Estimates of Soil Ingestion in a Population of Chinese Children

Exposure risks of lead and other metals to humans: A consideration of specific size fraction and methodology

Particle size is a critical influencing factor in assessing human exposure risk as fine particles are generally more hazardous than larger coarse particles. However, how particle composition influences human health risk is only poorly understood as different studies have different utilised different definitions and as a consequence there is no consensus. Here, with a new methodology taking insights of each size fraction load (%GSFload), metal bioaccessibility, we classify which specific particle size can reliably estimate the human exposure risk of lead and other metals. We then validate these by correlating the metals in each size fraction with those in human blood, hair, crop grain and different anthropogenic sources. Although increasing health risks are linked to metal concentration these increase as particle size decrease, the adjusted-risk for each size fraction differs when %GSFload is introduced to the risk assessment program. When using a single size fraction (250-50 µm, 50-5 µm, 5-1 µm, and < 1 µm) for comparison, the risk may be either over- or under-estimated. However, by considering bulk and adjusting the risk, it would be possible to obtain results that are closer to the real scenarios, which have been validated through human responses and evidence from crops. Fine particle size fractions (< 5 µm) bearing the mineral crystalline or aggregates (CaCO3, Fe3O4, Fe2O3, CaHPO4, Pb5(PO4)3Cl) alter the accumulation, chemical speciation, and fate of metals in soil/dust/sediment from the different sources. Loaded lead in the size fraction of < 50 µm has a significantly higher positive association with the risk-receptor biomarkers (BLLs, Hair Pb, Corn Pb, and Crop Pb) than other size fractions (bulk and 50-250 µm). Thus, we conclude that the < 50 µm fraction would be likely to be recommended as a reliable fraction to include in a risk assessment program. This methodology acts as a valuable instrument for future research undertakings, highlighting the importance of choosing suitable size fractions and attaining improved accuracy in risk assessment results that can be effectively compared.

Digestive fluid components affect speciation and bioaccessibility and the subsequent exposure risk of soil chromium from stomach to intestinal phase in in-vitro gastrointestinal digestion

The simulated in-vitro gastrointestinal method provides a simple way to evaluate the health risk of human body exposed to soil contaminants. Several in-vitro methods have been successfully established for soil As, Pb, and Cd. However, the method development for soil Cr failed up to now, which could be resulted from alteration in the species of Cr (e.g., Cr(VI)/Cr(III)) caused by the gastrointestinal digestion components, ultimately affecting the accessibility of Cr. This study explored the transformation and bioaccessibility of Cr in two Cr-contaminated soils during the physiologically based extraction test. The water-soluble and exchangeable Cr in soil was dissolved in gastrointestinal tract, accompanied with reduction of Cr(VI) into Cr(III), and the reduction occurred after the chemical extraction in two soils rather than during the extraction. Pepsin and organic acids in gastric phase could reduce Cr(VI) into Cr(III) and reduction efficiency were 20.4%- 53.0%, while in intestinal phase, pancreatin and bile salt had little effect on the Cr(VI) reduction, instead, more Cr(VI) was released from soil. In the gastric solution, Cr(VI) was mainly present as HCrO4- and Cr(III) as free Cr3+ ion. In the intestinal phase, Cr(VI) mainly occurred as CrO42- and Cr(III) as Cr(OH)3 (aq). Cr in the soil solid phase was dominated as the precipitates of Cr-Fe oxide, which was hardly extracted. Bioaccessibility of Cr in gastric phase increased as extraction duration increased and decreased in the intestinal phase, the contrary trend was observed for the hazard quotient of Cr in two phases due to Cr(VI)/Cr(III) transformation. This study indicates that the gastrointestinal components could influence the Cr transformation and subsequently affect the Cr bioaccessibility, which would help for a successful establishment of in vitro determination method for soil Cr bioaccessibility.

Comprehensive assessment of phthalates in indoor dust across China between 2007 and 2019: Benefits from regulatory restrictions

China is the largest producer and consumer of phthalates in the world. However, it remains unclear whether China's phthalate restrictions have alleviated indoor phthalate pollution. We extracted the concentrations of dimethyl phthalate (DMP), diethyl phthalate (DEP), dibutyl phthalate (DBP), diisobutyl phthalate (DIBP), benzyl butyl phthalate (BBP), and bis(2-ethylhexyl) phthalate (DEHP) in indoor dust at 2762 sites throughout China between 2007 and 2019 from the published literature. Based on these data, we investigated the effects of phthalate restrictions and environmental factors on the temporal-spatial distribution and sources of phthalates and estimated human exposure and risk of phthalates. The results revealed that the mean concentrations of phthalates in indoor dust throughout China decreased in the following order: DEHP > DBP > DIBP > DMP > DEP > BBP. The concentrations of six phthalates were generally higher in northern and central-western China than in southern regions. BBP and DEHP concentrations decreased by 73.5% and 17.9%, respectively, from 2007 to 2019. Sunshine was a critical environmental factor in reducing phthalate levels in indoor dust. Polyvinyl chloride materials, personal care products, building materials, and furniture were the primary sources of phthalates in indoor dust. The phthalates in indoor dust posed the most significant threat to children and older adults. This study provides a picture of phthalate pollution, thus supporting timely and effective policies and legislation.

Importance of arsenic bioaccessibility in health risk assessment based on iron "Minette" rocks and related soils

Total element concentrations by themselves are not always good predictors of toxicity and are therefore not suitable for eco- and/or human toxicological risk determination. In addition, despite the growing call for harmonization, countries show significant variation in risk assessment tools, screening/background values, protocols and legal management of soils. By incorporating mobility and bioaccessibility/availability into soil risk assessments, location-specific physico-chemical and geological conditions can be considered in routinely applied general risk assessment methodologies. Minette soils and rocks are a great case in point since they often are associated with high geogenic As concentrations and consequently potential risks. Minette iron ores form the world largest Fe ore deposits since the "great oxidation". For the first time, oral bioaccessibility during direct ingestion was assessed on Minettes from Luxembourg by applying the in vitro Solubility/Bioavailability Research Consortium (SBRC) method. Out of > 180 samples, 25 representative samples were selected providing a unique dataset which showed an average gastric bioaccessibility of ∼10% (7.8 ± 4.0 mg/kg) of the total As-concentration, with a maximum of 45% (17.9 mg/kg). Of importance is that bioaccessibility of As in Minette rocks and soils are controlled by, and can be estimated from, lithology, mineralogy and total Ca content. Soils and ooid grainstones with an iron oxide or clayey matrix, are characterized by average gastric bioaccessible As concentrations < 6 mg/kg. Gastric As bioaccessibility is highest in Fe-bearing calcite-cemented bioclastic grainstones (∼12 mg/kg). Importantly, for all samples the maximal bioaccessible As concentrations remain below the threshold from which significant adverse non-carcinogenic and/or carcinogenic health effects are expected. These new results are in strong contrast with what total As concentrations might suggest. Considering bioaccessibilities, consequently, can help to avoid disproportionate, costly and environmentally impacting risk management strategies. Furthermore, this study illustrates the importance of cross-disciplinary collaboration between geo- and health scientists.

Estimate of the maximum amount of dust adhering to skin and the upper limit of dust-skin adherence factor for young adults: An example from Changchun, China

Contaminants present in dust adhering to the skin can pose a significant risk to human health through dermal absorption and hand-to-mouth contact. The adhesion capacity of dust differs significantly from that of soil due to its physicochemical properties. Therefore, applying the raw soil exposure parameters to estimate the health risks associated with dermal exposure to dust may lead to erroneous conclusions. In this study, we quantified the maximum amount of dust that adhered to the skin (MADmax) and the upper limit of dust-skin adherence factor (DSAFmax) in 26 adults using element markers as a proxy for dust. The volunteers were exposed to dust and rinse water samples were collected from their hands, forearms, lower legs, and feet. We analyzed both the raw dust samples and the rinse water samples for 11 element markers, including Be, V, Cr, Mn, Co, Ni, Cu, Zn, Se, Ba, and Pb. The results showed that the MADmax of indoor dust and outdoor dust increased by 0.08-0.62 mg and 0.33-0.56 mg following a 1 cm2 increase in skin surface area, respectively. Based on best dust element markers, the body part-weighted dust-skin adherences (WDSAFmaxs) of indoor dust and outdoor dust were 0.35 and 0.64 mg/cm2, respectively. A smaller particle size and higher moisture content resulted in a larger DSAFmax. Only when indoor dust concentrations exceed 24.2 mg/m3 or outdoor dust concentrations exceed 44.3 mg/m3, can the WDSAFmax be applied directly in the health risk assessment of dermal exposure to dust. The method from this study can be re-applied in different regions, and the adherence data can help to improve future studies on the health effects of dermal exposure to dust.

