Adverse Health Effects in Children
due to Arsenic Exposure, B. Windham (Ed.)
The toxic metals lead, mercury, and arsenic are the top 3 toxics
having the most adverse health effects on the public based on toxicity and
current exposure levels in the U.S. (1)
Arsenic, like
most of the other metals has been found in studies to be associated with
neurologic, cardiovascular, dermatologic, immune,
endocrine
(diabetes), hepatic, and
carcinogenic effects, along with reproductive effects (24,25,26,1b,3,16,18,20,
36-38,40,43etc.); and according to U.S. DOH affects more people than any other
toxic substance (1a).
Long-term exposure to ingested arsenic has been documented to
induce peripheral vascular disease,
cartoid
arteriosclerosis,
ischemic heart disease, and cerebral infarction in a dose-response relationship
(24a,1b).
A comparison of areas with higher levels of arsenic in the
water supply found higher fetal and infant mortality in areas with higher
arsenic levels and higher cancer rates. Some of the developmental effects
documented to be caused by low level toxic metal exposure include developmental
delays, growth problems, slower reaction times, diminished intellectual
ability, behavior problems, poor balance and motor function, hearing loss,
attention deficit disorder, peripheral neuropathy, etc.
(19,30,24,25,26,1b,16,18,34,36-38,40, etc.)
A comprehensive analysis of published data indicates that arsenic
exposure induces cardiovascular diseases (43), developmental abnormalities,
neurologic and neurobehavioral disorders, diabetes, hearing loss, hematologic
disorders, and various types of cancer (34,41,42). Recent reports have pointed
out that arsenic poisoning appears to be one of the major public health
problems of pandemic nature. Acute and chronic exposure to arsenic has been
reported in several countries of the world where a large proportion of drinking
water (groundwater) is contaminated with high concentrations of arsenic.
Research has also pointed significantly higher standardized mortality rates for
cancers of the bladder, kidney, skin, liver, and colon in many areas of arsenic
pollution (34,41,42). Arsenic is often found at high levels in drinking water
(34b,36).
Several studies have found Arsenic to be significantly associated
with type 2 diabetes and other conditions (36). Total
urine arsenic was associated with increased prevalence of type
2 diabetes, and since there is a widespread exposure worldwide this
finding supports the hypothesis that low levels of exposure to inorganic arsenic in
drinking water may play a role in diabetes prevalence
(36a). Arsenic multifactorial effects include accelerating birth and
postnatal weight gains, elevated body fat content, glucose intolerance, insulin
resistance, and increased serum lipid profile. Arsenic also elevated
cord blood and placental, as well as postnatal serum leptin levels. The data
from human studies indicate an association between
inorganic arsenic exposure and the risk of diabetes and
obesity (36c). A study also found polymorphisms in diabetes- related genes
to be a factor in toxic effects (36b).
Combinations
of toxic metals have synergistic effects that are associated with type 2
diabetes and other conditions (37). Associations between arsenic and
cadmium were reported for cardiovascular and kidney disease, type I and type
II diabetes, cognitive function, hypothyroidism, and increased prevalence
and mortality for lung and other cancers (37,38,41,42,43).
Studies have found Arsenic can cause several forms of cancer
including
Lung cancer, Bladder cancer, Skin cancer, lung,
digestive
tract, liver, kidney, tract, urothelial,
lymphtic
,
and hematopoietic
systems (44,45).
Study results demonstrated that As and Cd
exposure caused significant changes to the gut microbiome and metabolome by
affecting bile acids, amino acids and taxa associated with metabolic health
(37c). Inorganic Arsenic can increase DM risk by impairing mitochondrial
metabolism, one of the key steps in the regulation of glucose-stimulated
insulin secretion (GSIS) in pancreatic β-cells (36)
.
