Uranium exposure in drinking water and cardiovascular disease in the Strong Heart Study

强心研究中饮用水中的铀暴露与心血管疾病

• 批准号: 10679514
• 负责人: Wil Forrest Lieberman-Cribbin
• 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 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10679514
• 关键词: Affect; American Indians; Arizona; Cardiovascular Diseases; Cardiovascular system; Carotid Artery Plaques; Characteristics; Chronic; Clinical; Cohort Studies; Communities; Data; Data Set; Databases; Death Records; Disease; Disease Outcome; Dose; Echocardiography; Elements; Environment; Environmental Wind; Evaluation; Family Study; General Population; Health; Heart; Hospitalization; Household; Hypertension; Image; Incidence; Information Systems; Intervention; Kidney; Left; Link; Location; Longitudinal cohort; Machine Learning; Measurement; Measures; Metal exposure; Metals; Mining; Modeling; North Dakota; Oklahoma; Outcome; Participant; Peripheral arterial disease; Pilot Projects; Population; Population Heterogeneity; Prevalence; Privatization; Probability; Prospective Studies; Regulation; Research; Resources; Risk; Risk Factors; Sampling; Site; Soil; Source; South Dakota; Stream; System; Time; Tobacco smoking behavior; Toxic effect; United States; Uranium; Urine; Ventricular; Water; Work; anthropogenesis; burden of illness; cardiovascular disorder risk; cardiovascular health; data resource; drinking water; follow-up; geochemistry; ground water; insight; policy recommendation; primary outcome; secondary outcome; urinary

PROJECT SUMMARY Uranium (U) is a naturally occurring element potentially associated with cardiovascular health outcomes. Across the United States (US), U is released into the environment through wind and water erosion, as well as anthropogenic mining, milling and other forms of U processing. Importantly, U is ubiquitous in American Indian (AI) communities, where the cardiovascular disease (CVD) burden remains disproportionally high, and U exposure via drinking water remains a concern. While the maximum contaminant level (MCL) for U in public water systems (30 µg/L) took effect in 2008, no MCL was regulated in the US prior to this time, and AI communities relying on private wells for drinking water are not regulated. The Strong Heart Study (SHS), a prospective study of CVD among AI communities in North Dakota, South Dakota, Arizona and Oklahoma, represents an important population to understand the extent and impact of U exposure on health outcomes. This requires a comprehensive assessment of both water and internal dose U exposure, including U measured in urine. However, urinary U data is only available in a kinship-based extension of the SHS, those comprising the Strong Heart Family Study (SHFS), and there is need to estimate this exposure across the entire SHS community to identify those with elevated U exposure and determine the long-term health outcomes. The objectives of this study are to 1) estimate water U exposure in SHS and SHFS participants relying on existing nationwide groundwater measurements, 2) estimate urinary U concentrations in SHS participants leveraging the associations between drinking water U and urinary U concentrations in the SHFS, and 3) investigate if estimated U exposure (water and urinary) in the SHS and SHFS is linked to CVD outcomes, both overall, and according to participant region and other characteristics. Water U exposure estimations (Aim 1) will rely on community water system estimations of U concentrations derived from the US EPA, the National Uranium Resource Evaluation Hydrogeochemical and Stream Sediment Reconnaissance database, which includes 335,547 sampling locations across the contiguous US collected from 1975 to 1980; the USGS National Water Information System, which provides water-resources data on over 1.9 million sites across the US; the Strong Heart Water Study, a pilot study of household water U measures (n = 441); and the USGS Reconnaissance study. These datasets will be used to assign water U measures to household locations. For Aim 2, the relationship between estimated water U exposure and urinary U concentrations in SHFS will be used to predict urinary U values in SHS participants with machine learning approaches. For Aim 3, we will investigate the association between estimated water and urinary U concentrations with both clinical and subclinical cardiovascular outcomes in SHS and SHFS participants. This work will estimate U exposure across the entire SHS, identify populations at increased risk of U-related CVD outcomes, and inform interventions to reduce water U exposure in AI communities and other communities equally affected by U exposure across the US.

项目概要 铀 (U) 是一种天然存在的元素，可能与心血管健康结果相关。 在美国（US），U通过风和水的侵蚀以及 重要的人为采矿、铣削和其他形式的铀加工 重要的人为铀在美洲印第安人中无处不在。 （AI）社区，心血管疾病（CVD）负担仍然不成比例地高，并且U 通过饮用水接触仍然是一个问题，而公共场所的 U 最大污染物水平 (MCL) 仍然令人担忧。 水系统（30 µg/L）于 2008 年生效，在此之前美国没有对 MCL 进行监管，而 AI 依赖私人水井获取饮用水的社区不受强心脏研究 (SHS) 的监管。 北达科他州、南达科他州、亚利桑那州和俄克拉荷马州人工智能社区 CVD 的前瞻性研究， 代表了了解 U 暴露对健康结果的程度和影响的重要人群。 需要对水和内部剂量 U 暴露进行全面评估，包括在 然而，尿液 U 数据仅在基于亲属关系的 SHS 扩展中可用，这些扩展包括 强心家庭研究 (SHFS)，需要估计整个 SHS 社区的这种暴露情况 识别 U 暴露水平较高的人群并确定长期健康结果。 研究目的是 1) 根据现有的全国范围估计 SHS 和 SHFS 参与者的水 U 暴露量 地下水测量，2) 利用以下方法估计 SHS 参与者的尿 U 浓度 SHFS 中饮用水 U 和尿 U 浓度之间的关联，以及 3) 调查是否估计 SHS 和 SHFS 中的 U 暴露（水和尿液）与 CVD 结果相关，总体而言，并且根据 区域和其他特征。水 U 暴露估计（目标 1）将依赖于社区参与者的水。 来自美国 EPA（国家铀资源评估）的 U 浓度系统估计 水文地球化学和河流沉积物勘察数据库，其中包括 335,547 个采样点 USGS 国家水信息系统从 1975 年到 1980 年收集了美国本土的数据； 提供全美超过 190 万个地点的水资源数据，这是一项试点项目； 家庭用水 U 测量研究（n = 441）；以及 USGS 勘测研究。 用于将水 U 测量分配给家庭位置 对于目标 2，估计水之间的关系。 SHFS 中的 U 暴露和尿 U 浓度将用于预测 SHS 参与者的尿 U 值 对于目标 3，我们将研究估计的水和水之间的关联。 SHS 和 SHFS 中尿 U 浓度与临床和亚临床心血管结局的关系 这项工作将估计整个 SHS 的 U 暴露量，确定患病风险增加的人群。 与 U 相关的 CVD 结果，并为减少人工智能社区和其他地区的水 U 暴露的干预措施提供信息 美国各地同样受到 U 暴露影响的社区。