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Lieberman‐Cribbin W, Li Z, Lewin M, Ruiz P, Jarrett JM, Cole SA, Kupsco A, O'Leary M, Pichler G, Shimbo D, Devereux RB, Umans JG, Navas‐Acien A, Nigra AE. The Contribution of Declines in Blood Lead Levels to Reductions in Blood Pressure Levels: Longitudinal Evidence in the Strong Heart Family Study. J Am Heart Assoc 2024; 13:e031256. [PMID: 38205795 PMCID: PMC10926826 DOI: 10.1161/jaha.123.031256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 11/21/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Chronic lead exposure is associated with both subclinical and clinical cardiovascular disease. We evaluated whether declines in blood lead were associated with changes in systolic and diastolic blood pressure in adult American Indian participants from the SHFS (Strong Heart Family Study). METHODS AND RESULTS Lead in whole blood was measured in 285 SHFS participants in 1997 to 1999 and 2006 to 2009. Blood pressure and measures of cardiac geometry and function were obtained in 2001 to 2003 and 2006 to 2009. We used generalized estimating equations to evaluate the association of declines in blood lead with changes in blood pressure; cardiac function and geometry measures were considered secondary. Mean blood lead was 2.04 μg/dL at baseline. After ≈10 years, mean decline in blood lead was 0.67 μg/dL. In fully adjusted models, the mean difference in systolic blood pressure comparing the highest to lowest tertile of decline (>0.91 versus <0.27 μg/dL) in blood lead was -7.08 mm Hg (95% CI, -13.16 to -1.00). A significant nonlinear association between declines in blood lead and declines in systolic blood pressure was detected, with significant linear associations where blood lead decline was 0.1 μg/dL or higher. Declines in blood lead were nonsignificantly associated with declines in diastolic blood pressure and significantly associated with declines in interventricular septum thickness. CONCLUSIONS Declines in blood lead levels in American Indian adults, even when small (0.1-1.0 μg/dL), were associated with reductions in systolic blood pressure. These findings suggest the need to further study the cardiovascular impacts of reducing lead exposures and the importance of lead exposure prevention.
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Affiliation(s)
- Wil Lieberman‐Cribbin
- Department of Environmental Health SciencesColumbia University Mailman School of Public HealthNew YorkNYUSA
| | - Zheng Li
- Office of Capacity Development and Applied Prevention Science, Agency for Toxic Substances and Disease RegistryAtlantaGAUSA
| | - Michael Lewin
- Office of Community Health and Hazard Assessment, Agency for Toxic Substances and Disease RegistryAtlantaGAUSA
| | - Patricia Ruiz
- Office of Innovation and Analytics, Agency for Toxic Substances and Disease RegistryAtlantaGAUSA
| | - Jeffery M. Jarrett
- Division for Laboratory SciencesCenters for Disease Control and PreventionAtlantaGAUSA
| | - Shelley A. Cole
- Population Health ProgramTexas Biomedical Research InstituteSan AntonioTXUSA
| | - Allison Kupsco
- Department of Environmental Health SciencesColumbia University Mailman School of Public HealthNew YorkNYUSA
| | - Marcia O'Leary
- Missouri Breaks Research Industries Research, Inc.Eagle ButteSDUSA
| | - Gernot Pichler
- Department of CardiologyKarl Landsteiner Institute for Cardiovascular and Critical Care Research, Clinic FloridsdorfViennaAustria
| | - Daichi Shimbo
- Division of CardiologyColumbia University Irving Medical CenterNew YorkNYUSA
| | | | - Jason G. Umans
- MedStar Health Research InstituteHyattsvilleMDUSA
- Georgetown‐Howard Universities Center for Clinical and Translational ScienceWashingtonDCUSA
| | - Ana Navas‐Acien
- Department of Environmental Health SciencesColumbia University Mailman School of Public HealthNew YorkNYUSA
| | - Anne E. Nigra
- Department of Environmental Health SciencesColumbia University Mailman School of Public HealthNew YorkNYUSA
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Spaur M, Glabonjat RA, Schilling K, Lombard MA, Galvez-Fernandez M, Lieberman-Cribbin W, Hayek C, Ilievski V, Balac O, Izuchukwu C, Patterson K, Basu A, Bostick BC, Chen Q, Sanchez T, Navas-Acien A, Nigra AE. Contribution of arsenic and uranium in private wells and community water systems to urinary biomarkers in US adults: The Strong Heart Study and the Multi-Ethnic Study of Atherosclerosis. J Expo Sci Environ Epidemiol 2024; 34:77-89. [PMID: 37558699 PMCID: PMC10853483 DOI: 10.1038/s41370-023-00586-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Chronic exposure to inorganic arsenic (As) and uranium (U) in the United States (US) occurs from unregulated private wells and federally regulated community water systems (CWSs). The contribution of water to total exposure is assumed to be low when water As and U concentrations are low. OBJECTIVE We examined the contribution of water As and U to urinary biomarkers in the Strong Heart Family Study (SHFS), a prospective study of American Indian communities, and the Multi-Ethnic Study of Atherosclerosis (MESA), a prospective study of racially/ethnically diverse urban U.S. communities. METHODS We assigned residential zip code-level estimates in CWSs (µg/L) and private wells (90th percentile probability of As >10 µg/L) to up to 1485 and 6722 participants with dietary information and urinary biomarkers in the SHFS (2001-2003) and MESA (2000-2002; 2010-2011), respectively. Urine As was estimated as the sum of inorganic and methylated species, and urine U was total uranium. We used linear mixed-effects models to account for participant clustering and removed the effect of dietary sources via regression adjustment. RESULTS The median (interquartile range) urine As was 5.32 (3.29, 8.53) and 6.32 (3.34, 12.48) µg/L for SHFS and MESA, respectively, and urine U was 0.037 (0.014, 0.071) and 0.007 (0.003, 0.018) µg/L. In a meta-analysis across both studies, urine As was 11% (95% CI: 3, 20%) higher and urine U was 35% (5, 73%) higher per twofold higher CWS As and U, respectively. In the SHFS, zip-code level factors such as private well and CWS As contributed 46% of variation in urine As, while in MESA, zip-code level factors, e.g., CWS As and U, contribute 30 and 49% of variation in urine As and U, respectively. IMPACT STATEMENT We found that water from unregulated private wells and regulated CWSs is a major contributor to urinary As and U (an estimated measure of internal dose) in both rural, American Indian populations and urban, racially/ethnically diverse populations nationwide, even at levels below the current regulatory standard. Our findings indicate that additional drinking water interventions, regulations, and policies can have a major impact on reducing total exposures to As and U, which are linked to adverse health effects even at low levels.
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Affiliation(s)
- Maya Spaur
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.
| | - Ronald A Glabonjat
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Kathrin Schilling
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Melissa A Lombard
- U.S. Geological Survey, New England Water Science Center, Pembroke, NH, USA
| | - Marta Galvez-Fernandez
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Wil Lieberman-Cribbin
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Carolyn Hayek
- Columbia Water Center, Columbia Climate School, New York, NY, USA
| | - Vesna Ilievski
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Olgica Balac
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Chiugo Izuchukwu
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Kevin Patterson
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Anirban Basu
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Benjamin C Bostick
- Lamont-Doherty Earth Observatory of Columbia University, Palisades, NY, USA
| | - Qixuan Chen
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Tiffany Sanchez
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Anne E Nigra
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
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Hefferon R, Goin DE, Sarnat JA, Nigra AE. Regional and racial/ethnic inequalities in public drinking water fluoride concentrations across the US. J Expo Sci Environ Epidemiol 2024; 34:68-76. [PMID: 37391608 PMCID: PMC10756931 DOI: 10.1038/s41370-023-00570-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 06/05/2023] [Accepted: 06/12/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND Although the US Centers for Disease Control and Prevention (CDC) considers fluoridation of community water systems (CWSs) to be a major public health achievement responsible for reducing dental disease, recent epidemiologic evidence suggests that chronic exposure to population-relevant levels of fluoride may also be associated with adverse child neurodevelopmental outcomes. To our knowledge, a nationally representative database of CWS fluoride concentration estimates that can be readily linked to US epidemiologic cohorts for further study is not publicly available. Our objectives were to evaluate broad regional and sociodemographic inequalities in CWS fluoride concentrations across the US, and to determine if county-level racial/ethnic composition was associated with county-level CWS fluoride. METHODS We generated CWS-level (N = 32,495) and population weighted county-level (N = 2152) fluoride concentration estimates using over 250,000 routine compliance monitoring records collected from the US Environmental Protection Agency's (EPA) Third Six Year Review (2006-2011). We compared CWS-level fluoride distributions across subgroups including region, population size served, and county sociodemographic characteristics. In county-level spatial error models, we also evaluated geometric mean ratios (GMRs) of CWS fluoride per 10% higher proportion of residents belonging to a given racial/ethnic subgroup. RESULTS 4.5% of CWSs (serving >2.9 million residents) reported mean 2006-2011 fluoride concentrations ≥1500 µg/L (the World Health Organization's guideline for drinking water quality). Arithmetic mean, 90th, and 95th percentile contaminant concentrations were greatest in CWSs reliant on groundwater, located in the Southwest and Eastern Midwest, and serving Semi-Urban, Hispanic communities. In fully adjusted spatial error models, the GMR (95% CI) of CWS fluoride per a 10% higher proportion of county residents that were Hispanic/Latino was 1.16 (1.10, 1.23). IMPACT STATEMENT We find that over 2.9 million US residents are served by public water systems with average fluoride concentrations exceeding the World Health Organization's guidance limit. We also find significant inequalities in community water system fluoride concentration estimates (2006-2011) across the US, especially for Hispanic/Latino communities who also experience elevated arsenic and uranium in regulated public drinking water systems. Our fluoride estimates can be leveraged in future epidemiologic studies to assess the potential association between chronic fluoride exposure and related adverse outcomes.
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Affiliation(s)
- Rose Hefferon
- Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Dana E Goin
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, CA, USA
| | - Jeremy A Sarnat
- Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Anne E Nigra
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.
