Biological and behavioral factors modify biomarkers of arsenic exposure in a U.S. population

Micro-distribution of arsenic in toenail clippings using laser ablation inductively coupled plasma mass spectrometry: implications for biomonitoring

Toenails are a common monitoring tool for arsenic exposure, but the risk of external contamination of toenails has cast doubt on its usefulness. The main objective of this study is to investigate the micro-distribution of arsenic through the dorsoventral plane of nail clippings to understand endogenous vs exogenous sources. We used laser-ablation inductively coupled plasma mass spectrometry to measure arsenic through a dorsoventral cross-section of the nail plate collected from reference (N = 17) and exposed individuals (N = 35). Our main results showed (1) bulk toenail concentrations measured using ICP-MS in this study ranged from 0.54 to 4.35 µg/g; (2) there was a double-hump pattern in arsenic concentrations, i.e., dorsal and ventral layers had higher arsenic than the inner layer; (3) the double-hump was more pronounced in the exposed group (ventral: 6.25 μg/g; inner: 0.75 μg/g; dorsal: 0.95 μg/g) than the reference group (ventral: 0.58 μg/g; inner: 0.15 μg/g; dorsal: 0.29 μg/g) on average; (4) the distribution was, in part, associated with different binding affinity of nail layers (i.e., ventral > dorsal > inner); (5) most individuals in the higher exposure group showed > 25% contamination in ventral and dorsal nail layers; and (6) there were no statistically significant correlations between LA-ICP-MS arsenic with either bulk toenail arsenic or urine arsenic from the same individuals. Our results on micro-distribution and binding affinity provide insight into the impact of external contamination on arsenic concentrations and show how LA-ICP-MS can access the protected inner nail layer to provide a more accurate result.

Defining high confidence targets of differential CpG methylation in response to in utero arsenic exposure and implications for cancer risk

Arsenic is a relatively abundant metalloid that impacts DNA methylation and has been implicated in various adverse health outcomes including several cancers and diabetes. However, uncertainty remains about the identity of genomic CpGs that are sensitive to arsenic exposure, in utero or otherwise. Here we identified a high confidence set of CpG sites whose methylation is sensitive to in utero arsenic exposure. To do so, we analyzed methylation of infant CpGs as a function of maternal urinary arsenic in cord blood and placenta from geographically and ancestrally distinct human populations. Independent analyses of these distinct populations were followed by combination of results across sexes and populations/tissue types. Following these analyses, we concluded that both sex and tissue type are important drivers of heterogeneity in methylation response at several CpGs. We also identified 17 high confidence CpGs that were hypermethylated across sex, tissue type and population; 11 of these were located within protein coding genes. This pattern is consistent with hypotheses that arsenic increases cancer risk by inducing the hypermethylation of genic regions. This study represents an opportunity to understand consistent, reproducible patterns of epigenomic responses after in utero arsenic exposure and may aid towards novel biomarkers or signatures of arsenic exposure. Identifying arsenic-responsive sites can also contribute to our understanding of the biological mechanisms by which arsenic exposure can affect biological function and increase risk of cancer and other age-related diseases.

Survey to identify the metal accumulation pathway in humans using hair and nail as biomarkers from fisherfolk population

Human hair and nail samples from Cuddalore fisherfolk populations were used as biomarkers for assessing metal concentrations in humans. Hair samples from 80 participants (47 men and 33 women) and nail samples from 40 participants (21 men and 19 women) were collected, and the concentrations of Cd, Cu, Pb, and Zn were assessed using an atomic absorption spectrophotometer (AAS). Metal data from AAS were compared with the survey questionnaire's personal and dietary parameters. Results indicate that both personal and dietary parameters may influence metal exposure; however, majority of the sources may have originated from metal-contaminated seafood. Higher metal accumulation in communities, especially those which consume seafood on a daily basis, may increase the possibility for them to get affected by metal-related diseases. Based on environmental parameters, people who live ≤500 m from industrial zones accumulate more metals. Further extensive studies with more individuals and more questionnaire parameters are needed to identify the metal accumulation pathway in humans.

Levels and determinants of urinary and blood metals in the geothermal area of Mt. Amiata in Tuscany (Italy)

Natural sources and anthropogenic activities are responsible for the widespread presence of heavy metals in the environment in the volcanic and geothermal area of Mt. Amiata (Tuscany, Italy). This study evaluates the extent of the population exposure to metals and describes the major individual and environmental determinants. A human biomonitoring survey was carried out to determine the concentrations of arsenic (As), mercury (Hg), thallium (Tl), antimony (Sb), cadmium (Cd), nickel (Ni), chromium (Cr), cobalt (Co), vanadium (V), and manganese (Mn). The associations between socio-demographics, lifestyle, diet, environmental exposure, and metal concentrations were evaluated using multiple log-linear regression models, adjusted for urinary creatinine. A total of 2034 urine and blood samples were collected. Adjusted geometric averages were higher in women (except for blood Hg) and younger subjects (except for Tl and Cd). Smoking was associated with Cd, As, and V. Some dietary habits (rice, fish, and wine consumption) were associated with As, Hg, Co, and Ni. Amalgam dental fillings and contact lenses were associated with Hg levels, piercing with As, Co, and Ni. Among environmental determinants, urinary As levels were higher in subjects using the aqueduct water for drinking/cooking. The consumption of locally grown fruits and vegetables was associated with Hg, Tl, and Co. Exposure to geothermal plant emissions was associated only with Tl.

