Hair Arsenic Concentrations Research Articles

Arsenic Exposure-Related Hypertension in Bangladesh and Reduced Circulating Nitric Oxide Bioavailability.

Hypertension is a major cause of death worldwide. Although arsenic exposure has been associated with the risk of hypertension, this association appears nonuniform due to inconsistent results from studies conducted in different populations. Moreover, hypertension is a complex condition with multiple underlying mechanisms and factors. One factor is impaired production and bioavailability of vascular nitric oxide (NO). However, the implications of the effects of arsenic exposure on circulating NO and its association with hypertension in humans are largely unknown. We investigated the dose-response relationship between arsenic exposure and hypertension with vascular NO levels as a potential mediator of arsenic-related hypertension in individuals exposed to a broad range of arsenic. A total of 828 participants were recruited from low- and high-arsenic exposure areas in Bangladesh. Participants' drinking water, hair, and nail arsenic concentrations were measured by inductively coupled plasma mass spectroscopy. Hypertension was defined as a systolic blood pressure (SBP) value of and a diastolic (DBP) value of . Serum NO levels reflected by total serum nitrite concentrations were measured by immunoassay. A formal causal mediation analysis was used to assess NO as a mediator of the association between arsenic level and hypertension. Increasing concentrations of arsenic measured in drinking water, hair, and nails were associated with the increasing levels of SBP and DBP. The odds of hypertension were dose-dependently increased by arsenic even in participants exposed to relatively low to moderate levels () of water arsenic [odds ratios (ORs) and 95% confidence intervals (CIs): 2.87 (95% CI: 1.28, 6.44), 2.67 (95% CI: 1.27, 5.60), and 5.04 (95% CI: 2.71, 9.35) for the , , and groups, respectively]. Causal mediation analysis showed a significant mediating effect of NO on arsenic-related SBP, DBP, and hypertension. Increasing exposure to arsenic was associated with increasing odds of hypertension. The association was mediated through the reduction of vascular NO bioavailability, suggesting that impaired NO bioavailability was a plausible underlying mechanism of arsenic-induced hypertension in this Bangladeshi population. https://doi.org/10.1289/EHP13018.

Association of Methionine Synthase rs1805087 Polymorphism With Arsenic-Related Skin Pigmentary Changes: A Population-Based Case-Control Study

Objective: Chronic arsenic exposure causes skin lesions including skin cancers, pigmentary changes, and keratosis. Genetic polymorphism in arsenic metabolism may increase susceptibility to the development of arsenic-related skin lesions. This study was performed to determine whether arsenic metabolism-related gene variants are associated with arsenic-related pigmentary changes. Methods: This case–control study involved 189 patients with arsenic-related pigmentary changes and 103 controls. Thirty-eight polymorphisms in 10 genes determined by mass spectrometry assay served as candidate drivers of arsenic-induced pigmentary changes. Urine and plasma arsenic levels were determined by inductively coupled plasma mass spectrometry. Hair arsenic concentrations were measured by nondispersive atomic fluorescence spectrometry. Arsenic metabolites in urine were determined using high-performance liquid chromatography with inductively coupled plasma mass spectrometry. Serum folate was measured using a folate radio assay kit. Analysis of variance, nonparametric test, or the chi-square test was selected according to the data distribution. Spearman correlation analysis was used to determine the correlation between two parameters. Logistic regression was used to estimate the effect of single-nucleotide polymorphisms. Results: The arsenic concentrations in urine, plasma, and hair and the urine arsenic species were not significantly different between patients and controls. Logistic regression revealed that among the polymorphisms, the methionine synthase (MTR) rs1805087 polymorphism showed a protective effect against arsenic-related pigmentary changes. In the codominant model, the adjusted odds ratio for age, sex, and ethnicity was 0.41 (95% confidence interval [CI], 0.21–0.80; P = 0.008) for the AG genotype and 0.11 (95% CI, 0.02–0.60; P = 0.012) for the GG genotype. Conclusion: MTR polymorphism showed a protective effect against arsenic-related pigmentary changes in the logistic regression model. The effect of MTR rs1805087 might be independent of arsenic metabolism and one-carbon metabolism. More studies are needed to clarify the biological function of MTR rs1805087 and its relationship with the etiology of arsenic-related pigmentary changes.

Mineral, trace element, and toxic metal concentration in hair from dogs with idiopathic epilepsy compared to healthy controls.