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Levin R, Villanueva CM, Beene D, Cradock AL, Donat-Vargas C, Lewis J, Martinez-Morata I, Minovi D, Nigra AE, Olson ED, Schaider LA, Ward MH, Deziel NC. US drinking water quality: exposure risk profiles for seven legacy and emerging contaminants. J Expo Sci Environ Epidemiol 2024; 34:3-22. [PMID: 37739995 PMCID: PMC10907308 DOI: 10.1038/s41370-023-00597-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 08/16/2023] [Accepted: 08/17/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND Advances in drinking water infrastructure and treatment throughout the 20th and early 21st century dramatically improved water reliability and quality in the United States (US) and other parts of the world. However, numerous chemical contaminants from a range of anthropogenic and natural sources continue to pose chronic health concerns, even in countries with established drinking water regulations, such as the US. OBJECTIVE/METHODS In this review, we summarize exposure risk profiles and health effects for seven legacy and emerging drinking water contaminants or contaminant groups: arsenic, disinfection by-products, fracking-related substances, lead, nitrate, per- and polyfluorinated alkyl substances (PFAS) and uranium. We begin with an overview of US public water systems, and US and global drinking water regulation. We end with a summary of cross-cutting challenges that burden US drinking water systems: aging and deteriorated water infrastructure, vulnerabilities for children in school and childcare facilities, climate change, disparities in access to safe and reliable drinking water, uneven enforcement of drinking water standards, inadequate health assessments, large numbers of chemicals within a class, a preponderance of small water systems, and issues facing US Indigenous communities. RESULTS Research and data on US drinking water contamination show that exposure profiles, health risks, and water quality reliability issues vary widely across populations, geographically and by contaminant. Factors include water source, local and regional features, aging water infrastructure, industrial or commercial activities, and social determinants. Understanding the risk profiles of different drinking water contaminants is necessary for anticipating local and general problems, ascertaining the state of drinking water resources, and developing mitigation strategies. IMPACT STATEMENT Drinking water contamination is widespread, even in the US. Exposure risk profiles vary by contaminant. Understanding the risk profiles of different drinking water contaminants is necessary for anticipating local and general public health problems, ascertaining the state of drinking water resources, and developing mitigation strategies.
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Affiliation(s)
- Ronnie Levin
- Harvard TH Chan School of Public Health, Boston, MA, USA.
| | - Cristina M Villanueva
- ISGlobal, Barcelona, Spain
- CIBER epidemiología y salud pública (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Daniel Beene
- Community Environmental Health Program, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
- University of New Mexico Department of Geography & Environmental Studies, Albuquerque, NM, USA
| | | | - Carolina Donat-Vargas
- ISGlobal, Barcelona, Spain
- CIBER epidemiología y salud pública (CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Johnnye Lewis
- Community Environmental Health Program, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Irene Martinez-Morata
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Darya Minovi
- Center for Science and Democracy, Union of Concerned Scientists, Washington, DC, USA
| | - Anne E Nigra
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Erik D Olson
- Natural Resources Defense Council, Washington, DC, USA
| | | | - Mary H Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
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5
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Lewis JV, Knapp EA, Bakre S, Dickerson AS, Bastain TM, Bendixsen C, Bennett DH, Camargo CA, Cassidy-Bushrow AE, Colicino E, D'Sa V, Dabelea D, Deoni S, Dunlop AL, Elliott AJ, Farzan SF, Ferrara A, Fry RC, Hartert T, Howe CG, Kahn LG, Karagas MR, Ma TF, Koinis-Mitchell D, MacKenzie D, Maldonado LE, Merced-Nieves FM, Neiderhiser JM, Nigra AE, Niu Z, Nozadi SS, Rivera-Núñez Z, O'Connor TG, Osmundson S, Padula AM, Peterson AK, Sherris AR, Starling A, Straughen JK, Wright RJ, Zhao Q, Kress AM. Associations between area-level arsenic exposure and adverse birth outcomes: An Echo-wide cohort analysis. Environ Res 2023; 236:116772. [PMID: 37517496 PMCID: PMC10592196 DOI: 10.1016/j.envres.2023.116772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 06/20/2023] [Accepted: 07/27/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Drinking water is a common source of exposure to inorganic arsenic. In the US, the Safe Drinking Water Act (SDWA) was enacted to protect consumers from exposure to contaminants, including arsenic, in public water systems (PWS). The reproductive effects of preconception and prenatal arsenic exposure in regions with low to moderate arsenic concentrations are not well understood. OBJECTIVES This study examined associations between preconception and prenatal exposure to arsenic violations in water, measured via residence in a county with an arsenic violation in a regulated PWS during pregnancy, and five birth outcomes: birth weight, gestational age at birth, preterm birth, small for gestational age (SGA), and large for gestational age (LGA). METHODS Data for arsenic violations in PWS, defined as concentrations exceeding 10 parts per billion, were obtained from the Safe Drinking Water Information System. Participants of the Environmental influences on Child Health Outcomes Cohort Study were matched to arsenic violations by time and location based on residential history data. Multivariable, mixed effects regression models were used to assess the relationship between preconception and prenatal exposure to arsenic violations in drinking water and birth outcomes. RESULTS Compared to unexposed infants, continuous exposure to arsenic from three months prior to conception through birth was associated with 88.8 g higher mean birth weight (95% CI: 8.2, 169.5), after adjusting for individual-level confounders. No statistically significant associations were observed between any preconception or prenatal violations exposure and gestational age at birth, preterm birth, SGA, or LGA. CONCLUSIONS Our study did not identify associations between preconception and prenatal arsenic exposure, defined by drinking water exceedances, and adverse birth outcomes. Exposure to arsenic violations in drinking water was associated with higher birth weight. Future studies would benefit from more precise geodata of water system service areas, direct household drinking water measurements, and exposure biomarkers.
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Affiliation(s)
- Jonathan V Lewis
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Emily A Knapp
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shivani Bakre
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Aisha S Dickerson
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Theresa M Bastain
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Casper Bendixsen
- Marshfield Clinic Research Institute, Marshfield Clinic Health System, Marshfield, WI, USA
| | - Deborah H Bennett
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA
| | - Carlos A Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Elena Colicino
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Viren D'Sa
- Department of Pediatrics, Rhode Island Hospital, Providence, RI, USA
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Denver, CO, USA
| | - Sean Deoni
- Bill and Melinda Gates Foundation, Seattle, WA, USA
| | - Anne L Dunlop
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Amy J Elliott
- Avera Research Institute, Sioux Falls, SD, USA; Department of Pediatrics, University of South Dakota School of Medicine, Vermillion, SD, USA
| | - Shohreh F Farzan
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Rebecca C Fry
- Department of Environmental Sciences and Engineering, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Tina Hartert
- Departments of Medicine and Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Caitlin G Howe
- Dartmouth College Geisel School of Medicine, Hanover, NH, USA
| | - Linda G Kahn
- Departments of Pediatrics and Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | | | - Teng-Fei Ma
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | | | - Debra MacKenzie
- Community Environmental Health Program, University of New Mexico College of Pharmacy, Health Sciences Center, Albuquerque, NM, USA
| | - Luis E Maldonado
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Francheska M Merced-Nieves
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Anne E Nigra
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Zhongzheng Niu
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Sara S Nozadi
- Community Environmental Health Program, College of Pharmacy, Health Sciences Center, Albuquerque, NM, USA
| | - Zorimar Rivera-Núñez
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, New Brunswick, NJ, USA
| | - Thomas G O'Connor
- Departments of Psychiatry, Neuroscience, Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA
| | - Sarah Osmundson
- Department of OB/GYN, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Amy M Padula
- Department of Gynecology, Obstetrics and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, CA, USA
| | - Alicia K Peterson
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Allison R Sherris
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Anne Starling
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | | | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Qi Zhao
- Department of Preventive Medicine, University of Tennessee Health Science Center College of Medicine, Memphis, TN, USA
| | - Amii M Kress
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
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Spaur M, Bostick BC, Chillrud SN, Factor-Litvak P, Navas-Acien A, Nigra AE. Impact of lowering the US maximum contaminant level on arsenic exposure: Differences by race, region, and water arsenic in NHANES 2003-2014. Environ Pollut 2023; 333:122047. [PMID: 37331581 PMCID: PMC10529840 DOI: 10.1016/j.envpol.2023.122047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/23/2023] [Accepted: 06/14/2023] [Indexed: 06/20/2023]
Abstract
Our objective was to evaluate regional and sociodemographic inequalities in water arsenic exposure reductions associated with the US Environmental Protection Agency's Final Arsenic Rule, which lowered the arsenic maximum contaminant level to 10 μg/L in public water systems. We analyzed 8544 participants from the 2003-14 National Health and Nutrition Examination Survey (NHANES) reliant on community water systems (CWSs). We estimated arsenic exposure from water by recalibrating urinary dimethylarsinate (rDMA) to remove smoking and dietary contributions. We evaluated mean differences and corresponding percent reductions of urinary rDMA comparing subsequent survey cycles to 2003-04 (baseline), stratified by region, race/ethnicity, educational attainment, and tertile of CWS arsenic assigned at the county level. The overall difference (percent reduction) in urine rDMA was 0.32 μg/L (9%) among participants with the highest tertile of CWS arsenic, comparing 2013-14 to 2003-04. Declines in urinary rDMA were largest in regions with the highest water arsenic: the South [0.57 μg/L (16%)] and West [0.46 μg/L, (14%)]. Declines in urinary rDMA levels were significant and largest among Mexican American [0.99 μg/L (26%)] and Non-Hispanic White [0.25 μg/L (10%)] participants. Reductions in rDMA following the Final Arsenic Rule were highest among participants with the highest CWS arsenic concentrations, supporting legislation can benefit those who need it the most, although additional efforts are still needed to address remaining inequalities in CWS arsenic exposure.