Changes in arsenic accumulation and metabolic capacity after environmental management measures in mining area

Due to the public health concern of arsenic, environmental management measures in mining areas had been implemented. To assess the effect of environmental management measures in the mining area comprehensively, arsenic accumulation in the urine, hair, nails, and urinary metabolites of residents in a realgar mining area in Hunan province, China were investigated in 2019, and the changes in arsenic levels in the biomarkers during 2012-2019 were tracked. The importance of confounding factors (age, sex, occupation, residence, clinical history, vegetable source, cooking fuel, smoking, alcohol consumption, BMI) was analyzed using the Boruta algorithm. After the implementation of environmental management measures (including ceasing mining and smelting activities, building landfills, adjusting the planting structure, and soil restoration), urine, hair, and nail arsenic concentration decreased drastically but were still excessive. Arsenic accumulation was highest in older male miners who were long settled in the mining area and consumed homegrown vegetables. The only factor for changes in urinary arsenic levels was the cooking fuel type; residents using wood as cooking fuel experienced sustained arsenic exposure. Occupation and sex were important for determining arsenic changes in the hair and nails. Short-term arsenic accumulation in urine was affected by arsenic exposure, while long-term accumulation in hair and nails by arsenic metabolic capacity. The percentage of urinary arsenic metabolism and arsenic methylation indices of the participants in the mining area were within the normal range (%iAs: 10-30 %, %MMA: 10-20 %, % DMA: 60-80 %); samples indicated worse metabolic capacity than the reference population. The arsenic metabolic capacity of male miners was relatively weak, probably aggravated by alcohol drinking and smoking. Without soil remediation, arsenic exposure will continue. Homegrown vegetables and biomass fuels should be abandoned; reduced cigarette and alcohol consumption is recommended. Urinary arsenic would be more proper for assessing environmental remediation in mining areas.

GIS based interpolation method to urinary metal concentrations in Malaysia

Recently, there has been an increasing ecological and global public health concern associated with environmental contamination by arsenic (As), cadmium (Cd), nickel (Ni) and lead (Pb). This study aims to visualize distribution of these heavy metals concentration in urine of 817 Malaysian adults in Malaysia. This cross-sectional study compiled urine samples from October 2017 to March 2018. Spatial inverse distance weighted (IDW) interpolation method was used to derive a map which illustrate the distribution of these metals from urine samples. Moran's I Index was used to assess the spatial autocorrelation of these metals between the study area. The mean concentration for Ni and Cd was highest in Perak while for As and Pb, they were predominantly in East Coast region (Terengganu and Kelantan). Moran's I index showed significant spatial autocorrelation exist in the study area for all metals except for Pb (p-value<0.05). According to IDW, people in North East and Western regions had the highest concentrations for As and Cd. Individuals in Central region were less exposed than those in North region. These techniques can assist health authorities a better prediction in assessing exposure to heavy metals in population of an area to prioritize their control and preventive measure.

Biological monitoring of exposure to rare earth elements and selected metals in the Inuit population of Nunavik, Canada

In Nunavik (Northern Quebec, Canada), some mining projects are envisioned, that could increase the contamination of the environment by various chemicals, including rare earth elements (REEs), and implicitly Inuit population exposure. The objective of this study was to determine the baseline biological exposure of the population to these elements, before the potential mining development occurs. In the framework of the 2017 Qanuilirpitaa? Inuit health survey, urine samples were obtained from a representative sample of the adult Nunavik population, which were used to constitute 30 pooled samples according to age, sex and Nunavik subregions. Pooled samples were analyzed using sensitive and accurate methods involving ICP-MS platforms to quantify urinary concentrations of 17 REEs and 7 elements of interest in Nunavik (arsenic, antimony, chromium, cobalt, nickel, thallium and uranium). REEs were mostly not detected in pooled samples from this population. Detectable concentrations were found in some samples for cerium (range: 0.5-0.7 nmol/L; 27% > method detection limit (MDL) and lanthanum (range: 0.2-0.4 nmol/L; 33% > MDL). As for the other elements of interest, antimony, arsenic, cobalt and thallium were detected in 100% of the samples, whereas chromium and nickel were detected in 83% and 80% of the samples, respectively. Concentrations of arsenic (geometric mean (GM) = 0.5 μmol/L) and cobalt (GM = 5.2 nmol/L) were greater than in the general Canadian population; the opposite was observed for nickel (GM = 8.9 nmol/L). Arsenic concentrations increased significantly with age, whereas the opposite trend was observed for nickel and thallium. In this first biomonitoring study focusing on REEs and carried out in a representative sample of the Nunavik population, we found no evidence of significant exposure from pooled samples analysis. These results could eventually be used as baseline values in future studies aiming to assess temporal trends of exposure to REEs.