Altered trace element status is associated with epilepsy in humans and dogs with idiopathic epilepsy (IE). Compare hair element concentrations in epileptic and healthy dogs. Sixty-three dogs with IE (53 treated, 10 untreated) and 42 controls. Case-control study using ICP-MS to determine hair calcium, magnesium, phosphorus, sodium, potassium, iron, copper, manganese, zinc, selenium, chromium, lead, mercury, cadmium, arsenic, aluminum, and nickel concentration. Groups were compared using nonparametric tests. Results were controlled for diet, sex, age, and hair color using generalized linear mixed models. Compared to healthy controls, dogs with IE had lower hair phosphorus (mean ± SD; IE: 286.19 ± 69.62 μg/g, healthy: 324.52 ± 58.69 μg/g; P = .001), higher hair copper (IE: 10.97 ± 3.51 μg/g, healthy: 8.41 ± 1.27 μg/g; P < .001), zinc (IE: 158.25 ± 19.64 μg/g, healthy: 144.76 ± 32.18 μg/g; P < .001), copper/zinc ratio (IE: 0.07 ± 0.02, healthy: 0.06 ± 0.01; P = .003), selenium (IE: 1.65 ± 0.43 μg/g, healthy: 0.94 ± 0.73 μg/g; P < .001), and arsenic (IE: 0.40 ± 0.78 μg/g, healthy: 0.05 ± 0.08 μg/g; P < .001). When comparing treated and untreated epileptic dogs with healthy dogs, the differences in phosphorus and selenium remained significant for both groups, whereas the differences in copper, zinc, and arsenic were significant only for treated dogs. Potassium bromide treatment was strongly associated with high hair arsenic (P = .000). Altered trace element status could be involved in the pathophysiology of IE in dogs. Antiseizure drugs might affect trace element and arsenic metabolism.

Association between serum periostin levels and the severity of arsenic-induced skin lesions.

Arsenic is a potent environmental toxicant and human carcinogen. Skin lesions are the most common manifestations of chronic exposure to arsenic. Advanced-stage skin lesions, particularly hyperkeratosis have been recognized as precancerous diseases. However, the underlying mechanism of arsenic-induced skin lesions remains unknown. Periostin, a matricellular protein, is implicated in the pathogenesis of many forms of skin lesions. The objective of this study was to examine whether periostin is associated with arsenic-induced skin lesions. A total of 442 individuals from low- (n = 123) and high-arsenic exposure areas (n = 319) in rural Bangladesh were evaluated for the presence of arsenic-induced skin lesions (Yes/No). Participants with skin lesions were further categorized into two groups: early-stage skin lesions (melanosis and keratosis) and advanced-stage skin lesions (hyperkeratosis). Drinking water, hair, and nail arsenic concentrations were considered as the participants' exposure levels. The higher levels of arsenic and serum periostin were significantly associated with skin lesions. Causal mediation analysis revealed the significant effect of arsenic on skin lesions through the mediator, periostin, suggesting that periostin contributes to the development of skin lesions. When skin lesion was used as a three-category outcome (none, early-stage, and advanced-stage skin lesions), higher serum periostin levels were significantly associated with both early-stage and advanced-stage skin lesions. Median (IQR) periostin levels were progressively increased with the increasing severity of skin lesions. Furthermore, there were general trends in increasing serum type 2 cytokines (IL-4, IL-5, IL-13, and eotaxin) and immunoglobulin E (IgE) levels with the progression of the disease. The median (IQR) of IL-4, IL-5, IL-13, eotaxin, and IgE levels were significantly higher in the early-and advanced-stage skin lesions compared to the group of participants without skin lesions. The results of this study suggest that periostin is implicated in the pathogenesis and progression of arsenic-induced skin lesions through the dysregulation of type 2 immune response.

Changes in arsenic accumulation and metabolic capacity after environmental management measures in mining area

