Arsenic in groundwater in private wells in rural North Dakota and South Dakota: Water quality assessment for an intervention trial

Effect of an Arsenic Mitigation Program on Arsenic Exposure in American Indian Communities: A Cluster Randomized Controlled Trial of the Community-Led Strong Heart Water Study Program

BACKGROUND

Chronic arsenic exposure has been associated with an increased risk of cardiovascular disease; diabetes; cancers of the lung, pancreas and prostate; and all-cause mortality in American Indian communities in the Strong Heart Study.

OBJECTIVE

The Strong Heart Water Study (SHWS) designed and evaluated a multilevel, community-led arsenic mitigation program to reduce arsenic exposure among private well users in partnership with Northern Great Plains American Indian Nations.

METHODS

A cluster randomized controlled trial (cRCT) was conducted to evaluate the effectiveness of the SHWS arsenic mitigation program over a 2-y period on a) urinary arsenic, and b) reported use of arsenic-safe water for drinking and cooking. The cRCT compared the installation of a point-of-use arsenic filter and a mobile Health (mHealth) program (3 phone calls; SHWS mHealth and Filter arm) to a more intensive program, which included this same program plus three home visits (3 phone calls and 3 home visits; SHWS Intensive arm).

RESULTS

A 47% reduction in urinary arsenic [geometric mean  ( GM ) = 13.2  to  7.0 μ g / g creatinine] was observed from baseline to the final follow-up when both study arms were combined. By treatment arm, the reduction in urinary arsenic from baseline to the final follow-up visit was 55% in the mHealth and Filter arm (GM = 14.6  to  6.55 μ g / g creatinine) and 30% in the Intensive arm (GM = 11.2  to  7.82 μ g / g creatinine). There was no significant difference in urinary arsenic levels by treatment arm at the final follow-up visit comparing the Intensive vs. mHealth and Filter arms: GM ratio of 1.21 (95% confidence interval: 0.77, 1.90). In both arms combined, exclusive use of arsenic-safe water from baseline to the final follow-up visit significantly increased for water used for cooking (17% to 53%) and drinking (12% to 46%).

DISCUSSION

Delivery of the interventions for the community-led SHWS arsenic mitigation program, including the installation of a point-of-use arsenic filter and a mHealth program on the use of arsenic-safe water (calls only, no home visits), resulted in a significant reduction in urinary arsenic and increases in reported use of arsenic-safe water for drinking and cooking during the 2-y study period. These results demonstrate that the installation of an arsenic filter and phone calls from a mHealth program presents a promising approach to reduce water arsenic exposure among private well users. https://doi.org/10.1289/EHP12548.

Paving a Path to Equity in Cardiorenal Care

Cardiorenal syndrome encompasses a dynamic interplay between cardiovascular and kidney disease, and its prevention requires careful examination of multiple predisposing underlying conditions. The unequal distribution of diabetes, heart failure, hypertension, and kidney disease requires special attention because of the influence of these conditions on cardiorenal disease. Despite growing evidence regarding the benefits of disease-modifying agents (e.g., sodium-glucose cotransporter 2 inhibitors) for cardiovascular, kidney, and metabolic (CKM) disease, significant disparities remain in access to and utilization of these essential therapeutics. Multilevel barriers impeding their use require multisector interventions that address patient, provider, and health system-tailored strategies. Burgeoning literature also describes the critical role of unequal social determinants of health, or the sociopolitical contexts in which people live and work, in cardiorenal risk factors, including heart failure, diabetes, and chronic kidney disease. This review outlines (i) inequality in the burden and treatment of hypertension, type 2 diabetes, and heart failure; (ii) disparities in the use of key disease-modifying therapies for CKM diseases; and (iii) multilevel barriers and solutions to achieve greater pharmacoequity in the use of disease-modifying therapies. In addition, this review provides summative evidence regarding the role of unequal social determinants of health in cardiorenal health disparities, further outlining potential considerations for future research and intervention. As proposed in the 2023 American Heart Association presidential advisory on CKM health, a paradigm shift will be needed to achieve cardiorenal health equity. Through a deeper understanding of CKM health and a commitment to equity in the prevention, detection, and treatment of CKM disease, we can achieve this critical goal.