Human biomarkers associated with low concentrations of arsenic (As) and lead (Pb) in groundwater in agricultural areas of Thailand

Human biomarkers were used to evaluate the lead (Pb) and arsenic (As) exposure of local people who lived in an agricultural area with intense agrochemical usage and who consumed groundwater. Although the heavy metals/metalloids in the groundwater were at low concentrations, they could cause adverse effects due to a high daily water intake rate over the long term. Biomarkers (hair, fingernails and urine) were collected from 100 subjects along with the local shallow groundwater and tap water, which is the treated deep groundwater, and investigated for the concentrations of As and Pb. Shallow groundwater had an average pH of 5.21 ± 1.90, ranging from 3.77 to 8.34, with average concentrations of As and Pb of 1.311 µg/L and 6.882 µg/L, respectively. Tap water had an average pH of 5.24 ± 1.63, ranging from 3.86 to 8.89, with the average concentrations of As and Pb of 0.77 µg/L and 0.004 µg/L, respectively. The levels of both As and Pb in the hair, fingernails and urine of shallow groundwater-consuming residents were greater than those in the hair, fingernails and urine of tap water-consuming residents. Interestingly, the As level in urine showed a linear relationship with the As concentration in groundwater (R2 = 0.91). The average water consumption rate was approximately two-fold higher than the standard; thus, its consumption posed a health risk even at the low As and Pb levels in the groundwater. The hazard index (HI) ranged from 0.01 to 16.34 (average of 1.20 ± 2.50), which was higher than the acceptable level. Finally, the concomitant factors for As and Pb in the urine, hair and nails from both binary logistic regression and odds ratio (OR) analysis indicated that groundwater consumption was the major concomitant risk factor. This study suggested that direct consumption of this groundwater should be avoided and that the groundwater should be treated, especially before consumption. In conclusion, urine is suggested to be a biomarker of daily exposure to As and Pb, while for long-term exposure to these metals, fingernails are suggested as a better biomarker than hair.

Toenails as a biomarker of exposure to arsenic: A review

This systematic review summarizes the current evidence related to the reliability of toenail total arsenic concentrations (thereafter "arsenic") as a biomarker of long-term exposure. Specifically, we reviewed literature on consistency of repeated measures over time, association with other biomarkers and metal concentrations, factors influencing concentrations, and associations with health effects. We identified 129 papers containing quantitative original data on arsenic in toenail samples covering populations from 29 different countries. We observed geographic differences in toenail arsenic concentrations, with highest median or mean concentrations in Asian countries. Arsenic-contaminated drinking water, occupational exposure or living in specific industrial areas were associated with an increased toenail arsenic content. The effects of other potential determinants and sources of arsenic exposure including diet, gender and age on the concentrations in toenails need further investigations. Toenail arsenic was correlated with the concentrations in hair and fingernails, and with urine arsenic mainly among highly exposed populations with a toenail mean or median ≥1 μg/g. Overall, there is a growing body of evidence suggesting that arsenic content from a single toenail sample may reflect long-term internal dose-exposure. Toenail arsenic can serve as a reliable measure of toxic inorganic arsenic exposure in chronic disease research, particularly promising for cancer and cardiovascular conditions.

Serum matrix metalloproteinase-9 in children exposed to arsenic from playground dust at elementary schools in Hermosillo, Sonora, Mexico

Arsenic exposure in adults has been associated with increased serum matrix metalloproteinase-9 (MMP-9), a biomarker which is associated with chronic respiratory disease, lung inflammation, cardiovascular disease and cancer. The objective of this study was to evaluate the association between serum MMP-9 levels in children, urinary arsenic, arsenic chronic daily intake (CDI) and arsenic exposure from playground dust. This cross-sectional study examined 127 children from five elementary schools, in Hermosillo, Sonora, Mexico. Arsenic was analyzed in the dust using a portable X-ray fluorescence (XRF) analyzer. Total urinary arsenic was determined by inductively coupled plasma/optical emission spectrometry. Serum was analyzed for MMP-9 using ELISA. Arsenic levels in playground dust averaged 16.9 ± 4.6 mg/kg. Urinary arsenic averaged 34.9 ± 17.1 µg/L. Arsenic concentration in playground dust was positively associated with serum MMP-9 levels in crude analyses and after adjustment (P < 0.01), MMP-9 and CDI were positively associated only after adjustment (P < 0.01), and no association was found between MMP-9 and urinary arsenic. In conclusion, our study showed an association in children between serum MMP-9 levels and playground dust arsenic concentrations. Therefore, exposure to arsenic in dust where children spend significant time may manifest toxic effects.

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.

