Trends in urinary arsenic among the U.S. population by drinking water source: Results from the National Health and Nutritional Examinations Survey 2003-2014.
Trends in urinary arsenic among the U.S. population by drinking water source: Results from the National Health and Nutritional Examinations Survey 2003-2014.
复制标题
按饮用水源划分的美国人口尿砷趋势：2003-2014 年国家健康和营养检查调查结果。
DOI：
10.1016/j.envres.2017.12.012
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发表时间：
2018
影响因子：
8.3
通讯作者：
Kile,MollyL
中科院分区：
文献类型：
--
作者：
Welch,Barrett;Smit,Ellen;Cardenas,Andres;Hystad,Perry;Kile,MollyL
背景2001年，美国将公共饮用水系统的砷最高污染物水平从50 µg/L修订为10 µg/L。本研究旨在研究2003年至2014年美国人口中尿砷浓度的时间趋势，通过饮用水源，在12岁及以上的个体中，没有检测到砷甜菜碱-海鲜摄入砷暴露的生物标志物。（2003-2014; N=5848）。尿总砷（TUA）的计算方法是从总砷中减去砷甜菜碱的检测限和可检测的砷胆碱。使用第二个总尿砷指数（TUA 2，通过添加亚砷酸盐、砷酸盐、单甲基胂酸、二甲基胂酸计算）进行额外的敏感性分析。我们使用24小时饮食问卷调查数据将饮用水源分为社区供水（n=3427）、水井或雨水蓄水池（n=506）和不饮用自来水（n=1060）。结果通过调整年龄、性别、种族/民族、BMI、收入、肌酐、水源、饮用水类型、近期吸烟、以及海鲜、米饭、家禽和果汁的消费。与2003-2004年相比，调整后的TUA在2013-2014年在美国普通人群中降低了35.5%。按吸烟状况进行的分层分析表明，TUA降低的趋势仅在非吸烟者中一致。与2003-2004年相比，2013-2014年在使用社区供水的非吸烟参与者（1.98 vs 1.16 µg/L，p<0.001），水井或雨水蓄水池使用者（1.54 vs 1.28 µg/L，p<0.001）和不喝自来水的参与者（2.24 vs 1.53 µg/L，p<0.001）中观察到较低的调整TUA。敏感性分析显示，使用社区供水的参与者和不喝自来水的参与者的结果一致。然而，敏感性分析显示，水井或雨水蓄水池使用者的总体暴露量保持不变或更高。最后，TUA的最大下降是在最高暴露范围内的参与者中（例如，2013/2014年与2003/2004年相比，第95百分位数的TUA降低了34%，p<0.001）。在使用公共社区供水系统的非吸烟者中，观察到了最一致的接触减少趋势。这些结果表明，美国减少砷暴露的监管和预防策略可能会取得成功。
BackgroundIn 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.MethodsWe 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).ResultsGeometric 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).ConclusionsOverall, 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.