Teratogen update: lead and pregnancy

Assessing Heavy Metal Contamination in Commonly Used Fertilizers for Polyculture Fish Ponds and Its Implications for Human Health: A Comprehensive Investigation

Over-fertilizing fish ponds can cause pollution, introducing heavy metals into the food chain and posing health risks. The present study investigated the incidence of heavy metals (Pb, Cu, Cd, and Cr) in commonly applied fertilizers, including nitrogen, phosphorus and potassium (NPK), triple superphosphate (TSP), and di-ammonium phosphate (DAP), and their association with heavy metals in water, sediment, and cultured fish species (Catla catla, Labeo rohita, and Cyprinus carpio) in polyculture fish ponds. The study was conducted over 4 months, with four groups in triplicates: control (no fertilizer), group 1 (NPK), group 2 (TSP), and group 3 (DAP). Heavy metal analysis was carried out using atomic absorption spectrophotometry before and after fertilizer application. Significantly (p < 0.05) higher levels of heavy metals were observed in water and sediment after applying fertilizers, with the most pronounced results in group 3 (DAP) followed by group 2 (TSP). The concentration of heavy metals was significantly (p < 0.05) higher in group 3 (DAP) fertilizers compared to other groups. Compared to the control, the concentration and bioaccumulation of heavy metals were significantly (p < 0.05) higher in the fertilizer-applied groups, with notably higher levels in group 3 (DAP). Cluster analysis and the correlation matrix did not show any significant association between the heavy metals and the fertilizers, indicating a complex interplay between the biotic and abiotic factors of the system. The health index (HI) value was < 1 in fish muscles of all studied groups, indicating the fish are safe for consumption. The study recommends monitoring and regulating fertilizer use, especially DAP, to prevent heavy metal contamination, and exploring sustainable alternatives to minimize environmental and health risks.

Lead in umbilical cord blood and associated factors in Casablanca Morocco: A preliminary results

BACKGROUND

Lead is the most common toxic metal to which Moroccans are exposed. Given the susceptibility of the fetus to lead, it is crucial to assess prenatal lead exposure. However, in Morocco, no study has assessed prenatal exposure to lead. The main goals of the present study are to determine lead concentration in umbilical cord blood and identify risk factors for prenatal lead exposure in Casablanca, Morocco.

METHODS

To achieve these purposes, 87 cord blood lead samples were collected from mothers-baby pairs from January to December 2019. Indeed, a structured questionnaire was used to collect socio-demographic characteristics, obstetric data, leisure, cultural habits, and environmental information. Cord blood lead level was analyzed by inductively coupled plasma-mass spectrometry.

RESULTS

The median lead concentration was 4.902 µg/dl with a minimum and maximum of 0.833 µg/dl and 23.593 µg/dl, respectively. A high proportion of the newborns (65.52 %) had cord blood lead levels above the Centers for Disease Control (CDC) allowable threshold limit (3.5 µg/dl). Statistical analysis was performed to assess the association between blood levels and the above factors. Lead levels in cord blood were significantly associated with the maternal educational level, anemia history, delivery mode, passive smoking during pregnancy as well as with the frequency of consumption of tea.

CONCLUSION

This study provides the first data on lead levels in newborns. Cord blood lead levels were high in the majority of the participants, these results reinforce the need to establish health surveillance programs in Morocco.

Sub-Optimal Paternal Diet at the Time of Mating Disrupts Maternal Adaptations to Pregnancy in the Late Gestation Mouse

Pregnancy represents a stage during which maternal physiology and homeostatic regulation undergo dramatic change and adaptation. The fundamental purpose of these adaptations is to ensure the survival of her offspring through adequate nutrient provision and an environment that is tolerant to the semi-allogenic foetus. While poor maternal diet during pregnancy is associated with perturbed maternal adaptations during pregnancy, the influence of paternal diet on maternal well-being is less clearly defined. We fed C57BL/6 male mice either a control (CD), low protein diet (LPD), a high fat/sugar Western diet (WD) or the LPD or WD supplemented with methyl donors (MD-LPD and MD-WD, respectively) for a minimum of 8 weeks prior to mating with C57BL/6 females. Mated females were culled at day 17 of gestation for the analysis of maternal metabolic, gut, cardiac and bone health. Paternal diet had minimal influences on maternal serum and hepatic metabolite levels or gut microbiota diversity. However, analysis of the maternal hepatic transcriptome revealed distinct profiles of differential gene expression in response to the diet of the father. Paternal LPD and MD-LPD resulted in differential expression of genes associated with lipid metabolism, transcription, ubiquitin conjugation and immunity in dams, while paternal WD and MD-WD modified the expression of genes associated with ubiquitin conjugation and cardiac morphology. Finally, we observed changes in maternal femur length, volume of trabecular bone, trabecular connectivity, volume of the cortical medullar cavity and thickness of the cortical bone in response to the father's diets. Our current study demonstrates that poor paternal diet at the time of mating can influence the patterns of maternal metabolism and gestation-associated adaptations to her physiology.