A systematic characterization of soil/dust ingestion for typical subpopulations in China

An accurate assessment of human exposure to pollutants through the ingestion of dust and/or soil particles depends on a thorough understanding their rate of human ingestion. To this end, we investigated the load and size distribution patterns of dust/soil particles on the hands of three typical subpopulations, including preschoolers, college students, and security guards (outdoor workers). The geometric mean diameter of dust/soil particles on hands was observed to be 38.7 ± 11.2, 40.0 ± 12.1, and 36.8 ± 10.4 μm for preschoolers, college students, and security guards, respectively. The particle size distribution differed between subpopulations: Preschoolers were more exposed to fine particles, whereas security guards were exposed to more coarse particles. The geometric means of dust/soil particle loading on the hands were 0.126, 0.0163, and 0.0377 mg/cm2 for preschoolers, college students, and security guards, respectively. Males had statistically higher dust/soil particle loadings on hands than females, notably for preschoolers and college students; preschoolers with frequent hand contact with the bare ground had higher dust/soil particle loadings compared to those of peers in contact with commercial and residential grounds. The mean total dust/soil particle ingestion rate was estimated to be 245, 19.7, and 33.1 mg/day for preschoolers, college students, and security guards, respectively. Our estimates for college students and security guards are close to the consensus central-tendency values recommended by the U.S. EPA's Exposure Factor Handbook for American adults, whereas the estimates for children are much higher than the upper percentile values recommended for American children.

Estimation of indoor soil/dust-skin adherence factors and health risks for adults and children in two typical cities in southern China

Soil/dust (SD) skin adherence is key dermal exposure parameter used for calculating the health risk of dermal exposure to contaminants. However, few studies of this parameter have been conducted in Chinese populations. In this study, forearm SD samples were randomly collected using the wipe method from population in two typical cities in southern China as well as office staff in a fixed indoor environment. SD samples from the corresponding areas were also sampled. The wipes and SD were analyzed for tracer elements (aluminum, barium, manganese, titanium, and vanadium). The SD-skin adherence factors were 14.31 μg/cm² for adults in Changzhou, 7.25 μg/cm² for adults in Shantou, and 9.37 μg/cm² for children in Shantou, respectively. Further, the recommended values for indoor SD-skin adherence factors for adults and children in Southern China were calculated to be 11.50 μg/cm² and 9.37 μg/cm², respectively, which were lower than the U.S. Environmental Protection Agency (USEPA) recommended values. And the SD-skin adherence factor value for the office staff was small (1.79 μg/cm²), but the data were more stable. In addition, PBDEs and PCBs in dust samples from industrial and residential area in Shantou were also determined, and health risks were assessed using the dermal exposure parameters measured in this study. None of the organic pollutants posed a health risk to adults and children via dermal contact. These studies emphasized the importance of localized dermal exposure parameters, and further studies should be conducted in the future.

Necessity of introducing particle size distribution of hand-adhered soil on the estimation of oral exposure to metals in soil: Comparison with the traditional method

This study aimed to systematically investigate the relationship between children exposure possibility, metal concentration, metal bioaccessibility and soil particle size. fifty Children aged 3-8 years were recruited for the collection of hand-adhered soil, environmental soil, and blood samples. The mass distribution of hand-adhered soil with particle size were analyzed. Based on it, environmental soil samples were divided into five fractions to evaluate the effect of soil particle size on the total contents and bioaccessibilities of toxic metals. Then, a refined soil oral exposure model based on the particle size distribution of hand-adhered soil was established, and the estimation was compared with the typical traditional method. We found that finer particles were preferentially adhered to hand. The highest metal concentrations and bioaccessibilities occurred in the finest fraction, with values decreasing with increasing particle size. The exposure levels using the refined model were 2.0-3.4 times higher than those with the traditional method. In addition, Pb exposure level calculated using the refined model exhibited stronger and more significant correlation with blood Pb than those of the traditional soil. The construction of a refined exposure scenario based on hand-adhered soil could more exactly reflect the real exposure level and the difference among individuals.

Role of microbial iron reduction in arsenic metabolism from soil particle size fractions in simulated human gastrointestinal tract

Gut microbiota provides protection against arsenic (As) induced toxicity, and As metabolism is considered an important part of risk assessment associated with soil As exposures. However, little is known about microbial iron(III) reduction and its role in metabolism of soil-bound As in the human gut. Here, we determined the dissolution and transformation of As and Fe from incidental ingestion of contaminated soils as a function of particle size (<250 μm, 100-250 μm, 50-100 μm and < 50 μm). Colon incubation with human gut microbiota yielded a high degree of As reduction and methylation of up to 53.4 and 0.074 μg/(log CFU/mL)/hr, respectively; methylation percentage increased with increasing soil organic matter and decreasing soil pore size. We also found significant microbial Fe(III) reduction and high levels of Fe(II) (48 %-100 % of total soluble Fe) may promote the capacity of As methylation. Although no statistical change in Fe phases was observed with low Fe dissolution and high molar Fe/As ratios, higher As bioaccessibility of colon phase (avg. 29.4 %) was mainly contributed from reductive dissolution of As(V)-bearing Fe(III) (oxy)hydroxides. Our results suggest that As mobility and biotransformation by human gut microbiota (carrying arrA and arsC genes) are strongly controlled by microbial Fe(III) reduction coupled with soil particle size. This will expand our knowledge on oral bioavailability of soil As and health risks from exposure to contaminated soils.

Mechanisms and health implications of toxicity increment from arsenate-containing iron minerals through in vitro gastrointestinal digestion

Inadvertent oral ingestion is an important exposure pathway of arsenic (As) containing soil and dust. Previous researches evidenced health risk of bioaccessible As from soil and dust, but it is unclear about As mobilization mechanisms in health implications from As exposure. In this study, we investigated As release behaviors and the solid-liquid interface reactions toward As(V)-containing iron minerals in simulated gastrointestinal bio-fluids. The maximum As release amount was 0.57 mg/L from As-containing goethite and 0.82 mg/L from As-containing hematite at 9 h, and the As bioaccessibility was 10.8% and 21.6%, respectively. The higher exposure risk from hematite-sorbed As in gastrointestinal fluid was found even though goethite initially contained more arsenate than hematite. Mechanism analysis revealed that As release was mainly coupled with acid dissolution and reductive dissolution of iron minerals. Proteases enhanced As mobilization and thus increased As bioaccessibility. The As(V) released and simultaneously transformed to high toxic As(III) by gastric pepsin, while As(V) reduction in intestine was triggered by pancreatin and freshly formed Fe(II) in gastric digests. CaCl2 reduced As bioaccessibility, indicating that calcium-rich food or drugs may be effective dietary strategies to reduce As toxicity. The results deepened our understanding of the As release mechanisms associated with iron minerals in the simulated gastrointestinal tract and supplied a dietary strategy to alleviate the health risk of incidental As intake.

Arsenic Ingested Early in Life Is More Readily Absorbed: Mechanistic Insights from Gut Microbiota, Gut Metabolites, and Intestinal Morphology and Functions

Early-life arsenic (As) exposure is a particular health concern. However, it is unknown if As ingested early in life is more readily absorbed from the gastrointestinal (GI) tract, i.e., higher in oral bioavailability. Here, weanling (3-week) and adult (6-week-old) female mice were exposed to arsenate in the diet (10 μg g^-1) over a 3-week period with As oral bioavailability estimated using As urinary excretion as the bioavailability endpoint. The As urinary excretion factor was 1.54-fold higher in weanling mice compared to adult mice (82.2 ± 7.29 versus 53.1 ± 3.73%), while weanling mice also showed 2.28-, 1.50-, 1.48-, and 1.89-fold higher As concentration in small intestine tissue, blood, liver, and kidneys, demonstrating significantly higher As oral bioavailability of early-life exposure. Compared to adult mice, weanling mice significantly differed in gut microbiota, but the difference did not lead to remarkable differences in As biotransformation in the GI tract or tissue and in overall gut metabolite composition. Although the expression of several metabolites (e.g., atrolactic acid, hydroxyphenyllactic acid, and xanthine) was up-regulated in weanling mice, they had limited ability to elevate As solubility in the intestinal tract. Compared to adult mice, the intestinal barrier function and intestinal expression of phosphate transporters responsible for arsenate absorption were similar in weanling mice. However, the small intestine of weanling mice was characterized by more defined intestinal villi with greater length and smaller width, providing a greater surface area for As to be absorbed across the GI barrier. The results highlight that early-life As exposure can be more readily absorbed, advancing the understanding of its health risk.

