bihar, India, and related mitigation initiative

Fast growing arsenic menace is causing serious health hazards in Bihar, India, with an estimated 10 million people at risk. The exposed population is often unaware of the problem, which only amplifies the burden of arsenic health effects. In the present study, we have assessed the current situation of arsenic exposure in Chapar village of Samastipur district, Bihar. The health of the inhabitants was assessed and correlated with (1) arsenic concentrations in the groundwater of individual wells and (2) arsenic concentration found in their hair and urine. Altogether, 113 inhabitants were assessed, and 113 hair, urine and groundwater samples were collected. The health study reveals that the exposure to arsenic has caused serious health hazard amongst the exposed population with pronounced skin manifestations, loss of appetite, anaemia, constipation, diarrhoea, general body weakness, raised blood pressure, breathlessness, diabetes, mental disabilities, diabetes, lumps in the body and few cancer incidences. It was found that 52% of the total collected groundwater samples had arsenic levels higher than the WHO limit of 10 µg/l (with a maximum arsenic concentration of 1212 µg/l) and the reduced arsenite was the predominant form in samples tested for speciation (N = 19). In the case of hair samples, 29% of the samples had arsenic concentrations higher than the permissible limit of 0.2 mg/kg, with a maximum arsenic concentration of 46 µg/l, while in 20% exposed population, there was significant arsenic contamination in urine samples > 50 µg/l. In Chapar village, the probability of carcinogenic-related risk in the exposed population consuming arsenic contaminated water is 100% for children, 99.1% for females and 97.3% for male subjects. The assessment report shared to the government enabled the village population to receive two arsenic filter units. These units are currently operational and catering 250 households providing arsenic-free water through piped water scheme. This study therefore identified a significant solution for this arsenic-exposed population.

Nanomaterials as adsorbents for As(III) and As(V) removal from water: A review

Freshwater demand will rise in the next couple of decades, with an increase in worldwide population growth and industrial development. The development activities, on one side, have increased the freshwater demand. However, the ground water has been degraded. Among the various organic and inorganic contaminants, arsenic is one of the most toxic elements. Arsenic contamination in ground waters is a major issue worldwide, especially in South and Southeast Asia. Various methods have been applied to provide a remedy to arsenic contamination, including adsorption, ion exchange, oxidation, coagulation-precipitation and filtration, and membrane filtration. Out of these methods, adsorption of As(III)/As(V) using nanomaterials and biopolymers has been used on a wide scale. The present review focuses on recently used nanomaterials and biopolymer composites for As(III)/As(V) sorptive removal. As(III)/As(V) adsorption mechanisms have been explored for various sorbents. The impacts of environmental factors such as pH and co-existing ions on As(III)/As(V) removal, have been discussed. Comparison of various nanosorbents and biopolymer composites for As(III)/As(V) adsorption and regeneration of exhausted materials has been included. Overall, this review will be useful to understand the sorption mechanisms involved in As(III)/As(V) removal by nanomaterials and biopolymer composites and their comparative sorption performances.

Hydrochemical characterization, spatial distribution, and geochemical controls on arsenic and boron in waters from arid Arica and Parinacota, northern Chile

The livelihood of inhabitants from rural agricultural valleys in the arid Arica and Parinacota Region, northernmost Chile, strongly depends on water from high altitude rainfall and runoff to lower elevation areas. However, elevated arsenic, boron, and other potentially harmful elements compromise water quality, especially in rural areas. Samples (n = 90) of surface, underground, cold, geothermal springs, and treated and raw tap water were studied to assess water quality and to determine the main geochemical controls on water composition, origin, and geochemical evolution along dominant flowpaths. Water from major river basins across the region (Lluta, San Jose, Codpa-Chaca, Camarones and Altiplanicas) were collected for hydrogeochemical analysis of a suite of major and trace elements, δD and δ¹⁸O. Our new dataset was supplemented by hydrochemical data (n > 1500 data points) from secondary sources. Results show that 72% of the collected samples had As >10 μg/L (WHO drinking water provisional guideline) and affected 44% of the studied waters used for drinking (n = 32). Based on Chilean irrigation guidelines, elevated salinity (EC > 0.75 mS/cm) affected 80% of sampled waters, which were also impacted by high B (89% > 0.75 mg/L), and As (31% > 50 μg/L). Water composition was strongly controlled by geothermal water and freshwater mixing in high altitude areas. Magnitude and fate of As and B concentration was determined by the geothermal input type. Highest As (~21 mg/L) was associated with circum-neutral Na-Cl waters in Camarones basin, while lower As (~5 mg/L) with acid SO₄ waters in Lluta basin. Additionally, evaporative concentration and sediment-water interactions were shown to control the level of As in surface and groundwaters downstream. This works provides a comprehensive analysis and a conceptual model of geochemical controls on regional water compositions, contributing to better understanding the geochemical processes underpinning the water quality challenges in northern Chile.

