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Case–control study of bladder cancer and exposure to arsenic in Argentina
Abstract
Studies have found increased bladder cancer risks associated with high levels of arsenic in drinking water, but little information exists about risks at lower concentrations. Ecologic studies in Argentina have found increased bladder cancer mortality in Córdoba Province, where some wells are contaminated with moderate arsenic concentrations. This population-based bladder cancer case-control study in two Córdoba counties recruited 114 case-control pairs, matched on age, sex, and county, during 1996-2000. Water samples, particularly from wells, were obtained from subjects' current residences and residences in the last 40 years. Statistical analyses showed no evidence of associations with exposure estimates based on arsenic concentrations in drinking water. However, when well-water consumption per se was used as the exposure measure, time-window analyses suggested that use of well water more than 50 years before interview was associated with increased bladder cancer risk. This association was limited to ever smokers (odds ratio = 2.5, 95% confidence interval: 1.1, 5.5 for 51-70 years before interview), and the possibility that this association is due to chance cannot be excluded. This study suggests lower bladder cancer risks for arsenic than predicted from other studies but adds to evidence that the latency for arsenic-induced bladder cancers may be longer than previously thought.
... No statistical difference was found in grading of carcinoma regarding level of arsenic in drinking water as p value was 1.000 (obtained by Fisher Exact test). Bates et al (2004) showed that there was no association of bladder cancer with either measure; however, among smokers, but not among nonsmokers, positive trends in risk were found for exposures estimated for decade-long time periods. Exposures were in the range 0.5-160 microgram/liter. ...
... The data raise the possibility that smoking potentiates the effect of arsenic on risk of bladder cancer. However, the risk estimates obtained are much higher than predicted on the basis of the results of the Taiwanese studies, raising concerns about bias or the role of chance 21 . This study results supports the current study. ...
Background: Arsenic is a heavy metal and it is considered carcinogenic to humans. In Bangladesh, most of the people consume arsenic polluted water above the nationally accepted level. Several studies have demonstrated that the ingestion of arsenic in drinking water is a strong risk factor for several malignancies including urothelial carcinoma. Clinicopathological features of bladder cancer are related to the amount of arsenic exposure and duration of arsenic exposure into the urinary tract and other risk factors. Aim of the study was to see the relationship between grades of bladder cancers with the level of arsenic in drinking water. Objective: To see the relationship between the grades of bladder cancer with the level of arsenic in drinking water. Materials and Methods: This was a retrospective cross-sectional study done in the department of urology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka. In this study, a total of 72 histopathologically proven urothelial bladder carcinoma and history of at least 10 year underground water consumption patients were enrolled. Among them 12 patients were excluded from the study because no arsenic was found in sample underground drinking water. So, 60 patient was participants for this study. Sample of participant’s drinking water was collected by a selective non-reactive container. The level of arsenic level in microgram/Liter was measured by standard kit method and the level of arsenic was recorded. Results: Arsenic exposure 30 years or more was regardless of the amount of arsenic consumption in drinking water was found high-grade cancer. No significant statistical difference was found in the grading of carcinoma with the level of arsenic in drinking water. Conclusion: Arsenic exposure amount is not related to the grades of bladder cancer rather the duration of arsenic exposure in drinking water is related to the grades of bladder cancer. Bangladesh J. Urol. 2021; 24(2): 141-145
... A total of 8 studies were included in the meta-analysis of the risk of bladder cancer ( Figure 1B). 20,[24][25][26][27][28][29][30] Three studies were from the United States, and one each from Argentina, Bangladesh, Chile, Finland, and Taiwan (Table 2). A detailed description of the studies is included in Supplemental Appendix 3. ...
... for an increase of 10 mg/L. Results stratified by smoking status were reported in 4 studies [25][26][27]29 : The meta-analysis of results among nonsmokers resulted in an RR of 0.99 (95% CI: 0.93-1.06) for an increase of 10 mg/L; the corresponding RR among smokers was 1.03 (95% CI: 0.99-1.07). ...
Background
Exposure to high levels of arsenic in drinking water has been associated with an increased risk of lung and bladder cancer, but the presence of an increased risk at low levels is questionable.
Methods
A systematic review and a dose–response meta-analysis were conducted on risk estimates of lung and bladder cancer for exposure to arsenic in drinking water up to 150 µg/L, using a 2-stage approach based on a random-effects model.
Results
Five studies of lung cancer were identified; the meta-relative risk (RR) for an increase of 10 µg/L arsenic level was 1.03 (95% confidence interval [CI]: 0.99-1.06; P heterogeneity = .05). The meta-analysis of bladder cancer included 8 studies; the meta-RR for an increase of 10 µg/L arsenic level was 1.02 (95% CI: 0.97-1.07, P heterogeneity = .01). Sensitivity analyses, including a 1-stage meta-regression, confirmed the main findings.
Conclusion
This systematic review and meta-analysis provided evidence of a lack of an increased risk of lung and bladder cancer for exposure to arsenic in drinking water up to 150 µg/L, the highest concentration studied.
... This limit had been adopted by Italy too, through the Legislative Decree No. 31 of 2 February 2001, implementing the European Union Council Directive 98/83/EC of 3 November 1998 on the quality of water intended for human consumption. Epidemiologic studies on As exposure have shown carcinogenic effects on bladder, lung, skin, kidneys, prostate and liver, and non-carcinogenic effects on skin (Bates et al. 2004;Celik et al. 2008;Hopenhayn-Rich et al. 1998;Yuan et al. 2010;Lewis et al. 1999;Wadhwa et al. 2011), cardiovascular and respiratory diseases, diabetes and reproductive system diseases (Navas-Acien et al. 2006;Moon et al. 2012;Sanchez et al. 2016). This evidence has been observed in countries such as Bangladesh, Taiwan, Chile and Argentina with a high-level As concentration in drinking water (> 300 µg/l). ...
... The evidence of the association between low-level As exposure and cancer present in literature mainly derives from observational or case-control studies, frequently without individual exposure measurements. Although several studies have found an association with skin cancer (Leonardi et al. 2012), bladder cancer (Bates et al. 2004;Hopenhayn-Rich et al. 1996;Kurttio et al. 1999), and respiratory system cancer (Ferreccio et al. 2000), many other studies did not show any association or, in some cases, they observed a protective effect of these cancer sites (Baastrup et al. 2008;Chen et al. 2010;Han et al. 2009). In conclusion, the current evidence is insufficient to affirm that an association between these cancer sites and low-level As exposure exists. ...
Background:
Studies on low-level As exposure have not found an association with cancer, while increased risks were reported for skin lesions, respiratory and cardiovascular diseases and reproductive outcomes. Prospective observational studies with individual exposure measures are needed to study low-level As exposure effects. In a geothermal area in Southern Tuscany (Italy), characterized by a natural presence of As in drinking water (< 50 µg/l), As urinary concentrations were measured in a survey in 1998 and cohort members were followed to evaluate the effects on health.
Methods:
Around 900 subjects (20-55 years old) randomly sampled in 4 municipalities of the area (Monte Amiata), have been followed from 1999 to 2015, by hospitalisation and mortality registries. Standardized Hospitalisation Ratios (SHRs) were performed, compared to a reference area. Competing-risks regression models were performed to test the association between As urinary concentration and risk of first hospitalisation.
Results:
SHRs show various increased risks, more frequently among males. Internal analyses show a positive association between As and skin diseases in the general population, the Hazard Ratio (HR) for 1 µg/l increase of As urinary concentration is 1.06 (90%CI 1.01-1.11) and in males, HR 1.08 (90%CI 1.02-1.14), between As and circulatory system diseases in males, HR 1.03 (90%CI 1.01-1.05).
Conclusions:
The results suggest an effect on skin diseases and circulatory system diseases and, considering the relative young age of cohort members, they could be considered also as predictive of future severer diseases.
... Inorganic arsenic compounds found in potable groundwater are commonly recognized as carcinogens implicated in the development of lung and skin cancer [20], and the World Health Organization recommends that their concentration in drinking water should not exceed 10 mg/L [21]. Studies conducted in Argentina [22], Chile [23], USA [24], and Taiwan [25] have linked contamination with arsenic to the development of bladder cancer at concentrations of > 0.2 mg/L of drinking water [22][23][24][25]. ...
... Inorganic arsenic compounds found in potable groundwater are commonly recognized as carcinogens implicated in the development of lung and skin cancer [20], and the World Health Organization recommends that their concentration in drinking water should not exceed 10 mg/L [21]. Studies conducted in Argentina [22], Chile [23], USA [24], and Taiwan [25] have linked contamination with arsenic to the development of bladder cancer at concentrations of > 0.2 mg/L of drinking water [22][23][24][25]. ...
The article discusses the most important causes of bladder cancer, related to lifestyle (smoking, diet) and exposure to carcinogenic substances, and presents available chemoprevention strategies. Based on the current state of knowledge, it enumerates the factors of proven and potential role in reducing the incidence rate of the disease.
... Some evidence suggests that arsenic exposure is more strongly associated with transitional-cell carcinoma of the urinary bladder than with other types of urinary-bladder cancer (Guo et al. 1997, Chiou et al. 2001. Most studies found associations with cancer of the lung, urinary bladder, or prostate at lower arsenic concentrations than those reported in the Taiwanese study cited above; however, the evidence for carcinogenic effects at very low concen-trations of arsenic is inconclusive (Kurttio et al. 1999, Lewis et al. 1999, Ferreccio et al. 2000, Chiou et al. 2001, Steinmaus et al. 2003, Bates et al. 2004. In some studies of urinary-bladder cancer, an association with arsenic exposure was observed only when the analysis was limited to smokers and to arsenic exposures that had occurred at least 40 years previously (Steinmaus et al. 2003, Bates et al. 2004. ...
... Most studies found associations with cancer of the lung, urinary bladder, or prostate at lower arsenic concentrations than those reported in the Taiwanese study cited above; however, the evidence for carcinogenic effects at very low concen-trations of arsenic is inconclusive (Kurttio et al. 1999, Lewis et al. 1999, Ferreccio et al. 2000, Chiou et al. 2001, Steinmaus et al. 2003, Bates et al. 2004. In some studies of urinary-bladder cancer, an association with arsenic exposure was observed only when the analysis was limited to smokers and to arsenic exposures that had occurred at least 40 years previously (Steinmaus et al. 2003, Bates et al. 2004. ...
... It is known that prolonged drinking of water with high concentrations of As (> 10 μg/L) can cause skin lesions and cancerous and non-cancerous systemic alterations (Biaggini et al. 1993), leading to chronic arsenic poisoning. Arsenic health problems have been documented in different sectors of the province and also in other areas of the Pampean Plain (Goyenechea 1917;Ayerza 1918;Hopenhayn-Rich et al. 1996;Bates et al. 2004;Steinmaus et al. 2010). ...