Mapping Blood Lead Levels in China during 1980-2040 with Machine Learning

Lead poisoning is globally concerning, yet limited testing hinders effective interventions in most countries. We aimed to create annual maps of county-specific blood lead levels in China from 1980 to 2040 using a machine learning model. Blood lead data from China were sourced from 1180 surveys published between 1980 and 2022. Additionally, regional statistical figures for 15 natural and socioeconomic variables were obtained or estimated as predictors. A machine learning model, using the random forest algorithm and 2973 generated samples, was created to predict county-specific blood lead levels in China from 1980 to 2040. Geometric mean blood lead levels in children (i.e., age 14 and under) decreased significantly from 104.4 μg/L in 1993 to an anticipated 40.3 μg/L by 2040. The number exceeding 100 μg/L declined dramatically, yet South Central China remains a hotspot. Lead exposure is similar among different groups, but overall adults and adolescents (i.e., age over 14), females, and rural residents exhibit slightly lower exposure compared to that of children, males, and urban residents, respectively. Our predictions indicated that despite the general reduction, one-fourth of Chinese counties rebounded during 2015-2020. This slower decline might be due to emerging lead sources like smelting and coal combustion; however, the primary factor driving the decline should be the reduction of a persistent source, legacy gasoline-derived lead. Our approach innovatively maps lead exposure without comprehensive surveys.

Updating an Overview of Teratology

In this chapter, the authors aim to update an overview of the principles of teratology, beginning with the definition of teratology, the critical point at which this process occurs, and some of the most common etiological agents that improve our understanding of teratology.Modern teratology has greatly improved in recent years with advances in new methods in molecular biology, toxicology, animal laboratory science, and genetics, increasing our knowledge of ambient influences. Nevertheless, there is a lot to do to reduce the influence of hazardous intervening agents, whether they target our genetics or not, that can negatively affect pregnancy and induce congenital development disorders, including morphological, biochemical, or behavioral defects.Certain agents might indeed be related to certain defects, but we have not been able to identify the cause of most congenital defects, which highlights the importance of finding and testing out new genetics techniques and conducting laboratory animal science to unravel the etiology and pathogenicity of each congenital defect.

Human health risk assessment of heavy metal concentration in surface water of Sosian river, Eldoret town, Uasin-Gishu County Kenya

Heavy metal pollution in surface waters has become a major worldwide issue as people tend to settle where there is readily available source of water like a river. This research evaluates the causes, concentration and associated health risks of heavy metals in River Sosiani as it passes through the town of Eldoret. Seven water samples were collected and analysed for zinc (Zn), copper (Cu) and lead (Pb. The results disclosed that Pb concentrations were estimated to be in the range of 0.06 mg/l to 0.23 mg/l, higher than the permitted limit by WHO of 0.01 mg/l. Cu and Zn concentration levels were below the permissible limits. The chronic daily intake (CDI) indicated that total hazard quotient of non-cancer risk of Pb was above one and the total HI values for children were greatly elevated compared to those of adults in the studied area. This showed a high risk in exposure to Pb. Health human risk was assessed and the incremental life cancer risk (ILCR) values of Pb for children and adults in all sites were found to be negligible with values below 10-6. However, there is higher cancer and non-cancer risk for children than adults as far as lead metal is concerned. Therefore, measures should be taken in accordance with the standards to prevent potential risk of the river pollution.•Human activities make a significant contribution to heavy metal pollution to surface waters which is a threat to humans.•Water from Sosiani River is not safe for use domestically as far as lead metal levels are concerned.•The results of this study can be used by decision makers to develop measures which can improve the quality of water in the river catchment.

Induction of Labor at Term for Severe Antenatal Lead Poisoning

INTRODUCTION

Antenatal lead exposure is associated with multiple adverse maternal and fetal consequences. Maternal blood lead concentrations as low as 10 µg/dL have been associated with gestational hypertension, spontaneous abortion, growth retardation, and impaired neurobehavioral development. Current treatment recommendations for pregnant women with a blood lead level (BLL) ≥ 45 µg/dL include chelation. We report a successful case of a mother with severe gestational lead poisoning treated with induction of labor in a term infant.

CASE REPORT

A 22-year-old G2P1001 female, at 38 weeks and 5 days gestation, was referred to the emergency department for an outpatient venous BLL of 53 µg/dL. The decision was made to limit ongoing prenatal lead exposure by emergent induction as opposed to chelation. Maternal BLL just prior to induction increased to 70 µg/dL. A 3510 g infant was delivered with APGAR scores of 9 and 9 at 1 and 5 min. Cord BLL at delivery returned at 41 µg/dL. The mother was instructed to avoid breastfeeding until her BLLs decreased to below 40 µg/dL, consistent with federal and local guidelines. The neonate was empirically chelated with dimercaptosuccinic acid. On postpartum day 2, maternal BLL decreased to 36 µg/dL, and the neonatal BLL was found to be 33 µg/mL. Both the mother and neonate were discharged to an alternative lead-free household on postpartum day 4.

