Associations Between Drinking Water and Urinary Arsenic Levels and Skin Lesions in Bangladesh

Ahsan, Habibul; Perrin, Mary; Rahman, Atiqur; Parvez, Faruque; Stute, M.; Zheng, Yan; Milton, Abul Hasnat; Brandt‐Rauf, Paul W.; Geen, Alexander van; Graziano, Joseph H.

doi:10.1097/00043764-200012000-00016

Cited by 170 publications

(110 citation statements)

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“…Higher mean or median (Calderon et al, 1999;Meza et al, 2004;Valenzuela et al, 2005;Josyula et al, 2006;Rubin et al, 2007), as well as for other areas of the world (Ahsan et al, 2000;Aposhian et al, 2000;Caceres et al, 2005;Sun et al, 2007), that were known to have higher levels of arsenic in their drinking water. Median and mean total urinary arsenic levels for residents in some districts in Bangladesh have been reported to be about 50-fold higher than the respective levels in NHANES 2003(Ahsan et al, 2000Chowdhury et al, 2003) and geometric mean levels were about 70-fold higher for residents of Inner Mongolia, China (Sun et al, 2007). In the NHANES 2003-2004 subsample, only small differences in total urinary arsenic levels (and also dimethylarsinic acid) were observed among the various demographic groups.…”

Section: Discussionmentioning

confidence: 99%

Levels of urinary total and speciated arsenic in the US population: National Health and Nutrition Examination Survey 2003–2004

Caldwell

Jones

Verdon

et al. 2008

J Expo Sci Environ Epidemiol

171

110

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Objective: To provide levels of total and speciated urinary arsenic in a representative sample of the US population. Methods: For the first time, total arsenic and seven inorganic and organic arsenic species were measured in the urine of participants (n ¼ 2557) for the [2003][2004] National Health and Nutrition Examination Survey (NHANES). Data were compiled as geometric means and selected percentiles of urinary arsenic concentrations (mg/l) and creatinine-corrected urinary arsenic (mg/g creatinine) for total arsenic, dimethylarsinic acid, arsenobetaine, and a sum of the inorganic related species. Results: Arsenic acid, arsenous acid, arsenocholine, and trimethylarsine oxide were detected in 7.6%, 4.6%, 1.8%, and 0.3% of the participants, respectively (the limits of detection of 0.6-1.2 mg/l). Monomethylarsonic acid was detected in 35% of the overall population. For all participants aged Z6 years, dimethylarsinic acid (geometric mean of 3.71 mg/l) and arsenobetaine (geometric mean of 1.55 mg/l) had the greatest contribution to the total urinary arsenic levels. A relatively greater percentage contribution from arsenobetaine is seen at higher total urinary arsenic levels and from dimethylarsinic acid at lower total urinary arsenic levels. For all participants aged Z6 years, the 95th percentiles for total urinary arsenic and the sum of inorganic-related arsenic (arsenic acid, arsenous acid, dimethylarsinic acid, and monomethylarsonic acid) were 65.4 and 18.9 mg/l, respectively. For total arsenic and dimethylarsinic acid, covariate-adjusted geometric means demonstrated several slight differences due to age, gender, and race/ethnicity. Conclusions: The data reflect relative background contributions of inorganic and seafood-related arsenic exposures in the US population. Arsenobetaine and dimethylarsinic acid are the major arsenic species present with arsenobetaine, accounting for a greater proportion of total arsenic as total arsenic levels increase. Keywords: speciated arsenic, human, urine, biomonitoring, NHANES. IntroductionArsenic is an element that is widely distributed in the earth's surface in small amounts, primarily in its inorganic forms. Anthropomorphic sources of arsenic have included the smelting of mined metals. Inorganic arsenic is used currently as an outdoor wood preservative, in some pesticides, as semiconductor dopant materials, and in certain medicines. General human exposure to inorganic arsenic results from natural amounts consumed in drinking water. However, dietary arsenic may be an important source (NRC, 2001) when drinking water levels are low. Arsenic also forms organic compounds through biological action on inorganic arsenic. These organic forms are found in fish, shellfish, seaweed, and aquatic sediments and are generally much less toxic. These dietary arsenic species are commonly represented by arsenobetaine and, to a lesser extent, by arsenocholine and arsenosugars (Heinrich-Ramm et al., 2002). In addition to the arsenical forms found in marine organisms, mono-and dimethylated pentava...

