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George CM, Zacher T, Endres K, Richards F, Bear Robe L, Harvey D, Best LG, Red Cloud R, Black Bear A, Skinner L, Cuny C, Rule A, Schwab KJ, Gittelsohn J, Glabonjat RA, Schilling K, O’Leary M, Thomas ED, Umans J, Zhu J, Moulton LH, Navas-Acien A. Effect of an Arsenic Mitigation Program on Arsenic Exposure in American Indian Communities: A Cluster Randomized Controlled Trial of the Community-Led Strong Heart Water Study Program. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:37007. [PMID: 38534131 PMCID: PMC10967367 DOI: 10.1289/ehp12548] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/12/2023] [Accepted: 01/24/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Chronic arsenic exposure has been associated with an increased risk of cardiovascular disease; diabetes; cancers of the lung, pancreas and prostate; and all-cause mortality in American Indian communities in the Strong Heart Study. OBJECTIVE The Strong Heart Water Study (SHWS) designed and evaluated a multilevel, community-led arsenic mitigation program to reduce arsenic exposure among private well users in partnership with Northern Great Plains American Indian Nations. METHODS A cluster randomized controlled trial (cRCT) was conducted to evaluate the effectiveness of the SHWS arsenic mitigation program over a 2-y period on a) urinary arsenic, and b) reported use of arsenic-safe water for drinking and cooking. The cRCT compared the installation of a point-of-use arsenic filter and a mobile Health (mHealth) program (3 phone calls; SHWS mHealth and Filter arm) to a more intensive program, which included this same program plus three home visits (3 phone calls and 3 home visits; SHWS Intensive arm). RESULTS A 47% reduction in urinary arsenic [geometric mean ( GM ) = 13.2 to 7.0 μ g / g creatinine] was observed from baseline to the final follow-up when both study arms were combined. By treatment arm, the reduction in urinary arsenic from baseline to the final follow-up visit was 55% in the mHealth and Filter arm (GM = 14.6 to 6.55 μ g / g creatinine) and 30% in the Intensive arm (GM = 11.2 to 7.82 μ g / g creatinine). There was no significant difference in urinary arsenic levels by treatment arm at the final follow-up visit comparing the Intensive vs. mHealth and Filter arms: GM ratio of 1.21 (95% confidence interval: 0.77, 1.90). In both arms combined, exclusive use of arsenic-safe water from baseline to the final follow-up visit significantly increased for water used for cooking (17% to 53%) and drinking (12% to 46%). DISCUSSION Delivery of the interventions for the community-led SHWS arsenic mitigation program, including the installation of a point-of-use arsenic filter and a mHealth program on the use of arsenic-safe water (calls only, no home visits), resulted in a significant reduction in urinary arsenic and increases in reported use of arsenic-safe water for drinking and cooking during the 2-y study period. These results demonstrate that the installation of an arsenic filter and phone calls from a mHealth program presents a promising approach to reduce water arsenic exposure among private well users. https://doi.org/10.1289/EHP12548.
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Affiliation(s)
- Christine Marie George
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Tracy Zacher
- Missouri Breaks Industries Research Inc., Eagle Butte, South Dakota, USA
| | - Kelly Endres
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Francine Richards
- Missouri Breaks Industries Research Inc., Eagle Butte, South Dakota, USA
| | - Lisa Bear Robe
- Missouri Breaks Industries Research Inc., Eagle Butte, South Dakota, USA
| | | | - Lyle G. Best
- Missouri Breaks Industries Research Inc., Eagle Butte, South Dakota, USA
| | - Reno Red Cloud
- Environmental Resource Department, Oglala Sioux Tribe, Pine Ridge, South Dakota, USA
| | | | - Leslie Skinner
- Missouri Breaks Industries Research Inc., Eagle Butte, South Dakota, USA
| | - Christa Cuny
- Missouri Breaks Industries Research Inc., Eagle Butte, South Dakota, USA
| | - Ana Rule
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kellogg J. Schwab
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Joel Gittelsohn
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ronald Alexander Glabonjat
- Department of Environmental Health Science, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Kathrin Schilling
- Department of Environmental Health Science, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Marcia O’Leary
- Missouri Breaks Industries Research Inc., Eagle Butte, South Dakota, USA
| | - Elizabeth D. Thomas
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jason Umans
- Biomarker, Biochemistry, and Biorepository Core, Medstar Health, Washington, District of Columbia, USA
- Department of Medicine, School of Medicine, Georgetown University, Washington, District of Columbia, USA
| | - Jianhui Zhu
- Biomarker, Biochemistry, and Biorepository Core, Medstar Health, Washington, District of Columbia, USA
| | - Lawrence H. Moulton
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ana Navas-Acien
- Department of Environmental Health Science, Mailman School of Public Health, Columbia University, New York, New York, USA
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Cherian AG, Liu Z, McKie MJ, Almuhtaram H, Andrews RC. Microplastic Removal from Drinking Water Using Point-of-Use Devices. Polymers (Basel) 2023; 15:polym15061331. [PMID: 36987112 PMCID: PMC10054062 DOI: 10.3390/polym15061331] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 03/09/2023] Open
Abstract
The occurrence of microplastics in drinking water has drawn increasing attention due to their ubiquity and unresolved implications regarding human health. Despite achieving high reduction efficiencies (70 to >90%) at conventional drinking water treatment plants (DWTPs), microplastics remain. Since human consumption represents a small portion of typical household water use, point-of-use (POU) water treatment devices may provide the additional removal of microplastics (MPs) prior to consumption. The primary objective of this study was to evaluate the performance of commonly used pour-through POU devices, including those that utilize combinations of granular activated carbon (GAC), ion exchange (IX), and microfiltration (MF), with respect to MP removal. Treated drinking water was spiked with polyethylene terephthalate (PET) and polyvinyl chloride (PVC) fragments, along with nylon fibers representing a range of particle sizes (30–1000 µm) at concentrations of 36–64 particles/L. Samples were collected from each POU device following 25, 50, 75, 100 and 125% increases in the manufacturer’s rated treatment capacity, and subsequently analyzed via microscopy to determine their removal efficiency. Two POU devices that incorporate MF technologies exhibited 78–86% and 94–100% removal values for PVC and PET fragments, respectively, whereas one device that only incorporates GAC and IX resulted in a greater number of particles in its effluent when compared to the influent. When comparing the two devices that incorporate membranes, the device with the smaller nominal pore size (0.2 µm vs. ≥1 µm) exhibited the best performance. These findings suggest that POU devices that incorporate physical treatment barriers, including membrane filtration, may be optimal for MP removal (if desired) from drinking water.