Exposure of Reproductive-Aged Women to Multiple Metals and Its Associations with Unexplained Recurrent Miscarriage

Exposure to heavy metals exerts toxic effects on female reproduction and embryo development. This study examined the exposure of patients with unexplained recurrent miscarriage (uRM) to multiple metals and the correlations among exposures to different metals. A total of 275 participants were enrolled, including 43 healthy women without previous miscarriage (the control group) and 232 uRM women (the case group); among these uRM women, 159 had two miscarriages (2M), 42 had three miscarriages (3M) and 31 had four or more miscarriages (≥4M). A total of 22 elements were measured in serum samples via inductively coupled plasma-mass spectrometry. The levels of calcium (104.37 mg/L vs. 92.65/93.02/92.61/92.47 mg/L) and selenium (131.85 µg/L vs. 117.80/118.04/115.88/124.35 µg/L) were higher in the controls than in the total uRM group and the 2M, 3M and ≥4M subgroups. The level of vanadium was significantly lower in the controls than in the total uRM group (0.15 µg/L vs. 0.23 µg/L), and the level of lead was lower in the controls than that in the total uRM group and the 2M, 3M and ≥4M subgroups (0.01 µg/L vs. 0.28/0.18/0.63/0.34 µg/L). After adjusting for age, body mass index and education level, calcium and selenium exposure were consistently negatively associated with miscarriage, while lead exposure was positively associated with miscarriage. In addition, the correlations among exposures to different metals slightly differed between the control and uRM groups. Therefore, changes in some metal elements in the blood might be related to the risk of uRM.

Maternal exposure to metal components of PM2.5 and low birth weight in New Mexico, USA

Infants with low birth weight (LBW) are more likely to have health problems than normal weight infants. In studies examining the associations between particulate matter (PM) exposures and LBW, there is a tendency to focus on PM2.5 as a whole. However, insufficient information is available regarding the effects of different components of PM2.5 on birth weight. This study identified the associations between maternal exposure to 10 metal components of PM2.5 and LBW in offspring based on small area (divided by population size) level data in New Mexico, USA, from 2012 to 2016. This study used a pruned feed-forward neural network (pruned-FNN) approach to estimate the annual average exposure index to each metal component in each small area. The linear regression model was employed to examine the association between maternal PM2.5 metal exposures and LBW rate in small areas, adjusting for the female percentage and race/ethnicity compositions, marriage status, and educational level in the population. An interquartile range increase in maternal exposure to mercury and chromium of PM2.5 increased LBW rate by 0.43% (95% confidence interval (CI): 0.18-0.68%) and 0.63% (95% CI: 0.15-1.12%), respectively. These findings suggest that maternal exposure to metal components of air pollutants may increase the risk of LBW in offspring. With no similar studies in New Mexico, this study also posed great importance because of a higher LBW rate in New Mexico than the national average. These findings provide critical information to inform further epidemiological, biological, and toxicological studies.

Knowledge, confidence, and reported behaviors that promote safe water drinking among women of reproductive age

Introduction

Drinking lead contaminated water during pregnancy is associated with infant mortality. All women of reproductive age are advised by health agencies to adhere to healthy behaviors due to the chance of unintended pregnancy. Our objectives are to understand knowledge, confidence, and reported behaviors that promote safe water drinking and prevent lead exposure among women of reproductive age.

Methods

A survey among females of reproductive age from the University of Michigan - Flint was administered. A total of 83 females who wished to become pregnant one day participated.

Results

Low levels of knowledge, confidence, and reported preventative health behaviors related to safe water drinking and lead exposure prevention existed. Specifically, 71.1% of respondents (59 of 83) were not at all or were somewhat confident in their ability to choose an appropriate lead water filter. Most participants rated their knowledge on how to decrease exposure to lead during pregnancy as poor/fair. No statistically significant differences were detected between respondents residing inside and outside of the city of Flint, Michigan for most variables assessed.

Conclusion

While the small sample size is a limitation, the study adds to an area of scarce research. Despite widespread media attention and resources directed toward reducing the negative health effects of lead exposure following the Flint Water Crisis, significant gaps in knowledge related to safe water drinking remain. Interventions are needed to increase knowledge, confidence, and healthy behaviors that promote safe water drinking among women of reproductive age.

Impact of air pollution on human health in different geographical locations of Nepal

According to a recent survey, Nepal's urban air quality has been classified as one of the worst in the globe. A large portion of the country's population is subjected to health risks caused by air pollution. As Nepal has a wide variation in altitude coupled with socio-cultural and biological diversities, it is important to understand the different health hazards in the different geographical regions - Terai, Hills and Mountains. Constantly increasing physical infrastructures (such as transport vehicles, open burning of plastics and other fuels) are the main reasons for the escalating air pollution in the country. This study aims to critically review the current air pollution status in different geographical locations along with its impacts on public health in the country. It has been revealed that irrespective of geographic location, the air pollutants interfere with different human physiological systems related to respiration as well as cardiovascular, ophthalmic, and gastrointestinal functioning. Further, the research findings highlighting the influence of prolonged exposure of the population to the air pollution leading to the significant number of deaths have been presented. A notable rise in the number of hospitalized patients suffering from illnesses related to above mentioned pollution borne cases has been reported.