Exposure of the residents around the Three Gorges Reservoir, China to chromium, lead and arsenic and their health risk via food consumption

Hydrological management of the Three Gorges Dam has resulted in the interception of heavy metals in the Three Gorges Reservoir (TGR). However, the exposure to heavy metals and health risks among local residents remained poorly understood. Here we collected 208 biomarker samples (hair) and 20 food species from typical regions in the TGR to assess the exposure levels of three toxic metals (Cr, Pb and As) in residents of the TGR, and subsequently investigated their health risk via dietary intake. Results indicated that hair Cr and As levels were below the reference value for normal people and threshold of skin lesions, respectively, whereas about 22% hair Pb exceeded the reference for clinical medicine, indicating a potential Pb exposure of local residents. Smoking habit and fish consumption were found to be predictors for hair Pb. In addition, the concentrations of heavy metals in all investigated food samples were below the limits of contaminants in food in China, except for Pb in the sweet potato and fish. The estimated daily intake of metals (DIMs) revealed that the intakes of Cr and As from studied food were under the recommended thresholds of Cr and As. However, the intake of Pb via diet exceeded the limit of the prevalence of chronic kidney disease and closed to the threshold for cardiovascular, which was probably associated with the high Pb concentrations of fish and sweet potato. Overall, residents around the TGR were at low exposure to Cr and As, but Pb exposure may need more attention.

Environmental arsenic exposure and its contribution to human diseases, toxicity mechanism and management

Arsenic is a well-recognized environmental contaminant that occurs naturally through geogenic processes in the aquifer. More than 200 million people around the world are potentially exposed to the elevated level of arsenic mostly from Asia and Latin America. Many adverse health effects including skin diseases (i.e., arsenicosis, hyperkeratosis, pigmentation changes), carcinogenesis, and neurological diseases have been reported due to arsenic exposure. In addition, arsenic has recently been shown to contribute to the onset of non-communicable diseases, such as diabetes mellitus and cardiovascular diseases. The mechanisms involved in arsenic-induced diabetes are pancreatic β-cell dysfunction and death, impaired insulin secretion, insulin resistance and reduced cellular glucose transport. Whereas, the most proposed mechanisms of arsenic-induced hypertension are oxidative stress, disruption of nitric oxide signaling, altered vascular response to neurotransmitters and impaired vascular muscle calcium (Ca²⁺) signaling, damage of renal, and interference with the renin-angiotensin system (RAS). However, the contributions of arsenic exposure to non-communicable diseases are complex and multifaceted, and little information is available about the molecular mechanisms involved in arsenic-induced non-communicable diseases and also no suitable therapeutic target identified yet. Therefore, in the future, more basic research is necessary to identify the appropriate therapeutic target for the treatment and management of arsenic-induced non-communicable diseases. Several reports demonstrated that a daily balanced diet with proper nutrient supplements (vitamins, micronutrients, natural antioxidants) has shown effective to reduce the damages caused by arsenic exposure. Arsenic detoxication through natural compounds or nutraceuticals is considered a cost-effective treatment/management and researchers should focus on these alternative options. This review paper explores the scenarios of arsenic contamination in groundwater with an emphasis on public health concerns. It also demonstrated arsenic sources, biogeochemistry, toxicity mechanisms with therapeutic targets, arsenic exposure-related human diseases, and onsets of cardiovascular diseases as well as feasible management options for arsenic toxicity.