Las Peñas stream basin, developed in the Pampean Mountains of Córdoba (Argentina), has hydrogeological characteristics of high interest for local human activities. The objective of this study is to interpret the influence of the geomorphological and lithological features of the basin, their control on the main hydrodynamic and hydrochemical processes and the factors that constrain the occurrence of arsenic (As) in groundwater. The unconfined aquifer develops in fractured rocks and sediments of diverse origin and provenance. Hydraulic gradients and groundwater geochemistry are conditioned by lithology and relief. The groundwater is mainly fresh (electrical conductivities between 586 and 2000 µS/cm), although there are brackish-type samples (up to 3900 µS/cm) located in the piedmont. The groundwater showed calcium and sodium bicarbonate geochemical types, with the local occurrence of mixed types (sodium-calcium bicarbonate and sodium bicarbonate-sulfate). The dominant geomorphological and lithological aspects condition the chemical composition of groundwater while controlling the distribution and concentration of As in solution. The highest As values were found in gently undulating reliefs where loess sediments prevail, especially in the main relict paleosurface area located in the upper basin. Taking this into account, it is assumed that the abundant volcanic glass—which is known as an arsenic bearer—in the regional sediments, is the possible source of this chemical element as a result of hydrolysis. Also, desorption processes in Fe and Mn oxy-hydroxides present in the loess sediments are related to the passage of As ions to the solution. As it is known, not only the source but a specific geochemical environment to allow the transference of chemical elements from minerals to groundwater is needed. In this way, the results, including a multivariate statistical analysis, demonstrate that the highest As values in groundwater, well correlated with high fluoride (F) contents, are related to an alkaline environment of sodium bicarbonate groundwater with high pH values.
... The health effects of exposure to high levels of arsenic in drinking water are well documented in studies of populations exposed in endemic areas, such as some Asian countries (Bangladesh, Taiwan, Vietnam, India), Argentina, Chile, and several areas of the United States (Arizona, California and Nevada) [2][3][4][5][6][7][8][9][10]. Based on sufficient evidence of carcinogenicity in humans and limited evidence of carcinogenicity in animals, arsenic and inorganic arsenic compounds have been classified by the International Agency for Research on Cancer (IARC) in Group 1 (carcinogenic to humans), due to an increased risk of lung, bladder and skin cancers [11]. ...
Background
Arsenic in drinking water is a global public health concern. This study aims to investigate the association between chronic low-level exposure to arsenic in drinking water and health outcomes in the volcanic area of Mt. Amiata in Italy, using a residential cohort study design.
Methods
Chronic exposure to arsenic in drinking water was evaluated using monitoring data collected by the water supplier. A time-weighted average arsenic exposure was estimated for the period 2005–2010. The population-based cohort included people living in five municipalities in the Mt. Amiata area between 01/01/1998 and 31/12/2019. Residence addresses were georeferenced and each subject was matched with arsenic exposure and socio-economic status. Mortality and hospital discharge data were selected from administrative health databases. Cox proportional hazard models were used to test the associations between arsenic exposure and outcomes, with age as the temporal axis and adjusting for gender, socio-economic status and calendar period.
Results
The residential cohort was composed of 30,910 subjects for a total of 407,213 person-years. Analyses reported risk increases associated with exposure to arsenic concentrations in drinking water > 10 µg/l for non-accidental mortality (HR = 1.07 95%CI:1.01–1.13) and malignant neoplasms in women (HR = 1.14 95%CI:0.97–1.35). Long-term exposure to arsenic concentrations > 10 µg/l resulted positively associated with several hospitalization outcomes: non-accidental causes (HR = 1.06 95%CI:1.03–1.09), malignant neoplasms (HR = 1.10 95%CI:1.02–1.19), lung cancer (HR = 1.85 95%CI:1.14–3.02) and breast cancer (HR = 1.23 95%CI:0.99–1.51), endocrine disorders (HR = 1.13 95%CI:1.02–1.26), cardiovascular (HR = 1.12 95%CI:1.06–1.18) and respiratory diseases (HR = 1.10 95%CI:1.03–1.18). Some risk excesses were also observed for an exposure to arsenic levels below the regulatory standard, with evidence of exposure-related trends.
Conclusions
Our population-based cohort study in the volcanic area of Mt. Amiata showed that chronic exposure to arsenic concentrations in drinking water above the current regulatory limit was associated with a plurality of outcomes, in terms of both mortality and hospitalization. Moreover, some signs of associations emerge even at very low levels of exposure, below the current regulatory limit, highlighting the need to monitor arsenic concentrations continuously and implement policies to reduce concentrations in the environment as far as possible.
... Besides health damage, excess consumption of As induced water also cause several socioeconomic issues, loss of productivity, work loss, the earning potential of the affected people, and the social exclusion problem (Maddison et al., 2005;Mahanta et al., 2016;Pitt et al., 2015;Roy, 2008;Thakur and Gupta 2019). High concentrations of As in water is a global concern; the previous research indicates the presence of As from Latin America (Bates et al., 2004;Bundschuh et al., 2021;Khan et al., 2020;Litter et al., 2019a;Marshall et al., 2007), Australia and New Zealand (Gu et al., 2020;Rahman et al., 2014;Ashmore et al., 2019), North America (Cheung et al., 2020;Heck et al., 2009;Nachman et al., 2017;Steinmaus et al., 2003;Wang and Mulligan 2006), Europe (Ahmad et al., 2020;European Food Safety Authority et al., 2021;Menon et al., 2020;Niksic et al., 2016). The presence of excess As in Groundwater and soil have been reported from Africa (Abiye and Bhattacharya 2019; Ahoulé et al., 2015;Bretzler et al., 2017;Usese et al., 2017), and from the Asia (Chakraborti et al., 2015(Chakraborti et al., , 2017Chen et al., 2004;Mukherjee et al., 2006;Thakur and Gupta 2016;Uppal et al., 2019). ...
The paper studies the impact of socioeconomic factors on households' willingness-to-pay (WTP) for drinking water in Bihar, India. The data were collected from 420 households through a primary survey from two arsenic affected districts. A linear regression model was used to examine the causal relationship among various socioeconomic factors and their influence on household decision to pay for water services. Around 84% of the surveyed respondents were willing to pay for better-quality water sources. Households value the good water quality, which resulted in good health, and, therefore, influenced the household decision to pay and opt for the services. Average As concentration level were found to be 130.4 μg/L and 115.2 μg/L in 2013 and 2019, respectively. The results found that socioeconomic factors that influence overall WTP are: households' income, age, education, awareness, arsenic concentration levels, and visit to the doctor. Education of the household's head and awareness are interlinked, and more education causes a shift in water sources from poor quality to safer one. WTP for better-quality drinking water were estimated through Contingent Valuation Method (CVM). The annual WTP for the individual households and for the study area were estimated at INR 240 ($4.13) and INR 17.1 ($0.29) million, respectively. The inference of the results may be used in implementing of new policies for providing arsenic free drinking water in the affected areas.
... En la zona central de Argentina, se muestran correlaciones positivas y significativas entre los niveles de este químico en aguas de consumo y esta enfermedad en diferentes órganos en estudios ecológicos (29,30). En paralelo, un estudio que utilizó otra metodología de marcadores urinarios en casos y controles confirmó los hallazgos anteriores (31); además, otro análisis de casos y controles mostro la relación con niveles en aguas de consumo y el tiempo de exposiciones prolongadas (32). Por otro lado, la asociación hallada específicamente con respecto al cáncer de pulmón ya es bien conocida en la bibliografía. ...
Objetivo
La mortalidad por cáncer en la región centro de Argentina está dentro de las más elevadas del país. Dos posibles escenarios ambientales podrían explicar esta situación, su actividad agrícola y la calidad del agua de consumo. El objetivo del estudio es evaluar la interacción existente entre estas variables.
Métodos
Estudio retrospectivo de diseño ecológico. Se analizaron decenios de superficies sembradas totales (SST) y el porcentaje de población expuesta a niveles elevados de arsénico y nitratos en aguas de consumo en relación con las tasas de mortalidad total (TMT) y órgano-específicas (TME); se calculó el coeficiente de correlación de Spearman.
Resultados
Se hallaron correlaciones positivas y significativas entre los dos primeros decenios de SST y el primer decenio de TMT, así como correlaciones con cáncer de pulmón, páncreas y colon en hombres; y con cáncer de colon en mujeres. Los niveles elevados de arsénico se asocian con las TMT en ambos sexos y en todos los decenios, aunque de manera específica con cáncer de pulmón en hombres. No se hallaron correlaciones significativas con nitratos.
Conclusiones
La asociación entre las SST y las TMT y TME presentan mayor intensidad cuanto más cerca están entre ellas temporalmente, y expresan un mayor impacto de los cultivos más antiguos. La asociación entre las TMT y el consumo de aguas arsenicales, así como la hallada en TME de pulmón en hombres y colon en mujeres, muestran que esta exposición histórica es central para entender las condiciones epidemiológicas regionales. Se deben explorar fuerzas sinérgicas entre estas variables.
... Many Indian states, mostly those situated in the Ganga-Brahmaputra flood plains, experiencing the occurrence of elevated As concentrations in groundwater, which is higher than the WHO limit of 10 μgL − 1 reported by several researchers Goswami et al., 2020aGoswami et al., , 2022Shaji et al., 2021). Association between cancer and As concentration has been demonstrated by epidemiologic studies, which often rely on measurements of past exposure through the various pathways (Bates et al., 2004). However, because As concentrations keep on changing over time and As induced cancers are latent (up to 20 years), one should not rely on single measurements for accurate estimation of long-term exposure (Thundiyil et al., 2007). ...
The upper Brahmaputra floodplain (UBF) is highly enriched with geogenic contaminants, mostly the Arsenic (As), owing to its sensitive geomorphology, aquifer groundwater (GW) dynamics, huge sediment deposition along with natural and anthropogenic disturbance significantly accelerate the As leaching rate into the groundwater, leading to an increase the health risk. Concerning the above active processes in the Lakhimpur district of UBF, current work aims to investigate seasonal dynamics of As contamination and associated health hazard for local community. To carry out this study, 51 GW samples analysed which reveal the seasonal variation in As concentrations with the minimum average concentration in the monsoon season (4.7 μg.L⁻¹) and the maximum in the post-monsoon season (18.5 μg.L⁻¹) with 50% of the samples exceeding permissible limits. The differences in the local geological conditions and the GW flow may contribute to the spatial variations in mean As concentration in the study area. Also, the active GW recharge process identified in post-monsoon season accelerates the As leaching in the area's aquifers. Further, results indicate higher As levels associated with a pH range of 6–7 favours As desorption from minerals under reducing conditions. The hazard index indicates that the children population has high carcinogenic risk compared to adult populations. Furthermore, the study highlights the social risk potential arising from public health crises due to As exposure. Overall, results indicate high As concentrations in region with moderate seasonal variability and demand a dire attention for long-term monitoring to provide sustainable water resources to safeguard the people at risk.
... Clear exposure-response relationships have been shown between arsenic exposure and the risk of cancer [13,14]. Case-control studies indicate that a long latent stage between exposure and cancer diagnosis exists [15][16][17]. ...
... De nombreuses études épidémiologiques cas-témoins et de cohortes indiquent un excès de risque de cancer de l'arbre urinaire dans les populations consommant une eau contaminée par l'arsenic [28,140]. Ces études ont été conduites par de multiples équipes et dans plusieurs pays : à Taïwan [140], en Argentine [140,267], au Chili [140,264], au Japon [268] et aux USA [269]. ...
Contexte et objectifs
À la demande de la direction générale de la santé (DGS), la HAS et la STC ont coordonné l’élaboration d’une recommandation de bonne pratique à l’intention des professionnels de santé, pour le dépistage, la prise en charge et le suivi des populations résidant sur des sites et sols pollués ou à risque de pollution par l’arsenic inorganique (Asi).
