Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, MX.
Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados del IPN, MX.
Ann Glob Health. 2018 Jul 27;84(2):257-273. doi: 10.29024/aogh.913.
Mexico is included in the list of countries with concurrent arsenic and fluoride contamination in drinking water. Most of the studies have been carried out in the adult population and very few in the child population. Urinary arsenic and urinary fluoride levels have been accepted as good biomarkers of exposure dose. The Biomonitoring Equivalents (BE) values are useful tools for health assessment using human biomonitoring data in relation to the exposure guidance values, but BE information for children is limited.
We conducted a systematic review of the reported levels of arsenic and fluoride in drinking water, urinary quantification of speciated arsenic (inorganic arsenic and its methylated metabolites), and urinary fluoride levels in child populations. For BE values, urinary arsenic and fluoride concentrations reported in Mexican child populations were revised discussing the influence of factors such as diet, use of dental products, sex, and metabolism.
Approximately 0.5 and 6 million Mexican children up to 14 years of age drink water with arsenic levels over 10 μg/L and fluoride over 1.5 mg/L, respectively. Moreover, 40% of localities with arsenic levels higher than 10 μg/L also present concurrent fluoride exposure higher than 1.5 mgF/L. BE values based in urinary arsenic of 15 μg/L and urinary fluoride of 1.2 mg/L for the environmentally exposed child population are suggested.
An actual risk map of Mexican children exposed to high levels of arsenic, fluoride, and both arsenic and fluoride in drinking water was generated. Mexican normativity for maximum contaminant level for arsenic and fluoride in drinking water should be adjusted and enforced to preserve health. BE should be used in child populations to investigate exposure.
墨西哥被列入饮用水砷和氟同时污染的国家名单。大多数研究都是在成年人中进行的，而在儿童中进行的研究很少。尿砷和尿氟水平被认为是暴露剂量的良好生物标志物。生物监测等效值（BE）值是利用人体生物监测数据评估健康的有用工具，与暴露指导值有关，但针对儿童的 BE 信息有限。
我们对报告的饮用水砷和氟水平、儿童人群尿砷的形态定量（无机砷及其甲基化代谢物）以及尿氟水平进行了系统综述。对于 BE 值，我们讨论了饮食、使用牙科产品、性别和代谢等因素的影响，对墨西哥儿童人群报告的尿砷和氟浓度进行了修订。
约有 0.5 至 14 岁的 600 万墨西哥儿童饮用的水中砷含量超过 10μg/L，氟含量超过 1.5mg/L。此外，40%的砷含量超过 10μg/L 的地区也存在氟暴露水平超过 1.5mgF/L 的情况。建议根据暴露于环境中的儿童人群的尿砷值 15μg/L 和尿氟值 1.2mg/L 来确定 BE 值。
生成了一份实际的墨西哥儿童暴露于饮用水中高浓度砷、氟以及砷和氟的风险地图。墨西哥应调整和执行饮用水中砷和氟的最大污染物水平标准，以维护健康。应在儿童人群中使用 BE 值来调查暴露情况。