Effects of various Fe compounds on the bioavailability of Pb contained in orally ingested soils in mice: Mechanistic insights and health implications

Reducing lead (Pb) exposure via oral ingestion of contaminated soils is highly relevant for child health. Elevating dietary micronutrient iron (Fe) intake can reduce Pb oral bioavailability while being beneficial for child nutritional health. However, the practical performance of various Fe compounds was not assessed. Here, based on mouse bioassays, ten Fe compounds applied to diets (100-800 mg Fe kg^-1) reduced Pb oral relative bioavailability (RBA) in two soils variedly depending on Fe forms. EDTA-FeNa was most efficient, which reduced Pb-RBA in a soil from 79.5 ± 14.7 % to 23.1 ± 2.72 % (71 % lower) at 100 mg Fe kg^-1 in diet, more effective than other 9 compounds at equivalent or higher doses (3.6-68 % lower). When EDTA-FeNa, ferrous gluconate, ferric citrate, and ferrous bisglycinate were supplemented, Fe-Pb co-precipitation was not observed in the intestinal tract. EDTA-FeNa, ferrous gluconate, ferric citrate, and ferrous sulfate suppressed duodenal divalent metal transporter 1 (DMT1)mRNA relative expression similarly (27-68 % lower). In comparison, among ten compounds, EDTA-FeNa elevated Fe concentrations in mouse liver, kidney, and blood (1.50-2.69-fold higher) most efficiently, suggesting the most efficient Fe absorption that competed with Pb. In addition, EDTA was unique from other organic ligands, ingestion of which caused 12.0-fold higher Pb urinary excretion, decreasing Pb concentrations in mouse liver, kidney, and blood by 68-88 %. The two processes (Fe-Pb absorption competition and Pb urinary excretion with EDTA) interacted synergistically, leading to the lowest Pb absorption with EDTA-FeNa. The results provide evidence of a better inhibition of Pb absorption by EDTA-FeNa, highlighting that EDTA-FeNa may be the most appropriate supplement for intervention on human Pb exposure. Future researches are needed to assess the effectiveness of EDTA-FeNa for intervention on human Pb exposure.

Assessment of Children's Metal Exposure via Hand Wipe, Outdoor Soil and Indoor Dust and Their Associations with Blood Biomarkers

The soil environment contributes considerably to human exposure to metals. This study aimed to comprehensively compare children's exposure to soil metals using different sampling approaches (i.e., hand wipe, indoor dust and outdoor soil) and assessment strategies, combing the method of external exposure evaluation and the correlation with internal biomarkers. Environmental exposure samples (hand wipe, outdoor soil and indoor dust), blood samples and child-specific exposure factors were simultaneously collected for 60 children aged 3 to 12 years from an area of northwestern China. Eight typical toxic metals were analyzed. Results showed that metal levels in hand wipes were associated with children's age, years of residency and the ground types of the play areas. Hand-to-mouth contact was an important pathway for children's metal exposure, with the corresponding oral exposure cancer risk to Cr already exceeding the maximum acceptable level. In comparison, metal concentrations in hand wipes were one to seven times higher than those in outdoor soil and indoor dust. Even greater discrepancies were found for the estimated exposure dose, which could lead to differences of several to dozens of times. In addition, Pb, Mn and Cr in hand wipes were significantly correlated with those in blood, whereas no relationships were found with soil and dust. This study indicates that the selection of different sampling and assessing strategies could lead to great differences in children metal exposure outcomes. It also suggests that hand wipe, which could reflect the true and integrated exposure level and the individual difference, serves as a better matrix to assess children's metal exposure compared to soil and dust. Further studies should standardize the sampling method for hand wipes and verify its applicability for other age groups.

Lability, bioaccessibility, and ecological and health risks of anthropogenic toxic heavy metals in the arid calcareous soil around a nonferrous metal smelting area

Lability and bioaccessibility of anthropogenic toxic heavy metals in arid calcareous soils are critical to understand their ecological and health risks. This study examined toxic heavy metal speciation in the calcareous soil contaminated by nonferrous metal smelting. Results demonstrated that approximately 70 years' nonferrous metal smelting and mining in Baiyin led to significant contamination of nearby soil down to about 200 cm depth by cadmium (Cd), copper (Cu), lead (Pb), and zinc (Zn), with more serious contamination in the downwind areas of smelting or mining. More than half of Cd, Cu, Pb, and Zn in the soil was present in the labile fractions while more than 75% of cobalt (Co), chromium (Cr), nickel (Ni), and vanadium (V) was present in the residual fraction. Carbonate minerals in this calcareous soil play an important role in the labile fractions, with approximate 25% of Cd and Pb and 15% of Cu and Zn bound in carbonates. Bioaccessible Cd, Cu, Pb, and Zn in the soil were approximately 49.8%, 29.4%, 12.2%, and 33.8% in gastric phase and 13.5%, 15.9%, 4.3%, and 9.1% in intestinal phase of their total concentrations, respectively. Therefore, Cd and Zn were removed from gastric solution to a greater extent than Cu and Pb by neutral intestine environment. However, bioaccessible Co, Cr, Ni, and V in the soil were less than 3% of their total concentrations. Bioaccessibility of these metals but Cu in this calcareous soil was significantly lower than that for the acidic Ultisols and Alfisols in U.S. The concentrations of Cd, Cu, Pb, Zn, and Ni in each chemical and bioaccessible forms were significantly correlated linearly with their total concentrations in the calcareous soil, while only residual concentration was significantly correlated with the total concentration for Co, Cr, and V. These linear slopes showed that relative lability and bioaccessibility increased for Cd, but decreased for Cu, Pb, and Zn with the increase in their total concentrations in the calcareous soil. Direct oral soil ingestion would not pose a non-carcinogenic health risk to local children. However, very high potential ecological risk would be caused by these metals in the soil. These results provide improved insights into the biogeochemical processes of anthropogenic toxic heavy metals in the arid calcareous soils worldwide.

Effect of vitamin C supplement on lead bioaccessibility in contaminated soils using multiple in vitro gastrointestinal assays: Mechanisms and health risks

Effects of vitamin C supplementation on the oral bioaccessibility of lead (Pb) present in contaminated soils were examined using a number of in vitro assays (PBET, SBRC, UBM and IVG). In the presence of vitamin C, an increase in Pb bioaccessibility was observed in the gastric phase by 1.3-fold (30.5%-85.5%) and in the intestinal phase by 3.1-fold (0.9%-58.9%). Lead mobilization was regulated by reductive dissolution of Fe(III) and sequestration of Pb on secondary Fe minerals. Sequential extraction by the Bureau Community of Reference (BCR) provided more evidence that reducible fraction and residual fraction were major contributor of gastric Pb bioaccessibility, as well as reduced fractions in intestinal Pb bioaccessibility. In addition, higher non-carcinogenic risks may occur based on target hazard quotient (THQ ≥ 1). For people exposed to Pb present in soil, the management of vitamin C supplements is of serious concern.

Estimation of Children's Soil and Dust Ingestion Rates and Health Risk at E-Waste Dismantling Area

Due to environmental health concerns, exposure to heavy metals and related adverse effects in electronic waste (e-waste) dismantling areas have attracted considerable interest in the recent years. However, little information is available about the Soil/Dust Ingestion Rates (SIR) of heavy metals for children living in such sites. This study estimated the soil ingestion of 66 children from e-waste disassembly areas by collecting and analyzing selected tracer elements in matched samples of their consumed food, feces, and urine, as well as soil samples from their play areas. The concentrations of tracer elements (including Al, Ba, Ce, Mn, Sc, Ti, Y, and V) in these samples were analyzed. The SIR was estimated to be 148.3 mg/day (median) and 383.3 mg/day (95th percentile) based on the Best Tracer Method (BTM). These values are somewhat higher than those observed in America, Canada, and other parts of China. Health risk assessments showed that Cr presented the greatest carcinogenic risk, at more than 10^-6 in this typical polluted area, while As was second. These findings provide important insights into the exposure risks of heavy metals in e-waste dismantling sites and emphasize the health risk caused by Cr and As.

Is hand-to-mouth contact the main pathway of children's soil and dust intake?