Résultats et principales recommandations
Les principales sources d’exposition de la population générale à l’Asi sont alimentaires et constituées par l’eau et les céréales, en particulier le riz. Ce bruit de fond est assez important, avec des prises moyennes de 0,2 à 0,4 μg/kg pc/j et des 95es percentiles compris entre 0,5 et 0,8 μg/kg/j, selon les tranches d’âge ; les enfants âgés de 7 à 12 mois sont la fraction la plus exposée du fait de l’alimentation. Dans les sites dont le sol est pollué par l’Asi, le principal mode de contamination est l’ingestion de poussières et de terre ; les enfants de moins de 7 ans, en particulier, ceux âgés de 6 mois à 4 ans sont la fraction de la population la plus exposée ; des surexpositions sont également prévisibles chez les individus plus âgés mais géophages ou onychophages et à un moindre degré chez les consommateurs habituels de légumes produits localement (en particulier, les légumes-feuilles) ou d’eau locale (hors celle du réseau public). La bioaccessibilité (fraction dissoute dans le tube digestif et disponible pour y être absorbée) de l’Asi des sols et le risque de surexposition associé sont très variables. Les effets sur la santé de l’exposition chronique à l’Asi sont nombreux et divers. Les effets critiques (ceux qui surviennent pour les expositions les plus faibles) sont : pour les effets à seuil de dose des anomalies de la pigmentation et de la kératinisation de la peau ; pour les effets sans seuil de dose, des carcinomes cutanés baso-cellulaires et épidermoïdes en cas d’exposition par voie orale et des cancers broncho-pulmonaires pour la voie respiratoire. Les valeurs toxicologiques de référence (VTR) retenues par le groupe de travail sont : 0,3 μg/kg pc/j pour les effets à seuil de dose, toutes voies confondues et pour les effets sans seuil, des excès de risque unitaire (ERU) de respectivement, 1,5.10⁻³ par μg/kg pc/j par voie orale et 3,3.10⁻³ par μg/m³, par voie respiratoire. L’indicateur biologique d’exposition (IBE) de référence pour l’Asi est la somme des concentrations urinaires de l’Asi, de l’acide méthylarsonique (MMA) et de l’acide diméthylarsinique (DMA). Cette somme (ΣAs) est un bon indicateur de l’exposition récente (des derniers jours) à l’Asi. Les produits de la mer (animaux ou végétaux) contenant du DMA, ils ne doivent pas être consommés dans les 3 jours précédant le prélèvement urinaire qui doit être réalisé dans des conditions propres à prévenir toute contamination externe. Dans la population générale résidant en France et en l’absence d’exposition à une source spécifique d’Asi, ΣAs est généralement inférieure à 10 μg/g créatinine et 11 μg/L. Cependant, on manque de données chez les individus de moins de 18 ans, en particulier chez les moins de 6 ans. Le seuil de 25 mg/kg de poussière ou de terre constitue la limite supérieure de la concentration d’Asi dans les sols dits « ordinaires » dans le référentiel de l’INRA utilisé par la Méthodologie nationale de gestion des sites et sols pollués. Les évaluations réalisées par le groupe de travail ont montré que, à ce niveau, lorsque la bioaccessibilité de l’Asi était de 100 %, le risque de surexposition des enfants de 6 mois à 4 ans et des individus plus âgés géophages ou onychophages était élevé. Il est donc recommandé de rechercher une surexposition à l’Asi, lorsque la concentration de sa fraction bioaccessible dans le sol est > 25 mg/kg. Les populations cibles du dépistage des surexpositions sont alors : les enfants âgés de 6 mois à 4 ans ; les femmes enceintes ou envisageant de débuter une grossesse, si elles sont géophages ou onychophages ou si elles consomment des légumes produits localement, de l’eau extraite localement (hors l’eau du réseau public), si elles jardinent ou ont des activités de loisir exposant aux poussières de sol ; les individus de tous âges avec pica, géophagie ou onychophagie. L’outil du dépistage est ΣAs et les valeurs limites sont de 10 μg/g créatinine chez les personnes de plus de 12 ans, 10 μg/g créatinine + 11 μg/L chez les autres. Dans les sites pollués par l’Asi, il est recommandé de constituer une base de données rassemblant et conservant tous les résultats des évaluations biométrologiques des expositions : pour la traçabilité de ces dernières, à l’usage des intéressés, de leurs familles et des professionnels de santé concernés ; également, pour des analyses périodiques, guidant les actions de prévention et évaluant leur efficacité. Il n’est recommandé de rechercher des complications de l’exposition à l’Asi, sur un site pollué que lorsque le dépistage a montré des cas de surexposition (voir ci-dessus). La population-cible de cette recherche de complications n’est pas la même que celle visée par la recherche de surexpositions. Les complications sont surtout attendues chez les individus surexposés depuis longtemps. Il est recommandé de ne les rechercher que chez les personnes dont l’exposition (séjour sur un site dont l’Asi bioaccessible des sols est > 25 mg/kg) cumulée est d’au moins 5 ans et dont l’exposition a débuté avant l’âge de 4 ans et/ou qui ont une durée cumulée d’au moins un an de consommation habituelle de légumes produits localement ou d’eau locale (hors celle du réseau public) et/ou qui ont ou ont eu sur le site un pica, une géophagie ou une onychophagie. Les effets sur la santé à rechercher sont, en première intention, des troubles de la pigmentation et de la kératinisation cutanée, associés ou non à des carcinomes de la peau. Les autres effets possibles de l’exposition à l’Asi ne nécessitent d’être recherchés que si des signes cutanés sont présents. Les médecins locaux doivent recevoir une formation spécifique sur les complications possibles de l’exposition à l’Asi, les caractéristiques des personnes à risque et les modalités du diagnostic. La collaboration avec les spécialistes hospitalo-universitaires loco-régionaux est indispensable pour ces formations et la confirmation des diagnostics. En cas de dépassement du ou des seuils biométrologiques de référence, la personne concernée ou son entourage adulte doit être informée des causes probables de ce dépassement et des mesures à prendre pour prévenir d’autres contaminations. L’efficacité de ces mesures préventives est vérifiée par un nouveau dosage urinaire 1 à 3 mois plus tard (dans les 2 mois, s’il s’agit d’une femme enceinte). Même en l’absence de dépassement des valeurs seuils, une surveillance biométrologique est indiquée chez les individus à risque résidant sur un site ou l’Asi bioaccessible des sols est > 25 mg/kg : elle est semestrielle chez les enfants de 6 mois à 4 ans, annuelle chez ceux de 5 et 6 ans, au moins semestrielle chez les géophages, onychophages ou consommateurs habituels de légumes produits localement. De même une surveillance clinique (recherche de complications cutanées : voir ci-dessus) au moins annuelle est indiquée chez les personnes dont l’exposition cumulée est d’au moins 5 ans et dont l’exposition a débuté avant l’âge de 4 ans et/ou qui ont une durée cumulée d’au moins un an de consommation habituelle de légumes produits localement ou d’eau locale (hors celle du réseau public) et/ou qui ont ou ont eu sur le site un pica, une géophagie ou une onychophagie et/ou qui ont des antécédents personnels de dépassement des seuils biométrologiques.
... L'extrapolation aux faibles doses de courbes dose-réponse à partir de modèles linéaires n'est probablement pas adaptée au cas de l'arsenic (IRIS, 1998). Une étude récente (Bates et al. 2004) montre l'absence de lien entre la consommation d'eau potable (pendant 40 ans) contenant de l'arsenic et l'apparition de cancer de la vessie en Argentine.Toutefois, malgré ces limites, l'US-EPA a maintenu sa position en établissant sa VTR pour les cancers cutanés. ...
... Clear exposure-response relationships have been shown between arsenic exposure and the risk of cancer [13,14]. Case-control studies indicate that a long latent stage between exposure and cancer diagnosis exists [15][16][17]. ...
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This volume, closely related to MILS-6, deals mainly with metal(loid)-alkyl derivatives but also with the rarer aryl compounds. Most of these (commonly toxic) compounds are formed in the environment by microorganisms, but some anthropogenic input occurs as well. MILS-7, providing a most up-to-date view, is of special relevance for researchers in analytical and bioinorganic chemistry, enzymology, environmental chemistry, physiology, toxicology, and related medical fields.
... We explored whether carcinogens other than AA and arsenic could contribute to the high incidence of UTUC in arseniasisendemic areas. Previous studies revealed possible synergy between smoking-derived carcinogens and arsenic in inducing bladder urothelial cancer (6,(28)(29)(30). However, a history of smoking was reported by only 16.9% of the 89 patients in our hospital-based UTUC cohort, and the proportion of smokers were comparable in residents of arseniasis grade 0 (14.0%) and grade 1þ2þ3 (19.6%) zones (not significantly different by x 2 ). ...
Background:
Aristolochic acids (AA) and arsenic are chemical carcinogens associated with urothelial carcinogenesis. Here we investigate the combined effects of AA and arsenic towards the risk of developing upper tract urothelial carcinoma (UTUC).
Methods:
Hospital-based (n=89) and population-based (2,921 cases, 11,684 controls) Taiwanese UTUC cohorts were used to investigate the association between exposure to AA and/or arsenic and the risk of developing UTUC. In the hospital cohort, AA exposure was evaluated by measuring aristolactam-DNA adducts in the renal cortex and by identifying A>T TP53 mutations in tumors. In the population cohort, AA exposure was determined from prescription health insurance records. Arsenic levels were graded from 0-3 based on concentrations in well water and the presence of arseniasis-related diseases.
Results:
In the hospital cohort, 43, 26, and 20 patients resided in grade 0, 1+2, and 3 arseniasis-endemic areas, respectively. Aristolactam-DNA adducts were present in >90% of these patients indicating widespread AA exposure. A>T mutations in TP53 were detected in 28%, 44% and 22% of patients residing in grade 0, 1+2, and 3 arseniasis-endemic areas, respectively. Population studies revealed that individuals who consumed more AA-containing herbs had a higher risk of developing UTUC in both arseniasis-endemic and non-endemic areas. Logistic regression showed an additive effect of AA and arsenic exposure on the risk of developing UTUC.
Conclusions:
Exposure to both AA and arsenic acts additively to increase the UTUC risk in Taiwan.
Impact:
This is the first study to investigate the combined effect of AA and arsenic exposure on UTUC.
... Previous studies suggested that As concentration levels in drinking water over 50 μg/L (BIS standard) are likely to cause various skin diseases such as Arsenicosis, arsenical dermatosis, skin-lesions, keratosis, and hyperkeratosis (Chakraborti et al., 2017;Haque et al., 2003;Guha Mazumdar 2008;Kapaj et al., 2006), and if the concentration levels in drinking water continue with more than 300 μg/L for a few years, it can lead to gangrene and various forms of cancer, such as bladder cancer, B.K. Thakur et al. lung cancer, and intestine cancer, etc. (Bates et al., 2004;Marshall et al., 2007;Steinmaus et al., 2003). The results from the household survey found that poor households are suffering more due to As-induced health problems than the well-off households. ...
This study assesses the depth of tubewell and the associated concentration of arsenic (As) in drinking water within the arsenic-affected regions in Bihar, India. A survey of 935 tubewell from two As-contaminated blocks in Bihar were conducted to collect and test the water samples. The results demonstrate that As concentration is mainly found in shallow tubewells (14–49 m deep), which is the main source of drinking water in the region in deep tubewells (>49 m deep), have arsenic concentration < 50 μg/L. The analytical results by field test kits (FTK) revealed that the levels of As in around 61% of the drinking water sources were above 10 μg/L, 20.8% samples contained arsenic 51-<100 μg/L, 16.9% contained 101-<300 μg/L, and 5.03% of the samples contained arsenic between 300 and 500 μg/L. Iron test results showed that around 74.4% of the samples contained iron at more than the prescribed 500 μg/L level of WHO. The study also revealed a general lack of awareness about the drinking water contamination and its associated health impacts. Therefore, awareness through various channels among the affected stakeholders will be helpful for the households to change their water sources (Saha et al., 2018, 2019).
