Final Report: Food Borne Exposure to Arsenic During the First Year of Life

EPA Grant Number: R834599C002
Subproject: this is subproject number 002 , established and managed by the Center Director under grant R834599
(EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).

Center: Children's Environmental Health and Disease Prevention Center - Dartmouth College
Center Director: Karagas, Margaret Rita
Title: Food Borne Exposure to Arsenic During the First Year of Life
Investigators: Karagas, Margaret Rita , Cottingham, Kathryn L. , Folt, Carol L. , Punshon, Tracy
Institution: Dartmouth Medical School , Dartmouth College
EPA Project Officer: Callan, Richard
Project Period: February 15, 2010 through February 14, 2013 (Extended to February 14, 2014)
RFA: Children's Environmental Health and Disease Prevention Research Centers: Formative Centers (with NIEHS) (2009) RFA Text |  Recipients Lists
Research Category: Children's Health , Health

Objective:

This pilot project has contributed to the broader mission of the Dartmouth Center for Children’s Environmental Health and Disease Prevention Research to understand the health effects of low-dose exposure to environmental contaminants, including arsenic, by quantifying sources of arsenic exposure during the first year of life. The public health effects of arsenic in food, especially rice, are only beginning to be evaluated, but are a particularly pressing issue in regions such as New Hampshire where arsenic contamination of private well water is already a concern. We began the pilot project with one primary aim and two secondary aims:

Primary Aim: To determine how infant consumption of breast milk and formula contributes to exposure to arsenic during the first 4 months of life.

Secondary Aim 1: To begin evaluating how increased infant consumption of solid foods affects arsenic exposure during the period from 4-12 months.

Secondary Aim 2: To test the feasibility of measuring urinary metabolites of arsenic in infants at 4 months of age, and determine the relationships among urinary arsenic, arsenic ingestion estimated from food and water, and toenail arsenic levels.

During the course of the project, primary aim and secondary aim 2 coalesced, in that we evaluated exposure via breast milk and formula not only via direct arsenic measurements in these food sources, but also using urinary arsenic biomarkers in 6-week old infants. To our knowledge, these are the earliest measurements of urinary arsenic made to date. Quality assurance/quality control (QA/QC) of the urinary arsenic measurements is ensured through the use of National Institute of Standards and Technology traceable standards, certified standard reference materials, blank samples, and blinded replicate samples by the analytical laboratories to which samples were sent.

The primary achievements of this pilot project include nine published papers, two papers in preparation, numerous presentations at scientific meetings, and direct communication with the press and the public about our findings. For example, results to date confirm the seminal role of rice cereal, but have also demonstrated arsenic exposure due to the rice-based sweeteners (especially organic brown rice syrup, OBRS) that are increasingly used in place of high-fructose corn syrup in certain food markets. Our paper on OBRS (Jackson et al. 2012b) alerted a toddler formula manufacturer to the presence of arsenic in their products, and prompted a re-evaluation of the supply chain that resulted in reduced arsenic exposure within about 6 months of the paper’s online publication. Moreover, our work on OBRS goes well beyond children's health, since this product is widely used in both the organic and athletic performance food markets (Jackson, et al., 2012b).

Summary/Accomplishments (Outputs/Outcomes):

  1. Primary Aim & Secondary Aim 2:

    Market basket studies: Early in the project, we conducted market basket studies of arsenic concentrations in 17 powdered infant and toddler formulas (Jackson, et al., 2012a,b). Arsenic concentrations in formulas not sweetened with organic brown rice syrup (OBRS) varied from below detection (<3.4 µg As per kg formula) to as much as 12.6 µg/kg, and there were trends with brand and type, such that formulas containing soy components had ~2.2 µg/kg higher total arsenic than formulas containing lactose (Jackson, et al., 2012a). When reconstituted with distilled water, the mean arsenic concentration of these formulas was ~1 μg/L, or about 10% of the current US EPA maximum contaminant level (MCL). Speciation of the formulas with total concentrations >10 µg/kg revealed that most of the arsenic was in the highly toxic inorganic form. Strikingly, the two toddler formulas sweetened with OBRS contained very high concentrations of arsenic, 200-400 µg/kg (Jackson, et al., 2012b); when reconstituted with distilled water, arsenic concentrations of these products were up to twice the MCL. This finding attracted considerable attention from the press and brought this project into the public eye. In April 2012, PI Cottingham recorded a podcast for Environmental Health Perspectives describing the main points of that paper, while collaborator Jackson responded to many press inquiries. We are very proud of the fact that by August 2012, the supplier of that formula had figured out how to reduce arsenic in the supply chain, improving public health.

