Abstract
Arsenic is a known carcinogen and is naturally available in earth’s crust. Inorganic arsenic is an environmental pollutant with immunosuppressive properties. Human papillomavirus (HPV) is considered one of the most common sexually transmitted diseases in the United States. HPV is linked to several types of cancers in males, including oral, anal, and penile cancer. However, limited information is available on the effect of arsenic on HPV in males. The purpose of this study was to examine the association of urinary arsenic species (speciated and total) and the prevalence of HPV infection in the male population. HPV prevalence in males was analyzed using the 2013–2014 and 2015–2016 National Health and Nutrition Examination Survey (NHANES) dataset. Logistic regression analysis was used to examine associations of seven types of urinary arsenic species (arsenous acid, arsenic acid, arsenobetaine, arsenocholine, dimethylarsinic acid (DMA), monomethylarsonic acid (MMA), total arsenic acid) with HPV risk for male participants aged 18–59 years (N = 1516). Demographic characteristics were included in the logistic regression model for each arsenic variable. All statistical analyses were conducted by using the software R (version 4.2.0). Increasing DMA was positively associated with the prevalence of low-risk HPV (odds ratio (OR): 1.075, 95% confidence interval (CI): 1.025, 1.128) in addition to the sum of total toxic arsenic species (TUA1) including arsenous acid, arsenic acid, DMA, and MMA (OR: 1.068, 95% CI: 1.022, 1.116). High-risk HPV strains were found to be positively associated with arsenic acid (OR: 1.806, 95% CI: 1.134, 2.876) and total arsenic minus the sum of the two organic arsenic species arsenobetaine and arsenocholine (TUA2) at quartile 3 (Q3) level (OR: 1.523, 95% CI: 1.102, 2.103). The logistic regression models also showed that race and marital status were significant factors related to high-risk HPV. Our study reported that DMA and TUA1 are associated with low-risk HPV and arsenic acid is associated with high-risk HPV infections in males. Future research is required to confirm or refute this finding.
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Data Availability
The datasets supporting the conclusions of this article are available in the NHANES repository, at https://www.cdc.gov/nchs/nhanes/index.htm.
References
Abulizi G, Zhang YY, Mijiti P et al (2018) Serum Se, Ni, and As are associated with HPV infection and CIN2+ among Uyghur women in rural China. BMC Cancer 18(1):925. https://doi.org/10.1186/s12885-018-4734-6
[ACS] American Cancer Society (2020) HPV and cancer. American Cancer Society. https://www.cancer.org/cancer/cancer-causes/infectious-agents/hpv/hpv-and-cancer-info.html. Accessed 26 December 2021
Ahmed S, Ahsan KB, Kippler M et al (2012) In utero arsenic exposure is associated with impaired thymic function in newborns possibly via oxidative stress and apoptosis. Toxicol Sci 129(2):305–314. https://doi.org/10.1093/toxsci/kfs202
Ahmed S, Moore SE, Kippler M et al (2014) Arsenic exposure and cell-mediated immunity in pre-school children in rural Bangladesh. Toxicol Sci 141(1):166–175. https://doi.org/10.1093/toxsci/kfu113
[ATSDR] Agency for Toxic Substances and Disease Registry (2005) Toxicological profile for arsenic. Draft for public comment. Update. US Department of Health and Human Services, Public Health Service
Banerjee N, Banerjee S, Sen R et al (2009) Chronic arsenic exposure impairs macrophage functions in the exposed individuals. J Clin Immunol 29(5):582–594. https://doi.org/10.1007/s10875-009-9304-x
Bourdonnay E, Morzadec C, Fardel O, Vernhet L (2009) Redox-sensitive regulation of gene expression in human primary macrophages exposed to inorganic arsenic. J Cell Biochem 107(3):537–547. https://doi.org/10.1002/jcb.22155