Children (n = 240) between the ages of 2 and 17 years were randomly selected from three cities in China. The total amount of soil and dust (SD) on their hands was measured and ranged from 3.50-187.39 mg (median = 19.49 mg). We screened for seven elements (Ce, V, Y, Al, Ba, Sc, and Mn), and Ce levels were used to calculate hand SD by variability and soil elements. The main factors affecting SD amount were location and age group, as identified using a conditional inference tree. Hand SD and the hand SD intake rate were highest in Gansu Province, followed by Guangdong and Hubei provinces, respectively. Hand SD and the hand SD intake rate were highest among children in primary school, followed by kindergarten and secondary school, respectively. The hand SD intake rate of the three typical areas was 11.9 mg/d, which was about 26.6% of the children's soil intake rate (44.8 mg/d), indicating that hand-to-mouth contact is not the main route for children's soil intake in the three areas of China.

Model based prediction of age-specific soil and dust ingestion rates for children

BACKGROUND

Soil and dust ingestion can be a primary route of environmental exposures. Studies have shown that young children are more vulnerable to incidental soil and dust ingestion. However, available data to develop soil and dust ingestion rates for some child-specific age groups are either lacking or uncertain.

OBJECTIVE

Our objective was to use the Stochastic Human Exposure and Dose Simulation Soil and Dust (SHEDS-Soil/Dust) model to estimate distributions of soil and dust ingestion rates for ten age ranges from infancy to late adolescents (birth to 21 years).

METHODS

We developed approaches for modeling age groups previously not studied, including a new exposure scenario for infants to capture exposures to indoor dust via pacifier use and accounting for use of blankets that act as a barrier to soil and dust exposure.

RESULTS

Overall mean soil and dust ingestion rates ranged from ~35 mg/day (infants, 0-<6 m) to ~60 mg/day (toddlers and young children, 6m-<11 yr) and were considerably lower (about 20 mg/day) for teenagers and late adolescents (16-<21 y). The pacifier use scenario contributed about 20 mg/day to the median dust ingestion rate for young infants. Except for the infant age groups, seasonal analysis showed that the modeled estimates of average summer mean daily total soil plus dust ingestion rates were about 50% higher than the values predicted for the winter months. Pacifier use factors and carpet dust loading values were drivers of exposure for infants and younger children. For older children, influential variables included carpet dust loading, soil adherence, and factors that capture the frequency and intensity of hand-to-mouth behaviors.

SIGNIFICANCE

These results provide modeled estimates of children's soil and dust ingestion rates for use in decision making using real-world exposure considerations.

IMPACT STATEMENT

The parameterization of scenarios to capture infant soil and dust ingestion and the application of SHEDS-Soil/Dust to a broader age range of children provides additional estimates of soil and dust ingestion rates that are useful in refining population-based risk assessments. These data illuminate drivers of exposure that are useful to both risk management applications and for designing future studies that improve upon existing tracer methodologies.

Predictive capabilities of in vitro colon bioaccessibility for estimating in vivo relative bioavailability of arsenic from contaminated soils: Arsenic speciation and gut microbiota considerations

Arsenic (As) transformation by human gut microbiota has been evidenced to impact As toxicity and human health. However, little is known about the influence of gut microbiota on As bioavailability from incidental ingestion of soil. In this study, we assessed As relative bioavailability (RBA) using an in vivo mouse model and As bioaccessibility in the colon phase of in vitro assays. Strong in vivo-in vitro correlations (R² = 0.70-0.92, P < 0.05) were observed between soil As RBA (10.2%-57.7%) and colon bioaccessibility (4.8%-49.0%) in 13 As-contaminated soils. Upon in vitro incubation of human colon microbiota, we found a high degree of As transformation and 65.9% of generated As(III) was observed in soil residues. For in vivo mouse assay, DMA(V) accounted for 79.0% of cumulative urinary As excretion. Except for As(V), dominant As species including As(III), DMA(V) and As sulfides were also detected in mouse feces. Gut bacteria (families Rikenellaceae and Marinifilaceae) could be significantly correlated with As intake and excretion in mice (P < 0.05). Our findings provide evidence that gut microbiota can affect transformation, bioavailability, and fate of the orally ingested soil As in human gastrointestinal tract.

Health Risk Assessment for the Residential Area Adjacent to a Former Chemical Plant

A health risk assessment was carried out for the residents of Łęgnowo-Wieś settlement adjacent to a former Zachem Chemical Plant, Bydgoszcz, Poland. Due to the unique Zachem site history and contamination profile, an innovative strategy for soil sampling and contaminant selection was applied. The novelty in the developed strategy consisted of selecting substances for the health risk assessment, taking into consideration the location and boundaries of the groundwater contamination plumes in relation to contamination sources. This allowed limiting the number of the analysed contaminants. The risk assessment focused on the surface soil of a residential area, which was divided into 20 sampling sectors and 6 backyards with wells from which water was used for watering edible plants. A total of 80 inorganic and organic substances were determined, including metals, phenol, aniline, BTEX, diphenyl sulphone, chloroaniline, epichlorohydrin, hydroxybiphenyl, nitrobenzene, octylphenols, toluenediamine, toluidine, 16 polycyclic aromatic hydrocarbons, tetrachloroethylene and trichloroethylene. For the health risk assessment, the United States Environmental Protection Agency’s deterministic method was applied. This applies conservative assumptions to obtain risk estimates protective for most of the potential receptors. Three exposure pathways were analysed: (1) incidental soil ingestion, (2) dermal contact with soil and (3) inhalation of fugitive soil particles and volatiles. In all sampling sectors and backyards, the total non-cancer risks (hazard index) were significantly lower than the acceptable level of 1. The acceptable cancer risk level for the single carcinogen of 1 × 10⁻⁵ was only insignificantly exceeded in the case of benzo(a)pyrene in three sectors and one backyard. The total cancer risks were lower than the acceptable level of 1 × 10⁻⁴ in all sampling sectors and all backyards. The findings show that the soil in the entire residential area is safe for the residents’ health and no remedial actions are required. However, since not all possible exposure pathways were analysed in this study, further research focused on assessing the health risk resulting from the consumption of locally grown food is strongly recommended.

Presence, sources, and risk assessment of heavy metals in the upland soils of northern China using Monte Carlo simulation

The spatial dynamics of heavy metal contamination in the upland soils of northern China are relatively unknown, despite the region's high contribution to the national grain output. In this study, the concentrations of As, Cd, Co, Cr, Cu, Mn, Pb, Sb, Sc, Ti, and Zn and subsequent ecological and human health risks were investigated in three major grain producing areas (Hexi Corridor, L1; Hetao irrigation area, L2; and eastern Inner Mongolia, L3) of northern China. Among the heavy metals, Ti had the highest average concentration of 3.02 g/kg, followed by Mn (470 mg/kg), Cr (56.6 mg/kg), Zn (34.3 mg/kg), Pb (19.4 mg/kg), Cu (17.8 mg/kg), Co (9.66 mg/kg), Sc (7.26 mg/kg), As (5.35 mg/kg), Sb (0.73 mg/kg), and Cd (0.17 mg/kg). Generally, the heavy metal concentrations decreased from west to east (L1 > L2 > L3) across northern China. Moreover, three potential sources of the heavy metal were distinguished, including natural process, anthropogenic activities (industrial development and agricultural cultivation), and atmospheric deposition. Although the contamination of the single metal (including Cd, Cr, Cu, and Pb) was moderate in L1 and L2, the combined contamination was low in the upland soils. It was noted that Cd posed a moderate to considerable ecological risk on the upland soils in northern China. This metal was the most sensitive factor in assessing the combined ecological risk, with a contribution rate of 91.56-94.84%. Considering the ingestion exposure, the current concentrations of the metals posed minimal risks to human health. Furthermore, children experienced higher health risks than adults. Present study analyzed the probabilistic distribution of contamination, ecological, and health risk of heavy metals in upland soils of northern China, providing fundamental information for better agricultural heavy metal pollution assessment in China.