... De nombreuses études épidémiologiques cas-témoins et de cohortes indiquent un excès de risque de cancer de l'arbre urinaire dans les populations consommant une eau contaminée par l'arsenic [28,140]. Ces études ont été conduites par de multiples équipes et dans plusieurs pays : à Taïwan [140], en Argentine [140,267], au Chili [140,264], au Japon [268] et aux USA [269]. ...
Résumé
Contexte et objectifs
À la demande de la Direction générale de la santé, la Haute Autorité de santé, en partenariat avec la Société de toxicologie clinique, a élaboré des recommandations pour le dépistage des surexpositions environnementales à l’arsenic inorganique (Asi) et la prise en charge des populations concernées. Nous rapportons l’étape préalable à la production de ces recommandations qui a consisté à caractériser les effets possibles sur la santé de l’Asi et les valeurs toxicologiques de référence propres (VTR) à assurer la protection de la santé de la population.
Méthode
En première intention, les monographies publiées par des agences sanitaires nationales ou internationales au cours des trois dernières décennies ont été examinées. Cette analyse a été complétée par une recherche bibliographique conduite dans Medline et Scopus, ciblée sur les publications postérieures au 1er janvier 2016, année de publication de la plus récente des évaluations publiées antérieurement.
Résultats
L’exposition répétée à l’arsenic inorganique peut être à l’origine de multiples effets sanitaires. En raison de leur apparition aux doses les plus faibles et de leurs relations dose–réponse les mieux caractérisées, les effets cutanés non cancérogènes (troubles de la pigmentation et de la kératinisation) ont été retenus comme effets critiques à seuil, avec une VTR de 0,3 μg/kg pc/j. Les effets cancérogènes critiques sont les carcinomes cutanés pour la voie orale, avec un excès de risque unitaire vie entière de 1,5 × 10⁻³ par μg/kg pc/j et les cancers bronchopulmonaires pour la voie respiratoire avec un excès de risque unitaire vie entière de 3,3 × 10⁻³ par μg/m³.
Discussion
Les principales sources d’exposition à l’arsenic inorganique de la population générale sont alimentaires (eau et céréales, en particulier riz). En France, les dernières évaluations de l’exposition alimentaire de la population indiquent que le 95e percentile est de 0,46–0,51 μg/kg pc/j chez les adultes et de 0,61–0,77 μg/kg pc/j chez les enfants de 7–12 mois (les plus fortement exposés). Ces niveaux dépassent la VTR recommandée pour la protection contre les effets à seuil et correspondent à un risque de cancer cutané de 6,9 × 10⁻⁴ à 1,2 × 10⁻³, pour une exposition vie entière. Cela implique de maintenir les autres sources d’exposition à l’Asi à des niveaux aussi faibles que possible.
... Numerous studies from LA have reported an array of adverse health effects of As including cancer, cardiovascular, lung diseases, reproductive outcome, and cognitive impairment in adults as well as children. Earlier epidemiological investigations from As endemic areas of Antofagasta in Chile and Córdoba province in Argentina have consistently reported elevated risk of bladder and lung cancer mortality in population chronically exposed to As (Bates et al., 2004;Hopenhayn-Rich et al., 1996;Marshall et al., 2007;Smith et al., 2006). A few studies from the same region have also documented As-induced kidney, liver and skin cancer (Hopenhayn-Rich et al., 1998;Yuan et al., 2010). ...
Studies conducted over the past eight years in Latin America (LA) have continued to produce new knowledge regarding health impacts of arsenic (As) in drinking water. We conducted a systematic review of 92 peer-reviewed English articles published between 2011 and 2018 to expand our understanding on these health effects. Majority of the LA studies on As have been conducted in Chile and Mexico. Additional data have emerged from As-exposed populations in Argentina, Bolivia, Brazil, Colombia, Ecuador, and Uruguay. The present review has documented recent data on the biomarkers of As exposure, genetic susceptibility and genotoxicity, and risk assessment to further characterize the health effects and exposed populations. Some recent findings on the associations of As with bladder and lung cancers, reproductive outcomes, and declined cognitive performance have been consistent with what we reported in our previous systematic review article. We have found highly convincing evidence of in utero As exposure as a significant risk factor for several health outcomes, particularly for bladder cancer, even at moderate level. New data have emerged regarding the associations of As with breast and laryngeal cancers as well as type 2 diabetes. We observed early life As exposure to be associated with kidney injury, carotid intima-media thickness, and various pulmonary outcomes in children. Other childhood effects such as low birth weight, low gestational age, anemia, increased apoptosis, and decreased cognitive functions were also reported. Studies identified genetic variants of As methyltransferase that could determine susceptibility to As related health outcomes. Arsenic-induced DNA damage and alteration of gene and protein expression have also been reported. While the scope of research is still vast, the substantial work done on As exposure and its health effects in LA will help direct further large-scale studies for more comprehensive knowledge and plan appropriate mitigation strategies.
... Arsenic (As), which is toxic to most living organisms, causes potentially serious environmental problems throughout the world because of the contamination of soils and groundwater. The use of As contaminated groundwater for drinking and cooking in many parts of the world, including Bangladesh [1] [2], Taiwan [3] [4], China [4] [5], Mexico [6], Argentina [7], Chile [8], India [9][10] [11] and Mongolia [12] has been linked to increase the incidence of keratosis, cardiovascular illnesses and certain types of cancers. Numerous technologies and processes are now available for the removal of liquid-phase As like chemical precipitation, ion exchange, adsorption onto activated alumina and Fe-(oxy)hydroxides, reverse osmosis, modified coagulation/filtration, modified lime softening, electro deposition and oxidation/filtration [13]. ...
This paper presents the adsorption behavior of arsenic (As) onto lignite in saturated column experiments under various flow rates and adsorbent thicknesses. The lignite sample originated from Indonesia is predominantly composed of organic matter with minor amounts of pyrite (FeS 2). Arsenic content of lignite is 1.8 mg/kg with high sulfur content of 10.8 wt. %. The experiments were performed at room temperature using a glass column with an inner diameter of 2.4 cm and total length of 30 cm. Different lignite bed thicknesses (6 and 12 cm) at a constant flow rate of 0.85 cm 3 /min and a fixed lignite bed thickness of 12 cm with different flow rates (0.85 and 0.22 cm 3 /min) were conducted. All effluents had acidic pH (1.04 to 3.36) and were under oxidizing conditions (Eh: +554-+629 mV) regardless of the flow rate and lignite bed thickness. The breakthrough of As indicated both leaching and adsorption regions. The leaching of As could be attributed to very high concentration of dissolved organic carbon (DOC) that competes with As for Adsorption sites. Leaching region occurs until ca. 69 mL (ca. 1.35 h) at a thinner lignite bed. After this, the concentration of As in the effluent slowly increased and then reached the influent As concentration. In contract, the retardation of As observed until ca. 159 mg/L (ca. 3.15 h) at a thicker lignite bed, indicating that the As adsorption increased substantially at thicker lignite bed. Decreasing the flow rate (0.22 cm 3 /min) had a similar effect with case 2, that is, the As adsorption increased substantially. Based on these results, As removal efficiency under flow-through conditions is strongly influenced by thickness of adsorbent but not the flow rate.
... Arsenic (As), which is toxic to most living organisms, causes potentially serious environmental problems throughout the world because of the contamination of soils and groundwater. The use of As contaminated groundwater for drinking and cooking in many parts of the world, including Bangladesh [1] [2], Taiwan [3] [4], China [4] [5], Mexico [6], Argentina [7], Chile [8], India [9][10] [11] and Mongolia [12] has been linked to increase the incidence of keratosis, cardiovascular illnesses and certain types of cancers. Numerous technologies and processes are now available for the removal of liquid-phase As like chemical precipitation, ion exchange, adsorption onto activated alumina and Fe-(oxy)hydroxides, reverse osmosis, modified coagulation/filtration, modified lime softening, electro deposition and oxidation/filtration [13]. ...
This paper presents the adsorption behavior of arsenic (As) onto lignite in saturated column experiments under various flow rates and adsorbent thicknesses. The lignite sample originated from Indonesia is predominantly composed of organic matter with minor amounts of pyrite (FeS 2). Arsenic content of lignite is 1.8 mg/kg with high sulfur content of 10.8 wt. %. The experiments were performed at room temperature using a glass column with an inner diameter of 2.4 cm and total length of 30 cm. Different lignite bed thicknesses (6 and 12 cm) at a constant flow rate of 0.85 cm 3 /min and a fixed lignite bed thickness of 12 cm with different flow rates (0.85 and 0.22 cm 3 /min) were conducted. All effluents had acidic pH (1.04 to 3.36) and were under oxidizing conditions (Eh: +554-+629 mV) regardless of the flow rate and lignite bed thickness. The breakthrough of As indicated both leaching and adsorption regions. The leaching of As could be attributed to very high concentration of dissolved organic carbon (DOC) that competes with As for Adsorption sites. Leaching region occurs until ca. 69 mL (ca. 1.35 h) at a thinner lignite bed. After this, the concentration of As in the effluent slowly increased and then reached the influent As concentration. In contract, the retardation of As observed until ca. 159 mg/L (ca. 3.15 h) at a thicker lignite bed, indicating that the As adsorption increased substantially at thicker lignite bed. Decreasing the flow rate (0.22 cm 3 /min) had a similar effect with case 2, that is, the As adsorption increased substantially. Based on these results, As removal efficiency under flow-through conditions is strongly influenced by thickness of adsorbent but not the flow rate.
... If high concentrations of arsenic in drinking water continue for more years, arsenic gangrene and cancer are likely to appear (Clarke 2001;Rahman et al. 2005;Chakraborti et al. 2010Chakraborti et al. , 2015. The clinical manifestation of arsenic also includes different forms of cancer such as skin cancer (Luster and Simeonova 2004;Rossman et al. 2004;Col et al. 1999;Guo et al. 1998), bladder cancer (Morales et al. 2000;Steinmaus et al. 2003;Bates et al. 2004), lung cancer (Hopenhayn-Rich et al. 1998;Chen et al. 2004;Chiu et al. 2004;Xia and Liu 2004;Wu et al. 2004;Marshall et al. 2007;Heck et al. 2009), as well as other non-cancer forms (Ahmed et al. 2006;Guha Mazumdar 2003;Tseng et al. 2005;James et al. 2015). Chakraborti et al. (2016a) studied the arsenic-induced health problems in the Shahpur block and found that the population is at higher risk. ...
The current paper estimates the arsenic-contaminated drinking water and its associated effects on human health. The result is based on a primary survey of 173 households from five arsenic contaminated villages from Shahpur block in the Bhojpur district from Bihar state, India. A field test kit was used to test the concentration levels of arsenic in households’ drinking water. The results of the water tests revealed that more than 60% of the drinking water has excess arsenic concentration levels (more than 0.01 mg/L of WHO standards). The incidence rate due to arsenicosis (arsenic poisoning) was more among females than males. From the survey, it was also found that skin-lesions and other health issues due to arsenic induced-problems were more acute among children and women compared to men. More than half of the respondents (51%) did not hear about arsenic poisoning, and around 13.29% of the surveyed respondents know the serious health issues due to arsenic-contaminated drinking water.
