A benchmark concentration analysis for manganese in drinking water and IQ deficits in children

Artificial neural network modeling for the oxidation kinetics of divalent manganese ions during chlorination and the role of arsenite ions in the binary/ternary systems

This study investigated the coexistence and contamination of manganese (Mn(II)) and arsenite (As(III)) in groundwater and examined their oxidation behavior under different equilibrating parameters, including varying pH, bicarbonate (HCO3-) concentrations, and sodium hypochlorite (NaClO) oxidant concentrations. Results showed that if the molar ratio of NaClO: As(III) was >1, the oxidation of As(III) could be achieved within a minute with an extremely high oxidation rate of 99.7 %. In the binary system, the removal of As(III) prevailed over Mn(II). The As(III) oxidation efficiency increased from 59.8 ± 0.6 % to 70.8 ± 1.9 % when pH rose from 5.7 to 8.0. The oxidation reaction between As(III) and NaClO releases H+ ions, decreasing the pH from 6.77 to 6.19 and reducing the removal efficiency of Mn(II). The presence of HCO3- reduced the oxidation rate of Mn(II) from 63.2 % to 13.9 % within four hours. Instead, the final oxidation rate of Mn(II) increased from 68.1 % to 87.7 %. This increase can be attributed to HCO3- ions competing with the free Mn(II) for the adsorption sites on the sediments, inhibiting the formation of H+. Moreover, kinetic studies revealed that the oxidation reaction between Mn(II) and NaClO followed first-order kinetics based on their R2 values. The significant factors affecting the Mn(II) oxidation efficiency were the initial concentration of NaClO and pH. Applying an artificial neural network (ANN) model for data analysis proved to be an effective tool for predicting Mn(II) oxidation rates under different experimental conditions. The actual Mn(II) oxidation data and the predicted values obtained from the ANN model showed significant consistency. The training and validation data sets yielded R2 values of 0.995 and 0.992, respectively. Moreover, the ANN model highlights the importance of pH and NaClO concentrations in influencing the oxidation rate of Mn(II).

A Bayesian benchmark concentration analysis for urinary fluoride and intelligence in adults in Guizhou, China

Environmental fluoride exposure has been linked to numerous cases of fluorosis worldwide. Previous studies have indicated that long-term exposure to fluoride can result in intellectual damage among children. However, a comprehensive health risk assessment of fluorosis-induced intellectual damage is still pending. In this research, we utilized the Bayesian Benchmark Dose Analysis System (BBMD) to investigate the dose-response relationship between urinary fluoride (U-F) concentration and Raven scores in adults from Nayong, Guizhou, China. Our research findings indecate a dose-response relationship between the concentration of U-F and intelligence scores in adults. As the benchmark response (BMR) increased, both the benchmark concentration (BMCs) and the lower bound of the credible interval (BMCLs) increased. Specifically, BMCs for the association between U-F and IQ score were determined to be 0.18 mg/L (BMCL1 = 0.08 mg/L), 0.91 mg/L (BMCL5 = 0.40 mg/L), 1.83 mg/L (BMCL10 = 0.83 mg/L) when using BMRs of 1 %, 5 %, and 10 %. These results indicate that U-F can serve as an effective biomarker for monitoring the loss of IQ in population. We propose three interim targets for public policy in preventing interllectual harm from fluoride exposure.

Hydrogeochemical characteristics of groundwater contamination in Guwahati city, Assam, India: Tracing the elemental Threads

Groundwater serves as an important resource for drinking and agriculture in many countries, including India. Assessing the quality of groundwater is essential for understanding its chemical characteristics and suitability for consumption. This study aims to explore the factors affecting the hydrogeochemical changes in groundwater within Guwahati City, Assam, India. Groundwater samples were collected and analyzed for major and trace elements, as well as anion concentrations. Concentrations of As, Al, Ba, Cu, F-, Fe, Mn, and Pb exceeded the permissible limits set by both World Health Organization (WHO) and Bureau of Indian Standards (BIS), indicating serious health concerns for the local inhabitants. The distribution pattern of trace elements exceeding the guideline values is intricate, suggesting widespread contamination of groundwater throughout the study area. The Heavy Metal Pollution Index (HPI) and Water Quality Index (WQI) revealed that, except for the central zone, groundwater across the entire study area requires intervention. Piper plot illustrated that the groundwater is predominantly of Ca-HCO3 type, indicating the dominance of alkaline earth and weak acids. Groundwater hydrogeochemistry is mainly controlled by rock-water interaction and evolves through silicate weathering, carbonate weathering, and cation exchange processes. Multivariate statistical analysis identified distinct groups of groundwater based on chemical characteristics, emphasizing the role of both natural processes and anthropogenic activities in influencing groundwater quality. Regular monitoring, management, and intervention of groundwater sources throughout the study area are crucial for long-term use. The findings of this study will assist stakeholders, regulators, and policymakers in formulating strategies for the sustainable use of groundwater.

Benchmark dose modeling for epidemiological dose-response assessment using prospective cohort studies

Benchmark dose (BMD) methodology has been employed as a default dose-response modeling approach to determine the toxicity value of chemicals to support regulatory chemical risk assessment. Especially, a relatively standardized BMD analysis framework has been established for modeling toxicological data regarding the formats of input data, dose-response models, definitions of benchmark response, and model uncertainty consideration. However, the BMD approach has not been well developed for epidemiological data mainly because of the diverse designs of epidemiological studies and various formats of data reported in the literature. Although most of the epidemiological BMD analyses were developed to solve a particular question, the methods proposed in two recent studies are able to handle cohort and case-control studies using summary data with consideration of adjustments for confounders. Therefore, the purpose of the present study is to investigate and compare the "effective count"-based BMD modeling approach and adjusted relative risk (RR)-based BMD analysis approach to identify an appropriate BMD modeling framework that can be generalized for analyzing published data of prospective cohort studies for BMD analysis. The two methods were applied to the same set of studies that investigated the association between bladder and lung cancer and inorganic arsenic exposure for BMD estimation. The results suggest that estimated BMDs and BMDLs are relatively consistent; however, with the consideration of established common practice in BMD analysis, modeling adjusted RR values as continuous data for BMD estimation is a more generalizable approach harmonized with the BMD approach using toxicological data.

Probabilistic risk assessment for determining nonessential metals in commercial infant formula products in Taiwan

During the early months of life, infant formula plays a crucial role as a primary source of both food and essential nutrients for infants, serving as a replacement for or supplement to breast milk. However, nonessential metals in infant formulas are a concern because infants are highly vulnerable to chemical exposure. The aim of this study was to investigate infant exposure to nonessential metals in infant formula products in Taiwan and assess the associated health risks. In this study, concentrations of arsenic (As), barium (Ba), cadmium (Cd), manganese (Mn), lead (Pb), and vanadium (V) in 45 formula products for 0-1-year-old infants were determined by inductively coupled plasma mass spectrometry. The mean As, Ba, Cd, Mn, Pb, and V concentrations were 6.42, 280, 3.72, 1425, 20.4, and 21.9 µg/kg, respectively. According to our probabilistic simulation of the estimated daily intake of metals, the proportion of hazard quotients exceeding one was 7.69% for As and 3.29% for Mn, and that of hazard index (HI) values exceeding 1 was >17% for metals. Arsenic had the largest HI contribution (46.9%), followed by Mn (22.3%) and Pb (12.7%). The nonessential metals content in infant formula raises potential noncarcinogenic health concerns for infants in Taiwan. Therefore, regulations for nonessential metals must be imposed on related food products in Taiwan, with a particular focus on As and Mn.

Using in vitro data to derive acceptable exposure levels: A case study on PBDE developmental neurotoxicity

BACKGROUND

Current acceptable chemical exposure levels (e.g., tolerable daily intake) are mainly based on animal experiments, which are costly, time-consuming, considered non-ethical by many, and may poorly predict adverse outcomes in humans.

OBJECTIVE

To evaluate a method using human in vitro data and biological modeling to calculate an acceptable exposure level through a case study on 2,2',4,4'-tetrabromodiphenyl ether (BDE-47) developmental neurotoxicity (DNT).

METHODS

We reviewed the literature on in vitro assays studying BDE-47-induced DNT. Using the most sensitive endpoint, we derived a point of departure using a mass-balance in vitro disposition model and benchmark dose modeling for a 5% response (BMC05) in cells. We subsequently used a pharmacokinetic model of gestation and lactation to estimate administered equivalent doses leading to four different metrics of child brain concentration (i.e., average prenatal, average postnatal, average overall, and maximum concentration) equal to the point of departure. The administered equivalent doses were translated into tolerable daily intakes using uncertainty factors. Finally, we calculated biomonitoring equivalents for maternal serum and compared them to published epidemiological studies of DNT.

RESULTS

We calculated a BMC05 of 164 μg/kg of cells for BDE-47 induced alteration of differentiation in neural progenitor cells. We estimated administered equivalent doses of 0.925-3.767 μg/kg/day in mothers, and tolerable daily intakes of 0.009-0.038 μg/kg/day (composite uncertainty factor: 100). The lowest derived biomonitoring equivalent was 19.75 ng/g lipids, which was consistent with reported median (0.9-23 ng/g lipids) and geometric mean (7.02-26.9 ng/g lipids) maternal serum concentrations from epidemiological studies.

CONCLUSION

This case study supports using in vitro data and biological modeling as a viable alternative to animal testing to derive acceptable exposure levels.