Historical shifting in grain mineral density of landmark rice and wheat cultivars released over the past 50 years in India

The 'Green Revolution (GR)' has been successful in meeting food sufficiency in India, but compromising its nutritional security. In a first, we report altered grain nutrients profile of modern-bred rice and wheat cultivars diminishing their mineral dietary significance to the Indian population. To substantiate, we evaluated grain nutrients profile of historical landmark high-yielding cultivars of rice and wheat released in succeeding decades since the GR and its impacts on mineral diet quality and human health, with a prediction for decades ahead. Analysis of grain nutrients profile shows a downward trend in concentrations of essential and beneficial elements, but an upward in toxic elements in past 50 y in both rice and wheat. For example, zinc (Zn) and iron (Fe) concentration in grains of rice decreased by ~ 33.0 (P < 0.001) and 27.0% (P < 0.0001); while for wheat it decreased by ~ 30.0 (P < 0.0001) and 19.0% (P < 0.0001) in past more than 50 y, respectively. A proposed mineral-diet quality index (M-DQI) significantly (P < 0.0001) decreased ~ 57.0 and 36.0% in the reported time span (1960-2010) in rice and wheat, respectively. The impoverished M-DQI could impose hostile effects on non-communicable diseases (NCDs) like iron-deficiency anemia, respiratory, cardiovascular, and musculoskeletal among the Indian population by 2040. Our research calls for an urgency of grain nutrients profiling before releasing a cultivar of staples like rice and wheat in the future.

Behavioral determinants of arsenic-safe water use among Great Plains Indian Nation private well users: results from the Community-Led Strong Heart Water Study Arsenic Mitigation Program

BACKGROUND

The objective of this study was to evaluate the behavioral determinants associated with exclusive use of arsenic-safe water in the community-led Strong Heart Water Study (SHWS) arsenic mitigation program.

METHODS

The SHWS is a randomized controlled trial of a community-led arsenic mitigation program designed to reduce arsenic exposure among private well users in American Indian Great Plains communities. All households received point-of-use (POU) arsenic filters installed at baseline and were followed for 2 years. Behavioral determinants selected were those targeted during the development of the SHWS program, and were assessed at baseline and follow-up.

RESULTS

Among participants, exclusive use of arsenic-safe water for drinking and cooking at follow-up was associated with higher self-efficacy for accessing local resources to learn about arsenic (OR: 5.19, 95% CI: 1.48-18.21) and higher self-efficacy to resolve challenges related to arsenic in water using local resources (OR: 3.11, 95% CI: 1.11-8.71). Higher commitment to use the POU arsenic filter faucet at baseline was also a significant predictor of exclusive arsenic-safe water use for drinking (OR: 32.57, 95% CI: 1.42-746.70) and cooking (OR: 15.90, 95% CI: 1.33-189.52) at follow-up. From baseline to follow-up, the SHWS program significantly increased perceived vulnerability to arsenic exposure, self-efficacy, descriptive norms, and injunctive norms. Changing one's arsenic filter cartridge after installation was associated with higher self-efficacy to obtain arsenic-safe water for drinking (OR: 6.22, 95% CI: 1.33-29.07) and cooking (OR: 10.65, 95% CI: 2.48-45.68) and higher perceived vulnerability of personal health effects (OR: 7.79, 95% CI: 1.17-51.98) from drinking arsenic-unsafe water.

CONCLUSIONS

The community-led SHWS program conducted a theory-driven approach for intervention development and evaluation that allowed for behavioral determinants to be identified that were associated with the use of arsenic safe water and changing one's arsenic filter cartridge. These results demonstrate that theory-driven, context-specific formative research can influence behavior change interventions to reduce water arsenic exposure. The SHWS can serve as a model for the design of theory-driven intervention approaches that engage communities to reduce arsenic exposure.

TRIAL REGISTRATION

The SHWS is registered with ClinicalTrials.gov (Identifier: NCT03725592).