... We reviewed the water intake rates selected for the studies included by Lynch et al. (2017a) and made a few changes to improve overall consistency with the results reported in certain studies ( Bates et al. 2004;Meliker et al. 2010;Baris et al. 2016). For example, Lynch et al. (2017a) apparently assumed a default water consumption rate of 1.2 L/day for some U.S. studies (Meliker et al. 2010;Baris et al. 2016). ...
The biologic effects of inorganic arsenic predominantly involve reaction of the trivalent forms with sulfhydryl groups in critical proteins in target cells, potentially leading to various toxicologic events including cancer. This mode of action is a threshold process, requiring sufficient concentrations of trivalent arsenic to disrupt normal cellular function. Nevertheless, cancer risk assessments for inorganic arsenic have traditionally utilized various dose-response models that extrapolate risks from high doses assuming low-dose linearity without a threshold. We present here an approach for a cancer risk assessment for inorganic arsenic in drinking water that involves considerations of this threshold process. Extensive investigations in mode of action analysis, in vitro studies (>0.1 µM), and in animal studies (>2 mg/L in drinking water or 2 mg/kg of diet), collectively indicate a threshold basis for inorganic arsenic-related cancers. These studies support a threshold for the effects of arsenic in humans of 50–100 µg/L in drinking water (about 65 µg/L). We then evaluate the epidemiology of cancers of the urinary bladder, lung, and skin and non-cancer skin changes for consistency with this calculated value, focusing on studies involving low-level exposures to inorganic arsenic primarily in drinking water (approximately <150 µg/L). Based on the relevant epidemiological studies with individual-level data, a threshold level for inorganic arsenic in the drinking water for these cancers is estimated to be around 100 µg/L, with strong evidence that it is between 50 and 150 µg/L, consistent with the value calculated based on mechanistic, in vitro and in vivo investigations. This evaluation provides an alternative mode of action-based approach for assessing health-protective levels for oral arsenic exposure based on the collective in vitro, in vivo, and human evidence rather than the use of a linear low-dose extrapolation based on default assumptions and theories.
... The high prevalence of the risk factors and exposures in one region compared to another is one of the most important reasons of different BC incidence. Cigarette smoking, exposure to toxins and pesticides, and some occupations such as driving and hairdressing are identified to be associated with the high incidence of BC [63][64][65][66] . Mazandaran province, which has the highest ASR of BC among Iranian men, is one of the richest agricultural areas with high use of toxins and pesticides 67,68 . ...
Objective: There are several reports related to the incidence of bladder cancer (BC) from various geographical locations of Iran. Nevertheless, no comprehensive systematic review has conducted in this regard. Therefore, the present systematic review and meta-analysis carried out to estimate the incidence rate of BC among Iranian people.
Patients and Methods: This systematic review was done based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) in October 2017. A search was performed in five international database (Medline/PubMed, Scopus, Embase, ISI/ Web of Science, and Google Scholar), and four national databases (Scientific Information Database, MagIran, Barakat Knowledge Network System, and IranDoc). The incidence rate of BC was calculated using random-effect model.
Results: An aggregate of 226 papers was obtained in the primary search of the databases. After further refinement of the retrieved studies, 29 studies were included. The age-standardized rate of BC was 10.92, 95% CI (9.88-11.96) and, 2.80, 95% CI (2.47-3.13) in males and females, respectively.
Conclusions: The incidence of BC was lower in Iran compared to other parts of the world. However, more investigations are needed to outline the exact incidence rate and the trend of BC among Iranian population.
... In Córdoba, arsenicism health problems have been described in the northeastern part of the province by physicians for a long time ago (Ayerza 1918;Goyenechea 1917;Bates et al. 2004;Francisca and Perez 2009). High indexes of arsenuria (360-890 µg As/g creatinine) and fluoruria (1.53-2.97 ...
The studied area is part of the sandy plain of the South of Córdoba (Argentina). The objective of this work was to better understand the controls on groundwater geochemistry in the unconfined aquifer, especially in relation to arsenic occurrence and mobilization in groundwater, to provide baseline information for water managers. The aquifer shows a varied spatial geochemical pattern with fresh-to-salty water (0.4–10.0 g/L) and sodium bicarbonate-to-sodium chloride geochemical types, in some places of mixed anionic type. The groundwater dynamics and the geochemical features are influenced by changes in lithology and by large changes in relief at both a regional and a local scale. Numerical modeling suggested that the dissolution of carbonate minerals, cation exchange, and mineral hydrolysis are the main geochemical processes that support the chemical groundwater composition. Although the variation in As concentrations does not follow clear trends associated with major ion chemistry, laboratory batch tests, and geochemical modelingσ supported by statistical analysis indicated, As solubility is favored under alkaline and high pH conditions. Thus, the As values would be closely related to the desorption from the surfaces of oxides and hydroxides, due to the change in their net surface charge from positive to negative as the pH increases. The Eh–pH conditions show that the main species in solution are HAsO4²⁻. The results suggest a need to carry out epidemiological and toxicological studies which are scarce or even absent in the South of Córdoba province.
... El As-i está considerado un carcinógeno para el hombre, mientras que el DMA(V) se clasifica como probable cancerígeno (IARC, 2012). Numerosos estudios epidemiológicos han relacionado la exposición a As-i con un aumento de la incidencia de cáncer de pulmón, vejiga, piel, riñón e hígado (Chen et al., 1988;Hopenhayn-Rich et al., 1996;Hopenhayn-Rich et al., 1998;Ferreccio et al., 2000;Karagas et al., 2001;Bates et al., 2004). También se ha asociado la exposición crónica a As-i a varias patologías no cancerígenas, como lesiones en la piel (Ahsan et al., 2006), enfermedades respiratorias (Mazumder et al., 2000) y cardiovasculares (Mumford et al., 2007), diabetes tipo II (Lai et al., 1994) y retrasos en el desarrollo neuroconductual en la población infantil (Tyler y Allan, 2014). ...
El arsénico es un metaloide tóxico ampliamente distribuido en el medioambiente.Su forma inorgánica [As(III) y As(V)] es la más tóxica encontrada en agua y alimentos. La exposición a arsénico inorgánico, descrita en numerosas zonas del planeta y que en la actualidad se estima que afecta a 200 millones de personas, aumenta la incidencia de determinados tipos de cáncer y otras patologías no cancerígenas. Teniendo en cuenta que la principal vía de exposición es la oral, el
tracto gastrointestinal se considera la puerta de entrada de este tóxico al organismo; sin embargo, los estudios para determinar los efectos tóxicos del arsénico inorgánico a nivel intestinal son escasos. Esta tesis doctoral tiene como objetivo evaluar la toxicidad del arsénico inorgánico sobre el epitelio intestinal en diferentes tipos de exposición in vitro e in vivo, así como la búsqueda de componentes de la dieta que puedan contrarrestar este efecto tóxico. Para tal fin se han empleado modelos celulares de colon (Caco-2, células
procedentes de un adenocarcinoma y NCM460, línea celular no transformada) y ratones BALB/c. Como posibles estrategias de reducción de la toxicidad intestinal de este metaloide se han ensayado cepas de bacterias lácticas y suplementos dietéticos.
Los estudios in vitro ponen de manifiesto que las exposiciones de corta duración a arsénico inorgánico (2-24 h) generan un aumento de la liberación de la citoquina pro-inflamatoria IL-8 y de la generación de especies reactivas de oxígeno y/o nitrógeno en células Caco-2 y NCM460. Esta respuesta pro-inflamatoria puede ser la responsable de las modificaciones estructurales que cursan con cambios en los patrones de distribución de la zonula occludens 1 y de expresión de la claudina 1, proteínas de las uniones intercelulares que interviene en el mantenimiento de la estructura del epitelio. Paralelamente a estos efectos se evidencia una pérdida de la función barrera de las monocapas intestinales.
En las exposiciones subcrónicas in vitro (7-21 días), también se pone de manifiesto una respuesta pro-inflamatoria que se mantiene durante todo el tratamiento. Esta respuesta viene acompañada de cambios en el programa de proliferación celular y diferenciación, lo que conduce a un detrimento del proceso de reparación celular. Además, la exposición subcrónica afecta igualmente a la estructura epitelial, causando la pérdida de microvellosidades, y a la función de barrera del epitelio intestinal. Estos datos evidencian que la exposición aguda y subcrónica a arsénico inorgánico puede alterar la homeostasis intestinal, afectando la capa de la mucosa, que realiza las funciones más importantes de la pared intestinal.
Adicionalmente se ha evidenciado in vitro que exposiciones más prolongadas (6 meses) favorecen la adquisición de características tumorogénicas en células NCM460, en parte debido al mantenimiento de la respuesta pro-inflamatoria. En las células expuestas crónicamente se observa un aumento de la expresión de CD133, disminución de la expresión de CDX1 y CDX2, mayor secreción de la
metaloproteínasa de matrix MMP-2, modificaciones en el perfil de acetilación de la histona H3, aumento de la hiperproliferación y la formación de esferas flotantes. En general, estos datos sugieren que la exposición de células epiteliales de colon humano a As(III) provoca la adquisición de características de células transformadas.
Los resultados obtenidos en la exposición subcrónica in vivo confirman los datos obtenidos in vitro. Esta exposición genera estrés oxidativo y una respuesta pro-inflamatoria, evidenciada por una mayor expresión génica y proteica de las citoquinas IL-1β, IL-2 e IL-6 en el intestino grueso de animales tratados con As(III). Asimismo, se observa un efecto sobre la morfología del epitelio, con evidencias de hiperplasia en las criptas. Los tratamientos con arsénico también
reducen la expresión de la mucina 2 y posiblemente la formación de mucus. Estos efectos tóxicos pueden ser los causantes del aumento de permeabilidad observado en los animales tratados con arsénico. Este es el primer estudio que evidencia la pérdida de la función barrera del epitelio intestinal in vivo debido a una exposición a arsénico inorgánico.
Finalmente, los ensayos in vitro para evaluar el papel protector de componentes de la dieta ponen de manifiesto que determinadas cepas de Lactobacillus y ciertos suplementos dietéticos modulan la toxicidad que el arsénico inorgánico ejerce sobre el epitelio intestinal. La recuperación de la función barrera y/o de la capacidad de regeneración celular tras los tratamientos indica que estas estrategias, cuya seguridad alimentaria está probada, podrían emplearse para aminorar los efectos que ejerce el arsénico inorgánico a nivel intestinal, y posiblemente a nivel sistémico, en poblaciones afectadas.
... Chronic arsenic (As) exposure in drinking water afflicts > 140 million people in 70+ countries and contributes to various chronic diseases, notably multiple types of cancer (Smith and Steinmaus, 2009;Naujokas et al., 2013). Arsenic exposure is an established cause of bladder cancer (BCa) (Steinmaus et al., 2003;Bates et al., 2004;Chen and Ahsan, 2004;Lamm et al., 2004;Marshall et al., 2007;Chen et al., 2010;Melak et al., 2014). Exposure to high level arsenic might be associated with a 50-fold increase in mortality and a significantly higher incidence of BCa, indicating the strong carcinogenic potential of arsenic (Marshall et al., 2007;Steinmaus et al., 2014). ...
