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Ortiz-Garcia NY, Cipriano Ramírez AI, Juarez K, Brand Galindo J, Briceño G, Calderon Martinez E. Maternal Exposure to Arsenic and Its Impact on Maternal and Fetal Health: A Review. Cureus 2023; 15:e49177. [PMID: 38130554 PMCID: PMC10734558 DOI: 10.7759/cureus.49177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2023] [Indexed: 12/23/2023] Open
Abstract
Arsenic exposure is a significant public health issue, with harmful effects caused by its use in commercial products such as car batteries, pesticides, and herbicides. Arsenic has three main compounds: inorganic, organic, and arsine gas. Inorganic arsenic compounds in water are highly toxic. The daily intake of arsenic from food and beverages is between 20 and 300 mcg/day. Arsenic is known for its carcinogenic properties and is classified as a human carcinogen by different institutions. Exposure can lead to oxidative stress, DNA damage, and epigenetic deregulation, which can cause endocrine disorders, altered signal transduction pathways, and cell proliferation. In addition, arsenic can easily cross the placenta, making it a critical concern for maternal and fetal health. Exposure can lead to complications such as gestational diabetes, anemia, low birth weight, miscarriage, and congenital anomalies. Female babies are particularly vulnerable to the negative impact of arsenic exposure, with a higher risk of low weight for gestational age and congenital cardiac anomalies. Therefore, it is crucial to monitor and regulate the levels of arsenic in drinking water and food sources to prevent these adverse health outcomes. Further research is necessary to fully understand the impact of arsenic exposure on human health, especially during pregnancy and infancy, by implementing preventative measures and monitoring the levels of arsenic in the environment.
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Affiliation(s)
| | | | - Karen Juarez
- Infectious Disease, Universidad Nacional Autónoma de México (UNAM), Mexico City, MEX
| | | | - Gabriela Briceño
- Obstetrics and Gynecology, Universidad de Oriente, Barcelona, VEN
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2
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Sagha A, Shiri H, Juybari KB, Mehrabani M, Nasri HR, Nematollahi MH. The Association Between Arsenic Levels and Oxidative Stress in Myocardial Infarction: A Case-Control Study. Cardiovasc Toxicol 2023; 23:61-73. [PMID: 36648739 DOI: 10.1007/s12012-022-09778-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 12/27/2022] [Indexed: 01/18/2023]
Abstract
Cardiovascular diseases (CVDs) are known as the first causes of death throughout the world, and mainly myocardial infarction (MI), lead to 7.4 million deaths annually. Atherosclerosis is the major underlying cause of most CVDs. However, exposure to heavy metals, among other factors, deserves further attention as a risk factor for CVDs. This study was designed to evaluate the levels of arsenic (Ars) in myocardial infarction (MI) patients and healthy individuals as well as assess the association between the incidence of MI and Ars, total antioxidant capacity (TAC), and oxidative stress. This case-control study was conducted among patients with MI (n = 164) and normal individuals (n = 61) at Shafa Hospital in Kerman, Iran. Patients were classified into two groups, including coronary artery blocks above 50% (CAB > 50%, n = 83) and coronary artery blocks less than 50% (CAB < 50%, n = 83) based on their angiography findings. The demographic characteristics, clinical history, biochemical parameters, and serum Ars and TAC levels were evaluated. In the present study, both CAB groups had significantly reduced levels of TAC compared with the control. Furthermore, TAC was lower in the CAB > %50 group compared to the CAB < %50 group. Ars levels were significantly higher in both CAB groups compared with the control. There was a significant positive relationship between CAB and Ars, BG, HbA1c, urea, creatinine, TG, TC, and LDL-c, as well as a negative relationship between HDL-c and TAC. Moreover, TAC levels showed a significant inverse correlation with Ars, HbA1c, and creatinine, and a positive correlation with HDL-c. As risk factors, Ars, hs-CRP, TG, TC, and LDL-c enhance the severity of the disease, and HDL-c and TAC decrease the disease severity. Moreover, ROC curve analysis revealed that the highest AUC for the CAB > %50 (AUC = 78.29), and cytotoxic levels for both CAB groups (Ars ≥ 0.105 ppm), and no significant differences were found between the two groups. Our findings suggest that Ars at ≥ 0.105 ppm is able to increase the risk of MI through the increased OS and decreased TAC.
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Affiliation(s)
- Arian Sagha
- Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamidreza Shiri
- Department of Clinical Biochemistry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mehrnaz Mehrabani
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Reza Nasri
- Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences, and Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran.
| | - Mohammad Hadi Nematollahi
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.
- Department of Clinical Biochemistry, Afzalipoor Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
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3
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Farzan SF, Eunus HM, Haque SE, Sarwar G, Hasan AR, Wu F, Islam T, Ahmed A, Shahriar M, Jasmine F, Kibriya MG, Parvez F, Karagas MR, Chen Y, Ahsan H. Arsenic exposure from drinking water and endothelial dysfunction in Bangladeshi adolescents. ENVIRONMENTAL RESEARCH 2022; 208:112697. [PMID: 35007543 PMCID: PMC8917065 DOI: 10.1016/j.envres.2022.112697] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 01/03/2022] [Accepted: 01/05/2022] [Indexed: 05/12/2023]
Abstract
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide, with ∼80% of CVD-related deaths occurring in low- and middle-income countries. Growing evidence suggests that chronic arsenic exposure may contribute to CVD through its effect on endothelial function in adults. However, few studies have examined the influence of arsenic exposure on cardiovascular health in children and adolescents. To examine arsenic's relation to preclinical markers of endothelial dysfunction, we enrolled 200 adolescent children (ages 15-19 years; median 17) of adult participants in the Health Effects of Arsenic Longitudinal Study (HEALS), in Araihazar, Bangladesh. Participants' arsenic exposure was determined by recall of lifetime well usage for drinking water. As part of HEALS, wells were color-coded to indicate arsenic level (<10 μg/L, 10-50 μg/L, >50 μg/L). Endothelial function was measured by recording fingertip arterial pulsatile volume change and reactive hyperemia index (RHI) score, an independent CVD risk factor, was calculated from these measurements. In linear regression models adjusted for participant's sex, age, education, maternal education, land ownership and body weight, individuals who reported always drinking water from wells with >50 μg/L arsenic had a 11.75% lower level of RHI (95% CI: -21.26, -1.09, p = 0.03), as compared to participants who drank exclusively from wells with ≤50 μg/L arsenic. Sex-stratified analyses suggest that these associations were stronger in female participants. As compared to individuals who drank exclusively from wells with ≤50 μg/L arsenic, the use of wells with >50 μg/L arsenic was associated with 14.36% lower RHI (95% CI: -25.69, -1.29, p = 0.03) in females, as compared to 5.35% lower RHI (95% CI: -22.28, 15.37, p = 0.58) in males for the same comparison. Our results suggest that chronic arsenic exposure may be related to endothelial dysfunction in adolescents, especially among females. Further work is needed to confirm these findings and examine whether these changes may increase risk of later adverse cardiovascular health events.
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Affiliation(s)
- Shohreh F Farzan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | | | | | | | | | - Fen Wu
- Department of Population Health, New York University, New York, NY, USA
| | | | | | - Mohammad Shahriar
- UChicago Research Bangladesh, Dhaka, Bangladesh; Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Farzana Jasmine
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Muhammad G Kibriya
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Faruque Parvez
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Yu Chen
- Department of Population Health, New York University, New York, NY, USA
| | - Habibul Ahsan
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
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4
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Zhao J, Li A, Mei Y, Zhou Q, Li Y, Li K, Xu Q. The association of arsenic exposure with hypertension and blood pressure: A systematic review and dose-response meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 289:117914. [PMID: 34426185 DOI: 10.1016/j.envpol.2021.117914] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 06/13/2023]
Abstract
Chronic arsenic exposure can induce cardiovascular diseases through oxidative stress injury, inflammation and endothelial dysfunction. However, evidence for hypertension related to chronic arsenic exposure remains limited and inconclusive. To investigate the association of arsenic exposure with hypertension, we reviewed cross-sectional, case-control and longitudinal studies among general population (only excluded pregnant woman and children). Compared with non-exposure (or low exposure) group, we assessed relationship between the exposure (or high exposure) of arsenic and hypertension or blood pressure. We also examined the dose-response relationship to provide a theoretical basis for precision interventions in the population by conducting a two-stage random-effects dose-response meta-analysis. The weighted mean difference (WMD) was calculated to compare the blood pressure of exposed and reference arsenic exposure groups. Twenty-seven studies comprising 117,769 participants were included. The pooled OR and RR for hypertension compared the highest with lowest arsenic exposure categories were 1.14 [95 % confidence interval (CI): 1.06-1.23] and 1.30 [95 % CI: 0.91-1.84], respectively. A dose-response assessment of six studies with the necessary data available demonstrated that the OR of hypertension increased with an increasement of arsenic exposure. The differences in systolic blood pressure levels between the exposed and reference groups were 4.03 mmHg (95 % CI: 1.24-6.82). The meta-analysis further revealed the significant association of chronic arsenic exposure with hypertension among cross-sectional studies and the marginal significance in cohort studies. Besides, arsenic was mainly associated with increasing systolic blood pressure but not significantly related to diastolic blood pressure. We also demonstrated statistical evidence of a nonlinear dose-response association. Details on mechanisms and cohort studies are required to elucidate population-wide health influence of chronic arsenic exposure.
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Affiliation(s)
- Jiaxin Zhao
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Ang Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Yayuan Mei
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Quan Zhou
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Yanbing Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Kai Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Qun Xu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China.
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5
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Kabir R, Sinha P, Mishra S, Ebenebe OV, Taube N, Oeing CU, Keceli G, Chen R, Paolocci N, Rule A, Kohr MJ. Inorganic arsenic induces sex-dependent pathological hypertrophy in the heart. Am J Physiol Heart Circ Physiol 2021; 320:H1321-H1336. [PMID: 33481702 PMCID: PMC8260381 DOI: 10.1152/ajpheart.00435.2020] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 01/15/2021] [Accepted: 01/15/2021] [Indexed: 01/17/2023]
Abstract
Arsenic exposure though drinking water is widespread and well associated with adverse cardiovascular outcomes, yet the pathophysiological mechanisms by which iAS induces these effects are largely unknown. Recently, an epidemiological study in an American population with a low burden of cardiovascular risk factors found that iAS exposure was associated with altered left ventricular geometry. Considering the possibility that iAS directly induces cardiac remodeling independently of hypertension, we investigated the impact of an environmentally relevant iAS exposure on the structure and function of male and female hearts. Adult male and female C56BL/6J mice were exposed to 615 μg/L iAS for 8 wk. Males exhibited increased systolic blood pressure via tail cuff photoplethysmography, left ventricular wall thickening via transthoracic echocardiography, and increased plasma atrial natriuretic peptide via enzyme immunoassay. RT-qPCR revealed increased myocardial RNA transcripts of Acta1, Myh7, and Nppa and decreased Myh6, providing evidence of pathological hypertrophy in the male heart. Similar changes were not detected in females, and nitric oxide-dependent mechanisms of cardioprotection in the heart appeared to remain intact. Further investigation found that Rcan1 was upregulated in male hearts and that iAS activated NFAT in HEK-293 cells via luciferase assay. Interestingly, iAS induced similar hypertrophic gene expression changes in neonatal rat ventricular myocytes, which were blocked by calcineurin inhibition, suggesting that iAS may induce pathological cardiac hypertrophy in part by targeting the calcineurin-NFAT pathway. As such, these results highlight iAS exposure as an independent cardiovascular risk factor and provide biological impetus for its removal from human consumption.NEW & NOTEWORTHY This investigation provides the first mechanistic link between an environmentally relevant dose of inorganic arsenic (iAS) and pathological hypertrophy in the heart. By demonstrating that iAS exposure may cause pathological cardiac hypertrophy not only by increasing systolic blood pressure but also by potentially activating calcineurin-nuclear factor of activated T cells and inducing fetal gene expression, these results provide novel mechanistic insight into the theat of iAS exposure to the heart, which is necessary to identify targets for medical and public health intervention.
