Health Effects and Environmental Justice Concerns of Exposure to Uranium in Drinking Water

Zinc as a Mechanism-Based Strategy for Mitigation of Metals Toxicity

PURPOSE OF REVIEW

Zinc is an essential micronutrient with a myriad of key roles in human health. This review summarizes mechanistic data supporting the protective effects of zinc on metal toxicity and discusses the framework for an interventional clinical trial of zinc supplementation within a metal exposed Native American community.

RECENT FINDINGS

Many metals have common underlying mechanisms of toxicity that contribute to adverse human health effects. Studies demonstrate that multiple aspects of metal toxicity can be attributed to disruption of essential zinc-dependent functions. Multiple lines of evidence suggest that zinc may confer protection against metal toxicity in human populations with mixed-metal exposures. Thinking Zinc is a mechanism-informed intervention study of zinc supplementation to test the potential benefits of zinc while maintaining a culturally responsive research approach. The current knowledge of diverse metal and zinc interactions, coupled with strong mechanistic evidence for zinc benefits in the context of toxic metal exposures, supports the hypothesis that zinc supplementation may mitigate the impact of toxic metals exposures in populations with chronic mixed metal exposures and in populations with low zinc status.

Enhanced sorbent properties by synergistic effect of biomass extract functional groups for effective uranium uptake from aqueous system

Adsorption for uranium removal from aqueous systems has been extensively studied, due to its many advantages. However, the great costs and complexity of many sorbent preparation methods are still restricting the progress. Hence, this research aimed to introduce a novel, simple and green method for enhancing Amberlite IR-120 properties for U(VI) removal. Adsorption process parameters were evaluated by batch method and sorbent was characterized before and after uranium adsorption by FTIR, SEM and EDS analysis. The results demonstrated that sorbent was effective for U(VI) removal at pH 5, 100 mg dose with 60 mg/L of U(VI) concentration within 40 min at higher temperatures. The removal efficiency was 87.7% and process was found feasible according to thermodynamic data. Kinetic modelling showed best correlation with pseudo-second order model (r2 = 0.999) and applied isotherms could all describe investigated process suggesting a complex mechanism of U(VI) uptake. Effect of interfering ions (Pb(II), Ni(II) and Co(II)) in a concentration of 45 and 60 mg/L decreased U(VI) removal to 45%. Additionally, AAS method confirmed that used sorbent has significant affinity towards Pb(II). Desorption study revealed successful uranium recovery in up to 3 cycles of sorption/desorption. The EDS analysis revealed the uranium presence with 4.7% and FTIR analysis revealed bands characteristic for stretching vibrations of O=U=O. Proposed mechanism involved U(VI) uptake via non-covalent interactions, inter/intra-molecular hydrogen bonding and intraparticle diffusion. Techno-economic analysis showed that with used preparation method 1 g of ASP costs 0.022 $. Hence, this study offers a novel method for sorbents properties enhancements.

An assessment of radiological risks and chemical toxicity due to naturally occurring radionuclides in surface waters of a semiarid region in Brazil

Santa Quitéria, a city in northeastern Brazil, faces significant challenges in ensuring the availability of potable water due to its semi-arid climate and limited water resources. This study investigates the radiological quality of surface waters commonly used by the population for drinking and by animals for hydration. Water samples were collected from six different locations over a 25-month period, and the concentrations of naturally occurring radionuclides were measured using spectrophotometric analysis, total alpha, and gross beta counting. The mean activity concentrations of Unat, 226Ra, 210Pb, 232Th, and 228Ra were determined to be 9.89∙10-2, 5.35∙10-2, 5.86∙10-2, 6.89∙10-3, and 2.81∙10-3 Bq∙L-1, respectively. Statistical methods, such as cluster and factor analysis, were applied to understand the distribution patterns of these radionuclides. The study also estimated dose rates from radionuclide intake, with a maximum value of 108.5 µSv·y-1, and compared the results against dose limits set by relevant organizations. Furthermore, the risks of morbidity and mortality from radionuclide intake were assessed, revealing the need for optimization at one sampling point where the health risks exceeded intervention thresholds.

Association of Urinary Metals With Cardiovascular Disease Incidence and All-Cause Mortality in the Multi-Ethnic Study of Atherosclerosis (MESA)

BACKGROUND

Exposure to metals has been associated with cardiovascular disease (CVD) end points and mortality, yet prospective evidence is limited beyond arsenic, cadmium, and lead. In this study, we assessed the prospective association of urinary metals with incident CVD and all-cause mortality in a racially diverse population of US adults from MESA (the Multi-Ethnic Study of Atherosclerosis).

METHODS

We included 6599 participants (mean [SD] age, 62.1 [10.2] years; 53% female) with urinary metals available at baseline (2000 to 2001) and followed through December 2019. We used Cox proportional hazards models to estimate the adjusted hazard ratio and 95% CI of CVD and all-cause mortality by baseline urinary levels of cadmium, tungsten, and uranium (nonessential metals), and cobalt, copper, and zinc (essential metals). The joint association of the 6 metals as a mixture and the corresponding 10-year survival probability was calculated using Cox Elastic-Net.