Associations Between the Lead Level in Maternal Blood and Umbilical Cord Blood and Congenital Heart Diseases in Offspring

The incidence of congenital heart diseases (CHDs) shows an increasing trend and results in large health burdens in China. However, there have been inconsistent results of the relationship between lead (Pb) level and risk of CHDs. We performed a pair-matched case-control study and included 97 cases and 194 controls to investigate the association between pregnancy Pb exposure and the risk of CHDs in a birth cohort study conducted in Lanzhou, China. The results showed that compared to the lowest Pb tertile, both highest tertile levels of maternal blood and umbilical cord blood Pb were associated with an increased risk of CHDs. The similar significant results were found in cases with isolated CHDs. Compared to both lowest tertiles of Pb level in maternal blood and umbilical cord blood, the highest tertile was associated with an increased risk of CHDs, especially for isolated CHDs. Overall, our study suggests a significant association between pregnancy Pb exposure and risk of CHDs, especially for isolated CHDs. Future studies are needed to elucidate the underlying mechanism.

Environmental Exposure: Effect on Maternal Morbidity and Mortality and Neonatal Health

Environmental factors are important causes that impair global pregnancy outcomes and are, importantly, responsible for maternal morbidity and mortality. However, apart from the direct reasons for maternal deaths, mainly obstetric and neonatal complications, such factors are ignored or given less importance. The recent surge in research on the impact of various environmental factors on pregnancy outcomes suggests the need for immediate attention to such factors and device-specific policies to counter the situation. Moreover, the recent coronavirus disease of 2019 (COVID-19) pandemic, global warming, and climate change showed a lack of preparedness to counter the impact of such events on maternal survival and safe and successful pregnancy outcomes. In the present review, we have emphasized the specific factors responsible for increased maternal and neonatal deaths and their association with specific environmental factors. Increased attention on maternal healthcare, preparedness to counter sudden environmental challenges and improvement of the conventional requirement for better maternal healthcare access and nutrition at a global level may improve the scenario.

Maternal exposure to metal components of PM2.5 and low birth weight in New Mexico, USA

Infants with low birth weight (LBW) are more likely to have health problems than normal weight infants. In studies examining the associations between particulate matter (PM) exposures and LBW, there is a tendency to focus on PM 2.5 as a whole. However, insufficient information is available regarding the effects of different components of PM 2.5 on birth weight. This study identified the associations between maternal exposure to 10 metal components of PM 2.5 and LBW in offspring based on small area (divided by population size) level data in New Mexico, USA, from 2012 to 2016. This study used a pruned feed-forward neural network (pruned-FNN) approach to estimate the annual average exposure index to each metal component in each small area. The linear regression model was employed to examine the association between maternal PM 2.5 metal exposures and LBW rate in small areas, adjusting for the female percentage and race/ethnicity compositions, marriage status and educational level in the population. An interquartile range increase in maternal exposure to mercury and chromium of PM 2.5 increased LBW rate by 0.43% (95% confidence interval (CI): 0.18%-0.68%) and 0.63% (95% CI: 0.15%-1.12%), respectively. These findings suggest that maternal exposure to metal components of air pollutants may increase the risk of LBW in offspring. With no similar studies in New Mexico, this study also posed great importance because of a higher LBW rate in New Mexico than the national average. These findings provide critical information to inform further epidemiological, biological, and toxicological studies.

A unique investigation of thallium, tellurium, osmium, and other heavy metals in recurrent pregnancy loss: A novel approach

OBJECTIVE

To study the impact of heavy metals especially tellurium, thallium, and osmium, in recurrent pregnancy loss (RPL) and to study their association with antioxidant status and DNA damage.

METHODS

This case-control study included women with RPL (n = 30) and healthy pregnant women as control (n = 30). Following blood collection, serum levels of thallium, tellurium, osmium, lead, mercury, and cadmium were estimated by inductively coupled plasma mass spectrophotometer.

RESULTS

Women with RPL exhibited significantly higher levels of heavy metals (P < 0.001) when compared with control women. Intriguingly, increased levels of serum thallium, tellurium, osmium, and lead were negatively correlated with total antioxidant status (P < 0.05). Further, the RPL group demonstrated strong positive correlation between heavy metals (thallium, tellurium, osmium, lead) and DNA damage (P < 0.05). No significant correlation between other heavy metals and markers of cellular damage was noted.

CONCLUSION

Enhanced levels of heavy metals in women with RPL and correlation of thallium, tellurium, osmium, and lead with markers of cellular damage reflect the role of heavy metal poisoning, especially thallium, tellurium, and osmium, as potential risk factor in the etiology underlying recurrent miscarriage.