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Zacher T, Endres K, Richards F, Robe LB, Powers M, Yracheta J, Harvey D, Best LG, Red Cloud R, Black Bear A, Ristau S, Aurand D, Skinner L, Cuny C, Gross M, Thomas E, Rule A, Schwab KJ, O'Leary M, Moulton LH, Navas-Acien A, George CM. Evaluation of a water arsenic filter in a participatory intervention to reduce arsenic exposure in American Indian communities: The Strong Heart Water Study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 862:160217. [PMID: 36410482 PMCID: PMC10373100 DOI: 10.1016/j.scitotenv.2022.160217] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 10/10/2022] [Accepted: 11/12/2022] [Indexed: 06/16/2023]
Abstract
Many rural populations, including American Indian communities, that use private wells from groundwater for their source of drinking and cooking water are disproportionately exposed to elevated levels of arsenic. However, programs aimed at reducing arsenic in American Indian communities are limited. The Strong Heart Water Study (SHWS) is a randomized controlled trial aimed at reducing arsenic exposure among private well users in American Indian Northern Great Plains communities. The community-led SHWS program installed point-of-use (POU) arsenic filters in the kitchen sink of households, and health promoters delivered arsenic health communication programs. In this study we evaluated the efficacy of these POU arsenic filters in removing arsenic during the two-year installation period. Participants were randomized into two arms. In the first arm households received a POU arsenic filter, and 3 calls promoting filter use (SHWS mobile health (mHealth) & filter arm). The second arm received the same filter and phone calls, and 3 in-person home visits and 3 Facebook messages (SHWS intensive arm) for program delivery. Temporal variability in water arsenic concentrations from the main kitchen faucet was also evaluated. A total of 283 water samples were collected from 50 households with private wells from groundwater (139 filter and 144 kitchen faucet samples). Ninety-three percent of households followed after baseline had filter faucet water arsenic concentrations below the arsenic maximum contaminant level of 10 μg/L at the final visit during our 2 year study period with no difference between study arms (98 % in the intensive arm vs. 94 % in the mHealth & filter arm). No significant temporal variation in kitchen arsenic concentration was observed over the study period (intraclass correlation coefficient = 0.99). This study demonstrates that POU arsenic filters installed for the community participatory SHWS program were effective in reducing water arsenic concentration in study households in both arms, even with delivery of the POU arsenic filter and mHealth program only. Furthermore, we observed limited temporal variability of water arsenic concentrations from kitchen faucet samples collected over time from private wells in our study setting.
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Affiliation(s)
- Tracy Zacher
- Missouri Breaks Industries Research Inc., Eagle Butte, SD, USA
| | - Kelly Endres
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Lisa Bear Robe
- Missouri Breaks Industries Research Inc., Eagle Butte, SD, USA
| | - Martha Powers
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Joseph Yracheta
- Missouri Breaks Industries Research Inc., Eagle Butte, SD, USA
| | - David Harvey
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Indian Health Services, Rockville, MD, USA
| | - Lyle G Best
- Missouri Breaks Industries Research Inc., Eagle Butte, SD, USA
| | - Reno Red Cloud
- Environmental Resource Department, Oglala Sioux Tribe, USA
| | | | - Steve Ristau
- Mid Continent Testing Labs, Inc, Rapid City, SD, USA
| | - Dean Aurand
- Mid Continent Testing Labs, Inc, Rapid City, SD, USA
| | - Leslie Skinner
- Missouri Breaks Industries Research Inc., Eagle Butte, SD, USA
| | - Christa Cuny
- Missouri Breaks Industries Research Inc., Eagle Butte, SD, USA
| | - Marie Gross
- Missouri Breaks Industries Research Inc., Eagle Butte, SD, USA
| | - Elizabeth Thomas
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ana Rule
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kellogg J Schwab
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Marcia O'Leary
- Missouri Breaks Industries Research Inc., Eagle Butte, SD, USA
| | - Lawrence H Moulton
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ana Navas-Acien
- Department of Environmental Health Science, Mailman School of Public Health, Columbia University, NY, New York, USA
| | - Christine Marie George
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Arienzo MM, Saftner D, Bacon SN, Robtoy E, Neveux I, Schlauch K, Carbone M, Grzymski J. Naturally occurring metals in unregulated domestic wells in Nevada, USA. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 851:158277. [PMID: 36029812 PMCID: PMC9588670 DOI: 10.1016/j.scitotenv.2022.158277] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 08/18/2022] [Accepted: 08/21/2022] [Indexed: 05/26/2023]
Abstract
The dominant source of drinking water in rural Nevada, United States, is privately-owned domestic wells. Because the water from these wells is unregulated with respect to government guidelines, it is the owner's responsibility to test their groundwater for heavy metals and other contaminants. Arsenic, lead, cadmium, and uranium have been previously measured at concentrations above Environmental Protection Agency (EPA) guidelines in Nevada groundwater. This is a public health concern because elevated levels of these metals are known to have negative health effects. We recruited individuals through a population health study, the Healthy Nevada Project, to submit drinking water samples from domestic wells for testing. Water samples were returned from 174 households with private wells. We found 22 % had arsenic concentrations exceeding the EPA maximum contaminant level (MCL) of 10 μg/L. Additionally, federal, state, or health-based guidelines were exceeded for 8 % of the households for uranium and iron, 6 % for lithium and manganese, 4 % for molybdenum, and 1 % for lead. The maximum observed concentrations of arsenic, uranium, and lead were ∼80, ∼5, and ∼1.5 times the EPA guideline values, respectively. 41 % of households had a treatment system and submitted both pre- and post-treatment water samples from their well. The household treatments were shown to reduce metal concentrations, but concentrations above guideline values were still observed. Many treatment systems cannot reduce the concentration below guideline values because of water chemistry, treatment failure, or improper treatment techniques. These results show the pressing need for continued education and outreach on regular testing of domestic well waters, proper treatment types, and health effects of metal contamination. These findings are potentially applicable to other arid areas where groundwater contamination of naturally occurring heavy metals occurs.