Assessing the health risks of coal-burning arsenic-induced skin damage: A 22-year follow-up study in Guizhou, China

Risk assessment of arsenic-induced skin damage has always received significant global attention. Theories derived from arsenic exposure in drinking water may not be applicable to the coal-burning type to arsenic-exposed area. Furthermore, very few studies have successfully determined the reference value of cumulative arsenic (CA) exposure that leads to specific skin lesions. In this study, we conducted a 22-year follow-up investigation to assess the risk of skin lesions and cancer resulting from long-term, multi-channel arsenic exposure from hazard identification, dose-response assessment, exposure assessment, and risk characterization. The results show that the arsenic exposure can significantly increase the prevalence of skin lesions. For each interquartile range increase of hair arsenic (HA) and CA, the risk of skin damage increased by 1.91 and 3.90 times, respectively. The lower confidence limit of the benchmark dose of HA of arsenic-induced various skin lesions ranged from 0.07 to 0.12 μg·g-1, and 932.57 to 1368.92 mg for CA. The chronic daily intake, lifetime average daily dose in the arsenic-exposed area after the comprehensive prevention and control measures have decreased significantly, but remained higher than the daily baseline level of 3.0 μg·kg-1·d-1. Even as recently as 2020, the hazard quotients and hazard index still exceeded 1, measuring 155.33 and 55.20, and the lifetime excess risk of skin cancer (2.80 × 10-3) remains significantly higher than the acceptable level of 10-6. Our study underscores the effectiveness of comprehensive prevention and control measures in managing high arsenic exposure in coal-burning arsenic poisoning areas. However, it is crucial to acknowledge that the risk of both non-carcinogenic and carcinogenic effects on the skin remains substantially higher than the acceptable level. We recommend setting reference limits for monitoring skin damage among individuals exposed to arsenic, with a recommended upper limit of 0.07 μg·g-1 for HA and a maximum acceptable level of 935.57 mg for CA.

Signaling Pathways Involved in Manganese-Induced Neurotoxicity

Manganese (Mn) is an essential trace element, but insufficient or excessive bodily amounts can induce neurotoxicity. Mn can directly increase neuronal insulin and activate insulin-like growth factor (IGF) receptors. As an important cofactor, Mn regulates signaling pathways involved in various enzymes. The IGF signaling pathway plays a protective role in the neurotoxicity of Mn, reducing apoptosis in neurons and motor deficits by regulating its downstream protein kinase B (Akt), mitogen-activated protein kinase (MAPK), and mammalian target of rapamycin (mTOR). In recent years, some new mechanisms related to neuroinflammation have been shown to also play an important role in Mn-induced neurotoxicity. For example, DNA-sensing receptor cyclic GMP-AMP synthase (cCAS) and its downstream signal efficient interferon gene stimulator (STING), NOD-like receptor family pyrin domain containing 3(NLRP3)-pro-caspase1, cleaves to the active form capase1 (CASP1), nuclear factor κB (NF-κB), sirtuin (SIRT), and Janus kinase (JAK) and signal transducers and activators of the transcription (STAT) signaling pathway. Moreover, autophagy, as an important downstream protein degradation pathway, determines the fate of neurons and is regulated by these upstream signals. Interestingly, the role of autophagy in Mn-induced neurotoxicity is bidirectional. This review summarizes the molecular signaling pathways of Mn-induced neurotoxicity, providing insight for further understanding of the mechanisms of Mn.

The association between perchlorate in drinking water and height and weight of children and adolescents in Southwest China: a retrospective cross-sectional study

Objective

To investigate the association between the concentration of perchlorate in drinking water and the height and weight of children and adolescents in Sichuan Province.

Methods

Perchlorate in the drinking water of 24 counties in Sichuan Province from 2021 to 2022 was detected and analyzed, 66 drinking water samples were collected, and the content of perchlorate in drinking water during the wet season and dry season was detected by ultra-high performance liquid chromatography in series. The linear mixed effect model was used to estimate the relationship between perchlorate in drinking water and the height and weight of 144,644 children and adolescents, and 33 pieces of local average wage data were used as confounding factors for quality control.

Results

After controlling the age, gender, and local economic situation, we found that the concentration of perchlorate in drinking water increased by 10 μg/L is associated with a 1.0 cm decrease in height and a 1.6 kg decrease in weight in children and adolescents (p < 0.05).

Conclusion

The concentration of perchlorate in drinking water may be negatively correlated with the height and weight of children.

In vitro evaluation of the cytotoxic and genotoxic effects of Al and Mn in ambient concentrations detected in groundwater intended for human consumption

Environmental exposure to metals can induce cytotoxic and genotoxic effects in cells and affect the health of the exposed population. To investigate the effects of aluminum (Al) and manganese (Mn), we evaluated their cytogenotoxicity using peripheral blood mononuclear cells (PBMCs) exposed to these metals at previously quantified concentrations in groundwater intended for human consumption. The cell viability, membrane integrity, nuclear division index (NDI), oxidative stress, cell death, cell cycle, and DNA damage were analyzed in PBMCs exposed to Al (0.2, 0.6, and 0.8 mg/L) and Mn (0.1, 0.3, 1.0, and 1.5 for 48 h. We found that Al induced late apoptosis; decreased cell viability, NDI, membrane integrity; and increased DNA damage. However, no significant alterations in the early apoptosis, cell cycle, and reactive oxygen species levels were observed. In contrast, exposure to Mn altered all evaluated parameters related to cytogenotoxicity. Our data show that even concentrations allowed by the Brazilian legislation for Al and Mn in groundwater intended for human consumption cause cytotoxic and genotoxic effects in PBMCs. Therefore, in view of the results found, a comprehensive approach through in vivo investigations is needed to give robustness and validity to the results obtained, thus broadening the understanding of the impacts of metals on the health of environmentally exposed people.

Small Community Water Systems Have the Highest Prevalence of Mn in Drinking Water in California, USA

Manganese (Mn) is currently regulated as a secondary contaminant in California, USA; however, recent revisions of the World Health Organization drinking water guidelines have increased regulatory attention of Mn in drinking water due to increasing reports of neurotoxic effects in infants and children. In this study, Mn concentrations reported to California's Safe Drinking Water Information System were used to estimate the potentially exposed population within California based on system size. We estimate that between 2011 and 2021, over 525,000 users in areas with reported Mn data are potentially exposed to Mn concentrations exceeding the WHO health-based guideline (80 μg L-1), and over 34,000 users are potentially exposed to Mn concentrations exceeding the U.S. Environmental Protection Agency health-advisory limit (300 μg L-1). Water treatment significantly decreased Mn concentrations compared to intake concentrations for all system sizes. However, smaller water systems have a wider range and a higher skew of Mn concentrations in finished water than larger systems. Additionally, higher Mn concentrations were found in systems above the maximum contaminant levels for chromium and arsenic. The treatment of these primary contaminants appears to also remove Mn. Lastly, data missingness remains a barrier to accurately assess public exposure to Mn in very small, small, and medium community water system-delivered water.

6:2 Chlorinated Polyfluoroalkyl Ether Sulfonates Exert Stronger Thyroid Homeostasis Disruptive Effects in Newborns than Perfluorooctanesulfonate: Evidence Based on Bayesian Benchmark Dose Values from a Population Study

Growing toxicologic evidence suggests that emerging perfluoroalkyl substances (PFASs), like chlorinated polyfluoroalkyl ether sulfonate (Cl-PFESA), may be as toxic or more toxic than perfluorooctanesulfonate (PFOS) and perfluorooctanoic acid (PFOA). However, further investigations are needed in terms of the human health risk assessment. This study examined the effects of emerging and legacy PFAS exposure on newborn thyroid homeostasis and compared the thyroid disruption caused by 6:2 Cl-PFESA and PFOS using a benchmark dose approach. The health effects of mixture and individual exposure were estimated using the partial least-squares (PLS) model and linear regression, respectively. A Bayesian benchmark dose (BMD) analysis determined the BMD value for adverse effect comparison between 6:2 Cl-PFESA and PFOS. The median (interquartile range) concentrations of 6:2 Cl-PFESA (0.573 [0.351-0.872] ng/mL), PFOS (0.674 [0.462-1.007] ng/mL), and PFOA (1.457 [1.034, 2.405] ng/mL) were found to be similar. The PLS model ranked the PFAS variables' importance in projection (VIP) scores as follows: 6:2 Cl-PFESA > PFOS > PFOA. Linear regression showed that 6:2 Cl-PFESA had a positive association with free triiodothyronine (FT3, P = 0.006) and triiodothyronine (T3, P = 0.014), while PFOS had a marginally significant positive association with FT3 alone (P = 0.042). The BMD analysis indicated that the estimated BMD10 for 6:2 Cl-PFESA (1.01 ng/mL) was lower than that for PFOS (1.66 ng/mL) in relation to a 10% increase in FT3. These findings suggest that 6:2 Cl-PFESA, an alternative to PFOS, has a more pronounced impact on newborns' thyroid homeostasis compared to PFOS and other legacy PFASs.

Prenatal exposure to polycyclic aromatic hydrocarbons and cognition in early childhood

BACKGROUND

Epidemiological evidence for gestational polycyclic aromatic hydrocarbon (PAH) exposure and adverse child cognitive outcomes is mixed; little is known about critical windows of exposure.