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Affiliation(s)
- Maya Spaur
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health. 722 W 168th St, New York, NY, USA.
| | - Benjamin C Bostick
- Lamont-Doherty Earth Observatory of Columbia University. 61 Route 9W, Palisades, NY, USA
| | - Steven N Chillrud
- Lamont-Doherty Earth Observatory of Columbia University. 61 Route 9W, Palisades, NY, USA
| | - Pam Factor-Litvak
- Department of Epidemiology, Columbia University Mailman School of Public Health. 722 W 168th St, New York, NY, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health. 722 W 168th St, New York, NY, USA
| | - Anne E Nigra
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health. 722 W 168th St, New York, NY, USA
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7
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Nigra AE, Lieberman-Cribbin W, Bostick BC, Chillrud SN, Carrión D. Geospatial Assessment of Racial/Ethnic Composition, Social Vulnerability, and Lead Water Service Lines in New York City. Environ Health Perspect 2023; 131:87015. [PMID: 37646509 PMCID: PMC10467360 DOI: 10.1289/ehp12276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND The state of New York expects to receive $ 115 million in 2022 alone from the U.S. Infrastructure Investment and Jobs Act to support the replacement of lead water service lines. OBJECTIVES Our objective was to determine the number and proportion of potential lead water service lines across New York City (NYC) and to evaluate the association between census tract-level racial/ethnic composition, housing vulnerability, and child lead exposure vulnerability with service line type (Potential Lead, Unknown) for n = 2,083 NYC tracts. METHODS We conducted a descriptive analysis assessing water service line material recorded in the NYC Department of Environmental Protection's Lead Service Line Location Coordinates database. We used conditional autoregressive Bayesian Poisson models to assess the relative risk [RR; median posterior estimates, and 95% credible interval (CrI)] of service line type per 20% higher proportion of residents in a given racial/ethnic group and per higher housing vulnerability and child lead exposure vulnerability index scores corresponding to the interquartile range. We also evaluated the associations in flexible natural cubic spline models. RESULTS Out of 854,672 residential service line records, 136,891 (16.0%) were Potential Lead, and 227,443 (26.6%) were Unknown. In fully adjusted models, higher proportions of Hispanic/Latino residents and higher child lead exposure vulnerability were associated with Potential Lead service lines in flexible spline models and linear models [RR = 1.15 (95% CrI: 1.11, 1.21) and RR = 1.11 (95% CrI: 1.02, 1.20), respectively]. Associations were modified by borough; Potential Lead service lines were associated with higher proportions of non-Hispanic White and non-Hispanic Asian residents in the Bronx and Manhattan, and with higher proportions of non-Hispanic Black residents in Queens. DISCUSSION NYC has a high number of Potential Lead and Unknown water service lines. Communities with a high proportion of Hispanic/Latino residents and those with children who are already highly vulnerable to lead exposures from numerous sources are disproportionately impacted by Potential Lead service lines. These findings can inform equitable service line replacement across New York state and NYC. https://doi.org/10.1289/EHP12276.
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Affiliation(s)
- Anne E. Nigra
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Wil Lieberman-Cribbin
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Benjamín C. Bostick
- Lamont-Doherty Earth Observatory, Columbia University, Palisades, New York, USA
| | - Steven N. Chillrud
- Lamont-Doherty Earth Observatory, Columbia University, Palisades, New York, USA
| | - Daniel Carrión
- Department of Environmental Health Sciences, Yale University School of Public Health, New Haven, Connecticut, USA
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McGraw KE, Nigra AE, Klett J, Sobel M, Oelsner EC, Navas-Acien A, Hu X, Sanchez TR. Blood and Urinary Metal Levels among Exclusive Marijuana Users in NHANES (2005-2018). Environ Health Perspect 2023; 131:87019. [PMID: 37646523 PMCID: PMC10467359 DOI: 10.1289/ehp12074] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 05/19/2023] [Accepted: 07/19/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Marijuana is the third most used drug in the world. OBJECTIVES Because the cannabis plant is a known scavenger of metals, we hypothesized that individuals who use marijuana will have higher metal biomarker levels compared with those who do not use. METHODS We combined data from the National Health and Nutrition Examination Survey (2005-2018) for n = 7,254 participants, classified by use: non-marijuana/non-tobacco, exclusive marijuana, exclusive tobacco, and dual marijuana and tobacco use. Five metals were measured in blood and 16 in urine using inductively coupled plasma mass spectrometry; urinary metals were adjusted for urinary creatinine. RESULTS Participants reporting exclusive marijuana use compared with non-marijuana/non-tobacco use had statistically significantly higher mean cadmium levels in blood [1.22 μ g / L (95% CI: 1.11, 1.34); p < 0.001 ] and urine [1.18 μ g / g (95% CI: 1.0, 1.31); p = 0.004 ] and statistically significantly higher mean lead levels in blood [1.27 μ g / dL (95% CI: 1.07, 1.50); p = 0.006 ] and urine [1.21 μ g / g (95% CI: - 0.006 , 1.50); p = 0.058 ]. DISCUSSION Our results suggest marijuana is a source of cadmium and lead exposure. Research regarding cannabis use and cannabis contaminants, particularly metals, should be conducted to address public health concerns related to the growing number of cannabis users. https://doi.org/10.1289/EHP12074.
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Affiliation(s)
- Katlyn E. McGraw
- Department of Environmental Health Science, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Anne E. Nigra
- Department of Environmental Health Science, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Joshua Klett
- Department of Environmental Health Science, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Marisa Sobel
- Department of Environmental Health Science, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Elizabeth C. Oelsner
- Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Ana Navas-Acien
- Department of Environmental Health Science, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Xin Hu
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Tiffany R. Sanchez
- Department of Environmental Health Science, Columbia University Mailman School of Public Health, New York, New York, USA
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Spaur M, Lombard MA, Ayotte JD, Bostick BC, Chillrud SN, Navas-Acien A, Nigra AE. Cross-sectional associations between drinking water arsenic and urinary inorganic arsenic in the United States: NHANES 2003-2014. Environ Res 2023; 227:115741. [PMID: 36963713 PMCID: PMC10165942 DOI: 10.1016/j.envres.2023.115741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Inorganic arsenic is a potent carcinogen and toxicant associated with numerous adverse health outcomes. The contribution of drinking water from private wells and regulated community water systems (CWSs) to total inorganic arsenic exposure is not clear. OBJECTIVES To determine the association between drinking water arsenic estimates and urinary arsenic concentrations in the 2003-2014 National Health and Nutrition Examination Survey (NHANES). METHODS We evaluated 11,088 participants from the 2003-2014 NHANES cycles. For each participant, we assigned private well and CWS arsenic levels according to county of residence using estimates previously derived by the U.S. Environmental Protection Agency and U.S. Geological Survey. We used recalibrated urinary dimethylarsinate (rDMA) to reflect the internal dose of estimated water arsenic by applying a previously validated, residual-based method that removes the contribution of dietary arsenic sources. We compared the adjusted geometric mean ratios and corresponding percent change of urinary rDMA across tertiles of private well and CWS arsenic levels, with the lowest tertile as the reference. Comparisons were made overall and stratified by census region and race/ethnicity. RESULTS Overall, the geometric mean of urinary rDMA was 2.52 (2.30, 2.77) μg/L among private well users and 2.64 (2.57, 2.72) μg/L among CWS users. Urinary rDMA was highest among participants in the West and South, and among Mexican American, Other Hispanic, and Non-Hispanic Other participants. Urinary rDMA levels were 25% (95% confidence interval (CI): 17-34%) and 20% (95% CI: 12-29%) higher comparing the highest to the lowest tertile of CWS and private well arsenic, respectively. The strongest associations between water arsenic and urinary rDMA were observed among participants in the South, West, and among Mexican American and Non-Hispanic White and Black participants. DISCUSSION Both private wells and regulated CWSs are associated with inorganic arsenic internal dose as reflected in urine in the general U.S. POPULATION
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Affiliation(s)
- Maya Spaur
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.
| | - Melissa A Lombard
- U.S. Geological Survey, New England Water Science Center, Pembroke, NH, USA
| | - Joseph D Ayotte
- U.S. Geological Survey, New England Water Science Center, Pembroke, NH, USA
| | - Benjamin C Bostick
- Lamont-Doherty Earth Observatory of Columbia University, Palisades, NY, USA
| | - Steven N Chillrud
- Lamont-Doherty Earth Observatory of Columbia University, Palisades, NY, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Anne E Nigra
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
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10
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Li Z, Lewin M, Ruiz P, Nigra AE, Henderson NB, Jarrett JM, Ward C, Zhu J, Umans JG, O'Leary M, Zhang Y, Ragin-Wilson A, Navas-Acien A. Blood cadmium, lead, manganese, mercury, and selenium levels in American Indian populations: The Strong Heart Study. Environ Res 2022; 215:114101. [PMID: 35977585 PMCID: PMC9644284 DOI: 10.1016/j.envres.2022.114101] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 05/15/2023]
Abstract
BACKGROUND Many American Indian (AI) communities are in areas affected by environmental contamination, such as toxic metals. However, studies assessing exposures in AI communities are limited. We measured blood metals in AI communities to assess historical exposure and identify participant characteristics associated with these levels in the Strong Heart Study (SHS) cohort. METHOD Archived blood specimens collected from participants (n = 2014, all participants were 50 years of age and older) in Arizona, Oklahoma, and North and South Dakota during SHS Phase-III (1998-1999) were analyzed for cadmium, lead, manganese, mercury, and selenium using inductively coupled plasma triple quadrupole mass spectrometry. We conducted descriptive analyses for the entire cohort and stratified by selected subgroups, including selected demographics, health behaviors, income, waist circumference, and body mass index. Bivariate associations were conducted to examine associations between blood metal levels and selected socio-demographic and behavioral covariates. Finally, multivariate regression models were used to assess the best model fit that predicted blood metal levels. FINDINGS All elements were detected in 100% of study participants, with the exception of mercury (detected in 73% of participants). The SHS population had higher levels of blood cadmium and manganese than the general U.S. population 50 years and older. The median blood mercury in the SHS cohort was at about 30% of the U.S. reference population, potentially due to low fish consumption. Participants in North Dakota and South Dakota had the highest blood cadmium, lead, manganese, and selenium, and the lowest total mercury levels, even after adjusting for covariates. In addition, each of the blood metals was associated with selected demographic, behavioral, income, and/or weight-related factors in multivariate models. These findings will help guide the tribes to develop education, outreach, and strategies to reduce harmful exposures and increase beneficial nutrient intake in these AI communities.