RESULTS

During follow-up, 1162 participants developed CVD, and 1844 participants died. In models adjusted by behavioral and clinical indicators, the hazard ratios (95% CI) for incident CVD and all-cause mortality comparing the highest with the lowest quartile were, respectively: 1.25 (1.03, 1.53) and 1.68 (1.43, 1.96) for cadmium; 1.20 (1.01, 1.42) and 1.16 (1.01, 1.33) for tungsten; 1.32 (1.08, 1.62) and 1.32 (1.12, 1.56) for uranium; 1.24 (1.03, 1.48) and 1.37 (1.19, 1.58) for cobalt; 1.42 (1.18, 1.70) and 1.50 (1.29, 1.74) for copper; and 1.21 (1.01, 1.45) and 1.38 (1.20, 1.59) for zinc. A positive linear dose-response was identified for cadmium and copper with both end points. The adjusted hazard ratios (95% CI) for an interquartile range (IQR) increase in the mixture of these 6 urinary metals and the corresponding 10-year survival probability difference (95% CI) were 1.29 (1.11, 1.56) and -1.1% (-2.0, -0.05) for incident CVD and 1.66 (1.47, 1.91) and -2.0% (-2.6, -1.5) for all-cause mortality.

CONCLUSIONS

This epidemiological study in US adults indicates that urinary metal levels are associated with increased CVD risk and mortality. These findings can inform the development of novel preventive strategies to improve cardiovascular health.

Catalyst-Free Extraction of U(VI) in Solution by Tribocatalysis

Extraction of U(VI) in water is of great significance in energy and environmental fields. However, the traditional methods usually fail due to the indispensable extra addition of catalyst, adsorbent, precipitant, or sacrificial agents, which may lead to enhanced extraction costs and secondary pollution. Here, a new efficient uranium extraction strategy is proposed based on triboelectricity without adding a catalyst or other additives. It is found only under the friction between the microbubbles (generated under ultrasonication) and the water flow, that reactive oxygen species (ROS) can largely be generated, which thus contributes to the solidification of U(VI) from water. In addition, the magnetic field can affect the phase of the product. Under mechanical stirring, the product contains (UO2)O2·2H2O, while which contains UO2(OH)2 and (UO2)O2·4H2O under the magnetic stirring. Quenching experiments are also carried out to explore the influence of environmental factors. Most importantly, it shows great potential in the extraction of U(VI) from seawater. This work proposes a catalyst-free and light-free strategy toward the solidification of U(VI) from water, which avoids the secondary pollution of the catalyst to the environment and is low-cost, and has great potential in the real application.

Assessment of potential human health, radiological and ecological risks around mining areas in northeastern Brazil

Mining is responsible for the release of metallic pollutants and radioactive materials into the environment, which have the potential to disrupt ecosystems and pose significant risks to human health. Significant mining activity is concentrated in the municipality of Caetité (northeastern Brazil), where Latin America's only active uranium mine and significant iron ore deposits are located. Although previous studies have shown that the regional soil and water resources are highly contaminated by various toxic elements and that exposure to these elements is known to have adverse effects on human health, the health risks in this mining region have never been assessed. The aim of this unprecedented comprehensive investigation was to assess the health, radiological and ecological risks in this mining region, which is home to nearly 100,000 people. To achieve our goal, soil and water samples were collected in the vicinity of the mines and in the main settlements in the region. Fifteen metallic toxic elements were determined using Instrumental Neutron Activation Analysis and Inductively Coupled Plasma Optical Emission Spectrometry. The HERisk code, which follows the main methodological guidelines for risk assessment, was used to quantify human health, radiological and ecological indices. The average values of the total risk and cancer risk indices indicated that region falls into the moderate risk category (1.0 ≤ HItot < 4.0). However, 63% of the sites had high risk values, with Fe, Co and As being the metals contributing most to total and cancer risk, respectively. Near the mining areas, the potential ecological risk can be considered extreme (PERI ≥ 600). The values of the calculated radiological indices correspond to typical values ​​in natural uranium areas. However, in the communities near the mine, the dose values are slightly above the permissible limit (1 mSv y-1), so they must be continuously monitored, and risk mitigation measures must be taken.

Performance and mechanism of U(vi) removal from solution by humic acid-coated Fe3O4 nanoparticle-modified biochar from filamentous green algae

The adsorbent material humic acid-coated Fe3O4 nanoparticle-modified biochar from filamentous green algae was fabricated by introducing the composites of humic acid-coated Fe3O4 nanoparticles onto biochar from filamentous green algae using the co-precipitation method. Then, the removal of U(vi) from solution by humic acid-Fe3O4/BC was carried out through batch experiments. The results of the characterization showed that the reaction conditions had an important influence on U(vi) removal by humic acid-Fe3O4/BC. The pseudo-second-order kinetic model and Langmuir model better illustrate the adsorption process of U(vi) on the surface of humic acid-Fe3O4/BC. The adsorption processes were dominated by chemisorption and monolayer adsorption. The maximum adsorption capacity of U(vi) by humic acid-Fe3O4/BC could be calculated, and it could reach 555.56 mg g-1. The probable mechanisms of U(vi) removal by humic acid-Fe3O4/BC were reduction reaction, inner-sphere surface complexation and electrostatic adsorption. The high stability and reusability of humic acid-Fe3O4/BC made it more promising in U(vi) removal applications.

Consideration on the Intergenerational Ethics on Uranium Waste Disposal

PURPOSE OF REVIEW

This review provides insights into resolving intergenerational issues related to the disposal of waste containing high amounts of uranium (uranium waste), from which distant future generations will have higher health risks than the current generation.

RECENT FINDINGS

Uranium (half-life: 4.5 billion years) produces various progeny radionuclides through radioactive decay over the long term, and its radioactivity, as the sum of its contributions, continues to increase for more than 100,000 years. In contrast to high-level radioactive wastes, protective measures, such as attenuation of radiation and confinement of radionuclides from the disposal facility, cannot work effectively for uranium waste. Thus, additional considerations from the perspective of intergenerational ethics are needed in the strategy for uranium waste disposal. The current generation, which has benefited from the use and disposal of uranium waste, is responsible for protecting future generations from the potential risk of buried uranium beyond the lifetime of a disposal facility. Fulfilling this responsibility means making more creative efforts to convey critical information on buried materials to the distant future to ensure that future generations can properly take measures to reduce the harm by themselves in response to changing circumstances including people's values.