Due to the public health concern of arsenic, environmental management measures in mining areas had been implemented. To assess the effect of environmental management measures in the mining area comprehensively, arsenic accumulation in the urine, hair, nails, and urinary metabolites of residents in a realgar mining area in Hunan province, China were investigated in 2019, and the changes in arsenic levels in the biomarkers during 2012–2019 were tracked. The importance of confounding factors (age, sex, occupation, residence, clinical history, vegetable source, cooking fuel, smoking, alcohol consumption, BMI) was analyzed using the Boruta algorithm. After the implementation of environmental management measures (including ceasing mining and smelting activities, building landfills, adjusting the planting structure, and soil restoration), urine, hair, and nail arsenic concentration decreased drastically but were still excessive. Arsenic accumulation was highest in older male miners who were long settled in the mining area and consumed homegrown vegetables. The only factor for changes in urinary arsenic levels was the cooking fuel type; residents using wood as cooking fuel experienced sustained arsenic exposure. Occupation and sex were important for determining arsenic changes in the hair and nails. Short-term arsenic accumulation in urine was affected by arsenic exposure, while long-term accumulation in hair and nails by arsenic metabolic capacity. The percentage of urinary arsenic metabolism and arsenic methylation indices of the participants in the mining area were within the normal range (%iAs: 10–30 %, %MMA: 10–20 %, % DMA: 60–80 %); samples indicated worse metabolic capacity than the reference population. The arsenic metabolic capacity of male miners was relatively weak, probably aggravated by alcohol drinking and smoking. Without soil remediation, arsenic exposure will continue. Homegrown vegetables and biomass fuels should be abandoned; reduced cigarette and alcohol consumption is recommended. Urinary arsenic would be more proper for assessing environmental remediation in mining areas.

Impact of treated drinking water on arsenicosis patients with continuous consumption of contaminated dietary foodstuffs: A longitudinal health effect study from arsenic prone area, West Bengal, India

Health effect and future risk assessment have been evaluated for a year on a group of arsenicosis patients (n = 24) examining the impact of treated surface water with continuous consumption of arsenic-contaminated dietary foodstuffs. The daily dietary intake rate of arsenic through cooked rice is 5.50 μg/kg bw/day, which is much higher than PTDI recommended value compared to cooked vegetables and treated drinking water. The effect of acute toxicity showed a decreasing trend of 42.9% arsenic in urine (n = 24) after 6 months. Scalp hair (n = 19) and nail (n = 18) arsenic concentration showed a decreasing trend of 39.3% (range: 1.34–86.2%) and 36.9% (range: 0.88–85%), respectively after 12 months. The body hair (hand and leg) and skin scale arsenic accumulation showed high and diverse distribution pattern. Excretion of arsenic through sweat was higher than urine with a mean concentration of 34.7 μg/L (range: 4.76–65 μg/L). Chronic arsenic exposure for a long period of time is the considerable pathway to severe dermatological skin manifestations in the arsenical patients. One-way ANOVA (Tukey-test) interpretation showed a significant relationship between arsenic intakes, biological tissues and dermatological manifestations within the studied groups. Linear mixed modelling showed differential temporal trends of arsenic levels through biomarkers for both studied male and female patients. The SAMOE value for treated drinking water and cooked vegetables showed low to moderate concern level (class 3), whereas, high concern level (class 5) was observed for cooked rice. The future cancer and non-cancerous risk predominantly exists through consumption of rice compared to vegetables and treated drinking water. Supplementation of arsenic-safe drinking water and nutritional food is highly recommended for the arsenic patients to fight against the devastating arsenic calamity.

Assessment of Arsenic in Hair of the Inhabitants of East Croatia—Relationship to Arsenic Concentrations in Drinking Water

The problem of elevated arsenic concentrations in water and environment is an increasing public health concern. The aim of the study was to assess the arsenic content in human hair in selected areas of eastern Croatia and to compare them with measured values after installation of a new water supply system. The hair samples were taken in the areas of wider Osijek and Vinkovci area and analyzed using the ICP–MS method. These data were also compared with data for Vinkovci previously published in 2004. Depending on the investigated area, the median concentrations ranged from 0.02 to 0.9 µg g−1, whereby this last value exceeded the upper range of the reference value (0.319 µg g−1). The arsenic concentrations from the Našice, Osijek and Vinkovci areas were within or slightly above the maximum allowed reference range. The highest median values in hair samples were detected in Čepin, with arsenic-contaminated potable water, while in areas where the water source was changed, the values were significantly lower. The results add to the conclusion that there has been significant reduction in hair arsenic concentrations in the population that was given access to clean, uncontaminated water from other regional sources.

Assessment of Arsenic Levels in Water, Sediment, and Human Hair around Ie Seu’um Geothermal Manifestation Area, Aceh, Indonesia