CDC (2020) About adult BMI. https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html#trends. Accessed 5 January 2022
CDC (2018c) Alcohol Use (ALQ_I). National Center for Health Statistics. https://wwwn.cdc.gov/Nchs/Nhanes/2015-2016/ALQ_I.htm. Accessed 5 January 2022
CDC (2016b) Arsenic - Total - Urine (UTAS_H). National Center for Health Statistics. https://wwwn.cdc.gov/Nchs/Nhanes/2013-2014/UTAS_H.htm. Accessed 5 January 2022
CDC (2018a) Arsenic - Total - Urine (UTAS_I). National Center for Health Statistics. https://wwwn.cdc.gov/Nchs/Nhanes/2015-2016/UTAS_I.htm. Accessed 5 January 2022
CDC (2016c) Arsenics - Speciated - Urine (UAS_H). National Center for Health Statistics. https://wwwn.cdc.gov/Nchs/Nhanes/2013-2014/UAS_H.htm. Accessed 5 January 2022
CDC (2017a) Body Measures (BMX_I). National Center for Health Statistics. https://wwwn.cdc.gov/Nchs/Nhanes/2015-2016/BMX_I.htm. Accessed 5 January 2022
CDC (2019b) Cotinine and Hydroxycotinine - Serum (COT_I). National Center for Health Statistics. https://wwwn.cdc.gov/Nchs/Nhanes/2015-2016/COT_I.htm. Accessed 5 January 2022
CDC (2017b) Demographic Variables and Sample Weights (DEMO_I). National Center for Health Statistics. https://wwwn.cdc.gov/Nchs/Nhanes/2015-2016/DEMO_I.htm. Accessed 5 January 2022
CDC (2022) Genital HPV infection – fact sheet. Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention. https://www.cdc.gov/std/hpv/stdfact-hpv.htm. Accessed 9 January 2022
CDC (2016a) Human Papillomavirus (HPV) DNA Results from Penile Swab Samples: Roche Linear Array (HPVP_H). National Center for Health Statistics. https://wwwn.cdc.gov/Nchs/Nhanes/2013-2014/HPVP_H.htm. Accessed 5 January 2022
CDC (2019a) Human Papillomavirus (HPV) DNA - Penile Swabs: Roche Linear Array (HPVP_I). National Center for Health Statistics. https://wwwn.cdc.gov/Nchs/Nhanes/2015-2016/HPVP_I.htm. Accessed 5 January 2022
CDC (2018b) Speciated Arsenics - Urine (UAS_I). National Center for Health Statistics. https://wwwn.cdc.gov/Nchs/Nhanes/2015-2016/UAS_I.htm. Accessed 5 January 2022
Chang CP, Siwakoti B, Sapkota A et al (2020) Tobacco smoking, chewing habits, alcohol drinking and the risk of head and neck cancer in Nepal. Int J Cancer 147(3):866–875. https://doi.org/10.1002/ijc.32823
Choudhury S, Gupta P, Ghosh S et al (2016) Arsenic-induced dose-dependent modulation of the NF-κB/IL-6 axis in thymocytes triggers differential immune responses. Toxicology 357-358:85–96. https://doi.org/10.1016/j.tox.2016.06.005
Clarke P, Ebel C, Catotti DN, Stewart S (1996) The psychosocial impact of human papillomavirus infection: implications for health care providers. Int J Std Aids 7(3):197–200. https://doi.org/10.1258/0956462961917618
Cogliano V, Baan R, Straif K et al (2005) Carcinogenicity of human papillomaviruses. Lancet Oncol 6(4):204. https://doi.org/10.1016/s1470-2045(05)70086-3
Cohen SM, Arnold LL, Eldan M, Lewis AS, Beck BD (2006) Methylated arsenicals: the implications of metabolism and carcinogenicity studies in rodents to human risk assessment. Crit Rev Toxicol 36(2):99–133. https://doi.org/10.1080/10408440500534230
Daling JR, Madeleine MM, Johnson LG et al (2005) Penile cancer: importance of circumcision, human papillomavirus and smoking in in situ and invasive disease. Int J Cancer 116(4):606–616. https://doi.org/10.1002/ijc.21009
Dang J, Manrique H, Veron D, Feng Q (2015) Oral human papillomavirus (HPV) infection in healthy individuals and patients with head and neck squamous cell carcinoma (HNSCC). Epidemiology (sunnyvale) 5:1161–1165
Dunne EF, Unger ER, Sternberg M et al (2007) Prevalence of HPV infection among females in the United States. JAMA 297(8):813–819. https://doi.org/10.1001/jama.297.8.813
Elbasha EH, Dasbach EJ (2010) Impact of vaccinating boys and men against HPV in the United States. Vaccine 28(42):6858–6867. https://doi.org/10.1016/j.vaccine.2010.08.030