Arsenic is a known potent risk factor for bladder cancer. Increasing evidence suggests that epigenetic alterations, e.g., DNA methylation and histones posttranslational modifications (PTMs), contribute to arsenic carcinogenesis. Our previous studies have demonstrated that exposure of human urothelial cells (UROtsa cells) to monomethylarsonous acid (MMAIII), one of arsenic active metabolites, changes the histone acetylation marks across the genome that are correlated with MMAIII-induced UROtsa cell malignant transformation. In the current study, we employed a high-resolution and high-throughput liquid chromatography tandem mass spectrometry (LC-MS/MS) to identify and quantitatively measure various PTM patterns during the MMAIII-induced malignant transformation. Our data showed that MMAIII exposure caused a time-dependent increase in histone H3 acetylation on lysine K4, K9, K14, K18, K23, and K27, but a decrease in acetylation on lysine K5, K8, K12, and K16 of histone H4. Consistent with this observation, H3K18ac was increased while H4K8ac was decreased in the leukocytes collected from people exposed to high concentrations of arsenic compared to those exposed to low concentrations. MMAIII was also able to alter histone methylation patterns: MMAIII transformed cells experienced a loss of H3K4me1, and an increase in H3K9me1 and H3K27me1. Collectively, our data shows that arsenic exposure causes dynamic changes in histone acetylation and methylation patterns during arsenic-induced cancer development. Exploring the genomic location of the altered histone marks and the resulting aberrant expression of genes will be of importance in deciphering the mechanism of arsenic-induced carcinogenesis.
... 13 El arsénico inorgánico ingerido pasa al torrente sanguíneo, donde se enlaza a la hemoglobina y en 24 horas puede encontrarse en el hígado, riñones, vejiga, pulmones, bazo y piel. 15,16 Los órganos de mayor almacenamiento son la piel, el hueso y el músculo. Su acumulación en la piel se relaciona con su reacción sobre las proteínas que poseen grupos sulfihidrilo. ...
Aim: To disclose scientific knowledge about hydroarsenicism in Latin America, as well as to determine the presence of arsenic in water used for human consumption in risk areas of Costa Rica, specifically at the Central, Oreamuno, Paraíso and Alvarado counties of the province of Cartago. Methods: Quantification of inorganic arsenic by hydride generation and flame atomic absorption, according to method 7062 of the US Agency of Environmental Protection. Results: None of the analyzed samples surpassed the maximum limit of 10 µg/L allowed by the present Costa Rican legislation. Conclusion: Even though sampled areas are of volcanic nature and therefore of arsenic risk, the population consumes water of direct underground origin with a great superficial influence and little or no contact to deeper volcanic rock, thus not contaminated with arsenic.
... Some studies found no evidence to support exposureresponse trends at low water or biomarker concentrations of arsenic. [11][12][13][14] However, more common were findings of elevated risks restricted to subsets of the study cohorts characterized by differences in smoking history, exposure duration, timing, [15][16][17] or degree of urbanization. 18 Several studies reported monotonic exposure-response trends for bladder or lung cancer, with elevated risks in cohorts exposed to water arsenic concentrations that extended below 100 μg/l; however, increases in risk for the individual cohorts only achieved statistical significance at exposures greater than 100 μg/l. ...
Increased risks of lung and bladder cancer have been observed in populations exposed to high levels of inorganic arsenic. However, studies at lower exposures (i.e., less than 100 μg/l in water) have shown inconsistent results. We therefore conducted an ecological analysis of the association between historical drinking water arsenic concentrations and lung and bladder cancer incidence in U.S. counties. We used drinking water arsenic concentrations measured by the U.S. Geological Survey and state agencies in the 1980s and 1990s as proxies for historical exposures in counties where public groundwater systems and private wells are important sources of drinking water. Relationships between arsenic levels and cancer incidence in 2006–2010 were explored by Poisson regression analyses, adjusted for groundwater dependence and important demographic covariates. The median and 95th percentile county mean arsenic concentrations were 1.5 and 15.4 μg/l, respectively. Water arsenic concentrations were significant and positively associated with female and male bladder cancer, and with female lung cancer. Our findings support an association between low water arsenic concentrations and lung and bladder cancer incidence in the United States. However, the limitations of the ecological study design suggest caution in interpreting these results.
... Epidemiological data regarding the association between high levels of inorganic As exposure (>100 mg/l) and all cancer risk, have shown a positive association especially for bladder (Chen et al., 1986); (Bates et al., 2004); (Chiou et al., 2001); (Chen et al., 1986;Ferreccio et al., 2000;Kurttio et al., 1999), lung (Chen et al., 1986,Ferreccio et al., 2000 and skin tumors (Cabrera and Gomez, 2003); (Gerstenfeld et al., 2012). For concentrations <100 mg/l the association is more doubtful. ...
Prostate cancer is the most common cancer in men in many industrialized countries. A role for androgens in prostate tumor progression is well recognized, while estrogens may cooperate with androgens in prostate carcinogenesis. The incidence of prostate cancer is highly variable in the different countries, suggesting an important role of environmental factors. Heavy metals are common environmental contaminants and some of them are confirmed or suspected human carcinogens. Some metals are endowed with estrogenic and/or androgenic activities and may play a role as cancer risk factors through this mechanism. Moreover, prostate cancer may present alterations in the intracellular balance of trace metals, such as zinc and copper, which are involved in several regulatory proteins. Herein, we review the possible role of environmental heavy metals and of metal-dyshomeostasis in prostate cancer development and promotion as well as the potential use of some metals in the prevention and therapy of prostate cancer.
... In Córdoba, arsenicism health problems have been described in the northeastern part of the province by physicians for a long time ago (Ayerza 1918;Goyenechea 1917;Bates et al. 2004;Francisca and Perez 2009). High indexes of arsenuria (360-890 µg As/g creatinine) and fluoruria (1.53-2.97 ...
The phreatic aquifer of the Los Jagüeies basin is made up principally of Quaternary loessic sediments. It has sodium bicarbonate (high and middle basin) and sodium sulfate (lower basin) water, with fluoride and arsenic concentrations that exceed the permissible limits for human consumption. The major contents of fluoride and arsenic are found in the middle basin, where the predominance of loess, bicarbonate waters, and the highest Na +/Ca ++ index values coincide, The fluoride is derived from the main components of loess, with onion exchange being the most important release mechanism. Arsenic is derived from the alteration of volcanic glass and, although it is generally related to reducing conditions, it occurs in the basin under oxidizing conditions. In this paper, some appropriate techniques to lower the concentrations of fluoride and arsenic are suggested.
... Arsenic exposure at an early age may also lead to disease later in life (Dauphine et al., 2011). Arsenic is a known carcinogen which has also been associated with decreased lung function and increased susceptibility to respiratory infections and cardiovascular effects (Ahsan et al., 2006(Ahsan et al., , 2000Bates et al., 2004;Chen et al., 1995;Dauphine et al., 2011;Navas-Acien et al., 2005;Lantz et al., 2009). ...
Children living near contaminated mining waste areas may have high exposures to metals from the environment. This study investigates whether exposure to arsenic and lead is higher in children in a community near a legacy mine and smelter site in Arizona compared to children in other parts of the United States and the relationship of that exposure to the site. Arsenic and lead were measured in residential soil, house dust, tap water, urine, and toenail samples from 70 children in 34 households up to 7 miles from the site. Soil and house dust were sieved, digested, and analyzed via ICP-MS. Tap water and urine were analyzed without digestion, while toenails were washed, digested and analyzed. Blood lead was analyzed by an independent, certified laboratory. Spearman correlation coefficients were calculated between each environmental media and urine and toenails for arsenic and lead. Geometric mean arsenic (standard deviation) concentrations for each matrix were: 22.1 (2.59) ppm and 12.4 (2.27) ppm for soil and house dust (<63 μm), 5.71 (6.55) ppb for tap water, 14.0 (2.01) μg/L for specific gravity-corrected total urinary arsenic, 0.543 (3.22) ppm for toenails. Soil and vacuumed dust lead concentrations were 16.9 (2.03) ppm and 21.6 (1.90) ppm. The majority of blood lead levels were below the limit of quantification. Arsenic and lead concentrations in soil and house dust decreased with distance from the site. Concentrations in soil, house dust, tap water, along with floor dust loading were significantly associated with toenail and urinary arsenic but not lead. Mixed models showed that soil and tap water best predicted urinary arsenic. In our study, despite being present in mine tailings at similar levels, internal lead exposure was not high, but arsenic exposure was of concern, particularly from soil and tap water. Naturally occurring sources may be an additional important contributor to exposures in certain legacy mining areas.
... Cuando los autores utilizaron el consumo de agua de pozo como medida de la exposición, y una ventana de tiempo para el uso del agua de pozo de más de 50 años antes de la entrevista, se observó asociación con un mayor riesgo de desarrollo de cáncer de vejiga. Este estudio sugiere un menor riesgo de cáncer de vejiga para el As que las previstas en otros estudios, pero se suma a la evidencia de que la latencia para los cánceres de vejiga inducidos por el As puede ser más largo de lo que se pensaba (133). ...
Pesticides, as substances extensively used in agriculture, are applied worldwide for the control of pest and disease vectors; and play an important role among the substances to which man is exposed. Information about the impact of its use on food quality, human health and environmental pollution in Argentina is available since the 70s. As a major agricultural producing country, the application of growing quantities of pesticides had, and still has, its impact on the quality of the environment. An important agricultural change, occurred in recent years in Argentina, was the introduction of glyphosate-resistant transgenic soy bean, which brought a significant increase in crop yields and sown areas, but it has also generated a considerable increase of the use of a technological package based on genetically modified seeds, glyphosate and other pesticides such as endosulfan, chlorpyrifos and pyrethroids. The results of recent research leaves no doubt about the potential risk of contamination, either by drift during pesticide application or leaching flows, generating potential risks to aquatic biota and humans, especially by pesticides cypermethrin, chlorpyrifos, endosulfan and glyphosate. While organophosphorus pesticides (POF) cause neurobehavioral alterations in young people, levels of biomarkers of exposure to organochlorine pesticides (OCPs) in biological fluids of environmentally exposed humans tend to decrease, probably due to the prohibitions and restrictions on its use. In parallel, research results indicate probable cytotoxic and genotoxic effects of glyphosate which is worrisome, since it would involve a potential risk to human health and to the environment.
Simple Summary
This study explores the potential use of retinoic acid in treating a severe form of bladder cancer, known as basal muscle-invasive bladder cancer (MIBC), which is among the deadliest cancers in the United States of America. All-trans retinoic acid (tretinoin), commonly used in the differentiation therapy of blood cancer, is investigated in this study for its efficacy against MIBC. By treating bladder cancer cells with tretinoin, the study aimed to determine whether it could diminish the aggressive behavior of these cells. The findings show promising results, suggesting that tretinoin can indeed make the basal muscle cancer cells less aggressive by reducing cell proliferation and increasing differentiation markers. This research could lead to new treatment approaches that improve survival chances for patients with basal muscle-invasive bladder cancer.