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MESH Headings
- Animals
- Arsenites/toxicity
- Calcineurin/metabolism
- Female
- Gene Expression Regulation
- HEK293 Cells
- Humans
- Hypertrophy, Left Ventricular/chemically induced
- Hypertrophy, Left Ventricular/metabolism
- Hypertrophy, Left Ventricular/pathology
- Hypertrophy, Left Ventricular/physiopathology
- Isolated Heart Preparation
- Male
- Mice, Inbred C57BL
- Myocytes, Cardiac/drug effects
- Myocytes, Cardiac/metabolism
- Myocytes, Cardiac/pathology
- NFATC Transcription Factors/metabolism
- Sex Factors
- Signal Transduction
- Sodium Compounds/toxicity
- Time Factors
- Ventricular Function, Left/drug effects
- Ventricular Remodeling/drug effects
- Water Pollutants, Chemical/toxicity
- Mice
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Affiliation(s)
- Raihan Kabir
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Prithvi Sinha
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Sumita Mishra
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Obialunanma V Ebenebe
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Nicole Taube
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Chistian U Oeing
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Gizem Keceli
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Rui Chen
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Nazareno Paolocci
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Biomedical Sciences, University of Padova, Padua, Italy
| | - Ana Rule
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Mark J Kohr
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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6
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Kaufman JA, Mattison C, Fretts AM, Umans JG, Cole SA, Voruganti VS, Goessler W, Best LG, Zhang Y, Tellez-Plaza M, Navas-Acien A, Gribble MO. Arsenic, blood pressure, and hypertension in the Strong Heart Family Study. ENVIRONMENTAL RESEARCH 2021; 195:110864. [PMID: 33581093 PMCID: PMC8021390 DOI: 10.1016/j.envres.2021.110864] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 02/02/2021] [Accepted: 02/05/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Arsenic has been associated with hypertension, though it is unclear whether associations persist at the exposure concentrations (e.g. <100 μg/L) in drinking water occurring in parts of the Western United States. METHODS We assessed associations between arsenic biomarkers and systolic blood pressure (SBP), diastolic blood pressure (DBP), and hypertension in the Strong Heart Family Study, a family-based cohort of American Indians from the Northern plains, Southern plains, and Southwest. We included 1910 participants from three study centers with complete baseline visit data (2001-2003) in the cross-sectional analysis of all three outcomes, and 1453 participants in the prospective analysis of incident hypertension (follow-up 2006-2009). We used generalized estimating equations with exchangeable correlation structure conditional on family membership to estimate the association of arsenic exposure biomarker levels with SBP or DBP (linear regressions) or hypertension prevalence and incidence (Poisson regressions), adjusting for urine creatinine, urine arsenobetaine, and measured confounders. RESULTS We observed cross-sectional associations for a two-fold increase in inorganic and methylated urine arsenic species of 0.64 (95% CI: 0.07, 1.35) mm Hg for SBP, 0.49 (95% CI: 0.03, 1.02) mm Hg for DBP, and a prevalence ratio of 1.10 (95% CI: 1.01, 1.21) for hypertension in fully adjusted models. During follow-up, 14% of subjects developed hypertension. We observed non-monotonic relationships between quartiles of arsenic and incident hypertension. Effect estimates were null for incident hypertension with continuous exposure metrics. Stratification by study site revealed elevated associations in Arizona, the site with the highest arsenic levels, while results for Oklahoma and North and South Dakota were largely null. Blood pressure changes with increasing arsenic concentrations were larger for those with diabetes at baseline. CONCLUSIONS Our results suggest a modest cross-sectional association of arsenic exposure biomarkers with blood pressure, and possible non-linear effects on incident hypertension.
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Affiliation(s)
- John A Kaufman
- Department of Epidemiology, Emory University, Atlanta, GA, USA.
| | - Claire Mattison
- Department of Environmental Health, Emory University, Atlanta, GA, USA
| | - Amanda M Fretts
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA
| | - Jason G Umans
- Department of Medicine, Georgetown University Medical Center, Washington, DC, USA
| | - Shelley A Cole
- Texas Biomedical Research Institute, San Antonio, TX, USA
| | - V Saroja Voruganti
- Department of Nutrition, University of North Carolina, Chapel Hill, NC, USA
| | | | - Lyle G Best
- Missouri Breaks Industries Research, Inc., Eagle Butte, SD, United States
| | - Ying Zhang
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Maria Tellez-Plaza
- Department of Chronic Diseases Epidemiology, National Center for Epidemiology, Carlos III Health Institute, Madrid, Spain
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University, New York, NY, USA
| | - Matthew O Gribble
- Department of Epidemiology, Emory University, Atlanta, GA, USA; Department of Environmental Health, Emory University, Atlanta, GA, USA
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7
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Dose-response meta-analysis of arsenic exposure in drinking water and hypertension. Heliyon 2021; 7:e06409. [PMID: 33748480 PMCID: PMC7970273 DOI: 10.1016/j.heliyon.2021.e06409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 11/08/2020] [Accepted: 02/26/2021] [Indexed: 11/20/2022] Open
Abstract
Background Based on the cross-sectional and cohort studies, exposure to As via drinking water can cause hypertension. Methods We searched PubMed, ISI WOS, and Scopus for relevant studies up to 1 January 2018 using related keywords. The meta-analysis was done on 10 studies (n = 28255) that report Odds Ratio for hypertension. The extracted ORs between As concentration and hypertension were pooled using random effect models. Study heterogeneity was analyzed using I 2. Results The estimated adjusted OR for association between As and hypertension was 1.44 (95% CI: 1.12, 1.84) with I 2 = 71%. Dose-Response analysis showed a linear relationship between As and hypertension (OR = 1.0008 95% CI: 1.0003, 1.001). In general, by increase of each unit in arsenic concentration, odds of the hypertension would increase as 0.08%. Conclusion There was a significant relationship between As exposure and hypertension.
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8
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Varshavsky J, Smith A, Wang A, Hom E, Izano M, Huang H, Padula A, Woodruff TJ. Heightened susceptibility: A review of how pregnancy and chemical exposures influence maternal health. Reprod Toxicol 2020; 92:14-56. [PMID: 31055053 PMCID: PMC6824944 DOI: 10.1016/j.reprotox.2019.04.004] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 03/12/2019] [Accepted: 04/22/2019] [Indexed: 12/19/2022]
Abstract
Pregnancy is a unique period when biological changes can increase sensitivity to chemical exposures. Pregnant women are exposed to multiple environmental chemicals via air, food, water, and consumer products, including flame retardants, plasticizers, and pesticides. Lead exposure increases risk of pregnancy-induced hypertensive disorders, although women's health risks are poorly characterized for most chemicals. Research on prenatal exposures has focused on fetal outcomes and less on maternal outcomes. We reviewed epidemiologic literature on chemical exposures during pregnancy and three maternal outcomes: preeclampsia, gestational diabetes, and breast cancer. We found that pregnancy can heighten susceptibility to environmental chemicals and women's health risks, although variations in study design and exposure assessment limited study comparability. Future research should include pregnancy as a critical period for women's health. Incorporating biomarkers of exposure and effect, deliberate timing and method of measurement, and consistent adjustment of potential confounders would strengthen research on the exposome and women's health.
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Affiliation(s)
- Julia Varshavsky
- University of California, San Francisco, Program on Reproductive Health and the Environment, San Francisco, CA, USA.
| | - Anna Smith
- University of California, Berkeley, School of Public Health, Berkeley, CA, USA
| | - Aolin Wang
- University of California, San Francisco, Program on Reproductive Health and the Environment, San Francisco, CA, USA; University of California, San Francisco, Bakar Computational Health Sciences Institute, San Francisco, CA, USA
| | - Elizabeth Hom
- University of California, San Francisco, Program on Reproductive Health and the Environment, San Francisco, CA, USA
| | - Monika Izano
- University of California, San Francisco, Program on Reproductive Health and the Environment, San Francisco, CA, USA
| | - Hongtai Huang
- University of California, San Francisco, Program on Reproductive Health and the Environment, San Francisco, CA, USA; University of California, San Francisco, Bakar Computational Health Sciences Institute, San Francisco, CA, USA
| | - Amy Padula
- University of California, San Francisco, Program on Reproductive Health and the Environment, San Francisco, CA, USA
| | - Tracey J Woodruff
- University of California, San Francisco, Program on Reproductive Health and the Environment, San Francisco, CA, USA
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9
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Shi P, Jing H, Xi S. Urinary metal/metalloid levels in relation to hypertension among occupationally exposed workers. CHEMOSPHERE 2019; 234:640-647. [PMID: 31234081 DOI: 10.1016/j.chemosphere.2019.06.099] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 06/09/2019] [Accepted: 06/12/2019] [Indexed: 05/25/2023]
Abstract
Occupational exposure to metals can have an adverse effect on the cardiovascular system. However, epidemiological studies of the associations of metals expose with hypertension among occupationally exposed workers were limited. The aim of this study was to investigate the potential association between urinary metal levels and the risk of hypertension among molybdenum miners and iron and steel foundry workers. The cross-sectional study had 395 participants. Urinary metal levels were determined by inductively coupled plasma mass spectrometry. Log-binomial regression model and two-piece-wise regression model were applied to assess the dose-response relationship between metal exposure and hypertension. We observed that increased prevalence ratios for hypertension among the quartile of urinary concentrations of molybdenum, arsenic and lead were positive (all P for trend <0.05). Compared with the lowest quartiles, participants in the highest quartiles of molybdenum, arsenic and lead had a 2.58-fold, 4.30-fold and 4.85-fold increased probability of having hypertension, respectively. In the threshold effect analyses, we found the relationship was nonlinear between urinary molybdenum, cobalt, cadmium, arsenic and lead concentrations and the prevalence of hypertension. In addition, Pb, Mo, As and Co may have joint effect, and a strong positive correlation with the prevalence of hypertension. Conversely, the association between the joint effect of Cd, Pb and Mo versus the prevalence of hypertension is not significant. We provide reference levels of molybdenum, cobalt, cadmium, arsenic and lead that can be used to assess the effects of occupational metal exposure on hypertension.
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Affiliation(s)
- Peng Shi
- Department of Environmental and Occupational Health, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Hongmei Jing
- Department of Environmental and Occupational Health, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Shuhua Xi
- Department of Environmental and Occupational Health, School of Public Health, China Medical University, Shenyang, 110122, China.
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10
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Chen Y, Wu F, Liu X, Parvez F, LoIacono NJ, Gibson EA, Kioumourtzoglou MA, Levy D, Shahriar H, Uddin MN, Islam T, Lomax A, Saxena R, Sanchez T, Santiago D, Ellis T, Ahsan H, Wasserman GA, Graziano JH. Early life and adolescent arsenic exposure from drinking water and blood pressure in adolescence. ENVIRONMENTAL RESEARCH 2019; 178:108681. [PMID: 31520830 PMCID: PMC7010462 DOI: 10.1016/j.envres.2019.108681] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/14/2019] [Accepted: 08/18/2019] [Indexed: 05/26/2023]
Abstract
OBJECTIVES Evidence of the association between inorganic arsenic (As) exposure, especially early-life exposure, and blood pressure (BP) in adolescence is limited. We examined the association of As exposure during early childhood, childhood, and adolescence with BP in adolescence. METHODS We conducted a cross-sectional study of 726 adolescents aged 14-17 (mean 14.75) years whose mothers were participants in the Bangladesh Health Effects of Arsenic Longitudinal Study (HEALS). Adolescents' BP was measured at the time of their recruitment between December 2012 and December 2016. We considered maternal urinary As (UAs), repeatedly measured during childhood, as proxy measures of early childhood (<5 years old, A1) and childhood (5-12 years old, A2) exposure. Adolescents' current UAs was collected at the time of recruitment (14-17 years of age, A3). RESULTS Every doubling of UAs at A3 and maternal UAs at A1 was positively associated with a difference of 0.7-mmHg (95% confidence interval [CI]: 0.1, 1.3) and a 0.7-mmHg (95% CI: 0.05, 1.4) in SBP, respectively. These associations were stronger in adolescents with a BMI above the median (17.7 kg/m2) than those with a BMI below the median (P for interaction = 0.03 and 0.03, respectively). There was no significant association between any of the exposure measures and DBP. The Weighted Quantile Sum (WQS) regression confirmed that adolescents' UAs at A3 and maternal UAs at A1 contributed the most to the overall effect of As exposure at three life stages on SBP. Mixture analyses using Bayesian Kernel Machine Regression identified UAs at A3 as a significant contributor to SBP and DBP independent of other concurrent blood levels of cadmium, lead, manganese, and selenium. CONCLUSION Our findings suggest an association of current exposure and early childhood exposure to As with higher BP in adolescents, which may be exacerbated by higher BMI at adolescence.