[EPA] Environmental Protection Agency (1995) Arsenic, inorganic. https://iris.epa.gov/ChemicalLanding/&substance_nmbr=278. Accessed 9 January 2022
Ferrario D, Gribaldo L, Hartung T (2016) Arsenic exposure and immunotoxicity: a review including the possible influence of age and sex. Curr Environ Health Rep 3(1):1–12. https://doi.org/10.1007/s40572-016-0082-3
Gebel TW (2001) Genotoxicity of arsenical compounds. Int J Hyg Environ Health 203(3):249–262. https://doi.org/10.1078/S1438-4639(04)70036-X
Giuliano AR, Lu B, Nielson CM et al (2008) Age-specific prevalence, incidence, and duration of human papillomavirus infections in a cohort of 290 US men. J Infect Dis 198(6):827–835. https://doi.org/10.1086/591095
Guha Mazumder DN, Haque R, Ghosh N et al (1998) Arsenic levels in drinking water and the prevalence of skin lesions in West Bengal. India. Int J Epidemiol 27(5):871–877. https://doi.org/10.1093/ije/27.5.871
Guha Mazumder DN (2008) Chronic arsenic toxicity & human health. Indian J Med Res 128(4):436–447
Heaney CD, Kmush B, Navas-Acien A et al (2015) Arsenic exposure and hepatitis E virus infection during pregnancy. Environ Res 142:273–280. https://doi.org/10.1016/j.envres.2015.07.004
[IARC] International Agency for Research on Cancer (1995) IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Human papillomaviruses. IARC Monogr Eval Carcinog Risks Hum 64:1–378
[IARC] International Agency for Research on Cancer (2004) IARC monographs on the evaluation of carcinogenic risks to humans. Vol. 84. Some drinking-water disinfectants and contaminants, including arsenic. WHO, World Health Organization, Geneva
Insinga RP, Dasbach EJ, Myers ER (2003) The health and economic burden of genital warts in a set of private health plans in the United States. Clin Infect Dis 36(11):1397–1403. https://doi.org/10.1086/375074
Javanmard D, Namaei MH, Haghighi F et al (2017) The frequency and typing of human papilloma virus among women with normal and abnormal cytology in southern Khorasan. Eastern Iran. Jundishapur J Microbiol 10:43213
Jin J (2018) HPV infection and cancer. JAMA 319(10):1058. https://doi.org/10.1001/jama.2018.0687
Karbalaie Niya MH, Safarnezhad Tameshkel F, Panahi M, Bokharaei Salim F, Monavari SHR, Keyvani H (2017) Human papillomavirus investigation in head and neck squamous cell carcinoma: initial report from the low risk HPV types associations. Asian Pac J Cancer Prev 18(9):2573–2579. https://doi.org/10.22034/APJCP.2017.18.9.2573
Kozul CD, Ely KH, Enelow RI, Hamilton JW (2009) Low-dose arsenic compromises the immune response to influenza A infection in vivo. Environ Health Perspect 117(9):1441–1447. https://doi.org/10.1289/ehp.0900911
Kreimer AR, Clifford GM, Boyle P, Franceschi S (2005) Human papillomavirus types in head and neck squamous cell carcinomas worldwide: a systematic review. Cancer Epidemiol Biomarkers Prev 14(2):467–475. https://doi.org/10.1158/1055-9965.EPI-04-0551
Kumar R, Trivedi V, Murti K et al (2015) Arsenic exposure and haematological derangement in cervical cancer cases in India. Asian Pac J Cancer Prev 16(15):6397–6400. https://doi.org/10.7314/apjcp.2015.16.15.6397
Lacey CJ, Lowndes CM, Shah KV (2006) Chapter 4: Burden and management of non-cancerous HPV-related conditions: HPV-6/11 disease. Vaccine 24(Suppl 3):S3/35–S3/41. https://doi.org/10.1016/j.vaccine.2006.06.015
Lee CH, Liao WT, Yu HS (2011) Aberrant immune responses in arsenical skin cancers. Kaohsiung J Med Sci 27(9):396–401. https://doi.org/10.1016/j.kjms.2011.05.007
Mazumder DN, Steinmaus C, Bhattacharya P et al (2005) Bronchiectasis in persons with skin lesions resulting from arsenic in drinking water. Epidemiology 16(6):760–765. https://doi.org/10.1097/01.ede.0000181637.10978.e6