Environmental impact assessment due to the intake of uranium contained in surface waters in a semi-arid region in Brazil

In Santa Quitéria City, part of the population uses surface water for potation. These waters do not undergo any treatment before consumption. As the region has a deposit of uranium, assessing water quality becomes important. In the present study, the uranium activity concentration (AC) in becquerels per liter was determined in water samples from six points. Univariate statistics showed differences between the soluble and the particulate fraction (soluble AC > particulate AC). The particulate fraction showed no variation in AC among the six points. On the other hand, the soluble fraction and the total fraction presented different ACs between them. The multivariate statistics allowed to separate the soluble from the particulate fraction of the points. The same tools applied to the total fraction made it possible to differentiate the sampling points, grouping them ((#1, #2); (#3, #4), and (#5, #6)). The maximum mean value of AC found was 0.177 Bq∙L-1, corresponding to 25% of the chemical toxicity limit (0.72 Bq∙L-1). The maximum mean dose rate, 2.25 µSv∙year-1, is lower than the considered negligible dose rate (> 10 µSv∙year-1). The excess lifetime cancer risk was 10-6, two orders of magnitude smaller than the threshold considered for taking action. The assessment parameters used in this work indicate that the risk due to the uranium intake by the local population is negligible.

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

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.

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

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.

Preterm Birth and Metal Mixture Exposure among Pregnant Women from the Navajo Birth Cohort Study

BACKGROUND

Preterm birth (PTB), defined as birth before 37 wk gestation, is associated with hypertension, diabetes, inadequate prenatal care, unemployment or poverty, and metal exposure. Indigenous individuals are more likely to have maternal risk factors associated with PTB compared with other populations in the United States; however, the role of environmental metals on PTB among pregnant Indigenous women remains uncertain. Previous research identified associations between PTB and individual metals, but there is limited investigation on metal mixtures and this birth outcome.

OBJECTIVES

We used a mixtures analysis framework to investigate the association between metal mixtures and PTB among pregnant Indigenous women from the Navajo Birth Cohort Study (NBCS).

METHODS

Maternal urine and blood samples were collected at the time of study enrollment and analyzed for metals by inductively coupled plasma dynamic reaction cell mass spectrometry. Bayesian Profile Regression was used to identify subgroups (clusters) of individuals with similar patterns of coexposure and to model association with PTB.

RESULTS

Results indicated six subgroups of maternal participants with distinct exposure profiles, including one group with low exposure to all metals and one group with total arsenic, cadmium, lead, and uranium concentrations exceeding representative concentrations calculated from the National Health and Nutrition Examination Survey (NHANES). Compared with the reference group (i.e., the lowest exposure subgroup), the subgroup with the highest overall exposure had a relative risk of PTB of 2.9 times (95% credible interval: 1.1, 6.1). Exposures in this subgroup were also higher overall than NHANES median values for women 14-45 years of age.

DISCUSSION

Given the wide range of exposures and elevated PTB risk for the most exposed subgroups in a relatively small study, follow-up investigation is recommended to evaluate associations between metal mixture profiles and other birth outcomes and to test hypothesized mechanisms of action for PTB and oxidative stress caused by environmental metals. https://doi.org/10.1289/EHP10361.

3D Composite U(VI) Adsorbents Based on Alginate Hydrogels and Oxidized Biochar Obtained from Luffa cylindrica

3D naturally derived composites consisting of calcium alginate hydrogels (CA) and oxidized biochar obtained from Luffa cylindrica (ox-LC) were synthesized and further evaluated as adsorbents for the removal of U(VI) from aqueous media. Batch-type experiments were conducted to investigate the effect of various physicochemical parameters on the adsorption performance of materials. The maximum adsorption capacity (qmax) was 1.7 mol kg-1 (404.6 mg·g-1) at pH 3.0 for the CA/ox-LC with a 10% wt. ox-LC content. FTIR spectroscopy indicated the formation of inner-sphere complexes between U(VI) and the surface-active moieties existing on both CA and ox-LC, while thermodynamic data revealed that the adsorption process was endothermic and entropy-driven. The experimental data obtained from the adsorption experiments were well-fitted by the Langmuir and Freundlich models. Overall, the produced composites exhibited enhanced adsorption efficiency against U(VI), demonstrating their potential use as effective adsorbents for the recovery of uranium ions from industrial effluents and seawater.

"One-can" strategy for the synthesis of hydrothermal biochar modified with phosphate groups and efficient removal of uranium(VI)

Significant selectivity, reasonable surface modification and increased structural porosity were three key factors to improve the competitiveness of biochar in the adsorption field. In this study, a hydrothermal bamboo-derived biochar modified with phosphate groups (HPBC) was synthesized using "one-can" strategy. BET showed that this method could effectively increase the specific surface area (137.32 m2 g-1) and simulation of wastewater experiments indicated HPBC had an excellent selectivity for U(VI) (70.35%), which was conducive to removal of U(VI) in real and complex environments. The accurate matchings of pseudo-second-order kinetic model, thermodynamic model and Langmuir isotherm showed that at 298 K, pH = 4.0, the adsorption process dominated by chemical complexation and monolayer adsorption was spontaneous, endothermic and disordered. Saturated adsorption capacity of HPBC could reach 781.02 mg g-1 within 2 h. The introduction of phosphoric acid and citric acid by "one-can" method not only provided abundant -PO4 to assist adsorption, but also activated oxygen-containing groups on the surface of the bamboo matrix. Results showed that adsorption mechanism of U(VI) by HPBC included electrostatic action and chemical complexation involving P-O, PO and ample oxygen-containing functional groups. Therefore, HPBC with high phosphorus content, outstanding adsorption performance, excellent regeneration, remarkable selectivity and green value provided a novel solution for the field of radioactive wastewater treatment.

