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OCR for page 90
90 DRINKING WATER AND HEALTH
mg/m3) during major organogenesis and found no adverse fetal effects.
Ungvary et al. (1978) exposed rats to 1,500 ppm (3,840 mg/m3) during
pregnancy and observed that there was increased fetal mortality but no
malformations.
Although Infante et al. (1976a,b) reported increased rates of malforma-
tions in one city where a vinyl chloride plant was located, subsequent stud-
ies by Edmonds et al. (1978) revealed that the parents of these children had
not been workers in the plant nor had they been living closer to the manu-
facturing source than had the controls. Infante et al. (1976b) reported a
significant increase in fetal loss among the wives whose husbands had been
exposed. As a "control" group, they used workers in rubber plants.
Sanotskii et al. (1980) did not find an increase in spontaneous abortions
among the wives of vinyl chloride workers.
In summary, vinyl chloride does not appear to be teratogenic in rats or
rabbits. The data on humans are not adequate for judgment to be made.
CONCLUSIONS AND RECOMMENDATIONS
A SNARL for chronic exposure was not calculated because orally adminis-
tered vinyl chloride is an established carcinogen in humans. It is also car-
cinogenic in mice, hamsters, and rats, in which angiosarcomas were
found, regardless of route. The older animals and females appeared to be
more susceptible. The cancer risk estimate for vinyl chloride can be found
in Volume 1 of Drinking Water and Health.
URANIUM (U)
Uranium was evaluated in the third volume of Drinking Water and Health
(National Research Council, 1980, pp. 173-178~. That review was devoted
exclusively to the element's chemical toxicity. In the following review, the
committee also considers its radiological effects and provides updates and,
in some instances, reevaluations of the information on chemical toxicity
contained in the previous volume. Included are some references that were
not assessed in the earlier report.
Uranium is ubiquitously distributed throughout the earth's crust. It has
a complex radioactive decay scheme resulting in the emission of different
radiations and the production of several radioactive daughter products.
Because its abundance in the crust varies geographically, uranium is a
highly variable source of contamination of drinking waters that may be
directly consumed by humans and incorporated into their diet. In this brief
review, the committee discusses the potential for radiation and chemical
toxicity from the ingestion of natural uranium and clarifies the difference
OCR for page 91
Toxicity of Selected Contaminants 91
between radiation toxicity and the rather well-studied chemical toxicity of
this element. For the purpose of brevity and conciseness, not all of the
primary references have been cited; rather, the committee has provided
several references that are representative and sufficiently broad to cover
the needs of this report.
Natural uranium is present in soils and rocks in concentrations generally
varying between 0.5 and 5 ppm. The average is approximately 1.8 ppm in
most soils. Higher concentrations are present in salic rock, in granite, and
in sedimentary shale. More than 99% of uranium is present as the isotope
uranium-238. Another 0.72870 occurs as the fissionable isotope uranium-
235, and 0.0054~o by weight of uranium as uranium-234. The half-lives
are: uranium-238, 109 years; uranium-235, 108 years; and uranium-234,
105 years. The radioactivity of the three isotopes in natural uranium aver-
ages approximately 7.35 x 105 disintegrations per minute per gram, al-
most all of which is from uranium-238 (National Council on Radiation
Protection and Measurements, 1975~.
Uranium-238 is generally found to be in equilibrium with thorium-234,
palladium-234, and uranium-234, so that a gram of natural uranium
would contain 0.33 psi of each of the four nuclides. Furthermore, ura-
nium-238 and uranium-234 are generally in disequilibrium in nature. The
fractionation of 234 from 238 is believed to occur by the displacement of
the daughter atom uranium-234 from the crystal lattice by recoil, which
renders uranium-234 potentially capable of being oxidized to the hexava-
lent stage when it is more easily leached into the water phase than the par-
ent 238. Because of the disequilibrium, the 234:238 uranium activity con-
centration ratio can vary among water samples. Reported values range
from 0.7 up to 9 (United Nations, 1977~.
The activity concentration of uranium-238 in tap water is usually re-
ported to be less than 0.03 psi/liter. Thus, the contribution of drinking
water to total dietary intake is generally small. A report by the United Na-
tions (1977), however, states that concentrations of uranium found in Rus-
sian tap water have been as high as 70 psi/liter and that concentrations of
approximately 1,000 psi/liter have been measured in several wells in Fin-
land. The highest concentration actually reported was S,OOO psi/liter. The
very high concentration of uranium in the water from those wells was at-
tributed to small, localized uranium-rich deposits (Asikainen and Kahlos,
1980; Kahlos and Asikainen, 1980~.
