Smoking is the primary source of cadmium (Cd) exposure, however, there are unexplained differences in urinary Cd (uCd) levels that persist by sociodemographic characteristics. We characterized uCd levels across geographic regions and sociodemographic categories to better identify sources and contributors. We include 6729 adults from the Multi-Ethnic Study of Atherosclerosis (MESA) with uCd measured at the baseline exam (2000-2002) and covariate information. Percentage difference (95% confidence interval) of uCd levels were computed by established factors using linear regression models. The overall median (IQR) of uCd was 0.53 (0.36, 0.80) μg/g creatinine. uCd levels differed significantly by age, sex, cigarette use, and race/ethnicity, not by study site or dietary factors. In fully adjusted models, participants > 62 years (mean age) had 20% (16%, 22%) higher uCd levels compared to those ≤ 62 years; females had 71% (67%, 76%) higher uCd compared to males. Compared to never smoking, participants with current and former cigarette use had 46% (40%, 52%) and 9% (6%, 13%) higher uCd, respectively. Chinese and Hispanic participants had 81% (73%, 89%) and 6% (2%, 9%) higher uCd, respectively, compared with White participants. Chinese participants had higher levels than other self-reported race/ethnicities, particularly among younger participants, females, never smoking or other tobacco product use, and those born outside of the United States. Smoking continues to have important implications for Cd burden among the general population. Our results highlight non-smoking Chinese women and Chinese participants born outside the US are a particularly vulnerable subgroup affected by higher long-term Cd exposure and body burden.

The US Gulf region is heavily reliant on metal-emitting petrochemical and manufacturing industries. We sought to characterize associations between residential proximity to metal-emitting sites and toenail metal concentration in men from four US states along the Gulf of Mexico with particular attention to potential differential exposure burden by race. We measured toenail concentrations of arsenic, chromium, lead, manganese, mercury, and selenium using inductively coupled plasma mass spectrometry in 413 non-smoking men from the Gulf Long-term Follow-Up Study (2011-2013). Point sources of industrial metal emissions were identified using the US EPA's National Emissions Inventory (NEI) database and mapped to geocoded participant residential addresses. For each metal, we examined relationships between toenail metal concentrations and linear distance to the nearest metal emitting site, inverse distance weighted number of emissions sites, and inverse distance weighted volume of air metal emissions within 30 km radial buffers of participant residences using multivariable linear regression. Results were stratified by self-reported race. Compared to self-identified White participants, Black participants lived closer to NEI sites but had 23-70% lower toenail concentrations of arsenic, chromium, mercury, manganese, and selenium adjusting for personal/behavioral factors. Toenail lead concentration was positively associated with residential proximity to leademitting NEI sites though the relationship was significantly attenuated after adjustment for neighborhood-level socioeconomic factors such as poverty level and age of housing stock. Residential proximity to lead-emitting NEI sites in the Gulf region is associated with a higher body burden of lead as measured in the toenail. This relationship may be driven in part by nonNEI factors related to residence in industry-adjacent neighborhoods. Further research into dietary/occupational exposures is needed to explain the unexpected racial disparities in metal body burden in this population.

The Gold King Mine Spill (GKMS) disaster resulted in three million gallons of acid mine drainage-containing arsenic and lead being released into a tributary of the San Juan River. The San Juan River flows through the Navajo Nation and the Diné (Navajo) rely on this river for a variety of purposes lending to unique exposure pathways. We administered questionnaires in three Navajo communities in collaboration with the Navajo Nation Community Health Representatives to obtain frequency and duration data on 43 activities (e.g., praying with river water, fishing from the river). These activities were utilized to conduct a community-based probabilistic risk assessment from exposure to arsenic (As) and lead at three different time points (i.e., pre-GKMS, peak-GKMS, and post-GKMS) for four different exposure scenarios: 1) recreational, 2) cultural, 3) dietary, and 4) aggregate. The aggregate scenario combines exposure from engaging in recreational, cultural, and dietary related activities. Utilizing the Lifeline Community-Based Assessment Software distributions were incorporated for different exposure factors (e.g., hand-to-mouth contacts, transfer efficiency) along with Diné-specific activities (e.g., using the sediment as sunscreen) to estimate dose. The estimated lead and arsenic (As) hazard quotients (HQs) for the recreational, cultural, and dietary scenario for all time points were less than one, indicating no excess non-cancer risks. Only the dietary scenario resulted in an excess cancer risk, with less than 1% of the simulated estimates exceeding the 1 × 10 cancer risk guideline from exposure to arsenic through the dietary scenario (e.g., consuming fish from the San Juan River) at all time points. This risk assessment is the first to incorporate the unique exposure pathways of the Diné people following the GKMS and highlights the need to incorporate community-specific pathways during the risk analysis process.