Uranium: an overview of physicochemical properties, exposure assessment methodologies, and health effects of environmental and occupational exposure

Uranium is chemo- and radiotoxic element which can cause multifactorial health hazards. Natural and anthropogenic uranium contamination raises concerns about potential public health problems. Natural contamination plays a significant role with regard to uranium exposure in the general population, whereas anthropogenic contamination leads to occupational uranium exposure, particularly in nuclear industry workers. In this review, we present a state-of-the-art status concerning uranium-induced health risks with a focus on epidemiological findings of uranium processing and enrichment plant workers. We provide a general overview of physicochemical properties of uranium and analytical methods for measuring or monitoring uranium, describe environmental and occupational exposure scenarios, and discuss the challenges for objectively investigating risks from uranium exposure.

Flumequine-mediated fluorescent zeolitic imidazolate framework functionalized by Eu3+ for sensitive and selective detection of UO22+, Ni2+ and Cu2+ in nuclear wastewater

Currently, antibiotics and heavy metal contaminants have posed a great threat for ecological security and human health. Herein, the lanthanide functionalized ZIF (named ZIF-90-PABA-Eu) is constructed by coordinating with Eu³⁺ via p-aminobenzoic acid intermediate. Due to the excellent fluorescence properties, the novel fluorescent probe can selectively monitor flumequine based on "turn on" mode. Furthermore, the obtained new material (named ZIF-90-PABA-Eu-Flu) can be used as "turn off" sensor for selective detection of both radioactive and nonradioactive heavy metal ions (UO₂²⁺, Ni²⁺ and Cu²⁺) which are the main component of nuclear industrial wastewater. ZIF-90-PABA-Eu-Flu shows ultra-short fluorescence response time (3 s) and ultra-low limit of detection (9.0 × 10^-3, 1.3 × 10^-2 and 6.1 × 10^-4 ppm) for three metal ions, which may be attributed to its good affinity with UO₂²⁺, Ni²⁺ and Cu²⁺. Moreover, principal component analysis (PCA) is applied to distinguish the three metal ions. Additionally, the possible sensing mechanism is investigated by the UV-vis spectra, luminescence lifetimes and theoretical calculation analysis. Based on these results, ZIF-90-PABA-Eu possesses promising potential in practical application and provides insight for the design of novel probes to continuously monitor flumequine, radioactive and nonradioactive heavy metal ions.

Development and application of an evidence-based directed acyclic graph to evaluate the associations between metal mixtures and cardiometabolic outcomes

Objectives

Specifying causal models to assess relationships among metal mixtures and cardiometabolic outcomes requires evidence-based models of the causal structures; however, such models have not been previously published. The objective of this study was to develop and evaluate a directed acyclic graph (DAG) diagraming metal mixture exposure and cardiometabolic outcomes.

Methods

We conducted a literature search to develop the DAG of metal mixtures and cardiometabolic outcomes. To evaluate consistency of the DAG, we tested the suggested conditional independence statements using linear and logistic regression analyses with data from the San Luis Valley Diabetes Study (SLVDS; n=1795). We calculated the proportion of statements supported by the data and compared this to the proportion of conditional independence statements supported by 1,000 DAGs with the same structure but randomly permuted nodes. Next, we used our DAG to identify minimally sufficient adjustment sets needed to estimate the association between metal mixtures and cardiometabolic outcomes (i.e., cardiovascular disease, fasting glucose, and systolic blood pressure). We applied them to the SLVDS using Bayesian kernel machine regression, linear mixed effects, and Cox proportional hazards models.

Results

From the 42 articles included in the review, we developed an evidence-based DAG with 74 testable conditional independence statements (43 % supported by SLVDS data). We observed evidence for an association between As and Mn and fasting glucose.

Conclusions

We developed, tested, and applied an evidence-based approach to analyze associations between metal mixtures and cardiometabolic health.

Naturally occurring metals in unregulated domestic wells in Nevada, USA

The dominant source of drinking water in rural Nevada, United States, is privately-owned domestic wells. Because the water from these wells is unregulated with respect to government guidelines, it is the owner's responsibility to test their groundwater for heavy metals and other contaminants. Arsenic, lead, cadmium, and uranium have been previously measured at concentrations above Environmental Protection Agency (EPA) guidelines in Nevada groundwater. This is a public health concern because elevated levels of these metals are known to have negative health effects. We recruited individuals through a population health study, the Healthy Nevada Project, to submit drinking water samples from domestic wells for testing. Water samples were returned from 174 households with private wells. We found 22 % had arsenic concentrations exceeding the EPA maximum contaminant level (MCL) of 10 μg/L. Additionally, federal, state, or health-based guidelines were exceeded for 8 % of the households for uranium and iron, 6 % for lithium and manganese, 4 % for molybdenum, and 1 % for lead. The maximum observed concentrations of arsenic, uranium, and lead were ∼80, ∼5, and ∼1.5 times the EPA guideline values, respectively. 41 % of households had a treatment system and submitted both pre- and post-treatment water samples from their well. The household treatments were shown to reduce metal concentrations, but concentrations above guideline values were still observed. Many treatment systems cannot reduce the concentration below guideline values because of water chemistry, treatment failure, or improper treatment techniques. These results show the pressing need for continued education and outreach on regular testing of domestic well waters, proper treatment types, and health effects of metal contamination. These findings are potentially applicable to other arid areas where groundwater contamination of naturally occurring heavy metals occurs.