Chronic arsenic increases cell migration in BEAS-2B cells by increasing cell speed, cell persistence, and cell protrusion length

There is a strong association between arsenic exposure and lung cancer development, however, the mechanism by which arsenic exposure leads to carcinogenesis is not clear. In our previous study, we observed that when BEAS-2B cells are chronically exposed to arsenic, there is an increase in secreted TGFα, as well as an increase in EGFR expression and activity. Further, these changes were broadly accompanied with an increase in cell migration. The overarching goal of this study was to acquire finer resolution of the arsenic-dependent changes in cell migration, as well as to understand the role of increased EGFR expression and activity levels in the underlying mechanisms of cell migration. To do this, we used a combination of biochemical and single cell assays, and observed chronic arsenic treatment enhancing cell migration by increasing cell speed, cell persistence and cell protrusion length. All three parameters were further increased by the addition of TGFα, indicating EGFR activity is sufficient to enhance those aspects of cell migration. In contrast, EGFR activity was necessary for the increase in cell speed, as it was reversed with an EGFR inhibitor, AG1478, but was not necessary to enhance persistence and protrusion length. From these data, we were able to isolate both EGFR-dependent and -independent features of cell migration that were enhanced by chronic arsenic exposure.

Molecular Mechanism of Arsenic-Induced Neurotoxicity including Neuronal Dysfunctions

Arsenic is a key environmental toxicant having significant impacts on human health. Millions of people in developing countries such as Bangladesh, Mexico, Taiwan, and India are affected by arsenic contamination through groundwater. Environmental contamination of arsenic leads to leads to various types of cancers, coronary and neurological ailments in human. There are several sources of arsenic exposure such as drinking water, diet, wood preservatives, smoking, air and cosmetics, while, drinking water is the most explored route. Inorganic arsenic exhibits higher levels of toxicity compared its organic forms. Exposure to inorganic arsenic is known to cause major neurological effects such as cytotoxicity, chromosomal aberration, damage to cellular DNA and genotoxicity. On the other hand, long-term exposure to arsenic may cause neurobehavioral effects in the juvenile stage, which may have detrimental effects in the later stages of life. Thus, it is important to understand the toxicology and underlying molecular mechanism of arsenic which will help to mitigate its detrimental effects. The present review focuses on the epidemiology, and the toxic mechanisms responsible for arsenic induced neurobehavioral diseases, including strategies for its management from water, community and household premises. The review also provides a critical analysis of epigenetic and transgenerational modifications, mitochondrial oxidative stress, molecular mechanisms of arsenic-induced oxidative stress, and neuronal dysfunction.

Paradoxical effects of arsenic in the lungs

High levels (> 100 ug/L) of arsenic are known to cause lung cancer; however, whether low (≤ 10 ug/L) and medium (10 to 100 ug/L) doses of arsenic will cause lung cancer or other lung diseases, and whether arsenic has dose-dependent or threshold effects, remains unknown. Summarizing the results of previous studies, we infer that low- and medium-concentration arsenic cause lung diseases in a dose-dependent manner. Arsenic trioxide (ATO) is recognized as a chemotherapeutic drug for acute promyelocytic leukemia (APL), also having a significant effect on lung cancer. The anti-lung cancer mechanisms of ATO include inhibition of proliferation, promotion of apoptosis, anti-angiogenesis, and inhibition of tumor metastasis. In this review, we summarized the role of arsenic in lung disease from both pathogenic and therapeutic perspectives. Understanding the paradoxical effects of arsenic in the lungs may provide some ideas for further research on the occurrence and treatment of lung diseases.

Assessment of arsenic exposure in the population of Sabalpur village of Saran District of Bihar with mitigation approach

Arsenic poisoning through groundwater is the world's greatest normal groundwater catastrophe which got an immense effect on worldwide general wellbeing. India is confronting the outcomes of arsenic poisoning in the zone of Ganga Brahmaputra alluvial plains. In Bihar, out of 38 districts, 18 districts are exceptionally influenced with groundwater arsenic defilement. In the present study, we have assessed the current situation of arsenic exposure in Sabalpur village of Saran district of Bihar after reporting of breast, renal, skin and thyroid cancer cases from this village along with typical symptoms of arsenicosis. Such cancer patients were identified at our institute and were taken for the study. The present investigation deals with the quantification of arsenic in groundwater, hair and nail samples of subjects as well as the survey of entire village to know the overall health status of the village people. A total of n=128 household handpump water samples as well as n=128 human hair and nail samples were collected from over n=520 households. Using the graphite furnace atomic absorption spectrophotometer (GF-AAS), all the samples were analysed. The investigation resulted that the 61% of the analysed samples particularly the groundwater had the arsenic levels more than the permissible limit of WHO (> 10 μg/L) with 244.20 μg/L as the highest arsenic contamination in one of the handpump water sample. The exposure effect of hair sample was worst as 88% of all the collected samples were having high arsenic levels more than the permissible limit (> 0.2 mg/Kg). In case of nail samples, 92% of the samples were having high arsenic concentration more than the permissible limit (> 0.5 mg/Kg). The health survey study revealed high magnitude of disease burden in the exposed population with symptoms such as asthma, anaemia, hepatomegaly, diabetes, cardiac problem, skin fungal infections, breathlessness and mental disability. Few cancer cases of renal, skin, breast and cervix were also found among the exposed population of this village. The percentage of cancer cases in this village was 0.94% that was low, but it would be an aggravated situation in the near future if people will continue drinking arsenic-contaminated water. Therefore, a mitigation intervention was carried out in March 2020 by installing an arsenic filter plant. The health situation in the village in the present scenario is hope to improve in the coming years. However, motivation and awareness among the village population are still required.

