Arsenic is a toxic metalloid of global concern. It usually originates geogenically but can be intensified by human activities such as applications of pesticides and wood preservatives, mining and smelting operations, and coal combustion. Arsenic-contaminated food is a widespread problem worldwide. Data derived from population-based studies, clinical case series, and case reports relating to ingestion of inorganic arsenic in drinking water, medications, or contaminated food or beverages show the capacity of arsenate and arsenite to adversely affect multiple organ systems. Chronic arsenic poisoning can cause serious health effects including cancers, melanosis (hyperpigmentation or dark spots, and hypopigmentation or white spots), hyperkeratosis (hardened skin), restrictive lung disease, peripheral vascular disease (blackfoot disease), gangrene, diabetes mellitus, hypertension, and ischemic heart disease.

Inorganic arsenic (iAs) in drinking water and food items has been associated with lung and bladder cancers in several countries including Pakistan. In present study water, food items were collected from Arsenic (As) endemic areas (southern part of Pakistan) during 2008–2012, to evaluate its impact on the health of local population. Exposure of As was checked by analyzing biological samples (blood and scalp hairs) of male lung and bladder cancer patients (smokers and non-smokers). For comparative purpose the healthy subjects of same age group and residential area as exposed referents (EXR) and from non-contaminated area (Hyderabad, Pakistan) as non-exposed referents (NER) were also selected. As concentration in drinking water, food and biological samples were analyzed using electrothermal atomic absorption spectrometry. The validation of technique was done by the analysis of certified reference material (CRM) of blood and hair samples. The As contents in drinking water and food were found 3–15-folds elevated than permissible limits, where as in biological samples; EXR have 2–3-folds higher than NER and cancer patients have 5–9-folds higher than NER. The significant difference was observed in smokers (P < 0.01). The outcomes of the study revealed that As levels were elevated in blood and scalp hair samples of both types of cancer subjects as compared to referents (P < 0.001). It was observed that the lung cancer patients (LCP) have 20–35% higher levels of As in both biological samples as compared to bladder cancer patients (BCP) due to smoking habit. This study has proved the correlation among As contaminated water, food and cigarette smoking between different types of cancer risks.

Environmental pollution and food safety are two of the most important issues of our time. Soil and water pollution, in particular, have historically impacted on food safety which represents an important threat to human health. Nowhere has that situation been more complex and challenging than in China, where a combination of pollution and an increasing food safety risk have affected a large part of the population. Water scarcity, pesticide over-application, and chemical pollutants are considered to be the most important factors impacting on food safety in China. Inadequate quantity and quality of surface water resources in China have led to the long-term use of waste-water irrigation to fulfill the water requirements for agricultural production. In some regions this has caused serious agricultural land and food pollution, especially for heavy metals. It is important, therefore, that issues threatening food safety such as combined pesticide residues and heavy metal pollution are addressed to reduce risks to human health. The increasing negative effects on food safety from water and soil pollution have put more people at risk of carcinogenic diseases, potentially contributing to ‘cancer villages’ which appear to correlate strongly with the main food producing areas. Currently in China, food safety policies are not integrated with soil and water pollution management policies. Here, a comprehensive map of both soil and water pollution threats to food safety in China is presented and integrated policies addressing soil and water pollution for achieving food safety are suggested to provide a holistic approach.

Arsenic (As) is a toxic metalloid found to be an important groundwater contaminant of mainly natural geogenic origin worldwide particularly in large deltas and along major rivers in poor regions of South- and East-Asia. Excessive and long-term human intake of toxic inorganic As with food and water is causing arsenicosis, which is disfiguring, disabling, and leading to potentially fatal diseases like skin- and internal cancers. It is estimated that more than 100million people mainly in developing countries are at risk. The arsenicosis situation in affected countries has been named the largest chemical threat to public health ever experienced and arsenicosis is spreading to regions where near-sterile well water loaded with As has replaced microbial suspect surface water containing lower As concentrations. This review provides an overview of the state of the art knowledge on the water and food As intake and exposure, and how the As chemistry in water and food may influence chosen mitigation strategies. Although reports on severe health effects from exposure to As in water are abundant there are several weak points in our knowledge on causes and prevalence of arsenicosis in order to devise effective mitigation. The main mitigation strategies focus on drinking water based on exploration of As-free water and As removal from extracted water, whereas mitigation strategies on cooking water and reducing exposure through food are quite often overlooked. The experiences of adopted low cost methods for lowering the human intake of As in rural areas are critically evaluated in terms of public acceptance, sustainability and impact on arsenicosis.

In China, urbanization strengthens the water-food-health nexus by driving dietary changes both at home and away from home (AFH). However, few studies have compared the effects of dining location on water footprint generation and/or linked such habits to the prevalence of non-communicable diseases (NCDs), such as hypertension, diabetes, asthma, myocardial infarction, stroke and cancer. Here, household survey data were used to develop a multiple-component urbanization sequence, on which the diet-related water footprint was quantified and the mechanisms under the water-food-health nexus were explored. Significant dietary changes due to urbanization have occurred at home (instead of AHF), and increases or decreases in various food groups are stratified across dining locations. Log mean Divisia index decomposition shows that the diet-structure effect outweighing the intake effect dominates the water footprint changes during China's urbanization. Animal products contribute 92(94)% of the diet-structure effect on net water footprint growth at home(AFH); in contrast, vegetal foods dominate the intake effect, contributing 67(49)%. The at-home water footprint ratio of animal products to vegetal foods is highly related to the prevalence of diabetes, hypertension, cancer, and asthma, and reaching statistical significance. Two urbanization components, namely housing situation and community diversity, serve as the key drivers of water-food-health nexus enhancement in urbanized China. Due to the complexity of water-food-health links, nexus thinking is needed to benefit human health and diet-related water consumption; besides, it may be reasonable to expand current dimension of food-energy-water nexus topic to include health issues.

In this study, a health risk assessment of N-nitrosodimethylamine (NDMA) in drinking water and food was conducted using disability-adjusted life years (DALYs) in major cities of China. Considering the numerous non-detected values found in drinking water samples, a zero-inflated model was employed to obtain a more precise NDMA concentration distribution function in drinking water. With exogenous chronic daily intake of 1.20 × 10⁻⁶ mg/(kg*d), the lifetime cancer risk and disability-adjusted life years of NDMA are 4.01 × 10⁻⁵ and 5.52 × 10⁻⁶ per person-year (ppy). The disease burden attributable to water sources accounts for nearly 9.94% of total exogenous intake. The contribution rate of vegetables is the largest, followed by cereals, milk products, fish and shrimp, and meat. Taking endogenous sources into consideration, the contribution rates of drinking water and food sources decrease to 0.08% and 0.69%. This study provides a scientific basis for making policy decisions on NDMA pollution management.