    Urinary arsenic biomarkers and diet: Since August 2012, we have been sampling infant diet and collecting urine at 6 weeks post-partum for infants in the NHBCS. Parents complete a written, three-day food diary (created in collaboration with dietary epidemiologist Kristy Hendricks) and then collect an infant urine sample just before the mother’s 6 week-postnatal visit to her obstetrician or midwife. A novel part of our food diary, relative to existing ones, is the emphasis on the source and amount of water added to foods (i.e., formula), so that we can accurately quantify intake from the multiple pathways of food and water. By coordinating sample collection with ongoing maternal care, we strengthened response rates and reduced costs by having participants bring samples to us rather than mailing them. As of August 2013, more than 100 food diaries and 82 urine samples had been collected; measurements of arsenic in the home tap water of most of these infants were available from samples taken at the time the mother was recruited into the cohort. Papers reporting findings from these samples are currently in preparation.

  2. Secondary Aim 1:
    To begin evaluating how increased infant consumption of solid foods affects arsenic exposure during the period from 4-12 months.

    Market basket study: During the first part of the study period, we analyzed 8 infant cereals and biscuits, 41 pureed fruits and vegetables, and 19 weaning foods (those given starting ~9 months) for total arsenic concentration and speciation where total concentrations exceed 5 ng/g (Jackson, et al., 2012a). These analyses showed a strong relationship to rice content: solid foods containing rice (e.g., rice cereal, lentils & rice, chicken & rice) had higher total arsenic than solid foods without rice (P<0.001). Moreover, fruit purees containing pears had 10.7 ng/g more arsenic than purees without pears; >75% of this arsenic was in the more highly toxic inorganic forms.

    Diet data: Throughout the project, we have been collecting data on diet for infants in the NHBCS at 4, 8 and 12 months of age via telephone questionnaire, in collaboration with Project 1. We also have been collecting three-day food diaries, infant urine samples, and infant and maternal toenail samples at age 12 months. This food diary (again developed in consultation with Hendricks) is a longer, more complex version of the one used at 6 weeks. These samples will allow us to learn about post-weaning exposure through direct measurements, rather than the indirect assessments from the telephone questionnaire. We plan to combine data on consumption of solids from these dietary records with our market basket surveys to estimate actual exposure for infants in our cohort and to compare the estimated exposure with urinary arsenic concentrations as part of our full Children’s Center moving forward (P01 ES022832, RD83544201).

    Related studies: Finally, as part of the preliminary work to develop and refine our methodologies for our studies of infant dietary exposure to arsenic, we conducted several studies on dietary exposure to arsenic in other age groups, including pregnant women (Gilbert-Diamond, et al., 2011), New Hampshire adults (Gruber, et al., 2012; Cottingham, et al., 2013), and children sampled as part of the National Health and Nutrition Examination Survey (Davis, et al., 2012).

Conclusions:

We are very excited to have received funding for a new (P01) Children's Center, and look forward to continuing our research to underscore the importance of evaluating the effects of in utero and early life exposure to arsenic on children’s health, and the potential impacts of this exposure later in life.