Source identification of pollution and health risks to metals in household indoor and outdoor dust: A cross-sectional study in a typical mining town, China

Dust is regarded as an important pathway of heavy metal(loid)s to the human body. Health risks posed by metal(loid)s from household dust are of particular concern. However, the contamination and sources of heavy metal(loid)s in household dust environments, as well as source identification of health risks related to heavy metal(loid)s from household dust for vulnerable populations such as children, have not been thoroughly studied in China, particularly for the areas involved with industrial activities such as ore mining. Thus, a cross-sectional study was conducted in a rural area famous for Pb/Zn ore mining, to assess the pollution sources and health risks of heavy metal(loid)s from household indoor and outdoor dust and to identify the contribution of household dust to the health risks for children. The results indicated that household environment was heavily contaminated by metal(loid)s, which were mainly attributed to mining activity. Meanwhile, the indoor/outdoor ratio and the redundancy analysis indicated that there were other pollution sources in indoor environments such as coal combustion, materials for interior building and decoration. Vapor inhalation was the main exposure pathway for Hg, while ingestion was the predominant pathway for other metal(loid)s. Although the cancer risks were relatively low, the HIt from household indoor and outdoor dust (2.19) was about twice the acceptable limit (1) and was primarily from Pb (64.52%) and As (23.42%). Outdoor dust was a larger contributor to the HI of Sb, As, Cr, Cd, Zn and Pb, which accounted for 51.37%, 58.63%, 52.14%, 59.66%, 52.87% and 64.47%, respectively, and the HIt was mainly from outdoor dust (60.76%). These results indicated that non-cancer health risks were largely from outdoor dust exposure, and strengthened the notion that concern should be given to the potential health risks from metal(loid)s in household dust both originating from mining activity and indoor environmental sources.

Arsenic exposure analysis for children living in central China: From ingestion exposure to biomarkers

Emerging evidence indicates that chronic low-dose arsenic (As) exposure can pose adverse health effects to children. This study aimed to systematically study the exposure risk induced by As ingestion in children living in Hubei Province, central China. The feasibility of first morning spot urine instead of 24-h urine as an environmental exposure biomarker was also explored. A total of 120 children aged 2-17 years were recruited from an urban area for the collection of biomarker samples (first morning and 24-h urine samples), environmental exposure samples (duplicate diets, drinking water, and soil), and related child-specific exposure factors. The external exposure risk, internal exposure level, and source of exposure to As in children were analyzed. The results indicated that As concentration in duplicated diets, water, and soil were 29.2 μg kg^-1, 1.3 μg L^-1, and 9.3 mg kg^-1, respectively; these were all below the corresponding maximum allowable levels in China (the threshold value of As in most food, drinking water and soil are 0.5 mg⸱kg^-1, 0.01 mg L^-1, and 20 mg⸱kg^-1, respectively). Dietary intake was the predominant exposure route, accounting for 90% of the total daily dose. The combined oral non-carcinogenic and carcinogenic risks all exceeded the corresponding maximum acceptable risk level. Therefore, As bioavailability should be investigated and used in health risk assessment. Multiple linear regression analysis indicated that urinary As was positively associated with dietary As, with a one-unit increase in daily As intake from the diet associating with 4.82 and 5.21 μg g^-1 increases in 24-h urine and first morning urine, respectively. Furthermore, significant correlations with 24-h urine and external exposure metrics suggested that creatine-adjusted As concentrations in first morning urine could be an appropriate substitute of 24-h urine as exposure biomarkers.

Health Risk Assessment of Metals via Multi-Source Oral Exposure for Children Living in Areas with Intense Electronic Manufacturing Activities

Oral ingestion is the predominant pathway of metal(loid)s exposure. In this study, the health risks of typical metal(loid)s (including Mn, As, Cr, Cd, and Pb) via multi-source, oral pathways for children aged 3-12 years, living in an area of China dominated by the electronic manufacturing industry, were studied based on the field sampling of duplicated diet, soil, and drinking water. Child-specific ingestion parameters were measured (except the soil ingestion rates, which were from a previous study of the same population), and a Monte Carlo method was applied to determine the uncertainty of the risk assessment. It was observed that children living in such environments were at risk of metal(loid)s exposure, with the accumulative carcinogenic risk exceeding the maximum acceptable level. Food intake was identified to be the primary exposure pathway. Moreover, Pb and Cr were the major risk elements to local children's health. Compared with primary school students, kindergarten children experienced a higher risk. This study highlights that high attention should be paid to children living in suburban areas dominated by the electronic manufacturing industry, and that priority should be given to studies on metal(loid)s exposure deriving from different types of food and their corresponding bioavailability, in order to further discern the precise risk sources to protect children's health.

Estimation of Soil and Dust Ingestion Rates from the Stochastic Human Exposure and Dose Simulation Soil and Dust Model for Children in Taiwan

This study focuses on estimating the probabilistic soil and dust ingestion rates for children under 3 years old by the Stochastic Human Exposure and Dose Simulation Soil and Dust (SHEDS-S/D) model developed by the U.S. Environmental Protection Agency. The health risk of children's exposure to heavy metals through soil and dust ingestion and dermal absorption was then assessed in three exposure scenarios. In the exposure scenario of direct contact with soil, the average soil and dust ingestion rates for children aged 24 to 36 months were 90.7 and 29.8 mg day^-1 in the sand and clay groups, respectively. Hand-to-mouth soil ingestion was identified as the main contributor to soil and dust ingestion rates, followed by hand-to-mouth dust ingestion and object-to-mouth dust ingestion. The soil-to-skin adherence factor was the most influential factor increasing the soil and dust ingestion rate based on a sensitivity analysis in the SHEDS-S/D model. Furthermore, the modeled soil and dust ingestion rates based on the SHEDS-S/D model were coincident with results calculated by the tracer element method. Our estimates highlight the soil ingestion rate as the key parameter increasing the risk for children, while a higher frequency of hand washing could potentially reduce the risk.

Effect of gut microbiota on in vitro bioaccessibility of heavy metals and human health risk assessment from ingestion of contaminated soils

To identify the role of gut microbiota in human health risk assessment, the bioaccessibility of heavy metals in 14 soil samples were determined in simulated gastrointestinal fluids. Compared to the small intestinal phase, the bioaccessibility values of the colon phase varied, either increased by 3.5-fold for As, by 2.2-fold for Cr, and by 1.6-fold for Ni, or reduced by 4.4-fold for Cu, respectively. The colon incubation with adult gut microbiota yielded higher bioaccessibility value of As (1.3 times) and Fe (3.4 times) than that of the child in most soil samples. Colon bioaccessibility was about 60% greater of Cd for the adult and 30% higher of Cr for the child. Congruent data on the bioaccessibility of Cu and Ni was observed. In addition, correlation analysis indicated that in vitro bioaccessibility was primarily related to total concentrations of heavy metals in soils, followed by soil pH and active Fe/Mn oxide. Significantly, risk assessment calculated based on colon bioaccessibility indicated that the target hazard quotient (THQ > 1) of As was presented in 3 soil samples for the adult (1.05-3.35) and in 9 soil samples for the child (1.06-26.93). The hazard index (HI) of the child was 4.00 on average, greater than that of the adult (0.62), primarily due to the contribution of As and Cd. It suggested non-carcinogenic risks are likely to occur in children through typical hand-to-mouth behavior. The adjustment of colon bioaccessibility will result in more accurate risk assessment of human exposure to heavy metals from oral ingestion of contaminated soils.

Antibiotic exposure decreases soil arsenic oral bioavailability in mice by disrupting ileal microbiota and metabolic profile

Oral bioavailability of arsenic (As) determines levels of As exposure via ingestion of As-contaminated soil, however, the role of gut microbiota in As bioavailability has not evaluated in vivo although some in vitro studies have investigated this. Here, we made a comparison in As relative bioavailability (RBA) estimates for a contaminated soil (3913 mg As kg^-1) using a mouse model with and without penicillin perturbing gut microbiota and metabolites. Compared to soil exposure alone (2% w/w soil in diets), addition of penicillin (100 or 1000 mg kg^-1) reduced probiotic Lactobacillus and sulfate-reducing bacteria Desulfovibrio, enriched penicillin-resistant Enterobacter and Bacteroides, and decreased amino acid concentrations in ileum. With perturbed gut microbiota and metabolic profile, penicillin and soil co-exposed mice accumulated 2.81-3.81-fold less As in kidneys, excreted 1.02-1.35-fold less As in urine, and showed lower As-RBA (25.7-29.0%) compared to mice receiving diets amended with soil alone (56 ± 9.63%). One mechanism accounted for this is the decreased concentrations of amino acids arising from the gut microbiota shift which resulted in elevated iron (Fe) and As co-precipitation, leading to reduced As solubilization in the intestine. Another mechanism was conversion of bioavailable inorganic As to less bioavailable monomethylarsonic acid (MMA^V) and dimethylarsinic acid (DMA^V) by the antibiotic perturbed microflora. Based on in vivo mouse model, we demonstrated the important role of gut microbiota and gut metabolites in participating soil As solubilization and speciation transformation then affecting As oral bioavailability. Results are useful to better understand the role of gut bacteria in affecting As metabolism and the health risks of As-contaminated soils.