Although uranium may adhere to inhaled particles, inhalation is only a
minor route of entry into humans. The United Nations (1977) estimated
that the daily adult intake via inhalation is approximately 1 X 10-3 psi.
The major route of entry is ingestion.
The National Council on Radiation Protection and Measurements
OCR for page 92
92 DRINKING WATER AND HEALTH
(1975) assumed a 1.8 kg/day food intake level for a "reference man" and,
in limited measurements, determined that drinking water provides to of
the 1 psi of uranium ingested daily. Approximately 20~o of the daily in-
take is provided by grains and cereal products; 20~o by meat, fish, and
eggs; 20% by green vegetables, fruits, and pulses; and 20~o by root vegeta-
bles. As much as logo may be present in milk and dairy products.
METAB O LI S M
The data indicate that approximately 1 psi (~ 1 Age of uranium is con-
sumed daily and that from 2 % to 3 % of that amount is derived from drink-
ing water (National Council on Radiation Protection and Measurements,
1975~. To a large extent, the uptake and fate of ingested uranium are con-
trolled by the total quantity ingested and, to a lesser extent, on the particu-
lar chemical form. In general, the smaller the amount ingested, the greater
the fraction absorbed (Durbin and Wrenn, 197S). For the purposes of this
report, it will be assumed that the quantity of uranium ingested by humans
is very small and, therefore, the maximum uptake possible occurs. Hursh
and Spoor (1973) cite data indicating that between 12~o and 30~0 of the
ingested uranium is absorbed from the intestinal tract into the blood-
stream. An inte~.~ediate figure of 20~o is assumed in the following discus-
s~on.
Of the absorbed uranium, approximately 805to is excreted, logo goes to
the kidneys, and the remaining logo is deposited in the skeleton. The kid-
ney retention is believed to be brief, with a biological half-life of 1 to 2
weeks. The uranium deposited in the skeleton is divided disproportion-
ately between the spongy and compact bone compartments. Approxi-
mately 80~o of the skeletal mass is assumed to be compact bone in which
~95~o of the deposited uranium has a short effective half-life ranging
from 1 month to 1 year, whereas only ~ to of the absorbed uranium in the
remaining 20~o of the skeleton may have an average half-life of about
10 years (Roswell and Wrenn, 1980~. Because of efficient renal clearance
of circulating uranium, redistribution of uranium deposits is inefficient
and the body burden of uranium probably reflects recent dietary intakes.
Natural uranium bicarbonate complexed with proteins is filtered by the
kidney glomeruli. The plasma equilibrium is shifted from the proteinate to
the bicarbonate until all uranium not deposited in the skeleton has passed
through the glomeruli. Once in the kidney tubules, the bicarbonate com-
plex is partially dissociated to consenre sodium. With the accompanying
renal reabsorption of water, the urine becomes more acidic, the uranium
more concentrated, and further bicarbonate disassociation occurs. The
freed uranium can bind to the luminal surfaces of the cells lining the proxi-
OCR for page 93
Toxicity of Selected Contaminants 93
mal renal tubules and, with sufficient time and dosage, can cause tubular
damage (Durbin and Wrenn, 1975~. Hodge (1951) noted, "The uranium-
inhibited reaction is located on the cell surface, is rate limiting in the pres-
ence of uranium, is chemical in nature, is an enzymatic not a diffusion
process, is specific, and probably involves the reaction of uranium with the
phosphates of adenosine triphosphate." Therefore, the mechanism of tox-
icity is likely to be suppression of cellular respiration. The site of action is
invariably confined to the proximal convoluted tubules of the kidney
(Hursh and Spoor, 1973~.
HEALTH ASPECTS
Observations in Humans
The committee found no reports of radiological toxicity in humans ex-
posed to natural uranium by ingestion. Furthermore, as Hursh and Spoor
(1973) noted, "The implication that the contamination of drinking water
by uranium is an uncommon and relatively unimportant hazard is con-
finned by the dearth of precise and unambiguous information in the litera-
ture." The excellent summarized history of uranium poisoning by Hodge
(1973) indicates that renal injury occurred in uranium-treated diabetics in
the last century and early in this century. These patients were generally
given hundreds of milligrams per day over extended periods. There are no
population studies, and only specific clinical assessments have been re-
ported. Recent studies in humans are confined to those in which much
lower concentrations of uranium were used. The aim of these studies was
to determine the absorption and urinary excretion of oral doses to assist in
interpreting reports of early therapeutic administrations.