A Study of Maternal and Umbilical Cord Blood Lead Levels in Pregnant Women

Lead is a highly toxic element which can cross the placental barrier and enter the fetus during pregnancy. Parental lead exposure has adverse effect on infant as well as on maternal health. As part of our program to investigate the lead poisoning in human population we investigated the maternal blood lead levels (MBLL) and umbilical cord blood lead (UBLL) levels in 200 pregnant women and collected their socio-demographic details. In the study we found high lead levels in both maternal and umbilical cord blood samples. The results showed 47.5% maternal blood (n = 95) detected with lead while 38.5% umbilical cord blood (n = 77) samples had lead concentration higher than that of reference range of ≤ 5 µg/dL. We also found that the Spearman's correlation coefficient (rs) revealed a strong positive correlation between the MBLL and UBLL (rs = 0.63). The results from socio-demographic questionnaire demonstrated that the recent home painting (p = 0.002) and residing close proximity to traffic congestion (p = 0.05) were significantly associated with MBLL. Education, mother age, fuel and water sources were not significantly associated with MBLL. Iron and calcium deficiency along with tiredness, lethargy, abdominal pain were also reported in women having high lead level > 5 µg/dL. Concludingly, on the basis of results obtained it may be stated that we found elevated BLLs in both pregnant women as well as in umbilical cord blood. The prevalence of elevated lead levels in mothers will expose the fetus to lead through placental barriers mobilization and it can have long term adverse effects on the developing fetus. Therefore, it is recommended that screening of blood lead levels be carried out in high-risk women based on their social, occupational, environmental, and individual factors. In addition, stringent regulations on lead-based products are also required from government agencies/authorities to reduce environmental lead burden and toxicity. Moreover, public awareness programs should be organized on hazardous effect of lead.

The construction and validation of a lead exposure screening tool for pregnant women in Thailand (ThaiL8Is)

Objectives

To construct, validate, and implement a new screening tool for lead exposure in Thai pregnant women.

Methods

A cross-sectional study that included three processes: screening tool development, validation, and implementation. The participants were pregnant women who had received antenatal care at district health promotion hospitals. There were 100 pregnant women in Nakhon Si Thammarat province during the validation process, and 30 pregnant women in Phang Nga province during the implementation process. Blood lead levels (BLLs) were analysed by atomic absorption spectrophotometry. The sensitivity and specificity of the screening instrument, as well as the Area Under the Curve (AUC), demonstrate its validity.

Results

There were 80 BLL-related items found through the collection of primary and secondary data and examined for validity and inter-rater reliability by five experts. Six items were excluded because the values were less than the criteria set. Seventy-four items remained with the Item Content Validity Index (I-CVI) = 0.80-1.00, the Content Validity Index Average (S-CVI/Ave) = 0.91, and Kappa scores = 0.76-1.00. After using 74 items collected on pregnant women, only 31 items were included in the validation process. Following that, the pooled eight items with cut-off point scores of 1 had the highest validity, which included systolic blood pressure, diastolic blood pressure, urine sugar, haemoglobin level, occupation, drinking coffee, using chemical products, and education level (ThaiL8Is). The ThaiL8Is in the validation process yielded sensitivity = 80.9%, specificity = 69.8%, and an AUC (95%CI) = 0.78 (0.69-0.87). The implementation process has confirmed the validity of the screening tool; sensitivity = 78.9%, specificity = 81.8%, and the AUC (95%CI) = 0.80 (0.63-0.97).

Conclusions

The ThaiL8Is a valid screening tool for Thai pregnant women. ThaiL8Is' sensitivity in detecting the risk groups for lead exposure can be enhanced by a combination of biochemical markers used in routine prenatal screening. It can be used to screen pregnant women for early indicators of lead exposure prior to a blood lead test.

Associations between Phthalate Exposure and Gestational Age at Delivery in a Diverse Pregnancy Cohort

The association between prenatal phthalate exposure and late preterm birth (LPTB) is unclear. We examined singleton pregnancies (2006-2011) from a racially and socioeconomically diverse sample of women in the CANDLE cohort of the ECHO-PATHWAYS Consortium. Urine collected in the second and third trimester was analyzed for 14 phthalate metabolites. Multivariate logistic and linear regressions were performed for LPTB, defined as delivery 34-37 weeks, and gestational week, respectively. Models were controlled for socio-demographics, behavioral factors, clinical measurements, medical history, and phthalates in the other trimester. Effect modification by race and pregnancy stress, indicated by intimate partner violence (IPV), was investigated. We conducted a secondary analysis in women with spontaneous preterm labor. The rate of LPTB among 1408 women (61% Black, 32% White) was 6.7%. There was no evidence of decreased gestational age (GA) in association with any phthalate metabolite. Each two-fold increase in third trimester mono-benzyl phthalate (MBzP) was associated with 0.08 weeks longer gestational age (95% CI: 0.03, 0.12). When restricting to women with spontaneous labor, second trimester mono-n-butyl phthalate (MBP) was associated with 54% higher odds (95% CI: 2%, 132%) of LPTB. Associations were not modified by maternal race or IPV exposure. In conclusion, we observed mixed evidence concerning our hypothesis that prenatal phthalate exposure increases risk of LPTB, though secondary analyses suggest increased risk of spontaneous LPTB associated with MBP, which is consistent with a recent pooled analysis of 16 cohorts.