OBJECTIVE

We investigated associations between prenatal PAH exposure and child cognition in a large, multi-site study.

METHODS

We included mother-child dyads from two pooled prospective pregnancy cohorts (CANDLE and TIDES, N = 1,223) in the ECHO-PATHWAYS Consortium. Seven urinary mono-hydroxylated PAH metabolites were measured in mid-pregnancy in both cohorts as well as early and late pregnancy in TIDES. Child intelligence quotient (IQ) was assessed between ages 4-6. Associations between individual PAH metabolites and IQ were estimated with multivariable linear regression. Interaction terms were used to examine effect modification by child sex and maternal obesity. We explored associations of PAH metabolite mixtures with IQ using weighted quantile sum regression. In TIDES, we averaged PAH metabolites over three periods of pregnancy and by pregnancy period to investigate associations between PAH metabolites and IQ.

RESULTS

In the combined sample, PAH metabolites were not associated with IQ after full adjustment, nor did we observe associations with PAH mixtures. Tests of effect modification were null except for the association between 2-hydroxynaphthalene and IQ, which was negative in males (βmales = -0.67 [95%CI:-1.47,0.13]) and positive in females (βfemales = 0.31 [95%CI:-0.52,1.13])(pinteraction = 0.04). In analyses across pregnancy (TIDES-only), inverse associations with IQ were observed for 2-hydroxyphenanthrene averaged across pregnancy (β = -1.28 [95%CI:-2.53,-0.03]) and in early pregnancy (β = -1.14 [95%CI:-2.00,-0.28]).

SIGNIFICANCE

In this multi-cohort analysis, we observed limited evidence of adverse associations of early pregnancy PAHs with child IQ. Analyses in the pooled cohorts were null. However, results also indicated that utilizing more than one exposure measures across pregnancy could improve the ability to detect associations by identifying sensitive windows and improving the reliability of exposure measurement. More research with multiple timepoints of PAH assessment is warranted.

The Regulation of ZIP8 by Dietary Manganese in Mice

ZIP8 is a newly identified manganese transporter. A lack of functional ZIP8 results in severe manganese deficiency in both humans and mice, indicating that ZIP8 plays a crucial role in maintaining body manganese homeostasis. Despite a well-acknowledged connection between ZIP8 and manganese metabolism, how ZIP8 is regulated under high-manganese conditions remains unclear. The primary goal of this study was to examine the regulation of ZIP8 by high-manganese intake. We used both neonatal and adult mouse models in which mice were supplied with dietary sources containing either a normal or a high level of manganese. We discovered that high-manganese intake caused a reduction in liver ZIP8 protein in young mice. Since a decrease in hepatic ZIP8 leads to reduced manganese reabsorption from the bile, our study identified a novel mechanism for the regulation of manganese homeostasis under high-manganese conditions: high dietary manganese intake results in a decrease in ZIP8 in the liver, which in turn decreases the reabsorption of manganese from the bile to prevent manganese overload in the liver. Interestingly, we found that a high-manganese diet did not cause a decrease in hepatic ZIP8 in adult animals. To determine the potential reason for this age-dependent variation, we compared the expressions of liver ZIP8 in 3-week-old and 12-week-old mice. We found that liver ZIP8 protein content in 12-week-old mice decreases when compared with that of 3-week-old mice under normal conditions. Overall, results from this study provide novel insights to facilitate the understanding of ZIP8's function in regulating manganese metabolism.

Hotspots of geogenic arsenic and manganese contamination in groundwater of the floodplains in lowland Amazonia (South America)

Arsenic enrichment in groundwater resources in deltas and floodplains of large sediment-rich rivers is a worldwide natural hazard to human health. High spatial variability of arsenic concentrations in affected river basins limits cost-effective mitigation strategies. Linking the chemical composition of groundwater with the topography and fluvial geomorphology is a promising approach for predicting arsenic pollution on a regional scale. Here we correlate the distribution of arsenic contaminated wells with the fluvial dynamics in the Amazon basin. Groundwater was sampled from tube wells along the Amazon River and its main tributaries in three distinct regions in Peru and Brazil. For each sample, the major and trace element concentrations were analyzed, and the position of the well within the sedimentary structure was determined. The results show that aquifers in poorly weathered sediments deposited by sediment-rich rivers are prone to mobilization and accumulation of aqueous arsenic and manganese, both in sub-Andean foreland basins, and in floodplains downstream. Two zones at risk are distinguished: aquifers in the channel-dominated part of the floodplain (CDF) and aquifers in the overbank deposits on the less-dynamic part of the floodplain (LDF). Some 70 % of the wells located on the CDF and 20 % on the LDF tap groundwater at concentrations exceeding the WHO guideline of 10 μg/L arsenic (max. 430 μg/L), and 70 % (CDF) and 50 % (LDF) exceeded 0.4 mg/L manganese (max. 6.6 mg/L). None of the water samples located outside the actual floodplain of sediment-rich rivers, or on riverbanks of sediment-poor rivers exceed 5 μg/L As, and only 4 % exceeded 0.4 mg/L Mn. The areas of highest risk can be delineated using satellite imagery. We observe similar patterns as in affected river basins in South and Southeast Asia indicating a key role of sedimentation processes and fluvial geomorphology in priming arsenic and manganese contamination in aquifers.

Multiple exposure pathways and health risk assessment of potentially harmful elements for children and adults living in a coal region in Brazil

Energy generated by coal can contaminate the environment by releasing toxic elements, including metals. The human health risk assessment (HHRA) associated with geographic information system (GIS) tools can assist the management of contaminated areas, such as coal mining areas. The objective of the study was to carry out the assessment and spatialization of the risk to human health of potentially hazards elements (PHEs) in the soil for children and adults, from multiple exposure routes (oral, inhalation and dermal) in the Candiota mines, largest coal mining region of Brazil. The non-carcinogenic risks (HQ) of PHEs (Cu, Pb, Zn, Ni, Cr, Fe, Mn, Cd, As and Se) and carcinogenic risks of As were estimated and spatialized. The results revealed a risk for children exposure to Mn, with greatest contribution through dermal route. Mn (HQ_derm 72.41-96.09% and HQ_inh 40.84-82.52%) and Fe (HQ_o 43.90-81.44%) were the metals with greatest contribution to human health risk among studied population. As did not present carinogenic risk to adults. The spatial distribution of non-carcinogenic risk showed that Cr, As, Fe, Pb, Ni, Zn and Cu have higher HInc close to the coal mining areas, while Mn, Se and Cd have the highest HInc values in surrounding municipalities (Pinheiro Machado; Pedras Altas and Hulha Negra). The use of HHRA associated with GIS tools provides important elements for decision-making in the management of contaminated sites, indicating chemical elements, locations, routes of exposure and priority target populations.

Spatiotemporal characteristics of groundwater quality and health risk assessment in Jinghe River Basin, Chinese Loess Plateau

Groundwater is a very important natural resource for humanity, however, the degradation of groundwater quality caused by anthropogenic activities may pose a serious hazard to human health and ecosystem. In this study, 143 groundwater samples were analyzed to investigate the spatiotemporal variations of hydrochemistry, groundwater quality and potential human health risk of groundwater in Jinghe River Basin, Chinese Loess Plateau. Based on the mean concentrations value (MCV) and over-standard rate (OSR), the groundwater in Jinghe River Basin were divided into three groups: Group Ⅰ (high MCV: greater than standard values and high OSR: ≥ 10 %) contains TDS (total dissolved solids), TH (total harness), SO₄^2-, F^- and Fe; Group Ⅱ (low MCV and high OSR) contains pH, Cl^-, NO₃^-, Cr⁶⁺ and As, Group Ⅲ (low MCV and low OSR) contains NO₂^-, NH₄⁺, Zn, Mn, Pb, I^- and Cd. The results of set pair assessment indicated that the unsuitable and doubtful class of comprehensive groundwater quality are mainly distributed in the northern part of study area, accounting for 29 % and 13.6 % of the area in 2004 and 2015, respectively. Human health risk assessment based on the triangular fuzzy number suggested that the variation of risk levels in different age groups is Children > Adult Men > Adult Women. Average carcinogenic risks of As in groundwater for the three groups exceed the acceptable level, and non-carcinogenic risk of NO₃^- for Children is higher than the acceptable threshold. The findings of this study provide valuable insight into the spatiotemporal characteristics of groundwater quality and potential health risks of polluted groundwater by anthropogenic activities.

The cGAS-STING-autophagy pathway: Novel perspectives in neurotoxicity induced by manganese exposure

Chronic high-level heavy metal exposure increases the risk of developing different neurodegenerative diseases. Chronic excessive manganese (Mn) exposure is known to lead to neurodegenerative diseases. In addition, some evidence suggests that autophagy dysfunction plays an important role in the pathogenesis of various neurodegenerative diseases. Over the past decade, the DNA-sensing receptor cyclic GMP-AMP synthase (cGAS) and its downstream signal-efficient interferon gene stimulator (STING), as well as the molecular composition and regulatory mechanisms of this pathway have been well understood. The cGAS-STING pathway has emerged as a crucial mechanism to induce effective innate immune responses by inducing type I interferons in mammalian cells. Moreover, recent studies have found that Mn²⁺ is the second activator of the cGAS-STING pathway besides dsDNA, and inducing autophagy is a primitive function for the activation of the cGAS-STING pathway. However, overactivation of the immune response can lead to tissue damage. This review discusses the mechanism of neurotoxicity induced by Mn exposure from the cGAS-STING-autophagy pathway. Future work exploiting the cGAS-STING-autophagy pathway may provide a novel perspective for manganese neurotoxicity.