The concentration of arsenic in water, sediment, and resident hair in the Ie Seu’um geothermal manifestation area has been analyzed using the Atomic Graphite Furnace Atomic Absorption Spectrophotometry (GF-AAS) method. Sediment and hair samples were prepared by wet digestion using an acid solution. The measurement results were validated by linearity, Limit of Detection (LoD), Limit of Quantification (LoQ), Relative Standard Deviation (%RSD), and %Recovery. The validation test showed that this method is very linear, sensitive, accurate, and precise with a correlation coefficient of 0.9999, LoD of 0.009 μg/L, LoQ of 0.027 μg/L, recovery values of 89.117–101.027% for hair samples and 88.337–105.175% for sediment samples, and RSD of 1.067%. The sample test results showed that the hot springs contained the highest arsenic with levels of 166.73 ± 0.0081 μg/L (IS1). In comparison, the water samples with the lowest arsenic levels were in the rivers that had not been in direct contact with the hot water (IS2) flow, which is 0.80 ± 0.0036 μg/L. All the river water samples that had been in contact with hot water were boreholes, and the resident boreholes located around hot water streams/rivers contaminated with arsenic were above the threshold. Only the river water that had not been in contact with hot water, refill water, and borehole waters outside the hot water flow were detected to be below the threshold level. All the sediment samples showed arsenic contamination, with levels ranging from 2.56–6.86 mg/kg, and it was still within the normal limits recommended by the National Oceanic and Atmospheric Administration (NOAA). Arsenic exposures in communities living around the Ie Seu’um geothermal area, Mesjid Raya Sub-District, Aceh Besar District, Aceh Province, were very high, where 9 out of 10 respondents were positive for arsenic with levels ranging from 54.59–164.57 mg/kg, which was already above the threshold set by the researchers.

T helper 2-driven immune dysfunction in chronic arsenic-exposed individuals and its link to the features of allergic asthma

Limited information is available regarding the effects of arsenic exposure on immune function. We have recently reported that chronic exposure to As was associated asthma, as determined by spirometry and respiratory symptoms. Because T helper 2 (Th2)-driven immune responses are implicated in the pathogenesis of allergic diseases, including asthma, we studied the associations of serum Th1 and Th2 mediators with the As exposure markers and the features of asthma among individuals exposed to As. A total of 553 blood samples were selected from the same study subjects recruited in our previous asthma study. Serum levels of Th1 and Th2 cytokines were analyzed by immunoassay. Subjects' arsenic exposure levels (drinking water, hair and nail arsenic concentrations) were determined by inductively coupled plasma mass spectroscopy. Arsenic exposure levels of the subjects showed significant positive associations with serum Th2-mediators— interleukin (IL)-4, IL-5, IL-13, and eotaxin without any significant changes in Th1 mediators— interferon-γ and tumor necrosis factor-α. The ratios of Th2 to Th1 mediators were significantly increased with increasing exposure to As. Notably, most of the Th2 mediators were positively associated with serum levels of total immunoglobulin E and eotaxin. The serum levels of Th2 mediators were significantly higher in the subjects with asthma than those without asthma. The results of our study suggest that the exacerbated Th2-driven immune responses are involved in the increased susceptibility to allergic asthma among individuals chronically exposed to As.

Does Arsenic Exposure Have a Role in Development of Thyroid Disease?

Abstract Background: Several animal studies indicate arsenic toxicity can affect thyroid hormone metabolism. There is no study in the English scientific literature of the relationship between thyroid disease and arsenic exposure in human population. The Indian state of West Bengal is affected by arsenic contamination of ground water. According to the World Health Organisation 6 of the 23 districts of West Bengal are higher affected areas. Objectives: To study the role of arsenic in development of thyroid disease. Methods: Arsenic exposure in seven patients with thyroid disease was estimated by Inductive Coupled Plasma Mass Spectroscopy (ICP-MS) of hair and nail samples. Results: Of the seven patients 2 were male and 5 were female. Two patients had thyroid malignancy (papillary carcinoma) while the rest had benign thyroid disease. Six out of the seven were residents of higher arsenic affected districts of West Bengal. One patient with a thyroid adenoma had elevated concentration of arsenic in hair (1.19 mg/kg). A second patient with of follicular adenoma had sub-clinical hypothyroidism at the time of the survey. Conclusion: This small study suggests that arsenic exposure may be associated with the development of thyroid disease. A larger study with adequate controls is warranted to establish the true role of arsenic in the aetio-pathogenesis of thyroid disorders.