Luessenhop et al. (1958) investigated the effects of intravenous adminis-
tration of uranyl nitrate [UO2(NO3~2] in humans. Five volunteers with ter-
minal brain cancer received doses that ranged from 0.097 to 0.28 mg/kg
(average, 0.15 mg/kg). They noted the following distribution-excretion
pattern: from to to 14~o to the skeletal system, 165'o to the kidneys, and
49~o to 84~o excreted in the urine. These percentages are comparable to
those found in studies of small animals. The most sensitive indicator of
renal damage was an increase in urinary catalase. Other chemical signs
included albuminuria, urinary casts, and a suggestion that there was inter-
ference with the renal capacity for reabsorption of sodium and chloride
and the secretion of potassium. These authors concluded that, of the com-
mon laboratory animals, rats appear to correspond most closely in sensitiv-
ity to humans in regard to intravenous tolerance to uranium.
OCR for page 94
94 DRINKING WATER AND HEALTH
Observations in Other Species
Acute Effects The renal injury associated with uranium toxicity usu-
ally manifests itself several days after exposure. In rats, cellular necrosis
appears in the lower portion of the proximal convoluted tubules as demon-
strated by hyaline casts or casts containing shed necrotic cells. Accompa-
nying the pathological changes are functional changes in the kidney, char-
acterized by proteinuria, impaired Diodrast and p-aminohippuric acid
clearance, and increased clearance of amino acids and glucose (Stone et
al., 1961~.
In studies in dogs, Thompson and Nechay (1981) demonstrated that
uranium as uranyl nitrate [UO2(NO3~2] produced a 74~o inhibition of re-
nal calcium Ca2+ ATPase and an 84~o inhibition of renal magnesium
Mg2+ ATPase at concentrations of 3 X 10-s M and 1 X 10-s M, respec-
tively. They postulated that uranium dioxide (uo2+) may compete with
ATP for binding sites on the Ca2+ and Mg2+ ATPase and that this may be
a factor in its renal toxicity.
Nomiyama et al. (1974) demonstrated in rabbits that early renal injury
could be detected by increases of specific enzymes in the urine following
one intravenous injection of uranyl acetate (0.2 mg of uranium/kg bw).
Urinary alkaline phosphatase, glutamic oxaloacetic transaminase, and
glutamic-pyruvic transaminase all increased significantly before changes
were observed in routine urinalyses or renal function tests. Thus, assays for
selected urinary enzymes may be more sensitive indicators of early renal
· .
nJury.
An interesting phenomenon observed after acute exposure to uranium is
the development of tolerance (mainly in rats) to the effects of repeated ex-
posure. This tolerance may be related to the ability of "uranium-condi-
tioned" animals to excrete uranium more efficiently or to a mechanism in
which the renal tubular epithelium does not bind and retain uranium as
well as "unconditioned" epithelium (Durbin and Wrenn, 1975~.
Maynard and Hodge (1949) also studied the acquired uranium tolerance
in rats and concluded that "prolonged exposure to uranium may produce
conditions under which injection of an ordinary damaging dose of uranium
results in no appreciable renal tubular necrosis."
Chronic Effects Many studies have been conducted to compare the
toxicity of natural uranium and some of its isotopes after continuous inges-
tion. Rodents and dogs continuously fed a wide range of natural uranium
concentrations developed no radiogenic cancers. At the higher levels, renal
OCR for page 95
Toxicity of Selected Contaminants 95
damage predominates as the toxic end point. As pointed out by Durbin
and Wrenn (1975), "Because uranium has a long residence time in bone,
the radiation dose is limiting for all uranium isotopes except 23su and 238U
and all mixtures of uranium isotopes containing at least 91.5~o 238U by
weight (12-fold enrichment in 23su by the gaseous diffusion process has at
least an equal amount of 234U)."
For example, in a classic toxicity study by Finkel (1953), injections of
natural uranium in concentrations as high as 1 mg/kg induced no malig-
nant bone tumors, whereas uranium-233 doses of 1 mg/kg proved to be a
maximally effective bone carcinogen, comparable to uranium-232 at 5 X
10-4 mg/kg. More importantly, the uranium-232 activity was approxi-
mately 10 psi/kg' as was that of the uranium-233, whereas the natural
uranium contained a maximum of 7 X 10-4 ~Ci/kg.
Maynard and Hodge (1949) conducted 2-year studies in which rats were
continuously fed different uranium compounds ranging from O.l~o to
20~o of the dietary mass. The lowest dietary levels producing retardation of
growth were: uranyl fluoride, 0.1%; uranyl nitrate hexahydrate, 0.5~o;
and uranium tetrafluoride, 20~o. Uranium dioxide at 20~o, the highest
level tested, produced no effect. The only major pathological effect ob-
served as a result of chronic oral exposure was necrosis of the renal tubular
epithelium, involving predominantly the proximal convoluted tubule. The
same effects were frequently observed in dogs and rabbits exposed for only
30 days. Although chemical toxicity was observed, primarily in the kidney,
no radiogenic effects were noted.