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Affiliation(s)
- Yu Chen
- Departments of Population Health, New York, NY, USA; Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA.
| | - Fen Wu
- Departments of Population Health, New York, NY, USA; Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Xinhua Liu
- Department of Biostatistics, New York, NY, USA
| | - Faruque Parvez
- Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Nancy J LoIacono
- Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Elizabeth A Gibson
- Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | - Diane Levy
- Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | | | - Taruqul Islam
- U-Chicago Research Bangladesh, Ltd., Dhaka, Bangladesh
| | - Angela Lomax
- Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Roheeni Saxena
- Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Tiffany Sanchez
- Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - David Santiago
- Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Tyler Ellis
- Lamont-Doherty Earth Observatory, Columbia University, New York, NY, USA
| | - Habibul Ahsan
- Department of Health Studies, Center for Cancer Epidemiology and Prevention, The University of Chicago, Chicago, IL, USA
| | - Gail A Wasserman
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Joseph H Graziano
- Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
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11
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da Cunha Martins A, Carneiro MFH, Grotto D, Adeyemi JA, Barbosa F. Arsenic, cadmium, and mercury-induced hypertension: mechanisms and epidemiological findings. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2018; 21:61-82. [PMID: 29446707 DOI: 10.1080/10937404.2018.1432025] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Arsenic (As), cadmium (Cd), and mercury (Hg) are toxic elements widely distributed in the environment. Exposure to these elements was attributed to produce several acute and chronic illnesses including hypertension. The aim of this review is to provide a summary of the most frequently proposed mechanisms underlying hypertension associated with As, Cd, and Hg exposure including: oxidative stress, impaired nitric oxide (NO) signaling, modified vascular response to neurotransmitters and disturbed vascular muscle Ca2+ signaling, renal damage, and interference with the renin-angiotensin system. Due to the complexity of the vascular system, a combination rather than a singular mechanism needs to be considered. In addition, epidemiological findings showing the relationship between various biomarkers of metal exposure and hypertension are described. Given the complex etiology of hypertension, further epidemiological studies evaluating the roles of confounding factors such as age, gender, and life style are still necessary.
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Affiliation(s)
- Airton da Cunha Martins
- a Laboratório de Toxicologia e Essencialidade de Metais, Depto. de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto-SP , Brazil
| | - Maria Fernanda Hornos Carneiro
- a Laboratório de Toxicologia e Essencialidade de Metais, Depto. de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto-SP , Brazil
| | - Denise Grotto
- b Laboratório de Pesquisa em Toxicologia , Universidade de Sorocaba , Sorocaba-SP , Brazil
| | - Joseph A Adeyemi
- a Laboratório de Toxicologia e Essencialidade de Metais, Depto. de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto-SP , Brazil
| | - Fernando Barbosa
- a Laboratório de Toxicologia e Essencialidade de Metais, Depto. de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto-SP , Brazil
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12
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Hall EM, Acevedo J, López FG, Cortés S, Ferreccio C, Smith AH, Steinmaus CM. Hypertension among adults exposed to drinking water arsenic in Northern Chile. ENVIRONMENTAL RESEARCH 2017; 153:99-105. [PMID: 27918984 PMCID: PMC5534354 DOI: 10.1016/j.envres.2016.11.016] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Revised: 10/28/2016] [Accepted: 11/23/2016] [Indexed: 05/19/2023]
Abstract
BACKGROUND A growing number of studies have identified an association between exposure to inorganic arsenic and hypertension. However, results have not been consistent across studies. Additional studies are warranted, given the global prevalence of both arsenic exposure and morbidity attributable to hypertension. METHODS We analyzed data collected from October 2007-December 2010 for a population-based cancer case-control study in northern Chile. Data included lifetime individual arsenic exposure estimates and information on potential confounders for a total of 1266 subjects. Those self-reporting either a physician diagnosis of hypertension or use of an anti-hypertensive medication were classified as having hypertension (n=612). The association between hypertension and drinking water arsenic exposure was analyzed using logistic regression models. RESULTS Compared to those in the lowest category for lifetime highest 5-year average arsenic exposure (<60µg/L), those in the middle (60-623μg/L) and upper (>623μg/L) exposure categories had adjusted hypertension ORs of 1.49 (95% CI: 1.09, 2.05) and 1.65 (95% CI: 1.18, 2.32), respectively. Similar results were observed in analyses of lifetime cumulative exposures and analyses restricted to exposures from the distant past. CONCLUSIONS We identified evidence of increased odds of hypertension with exposure to arsenic in drinking water among study participants. Our findings add to the growing body of research supporting this association, which could have important public health implications.
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Affiliation(s)
- Emily M Hall
- Texas Department of State Health Services, Austin, Texas, USA
| | - Johanna Acevedo
- Pontificia Universidad Católica de Chile, Santiago, Chile; Advanced Center for Chronic Diseases (ACCDIS), Chile
| | | | - Sandra Cortés
- Pontificia Universidad Católica de Chile, Santiago, Chile; Advanced Center for Chronic Diseases (ACCDIS), Chile
| | - Catterina Ferreccio
- Pontificia Universidad Católica de Chile, Santiago, Chile; Advanced Center for Chronic Diseases (ACCDIS), Chile
| | - Allan H Smith
- Arsenic Health Effects Research Group, School of Public Health, University of California, Berkeley, USA
| | - Craig M Steinmaus
- Arsenic Health Effects Research Group, School of Public Health, University of California, Berkeley, USA; Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, California, USA.
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13
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Khuman MW, Harikumar SK, Sadam A, Kesavan M, Susanth VS, Parida S, Singh KP, Sarkar SN. Candesartan ameliorates arsenic-induced hypertensive vascular remodeling by regularizing angiotensin II and TGF-beta signaling in rats. Toxicology 2016; 374:29-41. [PMID: 27889505 DOI: 10.1016/j.tox.2016.11.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 11/21/2016] [Accepted: 11/23/2016] [Indexed: 01/05/2023]
Abstract
Arsenic exposure can cause several cardiovascular diseases, including hypertension, atherosclerosis and microvascular disease. Earlier, we reported that arsenic-mediated enhancement of angiotensin II (AngII) signaling can impair vascular physiology. Here, we investigated whether the AT1 receptor (AT1R) blocker candesartan can ameliorate the arsenic-induced hypertensive vascular remodeling in rats and whether the amelioration could relate to attenuation in vascular AngII and TGF-β signaling. Rats were exposed to sodium arsenite (50ppm) through drinking water for 90 consecutive days. Candesartan (1mg/kg bw, orally) was administered once daily during the last 30days of arsenic exposure. Non-invasive blood pressure was recorded weekly in conscious rats, while AngII-induced change in mean arterial pressure in anaesthetized rats was measured by invasive method on the 91st day. On this day, blood was collected from other animals for measuring AngII level. Western blot of AT1, AT2 and TβRII receptors; ELISA of PTK, RasGAP, ERK-1/2, TGF-β and CTGF; immunohistochemistry of phosphorylated Smad3, Smad4 and collagen III, hydroxyproline/total collagen estimation, collagen deposition by Masson's trichrome staining and histomorphometry were carried out in thoracic aorta. Arsenic increased non-invasive systolic, diastolic and mean arterial pressure. Further, AngII caused concentration-dependent incremental change in mean arterial pressure in the arsenic-exposed rats. Arsenic upregulated AT1 and TβRII receptor proteins; elevated the levels of PTK, ERK-1/2, TGF-β and CTGF, decreased RasGAP level and augmented the immunoreactivities of Smad3, Smad4 and collagen III. Arsenic also increased hydroxyproline/total collagen level, proliferation of collagen fibres and thickness of aortic wall and collagenous adventitia. Candesartan normalized blood pressure, regularized receptor expressions, MAP kinase and TGF-β signaling, restored collagen deposition and regressed aortic thickness. Our results demonstrate that candesartan can ameliorate the arsenic-mediated systemic hypertension and vascular remodeling in rats by regularizing the signaling pathways of AngII and TGF-β.
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Affiliation(s)
- Maibam Wanta Khuman
- Division of Pharmacology and Toxicology, ICAR-Indian Veterinary Research Institute, Izatnagar - 243122, Bareilly, Uttar Pradesh, India
| | - Sankaran Kutty Harikumar
- Division of Pharmacology and Toxicology, ICAR-Indian Veterinary Research Institute, Izatnagar - 243122, Bareilly, Uttar Pradesh, India
| | - Abdul Sadam
- Division of Pharmacology and Toxicology, ICAR-Indian Veterinary Research Institute, Izatnagar - 243122, Bareilly, Uttar Pradesh, India
| | - Manickam Kesavan
- Division of Pharmacology and Toxicology, ICAR-Indian Veterinary Research Institute, Izatnagar - 243122, Bareilly, Uttar Pradesh, India
| | - Vattaparambil Sukumaran Susanth
- Division of Pharmacology and Toxicology, ICAR-Indian Veterinary Research Institute, Izatnagar - 243122, Bareilly, Uttar Pradesh, India
| | - Subhashree Parida
- Division of Pharmacology and Toxicology, ICAR-Indian Veterinary Research Institute, Izatnagar - 243122, Bareilly, Uttar Pradesh, India
| | - Karam Pal Singh
- Centre for Animal Disease Research and Diagnosis, ICAR-Indian Veterinary Research Institute, Izatnagar - 243122, Bareilly, Uttar Pradesh, India
| | - Souvendra Nath Sarkar
- Division of Pharmacology and Toxicology, ICAR-Indian Veterinary Research Institute, Izatnagar - 243122, Bareilly, Uttar Pradesh, India.
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14
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Feseke SK, St-Laurent J, Anassour-Sidi E, Ayotte P, Bouchard M, Levallois P. Arsenic exposure and type 2 diabetes: results from the 2007-2009 Canadian Health Measures Survey. HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN CANADA-RESEARCH POLICY AND PRACTICE 2016; 35:63-72. [PMID: 26083521 DOI: 10.24095/hpcdp.35.4.01] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Inorganic arsenic and its metabolites are considered dangerous to human health. Although several studies have reported associations between low-level arsenic exposure and diabetes mellitus in the United States and Mexico, this association has not been studied in the Canadian population. We evaluated the association between arsenic exposure, as measured by total arsenic concentration in urine, and the prevalence of type 2 diabetes (T2D) in 3151 adult participants in Cycle 1 (2007-2009) of the Canadian Health Measures Survey (CHMS). METHODS All participants were tested to determine blood glucose and glycated hemoglobin. Urine analysis was also performed to measure total arsenic. In addition, participants answered a detailed questionnaire about their lifestyle and medical history. We assessed the association between urinary arsenic levels and T2D and prediabetes using multivariate logistic regression while adjusting for potential confounders. RESULTS Total urinary arsenic concentration was positively associated with the prevalence of T2D and prediabetes: adjusted odds ratios were 1.81 (95% CI: 1.12-2.95) and 2.04 (95% CI: 1.03-4.05), respectively, when comparing the highest (fourth) urinary arsenic concentration quartile with the lowest (first) quartile. Total urinary arsenic was also associated with glycated hemoglobin levels in people with untreated diabetes. CONCLUSION We found significant associations between arsenic exposure and the prevalence of T2D and prediabetes in the Canadian population. Causal inference is limited due to the cross-sectional design of the study and the absence of long-term exposure assessment.
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Affiliation(s)
- S K Feseke
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec, Québec, Quebec, Canada.,Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, Quebec, Canada
| | - J St-Laurent
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec, Québec, Quebec, Canada
| | - E Anassour-Sidi
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec, Québec, Quebec, Canada
| | - P Ayotte
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec, Québec, Quebec, Canada.,Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, Quebec, Canada.,Direction de la santé environnementale et de la toxicologie, Institut national de santé publique du Québec, Québec, Quebec, Canada
| | - M Bouchard
- Département de santé environnementale et santé au travail, Chaire d'analyse et de gestion des risques toxicologiques, École de santé publique, Université de Montréal, Montréal, Quebec, Canada
| | - P Levallois
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec, Québec, Quebec, Canada.,Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, Quebec, Canada.,Direction de la santé environnementale et de la toxicologie, Institut national de santé publique du Québec, Québec, Quebec, Canada
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Piñol S, Sala A, Guzman C, Marcos S, Joya X, Puig C, Velasco M, Velez D, Vall O, Garcia-Algar O. Arsenic levels in immigrant children from countries at risk of consuming arsenic polluted water compared to children from Barcelona. ENVIRONMENTAL MONITORING AND ASSESSMENT 2015; 187:661. [PMID: 26431705 DOI: 10.1007/s10661-015-4869-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Accepted: 09/15/2015] [Indexed: 05/20/2023]
Abstract
Arsenic is a highly toxic element that pollutes groundwater, being a major environmental problem worldwide, especially in the Bengal Basin. About 40% of patients in our outpatient clinics come from those countries, and there is no published data about their arsenic exposure. This study compares arsenic exposure between immigrant and native children. A total of 114 children (57 natives, 57 immigrants), aged 2 months to 16 years, were recruited and sociodemographic and environmental exposure data were recorded. Total arsenic in urine, hair, and nails and arsenic-speciated compounds in urine were determined. We did not find significant differences in total and inorganic arsenic levels in urine and hair, but in organic arsenic monomethylarsenic acid (MMA) and dimethylarsinous acid (DMA) in urine and in total arsenic in nails. However, these values were not in the toxic range. There were significant differences between longer than 5 years exposure and less than 5 years exposure (consumption of water from tube wells), with respect to inorganic and organic MMA arsenic in urine and total arsenic in nails. There was partial correlation between the duration of exposure and inorganic arsenic levels in urine. Immigrant children have higher arsenic levels than native children, but they are not toxic. At present, there is no need for specific arsenic screening or follow-up in immigrant children recently arrived in Spain from exposure high-risk countries.