Evaluation of a water arsenic filter in a participatory intervention to reduce arsenic exposure in American Indian communities: The Strong Heart Water Study

Many rural populations, including American Indian communities, that use private wells from groundwater for their source of drinking and cooking water are disproportionately exposed to elevated levels of arsenic. However, programs aimed at reducing arsenic in American Indian communities are limited. The Strong Heart Water Study (SHWS) is a randomized controlled trial aimed at reducing arsenic exposure among private well users in American Indian Northern Great Plains communities. The community-led SHWS program installed point-of-use (POU) arsenic filters in the kitchen sink of households, and health promoters delivered arsenic health communication programs. In this study we evaluated the efficacy of these POU arsenic filters in removing arsenic during the two-year installation period. Participants were randomized into two arms. In the first arm households received a POU arsenic filter, and 3 calls promoting filter use (SHWS mobile health (mHealth) & filter arm). The second arm received the same filter and phone calls, and 3 in-person home visits and 3 Facebook messages (SHWS intensive arm) for program delivery. Temporal variability in water arsenic concentrations from the main kitchen faucet was also evaluated. A total of 283 water samples were collected from 50 households with private wells from groundwater (139 filter and 144 kitchen faucet samples). Ninety-three percent of households followed after baseline had filter faucet water arsenic concentrations below the arsenic maximum contaminant level of 10 μg/L at the final visit during our 2 year study period with no difference between study arms (98 % in the intensive arm vs. 94 % in the mHealth & filter arm). No significant temporal variation in kitchen arsenic concentration was observed over the study period (intraclass correlation coefficient = 0.99). This study demonstrates that POU arsenic filters installed for the community participatory SHWS program were effective in reducing water arsenic concentration in study households in both arms, even with delivery of the POU arsenic filter and mHealth program only. Furthermore, we observed limited temporal variability of water arsenic concentrations from kitchen faucet samples collected over time from private wells in our study setting.

Implementing a Community-Led Arsenic Mitigation Intervention for Private Well Users in American Indian Communities: A Qualitative Evaluation of the Strong Heart Water Study Program

Arsenic is a naturally occurring toxicant in groundwater, which increases cancer and cardiovascular disease risk. American Indian populations are disproportionately exposed to arsenic in drinking water. The Strong Heart Water Study (SHWS), through a community-centered approach for intervention development and implementation, delivered an arsenic mitigation program for private well users in American Indian communities. The SHWS program comprised community-led water arsenic testing, point-of-use arsenic filter installation, and a mobile health program to promote sustained filter use and maintenance (i.e., changing the filter cartridge). Half of enrolled households received additional in-person behavior change communication and videos. Our objectives for this study were to assess successes, barriers, and facilitators in the implementation, use, and maintenance of the program among implementers and recipients. We conducted 45 semi-structured interviews with implementers and SHWS program recipients. We analyzed barriers and facilitators using the Consolidated Framework for Implementation Research and the Risks, Attitudes, Norms, Abilities, and Self-regulation model. At the implementer level, facilitators included building rapport and trust between implementers and participating households. Barriers included the remoteness of households, coordinating with community plumbers for arsenic filter installation, and difficulty securing a local supplier for replacement filter cartridges. At the recipient level, facilitators included knowledge of the arsenic health risks, perceived effectiveness of the filter, and visual cues to promote habit formation. Barriers included attitudes towards water taste and temperature and inability to procure or install replacement filter cartridges. This study offers insights into the successes and challenges of implementing an arsenic mitigation program tailored to American Indian households, which can inform future programs in partnership with these and potentially similar affected communities. Our study suggests that building credibility and trust between implementers and participants is important for the success of arsenic mitigation programs.