One-carbon metabolism nutrient intake and the association between body mass index and urinary arsenic metabolites in adults in the Chihuahua cohort

BACKGROUND

Exposure to inorganic arsenic (iAs) via drinking water is a serious global health threat. Various factors influence susceptibility to iAs-associated health outcomes, including differences in iAs metabolism. Previous studies have shown that obesity is associated with iAs metabolism. It has been hypothesized that this association can be explained by confounding from nutritional factors involved in one-carbon metabolism, such as folate or other B vitamins, whose intake may differ across BMI categories and is known be associated with iAs metabolism. However, no studies have explored whether this association is confounded by nutritional factors.

METHODS

We investigated the relationship between body mass index (BMI) and the distribution of urinary arsenic species in a cross-sectional cohort of 1166 adults living in Chihuahua, Mexico from 2008 to 2013. Nutrient intake related to one-carbon metabolism, including folate, vitamin B2, and vitamin B12, was assessed using a food frequency questionnaire developed for Mexican populations. Multivariable linear regression was used to estimate the association between BMI and the distribution of urinary arsenic metabolites. Effect modification by drinking water iAs level and sex was also examined.

RESULTS

After adjusting for potential confounders, including age, educational attainment, smoking, alcohol consumption, seafood consumption, water iAs, and sex, BMI was negatively associated with the proportion of urinary inorganic arsenic (%U-iAs) and urinary monomethylated arsenic (%U-MMAs) and positively associated with urinary dimethylated arsenic (%U-DMAs). This relationship was not influenced by additional adjustment for folate, vitamin B2, or vitamin B12 intake. Additionally, there was significant effect modification by both drinking water iAs level and sex.

CONCLUSIONS

This study provides further evidence for an association between BMI and arsenic metabolism. However, contrary to previous hypotheses, these results suggest that this association is not confounded by the intake of micronutrients involved in one-carbon metabolism.

Health Risk Assessment and Urinary Excretion of Children Exposed to Arsenic through Drinking Water and Soils in Sonora, Mexico

Environmental arsenic exposure is associated with increased risk of non-cancerous chronic diseases and a variety of cancers in humans. The aims of this study were to carry out for the first time a health risk assessment for two common arsenic exposure routes (drinking water and soil ingestion) in children living in the most important agricultural areas in the Yaqui and Mayo valleys in Sonora, Mexico. Drinking water sampling was conducted in the wells of 57 towns. A cross-sectional study was done in 306 children from 13 villages in the valleys. First morning void urine samples were analyzed for inorganic arsenic (InAs) and monomethyl and dimethyl arsenic (MMA and DMA) by HPLC/ICP-MS. The results showed a wide range of arsenic levels in drinking water between 2.7 and 98.7 μg As/L. Arsenic levels in agricultural and backyard soils were in the range of < 10-27 mg As/kg. The hazard index (HI) = ∑hazard quotient (HQ) for drinking water, agricultural soil, and backyard soil showed values > 1 in 100% of the study towns, and the carcinogenic risk (CR) was greater than 1E-04 in 85%. The average of arsenic excreted in urine was 31.7 μg As/L, and DMA had the highest proportion in urine, with averages of 77.8%, followed by InAs and MMA with 11.4 and 10.9%, respectively, percentages similar to those reported in the literature. Additionally, positive correlations between urinary arsenic levels and HI values were found (r = 0.59, P = 0.000). These results indicated that this population is at high risk of developing chronic diseases including cancer.

Evaluation of a Physiologically Based Pharmacokinetic (PBPK) Model for Inorganic Arsenic Exposure Using Data from Two Diverse Human Populations

BACKGROUND

Multiple epidemiological studies exist for some of the well-studied health endpoints associated with inorganic arsenic (iAs) exposure; however, results are usually expressed in terms of different exposure/dose metrics. Physiologically based pharmacokinetic (PBPK) models may be used to obtain a common exposure metric for application in dose-response meta-analysis.

OBJECTIVE

A previously published PBPK model for inorganic arsenic (iAs) was evaluated using data sets for arsenic-exposed populations from Bangladesh and the United States.

METHODS

The first data set was provided by the Health Effects of Arsenic Longitudinal Study cohort in Bangladesh. The second data set was provided by a study conducted in Churchill County, Nevada, USA. The PBPK model consisted of submodels describing the absorption, distribution, metabolism and excretion (ADME) of iAs and its metabolites monomethylarsenic (MMA) and dimethylarsenic (DMA) acids. The model was used to estimate total arsenic levels in urine in response to oral ingestion of iAs. To compare predictions of the PBPK model against observations, urinary arsenic concentration and creatinine-adjusted urinary arsenic concentration were simulated. As part of the evaluation, both water and dietary intakes of arsenic were estimated and used to generate the associated urine concentrations of the chemical in exposed populations.

