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

抽象的。这个K01项目的广泛和长期目标是改善美国阿帕奇人的健康 印度人通过一项研究，检查癌症(CA)结果与砷(AS)之间的关系，共同 亚利桑那州圣卡洛斯阿帕奇(SCA)保留地上的金属和硝酸盐。研究背景具有广泛的 20世纪初以来坚硬岩石开采的历史，当时铀(U)、铜、银和石棉 提取出来的。人为原因和自然存在的元素会导致砷和钴的迁移 进入环境，并可能导致不利的健康影响。砷是一种已知的致癌物，与 患有糖尿病、不良生殖结局和心血管疾病。这项初步研究的一个主要目标是 开发和实施暴露评估工具(EAT)以研究癌症，并在未来用于 检查暴露与多种不良健康后果之间的联系。具体目标是： 1)按时间表征历史水数据，并从以下位置记录As、Cd、Pb、U和硝酸盐浓度水平 1981-2021，2)研究了水中As、Cd、Pb、U和硝酸盐的长期升高与 CA结果(膀胱、肾脏、前列腺、肺、乳房和皮肤)，3)分析和应用地理 信息系统(GIS)模型，以此为基础绘制高危地区(砷、镉、铅、铀、硝酸盐)，以及4) 向部落成员和首领提供研究结果。回顾性配对病例对照研究(N=160) 将采用设计。美国记录的数十年砷、镉、铅、铀和硝酸盐浓度水平 环境保护局(EPA)，部落EPA和美国地质调查局，来自已知有 超标的砷、钴金属和硝酸盐浓度水平将被收集。当地部落健康/印第安人健康 服务(IHS)记录将检查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登记和过去10年的死亡记录。学习 对照将从SCA注册数据中选择，并按性别和年龄与病例匹配。赔率比将是 报告使用Logistic回归来确定暴露风险和结果之间的关联。一剂 预期慢性砷、镉、铅、铀和硝酸盐水摄入与已报道的癌症之间的反应。 这是第一项回顾检查与多个CA相关的水污染物水平的本地研究 结果。这些数据将构成R01干预研究的基础，以教育、筛选和识别风险 在居民中造成不利的健康后果。调查结果将分发给部落成员和首领， 医疗设施和普通民众。这项研究有可能加强预防工作， 干预、教育、监测/监督，并可支持政策制定和立法。这个 该项目将覆盖在生物医学、社会、行为和临床方面服务不足的全国人口 根据国家科学委员会的拨款目的和使命，该计划将与培训不同领域的科学家保持一致。 这项研究在促进科学知识的同时，解决了服务不足社区中的CA差异。

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.