Associations of Pre- and Postnatal Air Pollution Exposures with Child Behavioral Problems and Cognitive Performance: A U.S. Multi-Cohort Study

BACKGROUND

Population studies support the adverse associations of air pollution exposures with child behavioral functioning and cognitive performance, but few studies have used spatiotemporally resolved pollutant assessments.

OBJECTIVES

We investigated these associations using more refined exposure assessments in 1,967 mother-child dyads from three U.S. pregnancy cohorts in six cities in the ECHO-PATHWAYS Consortium.

METHODS

Pre- and postnatal nitrogen dioxide (NO2) and particulate matter (PM) ≤2.5μm in aerodynamic diameter (PM2.5) exposures were derived from an advanced spatiotemporal model. Child behavior was reported as Total Problems raw score using the Child Behavior Checklist at age 4-6 y. Child cognition was assessed using cohort-specific cognitive performance scales and quantified as the Full-Scale Intelligence Quotient (IQ). We fitted multivariate linear regression models that were adjusted for sociodemographic, behavioral, and psychological factors to estimate associations per 2-unit increase in pollutant in each exposure window and examined modification by child sex. Identified critical windows were further verified by distributed lag models (DLMs).

RESULTS

Mean NO2 and PM2.5 ranged from 8.4 to 9.0 ppb and 8.4 to 9.1 μg/m3, respectively, across pre- and postnatal windows. Average child Total Problems score and IQ were 22.7 [standard deviation (SD): 18.5] and 102.6 (SD: 15.3), respectively. Children with higher prenatal NO2 exposures were likely to have more behavioral problems [β: 1.24; 95% confidence interval (CI): 0.39, 2.08; per 2 ppb NO2], particularly NO2 in the first and second trimester. Each 2-μg/m3 increase in PM2.5 at age 2-4 y was associated with a 3.59 unit (95% CI: 0.35, 6.84) higher Total Problems score and a 2.63 point (95% CI: -5.08, -0.17) lower IQ. The associations between PM2.5 and Total Problems score were generally stronger in girls. Most predefined windows identified were not confirmed by DLMs.

DISCUSSION

Our study extends earlier findings that have raised concerns about impaired behavioral functioning and cognitive performance in children exposed to NO2 and PM2.5 in utero and in early life. https://doi.org/10.1289/EHP10248.

The Relationship between Fluid Milk, Water, and 100% Juice and Health Outcomes among Children and Adolescents

Beverages can provide improved nutrient intake and hydration, but also pose concerns related to overnutrition or contamination for children and adolescents who are in a time of critical growth. This narrative review aims to understand the impact of milk, 100% juice, and water consumption on health-related outcomes in youth. The literature review conducted used PubMed, Web of Science, and CABI global. Forty-five research articles met the quality criteria and were included. Health organization and governmental resources were also reviewed to identify current intake and consumption recommendations. All beverages in this review were associated with a variety of desirable and undesirable findings that spanned over 40 different health outcomes. Most studies that assessed milk lacked clear distinction between milk type (flavored vs. unflavored) or fat percentage, making it difficult to understand the impact of milk consumption. The relationship between milk intake and anthropometric-related outcomes were mixed within and across studies. Water was consistently associated with better hydration, while 100% juice and flavored milk intake was associated with more desirable dietary patterns or nutrients that children are currently not consuming adequate amounts of. The implications of these findings were discussed in the context of the National School Lunch Program (NSLP), while considering the impact of issues such as contaminated water and lactose intolerance. This review suggests that water may be an optimal default beverage option in the NSLP to promote hydration and accommodate beverage preferences for those with lactose intolerance.

The effect of water source on cognitive functioning in Chinese adults: A cross-sectional and follow-up study

The effect of water source on cognitive functioning is poorly understood. The present study explored the associations between water source and cognition in 9921 participants from the China Health and Retirement Longitudinal Study (CHARLS). Cognitive functioning was measured from three aspects: orientation and attention, episodic memory, and visuo-construction. Water sources included tap and non-tap water. Generalized linear models and multiple logistic regression models were conducted to investigate the associations of cognitive scores with water source among the whole population and different subgroups. Results from cross-sectional analysis reported that participants without access to tap water showed a lower cognitive score (β = - 0.57; 95% CI: - 0.74, - 0.39) than those with tap water as a water source; and this phenomenon was pronounced for both sexes and across all residences. During 4-years' follow-up, a greater decline of cognitive score was associated with no tap water use in the lowest quartile of baseline cognitive scores (β = - 0.67; 95% CI: - 1.26, - 0.08). Additionally, the utilization rate of tap water was lower in rural areas compared to urban areas. The lowest utilization rates were observed in urban areas of the Anhui province (0.38 in 2011 and 0.55 in 2015) and in rural areas of Inner Mongolia (0.09 in 2011 and 0.20 in 2015). These findings suggest that having no tap water may be a risk factor for cognition impairment, particularly for those with a low basic cognition score. Additionally, our results support the need to expand tap water use in China.

Heat shock proteins took part in oxidative stress-mediated inflammatory injury via NF-κB pathway in excess manganese-treated chicken livers

Manganese (Mn) is an essential metal in humans and animals. However, excess Mn entered environment due to the wide application of Mn in industry and agriculture, and became an environmental pollutant. Exposure to high doses of Mn is toxic to humans and animals (including chickens). Liver is a target organ of Mn poisoning. Nevertheless, there were few studies on whether Mn poisoning damages chicken livers and poisoning mechanism of Mn in chicken livers. Herein, the aim of this study was to explore if oxidative stress, heat shock proteins (HSPs), and inflammatory response were involved in the mechanism of Mn poisoning-caused damage in chicken livers. A chicken Mn poisoning model was established. One hundred and eighty chickens were randomly divided into one control group (containing 127.88 mg Mn kg^-1) and three Mn-treated groups (containing 600, 900, and 1800 mg Mn kg^-1, respectively). Histomorphological structure was observed via microstructure and ultrastructure. Spectrophotometry was used to detect total antioxidant capacity (T-AOC) and inducible nitric oxide synthase (iNOS) activity, as well as nitric oxide (NO) content. And qRT-PCR was performed to measure mRNA expression of inflammatory genes (nuclear factor kappa B (NF-κB), tumor necrosis factor α (TNF-α), cyclooxygenase-2 (COX-2), prostaglandin E2 (PGE2), and iNOS) and heat shock protein (HSP) genes (HSP27, HSP40, HSP60, HSP70, and HSP90). Multivariate correlation analysis, principal component analysis, and cluster analysis were used to demonstrate the reliability of mechanism of Mn poisoning in our experiment. The results indicated that excess Mn led to inflammatory injury at three contents and three time points. Meanwhile, we found that NO content, iNOS activity, and NF-κB, TNF-α, COX-2, PGE2, and iNOS mRNA expression increased after Mn treatment, meaning that exposure to Mn induced inflammatory response via NF-κB pathway in chicken livers. Moreover, excess Mn decreased T-AOC activity, indicating that Mn exposure caused oxidative stress. Furthermore, mRNA expression of above five HSP genes was up-regulated during Mn exposure. Oxidative stress triggered the increase of HSPs and the increase of HSPs mediated inflammatory response induced by Mn. In addition, there were time- and dose-dependent effects on Mn-caused chicken liver inflammatory injury. Taken together, HSPs participated in oxidative stress-mediated inflammatory damage caused by excess Mn in chicken livers via NF-κB pathway. For the first time, we found that oxidative stress can trigger HSP70 and HSPs can trigger poisoning-caused inflammatory damage, which needs to be further explored. This study provided a new insight into environmental pollutants and a reference for further study on molecular mechanisms of poisoning.

Risks to children from inhalation of aerosolized aqueous manganese emitted from ultrasonic humidifiers can be greater than for corresponding ingestion

The essential trace element manganese (Mn) can cause neurotoxicity with inhalation acknowledged as a more severe health and cognition threat than ingestion.

METHODS

Over a range of aqueous Mn concentrations present in tap water, this research characterizes exposures and risks for adults and 0.25, 1, 2.5, and 6 yr old children who ingest the water and inhale respirable particles produced by a room-sized ultrasonic humidifier filled with the same water. Aqueous Mn concentrations evaluated included 50 µg/L USEPA esthetic guideline, 80 µg/L WHO infant guideline, and 120 µg/L Canadian regulatory level. Airborne-particle-bound Mn concentrations were generated for water filling an ultrasonic humidifier under four realistic room conditions (33 m³ small or 72 m³ large) with varying ventilation rates from 0.2/h -1.5/h. Average daily doses (ADD) and reference intake doses were calculated for ingestion and 8-h inhalation of humidified air. Hazard quotients (HQ) compared the intake doses and reference doses. Multi-path particle dosimetry (MPPD) model quantified the particle deposition and deposited dose in children's and adults' respiratory tracts.

RESULTS

At only 11 µg/L Mn, the resulting humidified air Mn exceeds USEPA's reference concentration of 0.05 µg/m³ Mn in small room with low, energy-efficient ventilation. Inhalation ADD are 2 magnitudes lower than ingestion ADD for identical water Mn concentrations and daily exposure frequency. Even so, ingestion HQs are approximately 0.2 but inhalation risk is significant (HQ>1) for children and adults when breathing Mn-humidified air under most small room conditions at 50, 80 or 120 µg/L Mn. MPPD model indicates inhaled Mn deposits in head and pulmonary regions, with greater Mn dose deposits in children than adults.