Integrated review of the nexus between toxic elements in the environment and human health

Emerging pollutants in the environment due to economic development have become a global challenge for environmental and human health management. Potentially toxic elements (PTEs), a major group of pollutants, have been detected in soil, air, water and food crops. Humans are exposed to PTEs through soil ingestion, consumption of water, uptake of food crop products originating from polluted fields, breathing of dust and fumes, and direct contact of the skin with contaminated soil and water. The dose absorbed by humans, the exposure route and the duration (i.e., acute or chronic) determine the toxicity of PTEs. Poisoning by PTEs can lead to excessive damage to health as a consequence of oxidative stress produced by the formation of free radicals and, as a consequence, to various disorders. The toxicity of certain organs includes neurotoxicity, nephrotoxicity, hepatotoxicity, skin toxicity, and cardiovascular toxicity. In the treatment of PTE toxicity, synthetic chelating agents and symptomatic supportive procedures have been conventionally used. In addition, there are new insights concerning natural products which may be a powerful option to treat several adverse consequences. Health policy implications need to include monitoring air, water, soil, food products, and individuals at risk, as well as environmental manipulation of soil, water, and sewage. The overall goal of this review is to present an integrated view of human exposure, risk assessment, clinical effects, as well as therapy, including new treatment options, related to highly toxic PTEs.

The Effects of Toxic Heavy Metals Lead, Cadmium and Copper on the Epidemiology of Male and Female Infertility

Infertility is a major problem in modern society that affects a significant number of couples around the world. Heavy metals and a number of other factors have been causally linked to infertility. The aim of this study was to determine the effect of heavy metals lead, cadmium, and copper on the epidemiology of male and female infertility. Searches for articles published from 1982 to 2020 using related keywords such as male and female infertility and heavy metals were performed in scientific databases PubMed, Google Scholar, Science Direct, and others. The results showed that, in recent years, the number of infertile individuals has increased. Various environmental, occupational, and genetic factors have been described as potential causes. Heavy metals lead, cadmium, and copper cause infertility in couples through various mechanisms, such as changes in sperm motility factors, decreased semen quality, or effects on the egg. Exposure to physical phenomena such as radiation (ionized or microwave) and heat; stress and mental disorders; chemicals from cigarettes, respiratory pollutants (lead), insecticides and pesticides; anesthetic gases; and mercury and cytotoxic drugs may also contribute to the onset of infertility.

Investigation of exposure to heavy metals (Hg, Pb, Cd, Co, and Cr) as the cause of congenital anomaly cases (orofacial cleft) in infants

Orofacial cleft (OFC) is one of the most common congenital defects, with worldwide cases occurring in approximately 1:700 to 1:1000 births. This incidence is among the highest birth defects in Indonesia, and the incidence rate in Bandung Regency (14.69%) is the second-highest in West Java province. The purpose of this study was to analyze the association of heavy metal factors that accumulate in infants to the risk of OFC in Bandung Regency. The method was used by testing heavy metals Hg, Pb, Cd, Co, and Cr in infant blood. The total sample were 54 samples, where the case respondent of 32 and 22 respondents as the control group. Blood samples were analyzed using ICP-MS Agilent 7900. The correlation using statistic analyze namely chi-square analysis (bivariate) and multiple logistic regression (multivariate). The results showed that there was a significant difference in the concentration of heavy metals Hg, Pb, and Cd as well as an increase in Pb and Cd in the infant's blood which was thought to be significantly associated with the risk of OFC.

In utero deposition of trace elements and metals in tissues

INTRODUCTION

All animals, including humans, are exposed to heavy metals which are known to accumulate in different tissues, especially in bone. During pregnancy, the maternal bone turnover is increased and the metals in the mother's body can be mobilized into the bloodstream. Heavy metals in maternal blood are known to pass through the placenta to the fetal blood and finally, deposited to bone tissue. However, there are no studies on the concentration of metals in the fetal solid tissues and until now, the rate of metal transfer from mother to fetus is not exactly known.

MATERIALS AND METHODS

Samples of the blood, liver, placenta, and three different bones were collected from 17 pregnant ewes and their 27 fetuses. The animals had no known exposure to heavy metals. The concentrations of Al, As, Ba, Ca, Cd, Co, Cr, Cu, Fe, Hg, K, Mg, Mn, Mo, Na, Ni, P, Pb, Rb, Sb, Sn, Sr, Te, Ti, Tl, V, and Zn were analyzed using ICP-MS.

RESULTS AND DISCUSSION

The concentration of Sb, Sn, Te, and Tl were under the detection limit in all the samples. The other metals were found in all maternal and fetal tissues, suggesting that all detectable metals cross the placenta. Blood concentrations were low compared to solid tissue concentrations. The concentrations of essential elements varied between maternal and fetal tissues, which could be explained by biological differences. The differences in concentrations of non-essential elements between the ewe and fetuses were smaller. The most significant differences were between maternal and fetal concentrations of Ba and Sr, which is at least partly explained by the mineralization degree of the bone.

CONCLUSION

Heavy metals accumulate in fetal solid tissues in sheep that are not directly exposed to heavy metals. Because of the differences in anatomy between human and sheep placenta, the accumulation in the tissue of human fetuses should be extrapolated cautiously. However, there might be some clinical relevance for fertile aged women who are exposed to heavy metals, such as women who work in the metal industry or who have undergone joint replacement surgery.

