Ecological analysis of associations between groundwater quality and hypertension and cardiovascular disease in rural Saskatchewan, Canada using Bayesian hierarchical models and administrative health data

Update of the risk assessment of inorganic arsenic in food

The European Commission asked EFSA to update its 2009 risk assessment on arsenic in food carrying out a hazard assessment of inorganic arsenic (iAs) and using the revised exposure assessment issued by EFSA in 2021. Epidemiological studies show that the chronic intake of iAs via diet and/or drinking water is associated with increased risk of several adverse outcomes including cancers of the skin, bladder and lung. The CONTAM Panel used the benchmark dose lower confidence limit based on a benchmark response (BMR) of 5% (relative increase of the background incidence after adjustment for confounders, BMDL05) of 0.06 μg iAs/kg bw per day obtained from a study on skin cancer as a Reference Point (RP). Inorganic As is a genotoxic carcinogen with additional epigenetic effects and the CONTAM Panel applied a margin of exposure (MOE) approach for the risk characterisation. In adults, the MOEs are low (range between 2 and 0.4 for mean consumers and between 0.9 and 0.2 at the 95th percentile exposure, respectively) and as such raise a health concern despite the uncertainties.

The Relationship between Mortality from Cardiovascular Diseases and Total Drinking Water Hardness: Systematic Review with Meta-Analysis

BACKGROUND

Interest in water chemical activity, its content, and its impact on human health has greatly increased throughout the last decade. Some studies suggest that drinking water with high hardness may have preventative effects on cardiovascular diseases. This study aims to investigate the association between drinking water hardness and cardiovascular disease (CVD) mortality.

METHODS

The study selection process was designed to find the association between drinking water hardness and CVDs mortality. The search included both qualitative and quantitative research and was performed in three databases: Web of Science (Clarivate Analytics, Ann Arbor, MI, USA), PubMed (National Institute of Health, Bethesda, MA, USA), and Scopus (Elsevier, RELX Group plc, London, UK). The project was registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number: CRD42020213102.

RESULTS

Seventeen studies out of a total of twenty-five studies qualitatively analyzed indicated a significant relation between total water hardness and protection from CVD mortality. The quantitative analysis concluded that high drinking water hardness has a significantly lowering effect on mortality from CVDs, however, the heterogeneity was high.

CONCLUSIONS

This systematic literature review shows that total water hardness could affect CVD prevention and mortality. Due to the many confounding factors in the studies, more research is needed.

Arsenic exposure promotes the emergence of cardiovascular diseases

A large number of studies conducted in the past decade 2010-2020 refer to the impact of arsenic (As) exposure on cardiovascular risk factors. The arsenic effect on humans is complex and mainly depends on the varying individual susceptibilities, its numerous toxic expressions and the variation in arsenic metabolism between individuals. In this review we present relevant data from studies which document the association of arsenic exposure with various biomarkers, the effect of several genome polymorphisms on arsenic methylation and the underling molecular mechanisms influencing the cardiovascular pathology. The corresponding results provide strong evidence that high and moderate-high As intake induce oxidative stress, inflammation and vessel endothelial dysfunction that are associated with increased risk for cardiovascular diseases (CVDs) and in particular hypertension, myocardial infarction, carotid intima-media thickness and stroke, ventricular arrhythmias and peripheral arterial disease. In addition, As exposure during pregnancy implies risks for blood pressure abnormalities among infants and increased mortality rates from acute myocardial infarction during early adulthood. Low water As concentrations are associated with increased systolic, diastolic and pulse pressure, coronary heart disease and incident stroke. For very low As concentrations the relevant studies are few. They predict a risk for myocardial infarction, stroke and ischemic stroke and incident CVD, but they are not in agreement regarding the risk magnitude.

High manganese and nickel concentrations in human hair and well water and low calcium concentration in blood serum in a pristine area with sulphide-rich bedrock

We report the trace element status of residents living in areas with naturally sulphide-rich bedrock and soil in two municipalities in Finland, Sotkamo and Kaavi. Altogether, 225 people from these sparsely populated regions participated voluntarily by providing hair and blood samples. The concentrations of calcium, zinc and copper in serum as well as selenium and cadmium in whole blood did not show correlation with those concentrations in hair samples. Calcium concentration in serum was slightly lower in the sulphide-rich areas (median value 91.4 mg/l, n = 103) than in the areas with adjacent sulphur-poor bedrock (median value 93.6 mg/l, n = 82). The concentrations of Ni and Mn in hair correlated with those in drinking water. The highest Mn and Ni concentrations in the water samples from private wells were 1620 µg/l and 51 µg/l and the highest concentrations in human hair samples 36.44 mg/kg and 12.3 mg/kg, respectively. The challenge with elevated trace element concentrations in some well waters is well documented. In northern countries (Finland, Sweden, Norway and Canada), only 10% of the population depend on private well water, and 90% have access to monitored municipal water supplies. Compared with data available from sulphide mine sites globally, the nickel and manganese concentrations in human hair samples were high in our sulphide-rich study area at Sotkamo representing the trace element status of residents under natural conditions.

Hard Water, More Elastic Arteries: A Case Study from Krupina District, Slovakia

The protective role of hard drinking water against cardiovascular diseases is well documented by numerous studies. This article describes the impact of Ca and Mg contents in the drinking water with different water hardness on the cardiovascular system (arterial stiffness, arterial age) of residents of the Krupina district, the Slovak Republic. The research was based on the measurements of arterial stiffness, including the measurements of aortic pulse wave velocity (PWVao) and the calculation of the arterial age of the residents. In total, 144 randomly selected residents were included in measurements, divided into the two groups according to Ca and Mg contents in drinking water (water hardness). The first group was supplied with soft drinking water (total dissolved solids (TDS): 200-300 mg·L^-1, Ca: 20-25 mg·L^-1, Mg: 5-10 mg·L^-1). The second group of residents was supplied with harder drinking water (TDS: 500-600 mg·L^-1, Ca: 80-90 mg·L^-1, Mg: 25-30 mg·L^-1). Differences in arterial stiffness between the two groups of respondents were documented. Higher arterial stiffness (low flexibility of arteries) was determined for a group of residents supplied with soft drinking water. This was reflected in higher PWVao levels, higher number of pathological cases (PWVao > 10 m·s^-1), and arterial age of respondents compared to their actual age. The "absolute" difference between the arterial and actual age between the two evaluated groups of residents (soft vs. harder water) was nearly 5 years on average. The higher arterial stiffness and age of residents that consumed soft drinking water indicate the health significance of lower contents of Ca and Mg in drinking water as an environmental risk factor of cardiovascular diseases. Measuring arterial stiffness of residents in the areas supplied with soft drinking water can be used as a non-invasive approach in the prevention of cardiovascular risks.