Digging into Toxoplasma gondii infections via soil: A quantitative microbial risk assessment approach

Soil has been identified as an important source of exposure to a variety of chemical and biological contaminants. Toxoplasma gondii is one of those potential biological contaminants associated with serious health effects in pregnant women and immunocompromised patients. Gardening or consumption of homegrown vegetables may present an important route of T. gondii infection via accidental ingestion of soil. In the Netherlands, there is quantitative information on the risk of T. gondii infection via meat products, but not on the risk of infection through soil. The objective of this study was to develop a quantitative microbial risk assessment (QMRA) model for estimating the risk associated with T. gondii exposure via accidental soil ingestion in the Netherlands. In order to obtain the needed information, a magnetic capture method for detection of T. gondii oocysts in soil samples was developed, and T. gondii DNA was detected using qPCR targeting the 529 bp repeat element. The method was shown to provide 95% probability of detection (95% CI: 88-100%) when at least 34 oocysts are present in 25 g of soil. T. gondii DNA was detected in 5 of 148 soil samples with interpretable results (3%, 95% CI: 1.5-7.7%). Results for 18 samples were not interpretable due to PCR inhibition. The estimated amount of oocysts presented in qPCR positive samples was quantified by a linear model, and the amount varied from 8 to 478 in 25 g of soil. The estimated incidence rate of T. gondii infection from the QMRA model via soil varied from 0.3 to 1.8 per 1000 individuals per day. Several data gaps (e.g., soil contamination/ingestion and oocysts viability) have been identified in this study, the structure of the model can be applied to obtain more accurate estimates of the risk of T. gondii infection via soil when data become available.

Soil ingestion among young children in rural Bangladesh

Ingestion of soil and dust is a pathway of children's exposure to several environmental contaminants, including lead, pesticides, and fecal contamination. Empirically based estimates of central tendency for soil consumption by children in high-income countries range from 9 to 135 dry mg/day. Using a Monte Carlo simulation, we modeled the mass of soil directly and indirectly ingested per day by rural Bangladeshi children and identified the parameters that influence the mass ingested. We combined data from observations of direct and indirect ingestion among children with measurements of soil mass on the children's hands, mother's hands, and objects to quantify soil ingestion/day. Estimated geometric mean soil ingestion was 162 dry mg/day for children 3-5 months, 224 dry mg/day for children 6-11 months, 234 dry mg/day for children 12-23 months, 168 dry mg/day for children 24-35 months, and 178 dry mg/day for children 36-47 months old. Across all age groups, children placing their hands in their mouths accounted for 46-78% of total ingestion and mouthing objects contributed 8-12%. Direct ingestion of soil accounted for nearly 40% of soil ingested among children 6-23 months old. Sensitivity analyses identified that the parameters most affecting the estimates were the load of soil on the child's hand, the frequency of hand-to-mouth contacts while not eating, and, for children 6-23 months old, the frequency of direct soil ingestion. In a rural, low-income setting, children's soil consumption was substantially more than the estimates for children in high-income countries. Further characterizing soil ingestion of children in low-income contexts would improve assessments of the risks they face from soil-associated contaminants.

Exposure of children to light rare earth elements through ingestion of various size fractions of road dust in REEs mining areas

Road dust, contains enhanced amounts of light rare earth elements (LREEs) in rare earth industrial cities, which poses a serious health risk particularly to children. Road dust samples were collected from Baotou, the largest rare earth industrial city in northern China, and sieved into six size fractions. The pollution characteristics of the LREEs (La, Ce, Pr, and Nd) in the size-fractioned road dust were investigated, and the LREEs exposure dose of children via ingestion of road dust was evaluated. The results showed that the finer size fractions of road dust had enhanced REEs concentrations, and the pollution level was found to be elevated with a decrease in particle size. Ce was the most abundant element, with concentrations ranging from 105 to 5420 mg·kg^-1, followed by La, Nd and Pr. REEs mining activities had a major contribution to the LREEs in the road dust and crust, among which coal combustion emissions could also be a potential source. The average daily intake dose of LREEs through ingestion of road dust by children ranged from 4.27 × 10^-4 to 2.63 × 10^-2 mg·kg^-1·day^-1 and was significantly affected by particle size. Road dust exposure is notably affected by particle size, and there is a serious risk to children of LREEs uptake from fine particles (<100 μm) of road dust.

Measuring Environmental Exposure to Enteric Pathogens in Low-Income Settings: Review and Recommendations of an Interdisciplinary Working Group

Infections with enteric pathogens impose a heavy disease burden, especially among young children in low-income countries. Recent findings from randomized controlled trials of water, sanitation, and hygiene interventions have raised questions about current methods for assessing environmental exposure to enteric pathogens. Approaches for estimating sources and doses of exposure suffer from a number of shortcomings, including reliance on imperfect indicators of fecal contamination instead of actual pathogens and estimating exposure indirectly from imprecise measurements of pathogens in the environment and human interaction therewith. These shortcomings limit the potential for effective surveillance of exposures, identification of important sources and modes of transmission, and evaluation of the effectiveness of interventions. In this review, we summarize current and emerging approaches used to characterize enteric pathogen hazards in different environmental media as well as human interaction with those media (external measures of exposure), and review methods that measure human infection with enteric pathogens as a proxy for past exposure (internal measures of exposure). We draw from lessons learned in other areas of environmental health to highlight how external and internal measures of exposure can be used to more comprehensively assess exposure. We conclude by recommending strategies for advancing enteric pathogen exposure assessments.

Geogenic nickel exposure from food consumption and soil ingestion: A bioavailability based assessment

Accumulation and oral bioavailability of nickel (Ni) were rarely assessed for staple crops grown in high geogenic Ni soils. To assess exposure risk of geogenic Ni, soil, wheat, and rice samples were collected from a naturally high background Ni area and measured for Ni oral relative bioavailability (RBA, relative to NiSO₄) using a newly developed mouse urinary Ni excretion bioassay. Results showed that soils were enriched with Ni (80.5 ± 23.0 mg kg^-1, n = 58), while high Ni contents were observed in rice (2.66 ± 1.46 mg kg^-1) and wheat (1.32 ± 0.78 mg kg^-1) grains, with rice containing ∼2-fold higher Ni content than wheat. Ni-RBA was low in soil (14.8 ± 7.79%, n = 18), but high in wheat and rice with rice Ni-RBA (85.9 ± 19.1%, n = 9) being ∼2-fold higher than wheat (46.1 ± 21.2%, n = 16). A negative correlation (r = 0.61) was observed between Ni-RBA and iron content in rice and wheat, suggesting the low iron status of rice drives its high Ni bioavailability. The higher Ni accumulation and bioavailability for rice highlights that rice consumption was a more important contributor to daily Ni intake compared to wheat, while Ni intake from direct soil ingestion was negligible. This study suggests a potential health risk of staple crops especially rice when grown in high geogenic Ni areas.

Quantificational exposure, sources, and health risks posed by heavy metals in indoor and outdoor household dust in a typical smelting area in China

Contamination of metals in household dust remains a concern for human health. However, few studies to date have been conducted on the contribution of both indoor and outdoor environments to the health risks posed by metals. This study was carried out to assess the potential health risks from both indoor and outdoor household dust and the respective contribution to the health risks for children. The results showed that household dusts were heavily polluted by metal(loid)s, which were up to 30 times higher than the relative background level, and were attributed to smelting activity. However, there are other pollution sources in indoor environments, since the I/O ratio values of Pb, Cd, and As were significantly higher than 1. HI values of Pb and As exceeded the threshold of (1) and accounted for approximately 60% and 24% to the HIt, respectively. The HIts of Zn, Cr, Mn, Hg, and Cu were mainly attributable to indoor dust exposure, particularly for Hg (73.44%), indicating non-carcinogenic health risks could be attributed more to the indoor dust exposure. This study highlights the potential risks of metal contamination in household environment, particularly indoor environment, on the health of children who live in the vicinity of smelting activity.