Association of arsenic exposure and cognitive impairment: A population-based cross-sectional study in China

BackgroundThe influence of chronic arsenic exposure on cognitive impairment has been explored broadly by previous studies. However, most of them focused mainly on children rather than adults. In addition, in China, studies in this field are not sufficient. To illustrate how long-term arsenic exposure affects cognitive function, we designed a cross-sectional study involving 1556 adults. MethodsAll of them came from three locations around the Realgar Plant. The cognitive function of the participants was evaluated using a Chinese version of the Mini-mental state Examination (MMSE). The participants' internal arsenic exposure status (hair arsenic concentrations) and the external arsenic exposure status (the distance between the participants' location of residence and the Realgar Plant) were measured. ResultsOur research revealed that both of hair arsenic concentrations and the prevalence of arsenicosis, two important indexes, were significantly higher in the cognitive-impaired (CI) group than in the cognitive-normal (CN) group (P < 0.05). In addition, distance from the Realgar Plant was positively correlated with the MMSE scores and was negatively correlated with the prevalence of cognitive impairment. Moreover, our results demonstrated that there was a negative correlation between hair arsenic concentrations and MMSE scores. We conducted a two-level Logistic regression analysis and further confirmed that even after adjusting for potential confounding variables, arsenicosis retained a risk factor for cognitive impairment (odds ratio (OR) = 1.84, P < 0.05). ConclusionsOur results indicated that chronic arsenic exposure could impair adults' cognitive function in a dose-dependent manner. Additionally, arsenicosis could be an independent risk factor for cognitive impairment.

Patient-Reported Outcomes of Arsenic-Related Skin Lesions in China.

Purpose Previous studies confirmed that chronic arsenic exposure could lead to pigmentary changes and hyperkeratosis. However, skin health-related quality of life (HRQoL) among people under lifetime arsenic exposure remains underappreciated. Our study is aimed at investigating several patient-reported outcomes in a population under chronic arsenic exposure. Patients and Methods. A cross-sectional study was conducted in communities in Shimen, China. Dermatologists performed skin examinations for participants. Patient-reported outcomes (PROs) included HRQoL, itch, sleep quality, and symptoms of anxiety and depression. The Dermatology Life Quality Index (DLQI) was used to measure skin HRQoL. The numerical rating scale (NRS) was used to measure the intensity of itching. Sleep disturbance was measured by Pittsburgh Sleep Quality Index (PSQI). Anxiety and depression were measured by two-item Generalized Anxiety Disorder (GAD-2) and Patient Health Questionnaire (PHQ-2), respectively. Results A total of 464 participants suffering from arsenic-related skin lesions finished the assessment of DLQI. Pigmentary changes and arsenical keratosis were not associated with the patient-reported outcomes except PHQ-2. Hair arsenic exceeding 1 μg/g was associated with higher itch NRS and DLQI (P < 0.05). Itch NRS (adjusted β = 0.80, 95% CI: 0.70–0.90, P < 0.01) and hair arsenic concentration (adjusted β = 0.12, 95% CI: 0.01–0.24, P < 0.05) were independently associated with the DLQI. Conclusion HRQoL, sleep quality, and mental wellbeing are impaired in residents under chronic arsenic exposure. Itching and hair arsenic are independent risk factors for impaired HRQoL.

Arsenic exposure-related hyperglycemia is linked to insulin resistance with concomitant reduction of skeletal muscle mass

BackgroundAlargebodyof evidence has shown a link between arsenic exposure and diabetes, but the underlying mechanisms have not yet been clarified. ObjectiveWe explored the association between arsenic exposure and the reduction of skeletal muscle mass as a potential mechanism of insulin resistance for developing arsenic-related hyperglycemia. MethodsA total of 581 subjects were recruited from arsenic-endemic and non-endemic areas in Bangladesh and their fasting blood glucose (FBG), serum insulin, and serum creatinine levels were determined. Subjects’ arsenic exposure levels were assessed by arsenic concentrations in water, hair, and nails. HOMA-IR and HOMA-β were used to calculate insulin resistance and β-cell dysfunction, respectively. Serum creatinine levels and lean body mass (LBM) were used as muscle mass indicators. ResultsWater, hair and nail arsenic concentrations showed significant positive associations with FBG, serum insulin and HOMA-IR and inverse associations with serum creatinine and LBM in a dose-dependent manner both in males and females. Water, hair and nail arsenic showed significant inverse associations with HOMA-β in females but not in males. FBG and HOMA-IR were increased with the decreasing levels of serum creatinine and LBM. Odds ratios (ORs)of hyperglycemia were significantly increased with the increasing concentrations of arsenic in water, hair and nails and with the decreasing levels of serum creatinine and LBM. Females’ HOMA-IR showed greater susceptibility to the reduction of serum creatinine and LBM, possibly causing the greater risk of hyperglycemia in females than males. Path analysis revealed the mediating effect of serum creatinine level on the relationship of arsenic exposure with HOMA-IR and hyperglycemia. ConclusionArsenic exposure elevates FBG levels and the risk of hyperglycemia through increasing insulin resistance with greater susceptibility in females than males. Additionally, arsenic exposure-related reduction of skeletal muscle mass may be a mechanism underlying the development of insulin resistance and hyperglycemia.