Chronic Community Exposure to Environmental Metal Mixtures Is Associated with Selected Cytokines in the Navajo Birth Cohort Study (NBCS)

Many tribal populations are characterized by health disparities, including higher rates of infection, metabolic syndrome, and cancer-all of which are mediated by the immune system. Members of the Navajo Nation have suffered chronic low-level exposure to metal mixtures from uranium mine wastes for decades. We suspect that such metal and metalloid exposures lead to adverse health effects via their modulation of immune system function. We examined the relationships between nine key metal and metalloid exposures (in blood and urine) with 11 circulating biomarkers (cytokines and CRP in serum) in 231 pregnant Navajo women participating in the Navajo Birth Cohort Study. Biomonitored levels of uranium and arsenic species were considerably higher in participants than NHANES averages. Each biomarker was associated with a unique set of exposures, and arsenic species were generally immunosuppressive (decreased cellular and humoral stimulating cytokines). Overall, our results suggest that environmental metal and metalloid exposures modulate immune status in pregnant Navajo women, which may impact long-term health outcomes in mothers and their children.

An adjusted partial least squares regression framework to utilize additional exposure information in environmental mixture data analysis

In a large-scale environmental health population study that is composed of subprojects, often different fractions of participants out of the total enrolled have measures of specific outcomes. It's conceptually reasonable to assume the association study would benefit from utilizing additional exposure information from those with a specific outcome not measured. Partial least squares regression is a practical approach to determine the exposure-outcome associations for mixture data. Like a typical regression approach, however, the partial least squares regression requires that each data observation must have both complete covariate and outcome for model fitting. In this paper, we propose novel adjustments to the general partial least squares regression to estimate and examine the association effects of individual environmental exposure to an outcome within a more complete context of the study population's environmental mixture exposures. The proposed framework takes advantage of the bilinear model structure. It allows information from all participants, with or without the outcome values, to contribute to the model fitting and the assessment of association effects. Using this proposed framework, incorporation of additional information will lead to smaller root mean square errors in the estimation of association effects, and improve the ability to assess the significance of the effects.

Co-exposure of sodium arsenite and uranyl acetate differentially alters gene expression in CD3/CD28 activated CD4+ T-cells

Communities in the western region of the United States experience environmental exposure to metal mixtures from living in proximity to numerous unremediated abandoned uranium mines. Metals including arsenic and uranium co-occur in and around these sites at levels higher than the United States Environmental Protection Agency maximum contaminant levels. To address the potential effect of these metals on the activation of CD4+ T-cells, we used RNA sequencing methods to determine the effect of exposure to sodium arsenite (1 μM and 10 μM), uranyl acetate (3 μM and 30 μM) or a mixture of sodium arsenite and uranyl acetate (1 μM sodium arsenite + 3 μM uranyl acetate). Sodium arsenite induced a dose dependent effect on activation associated gene expression; targeting immune response genes at the lower dose. Increases in oxidative stress gene expression were observed with both sodium arsenite doses. While uranyl acetate alone did not significantly alter activation associated gene expression, the mixture of uranyl acetate with sodium arsenite demonstrated a combined effect relative to sodium arsenite alone. The results demonstrate the need to investigate metal and metalloid mixtures at environmentally relevant concentrations to better understand the toxicological impact of these mixtures on T-cell activation, function and immune dysregulation.

Diné citizen science: Phytoremediation of uranium and arsenic in the Navajo Nation

Mid-20th century mining in Naabeehó Bináhásdzo (Navajo Nation) polluted soil and groundwater with uranium and arsenic. The Diné and other indigenous residents of this region use groundwater for drinking, livestock, and irrigation, creating a serious environmental health risk. Currently, many individuals and communities on the Navajo Nation must purchase and transport treated water from hours away. Sunflowers (Helianthus annuus) preferentially take up uranium and arsenic, potentially representing a tool to remove these contaminants through on-site, low-cost phytoremediation. This study reports the results of a collaboration among researchers, high school students, teachers, and tribal leaders to analyze water chemistry and perform a phytoremediation experiment. In 2018 and 2019, we compiled existing data from the Navajo Nation Environmental Protection Agency (NNEPA) and collected samples from surface and groundwater. We then used sunflower seedlings grown in local soil to assess whether phytoremediation could be effective at removing arsenic and uranium. For the NNEPA-sampled wells, 9.5% exceeded the maximum contaminant level for uranium (30 μg per liter) and 16% for arsenic (10 μg per liter). For the new samples, uranium was highest in surface pools, suggesting leaching from local soil. Unlike studies from humid regions, sunflowers did not decrease uranium and arsenic in soil water. Instead, there was no change in arsenic concentration and an increase in uranium concentration in both planted and control treatments, attributable to weathering of uranium-bearing minerals in the desert soil. Because much of global uranium mining occurs in arid and semiarid regions, the ineffectiveness of phytoremediation on the Navajo Nation emphasizes the importance of prevention and conventional remediation. More generally, the participatory science approach created meaningful relationships and an important collaboration between a tribal chapter and a university, providing both cultural and scientific experiential learning opportunities for Diné high school students, undergraduate researchers, and senior personnel.