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Affiliation(s)
- Zheng Li
- Office of Community Health and Hazard Assessment, Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Michael Lewin
- Office of Community Health and Hazard Assessment, Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Patricia Ruiz
- Office of Innovation and Analytics, Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Anne E Nigra
- Department of Environmental Health Sciences, School of Public Health, Columbia University, New York City, NY, USA
| | - Noelle B Henderson
- Office of Community Health and Hazard Assessment, Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jeffery M Jarrett
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Cynthia Ward
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jianhui Zhu
- MedStar Health Research Institute, Hyattsville, MD, USA
| | - Jason G Umans
- MedStar Health Research Institute, Hyattsville, MD, USA; Georgetown-Howard Universities Center for Clinical and Translational Science, Washington DC, USA
| | - Marcia O'Leary
- Missouri Breaks Industries and Research, Inc., Eagle Butte, SD, USA
| | - Ying Zhang
- Center for American Indian Health Research, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Angela Ragin-Wilson
- Office of Associate Director, Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, School of Public Health, Columbia University, New York City, NY, USA
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11
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Nigra AE, Cazacu-De Luca A, Navas-Acien A. Socioeconomic vulnerability and public water arsenic concentrations across the US. Environ Pollut 2022; 313:120113. [PMID: 36084737 PMCID: PMC9811132 DOI: 10.1016/j.envpol.2022.120113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 05/05/2023]
Abstract
Inorganic arsenic is a known human carcinogen and is routinely detected in US community water systems (CWSs). Inequalities in CWS arsenic exist across broad sociodemographic subgroups. Our objective was to evaluate the county-level association between socioeconomic vulnerability and CWS arsenic concentrations across the US. We evaluated previously developed, population-weighted CWS arsenic concentrations (2006-2011) and three socioeconomic domains (the proportion of adults with a high school diploma, median household income, and the Centers for Disease Control and Prevention's overall socioeconomic vulnerability score) for 2,604 conterminous US counties. We used spatial lag models and evaluated the adjusted geometric mean ratio (GMR) of CWS arsenic concentrations per higher socioeconomic domain score corresponding to the interquartile range, and also evaluated flexible quadratic spline models. We also stratified by region and by United States Department of Agriculture Rural-Urban Continuum Codes to assess potential effect measure modification by region and rurality. Associations between socioeconomic vulnerability and CWS arsenic were modified by region and rurality and specific to socioeconomic domain. The fully adjusted GMR (95% CIs) of CWS arsenic per interquartile range higher proportion of adults with a high school education was 0.83 (0.71, 0.98) in the Southwest (corresponding to 17% lower arsenic with higher education), 0.82 (0.71, 0.94) in the Eastern Midwest (18% lower), and 0.65 (0.31, 1.36) in New England (35% lower). Associations between median household income and CWS arsenic were largely null. Higher overall socioeconomic vulnerability was significantly associated with lower CWS arsenic, but only in counties in the Central Midwest and those with total populations less than 20,000. Findings may reflect regional/local differences in both socioeconomic/socio-cultural context and public drinking water regulatory efforts. Across the US, individual domains of socioeconomic vulnerability (especially educational attainment) are more strongly associated with inequalities in CWS arsenic than the complex overall socioeconomic vulnerability index.
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Affiliation(s)
- Anne E Nigra
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, 722 W 168th St, 11th Floor Rm 1107A, New York, 10032, NY, USA.
| | - Adina Cazacu-De Luca
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, 722 W 168th St, 11th Floor Rm 1107A, New York, 10032, NY, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, 722 W 168th St, 11th Floor Rm 1107A, New York, 10032, NY, USA
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12
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Zhao D, Domingo-Relloso A, Tellez-Plaza M, Nigra AE, Valeri L, Moon KA, Goessler W, Best LG, Ali T, Umans JG, Fretts A, Cole SA, Navas-Acien A. High Level of Selenium Exposure in the Strong Heart Study: A Cause for Incident Cardiovascular Disease? Antioxid Redox Signal 2022; 37:990-997. [PMID: 35350849 PMCID: PMC9689768 DOI: 10.1089/ars.2022.0029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 03/21/2022] [Indexed: 11/12/2022]
Abstract
Increasing evidence suggests that high selenium (Se) exposure is associated with adverse health effects. However, limited evidence exists on the association of Se exposure with cardiovascular disease (CVD), especially in communities affected by high naturally occurring Se in environmental media. We evaluated the prospective association between urinary Se levels and CVD incidence and mortality for 2727 American Indian adults who participated in the Strong Heart Study, with urinary Se levels measured at baseline (1989-1991) and CVD outcomes ascertained through 2017. The median (interquartile range) of urinary Se was 49.0 (36.7-67.4) μg/g creatinine. The multivariable adjusted hazard ratios (95% confidence interval) of incident CVD, coronary heart disease, and stroke comparing the 75th versus 25th percentile of urinary Se distributions were 1.11 (1.01-1.22), 1.05 (0.94-1.17), and 1.08 (0.88-1.33), respectively. In flexible dose-response models, increased risk for CVD incidence was only observed when the urinary Se level exceeded 60 μg/g creatinine. For CVD mortality, a nonstatistically significant U-shaped relationship was found across urinary Se levels. There was no evidence of effect modification by other urinary metal/metalloid levels. Our observation leads to the hypothesis that elevated Se exposure is a risk factor for CVD, especially in Se-replete populations. Antioxid. Redox Signal. 37, 990-997.
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Affiliation(s)
- Di Zhao
- State Key Laboratory of Crop Genetics and Germplasm Enhancement, College of Resources and Environmental Sciences, Nanjing Agricultural University, Nanjing, Jiangsu, China
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Arce Domingo-Relloso
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Maria Tellez-Plaza
- Department of Epidemiology of Chronic Diseases, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Anne E. Nigra
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Linda Valeri
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Katherine A. Moon
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - Lyle G. Best
- Missouri Breaks Industries Research, Inc., Eagle Butte, South Dakota, USA
| | - Tauqeer Ali
- Department of Biostatistics and Epidemiology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Jason G. Umans
- MedStar Health Research Institute, Washington, District of Columbia, USA
- Georgetown-Howard Universities Center for Clinical and Translational Sciences, Washington, District of Columbia, USA
| | - Amanda Fretts
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Shelley A. Cole
- Department of Epidemiology, University of North Carolina Gillings School of Public Health, Chapel Hill, North Carolina, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
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13
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Spaur M, Nigra AE, Sanchez TR, Navas-Acien A, Lazo M, Wu HC. Association of blood manganese, selenium with steatosis, fibrosis in the National Health and Nutrition Examination Survey, 2017-18. Environ Res 2022; 213:113647. [PMID: 35691383 PMCID: PMC10031575 DOI: 10.1016/j.envres.2022.113647] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/10/2022] [Accepted: 06/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND & AIMS Chronic liver disease is a growing health burden worldwide. Chronic metal exposures may be associated with non-alcoholic fatty liver disease (NAFLD). We aimed to evaluate the association of blood cadmium (Cd), mercury (Hg), lead (Pb), manganese (Mn), and selenium (Se) with two hallmark features of NAFLD: liver steatosis and fibrosis in the general U.S. METHODS We analyzed transient liver elastography data from participants of the National Health and Nutrition Examination Survey (NHANES) 2017-18, using ordinal logistic regression analyses to evaluate the cross-sectional association between blood metal concentrations and clinical stages of steatosis and fibrosis. We applied survey weights, strata, and primary sampling units and analyses were conducted using the R survey package. RESULTS 4,154 participants were included. Median (IQR) for blood Mn and blood Se were 9.28 (7.48-11.39) and 191.08 (176.55-207.16) μg/L, respectively. Per interquartile range increase of natural log transformed blood Mn, the adjusted odds ratio (OR) (95% CI) was 1.59 (1.13-2.23) for a higher grade of steatosis and 1.16 (0.67-2.00) for liver fibrosis. The corresponding OR for steatosis was 2.00 (1.24-3.24) and 2.14 (1.04-4.42) in Black and Mexican American participants, respectively. The corresponding OR for liver fibrosis was 2.96 (1.42-6.17) for females. Per interquartile range increase of natural log transformed blood Se, the adjusted OR was 2.25 (1.30-3.89) for steatosis but 0.31 (0.13-0.72) for liver fibrosis. The inverse association of blood Se with liver fibrosis was also observed in males and White participants. Blood Cd, Hg, and Pb were not associated with liver steatosis and fibrosis in fully-adjusted models overall. CONCLUSIONS In NHANES 2017-18, higher blood Mn was positively associated with liver steatosis, and higher Se was positively associated with liver steatosis but negatively associated with liver fibrosis. Longitudinal studies are needed to examine the association of Mn and Se with fibrosis progression.
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Affiliation(s)
- Maya Spaur
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, W 168th St, Room 1107, New York, NY, USA.
| | - Anne E Nigra
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, W 168th St, Room 1107, New York, NY, USA.
| | - Tiffany R Sanchez
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, W 168th St, Room 1107, New York, NY, USA.
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, W 168th St, Room 1107, New York, NY, USA.
| | - Mariana Lazo
- Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA.
| | - Hui-Chen Wu
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, W 168th St, Room 1107, New York, NY, USA; Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA.
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14
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Ravalli F, Yu Y, Bostick BC, Chillrud SN, Schilling K, Basu A, Navas-Acien A, Nigra AE. Sociodemographic inequalities in uranium and other metals in community water systems across the USA, 2006-11: a cross-sectional study. Lancet Planet Health 2022; 6:e320-e330. [PMID: 35397220 PMCID: PMC9037820 DOI: 10.1016/s2542-5196(22)00043-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 05/21/2023]
Abstract
BACKGROUND The US Environmental Protection Agency (EPA) currently sets maximum contaminant levels (MCLs) for ten metals or metalloids in public drinking water systems. Our objective was to estimate metal concentrations in community water systems (CWSs) across the USA, to establish if sociodemographic or regional inequalities in the metal concentrations exist, and to identify patterns of concentrations for these metals as a mixture. METHODS We evaluated routine compliance monitoring records for antimony, arsenic, barium, beryllium, cadmium, chromium, mercury, selenium, thallium, and uranium, collected from 2006-11 (2000-11 for uranium; timeframe based on compliance monitoring requirements) by the US EPA in support of their second and third Six-Year Reviews for CWSs. Arsenic, barium, chromium, selenium, and uranium (detectable in >10% records) were included in the main analyses (subgroup and metal mixture analyses; arsenic data reported previously). We compared the mean, 75th percentile, and 95th percentile contaminant concentrations and the percentage of CWSs with concentrations exceeding the MCL across subgroups (region, sociodemographic county-cluster, size of population served, source water type, and CWSs exclusively serving correctional facilities). We evaluated patterns in CWS metal concentration estimate profiles via hierarchical cluster analysis. We created an online interactive map and dashboard of estimated CWS metal concentrations for use in future analyses. FINDINGS Average metal concentrations were available for a total of 37 915 CWSs across the USA. The total number of monitoring records available was approximately 297 000 for arsenic, 165 000 for barium, 167 000 for chromium, 165 000 for selenium, and 128 000 for uranium. The percentage of analysed CWSs with average concentrations exceeding the MCL was 2·6% for arsenic (MCL=10 μg/L; nationwide mean 1·77 μg/L; n=36 798 CWSs), 2·1% for uranium (MCL=30 μg/L; nationwide mean 4·37 μg/L; n=14 503 CWSs), and less than 0·1% for the other metals. The number of records with detections was highest for uranium (63·1%). 75th and 95th percentile concentrations for uranium, chromium, barium, and selenium were highest for CWSs serving Semi-Urban, Hispanic communities, CWSs reliant on groundwater, and CWSs in the Central Midwest. Hierarchical cluster analysis revealed two distinct clusters: an arsenic-uranium-selenium cluster and a barium-chromium cluster. INTERPRETATIONS Uranium is an under-recognised contaminant in CWSs. Metal concentrations (including uranium) are elevated in CWSs serving Semi-Urban, Hispanic communities independent of location or region, highlighting environmental justice concerns. FUNDING US National Institutes of Health Office of the Director, US National Institutes for Environmental Health Sciences, and US National Institute of Dental and Craniofacial Research.