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Affiliation(s)
- Monica M Arienzo
- Division of Hydrologic Sciences, Desert Research Institute, Reno, NV, USA.
| | - Daniel Saftner
- Division of Hydrologic Sciences, Desert Research Institute, Reno, NV, USA
| | - Steven N Bacon
- Division of Hydrologic Sciences, Desert Research Institute, Reno, NV, USA
| | - Erika Robtoy
- Division of Hydrologic Sciences, Desert Research Institute, Reno, NV, USA
| | - Iva Neveux
- Center for Genomic Medicine, Desert Research Institute, Reno, NV, USA
| | - Karen Schlauch
- Center for Genomic Medicine, Desert Research Institute, Reno, NV, USA
| | | | - Joseph Grzymski
- Center for Genomic Medicine, Desert Research Institute, Reno, NV, USA; Renown Health, Reno, NV, USA
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Cooksey E, Verhougstraete M, Sneed SJ, Joseph CN, Blohm J, Paukgana M, Joshweseoma L, Sehongva G, Hadeed S, Harris R, O’Rourke MK. Drinking water and health assessment in a Northern Arizona community. HUMAN AND ECOLOGICAL RISK ASSESSMENT : HERA 2022; 29:157-173. [PMID: 37502498 PMCID: PMC10373582 DOI: 10.1080/10807039.2022.2146575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 11/08/2022] [Accepted: 11/08/2022] [Indexed: 07/29/2023]
Abstract
Arizona is a mineral rich state that relies on a mix of surface and ground water supplies for drinking water requirements. Small, rural water systems relying on groundwater frequently encounter elevated metal(loid) measures, particularly inorganic arsenic (As +3, +5). Such contaminant occurrences can be associated with adverse health outcomes including cancers. The Hopi Environmental Health Project examined drinking water quality and water consumption behaviors from 76 homes on Hopi lands over a four-year period. Water samples were analyzed for 28 elements and compared to US Environmental Protection Agengy (EPA) maximum contaminant levels (MCL). Only municipal/piped water had a mean arsenic concentration (11.01 μg/L) exceeding the MCL (10.0 μg/L). All other water types and elements occurred below MCL when detected. A lifetime cancer and hazard quotient associated with arsenic consumption through each water type was performed and piped/municipal water was found to carry the greatest risks (9.96 cases per 10,000 people). Results from this study showed the potential for multiple contaminants to be present in drinking water from Hopi lands and the need for further health assessment of routine exposure to low doses of contaminant mixtures through drinking water.
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Affiliation(s)
- Emily Cooksey
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Marc Verhougstraete
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Sam J. Sneed
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Carrie Nuva Joseph
- School of Sustainable Engineering and the Built Environment, Arizona State University, Tempe, AZ, USA
| | - Jonathan Blohm
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | | | | | | | - Steven Hadeed
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Robin Harris
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Mary Kay O’Rourke
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
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Langston ME, Brown HE, Lynch CF, Roe DJ, Dennis LK. Ambient UVR and Environmental Arsenic Exposure in Relation to Cutaneous Melanoma in Iowa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031742. [PMID: 35162766 PMCID: PMC8835255 DOI: 10.3390/ijerph19031742] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/28/2022] [Accepted: 01/28/2022] [Indexed: 12/23/2022]
Abstract
Intermittent sun exposure is the major environmental risk factor for cutaneous melanoma (CM). Cumulative sun exposure and other environmental agents, such as environmental arsenic exposure, have not shown consistent associations. Ambient ultraviolet radiation (UVR) was used to measure individual total sun exposure as this is thought to be less prone to misclassification and recall bias. Data were analyzed from 1096 CM cases and 1033 controls in the Iowa Study of Skin Cancer and Its Causes, a population-based, case-control study. Self-reported residential histories were linked to satellite-derived ambient UVR, spatially derived environmental soil arsenic concentration, and drinking water arsenic concentrations. In men and women, ambient UVR during childhood and adolescence was not associated with CM but was positively associated during adulthood. Lifetime ambient UVR was positively associated with CM in men (OR for highest vs. lowest quartile: 6.09, 95% confidence interval (CI) 2.21–16.8), but this association was not as strong among women (OR for highest vs. lowest quartile: 2.15, 95% CI 0.84–5.54). No association was detected for environmental soil or drinking water arsenic concentrations and CM. Our findings suggest that lifetime and adulthood sun exposures may be important risk factors for CM.
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Affiliation(s)
- Marvin E. Langston
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (H.E.B.); (D.J.R.); (L.K.D.)
- Correspondence:
| | - Heidi E. Brown
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (H.E.B.); (D.J.R.); (L.K.D.)
| | - Charles F. Lynch
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA;
| | - Denise J. Roe
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (H.E.B.); (D.J.R.); (L.K.D.)
| | - Leslie K. Dennis
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (H.E.B.); (D.J.R.); (L.K.D.)
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA;
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Under-Sink Activated Carbon Water Filters Effectively Remove Lead from Private Well Water for over Six Months. WATER 2020. [DOI: 10.3390/w12123584] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Children who rely on private well water in the United States have been shown to be at greater risk of having elevated blood lead levels. Evidence-based solutions are needed to prevent drinking water lead exposure among private well users, but minimal data are available regarding the real-world effectiveness of available interventions like point-of-use water treatment for well water. In this study, under-sink activated carbon block water filters were tested for lead and other heavy metals removal in an eight-month longitudinal study in 17 homes relying on private wells. The device removed 98% of all influent lead for the entirety of the study, with all effluent lead levels less than 1 µg/L. Profile sampling in a subset of homes showed that the faucet fixture is a significant source of lead leaching where well water is corrosive. Flushing alone was not capable of reducing first-draw lead to levels below 1 µg/L, but the under-sink filter was found to increase the safety and effectiveness of faucet flushing. The results of this study can be used by individual well users and policymakers alike to improve decision-making around the use of under-sink point-of-use devices to prevent disproportionate lead exposures among private well users.