Spatial relationship between well water arsenic and uranium in Northern Plains native lands

Arsenic and uranium in unregulated private wells affect many rural populations across the US. The distribution of these contaminants in the private wells of most American Indian communities is poorly characterized, and seldom studied together. Here, we evaluate the association between drinking water arsenic and uranium levels in wells (n = 441) from three tribal regions in North Dakota and South Dakota participating in the Strong Heart Water Study. Groundwater contamination was extensive; 29% and 7% of wells exceeded maximum contaminant levels for arsenic and uranium respectively. 81% of wells had both arsenic and uranium concentrations at one-tenth of their human-health benchmark (arsenic, 1 μg/L; uranium 3 μg/L). Well arsenic and uranium concentrations were uncorrelated (rs = 0.06); however, there appeared to be a spatial correlation of wells co-contaminated by arsenic and uranium associated with flow along a geologic contact. These findings indicate the importance of measuring multiple metals in well water, and to understand underlying hydrogeological conditions. The underlying mechanisms for the prevalence of arsenic and uranium across Northern Plains Tribal Lands in the US, and in particular the occurrence of both elevated arsenic and uranium in drinking water wells in this region, demands further study.

Effect of Zr(IV) to phosphorus ratio on U(VI) adsorption by diethylenetriamine-pentamethylene phosphate Zr(IV) hybrids

In this work, diethylenetriamine pentamethylenephosphonic acid (DTPMP) was ultilized into preparing of Zr(IV) organophosphates hybrids (Zr-DTPMP-x, x was the molar ratio of Zr(IV)/DTPMP in the synthetic process, x = 0.5, 1, 2, and 3) using a hydrothermal method. The physical and chemical properties of Zr-DTPMP-x were characterized by SEM&EDS, FT-IR, XRD, Zeta potential, XPS, TGA and contact angle analysis. Moreover, the adsorptive performances of Zr-DTPMP-x for U(VI) were investigated. The adsorption results showed that the optimum molar ratio of Zr(IV) to phosphine, pH, equilibrium time, and dosage was 0.5, 4.0, 180 min, and 10 mg, respectively. Besides, the adsorption of U(VI) was in accordance with the pseudo-second-order kinetic model and Sips isothermal model. Moreover, the adsorption capacity determined by Sips isothermal model was 181.34 mg g−1 for Zr-DTPMP-0.5. Furthermore, the adsorptive selectivity of Zr-DTPMP-0.5 for U(VI) was superior than the others. Zr-DTPMP-0.5 may be a powerful candidate for diminishing the contamination of U(VI).

Environmentally Relevant Levels of Depleted Uranium Impacts Dermal Fibroblast Proliferation, Viability, Metabolic Activity, and Scratch Closure

Uranium (U) is a heavy metal used in military and industrial settings, with a large portion being mined from the Southwest region of the United States. Uranium has uses in energy and military weaponry, but the mining process has released U into soil and surface waters that may pose threats to human and environmental health. The majority of literature regarding U's human health concern focuses on outcomes based on unintentional ingestion or inhalation, and limited data are available about its influence via cutaneous contact. Utilizing skin dermis cells, we evaluated U's topical chemotoxicity. Employing soluble depleted uranium (DU) in the form of uranyl nitrate (UN), we hypothesized that in vitro exposure of UN will have cytotoxic effects on primary dermal fibroblasts by affecting cell viability and metabolic activity and, further, may delay wound healing aspects via altering cell proliferation and migration. Using environmentally relevant levels of U found in water (0.1 μM to 100 μM [UN]; 23.8-23,800 ppb [U]), we quantified cellular mitosis and migration through growth curves and in vitro scratch assays. Cells were exposed from 24 h to 144 h for a time-course evaluation of UN chemical toxicity. The effects of UN were observed at concentrations above and below the Environmental Protection Agency threshold for safe exposure limits. UN exposure resulted in a dose-dependent decrease in the viable cell count; however, it produced an increase in metabolism when corrected for the viable cells present. Furthermore, cellular proliferation, population doubling, and percent closure was hindered at levels ≥10 μM UN. Therefore, inadvertent exposure may exacerbate pre-existing skin diseases in at-risk demographics, and additionally, it may substantially interfere in cutaneous tissue repair processes.

Assessing Uranium Pollution Levels in the Rietspruit River, Far West Rand Goldfield, South Africa

The Rietspruit is located in Gauteng Province, South Africa, within the Witwatersrand Basin. The basin is noted for its vast gold deposit. The river extends for about 60 km before joining the Vaal River. The aim of this study was to determine the concentration of uranium in the Rietspruit and the factors that influenced the concentration of U at each of the sites. The source of uranium in the river is the discharge from the gold mine and the mine wastes. Inductively coupled plasma mass spectrometry was used for water and sediment analysis in order to determine the concentration of U. High concentration of U was found in the river water and sediment, which is above the permissible limit of U. The water is used for irrigation of farmlands, cattle watering and for human consumption despite the high concentration of uranium in it. Ingestion of uranium is dangerous to human health. Due to the toxic nature of uranium, consumption of the water for domestic use and agriculture purpose must be discouraged.

Uranium Exposure in American Indian Communities: Health, Policy, and the Way Forward

BACKGROUND

Uranium contamination of drinking-water sources on American Indian (AI) reservations in the United States is a largely ignored and underfunded public health crisis. With an estimated 40% of the headwaters in the western U.S. watershed, home to many AI reservation communities, being contaminated with untreated mine waste, the potential health effects have largely been unexplored. With AI populations already facing continued and progressive economic and social marginalization, higher prevalence of chronic disease, and systemic discrimination, associations between various toxicant exposures, including uranium, and various chronic conditions, need further examination.

OBJECTIVES

Uranium's health effects, in addition to considerations for uranium drinking-water testing, reporting, and mitigation in reference to AI communities through the lens of water quality, is reviewed.

DISCUSSION

A series of environmental health policy recommendations are described with the intent to proactively improve responsiveness to the water quality crisis in AI reservation communities in the United States specific to uranium. There is a serious and immediate need for better coordination of uranium-related drinking-water testing and reporting on reservations in the United States that will better support and guide best practices for uranium mitigation efforts. https://doi.org/10.1289/EHP7537.