RESULTS

When arsenic intake from water alone was considered, the results of the PBPK model underpredicted urinary arsenic concentrations for individuals with low levels of arsenic in drinking water and slightly overpredicted urinary arsenic concentrations in individuals with higher levels of arsenic in drinking water. When population-specific estimates of dietary intakes of iAs were included in exposures, the predictive value of the PBPK model was markedly improved, particularly at lower levels of arsenic intake.

CONCLUSIONS

Evaluations of this PBPK model illustrate its adequacy and usefulness for oral exposure reconstructions in human health risk assessment, particularly in individuals who are exposed to relatively low levels of arsenic in water or food. https://doi.org/10.1289/EHP3096.

Predictors of Urinary Arsenic Levels among Postmenopausal Danish Women

Arsenic is a risk factor for several noncommunicable diseases, even at low doses. Urinary arsenic (UAs) concentration is a good biomarker for internal dose, and demographic, dietary, and lifestyle factors are proposed predictors in nonoccupationally exposed populations. However, most predictor studies are limited in terms of size and number of predictors. We investigated demographic, dietary, and lifestyle determinants of UAs concentrations in 744 postmenopausal Danish women who had UAs measurements and questionnaire data on potential predictors. UAs concentrations were determined using mass spectrometry (ICP-MS), and determinants of the concentration were investigated using univariate and multivariate regression models. We used a forward selection procedure for model optimization. In all models, fish, alcohol, and poultry intake were associated with higher UAs concentration, and tap water, fruit, potato, and dairy intake with lower concentration. A forward regression model explained 35% (R²) of the variation in concentrations. Age, smoking, education, and area of residence did not predict concentration. The results were relatively robust across sensitivity analyses. The study suggested that UAs concentration in postmenopausal women was primarily determined by dietary factors, with fish consumption showing the strongest direct association. However, the majority of variation in UAs concentration in this study population is still unexplained.

Type 2 Diabetes in Youth: New Lessons from the SEARCH Study

PURPOSE OF REVIEW

The purpose of this review is to provide an update on the recent body of evidence emerging for type 2 diabetes as identified through the SEARCH for Diabetes in Youth study.

RECENT FINDINGS

This body of evidence illustrates that type 2 diabetes continues to increase in incidence, although this increase may be partially attributable to increased surveillance. Disease management is influenced by the transition from adolescent to adult care and psychosocial factors may also contribute. This evidence also describes a high prevalence of disease-associated complications and comorbidities. Risk factors for cardiovascular disease are also highly prevalent. The SEARCH for Diabetes in Youth study continues to inform our understanding of the descriptive epidemiology and natural history of type 2 diabetes in youth. As the cohort matures, new opportunities emerge for building on our understanding of how youth-onset type 2 diabetes impacts future health.

Using hair and fingernails in binary logistic regression for bio-monitoring of heavy metals/metalloid in groundwater in intensively agricultural areas, Thailand

In this study, the hair and fingernails of the local people in an intensively cultivated agricultural area in Ubon Ratchathani province, Thailand, were used as biomarkers of exposure to arsenic (As) and heavy metals. The study area has shallow acidic groundwater that is contaminated with As and heavy metals. The local people often consume this shallow groundwater; thus, they are exposed to As and heavy metals. Hair and fingernail samples were collected to characterize the differences between shallow groundwater drinking (SGWD) and tap water drinking (TWD) residents. The concentrations of As and the heavy metals Cd, Pb and Hg were significantly higher in the hair samples from the SGWD group than those from the TWD group, especially for As (0.020-0.571 vs. 0.024-0.359µg/g) and Cd (0.009-0.575 vs. 0.013-0.230µg/g). Similarly, the concentrations of As and the heavy metals in the fingernail samples collected from the SGWD group were larger than those of the TWD group, especially for As (0.039-2.440µg/g vs. 0.049-0.806µg/g). The χ² statistic and binary logistic regression were used to find the associated factors and assess the associated probabilities. The regression results show that the factors associated with the concentrations of As and the heavy metals in the hair samples were drinking water source, rate of water consumption, gender, bathing water source, education, smoking and underlying disease, whereas the factors associated with the concentrations of these species in the fingernail samples were drinking water source, gender, occupation, work hours per day, alcohol consumption, and the use of pesticides.

Urinary Arsenic in Human Samples from Areas Characterized by Natural or Anthropogenic Pollution in Italy