Research on the neurodevelopmental effects of metal(loid)s has focused mainly on outcomes assessed at one time point, even though brain development progresses over time. We investigated biomarkers of perinatal exposure to metals and changes in child behavior over time. We followed 268 participants from the prospective New Hampshire Birth Cohort Study between birth and age 5 years. We measured arsenic (As), copper (Cu), manganese (Mn), lead (Pb), selenium (Se), and zinc (Zn) in toenails from 6-week-old infants. The Behavioral Symptoms Index (BSI), externalizing, and internalizing symptoms were assessed using the Behavior Assessment System for Children, 2nd edition (BASC-2) at ages 3 and 5 years. Multivariable linear regression was used to estimate associations of metals with behavior change, calculated as the difference in symptom raw scores between 3 and 5 years, in addition to the associations for symptom scores at 3 and 5 years separately. Sex-specific associations were also explored using stratified models and a sex-metal interaction term. Adjusted associations of metals and change in behavior varied by exposure and outcome. Each 1 μg/g increase in ln toenail Cu was associated with improved behavior between 3 and 5 years [BSI: = - 3.88 (95%CI: - 7.12, - 0.64); Externalizing problems: = - 2.20 (95%CI: - 4.07, - 0.33)]. Increasing Zn was associated with increased externalizing behavior over time ( = 3.42 (95%CI: 0.60, 6.25). Sex-stratified analyses suggested more pronounced associations among boys compared to girls. Perinatal exposure to metals may alter behavioral development between ages 3 and 5 years. Findings support the need for more research on associations between metals and neurodevelopment over longer time periods.

Human milk is a rich source of microRNAs (miRNAs), which can be transported by extracellular vesicles and particles (EVPs) and are hypothesized to contribute to maternal-offspring communication and child development. Environmental contaminant impacts on EVP miRNAs in human milk are largely unknown. In a pilot study of 54 mother-child pairs from the New Hampshire Birth Cohort Study, we examined relationships between five metals (arsenic, lead, manganese, mercury, and selenium) measured in maternal toenail clippings, reflecting exposures during the periconceptional and prenatal periods, and EVP miRNA levels in human milk. 798 miRNAs were profiled using the NanoString nCounter platform; 200 miRNAs were widely detectable and retained for downstream analyses. Metal-miRNA associations were evaluated using covariate-adjusted robust linear regression models. Arsenic exposure during the periconceptional and prenatal periods was associated with lower total miRNA content in human milk EVPs ( < 0.05). When evaluating miRNAs individually, 13 miRNAs were inversely associated with arsenic exposure, two in the periconceptional period and 11 in the prenatal period ( < 0.05). Other metal-miRNA associations were not statistically significant after multiple testing correction ( ≥ 0.05). Many of the arsenic-associated miRNAs are involved in lactation and have anti-inflammatory properties in the intestine and tumor suppressive functions in breast cells. Our findings raise the possibility that periconceptional and prenatal arsenic exposure may reduce levels of multiple miRNAs in human milk EVPs. However, larger confirmatory studies, which can apply environmental mixture approaches, evaluate potential effect modifiers of these relationships, and examine possible downstream consequences for maternal and child health and breastfeeding outcomes, are needed.