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Section: Discussionmentioning

confidence: 99%

Levels of urinary total and speciated arsenic in the US population: National Health and Nutrition Examination Survey 2003–2004

Caldwell

Jones

Verdon

et al. 2008

J Expo Sci Environ Epidemiol

171

110

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“…The details of nail and hair preparation and analysis are shown in the SI. Standards including Na 2 HAsO 4 ·7H 2 O, NaAsO 2 , MMA, DMA, and arsenic-glutathione (As(Glu) 3 as detailed in the SI) were also analyzed and used in the linear combination fit.…”

Section: ■ Materials and Methodsmentioning

confidence: 99%

“…18 Arsenic Speciation in Nails and Hair Using μ-XANES. The dominant feature of nail and hair μ-XANES spectra had an absorbance edge near As(Glu) 3 (Figure 4-II). The sulfur bonded As species (As-Glu) contributed 69−76% in nail and 54−64% in hair by linear combination fit (SI Table S6).…”

Section: ■ Materials and Methodsmentioning

confidence: 99%

Arsenic Levels and Speciation from Ingestion Exposures to Biomarkers in Shanxi, China: Implications for Human Health

Cui

Shi

Jiang

et al. 2013

Environ. Sci. Technol.

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Chronic exposure to arsenic (As) threatens human health. To systematically understand the health risks induced by As ingestion, we explored water and diet contributions to As exposure, and compared As in biomarkers and the arsenicosis in a geogenic As area in China. In this study, high percentages of water (77% of n = 131 total samples), vegetables (92%, n = 120), cereals (32%, n = 25), urine (70%, n = 99), nails (76%, n = 176), and hair (62%, n = 61) contained As higher than the acceptable levels. Dietary As contributed 92% of the average daily dose (ADD) when the water As concentration was less than 10 μg/L, for which 5 out of 30 examined participants were diagnosed with arsenicosis symptoms. The distinct positive correlation between ADD and As concentrations in urine, nails, and hair suggests different applicability for these biomarkers. Methylated As as the predominant urinary As species confirms that the ingested inorganic As is methylated and is excreted through urine. In situ microdistribution and speciation analysis indicates that As is mainly associated with sulfur in nails and hair. Nails, rather than hair and urine, could be used as a proper biomarker for arsenicosis. High ADD from the environment and low excretion could result in As toxicity to humans. ■ INTRODUCTIONArsenic (As) poses a severe threat to human health through exposure pathways mainly including water and diet. 1,2 Drinking water with elevated As levels is the primary source of As ingestion. 1,3 Moreover, As-laden groundwater, if used for irrigation, can lead to appreciable amounts of As accumulation in vegetables and cereals. 4−6 Extensive research demonstrates that rice and rice products could be another As source. 7,8 However, not much attention has been paid to other cereals like wheat, which are important staple foods worldwide, that could lead to significant As ingestion. 9 The intake of As results in its detection in noninvasive human biomarkers such as urine, nails, and hair. 10−12 Urine has frequently been used as a biomarker for short-term exposure because most As metabolites are excreted within 3−4 days through urine. 12,13 Nails and hair indicate long-term exposure for 2−12 months, 10 as As can be accumulated in these structures rich in keratin. 14 Thus, the association of As levels in biomarkers and groundwater has been recently studied to evaluate its health risks. 11,15 The speciation of As in biomarkers is crucial to understand the transformation, metabolism, and toxicity of ingested As. 12,16 As species in hair and nails are traditionally determined by chemical extraction, where inorganic and methylated As are detected. 14,17 No As−S species have been reported using indirect chemical extraction methods, even though As readily bonds to sulphydryl groups. 14 In contrast, As−S species have been detected in nail and hair samples using in situ X-ray absorption near-edge structure (XANES) spectroscopy. 15 Unfortunately, methylated As species are not distinguished from the As−S form in nails, 18 which deserves further...

