Abstract
Background:Mexico is included in the list of countries with concurrent arsenic and fluoride contamination in drinking water. Most of the studies have been carried out in the adult population and very few in the child population. Urinary arsenic and urinary fluoride levels have been accepted as good biomarkers of exposure dose. The Biomonitoring Equivalents (BE) values are useful tools for health assessment using human biomonitoring data in relation to the exposure guidance values, but BE information for children is limited.Methods:We conducted a systematic review of the reported levels of arsenic and fluoride in drinking water, urinary quantification of speciated arsenic (inorganic arsenic and its methylated metabolites), and urinary fluoride levels in child populations. For BE values, urinary arsenic and fluoride concentrations reported in Mexican child populations were revised discussing the influence of factors such as diet, use of dental products, sex, and metabolism.Results:Approximately 0.5 and 6 million Mexican children up to 14 years of age drink water with arsenic levels over 10 µg/L and fluoride over 1.5 mg/L, respectively. Moreover, 40% of localities with arsenic levels higher than 10 µg/L also present concurrent fluoride exposure higher than 1.5 mgF/L. BE values based in urinary arsenic of 15 µg/L and urinary fluoride of 1.2 mg/L for the environmentally exposed child population are suggested.Conclusions:An actual risk map of Mexican children exposed to high levels of arsenic, fluoride, and both arsenic and fluoride in drinking water was generated. Mexican normativity for maximum contaminant level for arsenic and fluoride in drinking water should be adjusted and enforced to preserve health. BE should be used in child populations to investigate exposure.
Highlights
Arsenic and fluorine are elements that form organic and inorganic compounds ubiquitously present in nature
There are many regions in Mexico where the natural concentration of arsenic in the groundwater depends on the arsenic content of the bedrock; here, the levels of arsenic in drinking water are higher than the recommended limit of 10 μg/L (Figure 1) and higher than Mexico’s limit 25 μg/L
We estimated that approximately 500,000 children up to 14 years of age drink water with arsenic levels over 10 μg/L, around 205,000 of them drink water with 25 μgAs/L, and approximately 17,500 children are at higher risk because their drinking water contains between 75 and 500 μgAs/L
Summary
Arsenic and fluorine are elements that form organic and inorganic compounds ubiquitously present in nature. Over 300 million people worldwide use groundwater contaminated with arsenic or fluoride as a source of drinking water. The occurrence of arsenic or fluoride in groundwater is primarily ascribed to geogenic processes These natural sources are usually related to the dissolution of arsenic- or fluorinecontaining minerals present in rocks and soils. Results: Approximately 0.5 and 6 million Mexican children up to 14 years of age drink water with arsenic levels over 10 μg/L and fluoride over 1.5 mg/L, respectively. BE values based in urinary arsenic of 15 μg/L and urinary fluoride of 1.2 mg/L for the environmentally exposed child population are suggested. Mexican normativity for maximum contaminant level for arsenic and fluoride in drinking water should be adjusted and enforced to preserve health. BE should be used in child populations to investigate exposure
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