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Affiliation(s)
- S Piñol
- Unitat de Recerca Infància i Entorn (URIE), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.
| | - A Sala
- Unitat de Recerca Infància i Entorn (URIE), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.
| | - C Guzman
- Pediatría, CAP Ciutat Vella, Institut Català de la Salut, Barcelona, Spain.
| | - S Marcos
- Pediatría, CAP Ciutat Vella, Institut Català de la Salut, Barcelona, Spain.
| | - X Joya
- Unitat de Recerca Infància i Entorn (URIE), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.
| | - C Puig
- Unitat de Recerca Infància i Entorn (URIE), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.
| | - M Velasco
- Unitat de Recerca Infància i Entorn (URIE), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.
| | - D Velez
- Departament de Pediatria, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - O Vall
- Unitat de Recerca Infància i Entorn (URIE), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.
- Departamento de Conservación y Calidad de los Alimentos, Instituto de Agroquímica y Tecnología de Slimentos (IATA-CSIC), Valencia, Spain.
| | - O Garcia-Algar
- Unitat de Recerca Infància i Entorn (URIE), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.
- Departamento de Conservación y Calidad de los Alimentos, Instituto de Agroquímica y Tecnología de Slimentos (IATA-CSIC), Valencia, Spain.
- Unitat de Recerca Infància i Entorn (URIE), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM) - Parc de Recerca Biomèdica de Barcelona (PRBB), C/ Dr. Aiguader, 88, 08003, Barcelona, Spain.
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16
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Farzan SF, Chen Y, Wu F, Jiang J, Liu M, Baker E, Korrick SA, Karagas MR. Blood Pressure Changes in Relation to Arsenic Exposure in a U.S. Pregnancy Cohort. ENVIRONMENTAL HEALTH PERSPECTIVES 2015; 123:999-1006. [PMID: 25793356 PMCID: PMC4590746 DOI: 10.1289/ehp.1408472] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 03/18/2015] [Indexed: 05/20/2023]
Abstract
BACKGROUND Inorganic arsenic exposure has been related to the risk of increased blood pressure based largely on cross-sectional studies conducted in highly exposed populations. Pregnancy is a period of particular vulnerability to environmental insults. However, little is known about the cardiovascular impacts of arsenic exposure during pregnancy. OBJECTIVES We evaluated the association between prenatal arsenic exposure and maternal blood pressure over the course of pregnancy in a U.S. METHODS The New Hampshire Birth Cohort Study is an ongoing prospective cohort study in which > 10% of participant household wells exceed the arsenic maximum contaminant level of 10 μg/L established by the U.S. EPA. Total urinary arsenic measured at 24-28 weeks gestation was measured and used as a biomarker of exposure during pregnancy in 514 pregnant women, 18-45 years of age, who used a private well in their household. Outcomes were repeated blood pressure measurements (systolic, diastolic, and pulse pressure) recorded during pregnancy. RESULTS Using linear mixed effects models, we estimated that, on average, each 5-μg/L increase in urinary arsenic was associated with a 0.15-mmHg (95% CI: 0.02, 0.29; p = 0.022) increase in systolic blood pressure per month and a 0.14-mmHg (95% CI: 0.02, 0.25; p = 0.021) increase in pulse pressure per month over the course of pregnancy. CONCLUSIONS In our U.S. cohort of pregnant women, arsenic exposure was associated with greater increases in blood pressure over the course of pregnancy. These findings may have important implications because even modest increases in blood pressure impact cardiovascular disease risk.
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Affiliation(s)
- Shohreh F Farzan
- Children's Environmental Health and Disease Prevention Research Center at Dartmouth, Hanover, New Hampshire, USA
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17
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Liu ZG, Chen X, Guo Z, Liu JH, Huang XJ. Facile Electrodeposition of MoOx onto Gold Microwire Electrode: Application to Voltammetric Determination of As(III) under Mild Conditions. CHEM LETT 2015. [DOI: 10.1246/cl.150212] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Zhong-Gang Liu
- Department of Chemistry, University of Science and Technology of China
- Nanomaterials and Environmental Detection Laboratory, Hefei Institutes of Physical Science, Chinese Academy of Sciences
| | - Xing Chen
- Nanomaterials and Environmental Detection Laboratory, Hefei Institutes of Physical Science, Chinese Academy of Sciences
| | - Zheng Guo
- Nanomaterials and Environmental Detection Laboratory, Hefei Institutes of Physical Science, Chinese Academy of Sciences
| | - Jin-Huai Liu
- Nanomaterials and Environmental Detection Laboratory, Hefei Institutes of Physical Science, Chinese Academy of Sciences
| | - Xing-Jiu Huang
- Department of Chemistry, University of Science and Technology of China
- Nanomaterials and Environmental Detection Laboratory, Hefei Institutes of Physical Science, Chinese Academy of Sciences
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18
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Basu N, Clarke E, Green A, Calys-Tagoe B, Chan L, Dzodzomenyo M, Fobil J, Long RN, Neitzel RL, Obiri S, Odei E, Ovadje L, Quansah R, Rajaee M, Wilson ML. Integrated assessment of artisanal and small-scale gold mining in Ghana--part 1: human health review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:5143-76. [PMID: 25985314 PMCID: PMC4454960 DOI: 10.3390/ijerph120505143] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 04/27/2015] [Accepted: 05/08/2015] [Indexed: 12/28/2022]
Abstract
This report is one of three synthesis documents produced via an integrated assessment (IA) that aims to increase understanding of artisanal and small-scale gold mining (ASGM) in Ghana. Given the complexities surrounding ASGM, an IA framework was utilized to analyze economic, social, health, and environmental data, and co-develop evidence-based responses with pertinent stakeholders. The current analysis focuses on the health of ASGM miners and community members, and synthesizes extant data from the literature as well as co-authors' recent findings regarding the causes, status, trends, and consequences of ASGM in Ghana. The results provide evidence from across multiple Ghanaian ASGM sites that document relatively high exposures to mercury and other heavy metals, occupational injuries and noise exposure. The work also reviews limited data on psychosocial health, nutrition, cardiovascular and respiratory health, sexual health, and water and sanitation. Taken together, the findings provide a thorough overview of human health issues in Ghanaian ASGM communities. Though more research is needed to further elucidate the relationships between ASGM and health outcomes, the existing research on plausible health consequences of ASGM should guide policies and actions to better address the unique challenges of ASGM in Ghana and potentially elsewhere.
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Affiliation(s)
- Niladri Basu
- Faculty of Agricultural and Environmental Sciences, McGill University, CINE Building Macdonald Campus of McGill University, 21,111 Lakeshore Rd., Ste. Anne de Bellevue, QC H9X 3V9, Canada.
| | | | - Allyson Green
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA.
| | | | - Laurie Chan
- Faculty of Science, Department of Biology, University of Ottawa, ON K1N 6N5, Canada.
| | - Mawuli Dzodzomenyo
- Department of Biological, Environmental, and Occupational Health Sciences, School of Public Health, University of Ghana, Legon Boundary, Accra, Ghana.
| | - Julius Fobil
- Department of Biological, Environmental, and Occupational Health Sciences, School of Public Health, University of Ghana, Legon Boundary, Accra, Ghana.
| | - Rachel N Long
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA.
| | - Richard L Neitzel
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA.
| | - Samuel Obiri
- Council for Scientific and Industrial Research-Water Research Institute, Accra, Ghana.
| | | | - Lauretta Ovadje
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA.
| | - Reginald Quansah
- Department of Biological, Environmental, and Occupational Health Sciences, School of Public Health, University of Ghana, Legon Boundary, Accra, Ghana.
- Noguchi Institute for Medical Research, College of Health Sciences, University of Ghana, Legon Boundary, Accra, Ghana.
| | - Mozhgon Rajaee
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA.
| | - Mark L Wilson
- Department of Epidemiology, Department of Ecology and Evolutionary Biology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA.
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Wade TJ, Xia Y, Mumford J, Wu K, Le XC, Sams E, Sanders WE. Cardiovascular disease and arsenic exposure in Inner Mongolia, China: a case control study. Environ Health 2015; 14:35. [PMID: 25889926 PMCID: PMC4409992 DOI: 10.1186/s12940-015-0022-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 03/30/2015] [Indexed: 05/20/2023]
Abstract
BACKGROUND Millions of people are at risk from the adverse effects of arsenic exposure through drinking water. Increasingly, non-cancer effects such as cardiovascular disease have been associated with drinking water arsenic exposures. However, most studies have been conducted in highly exposed populations and lacked individual measurements. OBJECTIVE To evaluate the association between cardiovascular disease and well-water arsenic exposure. METHODS We conducted a hospital based case control study in Inner Mongolia, China. Cases and controls were prospectively identified and enrolled from a large hospital in the Hangjin Hou area. Cases were patients diagnosed with cardiovascular disease and controls were patients free from cardiovascular disease, admitted for conditions unrelated to arsenic exposure. Water from the primary water source and toenail samples were collected from each subject and tested for inorganic arsenic. RESULTS Arsenic exposures were moderate with mean and median arsenic exposures of 8.9 μg/L and 13.1 μg/L, respectively. A total of 298 cases and 275 controls were enrolled. The adjusted odds ratio (AOR) and corresponding 95% confidence interval (95% CI) for a 10 μg/L increase in water arsenic were 1.19 (95% CI: 1.03, 1.38). Compared to exposures less than 10 μg/L, the AOR for water arsenic exposures above 40 μg/L was 4.05 (95% CI: 1.1-14.99, p = 0.04). Nail arsenic above 1.38 μg/g was also associated with an increased risk of cardiovascular disease. CONCLUSIONS By using standardized case definitions and collecting individual measurements of arsenic, this study addressed several limitations of previous studies. The results provide further evidence of the association between cardiovascular disease and arsenic at moderate exposures.
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Affiliation(s)
- Timothy J Wade
- United States Environmental Protection Agency, Office of Research and Development, Chapel Hill, North Carolina, USA.
| | - Yajuan Xia
- Inner Mongolia Centers for Endemic Disease Control and Research, Huhhot, Inner Mongolia, China.
| | - Judy Mumford
- United States Environmental Protection Agency, Office of Research and Development, Chapel Hill, North Carolina, USA.
| | - Kegong Wu
- Inner Mongolia Centers for Endemic Disease Control and Research, Huhhot, Inner Mongolia, China.
| | - X Chris Le
- University of Alberta, Edmonton, Alberta, Canada.
| | - Elizabeth Sams
- United States Environmental Protection Agency, Office of Research and Development, Chapel Hill, North Carolina, USA.
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Mechanisms of action for arsenic in cardiovascular toxicity and implications for risk assessment. Toxicology 2015; 331:78-99. [PMID: 25771173 DOI: 10.1016/j.tox.2015.02.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Revised: 02/09/2015] [Accepted: 02/27/2015] [Indexed: 11/20/2022]
Abstract
The possibility of an association between inorganic arsenic (iAs) exposure and cardiovascular outcomes has received increasing attention in the literature over the past decade. The United States Environmental Protection Agency (US EPA) is currently revising its Integrated Risk Assessment System (IRIS) review of iAs, and one of the non-cancer endpoints of interest is cardiovascular disease (CVD). Despite the increased interest in this area, substantial gaps remain in the available information, particularly regarding the mechanism of action (MOA) by which iAs could cause or exacerbate CVD. Few studies specifically address the plausibility of an association between iAs and CVD at the low exposure levels which are typical in the United States (i.e., below 100 μg As/L in drinking water). We have conducted a review and evaluation of the animal, mechanistic, and human data relevant to the potential MOAs of iAs and CVD. Specifically, we evaluated the most common proposed MOAs, which include disturbance of endothelial function and hepatic dysfunction. Our analysis of the available evidence indicates that there is not a well-established MOA for iAs in the development or progression of CVD. Few human studies of the potential MOAs have addressed plausibility at low doses and the applicability of extrapolation from animal studies to humans is questionable. However, the available evidence indicates that regardless of the specific MOA, the effects of iAs on physiological processes at the cellular level appear to operate via a threshold mechanism. This finding is consistent with the lack of association of CVD with iAs exposure in humans at levels below 100 μg/L, particularly when considering important exposure and risk modifiers such as nutrition and genetics. Based on this analysis, we conclude that there are no data supporting a linear dose-response relationship between iAs and CVD, indicating this relationship has a threshold.