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Affiliation(s)
- Filippo Ravalli
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Yuanzhi Yu
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Benjamin C Bostick
- Lamont-Doherty Earth Observatory of Columbia University, Palisades, NY, USA
| | - Steven N Chillrud
- Lamont-Doherty Earth Observatory of Columbia University, Palisades, NY, USA
| | - Kathrin Schilling
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA; Lamont-Doherty Earth Observatory of Columbia University, Palisades, NY, USA
| | - Anirban Basu
- Department of Earth Sciences, Royal Halloway, University of London, Surrey, UK
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Anne E Nigra
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.
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Nigra AE, Navas-Acien A. Racial Inequalities in Drinking Water Lead Exposure: A Wake-Up Call to Protect Patients with End Stage Kidney Disease. J Am Soc Nephrol 2021; 32:2419-2421. [PMID: 34544822 PMCID: PMC8722796 DOI: 10.1681/asn.2021060793] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- Anne E. Nigra
- Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York
| | - Ana Navas-Acien
- Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York
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16
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Spaur M, Lombard MA, Ayotte JD, Harvey DE, Bostick BC, Chillrud SN, Navas-Acien A, Nigra AE. Associations between private well water and community water supply arsenic concentrations in the conterminous United States. Sci Total Environ 2021; 787:147555. [PMID: 33991916 PMCID: PMC8192485 DOI: 10.1016/j.scitotenv.2021.147555] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/30/2021] [Accepted: 04/30/2021] [Indexed: 05/12/2023]
Abstract
Geogenic arsenic contamination typically occurs in groundwater as opposed to surface water supplies. Groundwater is a major source for many community water systems (CWSs) in the United States (US). Although the US Environmental Protection Agency sets the maximum contaminant level (MCL enforceable since 2006: 10 μg/L) for arsenic in CWSs, private wells are not federally regulated. We evaluated county-level associations between modeled values of the probability of private well arsenic exceeding 10 μg/L and CWS arsenic concentrations for 2231 counties in the conterminous US, using time invariant private well arsenic estimates and CWS arsenic estimates for two time periods. Nationwide, county-level CWS arsenic concentrations increased by 8.4 μg/L per 100% increase in the probability of private well arsenic exceeding 10 μg/L for 2006-2008 (the initial compliance monitoring period after MCL implementation), and by 7.3 μg/L for 2009-2011 (the second monitoring period following MCL implementation) (1.1 μg/L mean decline over time). Regional differences in this temporal decline suggest that interventions to implement the MCL were more pronounced in regions served primarily by groundwater. The strong association between private well and CWS arsenic in Rural, American Indian, and Semi Urban, Hispanic counties suggests that future research and regulatory support are needed to reduce water arsenic exposures in these vulnerable subpopulations. This comparison of arsenic exposure values from major private and public drinking water sources nationwide is critical to future assessments of drinking water arsenic exposure and health outcomes.
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Affiliation(s)
- Maya Spaur
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.
| | - Melissa A Lombard
- U.S. Geological Survey, New England Water Science Center, Pembroke, NH, USA
| | - Joseph D Ayotte
- U.S. Geological Survey, New England Water Science Center, Pembroke, NH, USA
| | - David E Harvey
- U.S. Public Health Service, Commissioned Corps, Rockville, MD, USA
| | - Benjamin C Bostick
- Lamont-Doherty Earth Observatory of Columbia University, Palisades, NY, USA
| | - Steven N Chillrud
- Lamont-Doherty Earth Observatory of Columbia University, Palisades, NY, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Anne E Nigra
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
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Nigra AE, Moon KA, Jones MR, Sanchez TR, Navas-Acien A. Urinary arsenic and heart disease mortality in NHANES 2003-2014. Environ Res 2021; 200:111387. [PMID: 34090890 PMCID: PMC8403626 DOI: 10.1016/j.envres.2021.111387] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 05/03/2021] [Accepted: 05/20/2021] [Indexed: 05/21/2023]
Abstract
BACKGROUND Evidence evaluating the prospective association between low-to moderate-inorganic arsenic (iAs) exposure and cardiovascular disease in the general US population is limited. We evaluated the association between urinary arsenic concentrations in National Health and Nutrition Examination Survey (NHANES) 2003-2014 and heart disease mortality linked from the National Death Index through 2015. METHODS We modeled iAs exposure as urinary total arsenic and dimethylarsinate among participants with low seafood intake, based on low arsenobetaine levels (N = 4990). We estimated multivariable adjusted hazard ratios (HRs) for heart disease mortality per interquartile range (IQR) increase in urinary arsenic levels using survey-weighted, Cox proportional hazards models, and evaluated flexible dose-response analyses using restricted quadratic spline models. We updated a previously published relative risk of coronary heart disease mortality from a dose-response meta-analysis per a doubling of water iAs (e.g., from 10 to 20 μg/L) with our results from NHANES 2003-2014, assuming all iAs exposure came from drinking water. RESULTS A total of 77 fatal heart disease events occurred (median follow-up time 75 months). The adjusted HRs (95% CI) of heart disease mortality for an increase in urinary total arsenic and DMA corresponding to the interquartile range were 1.20 (0.83, 1.74) and 1.18 (0.68, 2.05), respectively. Restricted quadratic splines indicate a significant association between increasing urinary total arsenic and the HR of fatal heart disease for all participants at the lowest exposure levels <4.5 μg/L. The updated pooled relative risk of coronary heart disease mortality per doubling of water iAs (μg/L) was 1.16 (95% CI 1.07, 1.25). CONCLUSIONS Despite a small number of events, relatively short follow-up time, and high analytical limits of detection for urinary arsenic species, iAs exposure at low-to moderate-levels is consistent with increased heart disease mortality in NHANES 2003-2014 although the associations were only significant in flexible dose-response models.
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Affiliation(s)
- Anne E Nigra
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.
| | - Katherine A Moon
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Miranda R Jones
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Oncology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Tiffany R Sanchez
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
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Nigra AE, Chen Q, Chillrud SN, Wang L, Harvey D, Mailloux B, Factor-Litvak P, Navas-Acien A. Inequalities in Public Water Arsenic Concentrations in Counties and Community Water Systems across the United States, 2006-2011. Environ Health Perspect 2020; 128:127001. [PMID: 33295795 PMCID: PMC7724967 DOI: 10.1289/ehp7313] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 05/02/2023]
Abstract
BACKGROUND In the United States, nationwide estimates of public drinking water arsenic exposure are not readily available. We used the U.S. Environmental Protection Agency's (EPA) Six-Year Review contaminant occurrence data set to estimate public water arsenic exposure. We compared community water system (CWS) arsenic concentrations during 2006-2008 vs. after 2009-2011, the initial monitoring period for compliance with the U.S. EPA's 10 μ g / L arsenic maximum contaminant level (MCL). OBJECTIVE Our objective was to characterize potential inequalities in CWS arsenic exposure over time and across sociodemographic subgroups. METHODS We estimated 3-y average arsenic concentrations for 36,406 CWSs (98%) and 2,740 counties (87%) and compared differences in means and quantiles of water arsenic (via quantile regression) between both 3-y periods for U.S. regions and sociodemographic subgroups. We assigned CWSs and counties MCL compliance categories (High if above the MCL; Low if below) for each 3-y period. RESULTS From 2006-2008 to 2009-2011, mean and 95th percentile CWS arsenic (in micrograms per liter) declined by 10.3% (95% CI: 6.5%, 14.1%) and 11.5% (8.3%, 14.8%) nationwide, by 11.4% (4.7%, 18.1%) and 16.3% (8.1%, 24.5%) for the Southwest, and by 36.8% (7.4%, 66.1%) and 26.5% (12.1%, 40.8%) for New England, respectively. CWSs in the High/High compliance category (not MCL compliant) were more likely in the Southwest (61.1%), served by groundwater (94.7%), serving smaller populations (mean 1,102 persons), and serving Hispanic communities (38.3%). DISCUSSION Larger absolute declines in CWS arsenic concentrations at higher water arsenic quantiles indicate declines are related to MCL implementation. CWSs reliant on groundwater, serving smaller populations, located in the Southwest, and serving Hispanic communities were more likely to continue exceeding the arsenic MCL, raising environmental justice concerns. These estimates of public drinking water arsenic exposure can enable further surveillance and epidemiologic research, including assessing whether differential declines in water arsenic exposure resulted in differential declines in arsenic-associated disease. https://doi.org/10.1289/EHP7313.