The same authors also fed various uranium compounds at graded doses
of 0.0002 to 0.2 g/kg/day to dogs over a 1-year period. With the exception
of one dog fed the highest level (0.2 g/kg/day) of uranyl nitrate, all the
dogs survived, gained weight, and were healthy and active. Only at dietary
doses greater than 0.02 g/kg/day were any effects of uranium toxicity
noted. Moderate elevations in blood nonprotein nitrogen and urea nitro-
gen were observed as well as transient urinary sugar and proteinuria. Path-
ological effects were not described.
The investigators observed~interesting differences in response between
dogs dosed for 1 year and rats dosed for 2 years. Rats were more resistant
to the toxicity of uranyl fluoride (UO2F2) by a factor of approximately 25.
For uranyl nitrate [UO2(NO3~2-6H2O], the rats were more resistant by a
factor of about 20, and for uranium tetrafluoride (UF4), by a factor of 4.
ln summary, studies in laboratory animals have produced radiation-re-
lated cancers only when high specific-activity isotopes of uranium were
used. There have been no reports of cancers resulting from the ingestion of
natural uranium in laboratory animals.
OCR for page 96
96 DRINKING WATER AND HEALTH
Mutagenicity No data were found by the committee.
Teratogenicity No data were found by the committee.
CONCLUSIONS AND RECOMMENDATIONS
Suggested No-Adverse-Response Level (SNARL)
Chronic Exposure Because there is no evidence that naturally occur-
ring uranium-238 is carcinogenic, a chronic exposure SNARL will be cal-
culated. Two-year studies in rats and a 1-year study in dogs by Maynard
and Hodge (1949) have indicated that the dog is the more sensitive species.
In chronic exposures, the highest dietary level tolerated by dogs with no
decreases in body weight gain or symptoms of renal involvement was
1 mg/kg/day. Luessenhop et al. (1958) found 0.15 mg/kg to be the mini-
mum-observed-effect dose in humans, but this dose was administered in-
travenously. This amount is approximately the same as that absorbed (as-
suming 20% gastrointestinal absorption) following an oral dose of
1 mg/kg. Using an uncertainty factor of 100, and assuming that a 70-kg
adult consumes 2 liters of water daily and that logo of the uranium intake
is provided by the water, one may calculate a chronic SNARL as:
1.0 mg/kg X 70 kg X 0 1 = 0.035 mg/liter, or 35 ~g/liter
If one assumes that the isotopic ratios in natural uranium are in equi-
librium, then there would be 0.33 pCi/pg of uranium-238. A value of
35 ~g/liter would be equivalent to 11.6 psi/liter, which is about twice the 5
psi/liter established as the current maximum contaminant level (MCL)
for radium (U.S. Environmental Protection Agency, 1975a). Ingestion of
water containing radium at 5 psi/liter is estimated to cany a risk of be-
tween 0.7 to 3.0 fatal cancers per year per million persons exposed. There
is currently no standard for uranium.
Ike total absence of carcinogenic effects from ingested natural uranium
in either animals or humans makes it difficult to develop an appropriate
model for the radiotoxicity of that element. Furthermore, the fact that
drinking water rarely contributes more than 2~o to 5~o of the total ura-
nium ingested daily leads to the conclusion that a radiation risk model for
natural uranium is inappropriate and unjustified on the basis of present
knowledge. When natural uranium is subjected to an enrichment process
resulting in specific activity exceeding 106 disintegrations per minute per
gram, it is possible that a radiotoxicity model could be developed (U.S.
OCR for page 97
Toxicity of Selected Contaminants 97
Energy Research and Development Administration, 1976~. This assump-
tion is based primarily on the findings of Finkel (1953), who studied ura-
nium-233 and natural uranium, and on the radioactivity rather than the
mass relationships of the different uranium isotopes tested in laboratory
animals. Finkel reported that the radioactivity, in terms of alpha disinte-
gration rate, reached levels comparable to those seen in radium-226 toxic-
ity. For purposes of this discussion, the effectiveness of uranium-233 and
uranium-235 can be regarded as fairly comparable to that of radium-226,
based on ingested psi per unit time.