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Huang L, Wu H, van der Kuijp TJ. The health effects of exposure to arsenic-contaminated drinking water: a review by global geographical distribution. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2014; 25:432-452. [PMID: 25365079 DOI: 10.1080/09603123.2014.958139] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
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.
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Affiliation(s)
- Lei Huang
- a State Key Laboratory of Pollution Control & Resource Reuse , School of the Environment, Nanjing University , Nanjing , China
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22
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Fort M, Grimalt JO, Casas M, Sunyer J. Food sources of arsenic in pregnant Mediterranean women with high urine concentrations of this metalloid. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2014; 21:11689-98. [PMID: 24557803 DOI: 10.1007/s11356-014-2614-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 01/30/2014] [Indexed: 05/03/2023]
Abstract
Seafood consumption provides a significant amount of arsenic, although in its organic, nontoxic forms. Mediterranean populations may incorporate high levels of this metalloid as a consequence of seafood consumption. In the present study, the significance of this input among pregnant women from a Mediterranean city (Sabadell, Catalonia, Spain) is assessed. Total urinary arsenic was analyzed in 489 pairs of urine samples, corresponding to the 12th and 32 th weeks of pregnancy. Association of arsenic content with seafood and other dietary items were studied. Geometric mean concentrations were 34 and 37 μg/g creatinine during the first and third trimesters, respectively. The observed concentrations were similar to those reported in studies from other Mediterranean countries. The differences between both periods were not statistically significant. The only dietary factor significantly and positively associated with total urinary arsenic in both series of samples was seafood, particularly lean fish. Moreover, lean fish consumption during both periods was found to be the main determinant for differences in levels of arsenic between the first and third trimesters, which confirms the association between high levels of total urinary arsenic and seafood consumption.
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Affiliation(s)
- Marta Fort
- Department of Environmental Chemistry, Institute of Environmental Assessment and Water Research, Jordi Girona, 18., 08034, Barcelona, Catalonia, Spain
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23
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Liu ZG, Chen X, Liu JH, Huang XJ. Robust electrochemical analysis of As(III) integrating with interference tests: a case study in groundwater. JOURNAL OF HAZARDOUS MATERIALS 2014; 278:66-74. [PMID: 24953937 DOI: 10.1016/j.jhazmat.2014.05.094] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Revised: 05/24/2014] [Accepted: 05/31/2014] [Indexed: 06/03/2023]
Abstract
In Togtoh region of Inner Mongolia, northern China, groundwater encountered high concentrations As contamination (greater than 50 μg L(-1)) causes an increasing concern. This work demonstrates an electrochemical protocol for robust (efficient and accurate) determination of As(III) in Togtoh water samples using Au microwire electrode without the need of pretreatment or clean-up steps. Considering the complicated conditions of Togtoh water, the efficiency of Au microwire electrode was systematically evaluated by a series of interference tests, stability and reproducibility measurements. No obvious interference on the determination of As(III) was observed. Especially, the influence of humic acid (HA) was intensively investigated. Electrode stability was also observed with long-term measurements (70 days) in Togtoh water solution and under different temperatures (0-35 °C). Excellent reproducibility (RSD:1.28%) was observed from different batches of Au microwire electrodes. The results obtained at Au microwire electrode were comparable to that obtained by inductively coupled plasma atomic emission spectroscopy (ICP-AES), indicating a good accuracy. These evaluations (efficiency, robustness, and accuracy) demonstrated that the Au microwire electrode was able to determine As(III) in application to real environmental samples.
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Affiliation(s)
- Zhong-Gang Liu
- Nanomaterials and Environmental Detection Laboratory, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, PR China; Department of Chemistry, University of Science and Technology of China, Hefei 230026, PR China
| | - Xing Chen
- Nanomaterials and Environmental Detection Laboratory, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, PR China
| | - Jin-Huai Liu
- Nanomaterials and Environmental Detection Laboratory, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, PR China
| | - Xing-Jiu Huang
- Nanomaterials and Environmental Detection Laboratory, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, PR China; Department of Chemistry, University of Science and Technology of China, Hefei 230026, PR China.
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Liu ZG, Chen X, Jia Y, Liu JH, Huang XJ. Role of Fe(III) in preventing humic interference during As(III) detection on gold electrode: spectroscopic and voltammetric evidence. JOURNAL OF HAZARDOUS MATERIALS 2014; 267:153-60. [PMID: 24440655 DOI: 10.1016/j.jhazmat.2013.12.054] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2013] [Revised: 11/30/2013] [Accepted: 12/18/2013] [Indexed: 05/21/2023]
Abstract
A drawback of As(III) detection using square wave anodic stripping voltammetry (SWASV) is that it is susceptible to interferences from various metals or organic compounds, especially in real sample water. This study attempts to understand the interference of co-existing of Fe(III) and humic acid (HA) molecules to the electrochemical detection of As(III) using Fourier transform infrared (FTIR) spectrum and X-ray photoelectron spectroscopy (XPS). The electrochemical experiments include stripping of As(III) in the solutions containing HA with different concentrations, cyclic voltammetry in 0.5M H2SO4 in the presence of HA or Fe(III) with/without addition of Fe(III) or HA, and stripping of As(III) in the presence of HA or Fe(III) with/without addition of Fe(III) or HA. FTIR and XPS are employed to confirm the affinity of HA to Fe(III) or As(III) in acidic condition.
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Affiliation(s)
- Zhong-Gang Liu
- Nanomaterials and Environmental Detection Laboratory, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, PR China; Department of Chemistry, University of Science and Technology of China, Hefei 230026, PR China
| | - Xing Chen
- Nanomaterials and Environmental Detection Laboratory, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, PR China
| | - Yong Jia
- Nanomaterials and Environmental Detection Laboratory, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, PR China
| | - Jin-Huai Liu
- Nanomaterials and Environmental Detection Laboratory, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, PR China
| | - Xing-Jiu Huang
- Nanomaterials and Environmental Detection Laboratory, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, PR China; Department of Chemistry, University of Science and Technology of China, Hefei 230026, PR China.
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Phan K, Phan S, Heng S, Huoy L, Kim KW. Assessing arsenic intake from groundwater and rice by residents in Prey Veng province, Cambodia. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2014; 185:84-9. [PMID: 24231403 DOI: 10.1016/j.envpol.2013.10.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 10/15/2013] [Accepted: 10/21/2013] [Indexed: 05/11/2023]
Abstract
We investigated total daily intake of As by residents in Prey Veng province in the Mekong River basin of Cambodia. Groundwater (n = 11), rice (n = 11) and fingernail (n = 23) samples were randomly collected from the households and analyzed for total As by inductively coupled plasma mass spectrometry. Calculation indicated that daily dose of inorganic As was greater than the lower limits on the benchmark dose for a 0.5% increased incidence of lung cancer (BMDL0.5 equals to 3.0 μg d(-1) kg(-1)body wt.). Moreover, positive correlation between As in fingernail and daily dose of As from groundwater and rice and total daily dose of As were found. These results suggest that the Prey Veng residents are exposed to As in groundwater. As in rice is an additional source which is attributable to high As accumulation in human bodies in the Mekong River basin of Cambodia.
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Affiliation(s)
- Kongkea Phan
- Research and Development Unit, Cambodian Chemical Society, Street 598, Phnom Penh, Cambodia.
| | - Samrach Phan
- Department of Chemistry, Faculty of Science, Royal University of Phnom Penh, Russian Blvd, Phnom Penh, Cambodia
| | - Savoeun Heng
- Department of Chemistry, Faculty of Science, Royal University of Phnom Penh, Russian Blvd, Phnom Penh, Cambodia
| | - Laingshun Huoy
- Department of Chemistry, Faculty of Science, Royal University of Phnom Penh, Russian Blvd, Phnom Penh, Cambodia
| | - Kyoung-Woong Kim
- School of Environmental Science and Engineering, Gwangju Institute of Science and Technology, Gwangju 500-712, Republic of Korea.
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26
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Zhang C, Mao G, He S, Yang Z, Yang W, Zhang X, Qiu W, Ta N, Cao L, Yang H, Guo X. Relationship between long-term exposure to low-level arsenic in drinking water and the prevalence of abnormal blood pressure. JOURNAL OF HAZARDOUS MATERIALS 2013; 262:1154-8. [PMID: 23069333 DOI: 10.1016/j.jhazmat.2012.09.045] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Revised: 09/08/2012] [Accepted: 09/19/2012] [Indexed: 05/05/2023]
Abstract
Arsenic increases the risk and incidence of cardiovascular disease. To explore the impact of long-term exposure to low-level arsenic in drinking water on blood pressure including pulse pressure (PP) and mean arterial blood pressure (MAP), a cross-sectional study was conducted in 2010 in which the blood pressure of 405 villagers was measured, who had been drinking water with an inorganic arsenic content <50 μg/L. A multivariate logistic regression model was used to estimate odds ratios and 95% confidence intervals. After adjusting for age, gender, Body Mass Index (BMI), alcohol consumption and smoking, the odds ratios showed a 1.45-fold (95%CI: 0.63-3.35) increase in the group with >30-50 years of arsenic exposure and a 2.95-fold (95%CI: 1.31-6.67) increase in the group with >50 years exposure. Furthermore, the odds ratio for prevalence of abnormal PP and MAP were 1.06 (95%CI: 0.24-4.66) and 0.87 (95%CI: 0.36-2.14) in the group with >30-50 years of exposure, and were 2.46 (95%CI: 0.87-6.97) and 3.75 (95%CI: 1.61-8.71) for the group with >50 years exposure, compared to the group with arsenic exposure ≤ 30 years respectively. Significant trends for Hypertension (p<0.0001), PP (p<0.0001) and MAP (p=0.0016) were found. The prevalence of hypertension and abnormal PP as well as MAP is marked among a low-level arsenic exposure population, and significantly increases with the duration of arsenic exposure.
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Affiliation(s)
- Chuanwu Zhang
- Wenzhou Medical College, Wenzhou, 325035, Zhejiang, PR China
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27
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Chen Y, Wu F, Graziano JH, Parvez F, Liu M, Paul RR, Shaheen I, Sarwar G, Ahmed A, Islam T, Slavkovich V, Rundek T, Demmer RT, Desvarieux M, Ahsan H. Arsenic exposure from drinking water, arsenic methylation capacity, and carotid intima-media thickness in Bangladesh. Am J Epidemiol 2013; 178:372-81. [PMID: 23788675 DOI: 10.1093/aje/kwt001] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
We conducted a cross-sectional study to evaluate the interrelationships between past arsenic exposure, biomarkers specific for susceptibility to arsenic exposure, and carotid intima-media thickness (cIMT) in 959 subjects from the Health Effects of Arsenic Longitudinal Study in Bangladesh. We measured cIMT levels on average 7.2 years after baseline during 2010-2011. Arsenic exposure was measured in well water at baseline and in urine samples collected at baseline and during follow-up. Every 1-standard-deviation increase in urinary arsenic (357.9 µg/g creatinine) and well-water arsenic (102.0 µg/L) concentration was related to a 11.7-µm (95% confidence interval (CI): 1.8, 21.6) and 5.1-µm (95% CI: -0.2, 10.3) increase in cIMT, respectively. For every 10% increase in monomethylarsonic acid (MMA) percentage, there was an increase of 12.1 µm (95% CI: 0.4, 23.8) in cIMT. Among participants with a higher urinary MMA percentage, a higher ratio of urinary MMA to inorganic arsenic, and a lower ratio of dimethylarsinic acid to MMA, the association between well-water arsenic and cIMT was stronger. The findings indicate an effect of past long-term arsenic exposure on cIMT, which may be potentiated by suboptimal or incomplete arsenic methylation capacity. Future prospective studies are needed to confirm the association between arsenic methylation capacity and atherosclerosis-related outcomes.
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Affiliation(s)
- Yu Chen
- Departments of Population Health and Environmental Medicine, School of Medicine, New York University, 650 First Avenue, Room 510, New York, NY 10016, USA.