The results also found that Manganese, like Arsenic, may inhibit
GSIS by impairing mitochondrial function, whereas Cd may target other
mechanisms that regulate GSIS in β-cells. Impairment of hepatic glucose
homeostasis can also play a crucial role in the pathogenesis of DM. Along with
compromised function of pancreas and muscles, diminished liver and kidney
functions also contribute considerably to increase the blood glucose level.
These metals have potential to bring conformational changes in these enzymes
and make them inactive. Additionally, these metals also disturb the hormonal
balance, such as insulin, glucocorticoids and catecholamines; by damaging
pancreas and adrenal gland, respectively. Moreover, these metals also enhance
the production of reactive oxygen species and depress the anti-oxidative
defense mechanism with subsequent disruption of multiple organs (37). Exposure
to Endocrine Disrupting Chemicals (
EDCs
) during fetal or early life can
disrupt the development of both the immune system and the pancreatic beta
cells, potentially increasing susceptibility to T1DM later in life. In
addition, developmental exposure to some EDCs can affect beta cell development
and function, influencing insulin secretion. These changes may increase stress
on the beta cells and identify them as a target to the immune system.
Developmental exposure to EDCs that disrupt metabolism by increasing insulin
resistance or obesity may also stress the beta cells. (38,37,36).
�Developmental exposure to some EDCs can cause immune system
dysfunction, increasing the risk of autoimmunity (37).
Arsenic is on the EPA Special Health
Hazard List because it is a potent Class A carcinogen in humans (3,31), as
well as being neurotoxic. An EPA study of cancer incidence for different
levels of arsenic in drinking water found a dose related response for all types
of cancer (31). The cancer rate for people with drinking water levels of
above .6 parts per million arsenic were approx. 3 times those for
people drinking water below .3 ppm arsenic, with large increases in
cancers of internal organs. According to U.S.EPA it also causes
birth defects, learning disabilities, damage to bone marrow, and other health problems, and
new studies estimate that drinking water contaminated with arsenic at the
current federal limit poses a 1 percent lifetime risk of cancer- about the same
as radon or tobacco smoke (3). EPA staff have proposed lowering
the drinking water standard for arsenic substantially from 10 ppb to 5 parts
per billion.
Arsenic is often found at high levels in coastal
and estuarian water bodies.
The metalloids arsenic, selenium, and tellurium can be converted
to volatile products of extreme toxicity (31,32). Arsenic is
acutely toxic to marine organisms but also has other effects at lower levels
including growth retardation and reproductive failure (33, etc.). Arsenic
is widely distributed in sediments in some areas
of Florida and bioaccumulates in the food chain. The
FDEP NOEL (no observed effect level) for arsenic is 8 ppm. The FDEP
sediment PEL is 64 ppm. The EPA contaminant criteria (33c)
for arsenic in seafood is 2 ppm. The drinking water standard is 10
ppb.
The toxic metals most
dangerous to people eating fresh- water fish are those that accumulate in the
edible muscle of fish‑ including mercury, arsenic, radioactive cesium, and to a
lesser degree lead (31). Shellfish, especially oysters, accumulate lead,
mercury, cadmium, copper, silver, arsenic, and radioactive metal isotopes
(31). Oysters and other shellfish are accumulating increasing
amounts of toxic metals, with oysters often accumulating levels of cadmium,
lead, and arsenic dangerous to people and above the FDA recommended action
level or guideline level (59).
While there is no FDA Action Level for arsenic,
arsenic is more acutely toxic than the other metals for which there is an
action level and arsenic is highly carcinogenic (1,3,31). The drinking water
guideline for arsenic is lower than those for mercury or cadmium-
10ppb. The EPA toxics contaminant criteria for arsenic in seafood is
2 ppm (33c).
Arsenic
accumulates in shellfish and has been found at levels 20 times the EPA
guideline maximum contaminant level (19.9). The toxic
arsenite
form is the primary form in shellfish and the
most toxic form to people.
