Iodine status and thyroid nodules in females: a comparison of Cyprus and Romania.

OBJECTIVES: The increased comparative prevalence rates of thyroid cancer in Cyprus (>EU average) led us to conduct this study on possible risk factors of thyroid nodules. Romania served as a reference with a comparative thyroid cancer prevalence < EU average. This study aimed to assess the association between urinary iodine (UI) and thyroid nodules in adult females (n = 208) from Cyprus and Romania. STUDY DESIGN: A case-control study (n = 208). METHODS: Cases were females with ultrasound-confirmed thyroid nodules and controls with confirmed absence of nodules. In both countries, subjects underwent ultrasound medical examinations, completed a questionnaire and offered a spot urine sample. RESULTS: Median UI level in Cyprus was 94 µg/L, whereas 32% of the Cypriot UI was < 50 µg/L, classifying the population as mildly iodine deficient. In Romania, both cases and controls were iodine sufficient. No significant differences (P > 0.05) in serum free thyroxin (fT4) and thyroid stimulating hormone (TSH) levels were found between cases and controls. Cases had lower median TSH levels compared with controls (1.4 mIU/L and 1.7 mIU/L, P = 0.060), but serum TSH and free thyroxin levels were within normal range. Albeit non-significant, participants with inadequate UI (<100 µg/L) had increased risk for thyroid nodules (odds ratio = 1.40, 95% confidence interval = 0.70, 2.81, P = 0.346), using multiple logistic regression after adjusting for age, body mass index, education, country and serum TSH. CONCLUSIONS: This was the first study to quantify UI levels in Cyprus. While the Romanian iodine fortification programme reflected onto its UI levels, a representative assessment of iodine status in Cyprus will address the necessity of an iodine fortification programme.

Influence of household cleaning practices on the magnitude and variability of urinary monochlorinated bisphenol A.

Low-dose health effects of BPA have not been adequately explored in the presence of BPA metabolites of chlorinated structure that may exert larger estrogenic effects than those of their parent compound. We hypothesized that chlorine-containing cleaning products used in household cleaning activities could modify the magnitude of total urinary BPA concentration measurements via the production of chlorinated BPA (ClBPA) derivatives. Our objective was to investigate the influence of typical household cleaning activities (dishwashing, toilet cleaning, mopping, laundry, etc.) on the magnitude and variability of urinary total BPA and mono-ClBPA levels in the general adult population. A cross-sectional study (n=224) included an adult (≥18 years) pool of participants from the general population of Nicosia, Cyprus. First morning urine voids were collected, and administered questionnaires included items about household cleaning habits, demographics, drinking water consumption rates and water source/usage patterns. Urinary concentrations of total BPA (range: 0.2-82 µg L(-1)), mono-ClBPA (16-340 ng L(-1)), and total trihalomethanes (0.1-5.0 µg L(-1)) were measured using gas chromatography coupled with triple quadrupole mass spectrometry and large volume injection. Linear multiple regression analysis revealed that dishwashing along with age and gender (females) were able to predict urinary mono-ClBPA levels (ng g(-1)), even after adjusting for covariates; this was not the case for urinary total BPA levels (ng g(-1)). Significant (p<0.001) association was observed between urinary mono-ClBPA and THM levels, underlying the important role of disinfectant (chlorine) in promoting formation of both ClBPA and THM. Urinary mono-ClBPA levels were measured for the first time using an appreciable sample size, highlighting the co-occurring patterns of both total BPA and mono-ClBPA. Epidemiological studies and probabilistic BPA risk assessment exercises should consider assessing daily intake estimates for chlorinated BPA compounds, as well.

Household cleaning activities as noningestion exposure determinants of urinary trihalomethanes.

Previous epidemiological studies linking drinking water total trihalomethanes (THM) with pregnancy disorders or bladder cancer have not accounted for specific household cleaning activities that could enhance THM exposures. We examined the relation between household cleaning activities (washing dishes/clothes, mopping, toilet cleaning, and washing windows/surfaces) and urinary THM concentrations accounting for water sources, uses, and demographics. A cross-sectional study (n = 326) was conducted during the summer in Nicosia, Cyprus, linking household addresses to the geocoded public water pipe network, individual household tap water, and urinary THM measurements. Household tap water THM concentrations ranged between 3-129 µg L(-1), while the median (Q1, Q3) creatinine-adjusted urinary THM concentration in females (669 ng g(-1) (353, 1377)) was significantly (p < 0.001) higher than that in males (399 ng g(-1), (256, 681)). Exposure assessment, based on THM exposure equivalency units, showed that hand dishwashing, mopping, and toilet cleaning significantly (p < 0.001) increased urinary THM levels. The effect of dishwashing by females ≥36 y of age remained significant, even after adjusting for potential confounders. No significant (p > 0.05) association was observed between ingestion-based THM exposure equivalency units and urinary THM. Noningestion routes of THM exposures during performance of routine household cleaning activities were shown for the first time to exert a major influence on urinary THM levels. It is warranted that future pregnancy-birth cohorts include monitoring of noningestion household THM exposures in their study design.

Association between water consumption from polycarbonate containers and bisphenol A intake during harsh environmental conditions in summer.