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Blood pressure hyperreactivity: an early cardiovascular risk in normotensive men exposed to low-to-moderate inorganic arsenic in drinking water. J Hypertens 2013. [PMID: 23203141 DOI: 10.1097/hjh.0b013e32835c175f] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Essential hypertension is associated with chronic exposure to high levels of inorganic arsenic in drinking water. However, early signs of risk for developing hypertension remain unclear in people exposed to chronic low-to-moderate inorganic arsenic. OBJECTIVE We evaluated cardiovascular stress reactivity and recovery in healthy, normotensive, middle-aged men living in an arsenic-endemic region of Romania. METHODS Unexposed (n = 16) and exposed (n = 19) participants were sampled from communities based on WHO limits for inorganic arsenic in drinking water (<10 μg/l). Water sources and urine samples were collected and analyzed for inorganic arsenic and its metabolites. Functional evaluation of blood pressure included clinical, anticipatory, cold pressor test, and recovery measurements. Blood pressure hyperreactivity was defined as a combined stress-induced change in SBP (> 20 mmHg) and DBP (>15 mmHg). RESULTS Drinking water inorganic arsenic averaged 40.2 ± 30.4 and 1.0 ± 0.2 μg/l for the exposed and unexposed groups, respectively (P < 0.001). Compared to the unexposed group, the exposed group expressed a greater probability of blood pressure hyperreactivity to both anticipatory stress (47.4 vs. 12.5%; P = 0.035) and cold stress (73.7 vs. 37.5%; P = 0.044). Moreover, the exposed group exhibited attenuated blood pressure recovery from stress and a greater probability of persistent hypertensive responses (47.4 vs. 12.5%; P = 0.035). CONCLUSIONS Inorganic arsenic exposure increased stress-induced blood pressure hyperreactivity and poor blood pressure recovery, including persistent hypertensive responses in otherwise healthy, clinically normotensive men. Drinking water containing even low-to-moderate inorganic arsenic may act as a sympathetic nervous system trigger for hypertension risk.
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Park S, Lee BK. Strong positive associations between seafood, vegetables, and alcohol with blood mercury and urinary arsenic levels in the Korean adult population. ARCHIVES OF ENVIRONMENTAL CONTAMINATION AND TOXICOLOGY 2013; 64:160-170. [PMID: 23011092 DOI: 10.1007/s00244-012-9808-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2012] [Accepted: 08/27/2012] [Indexed: 06/01/2023]
Abstract
Blood mercury and urinary arsenic levels are more than fivefold greater in the Korean population compared with those of the United States. This may be related to the foods people consumed. Therefore, we examined the associations between food categories and mercury and arsenic exposure in the Korean adult population. Data regarding nutritional, biochemical, and health-related parameters were obtained from a cross-sectional study, the 2008-2009 Korean National Health and Nutrition Examination Survey (3,404 men and women age ≥ 20 years). The log-transformed blood mercury and urinary arsenic levels were regressed against the frequency tertiles of each food group after covariate adjustment for sex, age, residence area, education level, smoking status, and drinking status using food-frequency data. Blood mercury levels in the high consumption groups compared to the low consumption groups were elevated by about 20 percents with salted fish, shellfish, whitefish, bluefish, and alcohol, and by about 9-14 percents with seaweeds, green vegetables, fruits and tea, whereas rice did not affect blood mercury levels. Urinary arsenic levels were markedly increased with consumption of rice, bluefish, salted fish, shellfish, whitefish, and seaweed, whereas they were moderately increased with consumption of grains, green and white vegetables, fruits, coffee, and alcohol. The remaining food categories tended to lower these levels only minimally. In conclusion, the typical Asian diet, which is high in rice, salted fish, shellfish, vegetables, alcoholic beverages, and tea, may be associated with greater blood mercury and urinary arsenic levels. This study suggests that mercury and arsenic contents should be monitored and controlled in soil and water used for agriculture to decrease health risks from heavy-metal contamination.
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Affiliation(s)
- Sunmin Park
- Department of Food and Nutrition, Hoseo University, Chungnam-Do, 336-795, South Korea
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Islam MR, Khan I, Attia J, Hassan SMN, McEvoy M, D’Este C, Azim S, Akhter A, Akter S, Shahidullah SM, Milton AH. Association between hypertension and chronic arsenic exposure in drinking water: a cross-sectional study in Bangladesh. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2012; 9:4522-36. [PMID: 23222207 PMCID: PMC3546776 DOI: 10.3390/ijerph9124522] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 11/27/2012] [Accepted: 11/29/2012] [Indexed: 12/12/2022]
Abstract
Chronic arsenic exposure and its association with hypertension in adults are inconclusive and this cross-sectional study investigated the association. The study was conducted between January and July 2009 among 1,004 participants from 1,682 eligible women and men aged ≥30 years living in rural Bangladesh who had continuously consumed arsenic-contaminated drinking water for at least 6 months. Hypertension was defined as systolic blood pressure ≥140 mmHg (systolic hypertension) and diastolic blood pressure ≥90 mmHg (diastolic hypertension). Pulse pressure was calculated by deducting diastolic from systolic pressure and considered to be increased when the difference was ≥55 mmHg. The prevalence of hypertension was 6.6% (95% CI: 5.1-8.3%). After adjustment for other factors, no excess risk of hypertension was observed for arsenic exposure >50 μg/L or to that of arsenic exposure as quartiles or as duration. Arsenic concentration as quartiles and >50 μg/L did show a strong relationship with increased pulse pressure (adjusted OR: 3.54, 95% CI: 1.46-8.57), as did arsenic exposure for ≥10 years (adjusted OR: 5.25, 95% CI: 1.41-19.51). Arsenic as quartiles showed a dose response relationship with increased pulse pressure. Our study suggests an association between higher drinking water arsenic or duration and pulse pressure, but not hypertension.
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Affiliation(s)
- Mohammad Rafiqul Islam
- Centre for Clinical Epidemiology & Biostatistics (CCEB), The University of Newcastle, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; E-Mails: (M.R.I.); (J.A.); (M.M.); (C.D.)
| | - Ismail Khan
- Department of Pharmacology, Dhaka Medical College, Dhaka 1000, Bangladesh; E-Mail:
| | - John Attia
- Centre for Clinical Epidemiology & Biostatistics (CCEB), The University of Newcastle, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; E-Mails: (M.R.I.); (J.A.); (M.M.); (C.D.)
| | | | - Mark McEvoy
- Centre for Clinical Epidemiology & Biostatistics (CCEB), The University of Newcastle, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; E-Mails: (M.R.I.); (J.A.); (M.M.); (C.D.)
| | - Catherine D’Este
- Centre for Clinical Epidemiology & Biostatistics (CCEB), The University of Newcastle, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; E-Mails: (M.R.I.); (J.A.); (M.M.); (C.D.)
| | - Syed Azim
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia; E-Mail:
| | - Ayesha Akhter
- Department of Obstetrics and Gynaecology, Tairunnessa Memorial Medical College, Targas, Kunia, Gazipur, Dhaka, Gazipur 1701, Bangladesh; E-Mail:
| | - Shahnaz Akter
- Department of Paediatrics, Institute of Child and Mother Health (ICMH), Matuail, Demra, Dhaka 1362, Bangladesh; E-Mail:
| | | | - Abul Hasnat Milton
- Centre for Clinical Epidemiology & Biostatistics (CCEB), The University of Newcastle, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; E-Mails: (M.R.I.); (J.A.); (M.M.); (C.D.)
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Pontoni L, Fabbricino M. Use of chitosan and chitosan-derivatives to remove arsenic from aqueous solutions--a mini review. Carbohydr Res 2012; 356:86-92. [PMID: 22537862 DOI: 10.1016/j.carres.2012.03.042] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Revised: 03/21/2012] [Accepted: 03/30/2012] [Indexed: 11/24/2022]
Abstract
Arsenic removal has become a relevant concern due to the final confirmation of its behaviour as chronic human carcinogen, corresponding to an ever-increasing contamination of water, soil and crops in many parts of the world. Developing easily accessible removal strategies is therefore a primary environmental matter. Chitosan and chitosan derivatives show good adsorption performances against arsenic removal and are considered low cost products, easily obtainable. This review provides a summary of recent advances of the application of these compounds in the area of sorption sciences for arsenate and arsenite removal from water, focusing on equilibrium and kinetic mechanisms.
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Affiliation(s)
- Ludovico Pontoni
- University of Naples Federico II, Department of Hydraulics Geotechnics and Environmental Engineering, Via Claudio 21, 80125 Naples, Italy.
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Abhyankar LN, Jones MR, Guallar E, Navas-Acien A. Arsenic exposure and hypertension: a systematic review. ENVIRONMENTAL HEALTH PERSPECTIVES 2012; 120:494-500. [PMID: 22138666 PMCID: PMC3339454 DOI: 10.1289/ehp.1103988] [Citation(s) in RCA: 195] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2011] [Accepted: 12/02/2011] [Indexed: 05/18/2023]
Abstract
BACKGROUND Environmental exposure to arsenic has been linked to hypertension in persons living in arsenic-endemic areas. OBJECTIVE We summarized published epidemiologic studies concerning arsenic exposure and hypertension or blood pressure (BP) measurements to evaluate the potential relationship. DATA SOURCES AND EXTRACTION We searched PubMed, Embase, and TOXLINE and applied predetermined exclusion criteria. We identified 11 cross-sectional studies from which we abstracted or derived measures of association and calculated pooled odds ratios (ORs) using inverse-variance weighted random-effects models. DATA SYNTHESIS The pooled OR for hypertension comparing the highest and lowest arsenic exposure categories was 1.27 [95% confidence interval (CI): 1.09, 1.47; p-value for heterogeneity = 0.001; I(2) = 70.2%]. In populations with moderate to high arsenic concentrations in drinking water, the pooled OR was 1.15 (95% CI: 0.96, 1.37; p-value for heterogeneity = 0.002; I(2) = 76.6%) and 2.57 (95% CI: 1.56, 4.24; p-value for heterogeneity = 0.13; I(2) = 46.6%) before and after excluding an influential study, respectively. The corresponding pooled OR in populations with low arsenic concentrations in drinking water was 1.56 (95% CI: 1.21, 2.01; p-value for heterogeneity = 0.27; I(2) = 24.6%). A dose-response assessment including six studies with available data showed an increasing trend in the odds of hypertension with increasing arsenic exposure. Few studies have evaluated changes in systolic and diastolic BP (SBP and DBP, respectively) measurements by arsenic exposure levels, and those studies reported inconclusive findings. CONCLUSION In this systematic review we identified an association between arsenic and the prevalence of hypertension. Interpreting a causal effect of environmental arsenic on hypertension is limited by the small number of studies, the presence of influential studies, and the absence of prospective evidence. Additional evidence is needed to evaluate the dose-response relationship between environmental arsenic exposure and hypertension.
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Affiliation(s)
- Lalita N Abhyankar
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA
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Elevated levels of plasma Big endothelin-1 and its relation to hypertension and skin lesions in individuals exposed to arsenic. Toxicol Appl Pharmacol 2012; 259:187-94. [DOI: 10.1016/j.taap.2011.12.023] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Revised: 12/20/2011] [Accepted: 12/26/2011] [Indexed: 11/19/2022]
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Sanchez-Soria P, Broka D, Monks SL, Camenisch TD. Chronic low-level arsenite exposure through drinking water increases blood pressure and promotes concentric left ventricular hypertrophy in female mice. Toxicol Pathol 2012; 40:504-12. [PMID: 22215511 DOI: 10.1177/0192623311432297] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Cardiovascular disease is the leading cause of death in the United States and worldwide. High incidence of cardiovascular diseases has been linked to populations with elevated arsenic content in their drinking water. Although this correlation has been established in many epidemiological studies, a lack of experimental models to study mechanisms of arsenic-related cardiovascular pathogenesis has limited our understanding of how arsenic exposure predisposes for development of hypertension and increased cardiovascular mortality. Our studies show that mice chronically exposed to drinking water containing 100 parts per billion (ppb) sodium arsenite for 22 weeks show an increase in both systolic and diastolic blood pressure. Echocardiographic analyses as well as histological assessment show concentric left ventricular hypertrophy, a primary cardiac manifestation of chronic hypertension. Live imaging by echocardiography shows a 43% increase in left ventricular mass in arsenic-treated animals. Relative wall thickness (RWT) was calculated showing that all the arsenic-exposed animals show an RWT greater than 0.45, indicating concentric hypertrophy. Importantly, left ventricular hypertrophy, although often associated with chronic hypertension, is an independent risk factor for cardiovascular-related mortalities. These results suggest that chronic low-level arsenite exposure promotes the development of hypertension and the comorbidity of concentric hypertrophy.
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Affiliation(s)
- Pablo Sanchez-Soria
- Pharmacology and Toxicology, College of Pharmacy, University of Arizona, Tucson, Arizona, USA.