Arsenic is related to neurodevelopmental outcomes and is associated with the composition of the gut microbiome. Data on the modifying role of the microbiome are limited. We probed suggestive relationships between arsenic and social behaviors to quantify the modifying role of the infant gut microbiome. We followed children for whom arsenic concentrations were quantified in 6-week-old toenail clippings. Scores on the Social Responsiveness Scale (SRS-2), which measures autism-related social behaviors, were provided by caregivers when the child was approximately 3 years of age. Metagenomic sequencing was performed on infant stools collected at 6 weeks and 1 year of age. To evaluate modification by the top ten most abundant species and functional pathways, we modeled SRS-2 total -scores as a function of arsenic concentrations, microbiome features dichotomized at their median, and an interaction between exposure and the microbiome, adjusting for other trace elements and sociodemographic characteristics. As compared to the standardized population (SRS-2 -scores = 50), participants in our study had lower SRS-2 scores ( = 78, mean = 44, SD = 5).The relative abundances of several functional pathways identified in 6-week stool samples modified the arsenic-SRS-2 association, including the pathways of valine and isoleucine biosynthesis; we observed no association among those with high relative abundance of each pathway [ = - 0.67 (95% CI - 1.46, 0.12)], and an adverse association [ = 1.67 (95% CI 0.3, 3.04), = 0.05] among infants with low relative abundance. Our findings indicate the infant gut microbiome may alter neurodevelopmental susceptibility to environmental exposures.

Laboratory studies have linked nickel with the pathogenesis of cardiovascular disease (CVD); however, few observational studies in humans have confirmed this association.

Long-term atmospheric quality monitoring of fine particulate matter (PM) and PM-bound polycyclic aromatic hydrocarbons (PAHs) was performed in Wuxi from 2016 to 2021. In total, 504 atmospheric PM samples were collected, and PM-bound 16 PAHs were detected. The PM and ∑PAHs level decreased annually from 2016 to 2021, from 64.3 to 34.0 μg/m and 5.27 to 4.22 ng/m, respectively. The benzo[a]pyrene (BaP) levels of 42% of the monitoring days in 2017 exceeded the recommended European Union (EU) health-based standard of 1 ng/m. Five- and six-ring PAHs were found, including benz[a]anthracene, benzo[k]fluoranthene (Bkf), BaP, and benzo[g,h,i]perylene, which were the dominant components (indicating a prominent petroleum, biomass, and coal combustion contribution) using molecular diagnostic ratios and positive matrix factorization analysis. Moreover, PM and PAHs were significantly negatively associated with local precipitation over a period of six years. Statistically significant temporal and spatial distribution differences of PM, and ∑PAHs were also found. The toxicity equivalent quotient (TEQ) of total PAHs was 0.70, and the TEQ of BaP (0.178) was the highest, followed by that of Bkf (0.090), dibenz[a,h]anthracene (Dah) (0.048), and indeno[1,2,3-cd]pyrene (0.034). The medians of the incremental lifetime cancer risk for long-term exposure to PAHs were 2.74E-8, 1.98E-8, and 1.71E-7 for children, teenagers, and adults, respectively, indicating that the carcinogenic risk of PAHs pollution in air was acceptable to local residents in this area. Sensitivity analysis revealed that BaP, Bkf, and Dah significantly contributed to carcinogenic toxicity. This research provides comprehensive statistics on the local air persistent organic pollutants profile, helps to identify the principal pollution source and compounds, and contributes to the prevention of regional air pollution.

