Poultry Consumption and Arsenic Exposure in the U.S. Population

Background: Arsenicals (roxarsone and nitarsone) used in poultry production likely increase inorganic arsenic (iAs) concentrations in poultry meat. The association between poultry intake and iAs exposure, as reflected in elevated urinary arsenic concentrations, however, is unknown. Objectives: Evaluate the association between 24-hour dietary recall of poultry consumption and iAs exposure, as reflected in increased urine arsenic concentrations, in the U.S. population. We hypothesized 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 dimethylarsinic acid (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 (1.06, 1.20) times higher than non-consumers. During the fall/winter participants in the highest quartile of turkey intake had urine total arsenic and DMA 1.17 (0.99, 1.39, p-trend=0.02) and 1.13 (0.99, 1.30, p-trend=0.03) times higher, respectively, than non-consumers. Past 24-hour consumption of turkey 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 iAs exposure. Seasonally stratified analyses by poultry type provide strong suggestive evidence that the historical use of arsenic-based poultry drugs contributed to iAs exposure in the U.S. population, and support the banning of arsenic-based poultry drugs internationally

Urinary Metal Levels after Repeated Edetate Disodium Infusions: Preliminary Findings

Environmentally acquired lead and cadmium are associated with increased cardiovascular disease risk. In the Trial to Assess Chelation Therapy, up to 40 infusions with edetate disodium over an approximately one-year period lowered the cardiovascular disease risk in patients with a prior myocardial infarction. We assessed whether a reduction in surrogate measures of total body lead and cadmium, post-edetate disodium urine lead and pre-edetate urine cadmium, could be detected after repeated edetate disodium-based infusions compared to the baseline. Fourteen patients with coronary artery disease received multiple open-label edetate disodium infusions. The urine metals pre- and post-edetate infusion, normalized for urine creatinine, were compared to urine levels pre and post final infusion by a paired t-test. Compared with the pre-edetate values, post-edetate urine lead and cadmium increased by 3581% and 802%, respectively, after the first infusion. Compared to baseline, post-edetate lead decreased by 36% (p = 0.0004). A reduction in post-edetate urine lead was observed in 84% of the patients after the final infusion. Pre-edetate lead decreased by 60% (p = 0.003). Pre-edetate lead excretion became undetectable in nearly 40% of patients. This study suggests that edetate disodium-based infusions may decrease the total body burden of lead. However, our data suggest no significant reduction in the body burden of cadmium

Hazardous heat exposure among incarcerated people in the United States

Climate change is predicted to increase the frequency of potentially hazardous heat conditions across the United States, putting the incarcerated population of 2 million at risk for heat-related health conditions. We evaluate the exposure to potentially hazardous heat for 4,078 continental US carceral facilities during 1982–2020. Results show that the number of hot days per year increased during 1982–2020 for 1,739 carceral facilities, primarily located in the southern United States. State-run carceral facilities in Texas and Florida accounted for 52% of total exposure, despite holding 12% of all incarcerated people. This highlights the urgency for enhanced infrastructure, health system interventions and treatment of incarcerated people, especially under climate change

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)

Summary: Background: In 2006, the current US Environmental Protection Agency (EPA) maximum contaminant level for arsenic in public water systems (10 μg/L) took effect. We aimed to assess national trends in water arsenic exposure in the USA, hypothesising that urinary arsenic concentrations would decrease over time in individuals using public water systems but not in those using well water (which is not federally regulated). We further estimated the expected number of avoided skin or lung and bladder cancer cases. Methods: In this analysis of the 2003â14 cycles of the National Health and Nutrition Examination Survey (NHANES), we used data for dimethylarsinate (DMA), the main metabolite of inorganic arsenic in human beings, and total urine arsenic to reflect water arsenic exposure in survey participants. To isolate exposure to water arsenic, we expanded a residual-based method to remove tobacco and dietary sources of urinary DMA and total arsenic. We also applied EPA risk-assessment approaches to estimate the expected annual number of avoided skin or lung and bladder cancer cases comparing arsenic exposure in 2013â14 with 2003â04. Findings: We obtained data from 14â127 individuals who participated in the NHANES between 2003 and 2014. Among public water users, fully adjusted geometric means of DMA decreased from 3·01 μg/L in 2003â04 to 2·49 μg/L in 2013â14 (17% reduction; 95% CI 10â24; p-trend<0·001); no change was observed in well water users (p-trend=0·35). Assuming these estimated exposure reductions will remain similar across a lifetime, we estimated a reduction of 200â900 lung and bladder cancer cases or 50 cases of skin cancer per year depending on the approach used. Interpretation: The decrease in urinary arsenic observed in public water but not private well users in NHANES 2003â14 suggests that the implementation of the current maximum contaminant level regulation is associated with reduced arsenic exposure in the US population. Our study suggests that well water users are inadequately protected against drinking water arsenic, and supports the crucial role of federal drinking water regulations in reducing toxic exposures and protecting human health. Funding: The National Institute of Environmental Health Sciences

A survey of trace metal burdens in increment cores from eastern cottonwood (\u3ci\u3ePopulus deltoides\u3c/i\u3e) across a childhood cancer cluster, Sandusky County, OH, USA

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 \u27hotspots\u27, 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

US drinking water quality: exposure risk profiles for seven legacy and emerging contaminants

Data de publicació electrònica: 22-09-2023Background: 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

The Contribution of Declines in Blood Lead Levels to Reductions in Blood Pressure Levels: Longitudinal Evidence in the Strong Heart Family Study

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

Association of water arsenic with incident diabetes in U.S. adults: The Multi-Ethnic Study of Atherosclerosis and The Strong Heart Study

Objective: We examined the association of arsenic in federally regulated community water systems (CWS) and unregulated private wells with type 2 diabetes (T2D) incidence 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.Research Design and Methods: We evaluated N=1,791 participants from SHFS and N=5,777 participants from MESA with water arsenic estimates available and free of T2D at baseline (2001-2003 and 2000-2002, respectively). Participants were followed for incident T2D until 2010 (SHFS) or 2019 (MESA). We used Cox proportional hazards mixed-effects models to account for clustering by family and residential zip code, with adjustment for sex, baseline age, body mass index (BMI), smoking status, and education.Results: T2D incidence was 24.4 cases per 1,000 person-years (mean follow-up 5.6 years) in SHFS and 11.2 per 1,000 person-years (mean follow-up 6.0 years) in MESA. In a meta-analysis across SHFS and MESA, the hazard ratio (95% confidence interval) per doubling in CWS arsenic was 1.10 (95%CI 1.02, 1.18). The corresponding hazard ratio was 1.09 (0.95, 1.26) in SHFS and 1.10 (1.01, 1.20) in MESA. The corresponding hazard ratio (95%CI) for arsenic in private wells and incident T2D in SHFS was 1.05 (0.95, 1.16). We observed statistical interaction and larger magnitude hazard ratios for participants with BMI Conclusions: Low to moderate water arsenic levels (<10 µg/L) were associated with T2D incidence in the SHFS and MESA.</p