Uranium contaminated drinking water linked to leukaemia-Revisiting a case study from South Africa taking alternative exposure pathways into account.

The paper presents results of a follow-up to an earlier study which established a geospatial link between naturally elevated uranium (U) levels in borehole water and haematological abnormalities in local residents serving as a proxy for leukaemia prevalent in the area. While the original study focussed on drinking water only, this paper also explores alternative exposure pathways including the inhalation of dust and the food chain. U-levels in grass and tissue of sheep generally reflect U-levels in nearby borehole water and exceed background concentrations by 20 to nearly 500 times. U-levels in sheep tissue increase with age of the animal. Wool showed the highest U-concentration followed by other non-consumable tissue such as hooves, teeth and bones. Lower levels occur in edible parts such as meat and inner organs. The U-deposition rate in wool is several orders of magnitudes higher than in bone as a known target organ. Wool is an easy-to-sample non-invasive bioindicator for U-levels in meat. Depending on the original water content, dried samples show up to 5 times higher U-levels than identical fresh material. Contaminated drinking water is the main exposure pathway for farm residents resulting in U-uptake rates exceeding the WHO's tolerable daily intake (TDI) limit by up to 900%. This is somewhat mitigated by the fact that U-speciation is dominated by a neutral calcium-uranyl-carbonate complex of relatively low toxicity. Commercially available household filters are able to significantly reduce U-levels in well water and are thus recommended as a short-term intervention. Based on average consumption rates sheep meat, as local staple food, accounts for 34% of the TDI for U. Indoor levels of radon should be monitored, too, since it is linked to both, U and leukaemia. With elevated U-levels being present in other geological formations across South Africa boreholes in these areas should be surveyed.