Prenatal and childhood arsenic exposure through drinking water and food and cognitive abilities at 10 years of age: A prospective cohort study

BackgroundOur studies of children in a rural Bangladeshi area, with varying concentrations of arsenic in well-water, indicated modest impact on child verbal cognitive function at 5 years of age. ObjectivesFollow-up of arsenic exposure and children’s cognitive abilities at school-age. MethodsIn a nested sub-cohort of the MINIMat supplementation trial, we assessed cognitive abilities at 10 years of age (n = 1523), using Wechsler Intelligence Scale for Children (WISC-IV). Arsenic in maternal urine and erythrocytes in early pregnancy, in child urine at 5 and 10 years, and in hair at 10 years, was measured using Inductively Coupled Plasma Mass Spectrometry. ResultsMedian urinary arsenic at 10 years was 58 µg/L (range 7.3–940 µg/L). Multivariable-adjusted regression analysis showed that, compared to the first urinary arsenic quintile at 10 years (<30 µg/L), the third and fourth quintiles (30–45 and 46–73 µg/L, respectively) had 6–7 points lower Full developmental raw scores (B: −7.23, 95% CI −11.3; −3.18, and B: −6.37, 95% CI −10.5; −2.22, respectively), corresponding to ~0.2 SD. Verbal comprehension and Perceptual reasoning seemed to be affected. Models with children’s hair arsenic concentrations showed similar results. Maternal urinary arsenic in early pregnancy, but not late pregnancy, showed inverse associations with Full developmental scores (quintiles 2–4: B: −4.52, 95% CI −8.61; −0.43, B: −5.91, 95% CI −10.0; −1.77, and B: −5.98, 95%CI −10.2; −1.77, respectively, compared to first quintile), as well as with Verbal comprehension, Perceptual reasoning, and Processing speed, especially in girls (p < 0.05 for interaction of sex with Full developmental scores and Perceptual reasoning). In models with all exposure time points included, both concurrent exposure at 10 years and early prenatal exposure remained associated with cognitive abilities. ConclusionsBoth early prenatal and childhood arsenic exposure, even at low levels (about 50 µg/L in urine), was inversely associated with cognitive abilities at school-age, although the estimates were modest.

Pilot Study on the Safety of Intravenous Arsenic Trioxide and Oral Realgar-Indigo Naturalis Formula Administrated in Children with Acute Promyelocytic Leukemia: A Single-Center Study

Objective Intravenous arsenic trioxide (ATO) and all-trans retinoic acid have become the front-line treatments for patients with acute promyelocytic leukemia (APL). Realgar-Indigo naturalis formula (RIF), an oral arsenic drug, not only shows a clinical efficacy comparable to ATO but also promotes incorporating an outpatient postremission therapy model into clinical practice for both low-risk and high-risk APL patients in China. However, the safety of ATO/RIF used in children with APL is unknown. To assess the safety of arsenic (ATO/RIF) administrated in children with APL, we designed the study. Methods Children with newly diagnosed APL treated with CCLG-APL2016 protocol (ChiCTR-OIN-17011227) in Beijing Children's Hospital from July 2016 to December 2018 were eligible for the study. The arsenic concentrations in different tissues, including plasma, urine, hair and nail, were measured at 10 time points: before ATO/RIF(D0), on the 7th, 14th and 28th day of ATO/RIF administration(D7, D14, D28), on the end of consolidation therapy (Con), during the 10 weeks of maintenance therapy (W10), on the cessation of therapy, after six months, one year and 1.5 years without arsenic administration. Adverse reactions were observed to evaluate the safety of arsenic received in children with APL. Results Nineteen patients with newly diagnosed APL were enrolled, including 9 boys and 7 girls with an onset average age of (10.9±3.7) years. There were 14 patients in low-risk group (white cell count &lt;10,000/ul) and 5 patients in high-risk group (white cell count≥10,000/ul). All of them got hematologic complete remission (HCR) and molecular complete remission (MCR). The time to get HCR and MCR were 31 days (range, 27~74days) and (72.2±16.4) days, respectively. Besides, there were 13 patients getting ATO and 6 patients getting RIF in induction phase, and all patients receiving RIF as an outpatient postremission therapy. It showed that plasma and urine arsenic levels were significantly elevated after ATO/RIF administration. The median plasma arsenic ranged from 38.4 ng/ml to 76.10 ng/ml on D7, D14, D28, Con and W10 while the median urine arsenic retention ranged from 1562.80ng/ml to 3791.00ng/ml on D7, D14, D28, Con and W10. Plasma arsenic level rapidly decreased to 1.01 ng/ml after six months without RIF administration, which was slightly higher than D0 (1.01ng/ml vs 0.60ng/ml, P=0.043) and decreased to normal after 1 year without arsenic administration compared with D0 (0.55 ng/ml vs 0.60ng/ml, P=0.655). Urine arsenic level decreased to normal within 0~6 months off therapy (25.80ng/ml vs 13.74ng/ml, P=0.866). Hair arsenic (6480.95ng/g, range 2616.20-14683.70ng/g) and nail arsenic levels (17896.85ng/g, range 400.00-30334.00ng/g) peaked at the time of cessation of therapy. Hair arsenic level decreased to normal within half a year off arsenic (156.50 ng/g vs 103.45 ng/g, P=0.345) while nail arsenic retention decreased to normal after 1 year off arsenic (P=0.655). In addition, Spearman rank correlation analysis showed that plasma arsenic concentration was positively correlated with urine (r=0.825, P&lt;0.001), hair (r=0.595, P&lt;0.001) and nail (r=0.584, P&lt;0.001) arsenic. Urine arsenic were also positively correlated with hair (r=0.624, P&lt;0.001), and nail (r=0.575, P&lt;0.001). And arsenic concentration in hair was positively correlated with nail (r=0.805, P&lt;0.001), too. Conclusions Through the detection of arsenic concentration in different periods and different tissues, it was found that the plasma arsenic concentration could be maintained within the effective concentration range in each treatment stage, and the arsenic concentration in plasma and hair gradually decreased to normal after six months off arsenic. Urine and nail arsenic went down to normal after 1 year off arsenic. Up to now, with a longest follow-up period of 34.7 months and the mean follow-up time of 19.6 months, the short-term response of arsenic disappeared after symptomatic therapy or arsenic reduction, and no chronic side effects of arsenic were observed. Therefore, the use of ATO/RIF in children with APL is safe, but it still needs long-term follow-up. Disclosures No relevant conflicts of interest to declare.