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

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

Inflammation biomarkers associated with arsenic exposure by drinking water and respiratory outcomes in indigenous children from three Yaqui villages in southern Sonora, México

Environmental arsenic exposure in adults and children has been associated with a reduction in the expression of club cell secretory protein (CC16) and an increase in the expression of matrix metalloproteinase-9 (MMP-9), both biomarkers of lung inflammation and negative respiratory outcomes. The objectives of this study were to determine if the levels of serum CC16 and MMP-9 and subsequent respiratory infections in children are associated with the ingestion of arsenic by drinking water. This cross-sectional study included 216 children from three Yaqui villages, Potam, Vicam, and Cocorit, with levels of arsenic in their ground water of 70.01 ± 21.85, 23.3 ± 9.99, and 11.8 ± 4.42 μg/L respectively. Total arsenic in water and urine samples was determined by inductively coupled plasma/optical emission spectrometry. Serum was analyzed for CC16 and MMP-9 using ELISA. The children had an average urinary arsenic of 79.39 μg/L and 46.8 % had levels above of the national concern value of 50 μg/L. Increased arsenic concentrations in drinking water and average daily arsenic intake by water were associated with decreased serum CC16 levels (β = - 0.12, 95% CI - 0.20, - 0.04 and β = - 0.10, 95% CI - 0.18, - 0.03), and increased serum MMP-9 levels (β = 0.35, 95% CI 0.22, 0.48 and β = 0.29, 95% CI 0.18, 0.40) at significant levels (P < 0.05). However, no association was found between levels of these serum biomarkers and urinary arsenic concentrations. In these children, reduced serum CC16 levels were significantly associated with increased risk of respiratory infections (OR = 0.34, 95% CI 0.13, 0.90). In conclusion, altered levels of serum CC16 and MMP-9 in the children may be due to the toxic effects of arsenic exposure through drinking water.

A modifiable risk factors atlas of lung cancer: A Mendelian randomization study

BACKGROUND

There has been no study systematically assessing the causal effects of putative modifiable risk factors on lung cancer. In this study, we aimed to construct a modifiable risk factors atlas of lung cancer by using the two-sample Mendelian randomization framework.

METHODS

We included 46 modifiable risk factors identified in previous studies. Traits with p-value smaller than 0.05 were considered as suggestive risk factors. While the Bonferroni corrected p-value for significant risk factors was set to be 8.33 × 10-4 .

RESULTS

In this two-sample Mendelian randomization analysis, we found that higher socioeconomic status was significantly correlated with lower risk of lung cancer, including years of schooling, college or university degree, and household income. While cigarettes smoked per day, time spent watching TV, polyunsaturated fatty acids, docosapentaenoic acid, eicosapentaenoic acid, and arachidonic acid in blood were significantly associated with higher risk of lung cancer. Suggestive risk factors for lung cancer were found to be serum vitamin A1, copper in blood, docosahexaenoic acid in blood, and body fat percentage.

CONCLUSIONS

This study provided the first Mendelian randomization assessment of the causality between previously reported risk factors and lung cancer risk. Several modifiable targets, concerning socioeconomic status, lifestyle, dietary, and obesity, should be taken into consideration for the development of primary prevention strategies for lung cancer.