Brain-derived neurotrophic factor (BDNF) and kisspeptin-1 (KISS-1) regulate placental development and fetal growth. The predictive value of maternal serum BDNF and KISS-1 concentrations for placental and umbilical cord levels has not yet been explored. The influence of prenatal lead (Pb) and cadmium (Cd) exposure and maternal iron status on BDNF and KISS-1 levels is also unclarified and of concern. In a pilot cross-sectional study with 65 mother-newborn pairs, we analyzed maternal and cord serum levels of pro-BDNF, mature BDNF, and KISS-1, BDNF, and KISS-1 gene expression in placenta, Pb and Cd in maternal and umbilical cord blood (erythrocytes), and placenta. We conducted a series of in vitro experiments using human primary trophoblast cells (hTCs) and BeWo cells to verify main findings of the epidemiological analysis. Strong and consistent correlations were observed between maternal serum levels of pro-BDNF, mature BDNF, and KISS-1 and corresponding levels in umbilical serum and placental tissue. Maternal red blood cell Pb levels were inversely correlated with serum and placental KISS-1 levels. Lower expression and release of KISS-1 was also observed in Pb-exposed BeWo cells. In vitro Pb exposure also reduced cellular BDNF levels. Cd-treated BeWo cells showed increased pro-BDNF levels. Low maternal iron status was positively associated with low BDNF levels. Iron-deficient hTCs and BeWo cells showed a consistent decrease in the release of mature BDNF. The correlations between maternal BDNF and KISS-1 levels, placental gene expression, and umbilical cord serum levels, respectively, indicate the strong potential of maternal serum as predictive matrix for BDNF and KISS-1 levels in placentas and fetal sera. Pb exposure and iron status modulate BDNF and KISS-1 levels, but a clear direction of modulations was not evident. The associations need to be confirmed in a larger sample and validated in terms of placental and neurodevelopmental function.

Polycyclic aromatic hydrocarbons (PAHs) and heavy metal(loid)s (HMs) pose risks to environmental and human health. Identification of priority control contaminants is important in guiding the management and control of these synchronous pollutants. A total of 247 soil samples were collected from 64 urban parks in the karst plateau city of Guiyang in SW China to determine the concentrations, spatial distributions, and health risks of PAHs and HMs. The results indicate that dibenz(ah)anthracene and benzo(a)pyrene are the main PAHs species of high ecological risk, and Cr, Mn, and Ni pose elevated ecological risk among the HMs. Four sources were identified for PAHs (biomass burning, coke oven, traffic sources, and coal burning) and HMs (traffic sources, coal burning, industrial sources, and natural sources). The non-carcinogenic risk (NCR) and total carcinogenic risk (TCR) of PAHs were all determined to be negligible and at acceptable levels, several orders of magnitude below those of HMs. The NCR and TCR values of HMs were relatively high, especially for children (11.9% of NCR > 1; 79.1% of TCR > 10). Coal burning and natural sources make the greatest contributions to the NCR and TCR values from karst park soils in Guiyang. Considering HMs bioavailability, NCR and TCR values were rather low, due to the high residual HM fractions. Integrated insights into source specific ecological and human health risk indicate future directions for management and control of synchronous PAH and HM pollution, particularly for karst plateau areas.

Endocrine-disrupting chemicals (EDCs) are a prime concern for the environment and health globally. Research shows that in developing countries such as India both the environment and human populations are severely exposed to EDCs and consequently experience rising incidents of adverse health effects such as diabetes and cancers. In this paper, we discuss the current EDC management approach in India, critically assess its limitations, and describe opportunities for potential improvements. Foremost, current EDC management actions and interventions in India are fragmented and outdated, and far behind the modern and comprehensive approaches adopted in the European Union and other developed countries. Strong and well-planned actions are required on various fronts of science, policy, commerce, and public engagement. These actions include the adoption of a dedicated and modern regulatory framework for managing EDCs, enhancing capacity and infrastructure for EDC monitoring in the environment and human population, employing public-private partnership programs for not only managing EDCs but also in the sectors that indirectly contribute toward the mismanagement of EDCs in the country, and raising awareness on EDCs and promoting health-preserving consumption habits among the public. As India hosts a large proportion of the global human population and biodiversity, the success or failure of its actions will substantially affect the direction of global efforts to manage EDCs and set an example for other developing countries.

The prevalence of internalizing behavior disorders in children is increasing. Reasons for increasing anxiety and depression include several factors with a less studied consideration being the potential neurotoxic effects of environmental exposures. One group at risk for environmental exposures is children living near coal-burning power plants with coal ash storage facilities. Multivariate logistic regression was used to assess the relationship between metal(loid) exposures and internalizing behaviors in children aged 6-14 years. Metal(loid)s in nail samples were determined by Proton-Induced X-ray Emission and internalizing behavior problems were obtained from the parent ratings on the Child Behavior Checklist. Results indicated that concentrations of metal(loid)s in nails differ between children with internalizing behaviors and without internalizing behaviors. Logistic regression models suggested that exposure to zinc and imputed zirconium were associated with internalizing behaviors in children. However, when a sex-metal(loid) interaction term was included, none of the metal(loid)s were associated with internalizing behaviors indicating a role of sex differences in neurotoxicity with zinc and copper showing effects only for males. In all models, greater exposure to traffic was associated with internalizing behaviors. Zinc has previously been shown to increase risk for mental health problems, while zirconium has received less attention. Out findings indicate that environmental exposures of zinc and zirconium deserve further attention in studies of childhood internalizing disorders.