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Yang Q, Flanagan SV, Chillrud S, Ross J, Zeng W, Culbertson C, Spayd S, Backer L, Smith AE, Zheng Y. Reduction in drinking water arsenic exposure and health risk through arsenic treatment among private well households in Maine and New Jersey, USA. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 738:139683. [PMID: 32535281 PMCID: PMC7429269 DOI: 10.1016/j.scitotenv.2020.139683] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/19/2020] [Accepted: 05/23/2020] [Indexed: 05/13/2023]
Abstract
Over 2 million mostly rural Americans are at risk of drinking water from private wells that contain arsenic (As) exceeding the U.S. Environmental Protection Agency (USEPA) Maximum Contaminant Level (MCL) of 10 micrograms per liter (μg/L). How well existing treatment technologies perform in real world situations, and to what extent they reduce health risks, are not well understood. This study evaluates the effectiveness of household As treatment systems in southern-central Maine (ME, n = 156) and northern New Jersey (NJ, n = 94) and ascertains how untreated well water chemistry and other factors influence As removal. Untreated and treated water samples, as well as a treatment questionnaire, were collected. Most ME households had point-of-use reverse-osmosis systems (POU RO), while in NJ, dual-tank point-of-entry (POE) whole house systems were popular. Arsenic treatment systems reduced well water arsenic concentrations ([As]) by up to two orders of magnitude, i.e. from a median of 71.7 to 0.8 μg/L and from a mean of 105 to 14.3 μg/L in ME, and from a median of 8.6 to 0.2 μg/L and a mean of 15.8 to 2.1 μg/L in NJ. More than half (53%) of the systems in ME reduced water [As] to below 1 μg/L, compared to 69% in NJ. The treatment system failure rates were 19% in ME (>USEPA MCL of 10 μg/L) and 16% in NJ (>NJ MCL of 5 μg/L). In both states, the higher the untreated well water [As] and the As(III)/As ratio, the higher the rate of treatment failure. POE systems failed less than POU systems, as did the treatment systems installed and maintained by vendors than those by homeowners. The 7-fold reduction of [As] in the treated water reduced skin cancer risk alone from 3765 to 514 in 1 million in ME, and from 568 to 75 in 1 million in NJ.
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Affiliation(s)
- Qiang Yang
- Lamont-Doherty Earth Observatory, Columbia University, Palisades, NY 10964, USA
| | - Sara V Flanagan
- Lamont-Doherty Earth Observatory, Columbia University, Palisades, NY 10964, USA
| | - Steven Chillrud
- Lamont-Doherty Earth Observatory, Columbia University, Palisades, NY 10964, USA
| | - James Ross
- Lamont-Doherty Earth Observatory, Columbia University, Palisades, NY 10964, USA
| | - Wenke Zeng
- School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen, Guangdong 518055, China; Lamont-Doherty Earth Observatory, Columbia University, Palisades, NY 10964, USA
| | - Charles Culbertson
- U.S. Geological Survey, New England Water Science Center, Augusta, ME 04330, USA
| | - Steven Spayd
- New Jersey Geological and Water Survey, Trenton, NJ 08625, USA
| | - Lorraine Backer
- National Center for Environmental Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Andrew E Smith
- Maine Department of Health and Human Services, Center for Disease Control and Prevention, Augusta, ME 04333, USA
| | - Yan Zheng
- School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen, Guangdong 518055, China; Lamont-Doherty Earth Observatory, Columbia University, Palisades, NY 10964, USA.
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Munene A, Hall DC. Factors influencing perceptions of private water quality in North America: a systematic review. Syst Rev 2019; 8:111. [PMID: 31077249 PMCID: PMC6511211 DOI: 10.1186/s13643-019-1013-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 04/01/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND An estimated four million and 43 million people in Canada and the USA use private water supplies. Private water supplies are vulnerable to waterborne disease outbreaks. Private water supplies in Canada and the USA are often unregulated and private water management is often a choice left to the owner. Perceptions of water quality become important in influencing the adoption of private water stewardship practices, therefore safeguarding public health. METHODS We conducted a systematic literature review to understand factors that shape perceptions of water quality among private water users. We searched six computer databases (Web of science, Medline, Scopus, EBSCO, PubMed and Agricola). The search was limited to primary peer-reviewed publications, grey literature and excluded conference proceedings, review articles, and non-peer review articles. We restricted the search to papers published in English and to articles which published data on surveys of private water users within Canada and the USA. The search was also restricted to publications from 1986 to 2017. The literature search generated 36,478 records. Two hundred and four full text were reviewed. RESULTS Fifty-two articles were included in the final review. Several factors were found to influence perceptions of water quality including organoleptic preferences, chemical and microbiological contaminants, perceived risks, water well infrastructure, past experience with water quality, external information, demographics, in addition to the values, attitudes, and beliefs held by well owners. CONCLUSIONS Understanding the factors that shape perceptions of water quality among private water users is an important step in developing private water management policies to increase compliance towards water testing and treatment in Canada and the USA. As many jurisdictions in Canada and the USA do not have mandatory private water testing or treatment guidelines, delineating these factors is an important step in informing future research and guiding policy on the public health of private water systems.
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Affiliation(s)
- Abraham Munene
- Department of Ecosystem and Public Health, Faculty of Veterinary Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
| | - David C Hall
- Department of Ecosystem and Public Health, Faculty of Veterinary Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
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Seasonal Variation of Water Quality in Unregulated Domestic Wells. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16091569. [PMID: 31060292 PMCID: PMC6539867 DOI: 10.3390/ijerph16091569] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 04/30/2019] [Accepted: 05/01/2019] [Indexed: 12/01/2022]
Abstract
In the United States (U.S.), up to 14% of the population depend on private wells as their primary drinking water source. The U.S. government does not regulate contaminants in private wells. The goals of this study were to investigate the quality of drinking water from unregulated private wells within one mile (1.6 kilometers) of an effluent-dominated river in the arid Southwest, determine differences in contaminant levels between wet and dry seasons, and identify contributions from human sources by specifically measuring man-made organic contaminants (perfluorooctanoic acid (PFOA), perfluorooctane sulfate (PFOS), and sucralose). Samples were collected during two dry seasons and two wet seasons over the course of two years and analyzed for microbial (Escherichia coli), inorganic (arsenic, cadmium, chromium, copper, lead, mercury, nitrate), and synthetic organic (PFOA, PFOS, and sucralose) contaminants. Arsenic, nitrate, and Escherichia coli concentrations exceeded their respective regulatory levels of 0.01 mg/L, 10 mg/L, and 1 colony forming unit (CFU)/100 mL, respectively. The measured concentrations of PFOA and PFOS exceeded the respective Public Health Advisory level. Arsenic, PFOA, PFOS, and sucralose were significantly higher during the dry seasons, whereas E. coli was higher during the wet seasons. While some contaminants were correlated (e.g., As and Hg ρ = 0.87; PFOA and PFOS ρ = 0.45), the lack of correlation between different contaminant types indicates that they may arise from different sources. Multi-faceted interventions are needed to reduce exposure to drinking water above health-based guidelines.