Meites E, Szilagyi PG, Chesson HW, Unger ER, Romero JR, Markowitz LE (2019) Human papillomavirus vaccination for adults: updated recommendations of the Advisory Committee on Immunization Practices. MMWR Morb Mortal Wkly Rep 68:698–702. https://doi.org/10.15585/mmwr.mm6832a3externalicon
Meza MM, Kopplin MJ, Burgess JL, Gandolfi AJ (2004) Arsenic drinking water exposure and urinary excretion among adults in the Yaqui Valley, Sonora, Mexico. Environ Res 96(2):119–126. https://doi.org/10.1016/j.envres.2003.08.010
Munk C, Svare EI, Poll P, Bock JE, Kjaer SK (1997) History of genital warts in 10,838 women 20 to 29 years of age from the general population. Risk factors and association with Papanicolaou smear history. Sex Transm Dis 24(10):567–572. https://doi.org/10.1097/00007435-199711000-00003
[NCHS] National Center for Health Statistics (2017) About the National Health and Nutrition Examination Survey. CDC. https://www.cdc.gov/nchs/nhanes/about_nhanes.htm. Accessed 5 January 2022
Osazuwa-Peters N, Adjei Boakye E, Rohde RL et al (2019) Understanding of risk factors for the human papillomavirus (HPV) infection based on gender and race. Sci Rep 9(1):297. https://doi.org/10.1038/s41598-018-36638-z
Pal P, Halder A (2019) Is there any role of arsenic toxicity in HPV related oral squamous cell carcinoma? Biol Trace Elem Res 188(2):274–283. https://doi.org/10.1007/s12011-018-1419-6
Palefsky JM (2010) Human papillomavirus-related disease in men: not just a women’s issue. J Adolesc Health 46(4 Suppl):S12–S19. https://doi.org/10.1016/j.jadohealth.2010.01.010
Rahman HH, Niemann D, Munson-McGee SH (2021a) Association among urinary polycyclic aromatic hydrocarbons and depression: a cross-sectional study from NHANES 2015-2016. Environ Sci Pollut Res Int. https://doi.org/10.1007/s11356-021-16692-3
Rahman HH, Niemann D, Munson-McGee SH (2021c) Association among urinary polycyclic aromatic hydrocarbons and depression: a cross-sectional study from NHANES 2015-2016. Environ Sci Pollut Res Int. https://doi.org/10.1007/s11356-021-16692-3
Rahman HH, Niemann D, Munson-McGee SH (2021f) Association of albumin to creatinine ratio with urinary arsenic and metal exposure: evidence from NHANES 2015-2016. Int Urol Nephrol. https://doi.org/10.1007/s11255-021-03018-y
Rahman HH, Niemann D, Munson-McGee SH (2021e) Association of environmental toxic metals with high sensitivity C-reactive protein: a cross-sectional study. Occup Dis Environ Med 9(4):173–184. https://doi.org/10.4236/odem.2021.94013
Rahman HH, Niemann D, Munson-McGee SH (2021d) Environmental exposure to metals and the risk of high blood pressure: a cross-sectional study from NHANES 2015-2016. Environ Sci Pollut Res Int. https://doi.org/10.1007/s11356-021-15726-0
Rahman HH, Niemann D, Munson-McGee SH (2021b) Association of chronic kidney disease with exposure to polycyclic aromatic hydrocarbons in the US population. Environ Sci Pollut Res Int. https://doi.org/10.1007/s11356-021-17479-2
Rahman HH, Niemann D, Singh D (2020a) Arsenic exposure and association with hepatitis E IgG antibodies. Occup Dis Environ Med 8:111–122. https://doi.org/10.4236/odem.2020.83009
Rahman HH, Niemann D, Yusuf KK (2021g) Association of urinary arsenic and sleep disorder in the US population: NHANES 2015-2016. Environ Sci Pollut Res Int. https://doi.org/10.1007/s11356-021-16085-6
Rahman HH, Yusuf KK, Niemann D, Dipon SR (2020b) Urinary speciated arsenic and depression among US adults. Environ Sci Pollut Res Int 27(18):23048–23053. https://doi.org/10.1007/s11356-020-08858-2
Rocha-Amador DO, Calderón J, Carrizales L, Costilla-Salazar R, Pérez-Maldonado IN (2011) Apoptosis of peripheral blood mononuclear cells in children exposed to arsenic and fluoride. Environ Toxicol Pharmacol 32(3):399–405. https://doi.org/10.1016/j.etap.2011.08.004