In utero and early life exposure to inorganic arsenic (iAs) alters immune response in experimental animals and is associated with an increased risk of infant infections. iAs exposure is related to differences in the gut microbiota diversity, community structure, and the relative abundance of individual microbial taxa both in laboratory and human studies. Metabolomics permits a direct measure of molecular products of microbial and host metabolic processes. We conducted NMR metabolomics analysis on infant stool samples and quantified the relative concentrations of 34 known microbial-related metabolites. We examined these metabolites in relation to both in utero and infant log urinary total arsenic concentrations (utAs, the sum of iAs and iAs metabolites) collected at approximately 6 weeks of age using linear regression models, adjusted for infant sex, age at sample collection, type of delivery (vaginal vs. cesarean section), feeding mode (breast milk vs. any formula), and specific gravity. Increased fecal butyrate ( = 214.24), propionate ( = 518.33), cholate ( = 8.79), tryptophan (= 14.23), asparagine ( = 28.80), isoleucine ( = 65.58), leucine ( = 95.91), malonate ( = 50.43), and uracil ( = 36.13), concentrations were associated with a doubling of infant utAs concentrations ( 0.05). These associations were largely among infants who were formula fed. No clear associations were observed with maternal utAs and infant fecal metabolites. Metabolomic analyses of infant stool samples lend further evidence that the infant gut microbiota is sensitive to As exposure, and these effects may have functional consequences.

The occurrence of major water contamination events across the world have been met with varying levels of policy responses. Arsenic-a priority water contaminant globally, occurring naturally in groundwater, causing adverse health effects-is widespread in Bangladesh. However, the policy response has been slow, and marked by ineffectiveness and a lack of accountability. We explore the delayed policy response to the arsenic crisis in Bangladesh through comparison with water contamination crises in other contexts, using the Multiple Streams Framework to compare policy processes. These included O157:H7 and in Walkerton, Canada; lead and in Flint, Michigan, USA; and chromium-6 contamination in Hinkley, California, USA. We find that, while water contamination issues are solvable, a range of complex conditions have to be met in order to reach a successful solution. These include aspects of the temporal nature of the event and the outcomes, the social and political context, the extent of the public or media attention regarding the crisis, the politics of visibility, and accountability and blame. In particular, contaminants with chronic health outcomes, and longer periods of subclinical disease, lead to smaller policy windows with less effective policy changes. Emerging evidence on health threats from drinking water contamination raise the risk of new crises and the need for new approaches to deliver policy change.

Per- and polyfluoroalkyl substances (PFAS) are a focus of biomonitoring studies globally. In Australia, population PFAS serum concentrations have been determined since 2002 using pooled de-identified serum samples ( = 4800) collected from the population bi-annually, as a component of the Australian Human Biomonitoring (HBM) project. Locations of environmental PFAS contamination ('PFAS hotspots') are known to exist in Australia, but the extent of human exposure at many of these hotspots remains unknown. This study assesses if systematic use of geographical pooling of surplus pathology samples can be effective to identify if elevated PFAS exposure has occurred in populations residing near 'PFAS hotspots'. De-identified surplus pathology serum samples ( > 1800) were obtained and pooled from postcodes near three 'PFAS hotspots'. Samples were analyzed for PFAS and compared with the Australian HBM project. Selected PFAS were consistently higher compared to the Australian HBM project in pools from two of the three 'PFAS hotspots', suggesting that these populations may have experienced elevated exposure to PFAS. This study demonstrates that targeted serum pooling can be an effective tool for determining indications of population exposure to persistent chemicals in communities at risk. The technique has the potential to be used for rapid surveillance and as a trigger for further investigations of populations in proximity to sites with known contamination.