Drinking Water Criteria for Arsenic in High-Income, Low-Dose Countries: The Effect of Legislation on Public Health

Due to the potential health risks at very low concentrations, the criterion for arsenic in drinking water has been debated. High-income, low-dose countries are uniquely positioned to follow WHO's recommendation of keeping concentrations "as low as reasonably possible." In this policy analysis, 47646 arsenic analyses from Denmark are used to follow the effect of lowering the national criterion from 50 to 5 μg/L. The first 3 years (2002-2004) following the criterion change, 106 waterworks were identified as noncompliant. An additional 64 waterworks were identified as noncompliant in the next 12 years (2005-2016). Of the 106 waterworks initially (2002-2004) aware of the violation, an average concentration drop from 6 to 3 μg/L was observed during a 6 year period following a lag time of 1 year. After this point, no further improvements were observed. Thirteen years after regulation was imposed, 25 of 170 waterworks were still in violation. The results suggest that legislation alone is insufficient to ensure better drinking water quality at some waterworks and that stakeholders' drivers and barriers to change also play an important role. In an exploration of five legislation scenarios, this study showed that a criterion of 1 μg/L would require action by more than 500 Danish waterworks, with treatment costs from 0.06 to 0.70 €/m³. These scenarios illustrate that it can be technically feasible and affordable to lower the arsenic criterion below 5 μg/L in low-dose, high-income countries. However, more information is needed to apply a cost-benefit model, and comparative studies from other counties are warranted.

Different mechanisms of arsenic related signaling in cellular proliferation, apoptosis and neo-plastic transformation

Arsenic is a toxic heavy metal vastly dispersed all over the earth crust. It manifests several major adverse health issues to millions of arsenic exposed populations. Arsenic is associated with different types of cancer, cardiovascular disorders, diabetes, hypertension and many other diseases. On the contrary, arsenic (arsenic trioxide, As₂O₃) is used as a chemotherapeutic agent in the treatment of acute promyelocytic leukemia. Balance between arsenic induced cellular proliferations and apoptosis finally decide the outcome of its transformation rate. Arsenic propagates signals via cellular and nuclear pathways depending upon the chemical nature, and metabolic-fates of the arsenical compounds. Arsenic toxicity is propagated via ROS induced stress to DNA-repair mechanism and mitochondrial stability in the cell. ROS induced alteration in p53 regulation and some mitogen/ oncogenic functions determine the transformation outcome influencing cyclin-cdk complexes. Growth factor regulator proteins such as c-Jun, c-fos and c-myc are influenced by chronic arsenic exposure. In this review we have delineated arsenic induced ROS regulations of epidermal growth factor receptor (EGFR), NF-ĸβ, MAP kinase, matrix-metalloproteinases (MMPs). The role of these signaling molecules has been discussed in relation to cellular apoptosis, cellular proliferation and neoplastic transformation. The arsenic stimulated pathways which help in proliferation and neoplastic transformation ultimately resulted in cancer manifestation whereas apoptotic pathways inhibited carcinogenesis. Therapeutic strategies against arsenic should be designed taking into account all these factors.

Use of study-specific MOE-like estimates to prioritize health effects from chemical exposure for analysis in human health assessments

There are unique challenges in estimating dose-response with chemicals that are associated with multiple health outcomes and numerous studies. Some studies are more suitable than others for quantitative dose-response analyses. For such chemicals, an efficient method of screening studies and endpoints to identify suitable studies and potentially important health effects for dose-response modeling is valuable. Using inorganic arsenic as a test case, we developed a tiered approach that involves estimating study-specific margin of exposure (MOE)-like unitless ratios for two hypothetical scenarios. These study-specific unitless ratios are derived by dividing the exposure estimated to result in a 20% increase in relative risk over the background exposure (RRE20) by the background exposure, as estimated in two different ways. In our case study illustration, separate study-specific ratios are derived using estimates of United States population background exposure (RRB-US) and the mean study population reference group background exposure (RRB-SP). Systematic review methods were used to identify and evaluate epidemiologic studies, which were categorized based on study design (case-control, cohort, cross-sectional), various study quality criteria specific to dose-response analysis (number of dose groups, exposure ascertainment, exposure uncertainty), and availability of necessary dose-response data. Both case-control and cohort studies were included in the RRB analysis. The RRE20 estimates were derived by modeling effective counts of cases and controls estimated from study-reported adjusted odds ratios and relative risks. Using a broad (but not necessarily comprehensive) set of epidemiologic studies of multiple health outcomes selected for the purposes of illustrating the RRB approach, this test case analysis would suggest that diseases of the circulatory system, bladder cancer, and lung cancer may be arsenic health outcomes that warrant further analysis. This is suggested by the number of datasets from adequate dose-response studies demonstrating an effect with RRBs close to 1 (i.e., RRE20 values close to estimated background arsenic exposure levels).