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Affiliation(s)
- Anne E. Nigra
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Qixuan Chen
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Steven N. Chillrud
- Lamont-Doherty Earth Observatory, Columbia University, Palisades, New York, USA
| | - Lili Wang
- Office of Water, U.S. Environmental Protection Agency, Washington, DC, USA
| | - David Harvey
- United States Public Health Service, Rockville, Maryland, USA
| | - Brian Mailloux
- Lamont-Doherty Earth Observatory, Columbia University, Palisades, New York, USA
- Barnard College, Columbia University, New York, New York, USA
| | - Pam Factor-Litvak
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
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Nigra AE, Navas-Acien A. Arsenic in US correctional facility drinking water, 2006-2011. Environ Res 2020; 188:109768. [PMID: 32585331 PMCID: PMC7483613 DOI: 10.1016/j.envres.2020.109768] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/29/2020] [Accepted: 05/30/2020] [Indexed: 05/02/2023]
Abstract
BACKGROUND Little is known about the quality of drinking water in US correctional facilities (e.g. detention centers, prisons, jails, etc.). Our objective was to determine if incarcerated persons are at risk for chronic, elevated arsenic exposure relative to the non-incarcerated US population, particularly in the Southwestern US where public water and groundwater arsenic concentrations are high compared to the rest of the US. METHODS We analyzed 230,158 arsenic monitoring records from 37,086 community water systems (CWSs) from the Environmental Protection Agency's (EPA) Third Six Year Review of Contaminant Occurrence dataset (covering 2006-2011). We compared six-year average arsenic concentrations and the odds of exceeding the EPA's 10 μg/L maximum contaminant level (MCL) for CWSs exclusively serving correctional facilities versus all other CWSs in the Southwestern US, where groundwater arsenic concentrations are high. RESULTS Average six-year water arsenic concentrations were higher for Southwestern correctional facility CWSs (6.41 μg/L, 95% CI 3.48, 9.34) compared to all other Southwestern CWSs (3.11 μg/L, 95% CI 2.97, 3.24) and to other CWSs across the rest of the US (1.39 μg/L, 95% CI 1.35, 1.42). In the Southwest, 26.1% (N = 6) of correctional facility CWSs versus 5.8% (509) of other CWSs reported six-year arsenic averages exceeding 10 μg/L, corresponding to an odds ratio of 5.70 (95% confidence interval 2.24, 14.52). Correctional facility CWSs in the Southwest were also more likely to report six-year averages exceeding 5 μg/L (the MCL for New Jersey and New Hampshire, N = 8, odds ratio 2.77, 95% CI 1.17, 6.54). DISCUSSION Persons incarcerated in the Southwestern US were at disproportionate risk of elevated drinking water arsenic exposure and related disease from 2006 to 2011. Strict enforcement of EPA regulations and additional technical and financial support for CWSs serving correctional facilities in the Southwest is necessary to protect the health and human rights of incarcerated persons.
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Affiliation(s)
- Anne E Nigra
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
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Garvin MC, Schijf J, Kaufman SR, Konow C, Liang D, Nigra AE, Stracker NH, Whelan RJ, Wiles GC. A survey of trace metal burdens in increment cores from eastern cottonwood (Populus deltoides) across a childhood cancer cluster, Sandusky County, OH, USA. Chemosphere 2020; 238:124528. [PMID: 31425869 DOI: 10.1016/j.chemosphere.2019.124528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/04/2019] [Accepted: 08/05/2019] [Indexed: 06/10/2023]
Abstract
A dendrochemical study of cottonwood trees (Populus deltoides) was conducted across a childhood cancer cluster in eastern Sandusky County (Ohio, USA). The justification for this study was that no satisfactory explanation has yet been put forward, despite extensive local surveys of aerosols, groundwater, and soil. Concentrations of eight trace metals were measured by ICP-MS in microwave-digested 5-year sections of increment cores, collected during 2012 and 2013. To determine whether the onset of the first cancer cases could be connected to an emergence of any of these contaminants, cores spanning the period 1970-2009 were taken from 51 trees of similar age, inside the cluster and in a control area to the west. The abundance of metals in cottonwood tree annual rings served as a proxy for their long-term, low-level accumulation from the same sources whereby exposure of the children may have occurred. A spatial analysis of cumulative metal burdens (lifetime accumulation in the tree) was performed to search for significant 'hotspots', employing a scan statistic with a mask of variable radius and center. For Cd, Cr, and Ni, circular hotspots were found that nearly coincide with the cancer cluster and are similar in size. No hotspots were found for Co, Cu, and Pb, while As and V were largely below method detection limits. Whereas our results do not implicate exposure to metals as a causative factor, we conclude that, after 1970, cottonwood trees have accumulated more Cd, Cr, and Ni, inside the childhood cancer cluster than elsewhere in Sandusky County.
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Affiliation(s)
- Mary C Garvin
- Oberlin College, Department of Biology, 119 Woodland St., Oberlin, OH, 44074, USA
| | - Johan Schijf
- University of Maryland Center for Environmental Science, Chesapeake Biological Laboratory, P.O. Box 38, Solomons, MD, 20688, USA.
| | - Sonya R Kaufman
- Oberlin College, Department of Biology, 119 Woodland St., Oberlin, OH, 44074, USA
| | - Courtney Konow
- Oberlin College, Department of Biology, 119 Woodland St., Oberlin, OH, 44074, USA
| | - Dong Liang
- University of Maryland Center for Environmental Science, Chesapeake Biological Laboratory, P.O. Box 38, Solomons, MD, 20688, USA
| | - Anne E Nigra
- Columbia University Mailman School of Public Health, Department of Environmental Health Sciences, 722 West 168th St., New York, NY, 10032, USA
| | - Norberth H Stracker
- Johns Hopkins University School of Medicine, Division of Infectious Diseases, 1830 East Monument St., Room 442, Baltimore, MD, 21287, USA
| | - Rebecca J Whelan
- University of Notre Dame, Department of Chemistry and Biochemistry, 140D McCourtney Hall, Notre Dame, IN, 46556, USA
| | - Gregory C Wiles
- The College of Wooster, Department of Earth Sciences, 944 College Hall, Wooster, OH, 44691, USA
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Nigra AE, Olmedo P, Grau-Perez M, O'Leary R, O'Leary M, Fretts AM, Umans JG, Best LG, Francesconi KA, Goessler W, Cole SA, Navas-Acien A. Dietary determinants of inorganic arsenic exposure in the Strong Heart Family Study. Environ Res 2019; 177:108616. [PMID: 31442790 PMCID: PMC6748659 DOI: 10.1016/j.envres.2019.108616] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 07/08/2019] [Accepted: 07/26/2019] [Indexed: 05/19/2023]
Abstract
BACKGROUND Chronic exposure to inorganic arsenic (iAs) in the US occurs mainly through drinking water and diet. Although American Indian (AI) populations have elevated urinary arsenic concentrations compared to the general US population, dietary sources of arsenic exposure in AI populations are not well characterized. METHODS We evaluated food frequency questionnaires to determine the major dietary sources of urinary arsenic concentrations (measured as the sum of arsenite, arsenate, monomethylarsonate, and dimethylarsinate, ΣAs) for 1727 AI participants in the Strong Heart Family Study (SHFS). We compared geometric mean ratios (GMRs) of urinary ΣAs for an interquartile range (IQR) increase in reported food group consumption. Exploratory analyses were stratified by gender and study center. RESULTS In fully adjusted generalized estimating equation models, the percent increase (95% confidence interval) of urinary ΣAs per increase in reported food consumption corresponding to the IQR was 13% (5%, 21%) for organ meat, 8% (4%, 13%) for rice, 7% (2%, 13%) for processed meat, and 4% (1%, 7%) for non-alcoholic drinks. In analyses stratified by study center, the association with organ meat was only observed in North/South Dakota. Consumption of red meat [percent increase -7% (-11%, -3%)] and fries and chips [-6% (-10%, -2%)] was inversely associated with urinary ΣAs. CONCLUSIONS Organ meat, processed meat, rice, and non-alcoholic drinks contribute to ΣAs exposure in the SHFS population. Organ meat is a unique source of ΣAs exposure for North and South Dakota participants and may reflect local food consumption. Further studies should comprehensively evaluate drinking water arsenic in SHFS communities and determine the relative contribution of diet and drinking water to total arsenic exposure.
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Affiliation(s)
- Anne E Nigra
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.
| | - Pablo Olmedo
- Department of Legal Medicine and Toxicology, School of Medicine, University of Granada, Granada, Spain
| | - Maria Grau-Perez
- Area of Cardiometabolic and Renal Risk, Biomedical Research Institute Hospital Clinic of Valencia, Valencia, Spain
| | - Rae O'Leary
- Missouri Breaks Industries Research Inc, Eagle Butte, SD, USA
| | - Marcia O'Leary
- Missouri Breaks Industries Research Inc, Eagle Butte, SD, USA
| | - Amanda M Fretts
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Jason G Umans
- MedStar Health Research Institute; Washington, DC, USA
| | - Lyle G Best
- Missouri Breaks Industries Research Inc, Eagle Butte, SD, USA
| | | | | | - Shelley A Cole
- Texas Biomedical Research Institute, Hyattsville, MD, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
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22
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Nigra AE, Howard BV, Umans JG, Best L, Francesconi KA, Goessler W, Devereux R, Navas-Acien A. Urinary tungsten and incident cardiovascular disease in the Strong Heart Study: An interaction with urinary molybdenum. Environ Res 2018; 166:444-451. [PMID: 29940477 PMCID: PMC6347476 DOI: 10.1016/j.envres.2018.06.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 05/22/2018] [Accepted: 06/09/2018] [Indexed: 05/25/2023]
Abstract
BACKGROUND Tungsten (W) interferes with molybdenum (Mo) binding sites and has been associated with prevalent cardiovascular disease (CVD). We evaluated if (1) W exposure is prospectively associated with incident CVD and (2) the association between urinary W levels and incident CVD is modified by urinary Mo levels. METHODS We estimated multi-adjusted hazard ratios (HRs) for incident CVD outcomes by increasing W levels for 2726 American Indian participants in the Strong Heart Study with urinary metal levels measured at baseline (1989-1991) and CVD events ascertained through 2008. RESULTS Increasing levels of baseline urinary W were not associated with incident CVD. Fully-adjusted HRs (95% CIs) of incident CVD comparing a change in the IQR of W levels for those in the lowest and highest tertile of urinary Mo were 1.05 (0.90, 1.22) and 0.80 (0.70, 0.92), respectively (p-interaction = 0.02); for CVD mortality, the corresponding HRs were 1.05 (0.82, 1.33) and 0.73 (0.58, 0.93), respectively (p-interaction = 0.03). CONCLUSIONS The association between W and CVD incidence and mortality was positive although non-significant at lower urinary Mo levels and significant and inverse at higher urinary Mo levels. Although prior cross-sectional epidemiologic studies in the general US population found positive associations between urinary tungsten and prevalent cardiovascular disease, our prospective analysis in the Strong Heart Study indicates this association may be modified by molybdenum exposure.