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Thomas ED, Gittelsohn J, Yracheta J, Powers M, O'Leary M, Harvey DE, Red Cloud R, Best LG, Black Bear A, Navas-Acien A, George CM. The Strong Heart Water Study: Informing and designing a multi-level intervention to reduce arsenic exposure among private well users in Great Plains Indian Nations. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 650:3120-3133. [PMID: 30373089 PMCID: PMC10472338 DOI: 10.1016/j.scitotenv.2018.09.204] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/11/2018] [Accepted: 09/16/2018] [Indexed: 05/18/2023]
Abstract
Elevated arsenic exposure from drinking water is associated with an increased risk of cardiovascular disease, diabetes, kidney disease, and skin, lung, and bladder cancer. Arsenic contamination in groundwater supplies disproportionately affects rural populations using private wells. Arsenic mitigation programs for American Indian communities are limited. There is an urgent need for targeted approaches to reduce arsenic exposure for at-risk communities using private wells. Formative research was conducted to inform and design a community-based arsenic mitigation intervention for Lakota and Dakota Nations in the Great Plains Area of the United States, where, in some communities, one-quarter of private wells are estimated to have elevated arsenic. Formative research included semi-structured interviews, a community workshop, intervention-planning workshops, and a pilot study of the developed intervention. Community members prioritize aesthetic qualities of water (e.g. taste, color), safety, and other situational factors (e.g. cost) when considering their drinking and cooking water. Although water safety is a concern, awareness and concern for arsenic vary substantially within communities. To reduce arsenic exposure, community members recommended communication of water test results, home visits for intervention delivery, and reminders to use arsenic-safe water. Findings informed the development of an intervention to prevent arsenic exposure through drinking water and cooking, including health promotion messages and household items to facilitate use of an arsenic removal device (e.g. tankards to store filtered water). The pilot study indicated promising acceptability and operability of the developed intervention. This research provides a model for the development of environmental health interventions in partnership with American Indian and other private well-using communities.
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Affiliation(s)
- Elizabeth D Thomas
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
| | - Joel Gittelsohn
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
| | - Joseph Yracheta
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, USA; Missouri Breaks Industries Research, Inc., 118 South Willow Street, P.O. Box 1824, Eagle Butte, SD 57625, USA.
| | - Martha Powers
- Missouri Breaks Industries Research, Inc., 118 South Willow Street, P.O. Box 1824, Eagle Butte, SD 57625, USA.
| | - Marcia O'Leary
- Missouri Breaks Industries Research, Inc., 118 South Willow Street, P.O. Box 1824, Eagle Butte, SD 57625, USA.
| | - David E Harvey
- The Indian Health Service, 5600 Fishers Ln, Rockville, MD 20857, USA.
| | | | - Lyle G Best
- Missouri Breaks Industries Research, Inc., 118 South Willow Street, P.O. Box 1824, Eagle Butte, SD 57625, USA.
| | - Annabelle Black Bear
- Missouri Breaks Industries Research, Inc., 209 West Main Street, Martin, SD 57551, USA.
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY 10032, USA.
| | - Christine Marie George
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
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12
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Selmin OI, Donovan MG, Skovan B, Paine-Murieta GD, Romagnolo DF. Arsenic‑induced BRCA1 CpG promoter methylation is associated with the downregulation of ERα and resistance to tamoxifen in MCF7 breast cancer cells and mouse mammary tumor xenografts. Int J Oncol 2019; 54:869-878. [PMID: 30664189 PMCID: PMC6365020 DOI: 10.3892/ijo.2019.4687] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 12/03/2018] [Indexed: 02/07/2023] Open
Abstract
A significant percentage (~30%) of estrogen receptor-α (ERα)-positive tumors become refractory to endocrine therapies; however, the mechanisms responsible for this resistance remain largely unknown. Chronic exposure to arsenic through foods and contaminated water has been linked to an increased incidence of several tumors and long-term health complications. Preclinical and population studies have indicated that arsenic exposure may interfere with endocrine regulation and increase the risk of breast tumorigenesis. In this study, we examined the effects of sodium arsenite (NaAsIII) exposure in ERα-positive breast cancer cells in vitro and in mammary tumor xenografts. The results revealed that acute (within 4 days) and long-term (10 days to 7 weeks) in vitro exposure to environmentally relevant doses reduced breast cancer 1 (BRCA1) and ERα expression associated with the gain of cyclin D1 (CCND1) and folate receptor 1 (FOLR1), and the loss of methylenetetrahydrofolate reductase (MTHFR) expression. Furthermore, long-term exposure to NaAsIII induced the proliferation and compromised the response of MCF7 cells to tamoxifen (TAM). The in vitro exposure to NaAsIII induced BRCA1 CpG methylation associated with the increased recruitment of DNA methyltransferase 1 (DNMT1) and the loss of RNA polymerase II (PolII) at the BRCA1 gene. Xenografts of NaAsIII-preconditioned MCF7 cells (MCF7NaAsIII) into the mammary fat pads of nude mice produced a larger tumor volume compared to tumors from control MCF7 cells and were more refractory to TAM in association with the reduced expression of BRCA1 and ERα, CpG hypermethylation of estrogen receptor 1 (ESR1) and BRCA1, and the increased expression of FOLR1. These cumulative data support the hypothesis that exposure to AsIII may contribute to reducing the efficacy of endocrine therapy against ERα-positive breast tumors by hampering the expression of ERα and BRCA1 via CpG methylation, respectively of ESR1 and BRCA1.
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Affiliation(s)
- Ornella I Selmin
- The University of Arizona Cancer Center, The University of Arizona, Tucson, AZ 85724, USA
| | - Micah G Donovan
- Cancer Biology Graduate Interdisciplinary Program, The University of Arizona, Tucson, AZ 85724, USA
| | - Bethany Skovan
- The University of Arizona Cancer Center, The University of Arizona, Tucson, AZ 85724, USA
| | | | - Donato F Romagnolo
- The University of Arizona Cancer Center, The University of Arizona, Tucson, AZ 85724, USA
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13
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Brown KW, Gessesse B, Butler LJ, MacIntosh DL. Potential Effectiveness of Point-of-Use Filtration to Address Risks to Drinking Water in the United States. ENVIRONMENTAL HEALTH INSIGHTS 2017; 11:1178630217746997. [PMID: 29270018 PMCID: PMC5731620 DOI: 10.1177/1178630217746997] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 11/16/2017] [Indexed: 05/25/2023]
Abstract
Numerous contemporary incidents demonstrate that conventional control strategies for municipal tap water have limited ability to mitigate exposures to chemicals whose sources are within distribution systems, such as lead, and chemicals that are not removed by standard treatment technologies, such as perfluorooctanoic acid (PFOA)/perfluorooctanesulfonic acid (PFOS). In these situations, point-of-use (POU) controls may be effective in mitigating exposures and managing health risks of chemicals in drinking water, but their potential utility has not been extensively examined. As an initial effort to fill this information gap, we conducted a critical review and analysis of the existing literature and data on the effectiveness of POU drinking water treatment technologies for reducing chemical contaminants commonly found in tap water in the United States. We found that many types of water treatment devices available to consumers in the United States have undergone laboratory testing and often certification for removal of chemical contaminants in tap water, but in most cases their efficacy in actual use has yet to be well characterized. In addition, the few studies of POU devices while "in use" focus on traditional contaminants regulated under the Safe Drinking Water Act, but do not generally consider nontraditional contaminants of concern, such as certain novel human carcinogens, industrial chemicals, pesticides, pharmaceuticals, personal care products, and flame retardants. Nevertheless, the limited information available at present suggests that POU devices can be highly effective when used prophylactically and when deployed in response to contamination incidents. Based on these findings, we identify future areas of research for assessing the ability of POU filters to reduce health-related chemical contaminants distributed through public water systems and private wells.