For the first time, this study reports the content of tropane alkaloids (TAs) in soybean and soymeal samples sourced from 13 different countries, as well as in various cereals (including corn, millet, wheat, and sorghum) and a product (Super Cereals). The analysis was conducted using a fully validated solid-liquid extraction (SLE) with dilute-and-shoot (DnS) method along with a liquid chromatography-tandem mass spectrometry (LC-MS/MS) triple quadrupole system. The samples were extracted using a solution of acetonitrile and water (60:40) with 1% formic acid. The limits of quantification (LOQ) were 0.10 µg kg and 0.25 µg kg for atropine and scopolamine, respectively. The extraction recovery was at least 80%, and the intra- and inter-day precision (relative standard deviation) were below 15% at 1, 5, and 50 µg kg atropine and scopolamine spiked levels. The validation parameters showed that the method was fit for the purpose of accurate LC-MS/MS quantification of atropine and scopolamine. The SLE with DnS is high-throughput, enabling the extraction of TAs in 2.3 min per sample or at least 60 samples in 140 min. Whereas typical TA extraction methods require lengthy and costly clean-up and concentration steps, the DnS does not require these steps, sophisticated equipment, or an expert operator for execution, which makes it a simpler and straightforward procedure for TA analysis in different grain-based food matrices. Application of the LC-MS/MS method showed that one in 80 millet or corn, 18 in 269 soybeans, 20 in 62 soymeal and 20 in 42 Super Cereals samples had atropine and scopolamine above the maximum level of 1 μg kg set by the EU Commission Regulation. TA contamination in these samples could either be due to the mixing with (visible) or exposure to (invisible) TA-producing plant material. The latter was proven through an exposure experiment, which showed that atropine and scopolamine from seeds can be transferred to food grains (soybeans) invisibly with prolonged contact.

The intersectional risks of children in United States immigrant communities include environmental exposures. Pesticide exposures and their biological outcomes are not well characterized in this population group. We assessed pesticide exposure and related these exposures to DNA double-strand breaks (DSBs) in Latinx children from rural, farmworker families (FW;  = 30) and from urban, non-farmworker families (NFW;  = 15) living in North Carolina. DSBs were quantified in hair follicular cells by immunostaining of 53BP1, and exposure to 72 pesticides and pesticide degradation products were determined using silicone wristbands. Cholinesterase activity was measured in blood samples. DSB frequencies were higher in FW compared to NFW children. Seasonal effects were detected in the FW group, with highest DNA damage levels in April-June and lowest levels in October-November. Acetylcholinesterase depression had the same seasonality and correlated with follicular DNA damage. Organophosphate pesticides were more frequently detected in FW than in NFW children. Participants with organophosphate detections had increased follicular DNA damage compared to participants without organophosphate detection. Follicular DNA damage did not correlate with organochlorine or pyrethroid detections and was not associated with the total number of pesticides detected in the wristbands. These results point to rural disparities in pesticide exposures and their outcomes in children from vulnerable immigrant communities. They suggest that among the different classes of pesticides, organophosphates have the strongest genotoxic effects. Assessing pesticide exposures and their consequences at the individual level is key to environmental surveillance programs. To this end, the minimally invasive combined approach used here is particularly well suited for children.

In Bangladesh most agronomic biomass (straw, husk, dried dung) is burnt for domestic cooking use. Consequently, the soil is continuously stripped of mineral nutrients and carbon (C) substrate. Here we investigate if recycling of household ash (ash) as fertilizer can sustainably improve soil fertility as well as minimise accumulation of toxic elements (As, Cd) in rice grain. Large scale field trials across two geographic regions (Barind, Madhupur) and two seasons (wet, dry) and with application of 3 fertiliser treatments (NPKS, ash, NPKS + ash) were conducted. At the end of each season, the impact of region*season*treatment on soil microbial comunities, rice yield, and grain quality (As, Cd, nutrient elements) was assessed. When compared to conventional field application rates of NPKS (control), application of ash boosted rice yield by circa. 20% in both regions during wet and dry season, with no effect on rice grain carcinogenic inorganic arsenic (iAs), dimethylarsonic acid (DMA) or cadmium (Cd), but with potential to increase zinc (Zn). For soil microbial communities, a significant region and season effect as well as correlation with elements in rice grain was observed, amongst these Cd, Zn, iAs and DMA. This study illustrates that application of ash can reduce the requirement for expensive chemical fertiliser, whilst at the same time increasing rice yield and maintaining grain quality, making farming in Bangladesh more sustainable and productive. The study also implies that the combined impact of region, season, and soil microbes determines accumulation of elements in rice grain.