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“…Skin hyperpigmentation and hyperkeratosis have long been known to be the hallmark signs of chronic arsenic exposure. They were the most common health effects found in populations exposed to arsenic-contaminated drinking water in many countries including Taiwan [9], Chile [69], Argentina [70], India [71,72] and Bangladesh [73]. Hyperpigmentation occurs as diffuse brownish black pigmentation with a characteristic ''rain drop'' hypopigmentation.…”

Section: Arsenic and Skin Cancermentioning

confidence: 99%

Arsenic Carcinogenesis in the Skin

2006

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SummaryChronic arsenic poisoning is a world public health issue. Long-term exposure to inorganic arsenic (As) from drinking water has been documented to induce cancers in lung, urinary bladder, kidney, liver and skin in a dose-response relationship. Oxidative stress, chromosomal abnormality and altered growth factors are possible modes of action in arsenic carcinogenesis. Arsenic tends to accumulate in the skin. Skin hyperpigmentation and hyperkeratosis have long been known to be the hallmark signs of chronic As exposure. There are significant associations between these dermatological lesions and risk of skin cancer. The most common arsenic-induced skin cancers are Bowen's disease (carcinoma in situ), basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Arsenic-induced Bowen's disease (As-BD) is able to transform into invasive BCC and SCC. Individuals with As-BD are considered for more aggressive cancer screening in the lung and urinary bladder. As-BD provides an excellent model for studying the early stages of chemical carcinogenesis in human beings. Arsenic exposure is associated with G2/M cell cycle arrest and DNA aneuploidy in both cultured keratinocytes and As-BD lesions. These cellular abnormalities relate to the p53 dysfunction induced by arsenic. The characteristic clinical figures of arsenic-induced skin cancer are: (i) occurrence on sun-protected areas of the body; (ii) multiple and recrudescent lesions. Both As and UVB are able to induce skin cancer. Arsenic treatment enhances the cytotoxicity, mutagenicity and clastogenicity of UV in mammalian cells. Both As and UVB induce apoptosis in keratinocytes by caspase-9 and caspase-8 signaling, respectively. Combined UVB and As treatments resulted in the antiproliferative and proapoptotic effects by stimulating both caspase pathways in the keratinocytes. UVB irradiation inhibited mutant p53 and ki-67 expression, as well as increased in the number of apoptotic cells in As-BD lesions which resulted in an inhibitory effect on proliferation. As-UVB interaction provides a reasonable explanation for the rare occurrences of arsenical cancer in the sun-exposed skin. The multiple and recurrent skin lesions are associated with cellular immune dysfunction in chronic arsenism. A decrease in peripheral CD4+ cells was noticed in the inhabitants of arsenic exposure areas. There was a decrease in the number of Langerhans cells in As-BD lesion which results in an impaired immune function on the lesional sites. Since CD4+ cells are the target cell affected by As, the interaction between CD4+ cells and epidermal keratinocytes under As affection might be closely linked to the pathogenesis of multiple occurrence of arsenic-induced skin cancer. In this

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Associations Between Drinking Water and Urinary Arsenic Levels and Skin Lesions in Bangladesh

Cited by 170 publications

References 15 publications

Levels of urinary total and speciated arsenic in the US population: National Health and Nutrition Examination Survey 2003–2004

Levels of urinary total and speciated arsenic in the US population: National Health and Nutrition Examination Survey 2003–2004

Arsenic Levels and Speciation from Ingestion Exposures to Biomarkers in Shanxi, China: Implications for Human Health

Arsenic Carcinogenesis in the Skin

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