Removal of arsenic from semiarid area groundwater using a biosorbent from watermelon peel waste

Groundwater is one of the most important reservoirs in semi-arid and arid zones of the world, particularly in Mexico. The aims of this work were to produce a biosorbent from watermelon peel waste and a biosorbent with citric acid treatment and to evaluate both biosorbents with different concentrations of arsenic in groundwater. The biosorbents were produced with watermelon peel residues, which were observed by SEM microscopy to evaluate their physical morphology. Its removal potential was tested at concentrations of 0, 1, 13, 22, and 65 μg/L of arsenic, and both adsorption capacity and removal percentage were analyzed by final measurement obtained by atomic absorption spectrometry. The pH was measured throughout the experimentation maintaining ranges between 5.5 and 7.5. The biosorbent without treatment presented clearer and more compact flakes. At the microscopic level, the biosorbent without treatment presented pores with a more circular shape, and the biosorbent with treatment was more polygonal, similar to a honeycomb. The highest removal percentage was 99.99%, for both treatments at 4 h. The biosorbent without treatment at 4 h with arsenic concentrations of 65 μg/L presented the highest adsorption capacity (2.42 μg/g). It is concluded that watermelon peel biosorbent is a material that has the potential to remove arsenic from groundwater. This type of biosorbent is effective to remove arsenic and could be used in the field, however, it still needs to be optimized to convert it into a material completely suitable for large-scale use.

Health risk assessment and geospatial analysis of arsenic contamination in shallow aquifer along Ravi River, Lahore, Pakistan

The exposure variation of arsenic from different ground and surface water sources has remained unpredictable which may cause severe human health problems. The current study is, therefore, designed to analyze the spatial variability of arsenic contamination in shallow aquifer and assess the potential human health risks. For this purpose, a total of 55 groundwater, 10 drain water, 4 river water, and 6 sediment samples were collected along zero to 5 km stretch of the River Ravi, Lahore. All water samples were tested for As, pH, and total dissolved solids (TDS), whereas sediments were only tested for As. Health risk models were used to predict cancer and non-cancer risk in adults and children. Among water samples, highest median (minimum-maximum) concentrations (µg/L) of As were recorded 53.32 (1.98-1555) in groundwater, followed by 53.04 (1.58-351.5) in drain water, and 4.80 (2.13-8.67) in river water, respectively, whereas As concentration (mg/kg) in river sediments was 6.03 (5.56-13.92). Variation of As in groundwater was non-significant (P > 0.05) among every 1-km stretch from the Ravi River. However, maximum median concentrations (µg/L) of 60.18 and 60.08 were recorded between 2-3 and 0-1 km from River Ravi, respectively, reflecting possible mixing of river water with shallow aquifers. A very high cancer and non-cancer risk (HI > 1.0 × 10^-4) through groundwater As exposure was predicted for both children and adults. The current study concluded that prevalence of As above WHO prescribed limits in shallow aquifer along the urban stretch of the River Ravi is posing serious health risk to the exposed population.

Effect of arsenic stress on the intestinal structural integrity and intestinal flora abundance of Cyprinus carpio

Aquatic organisms such as fish can accumulate high concentrations of arsenic (As), which has toxic effects on fish. However, whether the intestinal flora are involved in As damage to fish intestinal tissues and the underlying process are unclear. Common carp (Cyprinus carpio) were exposed to As (2.83 mg/L) in water for 30 days, and blood, muscle, intestine, and intestine samples were collected. Intestinal pathological sections were observed, and the lipopolysaccharide (LPS) levels in serum and the levels of As accumulation and tight junction-related factors in intestinal tissues were measured. The gut microbiota was analysed by 16S rRNA sequencing. The results showed that As treatment decreased the abundance of microbiota, increased the number of harmful bacteria, and decreased the number of beneficial bacteria in the intestine. In our experiment, the top 30 harmful and beneficial bacteria with the highest relative abundance were identified. Among the top 30 harmful and beneficial bacteria, As treatment resulted in a significant (P < 0.05) increase in harmful bacteria (such as Fusobacteriota, Bacteroidota (LPS-producing bacteria), Verrucomicrobiota, Bacteroides, Aeromonas, and Stenotrophomonas) and a significant (P < 0.05) decrease in beneficial bacteria (such as Actinobacteriota, Planctomycetota, Firmicutes, Reyranella, Akkermansia, and Pseudorhodobacter), which further demonstrated that As affects the abundance of intestinal flora. In addition, As exposure increased the LPS level in serum and the abundance of Bacteroidota (LPS-producing bacteria) in the intestine. Bacteroidota exhibits the six highest relative abundance at the phylum level, which indicates that LPS produced by Bacteroidota can increase the LPS level in serum. Additionally, the protein and gene levels of the tight junction markers ZO-1 and occludin in the intestine were reduced by As treatment, which further indicated that As exposure impaired the structural integrity of the intestine. In conclusion, the results obtained in our study indicate that the intestinal flora, LPS, and tight junctions participate in the impairment of the structural integrity of the common carp intestine resulting from As exposure.