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Affiliation(s)
- Anne E Nigra
- Columbia University Mailman School of Public Health, Department of Environmental Health Sciences, New York, NY, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Barbara V Howard
- MedStar Health Research Institute, Washington, DC, USA; Georgetown/Howard Universities Center for Clinical and Translational Sciences, USA
| | - Jason G Umans
- MedStar Health Research Institute, Washington, DC, USA; Georgetown/Howard Universities Center for Clinical and Translational Sciences, USA
| | - Lyle Best
- Epidemiology Department, Missouri Breaks Industries Research Inc., Timber Lake, SD, USA
| | | | | | | | - Ana Navas-Acien
- Columbia University Mailman School of Public Health, Department of Environmental Health Sciences, New York, NY, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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23
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Nachman KE, Punshon T, Rardin L, Signes-Pastor AJ, Murray CJ, Jackson BP, Guerinot ML, Burke TA, Chen CY, Ahsan H, Argos M, Cottingham KL, Cubadda F, Ginsberg GL, Goodale BC, Kurzius-Spencer M, Meharg AA, Miller MD, Nigra AE, Pendergrast CB, Raab A, Reimer K, Scheckel KG, Schwerdtle T, Taylor VF, Tokar EJ, Warczak TM, Karagas MR. Opportunities and Challenges for Dietary Arsenic Intervention. Environ Health Perspect 2018; 126:84503. [PMID: 30235424 PMCID: PMC6375412 DOI: 10.1289/ehp3997] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 07/16/2018] [Accepted: 07/20/2018] [Indexed: 05/18/2023]
Abstract
The diet is emerging as the dominant source of arsenic exposure for most of the U.S. population. Despite this, limited regulatory efforts have been aimed at mitigating exposure, and the role of diet in arsenic exposure and disease processes remains understudied. In this brief, we discuss the evidence linking dietary arsenic intake to human disease and discuss challenges associated with exposure characterization and efforts to quantify risks. In light of these challenges, and in recognition of the potential longer-term process of establishing regulation, we introduce a framework for shorter-term interventions that employs a field-to-plate food supply chain model to identify monitoring, intervention, and communication opportunities as part of a multisector, multiagency, science-informed, public health systems approach to mitigation of dietary arsenic exposure. Such an approach is dependent on coordination across commodity producers, the food industry, nongovernmental organizations, health professionals, researchers, and the regulatory community. https://doi.org/10.1289/EHP3997.
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Affiliation(s)
- Keeve E Nachman
- Risk Sciences and Public Policy Institute, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
- Johns Hopkins Center for a Livable Future, Johns Hopkins University, Baltimore, Maryland, USA
| | - Tracy Punshon
- Department of Biological Sciences, Dartmouth College, Hanover, New Hampshire, USA
- Dartmouth Superfund Research Program, Hanover, New Hampshire, USA
- Dartmouth Children's Environmental Health and Disease Prevention Research Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - Laurie Rardin
- Dartmouth Superfund Research Program, Hanover, New Hampshire, USA
| | - Antonio J Signes-Pastor
- Dartmouth Superfund Research Program, Hanover, New Hampshire, USA
- Dartmouth Children's Environmental Health and Disease Prevention Research Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Carolyn J Murray
- Dartmouth Children's Environmental Health and Disease Prevention Research Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - Brian P Jackson
- Dartmouth Superfund Research Program, Hanover, New Hampshire, USA
- Department of Earth Sciences, Dartmouth College, Hanover, New Hampshire, USA
| | - Mary Lou Guerinot
- Department of Biological Sciences, Dartmouth College, Hanover, New Hampshire, USA
| | - Thomas A Burke
- Risk Sciences and Public Policy Institute, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Celia Y Chen
- Department of Biological Sciences, Dartmouth College, Hanover, New Hampshire, USA
- Dartmouth Superfund Research Program, Hanover, New Hampshire, USA
| | - Habibul Ahsan
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois, USA
| | - Maria Argos
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois, USA
| | - Kathryn L Cottingham
- Department of Biological Sciences, Dartmouth College, Hanover, New Hampshire, USA
- Dartmouth Children's Environmental Health and Disease Prevention Research Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - Francesco Cubadda
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità - Italian National Institute of Health, Rome, Italy
| | - Gary L Ginsberg
- Yale School of Public Health, 60 College St, New Haven, Connecticut, USA
| | - Britton C Goodale
- Dartmouth Superfund Research Program, Hanover, New Hampshire, USA
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Margaret Kurzius-Spencer
- Department of Pediatrics, College of Medicine, University of Arizona, Tucson, Arizona, USA
- Department of Community, Environment and Policy, Mel & Enid College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Andrew A Meharg
- Institute for Global Food Security, Queen's University Belfast, David Keir Building, Malone Road, Belfast, BT9 5BN, Northern Ireland, UK
| | - Mark D Miller
- Western States Pediatric Environmental Health Specialty Unit, University of California, San Francisco, San Francisco, California, USA
| | - Anne E Nigra
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | | | - Andrea Raab
- Department of Chemistry, University of Aberdeen, Aberdeen, UK
| | - Ken Reimer
- Royal Military College, Kingston, Ontario, Canada
| | - Kirk G Scheckel
- Land and Materials Management Division, National Risk Management Research Laboratory, United States Environmental Protection Agency, Cincinnati, Ohio, USA
| | - Tanja Schwerdtle
- Institute of Nutritional Sciences, University of Potsdam, Germany
| | - Vivien F Taylor
- Dartmouth Superfund Research Program, Hanover, New Hampshire, USA
- Department of Earth Sciences, Dartmouth College, Hanover, New Hampshire, USA
| | - Erik J Tokar
- National Toxicology Program Laboratory, National Toxicology Program, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Todd M Warczak
- Department of Biological Sciences, Dartmouth College, Hanover, New Hampshire, USA
| | - Margaret R Karagas
- Dartmouth Superfund Research Program, Hanover, New Hampshire, USA
- Dartmouth Children's Environmental Health and Disease Prevention Research Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
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Nigra AE, Ruiz-Hernandez A, Redon J, Navas-Acien A, Tellez-Plaza M. Environmental Metals and Cardiovascular Disease in Adults: A Systematic Review Beyond Lead and Cadmium. Curr Environ Health Rep 2018; 3:416-433. [PMID: 27783356 DOI: 10.1007/s40572-016-0117-9] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Published systematic reviews concluded that there is moderate to strong evidence to infer a potential role of lead and cadmium, widespread environmental metals, as cardiovascular risk factors. For other non-essential metals, the evidence has not been appraised systematically. Our objective was to systematically review epidemiologic studies on the association between cardiovascular disease in adults and the environmental metals antimony, barium, chromium, nickel, tungsten, uranium, and vanadium. We identified a total of 4 articles on antimony, 1 on barium, 5 on chromium, 1 on nickel, 4 on tungsten, 1 on uranium, and 0 on vanadium. We concluded that the current evidence is not sufficient to inform on the cardiovascular role of these metals because of the small number of studies. Few experimental studies have also evaluated the role of these metals in cardiovascular outcomes. Additional epidemiologic and experimental studies, including prospective cohort studies, are needed to understand the role of metals, including exposure to metal mixtures, in cardiovascular disease development.
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Affiliation(s)
- Anne E Nigra
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, 722 W 168th St, 11 Floor Rm 1105, New York, NY, 10032, USA
| | - Adrian Ruiz-Hernandez
- Department of Internal Medicine, Hospital Clínico de Valencia, Avenida Blasco Ibañez, 17, 46010, Valencia, Spain.,Area of Cardiometabolic and Renal Risk, Institute for Biomedical Research Hospital Clinical of Valencia (INCLIVA), Av. Menendez Pelayo, 4 accesorio, 6010, Valencia, Spain
| | - Josep Redon
- Department of Internal Medicine, Hospital Clínico de Valencia, Avenida Blasco Ibañez, 17, 46010, Valencia, Spain.,Area of Cardiometabolic and Renal Risk, Institute for Biomedical Research Hospital Clinical of Valencia (INCLIVA), Av. Menendez Pelayo, 4 accesorio, 6010, Valencia, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Minister of Health, Madrid, Spain
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, 722 W 168th St, 11 Floor Rm 1105, New York, NY, 10032, USA.,Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Maria Tellez-Plaza
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. .,Area of Cardiometabolic and Renal Risk, Institute for Biomedical Research Hospital Clinical of Valencia (INCLIVA), Av. Menendez Pelayo, 4 accesorio, 6010, Valencia, Spain.
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Nigra AE, Sanchez TR, Nachman KE, Harvey D, Chillrud SN, Graziano JH, Navas-Acien A. The effect of the Environmental Protection Agency maximum contaminant level on arsenic exposure in the USA from 2003 to 2014: an analysis of the National Health and Nutrition Examination Survey (NHANES). Lancet Public Health 2018; 2:e513-e521. [PMID: 29250608 PMCID: PMC5729579 DOI: 10.1016/s2468-2667(17)30195-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background The current US Environmental Protection Agency (EPA) maximum
contaminant level (MCL) for arsenic in public water systems (10
µg/L) took effect in 2006. Arsenic is not federally regulated in
private wells. The impact of the 2006 MCL on arsenic exposure in the US, as
confirmed through biomarkers, is presently unknown. We evaluated national
trends in water arsenic exposure in the US, hypothesizing that urinary
arsenic levels would decrease over time among participants using public
water systems but not among those using well water. We further estimated the
expected number of avoided lung, bladder, and skin cancer cases. Methods We evaluated 14,127 participants in the National Health and Nutrition
Examination Survey (NHANES) 2003–2014 with urinary dimethylarsinate
(DMA) and total arsenic available. To isolate water exposure, we expanded a
residual-based method to remove tobacco and dietary contributions of
arsenic. We applied EPA risk assessment approaches to estimate the expected
annual number of avoided cancer cases comparing arsenic exposure in
2013–2014 vs. 2003–2004. Findings Among public water users, fully adjusted geometric means (GMs) of DMA
decreased from 3.01 µg/L in 2003–2004 to 2.49 µg/L
in 2013–2014 (17% reduction; 95% confidence interval
10%, 24%; p-trend<0.01); no change was observed
among well water users (p-trend= 0.35). Assuming these estimated exposure
reductions will remain similar across a lifetime, we estimate a reduction of
200 to 900 lung and bladder cancer cases per year depending on the approach
used. Interpretation The decline in urinary arsenic among public water but not private
well users in NHANES 2003–2014 indicates that the implementation of
the current MCL has reduced arsenic exposure in the US population. Our study
supports prior work showing that well water users are inadequately protected
against drinking water arsenic, and confirms the critical role of federal
drinking water regulations in reducing toxic exposures and protecting human
health. Funding This work was supported by the National Institute of Environmental
Health Sciences (1R01ES025216, R01ES021367, 5P30ES009089 and P42ES010349).