Exposure to uranium and co-occurring metals among pregnant Navajo women

Navajo Nation residents are at risk for exposure to uranium and other co-occurring metals found in abandoned mine waste. The Navajo Birth Cohort Study (NBCS) was initiated in 2010 to address community concerns regarding the impact of chronic environmental exposure to metals on pregnancy and birth outcomes. The objectives of this paper were to 1) evaluate maternal urine concentrations of key metals at enrollment and delivery from a pregnancy cohort; and 2) compare the NBCS to the US general population by comparing representative summary statistical values. Pregnant Navajo women (N = 783, age range 14-45 years) were recruited from hospital facilities on the Navajo Nation during prenatal visits and urine samples were collected by trained staff in pre-screened containers. The U.S. Centers for Disease Control and Prevention (CDC), National Center for Environmental Health's (NCEH) Division of Laboratory Sciences (DLS) analyzed urine samples for metals. Creatinine-corrected urine concentrations of cadmium decreased between enrollment (1st or 2nd trimester) and delivery (3rd trimester) while urine uranium concentrations were not observed to change. Median and 95th percentile values of maternal NBCS urine concentrations of uranium, manganese, cadmium, and lead exceeded respective percentiles for National Health and Nutrition Evaluation Survey (NHANES) percentiles for women (ages 14-45 either pregnant or not pregnant.) Median NBCS maternal urine uranium concentrations were 2.67 (enrollment) and 2.8 (delivery) times greater than the NHANES median concentration, indicating that pregnant Navajo women are exposed to metal mixtures and have higher uranium exposure compared to NHANES data for women. This demonstrates support for community concerns about uranium exposure and suggests a need for additional analyses to evaluate the impact of maternal metal mixtures exposure on birth outcomes.

Diet quality among pregnant women in the Navajo Birth Cohort Study

Proper nutrition during pregnancy is vital to maternal health and fetal development and may be challenging for Navajo Nation residents because access to affordable and healthy foods is limited. It has been several decades since reported diet quality during pregnancy was examined on Navajo Nation. We present the first study to estimate iodine intake and use the Healthy Eating Index (HEI-2015) to assess maternal diet quality among pregnant women in the Navajo Birth Cohort Study (NBCS). Based on dietary intake data derived from food frequency questionnaires, overall estimated micronutrient intake has remained similar since the last assessment in 1981, with potential improvements evident for folate and niacin. A high proportion of women (>50%) had micronutrient intakes from dietary sources below the Estimated Average Requirements during pregnancy. The median urinary iodine concentration for NBCS women (90.8 μg/L; 95% CI [80, 103.5]) was less than adequate and lower than concentrations reported for pregnant women that participated in the National Health and Nutrition Examination Survey (NHANES) between 2011 and 2014. Overall, average diet quality of NBCS women estimated using the HEI-2015 (62.4; 95% CI [60.7, 64.0]) was similar to that reported for women of child-bearing age and pregnant women in NHANES. Although, NBCS women had diets high in added sugar, with sugar-sweetened beverages as the primary contributors. Our study provides updated insights on maternal diet quality that can inform health and nutrition initiatives in Navajo communities emphasizing nutrition education and access to prenatal vitamins and calcium, iodine, and vitamin E dense foods.

Levels of uranium and thorium in maternal scalp hair and risk of orofacial clefts in offspring

Uranium and thorium are common radioactive elements that exist in the environment. However, few environmental epidemiological studies have focused on their possible effects on congenital malformations. Here, we explored the association between uranium and thorium concentrations in maternal scalp hair grown from 3 months before to 3 months after conception, namely during the periconceptional period and the risk of orofacial clefts (OFCs) in offspring. Our study included 153 women whose pregnancies were affected by OFCs (cases) and 601 women who delivered infants without birth defects (controls) from four provinces in China. Face-to-face interviews were used to collect sociodemographic characteristics with a structured questionnaire. Concentrations of uranium and thorium in maternal scalp hair grown during the periconceptional period were detected using inductively coupled plasma-mass spectrometry. The risk of OFCs in association with higher concentrations of the two radioactive elements was estimated using odds ratios (ORs) and 95% confidence intervals (CIs) while adjusting for potential confounding factors. The levels of uranium and thorium in maternal hair were in agreement with the published literature. After adjusting for several confounders, the ORs of thorium in the highest, upper, and lower quartile versus the lowest quartile were 2.63 (95% CI, 1.41-4.92), 1.98 (95% CI, 1.03-3.79), and 2.73 (95% CI, 1.46-5.12), respectively. No association was found between levels of uranium and the risk of OFCs. Maternal periconceptional exposure to thorium may be a risk factor for OFCs in offspring.

Quantification of Elemental Contaminants in Unregulated Water across Western Navajo Nation

The geologic profile of the western United States lends itself to naturally elevated levels of arsenic and uranium in groundwater and can be exacerbated by mining enterprises. The Navajo Nation, located in the American Southwest, is the largest contiguous Native American Nation and has over a 100-year legacy of hard rock mining. This study has two objectives, quantify the arsenic and uranium concentrations in water systems in the Arizona and Utah side of the Navajo Nation compared to the New Mexico side and to determine if there are other elements of concern. Between 2014 and 2017, 294 water samples were collected across the Arizona and Utah side of the Navajo Nation and analyzed for 21 elements. Of these, 14 elements had at least one instance of a concentration greater than a national regulatory limit, and six of these (V, Ca, As, Mn, Li, and U) had the highest incidence of exceedances and were of concern to various communities on the Navajo Nation. Our findings are similar to other studies conducted in Arizona and on the Navajo Nation and demonstrate that other elements may be a concern for public health beyond arsenic and uranium.