CONCLUSION

Inhalation of Mn-particles produced from ultrasonic humidifiers can pose greater risks than ingestion at the same water concentration, especially for children. Aqueous Mn concentration and room size influence risks. Limiting manganese exposures and setting regulations requires consideration of both ingestion and inhalation of water.

Effects of low-dose methylcyclopentadienyl manganese tricarbonyl-derived manganese on the development of diencephalic dopaminergic neurons in zebrafish

Fuel additive methylcyclopentadienyl manganese tricarbonyl (MMT) is counted as an organic manganese (Mn)-derived compound. The toxic effects of Mn (alone and complexed) on dopaminergic (DA) neurotransmission have been investigated in both cellular and animal models. However, the impact of environmentally relevant Mn exposure on DA neurodevelopment is rather poorly understood. In the present study, the MMT dose of 100 μM (about 5 mg Mn/L) caused up-regulation of DA-related genes in association with cell body swelling and increase in the number of DA neurons of the ventral diencephalon subpopulation DC2. Furthermore, our analysis identified significant brain Mn bioaccumulation and enhancement of total dopamine levels in association with locomotor hyperactivity. Although DA levels were restored at adulthood, we observed a deficit in the acquisition and consolidation of memory. Collectively, these findings suggest that developmental exposure to low-level MMT-derived Mn is responsible for the selective alteration of diencephalic DA neurons and with long-lasting effects on fish explorative behaviour in adulthood.

Sex-specific neurotoxic effects of heavy metal pollutants: Epidemiological, experimental evidence and candidate mechanisms

The heavy metals lead (Pb), mercury (Hg), and cadmium (Cd) are ubiquitous environmental pollutants and are known to exert severe adverse impacts on the nervous system even at low concentrations. In contrast, the heavy metal manganese (Mn) is first and foremost an essential nutrient, but it becomes neurotoxic at high levels. Neurotoxic metals also include the less prevalent metalloid arsenic (As) which is found in excessive concentrations in drinking water and food sources in many regions of the world. Males and females often differ in how they respond to environmental exposures and adverse effects on their nervous systems are no exception. Here, we review the different types of sex-specific neurotoxic effects, such as cognitive and motor impairments, that have been attributed to Pb, Hg, Mn, Cd, and As exposure throughout the life course in epidemiological as well as in experimental toxicological studies. We also discuss differential vulnerability to these metals such as distinctions in behaviors and occupations across the sexes. Finally, we explore the different mechanisms hypothesized to account for sex-based differential susceptibility including hormonal, genetic, metabolic, anatomical, neurochemical, and epigenetic perturbations. An understanding of the sex-specific effects of environmental heavy metal neurotoxicity can aid in the development of more efficient systematic approaches in risk assessment and better exposure mitigation strategies with regard to sex-linked susceptibilities and vulnerabilities.

Assessing the risk of coal-burning arsenic-induced liver damage: a population-based study on hair arsenic and cumulative arsenic

Exposure to arsenic-contaminated air and food caused by the burning of coal in unventilated indoor stoves is a major environmental public health concern in Guizhou Province, China. The liver is one of the main target organs for coal-fired arsenic exposure; however, there is little information about the risk assessment between cumulative arsenic exposure and the prevalence of liver damage. This study first evaluated the chronic daily intake (CDI) for two exposure pathways (inhalation and ingestion) and five environmental media (i.e., indoor and outdoor air, drinking water, rice, corn, and chili peppers) in 1998, 2006, 2014, and 2017. Then, the dose-effect and dose-response relationship between hair arsenic (HA) and cumulative arsenic (CA) levels and liver damage was analyzed. The results clearly show that the CDI in 1998 was 34.9 μg·kg^-1·d^-1, 22.9 μg·kg^-1·d^-1 in 2006, 11.7 μg·kg^-1·d^-1 in 2014, and 6.7 μg·kg^-1·d^-1 in 2017 in the arsenic exposure area. All of these values were higher than the daily baseline level of 3.0 μg·kg^-1·d^-1 as recommended by the Joint FAO/WHO Expert Committee on Food Additives (JECFA), and the increased HA and CA can increase the risk of coal-fired arsenic-induced liver damage. In addition, we analyzed the possible maximum acceptable CA exposure level for coal-fired arsenic-induced liver damage using the Bayesian benchmark dose. The recommended maximum acceptable CA exposure level for liver damage caused by coal-burning arsenic is 7120 mg. This study provides scientific insight into understanding the dose-response relationship of liver damage caused by coal-burning arsenic exposure and the monitoring and prevention of arsenic poisoning.

Manganese in potable water of nine districts, Bangladesh: human health risk

Safe drinking water is directly linked to good human health. An excessive amount of manganese (Mn) in drinking water supplies causes people show symptoms of neurotoxicity. In this study, the level of Mn in potable water sourced from tube wells located in 9 (nine) districts of Bangladesh was monitored. In total, 170 (one hundred and seventy) water samples were collected and Mn was quantified by atomic absorption spectroscopy (AAS). The levels of Mn found in the tube well water samples of Sirajganj, Meherpur, Chuadanga, Jhenaidah, Magura, Faridpur, Jashore, Satkhira, and Khulna were 0.37-1.86, 0.10-4.11, 0.30-0.76, 0.26-0.94, 0.01-0.18, 0.21-1.78, 0.08-1.23, 0.05-0.27, and 0.01-2.11 mg/L, respectively. Results revealed that Mn level was beyond the highest contaminated levels of 0.1 mg/L and 0.4 mg/L, which are recommended by Bangladesh Drinking Standard (BDS) and World Health Organization (WHO), respectively. The maximum Mn contaminated level reached up to 4.11 mg/L (mean, 0.53 mg/L). The Mn level in tube well water exceeded 51.1% and 75.9% set by the recommended value of WHO and BDS, respectively. Furthermore, the calculated hazard quotient (HQ) value for Mn was observed to be greater than unity, indicating both children and adults risked potential non-carcinogenic health issues. The water supply authorities should take steps to provide Mn-free drinking water for communities.

Up-regulation of the manganese transporter SLC30A10 by hypoxia-inducible factors defines a homeostatic response to manganese toxicity

Manganese (Mn) is an essential metal that induces incurable parkinsonism at elevated levels. However, unlike other essential metals, mechanisms that regulate mammalian Mn homeostasis are poorly understood, which has limited therapeutic development. Here, we discovered that the exposure of mice to a translationally relevant oral Mn regimen up-regulated expression of SLC30A10, a critical Mn efflux transporter, in the liver and intestines. Mechanistic studies in cell culture, including primary human hepatocytes, revealed that 1) elevated Mn transcriptionally up-regulated SLC30A10, 2) a hypoxia response element in the SLC30A10 promoter was necessary, 3) the transcriptional activities of hypoxia-inducible factor (HIF) 1 or HIF2 were required and sufficient for the SLC30A10 response, 4) elevated Mn activated HIF1/HIF2 by blocking the prolyl hydroxylation of HIF proteins necessary for their degradation, and 5) blocking the Mn-induced up-regulation of SLC30A10 increased intracellular Mn levels and enhanced Mn toxicity. Finally, prolyl hydroxylase inhibitors that stabilize HIF proteins and are in advanced clinical trials for other diseases reduced intracellular Mn levels and afforded cellular protection against Mn toxicity and also ameliorated the in vivo Mn-induced neuromotor deficits in mice. These findings define a fundamental homeostatic protective response to Mn toxicity-elevated Mn levels activate HIF1 and HIF2 to up-regulate SLC30A10, which in turn reduces cellular and organismal Mn levels, and further indicate that it may be possible to repurpose prolyl hydroxylase inhibitors for the management of Mn neurotoxicity.

Resveratrol attenuates manganese-induced oxidative stress and neuroinflammation through SIRT1 signaling in mice

Exposure to excess levels of manganese (Mn) leads to neurotoxicity. Increasing evidence demonstrates that oxidative stress and neuroinflammation are important pathological causes of neurotoxicity. Resveratrol (Rsv), a sirtuin-1 (SIRT1) activator, plays an important role in neuroprotection. However, the molecular mechanisms of Rsv alleviating Mn-induced oxidative stress and neuroinflammation are not fully understood. To evaluate whether Rsv treatment relieves the oxidative stress and neuroinflammation in the hippocampus after Mn exposure through SIRT1 signaling, C57BL/6 adult mice were exposed to MnCl2 (200 μmol/kg), Rsv (30 mg/kg), and EX527 (5 mg/kg). Our results showed that administering MnCl2 for 6 weeks caused behavioral impairment and nerve cell injury in hippocampal tissue, which was related to oxidative stress and neuroinflammation. Activating Mn-induced JNK and inhibiting SIRT1 increased the phosphorylated and acetylated levels of NF-κB and STAT3, respectively. However, Rsv reduced the phosphorylated and acetylated levels of NF-κB and STAT3, and attenuated Mn-induced oxidative stress and inflammatory cytokines by activating SIRT1 signaling. Most importantly, EX527, a potent SIRT1 inhibitor, inactivated SIRT1, which prevented Rsv from exerting its beneficial effects. Taken together, our findings revealed that Rsv alleviated Mn-induced oxidative stress and neuroinflammation in adult mice by activating SIRT1.