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Guha Mazumder D, Purkayastha I, Ghose A, Mistry G, Saha C, Nandy AK, Das A, Majumdar KK. Hypertension in chronic arsenic exposure: A case control study in West Bengal. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART A, TOXIC/HAZARDOUS SUBSTANCES & ENVIRONMENTAL ENGINEERING 2012; 47:1514-1520. [PMID: 22702810 DOI: 10.1080/10934529.2012.680329] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Various systemic manifestations are reported to be caused by chronic arsenic exposure in the population living in the Indo-Bangladesh subcontinent. This study from West Bengal assesses the likelihood of occurrence of hypertension (HTN) in individuals resident in an area of high groundwater contamination with arsenic (Nadia district) compared to those from a non-contaminated area (Hoogly district) in West Bengal, India. Two hundred and eight study participants (Group 1) were recruited from a cross-sectional study in six villages in the Nadia district and 100 controls (Group 2) from a village in the Hoogly district. The two groups were evenly matched in regard to age and sex. History taking and clinical examination including blood pressure measurement were undertaken in each participant. Water samples from current and previous drinking water sources and hair and urine samples from each participant were collected for estimation of arsenic. The present study shows evidence of increased association of HTN in individuals resident in arsenic endemic region compared to those from a non-endemic region in West Bengal. There were increased odds ratios for HTN [Adjusted Odds Ratio, OR, 2.87 (95 %CI = 1.26-4.83)] in Group- 1 participants compared to Group- 2 people. Within Group 1, there was no difference in prevalence of HTN between those with and without skin lesion. There was a dose-effect relationship seen with increasing cumulative arsenic exposure and arsenic level in hair and HTN in participants living in arsenic endemic region.The findings reported here support an association between arsenic exposure and HTN. More work is needed to characterize the link further.
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Mordukhovich I, Wright RO, Hu H, Amarasiriwardena C, Baccarelli A, Litonjua A, Sparrow D, Vokonas P, Schwartz J. Associations of toenail arsenic, cadmium, mercury, manganese, and lead with blood pressure in the normative aging study. ENVIRONMENTAL HEALTH PERSPECTIVES 2012; 120:98-104. [PMID: 21878420 PMCID: PMC3261928 DOI: 10.1289/ehp.1002805] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Accepted: 08/30/2011] [Indexed: 05/19/2023]
Abstract
BACKGROUND Arsenic, cadmium, mercury, and lead are associated with cardiovascular disease in epidemiologic research. These associations may be mediated by direct effects of the metals on blood pressure (BP) elevation. Manganese is associated with cardiovascular dysfunction and hypotension in occupational cohorts. OBJECTIVES We hypothesized that chronic arsenic, cadmium, mercury, and lead exposures elevate BP and that manganese lowers BP. METHODS We conducted a cross-sectional analysis of associations between toenail metals and BP among older men from the Normative Aging Study (n = 639), using linear regression and adjusting for potential confounders. RESULTS An interquartile range increase in toenail arsenic was associated with higher systolic BP [0.93 mmHg; 95% confidence interval (CI): 0.25, 1.62] and pulse pressure (0.76 mmHg; 95% CI: 0.22, 1.30). Positive associations between arsenic and BP and negative associations between manganese and BP were strengthened in models adjusted for other toenail metals. CONCLUSIONS Our findings suggest associations between BP and arsenic and manganese. This may be of public health importance because of prevalence of both metal exposure and cardiovascular disease. Results should be interpreted cautiously given potential limitations of toenails as biomarkers of metal exposure.
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Affiliation(s)
- Irina Mordukhovich
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA.
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Flora SJS. Arsenic-induced oxidative stress and its reversibility. Free Radic Biol Med 2011; 51:257-81. [PMID: 21554949 DOI: 10.1016/j.freeradbiomed.2011.04.008] [Citation(s) in RCA: 536] [Impact Index Per Article: 41.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2010] [Revised: 03/18/2011] [Accepted: 04/04/2011] [Indexed: 12/12/2022]
Abstract
This review summarizes the literature describing the molecular mechanisms of arsenic-induced oxidative stress, its relevant biomarkers, and its relation to various diseases, including preventive and therapeutic strategies. Arsenic alters multiple cellular pathways including expression of growth factors, suppression of cell cycle checkpoint proteins, promotion of and resistance to apoptosis, inhibition of DNA repair, alterations in DNA methylation, decreased immunosurveillance, and increased oxidative stress, by disturbing the pro/antioxidant balance. These alterations play prominent roles in disease manifestation, such as carcinogenicity, genotoxicity, diabetes, cardiovascular and nervous systems disorders. The exact molecular and cellular mechanisms involved in arsenic toxicity are rather unrevealed. Arsenic alters cellular glutathione levels either by utilizing this electron donor for the conversion of pentavalent to trivalent arsenicals or directly binding with it or by oxidizing glutathione via arsenic-induced free radical generation. Arsenic forms oxygen-based radicals (OH(•), O(2)(•-)) under physiological conditions by directly binding with critical thiols. As a carcinogen, it acts through epigenetic mechanisms rather than as a classical mutagen. The carcinogenic potential of arsenic may be attributed to activation of redox-sensitive transcription factors and other signaling pathways involving nuclear factor κB, activator protein-1, and p53. Modulation of cellular thiols for protection against reactive oxygen species has been used as a therapeutic strategy against arsenic. N-acetylcysteine, α-lipoic acid, vitamin E, quercetin, and a few herbal extracts show prophylactic activity against the majority of arsenic-mediated injuries in both in vitro and in vivo models. This review also updates the reader on recent advances in chelation therapy and newer therapeutic strategies suggested to treat arsenic-induced oxidative damage.
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Affiliation(s)
- Swaran J S Flora
- Division of Pharmacology & Toxicology, Defence Research and Development Establishment, Jhansi Road, Gwalior 474002, India.
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Urine arsenic and hypertension in US adults: the 2003-2008 National Health and Nutrition Examination Survey. Epidemiology 2011; 22:153-61. [PMID: 21206367 DOI: 10.1097/ede.0b013e318207fdf2] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND High chronic exposure to inorganic arsenic may contribute to the development of hypertension. Limited information is available, however, on the association of low to moderate exposure to inorganic arsenic with blood pressure levels and hypertension. We investigated the association of exposure to inorganic arsenic (as measured in urine) with systolic and diastolic blood pressure levels and the prevalence of hypertension in US adults. METHODS We studied 4167 adults 20 years of age or older who participated in the National Health and Nutrition Examination Survey (NHANES) from 2003 through 2008 and for whom total arsenic, dimethylarsinate (DMA), and arsenobetaine had been assessed in urine. RESULTS The median (interquartile range) urine concentrations were 8.3 μg/L (4.2-17.1) for total arsenic, 3.6 μg/L (2.0-6.0) for DMA, and 1.4 μg/L (0.3-6.3) for arsenobetaine. The weighted prevalence of hypertension in the study population was 36%. After multivariable adjustment, a 2-fold increase in total arsenic was associated with a hypertension odds ratio of 0.98 (95% confidence interval = 0.86-1.11). A doubling of total arsenic minus arsenobetaine was associated with a hypertension OR of 1.03 (0.94-1.14) and a doubling of DMA concentrations was associated with a hypertension OR of 1.11 (0.99-1.24). Total arsenic, total arsenic minus arsenobetaine, or DMA levels were not associated with systolic or diastolic blood pressure. CONCLUSIONS At the low to moderate levels, typical of the US population, total arsenic, total arsenic minus arsenobetaine, and DMA concentrations in urine were not associated with the prevalence of hypertension or with systolic or diastolic blood pressure levels. A weak association of DMA with hypertension could not be ruled out.
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Dutta A, Mukherjee B, Das D, Banerjee A, Ray MR. Hypertension with elevated levels of oxidized low-density lipoprotein and anticardiolipin antibody in the circulation of premenopausal Indian women chronically exposed to biomass smoke during cooking. INDOOR AIR 2011; 21:165-76. [PMID: 21118307 DOI: 10.1111/j.1600-0668.2010.00694.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
UNLABELLED This study aims to investigate whether indoor air pollution (IAP) from biomass fuel use was associated with hypertension, platelet hyperactivity, and elevated levels of oxidized low-density lipoprotein (oxLDL) and anticardiolipin antibody (aCL). We enrolled 244 biomass fuel-using (median age 34 year) and 236 age-matched control women who cooked with liquefied petroleum gas (LPG). Enzyme-linked immunosorbent assay was used to measure oxLDL in plasma and aCL in serum, flow cytometry for P-selectin expression on platelet and reactive oxygen species (ROS) generation by leukocytes, aggregometry for platelet aggregation, spectrophotometry for superoxide dismutase (SOD) in erythrocytes, and laser photometer for particulate matter <10 and 2.5 μm in diameter (PM(10) and PM(2.5), respectively) in cooking areas. Biomass users had three times more particulate pollution in kitchen, had higher prevalence of hypertension (29.5 vs. 11.0% in control, P < 0.05), elevated oxLDL (170.6 vs. 45.9 U/l; P < 0.001), platelet P-selectin expression (9.1% vs. 2.4%), platelet aggregation (23.2 vs. 15.9 Ohm), raised aCL IgG (28.7% vs. 2.1%), IgM (8.6% of vs. 0.4%), and ROS (44%) but depleted (13%) SOD. After controlling potential confounders, the changes were positively associated with PM(10) and PM(2.5) in indoor air, suggesting a positive association between IAP and increased cardiovascular risk. PRACTICAL IMPLICATIONS The study showing high risk of developing cardiovascular diseases (CVD) among poor, underprivileged women in their reproductive ages in rural India is important from public health perspectives. It may motivate the government and the regulatory agencies of the country to take a serious note of the indoor air pollution (IAP) from biomass fuel use as it threatens the health of millions of women, children, and the elderly who mostly stay indoor. We hope the findings will strengthen the demand for setting up a standard for indoor air quality in the country in the line of national ambient air quality standard. The findings may also inspire the authorities to take measures for the reduction in IAP by improving housing, kitchen ventilation, and cook stoves. Moreover, the parameters used in this study can be utilized for large, population-based studies to identify women at a higher risk of developing CVD so that medical intervention can be taken at the formative stage of a disease.
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Affiliation(s)
- A Dutta
- Department of Experimental Hematology, Chittaranjan National Cancer Institute, Kolkata, India
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Goncharov A, Pavuk M, Foushee HR, Carpenter DO. Blood pressure in relation to concentrations of PCB congeners and chlorinated pesticides. ENVIRONMENTAL HEALTH PERSPECTIVES 2011; 119:319-25. [PMID: 21362590 PMCID: PMC3059993 DOI: 10.1289/ehp.1002830] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2010] [Accepted: 11/01/2010] [Indexed: 05/17/2023]
Abstract
BACKGROUND Residents of Anniston, Alabama, live near a Monsanto plant that manufactured polychlorinated biphenyls (PCBs) from 1929 to 1971 and are relatively heavily exposed. OBJECTIVES The goal of this study was to determine the relationship, if any, between blood pressure and levels of total serum PCBs, several PCB groups with common actions or structure, 35 individual PCB congeners, and nine chlorinated pesticides. METHODS Linear regression analysis was used to determine the relationships between blood pressure and serum levels of the various contaminants after adjustment for age, body mass index, sex, race, smoking, and exercise in 394 Anniston residents who were not taking antihypertensive medication. RESULTS Other than age, total serum PCB concentration was the strongest determinant of blood pressure of the covariates studied. We found the strongest associations for those PCB congeners that had multiple ortho chlorines. We found the associations over the full range of blood pressure as well as in those subjects whose blood pressure was in the normal range. The chlorinated pesticides showed no consistent relationship to blood pressure. CONCLUSIONS In this cross-sectional study, serum concentrations of PCBs, especially those congeners with multiple ortho chlorines, were strongly associated with both systolic and diastolic blood pressure.
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Affiliation(s)
- Alexey Goncharov
- Department of Environmental Health Sciences, School of Public Health and
- Institute for Health and the Environment, University at Albany, Rensselaer, New York, USA
| | - Marian Pavuk
- Agency for Toxic Substances and Disease Registry, Atlanta, Georgia, USA
| | - Herman R. Foushee
- Survey Research Unit, University of Alabama–Birmingham, Birmingham, Alabama, USA
| | - David O. Carpenter
- Department of Environmental Health Sciences, School of Public Health and
- Institute for Health and the Environment, University at Albany, Rensselaer, New York, USA
- Address correspondence to D.O. Carpenter, Institute for Health and the Environment, 5 University Place, Rensselaer, NY 12144 USA. Telephone: (518) 525-2660. Fax: (518) 525-2665. E-mail:
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Esch L, Hendryx M. Chronic Cardiovascular Disease Mortality in Mountaintop Mining Areas of Central Appalachian States. J Rural Health 2011; 27:350-7. [DOI: 10.1111/j.1748-0361.2011.00361.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hajalilou B, Mosaferi M, Khaleghi F, Jadidi S, Vosugh B, Fatehifar E. Effects of abandoned arsenic mine on water resources pollution in north west of iran. Health Promot Perspect 2011; 1:62-70. [PMID: 24688901 DOI: 10.5681/hpp.2011.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Accepted: 07/07/2011] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Pollution due to mining activities could have an important role in health and welfare of people who are living in mining area. When mining operation finishes, environ-ment of mining area can be influenced by related pollution e.g. heavy metals emission to wa-ter resources. The present study was aimed to evaluate Valiloo abandoned arsenic mine ef-fects on drinking water resources quality and possible health effects on the residents of min-ing area in the North West of Iran. METHODS Water samples and some limited composite wheat samples in downstream of min-ing area were collected. Water samples were analyzed for chemical parameters according to standard methods. For determination of arsenic in water samples, Graphite Furnace Atomic Absorption Spectrometric Method (GFAAS) and for wheat samples X - Ray Fluorescence (XRF) and Inductively Coupled Plasma Method (ICP) were used. Information about possible health effects due to exposure to arsenic was collected through interviews in studied villages and health center of Herris City. RESULTS The highest concentrations of arsenic were measured near the mine (as high as 2000 µg/L in Valiloo mine opening water). With increasing distance from the mine, concentration was decreased. Arsenic was not detectable in any of wheat samples. Fortunately, no health effects had been reported between residents of studied area due to exposure to arsenic. CONCLUSION Valiloo abandoned arsenic mine has caused release of arsenic to the around en-vironment of the mine, so arsenic concentration has been increased in the groundwater and also downstream river that requires proper measures to mitigate spread of arsenic.