Arsenic is ubiquitous and has a potentially adverse impact on human health. We compared the distribution of concentrations of urinary inorganic arsenic plus methylated forms (uc(iAs+MMA+DMA)) in four Italian areas with other international studies, and we assessed the relationship between uc(iAs+MMA+DMA) and various exposure factors. We conducted a human biomonitoring study on 271 subjects (132 men) aged 20-44, randomly sampled and stratified by area, gender, and age. Data on environmental and occupational exposure and dietary habits were collected through a questionnaire. Arsenic was speciated using chromatographic separation and inductively coupled mass spectrometry. Associations between uc(iAs+MMA+DMA) and exposure factors were evaluated using the geometric mean ratio (GMR) with a 90% confidence interval by stepwise multiple regression analysis. The 95th percentile value of uc(iAs+MMA+DMA) for the whole sample (86.28 µg/L) was higher than other national studies worldwide. A statistical significant correlation was found between uc(iAs+MMA+DMA) and occupational exposure (GMR: 2.68 [1.79-4.00]), GSTT gene (GMR: 0.68 [0.52-0.80]), consumption of tap water (GMR: 1.35 [1.02-1.77]), seafood (GMR: 1.44 [1.11-1.88]), whole milk (GMR: 1.34 [1.04-1.73]), and fruit/vegetables (GMR: 1.37 [1.03-1.82]). This study demonstrated the utility of uc(iAs+MMA+DMA) as a biomarker to assess environmental exposure. In a public health context, this information could be used to support remedial action, to prevent individuals from being further exposed to environmental arsenic sources.

Using urine as a biomarker in human exposure risk associated with arsenic and other heavy metals contaminating drinking groundwater in intensively agricultural areas of Thailand

Urine used as a biomarker was collected and compared between two groups of participants: (1) a groundwater-drinking group and (2) a non-groundwater-drinking group in intensively agricultural areas in Ubon Ratchathani province, Thailand. The statistical relationship with the metal concentration in shallow groundwater wells was established with urine data. According to the groundwater data, the health risk assessment results for four metals appeared to be higher for participants who drank groundwater than for the other group. The carcinogenic risk and non-carcinogenic risk of arsenic (As) were found in 25.86 and 31.03% of participants, respectively. For lead (Pb), 13.79% of the participants had a non-carcinogenic risk. Moreover, 30 of the 58 participants in the groundwater-drinking group had As urine higher than the standard, and 26, 2 and 9 of the 58 participants had above-standard levels for cadmium (Cd), Pb and mercury (Hg) in urine, respectively. Both the risk assessment and biomarker level of groundwater-drinking participants were higher than in the other group. The results showed an average drinking rate of approximately 4.21 ± 2.73 L/day, which is twice as high as the standard. Interestingly, the As levels in the groundwater correlated with those in the urine of the groundwater-drinking participants, but not in the non-groundwater-drinking participants, as well as with the As-related cancer and non-carcinogenic risks. The hazard index (HI) of the 100 participants ranged from 0.00 to 25.86, with an average of 1.51 ± 3.63 higher than the acceptable level, revealing that 28 people appeared to have non-carcinogenic risk levels (24 and 4 people for groundwater-drinking participants and non-groundwater-drinking participants, respectively). Finally, the associated factors of heavy metals in urine were the drinking water source, body weight, smoking, sex and use of personal protective equipment.

Human exposure to organic arsenic species from seafood

Seafood, including finfish, shellfish, and seaweed, is the largest contributor to arsenic (As) exposure in many human populations. In contrast to the predominance of inorganic As in water and many terrestrial foods, As in marine-derived foods is present primarily in the form of organic compounds. To date, human exposure and toxicological assessments have focused on inorganic As, while organic As has generally been considered to be non-toxic. However, the high concentrations of organic As in seafood, as well as the often complex As speciation, can lead to complications in assessing As exposure from diet. In this report, we evaluate the presence and distribution of organic As species in seafood, and combined with consumption data, address the current capabilities and needs for determining human exposure to these compounds. The analytical approaches and shortcomings for assessing these compounds are reviewed, with a focus on the best practices for characterization and quantitation. Metabolic pathways and toxicology of two important classes of organic arsenicals, arsenolipids and arsenosugars, are examined, as well as individual variability in absorption of these compounds. Although determining health outcomes or assessing a need for regulatory policies for organic As exposure is premature, the extensive consumption of seafood globally, along with the preliminary toxicological profiles of these compounds and their confounding effect on assessing exposure to inorganic As, suggests further investigations and process-level studies on organic As are needed to fill the current gaps in knowledge.

Arsenic levels among pregnant women and newborns in Canada: Results from the Maternal-Infant Research on Environmental Chemicals (MIREC) cohort

Arsenic is a common environmental contaminant from both naturally-occurring and anthropomorphic sources and human exposure can be detected in various tissues. Its toxicity depends on many factors including the chemical form, valence state, bioavailability, metabolism and detoxification within the human body. Of paramount concern, particularly with respect to health effects in children, is the timing of exposure as the prenatal and early life periods are more susceptible to toxic effects. The Maternal-Infant Research on Environmental Chemicals (MIREC) cohort was established to obtain national-level biomonitoring data for approximately 2,000 pregnant women and their infants between 2008 and 2011 from 10 Canadian cities. We measured total arsenic (As) in 1st and 3rd trimester maternal blood, umbilical cord blood, and infant meconium and speciated arsenic in 1st trimester maternal urine. Most pregnant women had detectable levels of total arsenic in blood (92.5% and 87.3%, respectively, for 1st and 3rd trimester); median difference between 1st and 3rd trimester was 0.1124µg/L (p<0.0001), but paired samples were moderately correlated (Spearman r=0.41, p<0.0001). Most samples were below the LOD for umbilical cord blood (50.9%) and meconium (93.9%). In 1st trimester urine samples, a high percentage (>50%) of arsenic species (arsenous acid (As-III), arsenic acid (As-V), monomethylarsonic acid (MMA), and arsenobetaine (AsB)) were also below the limit of detection, except dimethylarsinic acid (DMA). DMA (>85% detected) ranged from <LOD to 64.42 (95th percentile: 11.99)µgAs/L. There was a weak but significant correlation between total arsenic in blood and specific gravity-adjusted DMA in urine (Spearman r=0.33, p<0.0001). Among this population of pregnant woman and newborns, levels of arsenic measured in blood and urine were lower than national population figures for Canadian women of reproductive age (20-39 years). In general, higher arsenic levels were observed in women who were older, foreign-born (predominantly from Asian countries), and had higher education. Further research is needed to elucidate sources of exposure and factors that may influence arsenic exposure in pregnant women and children.