Journal Articles on this Report : 10 Displayed | Download in RIS Format

Other subproject views: All 31 publications 12 publications in selected types All 12 journal articles
Other center views: All 76 publications 29 publications in selected types All 29 journal articles
Type Citation Sub Project Document Sources
Journal Article Carey A-M, Lombi E, Donner E, de Jonge MD, Punshon T, Jackson BP, Guerinot ML, Price AH, Meharg AA. A review of recent developments in the speciation and location of arsenic and selenium in rice grain. Analytical and Bioanalytical Chemistry 2012;402(10):3275-3286. R834599 (2012)
R834599 (Final)
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  • Journal Article Cottingham KL, Karimi R, Gruber JF, Zens MS, Sayarath V, Folt CL, Punshon T, Morris JS, Karagas MR. Diet and toenail arsenic concentrations in a New Hampshire population with arsenic-containing water. Nutrition Journal 2013;12:149. R834599 (2011)
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  • Journal Article Davis MA, Mackenzie TA, Cottingham KL, Gilbert-Diamond D, Punshon T, Karagas MR. Rice consumption and urinary arsenic concentrations in U.S. children. Environmental Health Perspectives 2012;120(10):1418-1424. R834599 (2012)
    R834599 (Final)
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  • Journal Article Gilbert-Diamond D, Cottingham KL, Gruber JF, Punshon T, Sayarath V, Gandolfi AJ, Baker ER, Jackson BP, Folt CL, Karagas MR. Rice consumption contributes to arsenic exposure in US women. Proceedings of the National Academy of Sciences of the United States of America 2011;108(51):20656-20660. R834599 (2011)
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  • Journal Article Gruber JF, Karagas MR, Gilbert-Diamond D, Bagley PJ, Zens MS, Sayarath V, Punshon T, Morris JS, Cottingham KL. Associations between toenail arsenic concentration and dietary factors in a New Hampshire population. Nutrition Journal 2012;11:45 (10 pp.). R834599 (2011)
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    R834599C001 (2012)
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  • Journal Article Jackson BP, Taylor VF, Punshon T, Cottingham KL. Arsenic concentration and speciation in infant formulas and first foods. Pure and Applied Chemistry 2012;84(2):215-223. R834599 (2012)
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  • Journal Article Jackson BP, Taylor VF, Karagas MR, Punshon T, Cottingham KL. Arsenic, organic foods, and brown rice syrup. Environmental Health Perspectives 2012;120(5):623-626. R834599 (2011)
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  • Journal Article Karagas MR, Andrew AS, Nelson HH, Li Z, Punshon T, Schned A, Marsit CJ, Morris JS, Moore JH, Tyler AL, Gilbert-Diamond D, Guerinot ML, Kelsey KT. SLC39A2 and FSIP1 polymorphisms as potential modifiers of arsenic-related bladder cancer. Human Genetics 2012;131(3):453-461. R834599 (2011)
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  • Journal Article Punshon T, Tappero R, Ricachenevsky FK, Hirschi K, Nakata PA. Contrasting calcium localization and speciation in leaves of the Medicago truncatula mutant cod5 analyzed via synchrotron X-ray techniques. The Plant Journal 2013;76(4):627-633. R834599 (Final)
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  • Journal Article Punshon T, Ricachenevsky FK, Hindt MN, Socha AL, Zuber H. Methodological approaches for using synchrotron X-ray fluorescence (SXRF) imaging as a tool in ionomics: examples from Arabidopsis thaliana. Metallomics 2013;5(9):1133-1145. R834599 (Final)
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  • Supplemental Keywords:

    water, drinking water, ground water, exposure, risk, health effects, human health, vulnerability, sensitive populations, population, infants, children, susceptibility, metals, heavy metals, public policy, decision making, community-based, public good, environmental chemistry, biology, geography, epidemiology, immunology, analytical, surveys, measurement methods, Northeast, EPA Region 1, food processing, water safety;, RFA, Health, Scientific Discipline, INTERNATIONAL COOPERATION, ENVIRONMENTAL MANAGEMENT, Water, HUMAN HEALTH, Exposure, Environmental Chemistry, Biochemistry, Children's Health, Environmental Policy, Drinking Water, Biology, Risk Assessment, birth defects, prenatal exposure, perinatal exposure, children's vulnerablity, biological markers, arsenic exposure, dietary exposure, growth & development, arsenic, developmental disorders

    Relevant Websites:

    Children's Environmental Health and Disease Prevention Research Center at Dartmouth Exit

    Progress and Final Reports:

    Original Abstract
  • 2010 Progress Report
  • 2011
  • 2012 Progress Report

  • Main Center Abstract and Reports:

    R834599    Children's Environmental Health and Disease Prevention Center - Dartmouth College

    Subprojects under this Center: (EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).
    R834599C001 Arsenic and Maternal and Infant Immune Function
    R834599C002 Food Borne Exposure to Arsenic During the First Year of Life
    R834599C003 An Integrated Geospatial and Epidemiological Study of Associations Between Birth Defects and Arsenic Exposure in New England
    R834599C004 Determining How Arsenic (As) Modulates Sonic Hedgehog (Shh) Signaling During Development