Naturally occurring metals in unregulated domestic wells in Nevada, USA

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

Tapwater Exposures, Effects Potential, and Residential Risk Management in Northern Plains Nations

In the United States (US), private-supply tapwater (TW) is rarely monitored. This data gap undermines individual/community risk-management decision-making, leading to an increased probability of unrecognized contaminant exposures in rural and remote locations that rely on private wells. We assessed point-of-use (POU) TW in three northern plains Tribal Nations, where ongoing TW arsenic (As) interventions include expansion of small community water systems and POU adsorptive-media treatment for Strong Heart Water Study participants. Samples from 34 private-well and 22 public-supply sites were analyzed for 476 organics, 34 inorganics, and 3 in vitro bioactivities. 63 organics and 30 inorganics were detected. Arsenic, uranium (U), and lead (Pb) were detected in 54%, 43%, and 20% of samples, respectively. Concentrations equivalent to public-supply maximum contaminant level(s) (MCL) were exceeded only in untreated private-well samples (As 47%, U 3%). Precautionary health-based screening levels were exceeded frequently, due to inorganics in private supplies and chlorine-based disinfection byproducts in public supplies. The results indicate that simultaneous exposures to co-occurring TW contaminants are common, warranting consideration of expanded source, point-of-entry, or POU treatment(s). This study illustrates the importance of increased monitoring of private-well TW, employing a broad, environmentally informative analytical scope, to reduce the risks of unrecognized contaminant exposures.

Forward-Looking Roadmaps for Long-Term Continuous Water Quality Monitoring: Bottlenecks, Innovations, and Prospects in a Critical Review

Long-term continuous monitoring (LTCM) of water quality can bring far-reaching influences on water ecosystems by providing spatiotemporal data sets of diverse parameters and enabling operation of water and wastewater treatment processes in an energy-saving and cost-effective manner. However, current water monitoring technologies are deficient for long-term accuracy in data collection and processing capability. Inadequate LTCM data impedes water quality assessment and hinders the stakeholders and decision makers from foreseeing emerging problems and executing efficient control methodologies. To tackle this challenge, this review provides a forward-looking roadmap highlighting vital innovations toward LTCM, and elaborates on the impacts of LTCM through a three-hierarchy perspective: data, parameters, and systems. First, we demonstrate the critical needs and challenges of LTCM in natural resource water, drinking water, and wastewater systems, and differentiate LTCM from existing short-term and discrete monitoring techniques. We then elucidate three steps to achieve LTCM in water systems, consisting of data acquisition (water sensors), data processing (machine learning algorithms), and data application (with modeling and process control as two examples). Finally, we explore future opportunities of LTCM in four key domains, water, energy, sensing, and data, and underscore strategies to transfer scientific discoveries to general end-users.

User experience of point-of-use water treatment for private wells in North Carolina: Implications for outreach and well stewardship

Private well users are potentially exposed to a range of chemical contaminants through their drinking water. Point-of-use (POU) water treatment represents one potential solution to reduce harmful exposures through well water, but well users frequently do not adopt household treatment even if they learn their water is contaminated. This study elucidates the experiences, perceptions, and beliefs of 17 households on private wells in North Carolina that participated in a pilot-scale POU water treatment intervention to better understand the drivers and barriers of POU treatment adoption among well users. The intervention consisted of an under-sink activated carbon block POU filter designed to remove lead and two long-chain perfluoroalkyl acids. Filter effluents and influents were tested monthly for eight months. Questionnaires administered before and after the intervention showed a significant decrease in participants' perceived vulnerability to well water contamination, with 77% feeling vulnerable to poor well water quality before, compared to 23% after the filter was installed. However, the POU filters did not fully eliminate feelings of water insecurity (for example, concerns about exposure to contaminants when bathing remained). Lack of knowledge and skills associated with installing and maintaining POU treatment were important barriers to adoption for some well users. Perceptions of POU treatment were also significantly correlated with the intent to implement other well stewardship behaviors such as well water testing. The results highlight the need for strengthened outreach and support programs that provide technical assistance, education, and financial support for households relying on private wells.

