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Trends in urinary arsenic among the U.S. population by drinking water source: Results from the National Health and Nutritional Examinations Survey 2003–2014
Environmental Research ( IF 8.3 ) Pub Date : 2017-12-19 , DOI: 10.1016/j.envres.2017.12.012
Barrett Welch , Ellen Smit , Andres Cardenas , Perry Hystad , Molly L. Kile

Background

In 2001, the United States revised the arsenic maximum contaminant level for public drinking water systems from 50 µg/L to 10 µg/L. This study aimed to examine temporal trends in urinary arsenic concentrations in the U.S. population from 2003 to 2014 by drinking water source among individuals aged 12 years and older who had no detectable arsenobetaine - a biomarker of arsenic exposure from seafood intake.

Methods

We examined data from 6 consecutive cycles of the National Health and Nutrition Examination Survey (2003–2014; N=5848). Total urinary arsenic (TUA) was calculated by subtracting arsenobetaine’s limit of detection and detectable arsenocholine from total arsenic. Additional sensitivity analyses were conducted using a second total urinary arsenic index (TUA2, calculated by adding arsenite, arsenate, monomethylarsonic acid, dimethylarsinic acid). We classified drinking water source using 24-h dietary questionnaire data as community supply (n=3427), well or rain cistern (n=506), and did not drink tap water (n=1060).

Results

Geometric means (GM) of survey cycles were calculated from multivariate regression models adjusting for age, gender, race/ethnicity, BMI, income, creatinine, water source, type of water consumed, recent smoking, and consumption of seafood, rice, poultry, and juice. Compared to 2003–2004, adjusted TUA was 35.5% lower in 2013–2014 among the general U.S. population. Stratified analysis by smoking status indicated that the trend in lower TUA was only consistent among non-smokers. Compared to 2003–2004, lower adjusted TUA was observed in 2013–2014 among non-smoking participants who used community water supplies (1.98 vs 1.16 µg/L, p<0.001), well or rain cistern users (1.54 vs 1.28 µg/L, p<0.001) and who did not drink tap water (2.24 vs 1.53 µg/L, p<0.001). Sensitivity analyses showed consistent results for participants who used a community water supplier and to a lesser extent those who did not drink tap water. However, the sensitivity analysis showed overall exposure stayed the same or was higher among well or rain cistern users. Finally, the greatest decrease in TUA was among participants within the highest exposure percentiles (e.g. 95th percentile had 34% lower TUA in 2013/2014 vs 2003/2004, p<0.001).

Conclusions

Overall, urinary arsenic levels in the U.S. population declined over a 12-year period that encompassed the adoption of the revised Arsenic Rule. The most consistent trends in declining exposure were observed among non-smoking individuals using public community water systems. These results suggest regulation and prevention strategies to reduce arsenic exposures in the U.S. may be succeeding.



中文翻译:

按饮用水来源划分的美国人群中尿砷的变化趋势:2003-2014年美国国家健康和营养检查结果

背景

2001年,美国将公共饮用水系统中砷的最大污染物含量从50 µg / L修改为10 µg / L。这项研究的目的是研究2003年至2014年间美国12岁及12岁以上人群中饮用水源中尿砷浓度的时间变化趋势,这些人没有可检测到的砷甜菜碱,这是海鲜摄入砷暴露的生物标志。

方法

我们检查了来自国家健康与营养检查调查(2003-2014; N = 5848)的六个连续周期的数据。通过从总砷中减去砷甜菜碱的检出限和可检测到的砷胆碱来计算总尿砷(TUA)。使用第二总尿砷指数(TUA2,通过添加亚砷酸盐,砷酸盐,一甲基亚砷酸,二甲基亚砷酸计算)进行了其他敏感性分析。我们使用24小时饮食调查表数据将饮用水源分类为社区供应(n = 3427),井水或雨水蓄水池(n = 506),而没有喝自来水(n = 1060)。

结果

根据多元回归模型计算出调查周期的几何平均值(GM),该模型对年龄,性别,种族/族裔,体重指数,收入,肌酐,水源,饮水类型,近期吸烟以及海鲜,大米,家禽,和果汁。与2003–2004年相比,2013–2014年美国总人口调整后的TUA降低了35.5%。通过吸烟状况进行的分层分析表明,较低的TUA趋势仅在非吸烟者中是一致的。与2003–2004年相比,2013–2014年使用社区供水的非吸烟参与者(1.98 vs 1.16 µg / L,p <0.001),井水或雨水蓄水池使用者(1.54 vs 1.28 µg / L)的调整后的TUA较低。,p <0.001)和不喝自来水的人(2.24 vs 1.53 µg / L,p<0.001)。敏感性分析显示,使用社区供水者的参与者和不喝自来水的参与者的结果一致。但是,敏感性分析显示,在水井或雨水池使用者中,总暴露量保持不变或更高。最后,TUA的最大下降是在最高暴露百分位数内的参与者(例如,95%的百分数在2013/2014年与2003/2004年相比降低了34%,p <0.001)。

结论

总体而言,包括采用修订后的《砷规则》的12年期间,美国人群中的尿砷水平有所下降。在使用公共社区供水系统的非吸烟者中,观察到暴露量下降的最一致趋势。这些结果表明,在美国减少砷暴露的法规和预防策略可能是成功的。

更新日期:2017-12-19
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