Machine-Learning Predictions of High Arsenic and High Manganese at Drinking Water Depths of the Glacial Aquifer System, Northern Continental United States

Globally, over 200 million people are chronically exposed to arsenic (As) and/or manganese (Mn) from drinking water. We used machine-learning (ML) boosted regression tree (BRT) models to predict high As (>10 μg/L) and Mn (>300 μg/L) in groundwater from the glacial aquifer system (GLAC), which spans 25 states in the northern United States and provides drinking water to 30 million people. Our BRT models' predictor variables (PVs) included recently developed three-dimensional estimates of a suite of groundwater age metrics, redox condition, and pH. We also demonstrated a successful approach to significantly improve ML prediction sensitivity for imbalanced data sets (small percentage of high values). We present predictions of the probability of high As and high Mn concentrations in groundwater, and uncertainty, at two nonuniform depth surfaces that represent moving median depths of GLAC domestic and public supply wells within the three-dimensional model domain. Predicted high likelihood of anoxic condition (high iron or low dissolved oxygen), predicted pH, relative well depth, several modeled groundwater age metrics, and hydrologic position were all PVs retained in both models; however, PV importance and influence differed between the models. High-As and high-Mn groundwater was predicted with high likelihood over large portions of the central part of the GLAC.

How much manganese is safe for infants? A review of the scientific basis of intake guidelines and regulations relevant to the manganese content of infant formulas

BACKGROUND

Recent research has uncovered the potential for excess manganese (Mn) intakes causing significant neurotoxic effects for early brain development.

METHODS

We identified the Mn tolerable intakes (TI) published by the U.S. Institute of Medicine (IOM), World Health Organization (WHO), Agence nationale de sécurité sanitaire (ANSES), and U.S. Environmental Protection Agency (US EPA) and examined the primary studies on which regulatory TIs are based. We converted the TIs to μg of Mn/kg/day using standard assumptions specific to each agency. We estimated μg of Mn/kg/day intakes due to formulas. Using our estimates for formula intakes, weights, and kcal content, we converted regulatory maxima and minima from μg of Mn/100 kcals to estimates of μg of Mn/kg/day.

RESULTS

Except for the proposed ANSES TI for drinking water, none of the primary studies on which Mn intake guidelines and regulations are based measured health outcomes. Some infant formulas may exceed the regulatory TIs, especially if prepared with water containing considerable concentrations of Mn (e.g. 250 μg/L), even while meeting national and international regulatory standards or guidelines.

CONCLUSIONS

Infant formula regulations must be revised to reduce the potential for excess manganese intakes and the practice of manganese supplementation of infant formulas should be ceased.

Manganese and Movement Disorders: A Review

Scientific and technological advances achieved with industrial expansion have led to an ever-increasing demand for heavy metals. This demand has, in turn, led to increased contamination of soil, water and air with these metals. Chronic exposure to metals may be detrimental not only to occupational workers but also to the nonoccupational population exposed to these metals. Manganese (Mn), a commonly used heavy metal, is an essential cofactor for many enzymatic processes that drive biological functions. However, it is also a potential source of neurotoxicity, particularly in the field of movement disorders. The typical manifestation of Mn overexposure is parkinsonism, which may be difficult to differentiate from the more common idiopathic Parkinson’s disease. In addition to environmental exposure to Mn, other potential etiologies causing hypermanganesemia include systemic health conditions, total parenteral nutrition and genetic mutations causing Mn dyshomeostasis. In this review, we critically analyze Mn and discuss its sources of exposure, pathophysiology and clinical manifestations. We have highlighted the global public health impact of Mn and emphasize that movement disorder specialists should record a detailed social and occupational history to ensure that a toxic etiology is not misdiagnosed as a neurodegenerative disease. In the absence of a definite therapeutic option, early diagnosis and timely institution of preventive measures are the keys to managing its toxic effects.

Potential for Manganese-Induced Neurologic Harm to Formula-Fed Infants: A Risk Assessment of Total Oral Exposure

BACKGROUND

High oral exposure and biological vulnerabilities may put formula-fed infants at risk for manganese-induced neurotoxicity.

OBJECTIVES

We sought to characterize manganese concentrations in public drinking water and prepared infant formulas commonly purchased in the United States, integrate information from these sources into a health risk assessment specific to formula-fed infants, and examine whether households that receive water with elevated manganese concentrations avoid or treat the water, which has implications for formula preparation.

METHODS

Manganese was measured in 27 infant formulas and nearly all Minnesota community public water systems (CPWS). The risk assessment produced central tendency and upper-end exposure estimates that were compared to a neonatal animal-based health reference dose (RfD) and considered possible differences in bioavailability. A survey study assessed esthetic concerns, treatment, and use of water in a Twin Cities community with various levels of manganese in drinking water.

RESULTS

Ten percent of CPWSs were estimated to exceed the EPA health advisory level of 300   μ g / L . Manganese concentrations in formula ranged from 69.8 to 741   μ g / L , with amino acid > soy > cow ' s   milk formula concentrations. Central tendency estimates of soy and amino acid formula reconstituted with water at the CPWS 95th percentile manganese concentration exceeded the neonatal-based RfD. Upper-end estimates of manganese intake from formula alone, independent of any water contribution, equaled or exceeded the neonatal-based RfD. In the survey study, we observed increased awareness of esthetic issues and water avoidance at higher manganese concentrations, but these concentrations were not a reliable consumption deterrent, as the majority of households with inside tap drinking water results above 300   μ g / L reported drinking the water.

DISCUSSION

Excessive exposure to manganese early in life can have long-lasting neurological impacts. This assessment underscores the potential for manganese overexposure in formula-fed infants. U.S. agencies that regulate formula and drinking water must work collaboratively to assess and mitigate potential risks. https://doi.org/10.1289/EHP7901.

Chemical and in vitro bioanalytical assessment of drinking water quality in Manhiça, Mozambique

BACKGROUND

The chemical quality of drinking water is widely unknown in low-income countries.

OBJECTIVE

We conducted an exploratory study in Manhiça district (Mozambique) to evaluate drinking water quality using chemical analyses and cell-based assays.

METHODS

We measured nitrate, fluoride, metals, pesticides, disinfection by-products, and industrial organochlorinated chemicals, and conducted the bioassays Ames test for mutagenicity, micronuclei assay (MN-FACS), ER-CALUX, and antiAR-CALUX in 20 water samples from protected and unprotected sources.

RESULTS

Nitrate was present in all samples (median 7.5 mg/L). Manganese, cobalt, chromium, aluminium, and barium were present in 90-100% of the samples, with median values of 32, 0.6, 2.0, 61, 250 μg/l, respectively. Manganese was above 50 μg/l (EU guideline) in eight samples. Arsenic, lead, nickel, iron, and selenium median values were below the quantification limit. Antimony, cadmium, copper, mercury, zinc and silver were not present. Trihalomethanes, haloacetic acids, haloacetonitriles and haloketones were present in 5-28% samples at levels ≤4.6 μg/l. DDT, dieldrin, diuron, and pirimiphos-methyl were quantified in 2, 3, 3, and 1 sample, respectively (range 12-60 ng/L). Fluoride was present in one sample (0.11 mg/l). Trichloroethene and tetrachloroethene were not present. Samples were negative in the in vitro assays.

SIGNIFICANCE

Results suggest low exposure to chemicals, mutagenicity, genotoxicity and endocrine disruption through drinking water in Manhiça population. High concentration of manganese in some samples warrants confirmatory studies, given the potential link to impaired neurodevelopment.

Previously unrecognized potential threat to children from manganese in groundwater in rohingya refugee camps in Cox's Bazar, Bangladesh

The forced displacement of over 700,000 Rohingyas from Myanmar to Bangladesh since the crackdown in August 2017 has resulted in a critical humanitarian and environmental crisis. Groundwater is the primary source of drinking water in the camps that were constructed to provide shelter for the refugee population. The current study explores occurrence of Mn in groundwater in the Rohingya camps and adjacent areas. A total of 52 groundwater samples were collected between August and October 2018 from different camps sites and the adjacent host area. It was found that 64% exceeded the Bangladesh standard (100 μg/L) suggesting the presence of elevated concentrations of Mn in some groundwater aquifers in the camp sites. Mn is a neurotoxicant and previous studies have reported intellectual impairment in children exposed to Mn levels similar to those detected in groundwater in the camp sites. Nearly 450,000 migrant and new-born children live in the camps in already stressed conditions. The occurrence of elevated Mn concentrations in groundwater in the camps and their adjacent areas is likely an additional stressor exposing these children to an increased risk of neurotoxicity. Based on the results of this small-scale study, we recommend undertaking an in-depth study on the occurrence of Mn in groundwater in the camps to come up with appropriate strategies to minimise exposure. In addition, we recommend conducting a systematic epidemiological study on potential impacts of manganese in drinking water on neurological development of the Rohingya children in the camps.