A. E. Nigra was supported by 5T32ES007322.
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Affiliation(s)
- Anne E Nigra
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY
| | - Tiffany R Sanchez
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY
| | - Keeve E Nachman
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Johns Hopkins Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Johns Hopkins Risk Sciences and Public Policy Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - David Harvey
- Commissioned Corps Officer of the U.S. Public Health Service, Rockville, MD
| | - Steven N Chillrud
- Lamont-Doherty Earth Observatory, Columbia University, Palisades, NY
| | - Joseph H Graziano
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY
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Nigra AE, Nachman KE, Love DC, Grau-Perez M, Navas-Acien A. Poultry Consumption and Arsenic Exposure in the U.S. Population. Environ Health Perspect 2017; 125:370-377. [PMID: 27735790 PMCID: PMC5332189 DOI: 10.1289/ehp351] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 08/24/2016] [Accepted: 09/19/2016] [Indexed: 05/17/2023]
Abstract
BACKGROUND Arsenicals (roxarsone and nitarsone) used in poultry production likely increase inorganic arsenic (iAs), monomethylarsonic acid (MMA), dimethylarsinic acid (DMA), and roxarsone or nitarsone concentrations in poultry meat. However, the association between poultry intake and exposure to these arsenic species, as reflected in elevated urinary arsenic concentrations, is unknown. OBJECTIVES Our aim was to evaluate the association between 24-hr dietary recall of poultry consumption and arsenic exposure in the U.S. population. We hypothesized first, that poultry intake would be associated with higher urine arsenic concentrations and second, that the association between turkey intake and increased urine arsenic concentrations would be modified by season, reflecting seasonal use of nitarsone. METHODS We evaluated 3,329 participants ≥ 6 years old from the 2003-2010 National Health and Nutrition Examination Survey (NHANES) with urine arsenic available and undetectable urine arsenobetaine levels. Geometric mean ratios (GMR) of urine total arsenic and DMA were compared across increasing levels of poultry intake. RESULTS After adjustment, participants in the highest quartile of poultry consumption had urine total arsenic 1.12 (95% CI: 1.04, 1.22) and DMA 1.13 (95% CI: 1.06, 1.20) times higher than nonconsumers. During the fall/winter, participants in the highest quartile of turkey intake had urine total arsenic and DMA 1.17 (95% CI: 0.99, 1.39; p-trend = 0.02) and 1.13 (95% CI: 0.99, 1.30; p-trend = 0.03) times higher, respectively, than nonconsumers. Consumption of turkey during the past 24 hr was not associated with total arsenic or DMA during the spring/summer. CONCLUSIONS Poultry intake was associated with increased urine total arsenic and DMA in NHANES 2003-2010, reflecting arsenic exposure. Seasonally stratified analyses by poultry type provide strong suggestive evidence that the historical use of arsenic-based poultry drugs contributed to arsenic exposure in the U.S. CITATION Nigra AE, Nachman KE, Love DC, Grau-Perez M, Navas-Acien A. 2017. Poultry consumption and arsenic exposure in the U.S. Environ Health Perspect 125:370-377; http://dx.doi.org/10.1289/EHP351.
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Affiliation(s)
- Anne E. Nigra
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
- Department of Epidemiology,
- Department of Environmental Health Sciences,
- Address correspondence to A.E. Nigra, Department of Environmental Health Sciences, Columbia Mailman School of Public Health, 722 W. 168th St., 11th Floor, Room 1105, New York, NY 10032 USA. E-mail: , or A. Navas-Acien, Department of Environmental Health Sciences, Columbia Mailman School of Public Health, 722 W. 168th St., 11th Floor, Room 1105, New York, NY 10032 USA. Telephone: 212-342-4712. E-mail:
| | - Keeve E. Nachman
- Department of Environmental Health Sciences,
- Center for a Livable Future, and
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - David C. Love
- Department of Environmental Health Sciences,
- Center for a Livable Future, and
| | - Maria Grau-Perez
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
- Department of Environmental Health Sciences,
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
- Department of Epidemiology,
- Department of Environmental Health Sciences,
- Address correspondence to A.E. Nigra, Department of Environmental Health Sciences, Columbia Mailman School of Public Health, 722 W. 168th St., 11th Floor, Room 1105, New York, NY 10032 USA. E-mail: , or A. Navas-Acien, Department of Environmental Health Sciences, Columbia Mailman School of Public Health, 722 W. 168th St., 11th Floor, Room 1105, New York, NY 10032 USA. Telephone: 212-342-4712. E-mail:
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Nachman KE, Love DC, Baron PA, Nigra AE, Murko M, Raber G, Francesconi KA, Navas-Acien A. Nitarsone, Inorganic Arsenic, and Other Arsenic Species in Turkey Meat: Exposure and Risk Assessment Based on a 2014 U.S. Market Basket Sample. Environ Health Perspect 2017; 125:363-369. [PMID: 27735789 PMCID: PMC5332177 DOI: 10.1289/ehp225] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 07/21/2016] [Accepted: 07/23/2016] [Indexed: 05/03/2023]
Abstract
BACKGROUND Use of nitarsone, an arsenic-based poultry drug, may result in dietary exposures to inorganic arsenic (iAs) and other arsenic species. Nitarsone was withdrawn from the U.S. market in 2015, but its use in other countries may continue. OBJECTIVES We characterized the impact of nitarsone use on arsenic species in turkey meat and arsenic exposures among turkey consumers, and we estimated cancer risk increases from consuming turkey treated with nitarsone before its 2015 U.S. withdrawal. METHODS Turkey from three cities was analyzed for total arsenic, iAs, methylarsonate (MA), dimethylarsinate, and nitarsone, which were compared across label type and month of purchase. Turkey consumption was estimated from NHANES data to estimate daily arsenic exposures for adults and children 4-30 months of age and cancer risks among adult consumers. RESULTS Turkey meat from conventional producers not prohibiting nitarsone use showed increased mean levels of iAs (0.64 μg/kg) and MA (5.27 μg/kg) compared with antibiotic-free and organic meat (0.39 μg/kg and 1.54 μg/kg, respectively) and meat from conventional producers prohibiting nitarsone use (0.33 μg/kg and 0.28 μg/kg, respectively). Samples with measurable nitarsone had the highest mean iAs and MA (0.92 μg/kg and 10.96 μg/kg, respectively). Nitarsone was higher in October samples than in March samples, possibly resulting from increased summer use. Based on mean iAs concentrations in samples from conventional producers with no known policy versus policies prohibiting nitarsone, estimated lifetime daily consumption by an 80-kg adult, and a recently proposed cancer slope factor, we estimated that use of nitarsone by all turkey producers would result in 3.1 additional cases of bladder or lung cancer per 1,000,000 consumers. CONCLUSIONS Nitarsone use can expose turkey consumers to iAs and MA. The results of our study support the U.S. Food and Drug Administration's removal of nitarsone from the U.S. market and further support its removal from the global marketplace. Citation: Nachman KE, Love DC, Baron PA, Nigra AE, Murko M, Raber G, Francesconi KA, Navas-Acien A. 2017. Nitarsone, inorganic arsenic, and other arsenic species in turkey meat: exposure and risk assessment based on a 2014 U.S. market basket sample. Environ Health Perspect 125:363-369; http://dx.doi.org/10.1289/EHP225.
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Affiliation(s)
- Keeve E. Nachman
- Johns Hopkins Center for a Livable Future,
- Department of Environmental Health Sciences,
- Department of Health Policy and Management,
- Risk Sciences and Public Policy Institute, and
- Address correspondence to K.E. Nachman, 615 N. Wolfe St., W7010-E, Baltimore, MD 21205 USA. Telephone: (410) 502-7578. E-mail:
| | - David C. Love
- Johns Hopkins Center for a Livable Future,
- Department of Environmental Health Sciences,
| | - Patrick A. Baron
- Johns Hopkins Center for a Livable Future,
- Department of Environmental Health Sciences,
| | - Anne E. Nigra
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Manuela Murko
- Institute of Chemistry-Analytical Chemistry, University of Graz, Graz, Austria
| | - Georg Raber
- Institute of Chemistry-Analytical Chemistry, University of Graz, Graz, Austria
| | | | - Ana Navas-Acien
- Department of Environmental Health Sciences,
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
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Nachman KE, Ginsberg GL, Miller MD, Murray CJ, Nigra AE, Pendergrast CB. Mitigating dietary arsenic exposure: Current status in the United States and recommendations for an improved path forward. Sci Total Environ 2017; 581-582:221-236. [PMID: 28065543 PMCID: PMC5303536 DOI: 10.1016/j.scitotenv.2016.12.112] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 12/08/2016] [Accepted: 12/16/2016] [Indexed: 05/19/2023]
Abstract
Inorganic arsenic (iAs) is a well-characterized carcinogen, and recent epidemiologic studies have linked chronic exposures to non-cancer health outcomes, including cardiovascular disease, diabetes, skin lesions and respiratory disorders. Greater vulnerability has been demonstrated with early life exposure for health effects including lung and bladder cancer, immunotoxicity and neurodevelopment. Despite its well-known toxicity, there are important gaps in the regulatory oversight of iAs in food and in risk communication. This paper focuses on the US regulatory framework in relation to iAs in food and beverages. The state of existing regulatory agency toxicological assessments, monitoring efforts, standard setting, intervention policies and risk communication are explored. Regarding the approach for standard setting, risk-based evaluations of iAs in particular foods can be informative but are insufficient to create a numeric criterion, given current uncertainties in iAs toxicology and the degree to which traditional risk targets can be exceeded by dietary exposures. We describe a process for prioritizing dietary exposures for different lifestages and recommend a relative source contribution-based approach to setting criteria for arsenic in prioritized foods. Intervention strategies begin with an appropriately set criterion and a monitoring program that documents the degree to which this target is met for a particular food. This approach will promote improvements in food production to lower iAs contamination for those foods which initially do not meet the criterion. Risk communication improvements are recommended to ensure that the public has reliable information regarding sources and alternative dietary choices. A key recommendation is the consideration of meal frequency advice similar to what is currently done for contaminants in fish. Recent action level determinations by FDA for apple juice and infant rice cereal are evaluated and used as illustrations of how our recommended approach can further the goal of exposure mitigation from key sources of dietary iAs in the US.
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Affiliation(s)
- Keeve E Nachman
- Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Johns Hopkins Center for a Livable Future, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Johns Hopkins Risk Sciences and Public Policy Institute, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | | | - Mark D Miller
- Western States Pediatric Environmental Health Specialty Unit, University of California, San Francisco, CA, USA
| | - Carolyn J Murray
- Dartmouth Children's Environmental Health and Disease Prevention Research Center, Hanover, NH, USA; Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Anne E Nigra
- Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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