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Affiliation(s)
| | | | - Lindsey J Butler
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - David L MacIntosh
- Environmental Health & Engineering Inc., Needham, MA, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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14
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Malecki KMC, Schultz AA, Severtson DJ, Anderson HA, VanDerslice JA. Private-well stewardship among a general population based sample of private well-owners. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 601-602:1533-1543. [PMID: 28605871 PMCID: PMC5662198 DOI: 10.1016/j.scitotenv.2017.05.284] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 05/26/2017] [Accepted: 05/31/2017] [Indexed: 05/12/2023]
Abstract
Private well stewardship, including on-going testing and treatment, can ensure private well users are able to maintain source-water quality and prevent exposures to potentially harmful constituents in primary drinking water supplies. Unlike municipal water supplies, private well users are largely responsible for their own testing and treatment and well stewardship is often minimal. The importance of factors influencing regular testing, and treatment behaviors, including knowledge, risk perception, convenience and social norms, can vary by geography and population characteristics. The primary goals of this study were to survey a general statewide population of private well users in Wisconsin in order to quantify testing and treatment patterns and gather data on motivations and barriers to well stewardship. The majority of respondents reported using and drinking well water daily but only about one half of respondents reported testing their wells in the last ten years and of these, only 10% reported testing in the last 12months. Bacteria and nitrates were contaminants most often tested; and, a private laboratory most often conducted testing. The most commonly reported water treatment was a water softener. Living in a particular geographic region and income were the most significant predictors of water testing and treatment. Iron and hardness, which influence water aesthetics but not always safety, were the most commonly reported water quality problems. Health concerns or perceived lack thereof were, respectively, motivators and barriers to testing and treatment. Limited knowledge of testing and treatment options were also identified as barriers. Results confirm previous findings that well stewardship practices are minimal and often context specific. Understanding the target population's perceptions of risk and knowledge are important elements to consider in identifying vulnerable populations and developing education and policy efforts to improve well stewardship.
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Affiliation(s)
- Kristen M C Malecki
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, United States.
| | - Amy A Schultz
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, United States
| | | | - Henry A Anderson
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, United States
| | - James A VanDerslice
- Department of Family and Preventive Medicine, University of Utah School of Medicine, United States
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15
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Barnaby R, Liefeld A, Jackson BP, Hampton TH, Stanton BA. Effectiveness of table top water pitcher filters to remove arsenic from drinking water. ENVIRONMENTAL RESEARCH 2017; 158:610-615. [PMID: 28719869 PMCID: PMC5571974 DOI: 10.1016/j.envres.2017.07.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 07/07/2017] [Accepted: 07/08/2017] [Indexed: 05/14/2023]
Abstract
Arsenic contamination of drinking water is a serious threat to the health of hundreds of millions of people worldwide. In the United States ~3 million individuals drink well water that contains arsenic levels above the Environmental Protection Agency (EPA) maximum contaminant level (MCL) of 10μg/L. Several technologies are available to remove arsenic from well water including anion exchange, adsorptive media and reverse osmosis. In addition, bottled water is an alternative to drinking well water contaminated with arsenic. However, there are several drawbacks associated with these approaches including relatively high cost and, in the case of bottled water, the generation of plastic waste. In this study, we tested the ability of five tabletop water pitcher filters to remove arsenic from drinking water. We report that only one tabletop water pitcher filter tested, ZeroWater®, reduced the arsenic concentration, both As3+ and As5+, from 1000μg/L to < 3μg/L, well below the MCL. Moreover, the amount of total dissolved solids or competing ions did not affect the ability of the ZeroWater® filter to remove arsenic below the MCL. Thus, the ZeroWater® pitcher filter is a cost effective and short-term solution to remove arsenic from drinking water and its use reduces plastic waste associated with bottled water.
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Affiliation(s)
- Roxanna Barnaby
- Department of Microbiology and Immunology, The Geisel School of Medicine at Dartmouth, Hanover, NH 03755, United States.
| | - Amanda Liefeld
- Department of Microbiology and Immunology, The Geisel School of Medicine at Dartmouth, Hanover, NH 03755, United States.
| | - Brian P Jackson
- Department of Earth Sciences, Dartmouth College, Hanover, NH 03755, United States.
| | - Thomas H Hampton
- Department of Microbiology and Immunology, The Geisel School of Medicine at Dartmouth, Hanover, NH 03755, United States.
| | - Bruce A Stanton
- Department of Microbiology and Immunology, The Geisel School of Medicine at Dartmouth, Hanover, NH 03755, United States.
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16
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Abstract
PURPOSE OF REVIEW Many thousands of research papers have been published on the occurrence, health effects, and mitigation of arsenic in drinking water sourced from groundwater around the world. Here, an attempt is made to summarize this large body of knowledge into a small number of lessons. RECENT FINDINGS This is an opinion paper reflecting on why we are far from the goal of eliminating this silent and widespread poison to protect the health of many millions. The lessons are drawn from research in countries representing a range of economic development and cultural contexts. The replacement of household wells with centralized water supplies has reduced population level exposure to moderate (50-100 μg/L) and high (>100 μg/L) levels of arsenic in drinking water in some countries as they become wealthier. However, there remains a very large rural population in all countries where the exposure to low levels (10-50 μg/L) of arsenic continues due to its dispersed occurrence in the environment and frequent reliance on private well. A set of natural (geological and biological), socioeconomic, and behavioral barriers to progress are summarized as lessons. They range from challenges in identifying the exposed households due to spatially heterogeneous arsenic distribution in groundwater, difficulties in quantifying the exposure let alone reducing the exposure, failures in maintaining compliance to arsenic drinking water standards, to misplaced risk perceptions and environmental justice issues. Environmental health professionals have an ethical obligation to help As mitigation among private well water households, along with physicians, hydrogeologists, water treatment specialists, community organizations, and government.