Evaluation of Groundwater Quality for Human Consumption and Irrigation in Relation to Arsenic Concentration in Flow Systems in a Semi-Arid Mexican Region

The supply of drinking water to the population is an important challenge facing humanity, since both surface and underground sources present a great variability of water storage with respect to space and time. This problem is further aggravated in arid and semi-arid areas where rainfall is low and torrential, which makes groundwater the main source of supply; therefore, it is necessary to carry out studies that allow evaluating the evolution of the quantity and quality of water. This study addresses the behavior of groundwater in a semi-arid region, considering the theory of flow systems to identify movement as well as water quality, es determined by a water quality index (WQI), calculated considering arsenic and fluorine. In addition, a quality irrigation classification is used, employing the norms in accordance with international standards and the Mexican Norm, which allows for a comparison. Local, regional, intermediate and mixed flow systems are identified, and the evolution of cations and anions in addition to temperature is examined. It is observed that the drinking water quality index classifies them as excellent in most of the monitored wells (<50), but with a negative evolution. Regarding irrigation, most of the water samples are classified without restriction for the establishment of any type II crop (C₂S₁) and with restrictions for horticultural crops. It is observed that arsenic had values between 0.49 and 61.40 (µg/L) in 2005, while in 2015 they were between 0.10 and 241.30 (µg/L). In addition, fluoride presented values between 0.00 and 2.6 (mg/L) in 2005, while in 2015 they were between 0.28 and 5.40 (mg/L). The correlations between arsenic and fluorine are noted as well as WQI and SAR. A finding in this research was to include arsenic and fluorine in the calculation of the WQI allowing a better interpretation of the quality of water for both human consumption and for agricultural use to based on this make the best decision to control any harmful effects for the population, in addition to identifying the appropriate purification treatment required to control pollutants. It is concluded that arsenic is an element of utmost importance when considering water quality, so it is necessary to examine its evolution and continue to monitor its levels constantly.

Effects of aluminum and soil mineralogy on arsenic bioaccessibility

A comprehensive characterization was performed to investigate the composition and mineralogy of soils from a gold mining region and their correlation with arsenic (As) total concentration and its bioaccessible fraction. The arsenic bioaccessible (BAC) fraction was determined through in vitro test and calculated as the ratio between the amounts of As released and the total As concentration in the soil sample. Among the minor constituents of environmental concern, only arsenic is significantly higher (median of 748.0 mg kg^-1) than the national guidelines (agricultural, 35 mg kg^-1 and residential, 55 mg kg^-1). All the other trace elements showed concentrations below the investigation values established for residential areas. The mean bioaccessible As was 7.0 mg kg^-1, with a median value of 4.4 mg kg^-1, and a median As BAC percentage of 0.7%. The Brunauer-Emmett-Teller (BET) surface area showed a consistent increase with the increase of the acid-soluble Al content in the soil samples. The distribution of As in the soil samples is not correlated with the abundance of As-minerals and the fraction of adsorbed As. Arsenic was shown to be trapped in oriented aggregates of crystalline (Al-)Fe-(hydr)oxides nanoparticles (the main metalloid reservoirs), as demonstrated by scanning and transmission electron microscopy analyses. This unique pattern supports the significant difference between total As concentration and the bioaccessible amount. There was a positive correlation between soluble Al (within the Fe-(hydr)oxides phases and minor gibbsite) and As concentration in the soil samples, and a negative correlation with bioaccessible As. Therefore, although Al in the soil is associated with high As levels, it also makes the metalloid less bioaccessible. The risk to human health from As exposure to these soils is low.