With the exception of polycarbonate (PC) baby bottles, little attention has been paid to bisphenol A (BPA) intake from packaged water consumption (PC water dispensers), especially during summer weather conditions. We determined the magnitude and variability of urinary BPA concentrations during summer in 35 healthy individuals largely relying upon PC packaged water to satisfy their potable needs. We used liquid chromatography-tandem mass spectrometry to measure urinary BPA concentrations. A questionnaire was administered in July/August and a spot urine sample was collected on the same day and 7 days after the completion of the interview (without intervention). Linear regression was performed to assess the association of variables, such as water consumption from different sources, on urinary BPA levels for the average of the two urine samples. A significant positive association (p = 0.017) was observed between PC water consumption and urinary BPA levels in females, even after adjusting for covariates in a multivariate regression model. The geometric mean of daily BPA intake back-calculated from urinary BPA data was 118 ng · (kg bw)(-1) · day(-1), nearly double the average intake levels observed in biomonitoring studies worldwide. High urinary BPA levels were partially ascribed to summer's high PC water consumption and weather characteristics (high temperatures, >40 °C; very high UV index values, >8), which could be causing BPA leaching from PC. It is suggested that PC-based water consumption could serve as a proxy for urinary BPA, although the magnitude of its relative contribution to overall daily intake requires further investigation.

Arsenic bioaccessibility in a soil amended with drinking-water treatment residuals in the presence of phosphorus fertilizer.

A laboratory incubation study was conducted to determine the effect of drinking-water treatment residuals (WTRs) on arsenic (As) bioaccessibility and phytoavailability in a poorly As-sorbing soil contaminated with arsenical pesticides and fertilized with triple super phosphate (TSP). The Immokalee soil (a sandy spodosol with minimal As-retention capacity) was amended with 2 WTRs (Al and Fe) at 5 application rates ranging between 0% and 5% wt/wt. Sodium arsenate and TSP were used to spike the soil with 90 mg As kg(-1) and 115 mg P kg(-1), respectively. Bioaccessible As was determined at time 0 (immediately after spiking), and at 6 and 12 months of equilibration using an in vitro gastrointestinal test, and As phytoavailability was measured with a 1-M KC1 extraction test. Arsenic phytoavailability decreased immediately after spiking (20% availability at 5% rate), but only after 6 months for the Al-WTR- and the Fe-WTR-amended soil, respectively. Arsenic bioaccessibility simulated for the stomach and intestine phases showed that the Fe-WTR was more effective than the Al-WTR in resisting the harsh acidic conditions of the human stomach, thus preventing As release. Both the phytoavailable As and the bioaccessible As were significantly correlated (p < 0.001) for soil spiked with either Al- or Fe-WTR. Both WTRs were able to decrease soil As bioaccessibility irrespective of the presence or absence of P, which was added as TSP. Results indicate the potential of WTRs in immobilizing As in contaminated soils fertilized with P, thereby minimizing soil As bioaccessibility and phytoavailability.

Effect of soil properties on arsenic fractionation and bioaccessibility in cattle and sheep dipping vat sites.

Historical use of high arsenic (As) concentrations in cattle/sheep dipping vat sites to treat ticks has resulted in severe contamination of soil and groundwater with this Group-A human carcinogen. In the absence of a universally applicable soil As bioaccessibility model, baseline risk assessment studies have traditionally used the extremely conservative estimate of 100% soil As bioaccessibility. Several in-vitro, as well as, in-vivo animal studies suggest that As bioaccessibility in soil can be lower than that in water. Arsenic in soils exists in several geochemical forms with varying degree of dissolution in the human digestive system, and thus, with highly varying As bioaccessibility. Earlier batch incubation studies with As-spiked soils have shown that As bioaccessibility is a function of soil physicochemical properties. We selected 12 dipping vat soils collected from USA and Australia to test the hypothesis that soil properties exert a significant effect on As bioaccessibility in As-contaminated sites. The 12 soils varied widely in terms of soil physico-chemical properties. They were subject to an As sequential fractionation scheme and two in-vitro tests (IVGS and IVGIA) to simulate soil As bioavailability in the human gastrointestinal system. Sequential As fractionation results showed that the majority of the As measured in the dipping vat soils resided either in the Fe/Al hydroxide fraction, or the Ca/Mg fractions, or in the residual fraction. Water-extractable As fraction of the 12 soils was typically <10% of the total, reaching values up to 23%, indicating minimal leaching potential, and hence, lower risk of As-contamination from exposure to groundwater, typically used as drinking water in many parts of the world. Partial individual correlations and subsequent multiple regression analyses suggested that the most significant soil factors influencing As bioaccessibility were total Ca+Mg, total P, clay content and EC. Collectively, these soil properties were able to explain 85 and 86% of the variability associated with the prediction of bioaccessible As, using IVGS and IVGIA in-vitro tests, respectively. This study showed that specific soil properties influenced the magnitude of soil As bioaccessibility, which was typically much lower than total soil-As concentrations, challenging the traditional risk assessment guideline, which assumes that soil As is 100% bioaccessible. Our study showed that total soil As concentration is unlikely to provide an accurate estimate of human health risk from exposure to dipping vat site soils.