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Affiliation(s)
- Yan Zheng
- School of Environmental Science and Engineering and Shenzhen Key Laboratory of Soil and Groundwater Pollution Control, Southern University of Science and Technology, Shenzhen, 518055, China.
- Lamont-Doherty Earth Observatory of Columbia University, Palisades, NY, 10964, USA.
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17
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Bitew BD, Gete YK, Biks GA, Adafrie TT. Knowledge, Attitude, and Practice of Mothers/Caregivers on Household Water Treatment Methods in Northwest Ethiopia: A Community-Based Cross-Sectional Study. Am J Trop Med Hyg 2017; 97:914-922. [PMID: 28722624 DOI: 10.4269/ajtmh.16-0860] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
In Ethiopia, ensuring safe drinking water remains a big challenge where waterborne diseases, including diarrhea cause a great harm in many rural communities. Limited knowledge, misinformation, negative attitude, and lack of experience toward best practices of alternative water treatment technologies were among the leading challenges. A community-based cross-sectional study was conducted from June 23 to 30, 2015, in Dabat District. The study participants were selected by using simple random sampling method. Questionnaire-based face-to-face interview technique of data collection was used by 20 data collectors under close supervision with six supervisors. From the total of 845 participants with mother-child paired 49.3%, 95% confidence interval [CI] (45.8, 52.5%) had good knowledge, and 54.8%, 95% CI (51.6, 58.3%) had favorable-attitude toward household water treatment. Only 23.1%, 95%CI (20, 26%) of the study participants had practiced household water treatment. Being an urban resident (adjusted odds ratio [AOR]: 2.58, 95% CI: [1.62, 4.11]), having good-knowledge (AOR: 2.62, 95% CI: [1.81, 3.79]), favorable attitude (AOR: 1.45, 95% CI: [1.01, 2.08]), and used unimproved water source (AOR: 1.67, 95% CI: [1.11, 2.50]) were factors associated with household water treatment practices in the district. Despite mothers/caregivers having a fairly good knowledge and positive attitude, their practice of treating drinking water at household level was quite low. Thus, well designed strategy for health education on effective water treatment methods through the national health extension program is recommended.
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Affiliation(s)
- Bikes Destaw Bitew
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yigzaw Kebede Gete
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gashaw Andargie Biks
- Department of Health Service Management and Health Economics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Takele Tadesse Adafrie
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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18
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Flanagan SV, Spayd SE, Procopio NA, Marvinney RG, Smith AE, Chillrud SN, Braman S, Zheng Y. Arsenic in private well water part 3 of 3: Socioeconomic vulnerability to exposure in Maine and New Jersey. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 562:1019-1030. [PMID: 27118035 PMCID: PMC5204458 DOI: 10.1016/j.scitotenv.2016.03.217] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 03/27/2016] [Accepted: 03/28/2016] [Indexed: 05/23/2023]
Abstract
Arsenic is a naturally occurring toxic element often concentrated in groundwater at levels unsafe for human consumption. Private well water in the United States is mostly unregulated by federal and state drinking water standards. It is the responsibility of the over 13 million U.S. households regularly depending on private wells for their water to ensure it is safe for drinking. There is a consistent graded association with health outcomes at all levels of socioeconomic status (SES) in the U.S. Differential exposure to environmental risk may be contributing to this persistent SES-health gradient. Environmental justice advocates cite overwhelming evidence that income and other SES measures are consistently inversely correlated with exposure to suboptimal environmental conditions including pollutants, toxins, and their impacts. Here we use private well household surveys from two states to investigate the association between SES and risks for arsenic exposure, examining the potentially cumulative effects of residential location, testing and treatment behavior, and psychological factors influencing behavior. We find that the distribution of natural arsenic hazard in the environment is socioeconomically random. There is no evidence that higher SES households are avoiding areas with arsenic or that lower SES groups are disproportionately residing in areas with arsenic. Instead, disparities in exposure arise from differing rates of protective action, primarily testing well water for arsenic, and secondly treating or avoiding contaminated water. We observe these SES disparities in behavior as well as in the psychological factors that are most favorable to these behaviors. Assessment of risk should not be limited to the spatial occurrence of arsenic alone. It is important that social vulnerability factors are incorporated into risk modeling and identifying priority areas for intervention, which should include strategies that specifically target socioeconomically vulnerable groups as well as all the conditions which cause these disparities in testing and treatment behavior.
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Affiliation(s)
- Sara V Flanagan
- Columbia University, Lamont-Doherty Earth Observatory, 61 Route 9W, Palisades, NY 10964, USA; Graduate School of Public Health and Health Policy, City University of New York, 55 W 125th Street, New York, NY 10027, USA; New Jersey Department of Environmental Protection, P.O. Box 420, Trenton, NJ 08625-0420, USA.
| | - Steven E Spayd
- New Jersey Department of Environmental Protection, P.O. Box 420, Trenton, NJ 08625-0420, USA.
| | - Nicholas A Procopio
- New Jersey Department of Environmental Protection, P.O. Box 420, Trenton, NJ 08625-0420, USA.
| | - Robert G Marvinney
- Maine Geological Survey, 93 State House Station, Augusta, ME 04333, USA.
| | - Andrew E Smith
- Maine Department of Health and Human Services, Maine Center for Disease Control and Prevention, 286 Water Street, Augusta, ME 04333, USA.
| | - Steven N Chillrud
- Columbia University, Lamont-Doherty Earth Observatory, 61 Route 9W, Palisades, NY 10964, USA.
| | - Stuart Braman
- Columbia University, Lamont-Doherty Earth Observatory, 61 Route 9W, Palisades, NY 10964, USA.
| | - Yan Zheng
- Columbia University, Lamont-Doherty Earth Observatory, 61 Route 9W, Palisades, NY 10964, USA; Graduate School of Public Health and Health Policy, City University of New York, 55 W 125th Street, New York, NY 10027, USA; Queens College, City University of New York, 65-30 Kissena Blvd, Flushing, NY 11367, USA.
