Long-term exposure to arsenic, and the co-occurrence of uranium, in public and private drinking water: associations with cardiovascular and chronic kidney diseases in the California Teachers Study

公共和私人饮用水中长期接触砷以及同时存在铀：加州教师研究中与心血管和慢性肾脏疾病的关联

• 批准号: 10677410
• 负责人: Danielle Medgyesi
• 金额: $ 3.47万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10677410
• 关键词: Acute myocardial infarction; Address; Arsenic; California; Cardiovascular Diseases; Cardiovascular system; Cessation of life; Chronic Disease; Chronic Kidney Failure; Cohort Studies; Collaborations; Communities; Consumption; Data; Data Set; Diabetes Mellitus; Disease; Disease Outcome; Effectiveness; End stage renal failure; Enrollment; Environmental Health; Environmental Risk Factor; Epidemiology; Ethnic Origin; Etiology; Exposure to; Future; Hazard Assessment; Health; Hospitalization; Hypertension; Incidence; Joints; Kidney; Knowledge; Life Style; Link; Malignant Neoplasms; Measurement; Modification; Monitor; Myocardial Infarction; Obesity; Outcome; Participant; Policies; Population; Population Sizes; Privatization; Property; Prospective cohort; Race; Regulation; Reporting; Research Personnel; Retirement; Rice; Risk; Rural Population; Smoking; Socioeconomic Status; Soil; Source; Southeastern Asia; Stroke; System; Testing; Time; Uranium; Water; Water Pollutants; Water Supply; Woman; administrative database; cardiovascular disorder risk; cardiovascular risk factor; comorbidity; demographics; dietary; drinking water; endothelial dysfunction; epidemiology study; ground water; insight; lifestyle factors; mortality; nephrotoxicity; novel; prospective; recruit; renal damage; response; rural area; spatiotemporal; systemic inflammatory response; teacher; trend; water quality

PROJECT SUMMARY/ABSTRACT The overarching objective of this proposal is to evaluate changes in levels of arsenic and uranium in public and private drinking water over several decades across the state of California, and to elucidate the relationship between long-term exposure to these contaminants and the risk of cardiovascular diseases (stroke, acute myocardial infarction) and chronic kidney disease in a large prospective cohort. Inorganic arsenic (As) naturally occurs in soil and groundwater globally. While arsenic in drinking water (wAs) is regulated in US community water supplies, the maximum contaminant level was recently reduced and enforced beginning in the early 2000s. Rural populations, however, rely on private wells which are not regulated for contaminants and may contain higher levels of wAs found in groundwater. Exposure to As has been linked to systemic inflammation and endothelial dysfunction, as well as kidney damage. A limited but growing body of evidence suggests that low-to-moderate levels of wAs present in the US increases the risk of cardiovascular disease (CVD) outcomes, including stroke and myocardial infarction. Few epidemiologic studies have evaluated the association between wAs and chronic kidney disease (CKD), a prevalent disease found at higher rates of unknown cause in some rural regions of California. Another drinking water contaminant, uranium (wU), which naturally occurs in groundwater, shares similar toxicologic properties to wAs and is particularly nephrotoxic. Given wU may co- occur with wAs, exposure to elevated levels of both contaminants may exacerbate the risk of CVD and CKD. In collaboration with the California Office of Environmental Health Hazard Assessment, a geospatial dataset of annual wAs and wU levels (1990-2020) has been developed using measurements from community water supplies and private wells, and spatially allocated to water system boundaries and private groundwater grids (1x1 mile grids), respectively. Our study proposes to first evaluate spatiotemporal trends and the co- occurrence of wAs and wU in community water supplies and private wells across California. We will leverage the geospatial dataset to estimate long-term residential drinking water levels of wAs and wU for participants in the California Teachers Study cohort (enrolled in 1995-96). We will conduct two epidemiologic studies evaluating the association between exposure to wAs and the prospective risks of CVD (including stroke and acute myocardial infarction) and CKD (stage 3 CKD to end stage renal disease) incidence/mortality. We will assess whether risk is greater for participants with the highest exposure levels of both wAs and wU. In summary, our study will describe trends in wAs and wU over time for both public and private water sources, identify regions in California with elevated exposure, as well as contribute to limited knowledge about exposure to low-to-moderate wAs levels and joint exposure to wU and the risks of CVD and CKD in the US.

项目总结/摘要 该提案的总体目标是评估公共场所和公共场所中砷和铀水平的变化， 私人饮用水在整个加州的几十年，并阐明关系 长期暴露于这些污染物与心血管疾病（中风、急性 心肌梗死）和慢性肾脏疾病。无机砷（As） 全球土壤和地下水中都有。而美国社区对饮用水中的砷（wAs）进行了监管， 最近，最高污染物水平有所降低，并从年初开始实施。 2000年代然而，农村人口依赖私人威尔斯水井，这些水井不受污染物管制， 地下水中的砷含量更高接触砷与全身炎症有关 内皮功能障碍以及肾损伤。有限但不断增加的证据表明， 在美国存在的低至中等水平的wA增加了心血管疾病（CVD）结果的风险， 包括中风和心肌梗塞。很少有流行病学研究评估了 wA和慢性肾脏疾病（CKD），这是一种在一些国家中以较高的未知原因发现的流行疾病， 加州的乡村地区。另一种饮用水污染物是铀（wU），它自然存在于 地下水与水具有相似的毒理学特性，特别是肾毒性。如果你能- 如果这两种污染物的水平升高，可能会加剧CVD和CKD的风险。在 与加州环境健康危害评估办公室合作， 利用对社区水的测量，制定了年度wAs和wU水平（1990-2020年 供应和私人威尔斯，并在空间上分配到水系统边界和私人地下水网格 (1x1英里网格）。我们的研究建议首先评估时空趋势和共同的， 整个加州的社区供水和私人威尔斯井中wA和wU的发生率。我们将利用 地理空间数据集，以估计参与者的长期居住饮用水wAs和wU水平， 加州教师研究队列（1995-96年入学）。我们将进行两项流行病学研究 评估暴露于wAs和CVD（包括中风和脑卒中）的预期风险之间的关联， 急性心肌梗死）和CKD（3期CKD至终末期肾病）的发病率/死亡率。我们将 评估wA和wU暴露水平最高的参与者的风险是否更大。在 总而言之，我们的研究将描述公共和私人水源的wA和wU随时间的变化趋势， 确定加州暴露水平较高的地区，并有助于了解有关暴露的有限知识 低至中等wAs水平和联合暴露于wU和CVD和CKD的风险。