Dose-dependent relationships between chronic arsenic exposure and cognitive impairment and serum brain-derived neurotrophic factor

BackgroundArsenic poisoning is a public health problem worldwide. A few studies have reported the effects of arsenic exposure on adult cognitive function, but with limitations in the subject selection and exposure markers. Moreover, information regarding the association between arsenic exposure and biomarker of cognitive impairment is scarce. ObjectivesWe examined the associations between arsenic exposure and adult cognitive impairment using the Mini-Mental State Examination (MMSE) and the serum levels of brain-derived neurotrophic factor (BDNF), a potential biomarker of cognitive health status. MethodsWe designed a cross-sectional study that recruited 693 adult (18–60 years old) subjects from the areas of low- and high‑arsenic exposure in rural Bangladesh. The subjects' arsenic exposure levels (drinking water, hair, and nail arsenic concentrations) were measured by inductively coupled plasma-mass spectroscopy. The Bangla version of the MMSE was used as a cognitive assessment tool. Serum BDNF (sBDNF) levels were assessed by immunoassay. ResultsIn this study, we found that average MMSE score and sBDNF level of the subjects in arsenic-endemic areas were significantly (p < 0.001 for both) lower than those of the subjects in non-endemic area. Our analyses revealed that both MMSE scores and sBDNF levels were decreased with the increasing concentrations of arsenic in drinking water, hair, and nails in a dose-dependent fashion. In regression analyses, significant associations of arsenic exposure metrics with MMSE scores and sBDNF levels were observed even after adjustment for several variables. Intriguingly, MMSE scores showed a significantly positive correlation with sBDNF levels. ConclusionOur findings demonstrate that chronic exposure to arsenic dose-dependently decreases cognitive function in adults, with a concomitant reduction of sBDNF levels. A decreased BDNF level may be part of the biochemical basis of chronic arsenic exposure-related cognitive impairment.

On the Use of Hair Analysis for Assessing Arsenic Intoxication.

Correlations between the concentrations of arsenic in scalp hair and in drinking water as well as in blood and/or urine have been reported. These correlations clearly show exposure–absorption–excretion relationships. In addition, arsenic metabolites such as monomethylarsonic acid and dimethylarsinic acid have been identified and quantified in these tissues and fluids, leaving little doubt that elevated levels of arsenic in the hair can reflect systemic arsenic intoxication. Consequently, hair analysis has potential merit as a screening procedure for poisoning by arsenic. However, questions regarding the exogenous versus the endogenous deposition of arsenic in the hair, and uncertainties about the normal level of arsenic in the hair remain unresolved. Pending their resolution, the determination of arsenic in hair should remain a screening tool, and clinical signs and symptoms should be employed to complete the diagnosis of arsenic poisoning.