Arsenic trioxide-increased MDCK cells proliferation requires activator protein 1-mediated increase of the sodium/proton exchanger 1 activity

The release of protons (H⁺) occurs via the Na⁺/H⁺ exchanger isoform 1 (NHE1) leading to a stable intracellular pH (pHi) in MDCK cells. Chronic intake of arsenic trioxide (ATO), in the drinking water, associated with higher morbidity and mortality in neoplastic tissues. ATO increased NHE1 expression and activity, resulting in intracellular alkalization and higher MDCK cells proliferation. Since the pro-proliferative transcription factor activator protein 1 (AP-1) gets activated by al alkaline intracellular pH, a phenomenon paralleled by higher NHEs activity, we asked whether ATO-increased MDCK cells proliferation involves AP-1-dependent NHE1 activation. Cells were exposed (48 h) to ATO (0.05 μmol/L), SR11302 (1 μmol/L, AP-1 inhibitor), HOE-694 (100 nmol/L, NHE1 inhibitor) and EIPA (50 μmol/L, NHE1/NHE3 inhibitor) in the presence of S3226 (10 μmol/L, NHE3 inhibitor), concanamycin A (0.1 μmol/L, V-ATPases inhibitor), and Schering (10 μmol/L, H⁺/K⁺-ATPase inhibitor). [³H]Thymidine incorporation, cell counting, wound healing assay, and AP-1 activity were determined. The pHi was measured in cells pre-loaded (10 min) with 2,7-bicarboxyethyl-5,6-carboxyfluorescein acetoxymethyl ester (12 mmol/L) and exposed to NH₄Cl (20 mmol/L). Basal pHi and recovery rate (dpHi/dt), intracellular buffer capacity (βi) and H⁺ flux (J_H⁺) were determined. NHE1 protein abundance was measured by Western blotting and immunofluorescence. ATO increased the cell growth (1.5 fold), basal pHi (0.4 pHi units), dpHi/dt (1.8 fold), J_H⁺ (1.4 fold), AP-1 activity and NHE1 protein abundance (1.3 fold). ATO also increased (1.5 fold) the nuclear/perinuclear NHE1 immunosignal. SR11302 and HOE-694 blocked ATO effects. Thus, ATO-increased proliferation resulted from AP-1-dependent NHE1 activation in MDCK cells.

Enhanced arsenic removal from water by a bimetallic material ZrOx-FeOx with high OH density

Arsenic in groundwater for human consumption has negative effects on human's health worldwide. Due to the above, it is essential to invest in the development of new materials and more efficient technology for the elimination of such priority contaminants as arsenic. Therefore, in the present work, it was synthesized an amorphous hybrid material ZrOx-FeOx with a high density of OH groups, to improve the arsenic adsorption capacity of iron (FeOx) and zirconium (ZrOx) that makes up the bimetallic oxyhydroxide. The spectra of FT-IR and pK_a's distribution suggest that in the synthesized binary oxides, a new union between the two metallic elements is formed by means of an oxygen (metal-O-metal). In addition, TEM profiles suggest that there are chemical interactions between both metals since no individual particles of iron oxide and zirconium oxide were found. According to the results, the adsorption capacity of the ZrOx-FeOx material increases 4.5 and 1.4 times with respect to FeOx and ZrOx, respectively. At pH 6, the maximum adsorption capacity was 27 mg g^-1, but at pH greater than 7, the arsenic adsorption capacity onto ZrOx-FeOx decreased 66%. Graphical Abstract.