Ryan DP, Mayer RJ (2000) Anal carcinoma: histology, staging, epidemiology, treatment. Curr Opin Oncol 12(4):345–352. https://doi.org/10.1097/00001622-200007000-00011
Salehi-Vaziri M, Sadeghi F, Hashemi FS et al (2016) Distribution of human papillomavirus genotypes in Iranian women according to the severity of the cervical lesion. Iran Red Crescent Med J 18(4):e24458. https://doi.org/10.5812/ircmj.24458
Schiffman M, Clifford G, Buonaguro FM (2009) Classification of weakly carcinogenic human papillomavirus types: addressing the limits of epidemiology at the borderline. Infect Agent Cancer 4:8. https://doi.org/10.1186/1750-9378-4-8
Schuhmacher-Wolz U, Dieter HH, Klein D, Schneider K (2009) Oral exposure to inorganic arsenic: evaluation of its carcinogenic and non-carcinogenic effects. Crit Rev Toxicol 39(4):271–298. https://doi.org/10.1080/10408440802291505
Sellors JW, Mahony JB, Kaczorowski J et al (2000) Prevalence and predictors of human papillomavirus infection in women in Ontario, Canada. Survey of HPV in Ontario Women (SHOW) Group. CMAJ 163(5):503–508
Smith EM, Rubenstein LM, Haugen TH, Hamsikova E, Turek LP (2010) Tobacco and alcohol use increases the risk of both HPV-associated and HPV-independent head and neck cancers. Cancer Causes Control 21(9):1369–1378. https://doi.org/10.1007/s10552-010-9564-z
States JC, Barchowsky A, Cartwright IL, Reichard JF, Futscher BW, Lantz RC (2011) Arsenic toxicology: translating between experimental models and human pathology. Environ Health Perspect 119(10):1356–1363. https://doi.org/10.1289/ehp.1103441
Thornton MJ (2005) Oestrogen functions in skin and skin appendages. Expert Opin Ther Targets 9(3):617–629. https://doi.org/10.1517/14728222.9.3.617
von Ehrenstein OS, Mazumder DN, Yuan Y et al (2005) Decrements in lung function related to arsenic in drinking water in West Bengal. India. Am J Epidemiol 162(6):533–541. https://doi.org/10.1093/aje/kwi236
von Krogh G, Lacey CJ, Gross G, Barrasso R, Schneider A (2000) European course on HPV associated pathology: guidelines for primary care physicians for the diagnosis and management of anogenital warts. Sex Transm Infect 76(3):162–168. https://doi.org/10.1136/sti.76.3.162
[WHO] World Health Organization (2001) Environmental health criteria 224, arsenic and arsenic compounds, 2nd edn. World Health Organization, Geneva
[WHO] World Health Organization (2020) Human papillomavirus (HPV) and cervical cancer. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical-cancer. Accessed 26 December 2021
Woodhall S, Ramsey T, Cai C et al (2008) Estimation of the impact of genital warts on health-related quality of life. Transm Infect 84(3):161–166. https://doi.org/10.1136/sti.2007.029512
Yan N, Xu G, Zhang C, et al (2020) Chronic arsenic exposure induces the time-dependent modulation of inflammation and immunosuppression in spleen. Cell Biosci 10:91. Published 2020 Jul 30. doi:https://doi.org/10.1186/s13578-020-00448-6
Yete S, D’Souza W, Saranath D (2018) High-risk human papillomavirus in oral cancer: clinical implications. Oncology 94(3):133–141. https://doi.org/10.1159/000485322
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Humairat H. Rahman conceptualized the study and contributed to the introduction and discussion. Soyoung Jeon and Zainab Akinjobi conducted the data analysis and contributed to the statistical method and the drafting of the paper. Danielle Niemann contributed to the drafting of the paper. All authors read and approved the final manuscript.
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Niemann, D., Akinjobi, Z., Jeon, S. et al. Arsenic exposure and prevalence of human papillomavirus in the US male population. Environ Sci Pollut Res 30, 1263–1275 (2023). https://doi.org/10.1007/s11356-022-22306-3
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DOI: https://doi.org/10.1007/s11356-022-22306-3