Accelerating evidence confirms the contribution of per- and polyfluoroalkyl substances (PFAS) to disease burden and disability across the lifespan. Given that policy makers raise the high cost of remediation and of substituting PFAS with safer alternatives in consumer products as barriers to confronting adverse health outcomes associated with PFAS exposure, it is important to document the costs of inaction even in the presence of uncertainty. We therefore quantified disease burdens and related economic costs due to legacy PFAS exposures in the US in 2018. We leveraged systematic reviews and used meta-analytic inputs whenever possible, identified previously published exposure-response relationships, and calculated PFOA- and PFOS-attributable increases in 13 conditions. These increments were then applied to census data to determine total annual PFOA- and PFOS-attributable cases of disease, from which we calculated economic costs due to medical care and lost productivity using previously published cost-of-illness data. We identified PFAS-attributable disease costs in the US of $5.52 billion across five primary disease endpoints shown to be associated with PFAS exposure in meta-analyses. This estimate represented the lower bound, with sensitivity analyses revealing as much as $62.6 billion in overall costs. While further work is needed to assess probability of causation and establish with greater certainty effects of the broader category of PFAS, the results confirm further that public health and policy interventions are still necessary to reduce exposure to PFOA and PFOS and their endocrine-disrupting effects. This study demonstrates the large potential economic implications of regulatory inaction.

Micro- and nanoplastics (MNPs) are recognized as emerging contaminants, especially in food, with unknown health significance. MNPs passing through the gastrointestinal tract have been brought in context with disruption of the gut microbiome. Several molecular mechanisms have been described to facilitate tissue uptake of MNPs, which then are involved in local inflammatory and immune responses. Furthermore, MNPs can act as potential transporters ("vectors") of contaminants and as chemosensitizers for toxic substances ("Trojan Horse effect"). In this review, we summarize current multidisciplinary knowledge of ingested MNPs and their potential adverse health effects. We discuss new insights into analytical and molecular modeling tools to help us better understand the local deposition and uptake of MNPs that might drive carcinogenic signaling. We present bioethical insights to basically re-consider the "culture of consumerism." Finally, we map out prominent research questions in accordance with the Sustainable Development Goals of the United Nations.

Even the low levels of non-essential elements exposure common in the US may have health consequences especially early in life. However, little is known about the infant's dynamic exposure to essential and non-essential elements. This study aims to evaluate exposure to essential and non-essential elements during infants' first year of life and to explore the association between the exposure and rice consumption. Paired urine samples from infants enrolled in the New Hampshire Birth Cohort Study (NHBCS) were collected at approximately 6 weeks (exclusively breastfed) and at 1 year of age after weaning ( = 187). A further independent subgroup of NHBCS infants with details about rice consumption at 1 year of age also was included ( = 147). Urinary concentrations of 8 essential (Co, Cr, Cu, Fe, Mn, Mo, Ni, and Se) and 9 non-essential (Al, As, Cd, Hg, Pb, Sb, Sn, V, and U) elements were determined as a measure of exposure. Several essential (Co, Fe, Mo, Ni, and Se) and non-essential (Al, As, Cd, Hg, Pb, Sb, Sn, and V) elements had higher concentrations at 1 year than at 6 weeks of age. The highest increases were for urinary As and Mo with median concentrations of 0.20 and 1.02 µg/L at 6 weeks and 2.31 and 45.36 µg/L at 1 year of age, respectively. At 1 year of age, As and Mo urine concentrations were related to rice consumption. Further efforts are necessary to minimize exposure to non-essential elements while retaining essential elements to protect and promote children's health.