Arsenic and other co-metals in the San Carlos Apache drinking water

摘要。这个K 01项目的广泛的长期目标是改善Apache American的健康状况。 印度人通过一项研究，检查癌症（CA）的结果和砷（As）之间的关系，共同 在亚利桑那州的圣卡洛斯阿帕奇（SCA）保留区，该研究环境具有广泛的 自20世纪初以来，硬岩开采的历史，当时铀（U），铜，银和石棉被 提取。人为原因和自然发生的元素可以导致运动的As和co-metals 进入环境，可能对健康造成不良影响。砷是一种已知的致癌物质， 糖尿病、不良生殖结果和心血管疾病。这项试点研究的主要目标是 开发和实施一个暴露评估工具（EAT），以研究癌症，并在未来使用， 检查暴露与多种不良健康结果之间的关联。具体目标是： 1)按时间和记录的As、Cd、Pb、U和硝酸盐浓度水平表征历史水数据， 1981-2021年，2）研究长期升高的As，Cd，Pb，U和水中硝酸盐之间的关系， CA结果（膀胱、肾脏、前列腺、肺、乳腺和皮肤），3）分析并应用地理 信息系统（GIS）模型，根据EAT绘制高风险（As、Cd、Pb、U、硝酸盐）区域，以及4） 向部落成员和领导人提供研究结果。回顾性配对病例对照（N = 160） 设计将被采用。美国记录的数十年As、Cd、Pb、U和硝酸盐浓度水平 环境保护局（EPA），部落EPA和美国地质调查局从已知的地区 将收集升高的As、共金属和硝酸盐浓度水平。当地部落健康/印第安人健康 将检查服务（IHS）记录中IHS报告的CA诊断和死亡率（使用ICD代码）， 部落健康、私人健康记录、州CA登记处和过去10年的死亡率记录。研究 对照组将从SCA入组数据中选择，并按性别和年龄与病例匹配。赔率将是 报告使用逻辑回归来确定暴露风险和结果之间的关联。的剂量 慢性砷，镉，铅，铀和硝酸盐水摄入和报告的癌症之间的反应是预期的。 这是第一个回顾性研究与多个CA有关的水污染物水平的本地研究 结果。这些数据将构成R 01干预研究的基础，以教育、筛选和识别风险 对居民的健康产生不良影响。调查结果将分发给部落成员和领导人， 医疗机构和一般人群。这项研究有可能加强预防工作， 这些活动包括干预、教育、监测/监督，并可支持政策制定和立法。的 该项目将覆盖全国在生物医学、社会、行为和临床方面服务不足的人群。 科学，并与按照NCI赠款目的和使命在各个领域培训不同的科学家保持一致。 这项研究解决了CA在服务不足的社区的差距，同时推进科学知识。

ABSTRACT. The broad, long-term objectives of this K01 project are to improve the health of Apache American Indians through a study that examines the association between cancer (CA) outcomes and Arsenic (As), co- metals, and nitrate on the San Carlos Apache (SCA) reservation in Arizona. The study setting has an extensive history of hard rock mining since the early 1900s when uranium (U), copper, silver, and asbestos were extracted. Anthropogenic causes and naturally occurring elements can cause movement of As and co-metals into the environment and may result in adverse health effects. Arsenic is a known carcinogen and is associated with diabetes, adverse reproductive outcomes, and cardiovascular disease. A main goal of this pilot study is to develop and implement an exposure assessment tool (EAT) to study cancers and to use in the future to examine the association between exposures and multiple adverse health outcomes. The specific aims are to: 1) characterize historical water data by time and recorded As, Cd, Pb, U, and nitrate concentration levels from 1981-2021, 2) examine the association between chronically elevated As, Cd, Pb, U, and nitrate in water and CA outcomes (bladder, kidney, prostate, lung, breast, and skin), 3) analyze and apply a Geographic Information System (GIS) model to map high-risk (As, Cd, Pb, U, nitrate) areas based on this EAT, and 4) provide study findings to tribal members and leaders. A retrospective pair matched case-control (N = 160) design will be employed. Decades of As, Cd, Pb, U, and nitrates concentration levels recorded by the US Environmental Protection Agency (EPA), tribal EPA, and US Geological Survey from areas known to have elevated As, co-metal and nitrate concentration levels will be collected. Local tribal health/Indian Health Service (IHS) records will be examined for CA diagnoses and mortality (using ICD codes) reported by the IHS, tribal health, private health records, state CA registries, and mortality records of the past 10 years. Study controls will be selected from SCA enrollment data and matched to cases by sex and age. Odds Ratios will be reported using logistic regression to determine associations between exposure risk and outcomes. A dose response between chronic As, Cd, Pb, U, and nitrate water ingestion and reported cancers are anticipated. This is the first local study to retrospectively examine water contaminant levels in relation to multiple CA outcomes. The data will form the foundation for an R01 intervention study to educate, screen, and identify risks for adverse health outcomes among residents. Findings will be disseminated to tribal members and leaders, healthcare facilities, and the general population. This study has the potential to augment prevention efforts, intervention, education, monitoring/surveillance, and can support policy development and legislation. The project will reach a nationally underserved population in the biomedical, social, behavioral, and clinical sciences and is in alignment with training diverse scientists in fields per the NCI grant purpose and mission. The study addresses CA disparities in an underserved community while advancing scientific knowledge.