Dietary exposure to arsenic and human health risks in western Tibet

The health effects of drinking water exposure to inorganic arsenic are well known but are less well defined for dietary exposure. The rising concerns of arsenic risks from diet motivated this study of arsenic concentrations in highland barley, vegetables, meat, and dairy products to evaluate arsenic exposure source and to assess health risks among rural residents of Ngari area, western Tibet. Total arsenic and arsenic speciation were measured by inductively coupled plasma mass spectrometry (ICP-MS) and high-performance liquid chromatography combined with ICP-MS (HPLC-ICP-MS) respectively. Average total arsenic concentrations of 0.18 ± 0.21 (n = 45, median: 0.07 mg·kg^-1), 0.40 ± 0.57 (n = 17, median: 0.15 mg·kg^-1), 0.21 ± 0.16 (n = 12, median: 0.17 mg·kg^-1), and 0.18 ± 0.08 (n = 11, median: 0.22 mg·kg^-1) were observed in highland barley, vegetables, meat, and dairy products, respectively. Inorganic arsenic was determined to be the main species of arsenic in highland barley, accounting for about 64.4 to 99.3% (average 83.3%) of total arsenic. Nearly half (44.4%) of the local residents had ingested >3.0 × 10^-4 mg·kg^-1·d^-1 daily dose of arsenic from highland barley alone, above the maximum oral reference dose recommended by the United States Environmental Protection Agency (USEPA). The inorganic arsenic daily intake from highland barley was 3.6 × 10^-4 mg·kg^-1·d^-1. Dietary exposure to inorganic arsenic alone increased the cancer risk probability to 5.4 in 10,000, assuming that the inorganic arsenic in highland barley has the same carcinogenic effects as that in water.

Chronic and acute arsenic exposure enhance EGFR expression via distinct molecular mechanisms

The impacts of acute arsenic exposure (i.e. vomiting, diarrhea, and renal failure) are distinct from those brought about by sustained, low level exposure from environmental sources or drinking of contaminated well water. Chronic arsenic exposure is a risk factor for the development of pulmonary diseases, including lung cancer. How arsenic exposure leads to pulmonary disease is not fully understood. Both acute versus chronic arsenic exposure increase EGFR expression, but do so via distinct molecular mechanisms. BEAS-2B cells were exposed to either acute sodium arsenite (5 μM for 24 h) or chronic sodium arsenite (100 nM for 24 weeks). Cells treated with acute arsenic exhibited a decrease in viability, changes in morphology, and increased mRNA level of BTC. In contrast, during 24 weeks of arsenic exposure, the cells had increased EGFR expression and activity, and increased mRNA and protein levels of TGFα. Further, chronic arsenic treatment caused an increase in cell migration in the absence of exogenous ligand. Elevated TGFα and EGFR expression are features of many non-small cell lung cancers. We propose that lung epithelial cells chronically exposed to low level arsenic increases EGFR signaling via TGFα production to enhance ligand-independent cell migration.

Cytotoxicity Assessment of Gallium- and Indium-Based Nanoparticles Toward Human Bronchial Epithelial Cells Using an Impedance-Based Real-Time Cell Analyzer

The semiconductor manufacturing sector plans to introduce III/V film structures (eg, gallium arsenide (GaAs), indium arsenide (InAs) onto silicon wafers due to their high electron mobility and low power consumption. Aqueous solutions generated during chemical and mechanical planarization of silicon wafers can contain a mixture of metal oxide nanoparticles (NPs) and soluble indium, gallium, and arsenic. In this work, the cytotoxicity induced by Ga- and In-based NPs (GaAs, InAs, Ga₂O₃, In₂O₃) and soluble III-V salts on human bronchial epithelial cells (16HBE14o-) was evaluated using a cell impedance real-time cell analysis (RTCA) system. The RTCA system provided inhibition data at different concentrations for multiple time points, for example, GaAs (25 mg/L) caused 60% inhibition after 8 hours of exposure and 100% growth inhibition after 24 hours. Direct testing of As(III) and As(V) demonstrated significant cytotoxicity with 50% growth inhibition concentrations after 16-hour exposure (IC₅₀) of 2.4 and 4.5 mg/L, respectively. Cell signaling with rapid rise and decrease in signal was unique to arsenic cytotoxicity, a precursor of strong cytotoxicity over the longer term. In contrast with arsenic, soluble gallium(III) and indium(III) were less toxic. Whereas the oxide NPs caused low cytotoxicity, the arsenide compounds were highly inhibitory (IC₅₀ of GaAs and InAs = 6.2 and 68 mg/L, respectively). Dissolution experiments over 7 days revealed that arsenic was fully leached from GaAs NPs, whereas only 10% of the arsenic was leached out of InAs NPs. These results indicate that the cytotoxicity of GaAs and InAs NPs is largely due to the dissolution of toxic arsenic species.