Abstract
Bladder cancer (BC) is the eighth most common cause of cancer death in the United States of America. BC is classified into non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC). Genetically, MIBCs are categorized into the more aggressive basal subtype or less aggressive luminal subtype. All-trans retinoic acid (tretinoin), the ligand for the RAR-RXR retinoic acid receptor, is clinically used as a differentiation therapy in hematological malignancies. This study aims to determine the effects of retinoic acid on arsenite-transformed malignant urothelial cells (UROtsa As), serving as a model for basal muscle-invasive bladder cancer. We treated three independent isolates of arsenite-transformed malignant human urothelial UROtsa cells (UROtsa As) with tretinoin for 48 h. Cell viability, proliferation, and apoptosis were analyzed using crystal violet staining and flow cytometry. mRNA and protein level analyses were performed using RT-qPCR and the Simple Western™ platform, respectively. Tretinoin was found to reduce cell proliferation and urosphere formation, as well as decrease the expression of basal markers (KRT1, KRT5, KRT6, EGFR) and increase the expression of luminal differentiation markers (GATA3, FOXA1). Mechanistically, the antiproliferative effect of tretinoin was attributed to the downregulation of c-myc. Our results suggest that targeting the retinoic acid pathway can diminish the aggressive behavior of basal muscle-invasive urothelial cancer and may enhance patient survival.
Metalloids are released into the environment due to the erosion of the rocks or anthropogenic activities, causing problems for human health in different world regions. Meanwhile, microorganisms with different mechanisms to tolerate and detoxify metalloid contaminants have an essential role in reducing risks. In this review, we first define metalloids and bioremediation methods and examine the ecology and biodiversity of microorganisms in areas contaminated with these metalloids. Then we studied the genes and proteins involved in the tolerance, transport, uptake, and reduction of these metalloids. Most of these studies focused on a single metalloid and co-contamination of multiple pollutants were poorly discussed in the literature. Furthermore, microbial communication within consortia was rarely explored. Finally, we summarized the microbial relationships between microorganisms in consortia and biofilms to remove one or more contaminants. Therefore, this review article contains valuable information about microbial consortia and their mechanisms in the bioremediation of metalloids.
In recent times Gallbladder cancer (GBC) incidences increased many folds in India and are being reported from arsenic hotspots identified in Bihar. The study aims to establish association between arsenic exposure and gallbladder carcinogenesis. In the present study, n = 200 were control volunteers and n = 152 confirmed gallbladder cancer cases. The studied GBC patient’s biological samples-gallbladder tissue, gallbladder stone, bile, blood and hair samples were collected for arsenic estimation. Moreover, n = 512 gallbladder cancer patients blood samples were also evaluated for the presence of arsenic to understand exposure level in the population. A significantly high arsenic concentration (p < 0.05) was detected in the blood samples with maximum concentration 389 µg/L in GBC cases in comparison to control. Similarly, in the gallbladder cancer patients, there was significantly high arsenic concentration observed in gallbladder tissue with highest concentration of 2166 µg/kg, in gallbladder stones 635 µg/kg, in bile samples 483 µg/L and in hair samples 6980 µg/kg respectively. Moreover, the n = 512 gallbladder cancer patient’s blood samples study revealed very significant arsenic concentration in the population of Bihar with maximum arsenic concentration as 746 µg/L. The raised arsenic concentration in the gallbladder cancer patients’ biological samples—gallbladder tissue, gallbladder stone, bile, blood, and hair samples was significantly very high in the arsenic exposed area. The study denotes that the gallbladder disease burden is very high in the arsenic exposed area of Bihar. The findings do provide a strong link between arsenic contamination and increased gallbladder carcinogenesis.
Background
In recent times Gallbladder cancer (GBC) incidences increased many folds in India. Majority of GBC cases are being reported from arsenic hotspots identified in Bihar.
Methods
In this prospective study volunteers were selected who underwent surgery in our cancer institute. There were 11 control benign gallbladder cases and 28 confirmed gallbladder cancer cases. Their biological samples such as blood, gallbladder tissue, gallbladder stone, bile and hair samples were collected for arsenic estimation. Moreover, n=512 gallbladder cancer patients blood samples were evaluated for the presence of arsenic to understand exposure level in the population.
Results
A significantly high arsenic concentration (p<0.05) was detected in the blood samples, gallbladder tissue, gallstones, bile and hair samples in comparison to the control group. Moreover, n=512 blood samples of GBC patients had significantly very high arsenic concentration.
Conclusions
The study shows very high arsenic concentration observed in the blood, gallbladder tissue, gallbladder stone, bile and hair samples in GBC cases in comparison to the benign control cases indicates the correlation between chronic arsenic exposure and gallbladder cancer incidences in eastern Indo-Gangetic plains region. The study also makes an attempt to establish the likely correlation/association between arsenic exposure and gallbladder cancer disease.
Abundant epidemiological evidence has shown that there is a strong causal relationship between long-term exposure to inorganic arsenic (iAs) through drinking water and a few types of cancer (e.g., lung and bladder cancer). Traditionally, a linear low-dose extrapolation assumption was applied in risk assessment for iAs which resulted in a relatively conservative cancer risk estimate. Growing biological evidence suggests that the mode of action of iAs-induced cancer follows a threshold process (e.g., sufficient concentration of trivalent arsenic is required to disrupt normal cellular function). In this study, we applied the benchmark dose (BMD) methodology to model the relationship between the relative risk of bladder and lung cancer and the iAs concentration in drinking water using the high-quality epidemiological data reported in recently published papers, with a special focus on the low exposure range (i.e., <150 μg/L). Because of its biological plausibility and statistical flexibility, the Hill model has been chosen to model the data under a Bayesian framework. A Bayesian hierarchal model together with a bootstrap method for exposure estimation were applied to quantify uncertainty from various sources, including the within-study, between-study, and exposure uncertainties. Dose-response assessment results obtained from a number of alternative model structures and methods consistently demonstrate a threshold type dose-response curve with a threshold in the range between 40 to 60 μg/L of iAs concentration in drinking water. The BMD for iAs in drinking water associated with 0.1% increase in relative risk of bladder cancer is 42.2 μg/L (BMDL 39.2 μg/L); for 0.05% increase, the BMD is 41.6 μg/L (BMDL 38.6 μg/L). For lung cancer, the two counterpart BMD estimates are 57.0 μg/L (BMDL 43.6 μg/L) and 55.7 μg/L (BMDL 42.5 μg/L) for 0.1% and 0.05% increase, respectively. These analyses provide additional statistical support for a non-linear dose response for cancer risk from inorganic arsenic which may have important policy implications.
Background
Many studies neglect to account for variation in population served by community water systems (CWSs) when aggregating CWS-level contaminant concentrations to county level.
Objective
In an ecological epidemiologic analysis, we explored two methods—unweighted and weighted (proportion of CWS population served by county population)—to account for population served by CWS in association between arsenic and three cancers to determine the impact of population served on aggregated measures of exposure.
Methods
CWS arsenic concentration data for 19 states were obtained from Centers for Disease Control and Prevention (CDC) National Environmental Public Health Tracking Network for 2000–10, aggregated to county level, and linked to county-level cancer data for 2011–5 from National Cancer Institute and CDC State Cancer Profiles. Negative binomial regression models estimated adjusted risk ratios (aRR) and 95% confidence intervals (CI) between county-level bladder, colorectal, and kidney cancers and quartiles of aggregated cumulative county-level arsenic concentration (ppb-years).
Results
We observed positive associations between the highest quartile of exposure, compared to the lowest, of aggregated cumulative county-level arsenic concentration (ppb-year) for bladder [weighted aRR: 1.89(1.53, 2.35)], colorectal [1.64(1.33, 2.01)], and kidney [1.69(1.37, 2.09)] cancers. We observed stronger associations utilizing the weighted exposure assessment method. However, inferences from this study are limited due to the ecologic nature of the analyses and different analytic study designs are needed to assess the utility that the weighted by CWS population served metric has for exposure assessment.
Significance
Weighting by CWS population served accounts for some potential exposure assignment error in epidemiologic analysis.
When assessing the human risks due to exposure to environmental chemicals, traditional dose-response analyses are not straightforward when there are numerous high-quality epidemiological studies of priority cancer and non-cancer health outcomes. Given this wealth of information, selecting a single "best" study on which to base dose-response analyses is difficult and would potentially ignore much of the available data. Therefore, systematic approaches are necessary for the analysis of these rich databases. Examples are meta-analysis (and further, meta-regression), which are well established methods that consider and incorporate information from multiple studies into the estimation of risks due to exposure to environmental contaminants. In this paper, we propose a hierarchical, Bayesian meta-analysis approach for the dose-response analysis of multiple epidemiological studies. This paper is the second of two papers detailing this approach; the first covered "pre-analysis" steps necessary to prepare the data for dose-response modeling. This paper focuses on the hierarchical Bayesian approach to dose-response modeling and extrapolation of risk to populations of interest using the association between bladder cancer and oral inorganic arsenic (iAs) exposure as an illustrative case study. In particular, this paper addresses the modeling of both case-control and cohort studies with a flexible, logistic model in a hierarchical Bayesian framework that estimates study-specific slopes, as well as a pooled slope across all studies. This approach is akin to a random effects model in which no assumption is made a priori that there is a single, common slope for all included studies. Further, this paper also details extrapolation of the estimates of logistic slope to extra risk in a target population using a lifetable analysis and basic assumptions about background iAs exposure levels. In this case, the target population was the general United States population and information on all-cause mortality and incidence and mortality from bladder cancer was used to perform the lifetable analysis. The methods herein were developed for general use in investigating the association between any pollutant and observed health-effects in epidemiological studies. In order to demonstrate these methods, inorganic arsenic was chosen as a case study given the large epidemiological database that exists for this contaminant.
There are unique challenges in estimating dose-response with chemicals that are associated with multiple health outcomes and numerous studies. Some studies are more suitable than others for quantitative dose-response analyses. For such chemicals, an efficient method of screening studies and endpoints to identify suitable studies and potentially important health effects for dose-response modeling is valuable. Using inorganic arsenic as a test case, we developed a tiered approach that involves estimating study-specific margin of exposure (MOE)-like unitless ratios for two hypothetical scenarios. These study-specific unitless ratios are derived by dividing the exposure estimated to result in a 20% increase in relative risk over the background exposure (RRE20) by the background exposure, as estimated in two different ways. In our case study illustration, separate study-specific ratios are derived using estimates of United States population background exposure (RRB-US) and the mean study population reference group background exposure (RRB-SP). Systematic review methods were used to identify and evaluate epidemiologic studies, which were categorized based on study design (case-control, cohort, cross-sectional), various study quality criteria specific to dose-response analysis (number of dose groups, exposure ascertainment, exposure uncertainty), and availability of necessary dose-response data. Both case-control and cohort studies were included in the RRB analysis. The RRE20 estimates were derived by modeling effective counts of cases and controls estimated from study-reported adjusted odds ratios and relative risks. Using a broad (but not necessarily comprehensive) set of epidemiologic studies of multiple health outcomes selected for the purposes of illustrating the RRB approach, this test case analysis would suggest that diseases of the circulatory system, bladder cancer, and lung cancer may be arsenic health outcomes that warrant further analysis. This is suggested by the number of datasets from adequate dose-response studies demonstrating an effect with RRBs close to 1 (i.e., RRE20 values close to estimated background arsenic exposure levels).