Utilities and
incinerators are the largest source of mercury, cadmium, arsenic, chromium, and
manganese emissions in the U.S. (32,3). Fossil fuel combustion is
also responsible for over 90% of nickel and beryllium emissions. Midwestern
coal, especially Missouri and Illinois, have very high levels of cadmium, nickel,
and lead. Gulf Coast coal is high in most trace
metals. Coal from northern Appalachia is high in arsenic, as well as
mercury.
. Most coal ash laboratory tests have
found cadmium and arsenic at levels considered hazardous per EPA RCRA
standards,
The
high PH that often
characterizes Western coals tends to cause the release of harmful toxic metals
such as arsenic, selenium, and manganese.
According to an EPA/ATSDR assessment,
the toxic metals lead, mercury, and arsenic are the top 3 toxics having the
most adverse health effects on the public based on toxicity and current
exposure levels in the U.S. (1), with cadmium, chromium and nickel also highly
listed.
Water, soils, and
shellfish are common sources of exposure (3), but the most common and
significant exposure to children is from pressure treated lumber in playgrounds
and patios (2,4).
Renee Sharp, principal author of a recent
study involving tests of children stated that the study found that: "In
two weeks, an average five-year-old playing on an arsenic-treated playset would
exceed the lifetime cancer risk considered acceptable under federal pesticide
law." (2) In recent months, dozens of public playgrounds in
Florida have been closed after detection of high levels of arsenic. Some case
histories of children with arsenic related neurological conditions with
exposure mostly through treated lumber are found in (18). Eating chicken has
also been found to be a significant source of arsenic exposure, since farmers
feed arsenic to chickens and pigs to prevent parasites that are prevalent in
crowded conditions (22).
Many similar studies measuring child
hair levels of the toxic metals- aluminum, arsenic, cadmium, lead, and mercury
have found that these toxic metals have significant effects on learning ability
and cognitive performance, explaining as much as 20 % of cognitive differences
among randomly tested children who have low levels of exposure not exceeding
health guidelines for exposure to any of these metals (6-15,17,19). These toxic
metals have been found to have synergistic negative effects on childhood
development and cognitive ability (8,13-15,21).
A study (35) of Uruguayan school children
found that arsenic concentrations were positively associated with 8-OHdG
concentrations, a marker for oxidative stress. In sum, even at low-level,
Arsenic exposure is associated with detectable oxidative damage to the DNA.
These toxic metals have also been
found to have significant effects on motor-visual ability and performance
(6a,8,19,20,30,40), as measured by the Bender Visual-Motor Gestalt Test score.
Arsenic, lead, and cadmium levels had the highest correlation with cognitive
scores, while aluminum had a significant relation mostly with motor-visual
performance and mercury had lesser but highly significant correlations to both.
A combined hair level score for mercury, lead, arsenic, cadmium
and aluminum was found to be significantly related to increased scores on the
WPBIC subscales measuring acting-out, disturbed peer relations, immaturity, and
the total score (6) among a population of students with no known acute
exposures.
Chronic exposure to arsenic at very low levels (below 10 parts per
billion) have been found to cause cancer by a review by the National Academy of
Sciences (23) and other studies (2,5). Two industry funded studies supported
causality of cancer in workers (5). The first concluded that arsenic
exposure was related to an increased risk of respiratory cancer in Tacoma
Smelter workers in every category of exposure(5a). The second study, conducted
by University of Michigan scientists, confirmed a previously established
relationship between arsenic exposure and lung cancer in Anaconda Smelter
workers(5b). A Univ. of Washington study found that those with significant
arsenic exposure have more than double the normal incidence of Parkinson's
(27).
Common sources of arsenic include wood preservatives (2),
antibiotics given to commercial livestock, air pollution, chemical processing,
coal-fired power plants, defoliants, drinking water, drying agents for cotton,
fish and shellfish, herbicides, insecticides, meats (from commercially raised
poultry and cattle), metal ore smelting, pesticides, seafood (fish, mussels,
oysters), and specialty glass.
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**********
edits(
27)