Spatiotemporal variations, sources, water quality and health risk assessment of trace elements in the Fen River

As the largest river in Shanxi Province, the Fen River is the main water source for regional economic and ecological development. Water deficiency and industrialization have led to serious water pollution in the Fen River. The major and trace elements of seasonal river waters were measured to determine the spatiotemporal variations and assess the water quality as well as its controlling factors in the Fen River. Trace elements are divided into high abundance elements (B, Ba, Li, and Mn) and low abundance elements (As, Cu, Fe, Ni, Rb, Se, U, and V). The spatial variation of trace elements is obvious, with low values upstream, intermediate values downstream, and very high values midstream. The average values of the trace elements showed different seasonal variations, with high values of As, B, Ba, Mn, and Rb in the wet season, high Cu, V, and Li values in the dry season, and minor seasonal variations of Fe, Ni, Se, and U concentrations. Principal component analysis (PCA) and correlation analysis (CA) showed natural origins of Ba, Mn, Ni, and U, anthropogenic input of As, B, Cu, Li, Rb, Se, and V. According to the results of absolute principal component sore-multivariate linear regression (APCS-MLR), the major pollution sources in the Fen River basin were related to human activities. The land use type significantly influenced the concentrations of trace elements, with high values in the cropland and low values in the forest. The water quality index (WQI) values were higher in the midstream and wet season. In comparison with other rivers in the world, the pollution of the Fen River is at a moderate level. Health risk assessment showed that As, Ba, Mn, Ni, V, and Se were the potential pollutants damaging in the Fen River, especially for children. This study highlights the importance of seasonal sample analysis and can provide vital data for water quality conservation in the Fen River basin.

Evaluation of Fetal Exposures to Metals and Metalloids through Meconium Analyses: A Review

This paper surveys the existing scientific literature on metals concentrations in meconium. We examine some 32 papers that analyzed meconium for aluminum, arsenic, barium, calcium, chromium, copper, iron, lithium, magnesium, manganese, zinc, lead, mercury, manganese, molybdenum, nickel, phosphorus, lead, antimony, selenium, tin, vanadium, and zinc. Because of the lack of detail in the statistics it is not possible to do a rigorous meta-analysis. What stands out is that almost every study had subjects with seemingly large amounts of at least one of the metals. The significance of metals in meconium is not clear beyond an indication of exposure although some studies have correlated metals in meconium to a number of adverse outcomes. A number of outstanding questions have been identified that, if resolved, would greatly increase the utility of meconium analysis for assessment of long-term gestational metals exposures. Among these are questions of the developmental and long-term significance of metals detected in meconium, the kinetics and interactions among metals in maternal and fetal compartments and questions on best methods for meconium analyses.

A benchmark dose analysis for urinary cadmium and type 2 diabetes mellitus

Cadmium (Cd) is a heavy metal referred to as one of the environmental endocrine disruptors. The dose-dependent association between Cd and type 2 diabetes mellitus (T2DM) has been elucidated, but the corresponding threshold has not been established. To evaluate the urinary Cd levels associated with T2DM, we perform a benchmark dose (BMD) analysis based on data from the 1999-2006 National Health and Nutrition Examination Survey (NHANES). Weighted datasets were generated by the inverse probability of treatment weighting analysis to develop the robustness of our analysis. We inferred a strong positive association between urinary Cd and T2DM in unweighted and weighted populations. BMD and its low limit (BMDL) estimates for 5% benchmark responses (BMR) was 0.297 (0.198) and 0.190 (0.178) μg/g creatinine for each population, respectively. The sensitivity analysis by race, followed by weight of sum method showed similar estimates of urinary Cd level for the risk of developing T2DM, which are rather low and far less than those for the renal or bone disease development risk. This indicates that T2DM can be a sensitive outcome of Cd exposure and therefore should be taken into account in the development of standard regulatory limits for safe exposure to Cd.

Estimating daily intakes of manganese due to breast milk, infant formulas, or young child nutritional beverages in the United States and France: Comparison to sufficiency and toxicity thresholds

BACKGROUND

Although manganese (Mn) is an essential nutrient, recent research has revealed that excess Mn in early childhood may have adverse effects on neurodevelopment.

METHODS

We estimated daily total Mn intake due to breast milk at average body weights by reviewing reported concentrations of breast milk Mn and measurements of body weight and breast milk intake at 3 weeks, 4.25 months, 7 months, and 18 months. We compared these figures to the Mn content measured in 44 infant, follow-up, and toddler formulas purchased in the United States and France. We calculated Mn content of formula products made with ultra-trace elemental analysis grade water (0 μg Mn/L) and with water containing 250 μg Mn/L, a concentration which is relatively high but less than the World Health Organization Health-based value of 400 μg Mn/L or the United States Environmental Protection Agency Health Advisory of 350 μg Mn/L.

RESULTS

Estimated mean daily Mn intake from breast milk ranged from 1.2 μg Mn/kg/day (3 weeks) to 0.16 μg Mn/kg/day (18 months), with the highest intakes at the youngest age stage we considered, 3 weeks. Estimated daily Mn intake from formula products reconstituted with 0 μg Mn/L water ranged from 130 μg Mn/kg/day (3 weeks) to 4.8 μg Mn/kg/day (18 months) with the highest intakes at 3 weeks. Formula products provided 28-520 times greater than the mean daily intake of Mn from breast milk for the 4 age stages that we considered. Estimated daily Mn intake from formula products reconstituted with water containing 250 μg Mn/L ranged from 12 μg Mn/kg/day to 170 μg Mn/kg/day, which exceeds the United States Environmental Protection Agency Reference Dose of 140 μg Mn/kg/day for adults.

CONCLUSIONS

Mn deficiency is highly unlikely with exclusive breast milk or infant formula feeding, but established tolerable daily intake levels for Mn may be surpassed by some of these products when following labeled instructions.

Alpha-synuclein is involved in manganese-induced spatial memory and synaptic plasticity impairments via TrkB/Akt/Fyn-mediated phosphorylation of NMDA receptors

Manganese (Mn) overexposure produces long-term cognitive deficits and reduces brain-derived neurotrophic factor (BDNF) in the hippocampus. However, it remains elusive whether Mn-dependent enhanced alpha-synuclein (α-Syn) expression, suggesting a multifaceted mode of neuronal toxicities, accounts for interference with BDNF/TrkB signaling. In this study, we used C57BL/6J WT and α-Syn knockout (KO) mice to establish a model of manganism and found that Mn-induced impairments in spatial memory and synaptic plasticity were related to the α-Syn protein. In addition, consistent with the long-term potentiation (LTP) impairments that were observed, α-Syn KO relieved Mn-induced degradation of PSD95, phosphorylated CaMKIIα, and downregulated SynGAP protein levels. We transfected HT22 cells with lentivirus (LV)-α-Syn shRNA, followed by BDNF and Mn stimulation. In vitro experiments indicated that α-Syn selectively interacted with TrkB receptors and inhibited BDNF/TrkB signaling, leading to phosphorylation and downregulation of GluN2B. The binding of α-Syn to TrkB and Fyn-mediated phosphorylation of GluN2B were negatively regulated by BDNF. Together, these findings indicate that Mn-dependent enhanced α-Syn expression contributes to further exacerbate BDNF protein-level reduction and to inhibit TrkB/Akt/Fyn signaling, thereby disturbing Fyn-mediated phosphorylation of the NMDA receptor GluN2B subunit at tyrosine. In KO α-Syn mice treated with Mn, spatial memory and LTP impairments were less pronounced than in WT mice. However, the same robust neuronal death was observed as a result of Mn-induced neurotoxicity.

Astrocyte-specific deletion of the transcription factor Yin Yang 1 in murine substantia nigra mitigates manganese-induced dopaminergic neurotoxicity

Manganese (Mn)-induced neurotoxicity resembles Parkinson's disease (PD), but the mechanisms underpinning its effects remain unknown. Mn dysregulates astrocytic glutamate transporters, GLT-1 and GLAST, and dopaminergic function, including tyrosine hydroxylase (TH). Our previous in vitro studies have shown that Mn repressed GLAST and GLT-1 via activation of transcription factor Yin Yang 1 (YY1). Here, we investigated if in vivo astrocytic YY1 deletion mitigates Mn-induced dopaminergic neurotoxicity, attenuating Mn-induced reduction in GLAST/GLT-1 expression in murine substantia nigra (SN). AAV5-GFAP-Cre-GFP particles were infused into the SN of 8-week-old YY1 ^flox/flox mice to generate a region-specific astrocytic YY1 conditional knockout (cKO) mouse model. 3 weeks after adeno-associated viral (AAV) infusion, mice were exposed to 330 μg of Mn (MnCl₂ 30 mg/kg, intranasal instillation, daily) for 3 weeks. After Mn exposure, motor functions were determined in open-field and rotarod tests, followed by Western blotting, quantitative PCR, and immunohistochemistry to assess YY1, TH, GLAST, and GLT-1 levels. Infusion of AAV5-GFAP-Cre-GFP vectors into the SN resulted in region-specific astrocytic YY1 deletion and attenuation of Mn-induced impairment of motor functions, reduction of TH-expressing cells in SN, and TH mRNA/protein levels in midbrain/striatum. Astrocytic YY1 deletion also attenuated the Mn-induced decrease in GLAST/GLT-1 mRNA/protein levels in midbrain. Moreover, YY1 deletion abrogated its interaction with histone deacetylases in astrocytes. These results indicate that astrocytic YY1 plays a critical role in Mn-induced neurotoxicity in vivo, at least in part, by reducing astrocytic GLAST/GLT-1. Thus, YY1 might be a potential target for treatment of Mn toxicity and other neurological disorders associated with dysregulation of GLAST/GLT-1.

