[砷污染地区暴露和早期效应标志物的研究:SEpiAs项目的方法与结果。自然或人为砷造成环境污染地区的流行病学监测]
[Studies on markers of exposure and early effect in areas with arsenic pollution: methods and results of the project SEpiAs. Epidemiological surveillance in areas with environmental pollution by natural or anthropogenic arsenic].
作者信息
Bustaffa Elisa, Minichilli Fabrizio, Andreassi Maria Grazia, Carone Simona, Coi Alessio, Cori Liliana, Faita Francesca, Faita Francesco, Grecchi Sabina, Minoia Claudio, Ronchi Anna, Scovassi Ivana, Sicari Rosa, Stea Francesco, Bianchi Fabrizio
机构信息
Istituto di fisiologia clinica del CNR, Unità di epidemiologia ambientale eregistri di patologia, Pisa.
出版信息
Epidemiol Prev. 2014 May-Aug;38(3-4 Suppl 1):27-94.
INTRODUCTION
Arsenic and its inorganic compounds are classified as carcinogenic to humans. Exposures to inorganic arsenic (iAs) in drinking water are associated with both carcinogenic and non-carcinogenic effects. The risk assessment of exposures to low-moderate levels of environmental arsenic (As) is a challenging objective for research and public health. The SEpiAs study, funded by the Italian Ministry of Health (CCM), was carried out in four areas with arsenic pollution prevalently of natural origin, Amiata and Viterbo areas, or of industrial origin, Taranto and Gela.
MATERIALS AND METHODS
271 subjects (132 men) aged 20-44, were randomly sampled stratifying by area, gender and age classes. Individual data on residential history, socio-economic status, environmental and occupational exposures, lifestyle and dietary habits, were collected through interviews using questionnaire. In urine samples of recruited subjects, the concentration of inorganic arsenic (iAs) and methylated species (MMA, DMA) was measured using inductively coupled mass spectrometer (DRCICP- MS), after chromatographic separation (HPLC). Molecular biomarkers and biomarkers of DNA damage, as well as markers of cardiovascular risk were measured The distributions of iAs and iAs+MMA+DMA were described by area and gender, geometric mean (GM), percentiles and standard deviation (SD). The associations between As species and variables collected by questionnaire were evaluated by multiple regression analysis.
RESULTS
Results showed a high variability of As species within and among areas. Gela and Taranto samples showed higher iAs concentration compared to Viterbo and Amiata. Subjects with iAs>1,5 μg/L or iAs+MMA+DMA>15 μg/L (thresholds suggested by the Italian Society of Reference Values), are 137 (50,6%) and 68 (25,1%), respectively. A positive association between iAs and use of drinking water emerged in the Viterbo sample, between iAs and occupational exposure in the Gela and Taranto samples. Fish consumption was associated with higher iAs concentration in the whole sample, and particularly in men of the Gela sample. Similar results were observed for iAs+MMA+DMA. Subjects with iAs or iAs+MMA+DMA values higher than the 95th percentile were 15 (6Taranto, 5 Gela, 3Viterbo, 1 Amiata). The relationships between iAs and organic species (methylation efficiency ratios) were different between sex in the four areas. The relevance of polymorphisms AS3MT Met287Thr, GST-T1, GST-M1, OGG1 was confirmed. The analysis of carotid intima-media-thickness showed normal values, but higher among man of Viterbo, Taranto and Gela areas.
CONCLUSIONS
Results are informative of exposure to inorganic and organic As in large or at least non-negligible quotas of the samples. The SEpiAs results suggest a further deepening on routes of exposure to arsenic species, and support the recommendation to implement primary prevention measures to reduce population exposure.
引言
砷及其无机化合物被归类为对人类致癌物质。饮用水中无机砷(iAs)的暴露与致癌和非致癌效应均相关。对低至中等水平环境砷(As)暴露的风险评估是研究和公共卫生领域一项具有挑战性的目标。由意大利卫生部(CCM)资助的SEpiAs研究在四个砷污染地区开展,这些地区的砷污染主要源于自然(阿米亚塔和维泰博地区)或工业(塔兰托和杰拉地区)。
材料与方法
随机抽取271名年龄在20 - 44岁之间的受试者(132名男性),按地区、性别和年龄组进行分层抽样。通过问卷调查访谈收集有关居住史、社会经济地位、环境和职业暴露、生活方式及饮食习惯的个人数据。招募受试者的尿液样本经色谱分离(HPLC)后,使用电感耦合质谱仪(DRCICP - MS)测定无机砷(iAs)和甲基化产物(MMA、DMA)的浓度。检测分子生物标志物、DNA损伤生物标志物以及心血管风险标志物。按地区和性别描述iAs以及iAs + MMA + DMA的分布情况,包括几何均值(GM)、百分位数和标准差(SD)。通过多元回归分析评估砷物种与问卷调查收集的变量之间的关联。
结果
结果显示各地区内部和地区之间砷物种存在高度变异性。与维泰博和阿米亚塔相比,杰拉和塔兰托的样本显示出更高的iAs浓度。iAs>1.5μg/L或iAs + MMA + DMA>15μg/L(意大利参考值协会建议的阈值)的受试者分别有137名(50.6%)和68名(25.1%)。在维泰博样本中,iAs与饮用水使用之间存在正相关;在杰拉和塔兰托样本中,iAs与职业暴露之间存在正相关。食用鱼类与整个样本中较高的iAs浓度相关,在杰拉样本的男性中尤为明显。iAs + MMA + DMA也观察到类似结果。iAs或iAs + MMA + DMA值高于第95百分位数受试者有15名(塔兰托6名、杰拉5名、维泰博3名、阿米亚塔1名)。四个地区中iAs与有机物种(甲基化效率比)之间的关系在性别上存在差异。证实了AS3MT Met287Thr、GST - T1、GST - M1、OGG1多态性的相关性。颈动脉内膜中层厚度分析显示数值正常,但在维泰博、塔兰托和杰拉地区的男性中较高。
结论
结果表明样本中很大一部分或至少不可忽略部分人群暴露于无机和有机砷。SEpiAs研究结果表明需要进一步深入研究砷物种的暴露途径,并支持实施一级预防措施以减少人群暴露的建议。