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19
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Flanagan SV, Spayd SE, Procopio NA, Chillrud SN, Braman S, Zheng Y. Arsenic in private well water part 1 of 3: Impact of the New Jersey Private Well Testing Act on household testing and mitigation behavior. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 562:999-1009. [PMID: 27118151 PMCID: PMC5204457 DOI: 10.1016/j.scitotenv.2016.03.196] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 03/27/2016] [Accepted: 03/28/2016] [Indexed: 05/23/2023]
Abstract
Regularly ingesting water with elevated arsenic increases adverse health risks. Since September 2002, the NJ Private Well Testing Act (PWTA) has required testing untreated well water for arsenic during real estate transactions in 12 counties. Its implementation provides an opportunity to investigate the effects of policy intervention on well testing and treatment behavior. Here we analyze results of a survey mailed to 1943 random addresses (37% response), including responses from 502 private well households who purchased their homes prior to PWTA commencement and 168 who purchased after. We find the PWTA has significantly increased arsenic testing rates in an area where 21% of wells contain arsenic above the 5μg/L NJ drinking water standard. The PWTA has allowed identification of more wells with arsenic (20% of post-PWTA vs. 4% of pre-PWTA households) and more treatment for arsenic (19% of post-PWTA vs. 3% of pre-PWTA households). Such an Act is a partial answer to significant socioeconomic disparities in testing observed among households for whom it is not required. Additionally residents purchasing homes since 2002 are younger and disproportionately more likely to have children in their household (60% vs. 32%), a priority group given their particular vulnerability to effects of arsenic. Despite more wells tested under the PWTA, post-PWTA well owners forget or misremember arsenic test results more often, are more likely to report not knowing what kind of treatment they are using, and are not reporting better maintenance or monitoring of their treatment systems than pre-PWTA households. This suggests serious challenges to reducing arsenic exposure remain even when testing is a requirement. Furthermore, only a fraction of wells have been tested under the PWTA due to the slow pace of housing turnover. We recommend more public resources be made available to support private well testing among socially and biologically vulnerable groups.
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Affiliation(s)
- Sara V Flanagan
- Columbia University, Lamont-Doherty Earth Observatory, 61 Route 9W, Palisades, NY 10964, USA; Graduate School of Public Health and Health Policy, City University of New York, 55 W 125th Street, New York, NY 10027, USA; New Jersey Department of Environmental Protection, P.O. Box 420, Trenton, NJ 08625-0420, USA.
| | - Steven E Spayd
- New Jersey Department of Environmental Protection, P.O. Box 420, Trenton, NJ 08625-0420, USA.
| | - Nicholas A Procopio
- New Jersey Department of Environmental Protection, P.O. Box 420, Trenton, NJ 08625-0420, USA.
| | - Steven N Chillrud
- Columbia University, Lamont-Doherty Earth Observatory, 61 Route 9W, Palisades, NY 10964, USA.
| | - Stuart Braman
- Columbia University, Lamont-Doherty Earth Observatory, 61 Route 9W, Palisades, NY 10964, USA.
| | - Yan Zheng
- Columbia University, Lamont-Doherty Earth Observatory, 61 Route 9W, Palisades, NY 10964, USA; Graduate School of Public Health and Health Policy, City University of New York, 55 W 125th Street, New York, NY 10027, USA; Queens College, City University of New York, 65-30 Kissena Blvd, Flushing, NY 11367, USA.
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20
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Loh MM, Sugeng A, Lothrop N, Klimecki W, Cox M, Wilkinson ST, Lu Z, Beamer PI. Multimedia exposures to arsenic and lead for children near an inactive mine tailings and smelter site. ENVIRONMENTAL RESEARCH 2016; 146:331-9. [PMID: 26803211 PMCID: PMC5344033 DOI: 10.1016/j.envres.2015.12.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Revised: 12/06/2015] [Accepted: 12/10/2015] [Indexed: 05/20/2023]
Abstract
Children living near contaminated mining waste areas may have high exposures to metals from the environment. This study investigates whether exposure to arsenic and lead is higher in children in a community near a legacy mine and smelter site in Arizona compared to children in other parts of the United States and the relationship of that exposure to the site. Arsenic and lead were measured in residential soil, house dust, tap water, urine, and toenail samples from 70 children in 34 households up to 7 miles from the site. Soil and house dust were sieved, digested, and analyzed via ICP-MS. Tap water and urine were analyzed without digestion, while toenails were washed, digested and analyzed. Blood lead was analyzed by an independent, certified laboratory. Spearman correlation coefficients were calculated between each environmental media and urine and toenails for arsenic and lead. Geometric mean arsenic (standard deviation) concentrations for each matrix were: 22.1 (2.59) ppm and 12.4 (2.27)ppm for soil and house dust (<63μm), 5.71 (6.55)ppb for tap water, 14.0 (2.01)μg/L for specific gravity-corrected total urinary arsenic, 0.543 (3.22)ppm for toenails. Soil and vacuumed dust lead concentrations were 16.9 (2.03)ppm and 21.6 (1.90) ppm. The majority of blood lead levels were below the limit of quantification. Arsenic and lead concentrations in soil and house dust decreased with distance from the site. Concentrations in soil, house dust, tap water, along with floor dust loading were significantly associated with toenail and urinary arsenic but not lead. Mixed models showed that soil and tap water best predicted urinary arsenic. In our study, despite being present in mine tailings at similar levels, internal lead exposure was not high, but arsenic exposure was of concern, particularly from soil and tap water. Naturally occurring sources may be an additional important contributor to exposures in certain legacy mining areas.
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Affiliation(s)
- Miranda M Loh
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Avenue, P.O. Box 245163, Tucson, AZ 85718, USA.
| | - Anastasia Sugeng
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Avenue, P.O. Box 245163, Tucson, AZ 85718, USA
| | - Nathan Lothrop
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Avenue, P.O. Box 245163, Tucson, AZ 85718, USA
| | - Walter Klimecki
- Department of Pharmacology and Toxicology, College of Pharmacy, The University of Arizona, P.O. Box 210207, Tucson, AZ 85724, USA
| | - Melissa Cox
- Hospital Medicine and Outreach, Department of Pediatrics, Diamond Children's Medical Center, The University of Arizona, 1501 N. Campbell Ave. Tucson, AZ 85724, USA
| | - Sarah T Wilkinson
- Superfund Research Program, The University of Arizona, 1110 E. South Campus Dr., Tucson, AZ 85721, USA
| | - Zhenqiang Lu
- BIO5 Institute, The University of Arizona, 1657 E. Mabel St., Tucson, AZ 85721, USA
| | - Paloma I Beamer
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Avenue, P.O. Box 245163, Tucson, AZ 85718, USA
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