A Review of Metal Exposure Studies Conducted in the Rural Southwestern and Mountain West Region of the United States

PURPOSE OF REVIEW

This review summarizes recent literature examining exposure to environmental metals in rural areas of the southwestern/mountain west region of the United States focusing on the range of exposures and exposure pathways unique to this region.

RECENT FINDINGS

Recent studies (2013-2018) indicated that exposures to arsenic (As), uranium (U), and cadmium (Cd) were the most commonly quantified metals in the study area. One or more of these three metals was analyzed in each study reviewed.

SUMMARY

The current review draws attention to the variety of exposure assessment methods, analytical tools, and unique non-occupational exposure pathways in this region. The reviewed studies identified potential sources of metals exposure including regulated and unregulated drinking water, particulate matter, and food items, and provided information about the levels of exposures experienced by populations through a variety of exposure assessment methods including spatial analysis methodologies. The findings suggest that exposure assessment methods could be further integrated with population studies to assess health effects of environmental metals exposure through pathways unique to Southwestern and Mountain West U.S.

Metal exposure and oxidative stress markers in pregnant Navajo Birth Cohort Study participants

Contamination of soil and water by waste from abandoned uranium mines has led to chronic exposures to metal mixtures in Native American communities. Our previous work demonstrated that community exposures to mine waste increase the likelihood of developing cardiovascular disease, as well as the likelihood of developing multiple chronic diseases including diabetes, hypertension and kidney disease. Exposure to various environmental metals is associated with elevated oxidative stress, which is considered a contributor to these and other chronic disease states. The purpose of the current research was to assess potential associations between exposure to uranium and arsenic and evidence for increased oxidative stress as measured by urinary F₂ -isoprostanes in pregnant women enrolled in the Navajo Birth Cohort Study. The current study also included an analysis of zinc as a potential mediator of oxidative stress in the study population. Urinary arsenic and uranium, serum zinc and urinary F₂ -isoprostanes were measured for each study participant at enrollment. Study participants were pregnant women with median age of 26.8; 18.9% were enrolled in the 1st trimester, 44.7% were enrolled in the 2nd trimester, and 36.4% were enrolled in the 3^rd trimester. Median urinary metal levels were 5.5 and 0.016 µg/g creatinine for arsenic and uranium, respectively. Multivariable regression analysis indicated a significant association between arsenic exposure and the lipid peroxidation product 8-iso-prostaglandin F_2α, controlling for zinc and trimester. No associations were detected with uranium despite evidence that levels were in the Navajo Birth Cohort samples were 2.3 times the median reported for women in the National Health and Nutrition Examination Survey (2011-12). Zinc was not found to have any causal mediation of the effects of the other metals on oxidative stress. The current work is consistent with other studies that have detected an association between arsenic and elevated oxidative stress. In contrast to arsenic, uranium did not appear to increase oxidative stress response in this study population. These findings are relevant to assessing the potential human impact of chronic exposure to mixed metal waste from abandoned uranium mines.

Spatial clustering of metal and metalloid mixtures in unregulated water sources on the Navajo Nation - Arizona, New Mexico, and Utah, USA

Contaminant mixtures are identified regularly in public and private drinking water supplies throughout the United States; however, the complex and often correlated nature of mixtures makes identification of relevant combinations challenging. This study employed a Bayesian clustering method to identify subgroups of water sources with similar metal and metalloid profiles. Additionally, a spatial scan statistic assessed spatial clustering of these subgroups and a human health metric was applied to investigate potential for human toxicity. These methods were applied to a dataset comprised of metal and metalloid measurements from unregulated water sources located on the Navajo Nation, in the southwest United States. Results indicated distinct subgroups of water sources with similar contaminant profiles and that some of these subgroups were spatially clustered. Several profiles had metal and metalloid concentrations that may have potential for human toxicity including arsenic, uranium, lead, manganese, and selenium. This approach may be useful for identifying mixtures in water sources, spatially evaluating the clusters, and help inform toxicological research investigating mixtures.

Using Watershed Boundaries to Map Adverse Health Outcomes: Examples From Nebraska, USA

In 2009, a paper was published suggesting that watersheds provide a geospatial platform for establishing linkages between aquatic contaminants, the health of the environment, and human health. This article is a follow-up to that original article. From an environmental perspective, watersheds segregate landscapes into geospatial units that may be relevant to human health outcomes. From an epidemiologic perspective, the watershed concept places anthropogenic health data into a geospatial framework that has environmental relevance. Research discussed in this article includes information gathered from the literature, as well as recent data collected and analyzed by this research group. It is our contention that the use of watersheds to stratify geospatial information may be both environmentally and epidemiologically valuable.

Water quality trend and change-point analyses using integration of locally weighted polynomial regression and segmented regression

Trend and change-point analyses of water quality time series data have important implications for pollution control and environmental decision-making. This paper developed a new approach to assess trends and change-points of water quality parameters by integrating locally weighted polynomial regression (LWPR) and segmented regression (SegReg). Firstly, LWPR was used to pretreat the original water quality data into a smoothed time series to represent the long-term trend of water quality. Then, SegReg was used to identify the long-term trends and change-points of the smoothed time series. Finally, statistical tests were applied to determine the significance of the long-term trends and change-points. The efficacy of this approach was validated using a 10-year record of total nitrogen (TN) and chemical oxygen demand (COD_Mn) from Shanxi Reservoir watershed in eastern China. Results showed that this approach was straightforward and reliable for assessment of long-term trends and change-points on irregular water quality datasets. The reliability was verified by statistical tests and practical considerations for Shanxi Reservoir watershed. The newly developed integrated LWPR-SegReg approach is not only limited to the assessment of trends and change-points of water quality parameters but also has a broad application to other fields with long-term time series records.