Because of its loo specific activity, natural uranium does not pose a
problem of radiotoxicity in drinking water. Assessment of uranium toxicity
in drinking water should be based on its chemical toxicity and not on radi-
ation toxicity. However, when the specific activity of uranium in drinking
water has been altered so that it is greater than that of natural uranium,
potential radiotoxicity should be given attention equal to that of the chemi-
cal toxicity. The committee also recommends that toxicological assessment
of uranium in cater be based solely on its renal toxicity in all instances
except when industrial processes result in a marked enrichment of shorter-
lived uranium isotopes.
Additional research should be carried out to determine with greater pre-
cision the dynamics of uranium absorption from the gastrointestinal tract
for different chemical forms of uranium.
CONCLUSIONS
Chronic Toxicity
Table II-10 lists the compounds reviewed in this volume for which there
were sufficient data to calculate either a chronic SNARL or cancer risk
estimate. The statistical methodology for the cancer risk estimate is de-
scribed for chlorobenzene on page 21. Further details on methodology can
be found in Volumes 1 and 3 of Drinking Water and Health (National
Research Council, 1977, 1980~. It is important to stress that the reader
should refer back to the discussion on individual compounds for specific
details.
Mutagenicity As described in Chapter 1, a chemical was judged to be a
mutagen when it could be shown that it was mutagenic in any one short-
term test. The data summary in Table Il-11 is based on this criterion. It is
important to stress that the reader should refer back to the discussion on
individual compounds for specific details.
OCR for page 98
98 DRINKING WATER AND HEALTH
TABLE II-10 Summation of Chronic Exposure Levels and
Carcinogenicity Risk Estimate for Chemicals Reviewed
Chemical
Suggested No-Adverse-Response
Level (SNARL), mg/liter, for
Chronic Exposure
Upper 95%
Confidence Estimate
of Lifetime Cancer
Risk per ~g/liter
Aldicarb
Chlorobenzene
o-Dichlorobenzene
p-Dichlorobenzene
1, 1 -Dichloroethylene
Dinoseb
Hexach lorobenzene
Methomyl
Picloram
Rotenone
Tetrachloroethylene
1,1, 1 -Trichloroethane
Trich loroethylene
Uranium
o. oo7a
0.3`
0.094a- C
0.10
0.039
0.175
1.05
0.014
0.035
2.13 x 10 - 7b
I .85 x l o ha
d
2.98 x 10 8b
3.3 X 10 7b
aThis is the suggested no-adverse~effect level calculated in Volume I of Drinking Water and [health (lsia-
tional Research Council, 1977) and continues to be the recommended SNARL.
bBased on limited evidence (see Chapter 1) from ongoing studies being conducted by the National Toxicol-
ogy Program ( I 982a.d,e). The studies on these compounds have undergone peer review and the results are
. . . .
In press at t lIS Writing.
This SNARL must be reviewed when the cancer bioassay is completed and reviewed (see text for details).
dNeither a SNARL nor a cancer risk estimate has been calculated by the committee pending the outcome of
an ongoing study being conducted by the National Toxicology Program (1982d).
Teratogenicity The only compound reviewed in this volume that
showed teratogenic potential following oral exposure was hexachloroben-
zene. Dinoseb was teratogenic following intraperitoneal, but not oral expo-
sure. The data for rotenone and trichloroethylene are inconclusive.
RE SEARCH REC OMMENI)ATION S
Although specific research recommendations are given for many of the
compounds reviewed, the major areas are summarized here.
1. The most urgent need is for comparative data on various aspects of
metabolism in laboratory animals and humans. Only with such data can
relevant animal models be used to predict more accurately the potentially
adverse health effects in humans.
2. In conjunction with the above recommendation, these kinds of data
ultimately need to be included in the mathematical models now used to
estimate cancer risk.
OCR for page 99
Toxicity of Selected Contaminants 99
TABLE II-11 Mutagenicity Studies of Chemicals
Reviewed in this Volume
Chemical
Mutagenicitya
Aldicarb
Carbofuran
Carbon tetrachloride
Chlorobenzene
o-Dichlorobenzene
p-Dichlorobenzene
1 .2-Dichloroethane
1, l-Dichloroethylene
cis- 1 ,2-Dichloroethylene
trans- 1 ,2-Dichloroethylene
Dichloromethane
Dinoseb
Hexachlorobenzene
Methomyl
Picloram
Rotenone
Tetrach loroethylene
1,1, 1 -Trichloroethane
Trichloroethylene
Vinyl chloride
Uranium
NDb
_ c
ND
+
+
_ c
+
ND
aScc text for details.
bND = no data.
Inconclusive data, see text for details.
3. Data on reproductive effects including teratogenicity should be gen-
erated for the majority of the compounds reviewed.
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Representative terms from entire chapter:
vinyl chloride