Arsenic exposure and seafood intake in Korean adults

Arsenic (As) is widely distributed in the environment, and humans can be exposed to As from various sources such as air, water, soil, and food. This study was performed to evaluate the As exposure levels in Korean adults by measuring total As in urine and its relation with the consumption of seafood, a favorite food in Korea. A total of 2077 adults were the study subjects; they ranged in age from 19 to 83, and they were recruited by probability sampling stratified by area, sex, and age. None of the subjects had been exposed to As occupationally. We collected information about the demographic characteristics, lifestyles, and food consumption of study subjects using a questionnaire and followed urine sampling. Diet was assessed in individual interviews using the 24-h recall method. Total As in urine was analyzed using inductively coupled plasma mass spectrometry (PerkinElmer NEXION 300S; Concord, Ontario, Canada). The geometric mean concentration of total As in urine was observed to be 97.6 µg/L and was higher in males (103.9 µg/L) than in females (93.0 µg/L). Total As levels in urine were affected by sex, age, seafood intake, and geographic location. In this study, total As in urine was positively correlated with fish and shellfish consumption, and was mainly determined by As intake through fish and shellfish/grains/flavors. These findings suggest that seafood consumption might be a major contributor to urinary As levels in Korean adults.

Human biomonitoring of metals in adults living near a waste-to-energy incinerator in ante-operam phase: Focus on reference values and health-based assessments

The human biomonitoring (HBM) of metals is a part of the ongoing project SPoTT for the longitudinal health surveillance of the population living near a waste-to-energy (WTE) incinerator (Turin, Italy). The HBM of metals in the SPoTT population aimed to evaluate: i) reference values (RVs) before the WTE incinerator started operation; ii) differences in exposure by variables; iii) variations respect to other HBM studies; iv) exposure that exceeds the available health-based benchmarks as the Biomonitoring Equivalents (BEs) for urine Cd and Human Biomonitoring (HBM-I and HBM-II) values for urine Hg, Tl, and blood Pb; v) risk assessment by generating hazard quotients (HQs) for the single metal and hazard index (HI) for the co-occurrence of metals. Eighteen metals in urine and Pb in blood were determined by sector field inductively coupled plasma mass spectrometry. Metal concentrations were comparable with RVs reported in other countries, except for slightly higher As, Be, Ir, Pd, Pt, Rh, and Tl levels. Smoking was associated with Cd; age with Pb; drinking bottled water with As and Cd; consumption of fish with As and Hg; amalgams with Hg and Sn; dental restorations with Pd and Pt; use of jewelry with Co and Rh, and piercing with Ni. While HQs for urine Cd, Hg, Tl and blood Pb suggested that adverse effects were unlikely, the HQ value raised the question of whether additive interactions of these metals could produce health concern. The obtained HBM data can be an early warning for accumulations of metals and identification of subgroups at risk.

Biological and behavioral factors modify urinary arsenic metabolic profiles in a U.S. population

BACKGROUND

Because some adverse health effects associated with chronic arsenic exposure may be mediated by methylated arsenicals, interindividual variation in capacity to convert inorganic arsenic into mono- and di-methylated metabolites may be an important determinant of risk associated with exposure to this metalloid. Hence, identifying biological and behavioral factors that modify an individual's capacity to methylate inorganic arsenic could provide insights into critical dose-response relations underlying adverse health effects.

METHODS

A total of 904 older adults (≥45 years old) in Churchill County, Nevada, who chronically used home tap water supplies containing up to 1850 μg of arsenic per liter provided urine and toenail samples for determination of total and speciated arsenic levels. Effects of biological factors (gender, age, body mass index) and behavioral factors (smoking, recent fish or shellfish consumption) on patterns of arsenicals in urine were evaluated with bivariate analyses and multivariate regression models.