Under-Sink Activated Carbon Water Filters Effectively Remove Lead from Private Well Water for over Six Months

Children who rely on private well water in the United States have been shown to be at greater risk of having elevated blood lead levels. Evidence-based solutions are needed to prevent drinking water lead exposure among private well users, but minimal data are available regarding the real-world effectiveness of available interventions like point-of-use water treatment for well water. In this study, under-sink activated carbon block water filters were tested for lead and other heavy metals removal in an eight-month longitudinal study in 17 homes relying on private wells. The device removed 98% of all influent lead for the entirety of the study, with all effluent lead levels less than 1 µg/L. Profile sampling in a subset of homes showed that the faucet fixture is a significant source of lead leaching where well water is corrosive. Flushing alone was not capable of reducing first-draw lead to levels below 1 µg/L, but the under-sink filter was found to increase the safety and effectiveness of faucet flushing. The results of this study can be used by individual well users and policymakers alike to improve decision-making around the use of under-sink point-of-use devices to prevent disproportionate lead exposures among private well users.

Reduction in drinking water arsenic exposure and health risk through arsenic treatment among private well households in Maine and New Jersey, USA

Over 2 million mostly rural Americans are at risk of drinking water from private wells that contain arsenic (As) exceeding the U.S. Environmental Protection Agency (USEPA) Maximum Contaminant Level (MCL) of 10 micrograms per liter (μg/L). How well existing treatment technologies perform in real world situations, and to what extent they reduce health risks, are not well understood. This study evaluates the effectiveness of household As treatment systems in southern-central Maine (ME, n = 156) and northern New Jersey (NJ, n = 94) and ascertains how untreated well water chemistry and other factors influence As removal. Untreated and treated water samples, as well as a treatment questionnaire, were collected. Most ME households had point-of-use reverse-osmosis systems (POU RO), while in NJ, dual-tank point-of-entry (POE) whole house systems were popular. Arsenic treatment systems reduced well water arsenic concentrations ([As]) by up to two orders of magnitude, i.e. from a median of 71.7 to 0.8 μg/L and from a mean of 105 to 14.3 μg/L in ME, and from a median of 8.6 to 0.2 μg/L and a mean of 15.8 to 2.1 μg/L in NJ. More than half (53%) of the systems in ME reduced water [As] to below 1 μg/L, compared to 69% in NJ. The treatment system failure rates were 19% in ME (>USEPA MCL of 10 μg/L) and 16% in NJ (>NJ MCL of 5 μg/L). In both states, the higher the untreated well water [As] and the As(III)/As ratio, the higher the rate of treatment failure. POE systems failed less than POU systems, as did the treatment systems installed and maintained by vendors than those by homeowners. The 7-fold reduction of [As] in the treated water reduced skin cancer risk alone from 3765 to 514 in 1 million in ME, and from 568 to 75 in 1 million in NJ.

Use of adsorption-influencing parameters for designing the batch adsorber and neural network-based prediction modelling for the aqueous arsenate removal using combustion synthesised nano-alumina

Removal of arsenic from water is of utmost priorities on a global scenario due to its ill effects. Therefore, in the present study, aluminium oxide nano-particles (nano-alumina) were synthesised via solution combustion method, which is self-propagating and eco-friendly in nature. Synthesised nano-alumina was further employed for arsenate removal from water. Usually, pre-oxidation of arsenite is performed for better removal of arsenic in its pentavalent form. Thus, arsenate removal as a function of influencing parameters such as initial concentration, dose, pH, temperature, and competing anions was the prime objective of the present study. The speciation analysis showed that H₂AsO4^- and HAsO₄^2- were co-existing anions between pH 6 and 8, as a result of which higher removal was observed. Freundlich isotherm model was well suited for data on adsorption. At optimal temperature of 298 K, maximum monolayer adsorption capacity was found as 1401.90 μg/g. The kinetic data showed film diffusion step was the controlling mechanism. In addition, competing anions like nitrate, bicarbonate, and chloride had no major effect on arsenate removal efficiency, while phosphate and sulphate significantly reduced the removal efficiency. The negative values of thermodynamic parameters ΔH° (- 23.15 kJ/mol) established the exothermic nature of adsorption, whereas the negative values of ΔG° (- 7.05, - 6.51, - 5.97, and - 5.43 kJ/mol at 298, 308, 318, and 328 K respectively) indicated the spontaneous nature of the process. The best-fitted isotherm was used to design a batch adsorber to estimate the required amount of aluminium oxide nano-particles for achieving the desired equilibrium arsenate concentration. Nano-alumina was also applied to treat the collected arsenic-contaminated groundwater from actual field. Experimental data were used to develop a neural network-based model for the effective prediction of removal efficiency without carrying out any extra experimentation.