Association of maternal chronic arsenic exposure with the risk of neural tube defects in Northern China

Numerous animal studies have shown that high arsenic exposure can induce neural tube defect (NTD) formation. However, epidemiological evidence related to this finding is scarce. The key objective of our study is to evaluate whether maternal arsenic exposure is associated with NTD risk in Northern China. Our case–control study was conducted in 11 countries or cities in Shanxi and Hebei provinces during 2003–2007. A total of 774 mothers were included as participants: 511 controls and 263 cases (including 123 with anencephaly, 115 with spina bifida, 18 with encephalocele, and 7 with other NTD subtypes). The arsenic concentration was measured in a specific section of hair that grew from 3 months before to 3 months after conception. We found a higher hair arsenic concentration in the NTD cases with median (inter-quartile range) of 0.093 (0.025–0.387) μg/g hair than that in the controls with a value of 0.082 (0.030–0.414) μg/g hair. Maternal hair arsenic concentration above its median of the controls was associated with an increased risk of the total NTDs with an adjusted odds ratio (OR) of 1.32 [95% confidence interval (CI): (0.91–1.92)], which was not statistically significant (p = 0.14), although the crude OR without adjusting for the confounders of 1.68 (95% CI: 1.24–2.27; p < 0.001) suggested that hair arsenic is a risk factor of NTDs. There was no dose-response relationship between maternal hair arsenic concentration and the risk of total NTDs. Similar phenomena were found for anencephaly and spina bifida, respectively. Overall, our findings showed that maternal periconceptional arsenic exposure may not significantly contribute to the risk of NTD development in Northern China; other risk factors need to be further examined in future studies.

Concentration of arsenic in groundwater, vegetables, human hair and nails in mining site in the Northern Thai Nguyen province, Vietnam: human exposure and risks assessment

This study was aimed to examine the risk of chronic arsenic (As) exposure for the residents living in Nui Phao, Thai Nguyen in the northern Vietnam. Groundwater, vegetables, human hair, and nail samples were collected from volunteers living in Nui Phao. The results revealed that 75% of the groundwater samples had As exceeding the World Health Organization (WHO) drinking water guideline of 10 µg L−1. The result of As concentration for most of the vegetable samples was greater than the WHO/FAO safe (0.1 mg kg−1). The result of hair and nail samples in this study showed that 3.5 and 20% of the samples had As concentration exceeding the level of As toxicity in hair and nails, respectively. The result of health risks indicated that the potential health risk of As contamination is greater for groundwater than vegetables. The total hazard quotient (HQ) value through vegetables ingestion and drinking water exceeded 1.0 suggesting potential health risk for local residents. The calculation of potential carcinogenic risk through both consumption of vegetables and drinking water was low cancer risk in adults. Other food sources and the exposure pathways are needed to exactly assess health risks in this area.

Heavy Metals Analysis in Human Body (Toenail, Fingernail and Hair Samples) and Drinking Waters of Santa Fe Region, Argentina

This study provides an insight into a province of Santa Fe region of a developing country, namely San Cristobal and Huanqueros, Argentina and a possible link between arsenic, copper and iron concentration in toenail, fingernail and hair in the population. A multivariate statistical tool, known as Principal Component Analysis (PCA) was applied to explain the behaviour of the elements in toenails, fingernails, drinking waters and hair using multi- base 2013 excel add- ins. Correlation test, error bars, and a 2-factor ANOVA test were employed. Results from one hundred and twenty- nine (n=129) samples of tap well water (n=23), rainwater (n=20), bottled water (n=6) and treated well water (n=80) and each of toenail, fingernail and hair (n=129) samples from the subjects were determined and the results compared with the previous works. Mean, standard deviation, covariance and maximum and minimum for each variable were reported. The hypothesis is to understand if there is a correlation between fingernail and toenail metals levels and make a comparison with previous researches. Results show that a positive correlation exists between fingernail and toenail metals concentrations. Also, the study reveals higher concentrations of arsenic, copper and iron in the samples tissues compared with the values available in the previous works. The elevated levels of these metals may be attributed to the drinking water sources. Since this study highlighted elevated levels of these metals, consumptions of contaminated drinking water should be constantly monitored. Finally, the application of multivariate statistical techniques can provide powerful information on heavy metals bioaccumulation analysis in human and environment.