Abstrak: Arsen adalah elemen jejak bersifat toksik dan dapat menyebabkan berbagai dampak negatif terhadap kesehatan manusia. Salah satu sumber paparan arsen untuk manusia adalah melalui air tanah. Air tanah yang terindikasi memiliki kandungan arsen tinggi salah satunya adalah air tanah yang berada pada lokasi yang terpengaruh oleh sistem panas bumi. Kontaminasi arsen pada air tanah merupakan suatu permasalahan global yang cukup serius dan telah didapati kontaminasi arsen pada air tanah terjadi di Taiwan, Chile, Bangladesh, Argentina, Meksiko, China, dan India. Sub-DAS Ciwidey merupakan area di salah satu lereng Gunung Patuha yang terletak di selatan Cekungan Bandung memiliki banyak manifestasi panas bumi yang merupakan salah satu sumber polutan alami yang merupakan polutan vulkanogenik. Penelitian yang dilakukan pada sampel air tanah dangkal di Sub-DAS Ciwidey menunjukkan bahwa konsentrasi arsen berkisar 0.001 mg/l sampai dengan 3.25 mg/l, melebihi batas aman yang telah ditetapkan oleh WHO dan Indonesia yaitu 0.01 mg/l. Metode geostatistik dengan Simple Kriging tanpa transformasi memberikan hasil prediksi yang paling akurat. Interpretasi kehadiran arsen berdasarkan analisa geokimia air tanah menggunakan Diagram Schoeller menunjukkan hasil bahwa air tanah di lokasi studi berasal dari sumber yang sama, dan terpengaruh oleh sistem panas bumi. Dengan demikian, maka diperkirakan sebanyak 430,600 jiwa berisiko terpapar oleh kontaminasi arsen di air tanah dangkal yang melebihi batas aman yang telah ditetapkan WHO. Kata kunci: arsen, panas bumi, air tanah dangkal, Sub-DAS Ciwidey, metode kriging Abstract: Arsenic is a toxic trace element that can cause various negative impacts on human health. One of arsenic exposure source for humans is through groundwater. One of groundwater indicated with high arsenic content, is groundwater in a location affected by geothermal systems. Arsenic contamination in groundwater is a serious global problem and arsenic contamination in groundwater has occurred in Taiwan, Chile, Bangladesh, Argentina, Mexico, China and India. Ciwidey Sub-watershed is an area on Mount Patuha slope located in the south of Bandung Basin has many geothermal manifestations which is one source of volcanogenic pollutant, including arsenic. A study conducted on shallow groundwater samples in Ciwidey Sub-watershed showed that arsenic concentrations ranged from 0.001 mg/L to 3.25 mg/L, exceeded the safe limits established by WHO and Indonesia. Geostatistical methods with Simple Kriging without transformation provide the most accurate prediction results. Interpretation of arsenic presence based on groundwater geochemical analysis using Schoeller Diagram shows the result that groundwater at the study site comes from the same source, which is influenced by geothermal system. Thus, an estimated 430,600 people are at risk of exposure to arsenic contamination in shallow groundwater beyond the safe limits established by WHO. Keywords: arsenic, geothermal, shallow groundwater, Ciwidey Sub-watershed, kriging method
El problema del hidroarsenicismo de origen geológico-sedimentario afecta a varias provincias en Argentina, principalmente en zonas rurales carentes de redes de distribución de agua potable. En este trabajo abordaremos específicamente la identificación de niveles de As históricos y actuales en aguas de abasto público en la Provincia del Chaco. Metodológicamente, en la primera etapa se realizó el relevamiento de la información disponible en el Chaco de los entes oficiales. Posteriormente, se acudió a realizar 200 muestreos de agua de fuentes y servicios en las distintas localidades del territorio chaqueño. De este estudio, queda información actualizada a escala regional imprescindible para el planteo y desarrollo de los estudios epidemiológicos del As ≤ 50 μg/l, como así también, para establecer y actualizar algunas estrategias y planes de acción prioritarios. Además, desde el análisis de datos se deriva que es reconocible la existencia de avances concretos en materia de accesibilidad al agua segura.
The Middle Ganga Plain (MGP) is the second largest arsenic (As) contaminated groundwater zone in south-east Asia after the Bengal Delta Plain. About 90% of the total population in the MGP depends on shallow aquifer based groundwater supply for their drinking and irrigation need. More than ten million people in the alluvial belt of MGP are exposed to elevated levels of As (more than the limit set by Bureau of Indian Standards (BIS) 2012 drinking limit of 50 μgL⁻¹) in their drinking water. In the light of synthesis of groundwater As distribution in MGP, the availability of safe sources of water for drinking have been analyzed. The current study delineates two aquifer systems in MGP through the study of borehole lithologs (n = 27). The first aquifer system persists from below the top aquitard to up to ~87–126 m below ground level (bgl), while the second aquifer system starts at various depths ranging from ~116 to 139 m bgl and continues up to the depth of ~250 m bgl. Suitability of the deeper (second) aquifer system for As free drinking water has been assessed through analysis of pumping test data. The Newer Alluvium comprising the top aquitard and the upper 15–20 m slice of the first aquifer system hosts the contaminated aquifers for the depth of ~50 m below ground surface. The Pleistocene aquifers (the bottom three-fourth part of the first aquifer system and the entire second aquifer system) are low in groundwater As. The second aquifer system, existing in confined condition, can be used for community water supply through the installation of deep tube wells with a regulated draft. Community hand pumps in the depth range of 5–15 m below ground can be constructed in the sandy areas in the floodplain for drinking need of the local people. Large diameter dug wells can also be constructed to tap the replenished dynamic groundwater, which normally remains oxic and low in As.
L'arsenic reste un poison d'actualité. Son utilisation depuis l'âge de bronze n'a jamais cessée. La toxicité à l'arsenic est un problème majeur de santé publique affectant de nombreux habitants à travers le monde. En effet, on estime que 150 millions de personnes seraient exposées à de l'eau contaminée par l'arsenic. Ces chiffres pourraient être revus à la hausse dans les années à venir car de nouvelles zones touchées sont régulièrement découvertes.
Dans les pays développés, il est simple de résoudre le problème en effectuant des contrôles réguliers de l'eau destinée à la consommation humaine afin de garantir sa sécurité sanitaire. Cependant dans les pays en voie de développement, il est extrêmement compliqué de résoudre rapidement le problème de l'eau contaminée comme on le voit au Bangladesh. En effet, avec des moyens limités, il est difficile de mettre en œuvre les solutions pour décontaminer sur une grande échelle l’eau provenant des puits existants. De plus, les populations locales ne comprennent pas forcement la gravité du problème et le danger que constitue la consommation de cette eau polluée en raison de la grande latence entre sa consommation et le développement de pathologies liées à celle-ci.
Afin qu'il y ait une mobilisation mondiale pour aider ces pays, il est important de prendre conscience qu'il s'agit là de la plus grande intoxication collective de l'histoire. Il serait judicieux qu'une organisation mondiale mène une grande campagne d'information sur l'arsenic. Pour le moment, aucun attentat terroriste islamique à l'arsine n'a été recensé. Cependant, il est important d'être prêt à tout moment afin de réagir face à cette potentielle menace. Du fait de la facilité de fabrication ainsi que de son faible coût, l'attentat à l'arme chimique peut voir le jour à n'importe quel moment. Par exemple, en mars 2016, un attentat islamiste à l'arme chimique a été déjoué au Maroc. En France, le plan Piratox, le plan Orsec et le plan blanc sont adaptés pour réagir au mieux à une telle situation. Cependant, le but primordial est d'éviter absolument tout type d'attentat. Malgré une récente loi antiterroriste, les massacres continuent. Pour contrer cela, nos politiques sont en pleine réflexion pour mettre en place une nouvelle loi anti-terroriste et ils ont lancé le débat. La France va t-elle prendre des mesures à l'image des américains avec le Patriot Act ou la guerre en Irak ?
A significant relationship between arsenic exposure and non-melanoma skin cancer (NMSC) is well known. The toxicity of arsenics which develop NMSC is dependent on their species. Accordingly, total arsenic levels are unreliable for risk assessment of NMSC. However, there are few studies on quantitative exposure assessment of arsenic species in NMSC patients. To validate the contribution of each arsenic species to NMSC, we compared the creatinine-adjusted urinary concentration of arsenic species in NMSC patients and community controls. A total of 124 biopsy-proven NMSC cases and 125 age- and sex-matched community controls, drinking tap water with low-level arsenic concentration (<5 μg/L), were included in the study. High-performance liquid chromatography and inductively coupled plasma mass spectrometry were used for the measurement. The NMSC group was found to have significantly higher levels of total inorganic arsenic, trivalent and pentavalent arsenic and monomethylarsonic acid than the control group. Total arsenic, organic arsenic and dimethylarsonic acid levels were lower in the NMSC group. We suggest that inorganic arsenic species, trivalent arsenic and pentavalent arsenic may influence the prevalence of NMSC, in spite of these levels being lower than the Agency for Toxic Substances and Disease Registry-recommended standard or the levels reported by other highly contaminated areas and neighboring countries in East Asia. Furthermore, it also suggests that total arsenic level cannot represent the risk of NMSC.
More than 10 million people residing in 13 districts of the state of Bihar are facing the acute problem of arsenic contamination in drinking water. The objective of this paper is to quantify arsenic in drinking water, and to understand the associated health problems, health costs and socio-economic issues in the region. In the study, a field test kit was used to test the arsenic concentration in drinking water collected from 276 households. It was revealed that 63% of the households’ drinking water contained arsenic in the excess of 10 ppb, 19.6% had arsenic concentration between 100 and <300 ppb, and 5% of the water samples contained arsenic between 300 and 500 ppb. Also, incidences of illness were found to be more frequent among children and females than among males. Monthly household cost and monthly per capita costs for the affected households and for all the surveyed households were found to be US$ 33.8 and US$ 3.9, and US$ 11.6 and US$ 1.3, respectively. The excess concentration of arsenic in drinking water over prolonged periods is likely to cause primary, secondary and tertiary health effects, and is a serious cause of concern.
Background. The lifetime risk for urinary bladder cancer in the United States ranges from 0.5%-3%, depending on gender and ethnic group, with Caucasian males having the highest rate. Occupational exposures account for one-quarter of this risk in Caucasian males, and chemicals are central to creating this workplace hazard. Past research indicates that the aryl amines, benzidine, 2-naphthalene, and aniline dyes, are the main chemicals associated with bladder carcinogenesis. Aim. Because long-term, high-level occupational exposure to strong-inorganic-acid mists containing sulphuric acid is an established carcinogen, the relationship between occupational acid exposure and bladder cancer was tested as part of an extensive occupational cancer case-control study of 513 male hospitalized patients in the Campania Region of Italy. Patients and methods. The full dataset included exposure information on up to 20 major groups of occupational chemicals with the target cancers of lung (n = 111), laryngeal (n = 35), naso/nasal/pharyngeal (n = 22), oral cavity (n = 23) and bladder (n = 75). For this study, cases (n = 75) were defined as people with bladder cancer, whilecontrols (n = 270) were other unmatched patients with oral cavity cancers (but none of the other three target cancers) or patients with any other reason for hospitalization. Unconditional logistic regression was used to fit the acid-bladder cancer model controlling the effects of tobacco and age. Other confounders, such as alcohol and coffee consumption (the only dietary variable in our dataset) are discussed and considered, but neither was significant. Results. The results demonstrate an adjusted statistically significant association between occupational acid exposure and bladder cancer (OR = 4.09; p = 0.028). Discussion. The implications of this new finding in humans are discussed, both in the context of existing evidence, and in light of the 1992-JARC designation based on research to that time demonstrating the role of acid mixtures in the causation of upper respiratory tract cancers. Conclusion. Further research is warranted to replicate this finding.
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