Dietary determinants of inorganic arsenic exposure in the Strong Heart Family Study

BACKGROUND

Chronic exposure to inorganic arsenic (iAs) in the US occurs mainly through drinking water and diet. Although American Indian (AI) populations have elevated urinary arsenic concentrations compared to the general US population, dietary sources of arsenic exposure in AI populations are not well characterized.

METHODS

We evaluated food frequency questionnaires to determine the major dietary sources of urinary arsenic concentrations (measured as the sum of arsenite, arsenate, monomethylarsonate, and dimethylarsinate, ΣAs) for 1727 AI participants in the Strong Heart Family Study (SHFS). We compared geometric mean ratios (GMRs) of urinary ΣAs for an interquartile range (IQR) increase in reported food group consumption. Exploratory analyses were stratified by gender and study center.

RESULTS

In fully adjusted generalized estimating equation models, the percent increase (95% confidence interval) of urinary ΣAs per increase in reported food consumption corresponding to the IQR was 13% (5%, 21%) for organ meat, 8% (4%, 13%) for rice, 7% (2%, 13%) for processed meat, and 4% (1%, 7%) for non-alcoholic drinks. In analyses stratified by study center, the association with organ meat was only observed in North/South Dakota. Consumption of red meat [percent increase -7% (-11%, -3%)] and fries and chips [-6% (-10%, -2%)] was inversely associated with urinary ΣAs.

CONCLUSIONS

Organ meat, processed meat, rice, and non-alcoholic drinks contribute to ΣAs exposure in the SHFS population. Organ meat is a unique source of ΣAs exposure for North and South Dakota participants and may reflect local food consumption. Further studies should comprehensively evaluate drinking water arsenic in SHFS communities and determine the relative contribution of diet and drinking water to total arsenic exposure.

The Strong Heart Water Study: Informing and designing a multi-level intervention to reduce arsenic exposure among private well users in Great Plains Indian Nations

Elevated arsenic exposure from drinking water is associated with an increased risk of cardiovascular disease, diabetes, kidney disease, and skin, lung, and bladder cancer. Arsenic contamination in groundwater supplies disproportionately affects rural populations using private wells. Arsenic mitigation programs for American Indian communities are limited. There is an urgent need for targeted approaches to reduce arsenic exposure for at-risk communities using private wells. Formative research was conducted to inform and design a community-based arsenic mitigation intervention for Lakota and Dakota Nations in the Great Plains Area of the United States, where, in some communities, one-quarter of private wells are estimated to have elevated arsenic. Formative research included semi-structured interviews, a community workshop, intervention-planning workshops, and a pilot study of the developed intervention. Community members prioritize aesthetic qualities of water (e.g. taste, color), safety, and other situational factors (e.g. cost) when considering their drinking and cooking water. Although water safety is a concern, awareness and concern for arsenic vary substantially within communities. To reduce arsenic exposure, community members recommended communication of water test results, home visits for intervention delivery, and reminders to use arsenic-safe water. Findings informed the development of an intervention to prevent arsenic exposure through drinking water and cooking, including health promotion messages and household items to facilitate use of an arsenic removal device (e.g. tankards to store filtered water). The pilot study indicated promising acceptability and operability of the developed intervention. This research provides a model for the development of environmental health interventions in partnership with American Indian and other private well-using communities.