The potassium regulator patiromer affects serum and stool electrolytes in patients receiving hemodialysis

Hyperkalemia is a common and an important cause of death in maintenance hemodialysis patients. Here we investigated the effect of patiromer, a synthetic cation exchanger, to regulate potassium homeostasis. Serum and stool electrolytes were measured in 27 anuric patients with hyperkalemia receiving hemodialysis (mainly 2 mEq/L dialysate) during consecutive two weeks of no-treatment, 12 weeks of treatment with patiromer (16.8g once daily), and six weeks of no treatment. The serum potassium decreased from a mean of 5.7 mEq/L pre-treatment to 5.1 mEq/L during treatment and rebounded to 5.4 mEq/L post-treatment. During the treatment phase, serum calcium significantly increased (from 8.9 to 9.1 mg/dL) and serum magnesium significantly decreased (from 2.6 to 2.4 mg/dL) compared to pre-treatment levels. For each one mEg/L increase in serum magnesium, serum potassium increased by 1.07 mEq/L. Stool potassium significantly increased during treatment phase from pre-treatment levels (4132 to 5923 μg/g) and significantly decreased post-treatment to 4246 μg/g. For each one μg/g increase in stool potassium, serum potassium significantly declined by 0.05 mEq/L. Stool calcium was significantly higher during the treatment phase (13017 μg/g) compared to pre-treatment (7874 μg/g) and post-treatment (7635 μg/g) phases. We estimated that 16.8 g of patiromer will increase fecal potassium by 1880 μg/g and reduce serum potassium by 0.5 mEq/L. Thus, there is a complex interaction between stool and blood potassium, calcium and magnesium during patiromer treatment. Long term consequence of patiromer-induced changes in serum calcium and magnesium remains to be studied.

External interference from ambient air pollution on using hair metal(loid)s for biomarker-based exposure assessment

Hair metal(loid)s are often measured as biomarkers to evaluate population internal exposure, however, hair samples could be easily contaminated by ambient particulate matter (PM) pollution. Here, we evaluated the potential external interference from ambient PM pollution on using hair metal(loid)s for population biomarker-based exposure assessment. The raw hair samples were strictly washed and placed under various indoor and outdoor scenarios for ~6 months at sites with high PM pollution. The contaminated hair was then washed using the same method. A total of 33 hair elements were quantified by inductively coupled plasma-mass spectrometry. The surface residual PM on hair after washing was observed by scanning electron microscopy. In addition, we chose a practical exposure scenario including 77 housewives in Shanxi Province, China for validation. The results for the hair exposure experiment revealed that external contamination of some elements that had relatively high concentrations in hair was generally mild in both indoor and outdoor exposure scenarios (i.e., Zn, Mg, Se, Fe, Sr, Ti, Mn, Sn, Ge, U, Co, Mo, and As). A relatively higher external contamination of other elements (e.g., Al, Cr, Pb, Cd, Li, and most rare earth elements (REEs)) was observed, especially for those elements with relatively low hair concentrations (e.g., Cd, and REEs) in the outdoor environment. This finding was due mainly to some small ambient PM not being fully removed by the current washing strategy when the hair sample was heavily contaminated. However, results from practical exposure scenario of the housewives showed that there were overall no significant differences of hair metal(loid)s between the housewives using coal and clean energy for cooking. We concluded that the external interference on hair internal metal(loid) analysis could be negligible when hair was efficiently washed, especially for population with relatively longer indoor activities. It is therefore promising to use hair analysis for their population exposure assessment.

Effects of soil particle size on metal bioaccessibility and health risk assessment

Oral ingestion is the main exposure pathway through which humans ingest trace metals in the soil, particularly for children. Metals in different soil particle size fractions may vary in terms of concentration and properties. Urban school/kindergarten soil samples were collected from three cities: Lanzhou in northwest China, Wuhan in central China, and Shenzhen in southeast China. Soil samples were classified according to particle size (<63 μm, 63-150 μm, 150-250 μm, and 250-2000 μm) to estimate the effects of soil particle size on the total content and bioaccessibility of metals (Cd, Cr, Cu, Ni, Pb, and Zn). Based on the results, we assessed whether the standard size <150 μm (containing < 63 μm and 63-150 μm), recommended by the Technical Review Workgroup (TRW) of the Environmental Protection Agency (EPA), and <250 μm (containing < 63 μm, 63-150 μm, and 150-250) recommended by the Bioaccessibility Research Group of Europe (BARGE), are suitable where the largest proportion adhering to hands is the finest soil (<63 μm). The results showed that different metals exhibited different relationships between soil particle size and content and between soil particle size and bioaccessibility. Pb and Zn generally exhibited the greatest bioaccessibility in the coarsest particle sizes (250-2000 μm); whereas the highest Ni bioaccessibility occurred in the finest sizes (<63 μm); the bioaccessibility of other metals did not exhibit any obvious relationships with particle size. When assessing health risks using bioaccessible metal content in the recommended soil particle size ranges (<150 μm and <250 μm) and in finer particles (<63 μm), the results for noncarcinogenic risks to children exhibited no obvious difference, while the actual carcinogenic risks may be underestimated with the use of soil particle size ranges < 150 μm and <250 μm. Therefore, when choosing an optimal particle size fraction to evaluate the health risk of oral soil ingestion, we recommend the use of the bioaccessible metal content in <63 μm soil fraction.

Antagonistic Interactions between Arsenic, Lead, and Cadmium in the Mouse Gastrointestinal Tract and Their Influences on Metal Relative Bioavailability in Contaminated Soils

Soils are often co-contaminated with As, Pb, and Cd. To what extent ingested metal(loid)s interact with each other in the gastrointestinal tract and influence their RBA (relative bioavailability) is largely unknown. Three soils predominantly contaminated with As (MS, mining/smelting impacted), Pb (WR, wire rope production impacted), and Cd (EP, enamel pottery production impacted) were administered to mice individually or in binary and tertiary combinations with sodium arsenate, Cd chloride, and/or Pb acetate. In binary combinations, ∼10-fold higher Pb addition decreased As-RBA in MS (26.0 ± 6.28% to 17.1 ± 1.08%), while ∼10-fold higher As addition decreased Pb-RBA in WR (61.3 ± 2.41% to 28.8 ± 5.45%). This was possibly due to the formation of insoluble Pb arsenate in mouse intestinal tract, as indicated by the formation of precipitates when As and Pb co-occurred in water or simulated human gastrointestinal fluids. Due to competition for shared absorption transporters, ∼10- and 100-fold higher Pb addition decreased Cd-RBA in EP (95.8 ± 12.9% to 67.8 ± 12.8% and 62.8 ± 8.24%). Tertiary combinations showed that interactions between two metal(loid)s were affected by the presence of the third metal(loid). Our study suggests that As oxyanion could interact with Pb or Cd ions in the mouse gastrointestinal tract, and the interactions vary depending on concentration and solution characteristics.

Oral Bioavailability of As, Pb, and Cd in Contaminated Soils, Dust, and Foods based on Animal Bioassays: A Review

Metal contamination in soil, dust, and food matrices impacts the health of millions of people worldwide. During the past decades, various animal bioassays have been developed to determine the relative bioavailability (RBA) of As, Pb, and Cd in contaminated soils, dust, and foods, which vary in operational approaches. This review discusses the strengths and weaknesses of different animal models (swine and mice), dosing schemes (single gavage dose, repeated gavage dose, daily repeated feeding, and free access to diet), and end points (blood, urine, and tissue) in metal-RBA measurement; compares metal-RBA obtained using mouse and swine bioassays, different dosing schemes, and different end points; and summarizes key findings on As-, Pb-, and Cd-RBA values in contaminated soils, dust, and foods. Future directions related to metal-RBA research are highlighted, including (1) comparison of metal-RBA determinations between different bioassays and different laboratories to ensure robust bioavailability data, (2) enhancing the metal-RBA database for contaminated dust and foods, (3) identification of physiological and physicochemical mechanisms responsible for variability in metal-RBA values, (4) formulation of strategies to decrease metal-RBA values in contaminated soils, dust, and foods, and (5) assessing the impacts of cocontaminants on metal-RBA measurement.

Unprecedentedly High Dust Ingestion Estimates for the General Population in a Mining District of DR Congo

The mining of metals in low income countries is often associated with high exposure to dust that contributes to metal exposure. Here, dust ingestion estimates were made from fecal excretion of inert tracers with corrections for dietary contribution. The study took place in the cobalt mining area of Lubumbashi (DR Congo) and involved 120 nonoccupationally exposed participants in the dry season, with 51 of these being repeated in the rainy season. For each participant, duplicate meals (0-96 h), feces (24-120 h), and indoor/outdoor dust (<250 μm) were collected. The dust ingestion estimates (g day^-1) were derived from Nb, Ti, and V as best tracers and were 0.28 (geometric mean), 3.3 (mean), and 13 (P95); these values are almost a factor 10 above currently accepted estimates for the general population in high income countries. Mean dust ingestion in the dry season was twice that of the rainy season, and the P95s were significantly higher in children (3-15 years) than in male adults and toddlers; geophagy (>40 g day^-1) was suspected in three individuals. These data explain the previously reported extreme cobalt exposures in children and support the need to manage dust in the metal mining operations.

