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.

项目概要/摘要 该提案的总体目标是评估公共和社区中砷和铀含量的变化。 几十年来加州各地的私人饮用水，并阐明其中的关系 长期接触这些污染物与心血管疾病（中风、急性心脏病）的风险之间的关系 心肌梗死）和慢性肾病在一个大型前瞻性队列中。天然无机砷 (As) 存在于全球土壤和地下水中。虽然美国社区对饮用水中的砷 (was) 进行了监管 供水方面，最近降低了最高污染物水平，并从年初开始实施 2000年代。然而，农村人口依赖私人水井，这些水井不受污染物监管，可能会受到污染。 地下水中含有较高含量的水砷。接触砷与全身炎症有关 和内皮功能障碍，以及肾脏损伤。有限但不断增加的证据表明 美国存在低至中等水平的 wAs 会增加心血管疾病 (CVD) 结局的风险， 包括中风和心肌梗塞。很少有流行病学研究评估了两者之间的关联 wAs 和慢性肾脏病 (CKD)，这是一种在某些地区以未知原因出现较高发病率的流行疾病 加利福尼亚州的农村地区。另一种饮用水污染物是铀 (wU)，它自然存在于 地下水，与WAS具有相似的毒理学特性，并且具有特别的肾毒性。鉴于 wU 可能会共同 如果发生在 wAs 中，暴露于两种污染物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，提供地理空间数据集 年度WAS和WU水平（1990-2020）是根据社区水的测量结果制定的 供应和私人水井，并在空间上分配给水系统边界和私人地下水网 （1x1 英里网格），分别。我们的研究建议首先评估时空趋势和共同 加利福尼亚州社区供水和私人水井中出现 was 和 wu。我们将利用 地理空间数据集，用于估计 WA 和 WU 参与者的长期居住饮用水水平 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 评估接触 wAs 与 CVD 的预期风险（包括中风和 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 总之，我们的研究将描述公共和私人水源的 WA 和 WU 随着时间的推移的趋势， 确定加利福尼亚州暴露程度较高的地区，并有助于了解有关暴露的有限知识 在美国，低至中度的WAS水平和联合暴露于WU以及CVD和CKD的风险。