Health Remedies as a Source of Lead, Mercury, and Arsenic Exposure, New York City, 2010-2019

Objectives. To describe the types of health remedies collected during poisoning investigations in New York City over a 10-year period that were found to contain high levels of lead, mercury, or arsenic. Methods. Between 2010 and 2019, the New York City Department of Health and Mental Hygiene collected 584 samples of health remedies during poisoning investigations and store surveys for lead, mercury, or arsenic analysis. Results. There was a significant association between blood lead levels and estimated cumulative daily lead exposures among adult users of rasa shastra Ayurvedic medications. Also, average blood lead levels among adult rasa shastra users were significantly higher than levels among those using other types of non-Ayurvedic health remedies. Conclusions. Rasa shastra Ayurvedic medications can contain very high levels of lead, mercury, and arsenic. This underscores the importance of screening for lead, mercury, and arsenic exposures within at-risk populations. Public Health Implications. The general ease of accessibility to rasa shastra medications raises concerns. There is a need for systemic change that results in primary prevention, that is, removal of the source through policy development and regulatory enforcement in the country of origin. (Am J Public Health. 2022;112(S7):S730-S740. https://doi.org/10.2105/AJPH.2022.306906).

Lead in drinking water and birth outcomes: A tale of two water treatment plants

The recent lead-in-water crisis in Newark has renewed concerns about the crisis being a widespread problem in the nation. Using data on the exact home addresses of pregnant women residing in the city combined with information on the spatial boundary separating areas within the city serviced by two water treatment plants, we exploit an exogenous change in water chemistry that resulted in lead leaching into the tap water of one plant's service area, but not the other's, to identify a causal effect of prenatal lead exposure on fetal health. We find robust evidence of adverse health impacts, which has important policy implications in light of the substantial number of lead water pipes that remain in use as part of our aging infrastructure and the cost-benefit calculus of lead abatement interventions.

Trends of Blood Lead Levels in US Pregnant Women: The National Health and Nutrition Examination Survey (2001–2018)

Objectives

This study investigates the trends of blood lead levels in US pregnant women based on the National Health and Nutrition Examination Survey from 2001 to 2018.

Methods

A total of 1,230 pregnant women were included in this study. The weighted logistic regression was applied to analyze the association between sociodemographic characteristics with high blood levels. We computed the blood lead levels for each survey period from 2001–2002 to 2017–2018. Moreover, we used the adjusted linear regression model to investigate the time-related change in blood lead level. The odds ratio (OR) with a 95% confidence interval (CI) was calculated accordingly.

Results

The mean blood lead was 0.73 ± 0.03 ug/dL, and high blood lead was observed in 2.53% of individuals. The Mexican Americans were more associated with high blood lead than the non-Hispanic white (OR, 1.072; 95% CI, 1.032-1.112). The mean blood lead level has decreased from 0.97 ug/dL in 2001–2002 to 0.46 ug/dL in 2013–2014. Afterward, a slight increase was observed with the mean blood lead of 0.55 ug/dL in 2015–2016 and 0.53 ug/dL in 2017-2018. In the adjusted linear regression model, each year's increase would lead to a 0.029 ug/dL decrease in blood lead (P < 0.001). However, no significant change was observed in the 2017–2018 cycle compared with 2009–2010 (P = 0.218).

Conclusion

This study summarized the trend of blood lead levels in US pregnant women over 2001–2018. Continued effort is still required to control lead sources better and protect this population from lead exposure.

Maternal and child biomonitoring strategies and levels of exposure in western Canada during the past seventeen years: The Alberta Biomonitoring Program: 2005-2021

The Alberta Biomonitoring Program (ABP) was created in 2005 with the initial goal of establishing baseline levels of exposure to environmental chemicals in specific populations in the province of Alberta, Canada, and was later expanded to include multiple phases. The first two phases focused on evaluating exposure in pregnant women (Phase One, 2005) and children (Phase Two, 2004-2006) by analyzing residual serum specimens. Phase Three (2013-2016) employed active recruitment techniques to evaluate environmental exposures using a revised list of chemicals in paired serum pools from pregnant women and umbilical cord blood. These three phases of the program monitored a total of 226 chemicals in 285 pooled serum samples representing 31,529 individuals. Phase Four (2017-2020) of the ABP has taken a more targeted approach, focusing on the impact of the federal legalization of cannabis on the exposure of pregnant women in Alberta to cannabis, as well as tobacco and alcohol using residual prenatal screening serum specimens. Chemicals monitored in the first three phases include herbicides, neutral pesticides, metals, metalloids, and micronutrients, methylmercury, organochlorine pesticides, organophosphate pesticides, parabens, phthalate metabolites, perfluoroalkyl substances (PFAS), phenols, phytoestrogens, polybrominated compounds, polychlorinated biphenyls (PCBs), dioxins and furans, polycyclic aromatic hydrocarbons (PAHs), and tobacco biomarkers. Phase Four monitored six biomarkers of tobacco, alcohol, and cannabis. All serum samples were pooled. Mean concentrations and 95% confidence intervals (CIs) were calculated for the chemicals detected in ≥25% of the sample pools. cross the first three phases, the data from the ABP has provided baseline exposure levels for the chemicals in pregnant women, children, and newborns across the province. Comparison within and among the phases has highlighted differences in exposure levels with age, geography, seasonality, sample type, and time. The strategies employed throughout the program phases have been demonstrated to provide effective models for population biomonitoring.