Exposure to Manganese in Drinking Water during Childhood and Association with Attention-Deficit Hyperactivity Disorder: A Nationwide Cohort Study

BACKGROUND

Manganese (Mn) in drinking water may increase the risk of several neurodevelopmental outcomes, including attention-deficit hyperactivity disorder (ADHD). Earlier epidemiological studies on associations between Mn exposure and ADHD-related outcomes had small sample sizes, lacked spatiotemporal exposure assessment, and relied on questionnaire data (not diagnoses)-shortcomings that we address here.

OBJECTIVE

Our objective was to assess the association between exposure to Mn in drinking water during childhood and later development of ADHD.

METHODS

In a nationwide population-based registry study in Denmark, we followed a cohort of 643,401 children born 1992-2007 for clinical diagnoses of ADHD. In subanalyses, we classified cases into ADHD-Inattentive and ADHD-Combined subtypes based on hierarchical categorization of International Classification of Diseases (ICD)-10 codes. We obtained Mn measurements from 82,574 drinking water samples to estimate longitudinal exposure during the first 5 y of life with high spatiotemporal resolution. We modeled exposure as both peak concentration and time-weighted average. We estimated sex-specific hazard ratios (HRs) in Cox proportional hazards models adjusted for age, birth year, socioeconomic status (SES), and urbanicity.

RESULTS

We found that exposure to increasing levels of Mn in drinking water was associated with an increased risk of ADHD-Inattentive subtype, but not ADHD-Combined subtype. After adjusting for age, birth year, and SES, females exposed to high levels of Mn (i.e., >100μg/L) at least once during their first 5 y of life had an HR for ADHD-Inattentive subtype of 1.51 [95% confidence interval (CI): 1.18, 1.93] and males of 1.20 (95% CI: 1.01, 1.42) when compared with same-sex individuals exposed to <5μg/L. When modeling exposure as a time-weighted average, sex differences were no longer present.

DISCUSSION

Mn in drinking water was associated with ADHD, specifically the ADHD-Inattentive subtype. Our results support earlier studies suggesting a need for a formal health-based drinking water guideline value for Mn. Future Mn-studies should examine ADHD subtype-specific associations and utilize direct subtype measurements rather than relying on ICD-10 codes alone. https://doi.org/10.1289/EHP6391.

Manganese (Mn) Concentrations and the Mn-Fe Relationship in Shallow Groundwater: Implications for Groundwater Monitoring

Manganese (Mn) concentrations in approximately 32,000 groundwater analyses from more than 4800 monitoring wells in northern Germany were evaluated. This region was considered well suited to study Mn in shallow groundwater in unconsolidated sediments. Spearman rank correlation was used to correlate between redox-sensitive parameters and the Mann–Kendall test for an evaluation of temporal trends. Manganese concentrations varied over two orders of magnitude and more than 40% of the wells had concentrations above 0.3 mg/L. Median Mn concentrations in the major hydrogeological units, the Geesten, tidal wetlands, and fluviatile lowlands were 0.12 mg/L, 0.46 mg/L, and 0.27 mg/L, respectively. Separating the data by land use, the median concentrations were 0.20 mg/L for arable land, 0.15 mg/L for forests, and 0.24 for grassland. Calculated background concentrations of Mn varied from <0.25 mg/L to 4.79 mg/L. A new parameter, ∆Mn-Fe, defined as the concentration difference between Mn and Fe in mg/L together with nitrate concentrations exceeding 50 mg/L was used to identify the fertilizer-borne input of nitrate. However, the factor controlling Mn occurrence seemingly was the depth of monitoring wells and the screen-length. Elevated concentrations of Mn and a high ∆Mn-Fe were generally found in shallow wells and wells with short screen-lengths.

Maintaining Translational Relevance in Animal Models of Manganese Neurotoxicity

Manganese is an essential metal, but elevated brain Mn concentrations produce a parkinsonian-like movement disorder in adults and fine motor, attentional, cognitive, and intellectual deficits in children. Human Mn neurotoxicity occurs owing to elevated exposure from occupational or environmental sources, defective excretion (e.g., due to cirrhosis), or loss-of-function mutations in the Mn transporters solute carrier family 30 member 10 or solute carrier family 39 member 14. Animal models are essential to study Mn neurotoxicity, but in order to be translationally relevant, such models should utilize environmentally relevant Mn exposure regimens that reproduce changes in brain Mn concentrations and neurological function evident in human patients. Here, we provide guidelines for Mn exposure in mice, rats, nematodes, and zebrafish so that brain Mn concentrations and neurobehavioral sequelae remain directly relatable to the human phenotype.

IRE1 signaling pathway mediates protective autophagic response against manganese-induced neuronal apoptosis in vivo and in vitro

Overexposure to manganese (Mn) can result in neurotoxicity and is associated with manganism, a Parkinson's-like neurological disorder. In addition, Mn can induce endoplasmic reticulum (ER) stress and autophagy. In this study, we used C57BL/6 mice to establish a model of manganism and found that Mn could induce cell injury. Our results also showed that Mn could initiate the unfolded protein response (UPR) signaling and autophagy, via initiation of the UPR signaling occurring earlier than autophagy. We further investigated the intrinsic relationship between the endoplasmic reticulum to nucleus 1(ERN1, also known as inositol requiring enzyme 1, IRE1) signaling pathway and autophagy induction in SH-SY5Y cells exposed to Mn. Our results revealed that autophagy activation was a protective response in Mn-induced toxicity. Additionally, we found that Jun N-terminal kinase (JNK) inhibition downregulated autophagy and interaction of c-Jun with the Beclin1 promoter. In addition, knockdown of IRE1 with the LV-IRE1 shRNA suppressed the expression of IRE1, TRAF2, p-ASK1, and p-JNK in Mn-treated SH-SY5Y cells. Furthermore, the expression of proteins associated with ASK1-TRAF2 complex formation and autophagy activation were reversed by the LV-IRE1 shRNA. These findings suggest that IRE1 was involved in the activation of JNK through the formation of the ASK1-TRAF2 complex, and JNK activation led to the induction of autophagy, which required Beclin1 transcription by c-Jun. In this study, we demonstrated that the IRE1 signaling pathway mediated the activation of JNK signaling via the formation of the ASK1-TRAF2 complex which could initiate autophagy and the protein c-Jun which regulates Beclin1 transcription in Mn-induced neurotoxicity.

Human health risk assessment of elevated and variable iron and manganese intake with arsenic-safe groundwater in Jashore, Bangladesh

Groundwater through hand-operated tubewell (a type of water well) tapping is the main source of drinking water in Bangladesh. This study investigated iron and manganese concentration in groundwater across Jashore district–one of the worst arsenic contaminated area in Bangladesh. One working tubewell that had been tested previously for arsenic and marked safe (green) was selected from each unions of the district. Results revealed that approximately 73% and 87% of groundwater samples exceeded the limits for iron and manganese in Bangladesh drinking water, respectively. Additionally, spatial distribution of iron and manganese indicate that only 5% of the total surface area of groundwater is covered by safe level of iron and manganese. Human health risk due to ingestion of iron and manganese through drinking water was evaluated using hazard quotients (HQ) for adults and children. The result of the health risk assessment revealed that the non-carcinogenic health risks due to ingestion of iron (HQ up to 1.446 for adults and 0.590 for children) and manganese (HQ up to 2.459 for adults and 1.004 for children) contaminated groundwater are much higher among adults than children. On the basis of occurrences, spatial distribution and health risk assessment results, the area can be categorized as a high-risk zone for iron and manganese-related problems and needs special attention in order to protect public health of local residents.

Manganese levels in infant formula and young child nutritional beverages in the United States and France: Comparison to breast milk and regulations

Exposure to high levels of manganese (Mn) in children has recently been associated with adverse neurodevelopmental effects. Current infant formula regulations for Mn content were set between 1981 (United States), 2006 (European Union, France), and 2007 (Codex Alimentarius) prior to the publication of much of the growing body of research on the developmental neurotoxicity of Mn. In this study, we sought to measure the concentrations of Mn in some infant formulas and young child nutritional beverages available on the United States (US) and French markets using ion beam analysis by particle induced X-ray emission (PIXE) spectrometry and then compare the analytical results to concentrations reported in the literature for breast milk and applicable infant formula regulations and guidelines. We were particularly interested in measuring Mn concentrations in product types for which there is very little data from previous surveys, especially soy-based, rice-based, goat-milk based, chocolate-flavored, and nutritional beverages for young children that are not regulated as infant or follow-on formulas (e.g. “toddler formulas” and “toddler powders”). We purchased 44 infant formulas and young child nutritional beverage products in the US and France with varying protein sources (cow-milk, goat-milk, soy, rice) labelled for birth to 3 years. We selected these samples using maximum variation sampling to explore market extremes to facilitate comparisons to regulatory limits. Since this sampling method is non-probabilistic, other inferences cannot be made beyond this set of samples to the overall markets. We used ion beam analysis to measure the concentrations of Mn in each product. The range of measured Mn concentrations in the products is 160–2,800 μg/L, substantially higher than the 3–6 μg/L mean Mn concentration reported in human breast milk. All products satisfied national and Codex Alimentarius Commission (CAC) international standards for minimum Mn content in infant formulas; however, 7/25 of the products purchased in the US exceeded the CAC Guidance Upper Level of 100 μg Mn/kcal for infant formula.