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Affiliation(s)
- Behzad Hajalilou
- Department of Geology, Payame Noor University of Iran, Tabriz, Iran
| | - Mohammad Mosaferi
- National Public Health Management Center (NPMC), Department of Environmental Health Engineering, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fazel Khaleghi
- Department of Geology, Islamic Azad University, Tabriz Branch, Tabriz, Iran
| | - Sakineh Jadidi
- Department of Geology, Payame Noor University of Iran, Tabriz, Iran
| | - Bahram Vosugh
- Department of Geology, Payame Noor University of Iran, Tabriz, Iran
| | - Esmail Fatehifar
- Environmental Engineering Research Center (EERC), Sahand University of Technology, Tabriz, Iran
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Padovani AMS, Molina MF, Mann KK. Inhibition of liver x receptor/retinoid X receptor-mediated transcription contributes to the proatherogenic effects of arsenic in macrophages in vitro. Arterioscler Thromb Vasc Biol 2010; 30:1228-36. [PMID: 20339114 DOI: 10.1161/atvbaha.110.205500] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To determine whether arsenic inhibits transcriptional activation of the liver X receptor (LXR)/retinoid X receptor (RXR) heterodimers, thereby impairing cholesterol efflux from macrophages and potentially contributing to a proatherogenic phenotype. METHODS AND RESULTS Arsenic is an important environmental contaminant and has been linked to an increased incidence of atherosclerosis. Previous findings showed that arsenic inhibits transcriptional activation of type 2 nuclear receptors, known to heterodimerize with RXR. Environmentally relevant arsenic doses decrease the LXR/RXR ligand-induced expression of the LXR target genes (ABCA1 and SREBP-1c). Arsenic failed to decrease cAMP-induced ABCA1 expression, suggesting a selective LXR/RXR effect. This selectivity correlated with the ability of arsenic to decrease LXR/RXR ligand-induced, but not cAMP-induced, cholesterol efflux. By using chromatin immunoprecipitation assays, we found that arsenic inhibits the ability of LXR/RXR ligands to induce activation markers on the ABCA1 and SREBP-1c promoters and blocks ligand-induced release of the nuclear receptor coexpressor (NCoR) from the promoter. Arsenic did not alter the ability of LXR to transrepress inflammatory gene transcription, further supporting our hypothesis that RXR is the target for arsenic inhibition. CONCLUSIONS Exposure to arsenic enhances the risk of atherosclerosis. We present data that arsenic inhibits the transcriptional activity of the liver X receptor, resulting in decreased cholesterol-induced gene expression and efflux from macrophages. Therefore, arsenic may promote an athersclerotic environment by decreasing the ability of macrophages to efflux excess cholesterol, thereby favoring increased plaque formation.
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Affiliation(s)
- Alessandra M S Padovani
- Segal Cancer Centre, Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
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Abstract
Arsenic, which is commonly found in drinking water, is a potent toxicant, but little is known about its effects on maternal health. Arsenic's modes of action include enzyme inhibition and oxidative stress as well as immune, endocrine, and epigenetic effects. A couple of studies reported increased blood pressure and anemia during pregnancy. Susceptibility to arsenic is dependent on the biomethylation, which occurs via one-carbon metabolism. Methylarsonic acid and dimethylarsinic acid are main metabolites in urine, and elevated methylarsonic acid is considered a general risk factor. Arsenic easily passes the placenta, and a few human studies indicate a moderately increased risk of impaired fetal growth and increased fetal and infant mortality. The fetus and infant are probably partly protected by the increased methylation of arsenic during pregnancy and lactation; the infant is also protected by low arsenic excretion in breast milk. Early-life exposure may induce changes that will become apparent much later in life.
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Affiliation(s)
- Marie Vahter
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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Straub AC, Klei LR, Stolz DB, Barchowsky A. Arsenic requires sphingosine-1-phosphate type 1 receptors to induce angiogenic genes and endothelial cell remodeling. THE AMERICAN JOURNAL OF PATHOLOGY 2009; 174:1949-58. [PMID: 19349368 DOI: 10.2353/ajpath.2009.081016] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Arsenic in drinking water is a major public health concern as it increases risk and incidence of cardiovascular disease and cancer. Arsenic exposure affects multiple vascular beds, promoting liver sinusoidal capillarization and portal hypertension, ischemic heart disease, peripheral vascular disease, and tumor angiogenesis. While Rac1-GTPase and NADPH oxidase activities are essential for arsenic-stimulated endothelial cell signaling for angiogenesis or liver sinusoid capillarization, the mechanism for initiating these effects is unknown. We found that arsenic-stimulated cell signaling and angiogenic gene expression in human microvascular endothelial cells were Pertussis toxin sensitive, indicating a G-protein coupled signaling pathway. Incubating human microvascular endothelial cells with the sphingosine-1-phosphate type 1 receptor (S1P(1)) inhibitor VPC23019 or performing small interfering RNA knockdown of S1P(1) blocked arsenic-stimulated HMVEC angiogenic gene expression and tube formation, but did not affect induction of either HMOX1 or IL8. Liver sinusoidal endothelial cells (LSECs) defenestrate and capillarize in response to aging and environmental oxidant stresses. We found that S1P(1) was enriched on LSECs in vivo and in primary cell culture and that VPC23019 inhibited both sphingosine-1-phosphate-stimulated and arsenic-stimulated LSEC oxidant generation and defenestration. These studies identified novel roles for S1P(1) in mediating arsenic stimulation of both angiogenesis and pathogenic LSEC capillarization, as well as demonstrating a role for S1P(1) in mediating environmental responses in the liver vasculature, providing possible mechanistic insight into arsenic-induced vascular pathogenesis and disease.
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Affiliation(s)
- Adam C Straub
- Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, USA
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Wade TJ, Xia Y, Wu K, Li Y, Ning Z, Le XC, Lu X, Feng Y, He X, Mumford JL. Increased mortality associated with well-water arsenic exposure in Inner Mongolia, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2009; 6:1107-23. [PMID: 19440436 PMCID: PMC2672378 DOI: 10.3390/ijerph6031107] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2009] [Accepted: 02/24/2009] [Indexed: 11/17/2022]
Abstract
We conducted a retrospective mortality study in an Inner Mongolian village exposed to well water contaminated by arsenic since the 1980s. Deaths occurring between January 1, 1997 and December 1, 2004 were classified according to underlying cause and water samples from household wells were tested for total arsenic. Heart disease mortality was associated with arsenic exposure, and the association strengthened with time exposed to the water source. Cancer mortality and all-cause mortality were associated with well-water arsenic exposure among those exposed 10-20 years. This is the first study to document increased arsenic-associated mortality in the Bayingnormen region of Inner Mongolia.
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Affiliation(s)
- Timothy J. Wade
- US Environmental Protection Agency, National Health and Environmental Effects Research Laboratory, Chapel Hill, North Carolina, USA; E-mail:
| | - Yajuan Xia
- Inner Mongolia Center for Endemic Disease Control and Research, Huhhot, Inner Mongolia, China; E-mails:
(Y.X.);
(K.W.);
(Y.L.)
| | - Kegong Wu
- Inner Mongolia Center for Endemic Disease Control and Research, Huhhot, Inner Mongolia, China; E-mails:
(Y.X.);
(K.W.);
(Y.L.)
| | - Yanhong Li
- Inner Mongolia Center for Endemic Disease Control and Research, Huhhot, Inner Mongolia, China; E-mails:
(Y.X.);
(K.W.);
(Y.L.)
| | - Zhixiong Ning
- Ba Men Anti Epidemic Station, Bayingnormen, Inner Mongolia, China; E-mail:
| | - X Chris Le
- University of Alberta, Department of Public Health Sciences, Edmonton, Canada; E-mails:
(X.C.L);
(X.L.)
| | - Xiufen Lu
- University of Alberta, Department of Public Health Sciences, Edmonton, Canada; E-mails:
(X.C.L);
(X.L.)
| | - Yong Feng
- Hangjin Hou Centers for Disease Control, Hangjin Hou, Inner Mongolia, China; E-mail:
| | - Xingzhou He
- Chinese Academy of Preventative Medicine, Institute of Environmental Health &Engineering, Beijing, China; E-mail:
| | - Judy L. Mumford
- US Environmental Protection Agency, National Health and Environmental Effects Research Laboratory, Chapel Hill, North Carolina, USA; E-mail:
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Abstract
Even at high concentrations, arsenic-contaminated water is translucent, tasteless, and odorless. Yet almost every day, studies report a continually increasing plethora of toxic effects that have manifested in exposed populations throughout the world. In this article we focus on recent findings, in particular those associated with major contributions since 2006. Early life exposure, both in utero and in childhood, has been receiving increased attention, and remarkable increases in consequent mortality in young adults have been reported. New studies address the dose-response relationship between drinking-water arsenic concentrations and skin lesions, and new findings have emerged concerning arsenic and cardiovascular disease. We also review the increasing epidemiological evidence that the first step of methylation of inorganic arsenic to monomethylated arsenic (MMA) is actually an activation step rather than the first step in detoxification, as once thought. Hexavalent chromium differs from arsenic in that it discolors water, turning the water yellow at high concentrations. A controversial issue is whether chromium causes cancer when ingested. A recent publication supports the original findings in China of increased cancer mortality in a population where well water turned yellow with chromium.
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Affiliation(s)
- Allan H. Smith
- School of Public Health, University of California, Berkeley, California 94720; ,
| | - Craig M. Steinmaus
- School of Public Health, University of California, Berkeley, California 94720; ,
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Environmental geochemistry of high arsenic groundwater at western Hetao plain, Inner Mongolia. ACTA ACUST UNITED AC 2008. [DOI: 10.1007/s11707-009-0004-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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50
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States JC, Srivastava S, Chen Y, Barchowsky A. Arsenic and cardiovascular disease. Toxicol Sci 2008; 107:312-23. [PMID: 19015167 DOI: 10.1093/toxsci/kfn236] [Citation(s) in RCA: 229] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Chronic arsenic exposure is a worldwide health problem. Although arsenic-induced cancer has been widely studied, comparatively little attention has been paid to arsenic-induced vascular disease. Epidemiological studies have shown that chronic arsenic exposure is associated with increased morbidity and mortality from cardiovascular disease. In addition, studies suggest that susceptibility to arsenic-induced vascular disease may be modified by nutritional factors in addition to genetic factors. Recently, animal models for arsenic-induced atherosclerosis and liver sinusoidal endothelial cell dysfunction have been developed. Initial studies in these models show that arsenic exposure accelerates and exacerbates atherosclerosis in apolipoprotein E-knockout mice. Microarray studies of liver mRNA and micro-RNA abundance in mice exposed in utero suggest that a permanent state of stress is induced by the arsenic exposure. Furthermore, the livers of the arsenic-exposed mice have activated pathways involved in immune responses suggesting a pro-hyperinflammatory state. Arsenic exposure of mice after weaning shows a clear dose-response in the extent of disease exacerbation. In addition, increased inflammation in arterial wall is evident. In response to arsenic-stimulated oxidative signaling, liver sinusoidal endothelium differentiates into a continuous endothelium that limits nutrient exchange and waste elimination. Data suggest that nicotinamide adenine dinucleotide phosphate oxidase-derived superoxide or its derivatives are essential second messengers in the signaling pathway for arsenic-stimulated vessel remodeling. The recent findings provide future directions for research into the cardiovascular effects of arsenic exposure.
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Affiliation(s)
- J Christopher States
- Department of Pharmacology and Toxicology, University of Louisville, Louisville, Kentucky 40292, USA.
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