Health risks to metals in multimedia via ingestion pathway for children in a typical urban area of China

With the rapid development of the industrialization and urbanization, the urban environment was heavily contaminated by metals. Therefore, studies on health risk assessment of exposure to metals for urban population is necessary and urgent, especially for children, who are more susceptible to environmental pollution due to their undeveloped immune system. Moreover, ingestion has been proved to be the most important pathway of human metals exposure. Therefore, typical metals, including Lead(Pb), Cadmium(Cd), Arsenic(As), Chromium(Cr), and Manganese(Mn), were analyzed in duplicated diet, drinking water, and soil in this study. The integrated risks of oral exposure to these metals for the local children were then evaluated on a field sampling and measured child-specific exposure factors basis. Results showed that the studied urban environments were polluted by metals to a certain degree. Food ingestion was the largest, which accounted for 66.7%-98.4%. Furthermore, soil ingestion was also a non-negligible exposure route, which accounted for 29.7% for Pb. The combined oral non-carcinogenic and carcinogenic risks all exceeding the corresponding maximum acceptable levels. The non-carcinogenic risk was mainly attributed to the food ingestion of As and Cr, and the soil ingestion of As, while, the carcinogenic risk was mainly attributed to the food ingestion of As and Cr, and the soil ingestion of Cr. This study emphasizes attentions should be paid to children in urban areas due to the potential adverse health risk associated with metals via oral exposure pathway.

Analysis of soil risk characteristics by comprehensive assessment in an industrial area of China

Soil pollution in industrial areas poses a major challenge for China's environmental protection. In this study, comprehensive assessment methodologies for soil risk in industrial areas were developed. The comprehensive assessment covered ecological and human health risks of soil pollution, as well as vulnerability of different types of risk receptors. Comprehensive ecological risk assessment integrated potential ecological risk assessment and landscape vulnerability assessment. Comprehensive social risk assessment specialized human health risk assessment by introducing spatial distribution of population. A typical industrial area in China was studied, and the quantitative and spatial assessments of the comprehensive soil risk were presented. The results showed that the spatial distribution of soil comprehensive ecological and social risks differed. High-risk areas of soil comprehensive ecological risk in the study area were mainly farmlands and nature reserves. Inhabited areas and industrial zones were less affected by comprehensive ecological risk of soil. By contrast, the spatial distribution of soil comprehensive social risk and human activities showed a clear trend of convergence. Vulnerability assessment of the risk receptors provided a suitable complement to the risk assessment of soil pollution.

A soil ingestion pilot study for teenage children in China

Soil ingestion by people is an important route of exposure to environmental contaminants. Studies on soil ingestion using tracer mass-balance method are mainly for young children and adults, scarcely for teenagers. In such case, the soil ingestion rate for teenagers recommended by regulators is generally identical to that of adults based on one activity pattern modeling study. However, teenagers are expected to have different soil ingestion exposure via ingestion pathway due to different activity patterns and exposure scenarios. We conducted a pilot study on soil ingestion in 30 teenage children aged 12.0-16.5 years from Hubei Province of China, using the best tracer method, with the results compared with previous soil ingestion studies. The estimated mean and median soil ingestion rates for teenagers in this study based on the best five tracers (Al, Ce, Sc, V, and Y) were 45.2 mg d^-1 and 44.8 mg d^-1 respectively, with the 95% confidence interval of the mean value ranging from 28.0 mg d^-1 to 50.9 mg d^-1. These soil ingestion rate estimates were slightly higher than the recommended values for adults by U.S. EPA, but lower than those for Chinese younger children observed in the other similar study. The result in this study is important to access the health risk resulting from exposure to toxic substances in soil via direct soil ingestion pathway by teenagers in China as well as other countries.

Heavy metal bioaccessibility and health risks in the contaminated soil of an abandoned, small-scale lead and zinc mine

The lack of management in small-scale mining operations has the potential for negative repercussions, e.g., mine collapses, compared with well-regulated large-scale mines. Here, we used an in vitro model to investigate heavy metal soil pollution characteristics and their attendant health risks in an abandoned, small-scale lead (Pb) and zinc (Zn) mine located in southwestern China that had suffered from collapse. Our results showed the following: (1) Even the mine had been closed for many years, the soil was still heavily polluted by Pb, cadmium (Cd), and Zn, and there is a risk of secondary pollution. Pb, Zn, and Cd concentrations in the mining areas were all approximately 22-42 times higher than the background soil levels of Guangxi Province. (2) Cd had the largest bioaccessibility, and mining areas tend to have soils containing more bioaccessible metals (78 ± 14%, 27 ± 4%, and 38 ± 12% for Cd, Pb, and Zn in gastric phase and 40 ± 12%, 10 ± 5%, and 19 ± 8% in intestinal phase correspondingly). (3) Results of a stepwise, multiple regression analysis revealed that the total soil content of the three metals (Pb, Zn, and Cd), TOC (total organic carbon), soil composition, and Mn content were the main impact factors for the Pb, Cd, and Zn soil bioaccessibility in study area (R² = 0.37~0.93). (4) A health risk assessment based on Pb, Cd, and Zn bioaccessibility indicated that the health risk for people in mine area is not high (HI is 1.07 at most and CR 2.40E-6 at most for children).

Child soil ingestion in rural Ghana - frequency, caregiver perceptions, relationship with household floor material and associations with child diarrhoea

OBJECTIVES

The objectives of this work were to evaluate (i) the prevalence and frequency of caregiver-reported soil ingestion by children, (ii) whether household flooring material in the bedroom (earth vs. concrete) affected caregiver-reported soil ingestion, (iii) whether caregiver-reported soil ingestion was associated with caregiver-reported diarrhoea and (iv) caregivers' perceptions of their children ingesting soil.

METHODS

We conducted 309 household surveys in northern Ghana, including 529 children under five (249 children aged 6-36 months), and measured faecal contamination in soil from 31 households.

RESULTS

Among all children, 15% were reported to have directly ingested soil in the past week, including 28% of children aged 6-36 months. Among children reported to have ingested soil, the median frequency was 14 times in the past week, and the median amount of soil ingested each time was half a handful. There was no association between household floor material and whether the caregiver observed a child directly ingesting soil. After adjusting for household floor material and other potential confounding variables, caregiver-reported soil ingestion was associated with caregiver-reported diarrhoea for children under five [adjusted odds ratio (adj. OR) = 3.13, 95% confidence interval (CI) 2.76-3.55] and children aged 6-36 months (adj. OR = 2.61, 95% CI 2.01-3.39). Approximately 83% of caregivers whose children ingested soil reported they thought it was unsafe and were more likely to report stopping their child from ingesting soil, but these responses did not affect the quantity of soil ingested.

CONCLUSIONS

Our results suggest direct soil ingestion is associated with diarrhoea independent of household floor material, and separate interventions may be necessary to prevent exploratory soil ingestion.

Per- and Polyfluoroalkyl Substances (PFASs) in Indoor Air and Dust from Homes and Various Microenvironments in China: Implications for Human Exposure

A newly developed solid-phase extraction cartridge composed of mixed sorbents was optimized for collection of both neutral and ionizable per- and polyfluoroalkyl substances (PFASs) in indoor air. Eighty-one indoor air samples and 29 indoor dust samples were collected from rooms of homes and hotels, textile shops, and cinemas in Tianjin, China. Fluorotelomer alcohols (FTOHs) were the predominant PFASs found in air (250-82 300 pg/m³) and hotel dust (24.8-678 ng/g). Polyfluoroalkyl phosphoric acid diesters were found at lower levels of nd-125 pg/m³ in air and 0.32-183 ng/g in dust. Perfluoroalkyl carboxylic acids (PFCAs) were dominant ionizable PFASs in air samples (121-20 600 pg/m³) with C4-C7 PFCAs contributing to 54% ± 17% of the profiles, suggesting an ongoing shift to short-chain PFASs. Long-chain PFCAs (C > 7) were strongly correlated and the intermediate metabolite of FTOHs, fluorotelomer unsaturated carboxylic acids, occurred in all the air samples at concentrations up to 413 pg/m³, suggesting the transformation of precursors such as FTOHs in indoor environment. Daily intake of ∑PFASs via air inhalation and dust ingestion was estimated at 1.04-14.1 ng/kg bw/d and 0.10-8.17 ng/kg bw/d, respectively, demonstrating that inhalation of air with fine suspended particles was a more important direct exposure pathway than dust ingestion for PFASs to adults.