RESULTS

Relative contributions of inorganic, mono-, and di-methylated arsenic to total speciated arsenic in urine were unchanged over the range of concentrations of arsenic in home tap water supplies used by study participants. Gender predicted both absolute and relative amounts of arsenicals in urine. Age predicted levels of inorganic arsenic in urine and body mass index predicted relative levels of mono- and di-methylated arsenic in urine. Smoking predicted both absolute and relative levels of arsenicals in urine. Multivariate regression models were developed for both absolute and relative levels of arsenicals in urine. Concentration of arsenic in home tap water and estimated water consumption were strongly predictive of levels of arsenicals in urine as were smoking, body mass index, and gender. Relative contributions of arsenicals to urinary arsenic were not consistently predicted by concentrations of arsenic in drinking water supplies but were more consistently predicted by gender, body mass index, age, and smoking.

CONCLUSIONS

These findings suggest that analyses of dose-response relations in arsenic-exposed populations should account for biological and behavioral factors that modify levels of inorganic and methylated arsenicals in urine. Evidence of significant effects of these factors on arsenic metabolism may also support mode of action studies in appropriate experimental models.

ChIP-Seq analysis of the adult male mouse brain after developmental exposure to arsenic

Exposure to the common environmental contaminant arsenic impacts the epigenetic landscape, including DNA methylation and histone modifications, of several cell types. Developmental arsenic exposure (DAE) increases acetylation and methylation of histone proteins and the protein expression of several chromatin-modifying enzymes in the dentate gyrus (DG) subregion of the adult male mouse brain [26]. To complement and support these data, ChIP-Seq analysis of DNA associated with trimethylation of histone 3 lysine 4 (H3K4me3) derived from the adult male DG after DAE was performed. DAE induced differential H3K4me3 enrichment on genes in pathways associated with cellular development and growth, cell death and survival, and neurological disorders, particularly as they relate to cancer, in the adult male brain. Comparison of H3K4me3 enrichment in controls revealed mechanisms that are potentially lacking in arsenic-exposed animals, including neurotransmission, neuronal growth and development, hormonal regulation, protein synthesis, and cellular homeostasis. New pathways impacted by arsenic include cytoskeleton organization, cell signaling, and potential disruption of immune function and warrant further investigation using this DAE paradigm in the mouse brain.

Modulation of aryl hydrocarbon receptor-regulated enzymes by trimethylarsine oxide in C57BL/6 mice: In vivo and in vitro studies

Arsenic is a worldwide environmental pollutant that is associated with skin and several types of internal cancers. Recent reports revealed that arsenic biomethylation could activate the toxic and carcinogenic potential of arsenic. Therefore, we investigated the effect of trimethylarsine oxide (TMAO) on the activation of AhR-regulated genes in vivo and in vitro. In vivo, C57BL/6 mice received TMAO (13mg/kg i.p.) with or without the prototypical AhR ligand, TCDD (15μg/kg), then the livers were harvested at 6 and 24h post-treatment. In vitro, isolated hepatocytes from C57BL/6 mice were treated with TMAO (5μM) in the absence and presence of TCDD (1nM) for 6 and 24h. Our in vivo results demonstrated that, TMAO alone increased Cyp1a1, Cyp1a2, Cyp1b1, Nqo1, Gsta1, and Ho-1 at mRNA level. Upon co-exposure to TMAO and TCDD, TMAO potentiated the TCDD-mediated induction of Cyp1a1, Cyp1b1, and Nqo1 mRNA levels. Western blotting revealed that, TMAO alone increased Cyp1a1, Cyp1a2, Nqo1, Gsta1/2, and Ho-1 protein levels, and potentiated the TCDD-mediated induction of Cyp1a1 and Cyp1b1 protein level. In addition, TMAO alone significantly increased Cyp1a1, Cyp1a2, Nqo1, Gst, and Ho-1 activities and significantly potentiated the TCDD-mediated induction of Cyp1a1 activity. At the in vitro level, TMAO induced Cyp1a1 and potentiated the TCDD-mediated induction of Cyp1a1 at mRNA, protein and activity levels. In addition, TMAO increased the nuclear localization of AhR and AhR-dependent XRE-driven luciferase activity. Our results demonstrate that the TMAO, modulates AhR-regulated genes which could potentially participate, at least in part, in arsenic induced toxicity and carcinogenicity.

The health effects of exposure to arsenic-contaminated drinking water: a review by global geographical distribution

Chronic arsenic exposure through drinking water has been a vigorously studied and debated subject. However, the existing literature does not allow for a thorough examination of the potential regional discrepancies that may arise among arsenic-related health outcomes. The purpose of this article is to provide an updated review of the literature on arsenic exposure and commonly discussed health effects according to global geographical distribution. This geographically segmented approach helps uncover the discrepancies in the health effects of arsenic. For instance, women are more susceptible than men to a few types of cancer in Taiwan, but not in other countries. Although skin cancer and arsenic exposure correlations have been discovered in Chile, Argentina, the United States, and Taiwan, no evident association was found in mainland China. We then propose several globally applicable recommendations to prevent and treat the further spread of arsenic poisoning and suggestions of future study designs and decision-making.