Comprehensive evaluation of the possible impact of roofing materials on the quality of harvested rainwater for human consumption

Water is a vital natural resource that influences life and contributes to domestic and industrial activities. Availability and accessibility of safe water sources are crucial for a country's economic growth. Harvesting of roof runoffs is an alternative source of water used for domestic purposes. However, the quality of harvested rainwater can be affected by roofing materials. This research seeks to assess heavy metals concentration, physicochemical and bacteriological parameters in roof runoffs and estimate the water quality index and health risk these metals pose to consumers. Rainwater samples were collected from Aluzinc, Aluminum, Galvanized, and Asbestos roofing materials within the Ejisu municipality. Rainwater collected directly from the sky was used as control. All runoffs from the four roofing materials recorded Cd, Fe, Cr, turbidity, pH, E.coli, total and fecal coliform levels above WHO limit for drinking water. There was a significant variation in pH, EC, Zn, Cd, Cr, Fe, E. coli, total and fecal coliform levels between control samples and roof runoffs (p < 0.05). The estimated water quality index for runoffs from the four roofing materials exceeded 100 indicating their unsuitability for drinking. Cadmium recorded the highest non-cancer health risk to children and adults in all the roof runoffs. Hazard quotients (HQs) above one were recorded for a child (HQ = 40.1) and an adult (HQ = 13.6) via dermal exposure to Cd in runoff from Aluminum roofing material. Hazard quotient of 9.53 and 4.08 were estimated for a child and an adult respectively via oral exposure to Cd in runoffs from Asbestos roofing material. The estimated cancer risks were above 10^-3 for a child and an adult via oral and dermal exposure to Cd in all roof runoffs, suggesting a possible cancer health effect. The study concludes that the four roofing materials impact negatively on the quality of runoffs.

Characterization of Ambient Air Quality in Selected Urban Areas in Uganda Using Low-Cost Sensing and Measurement Technologies

Air pollution is prevalent in cities and urban centers in developing countries including sub-Saharan Africa, but ground monitoring data on local pollution remain inadequate, hindering effective mitigation. We employed low-cost sensing and measurement technologies to quantify pollution levels based on particulate matter (PM_2.5), NO₂, and O₃ over a 6 month period for selected urban centers in three of the four macroregions in Uganda. PM_2.5 diurnal profiles exhibited consistent patterns across all monitoring locations with higher pollution levels manifesting from 18:00 to 00:00 and from 06:00 to 09:00; while the periods from 00:00 to 05:00 and from 09:00 to 17:00 had the lowest levels. Daily PM_2.5 varied widely between 34 and 107 μg/m³ over a 7 day period, well within unhealthy levels (55.5-150.4 μg/m³) for short-term exposure. The inconsistent daily trend are instructive for multiple pollutant assessment to aid specific policy initiatives. The results also show inverse relations between seasonal particulate levels and precipitation, that is, R (correlation coefficient) = -0.93 and -0.62 for Kampala and Wakiso, R = -0.49 and -0.44 for the Eastern region, and R = -0.65 and -0.96 for the Western region. NO₂ monthly concentrations replicated PM_2.5 spatial levels, whereas O₃ exhibited inverse relations probably due to a higher retention time in less-urbanized environments. Both PM_2.5 and NO₂ correlated positively with the resident population. Our findings show significant spatiotemporal variations and exceedances of health guidelines by about 4-6 times across most study locations (with two exceptions) for longer-term exposure. This paper demonstrably highlights the practicability and potential of low-cost approaches for air quality monitoring, with strong prospects for citizen science. This paper also provides novel information regarding air pollution that is needed to improve control strategies for reducing exposures.

What to Expect When Expecting in Lab: A Review of Unique Risks and Resources for Pregnant Researchers in the Chemical Laboratory

Pregnancy presents a unique risk to chemical researchers due to their occupational exposures to chemical, equipment, and physical hazards in chemical research laboratories across science, engineering, and technology disciplines. Understanding “risk” as a function of hazard, exposure, and vulnerability, this review aims to critically examine the state of the science for the risks and associated recommendations (or lack thereof) for pregnant researchers in chemical laboratories (labs). Commonly encountered hazards for pregnant lab workers include chemical hazards (organic solvents, heavy metals, engineered nanomaterials, and endocrine disruptors), radiation hazards (ionizing radiation producing equipment and materials and nonionizing radiation producing equipment), and other hazards related to the lab environment (excessive noise, excessive heat, psychosocial stress, strenuous physical work, and/or abnormal working hours). Lab relevant doses and routes of exposure in the chemical lab environment along with literature and governmental recommendations or resources for exposure mitigation are critically assessed. The specific windows of vulnerability based on stage of pregnancy are described for each hazard, if available. Finally, policy gaps for further scientific research are detailed to enhance future guidance to protect pregnant lab workers.

Heavy metal ion concentration in the amniotic fluid of preterm and term pregnancies from two cities with different industrial output

The growth and development of the fetus is a complex phenomenon that can be influenced by several variables. High quantities of heavy metal ions in the amniotic fluid have been linked to poor health, especially in industrial, polluted and poor areas. The aim of the present study was to assess the differences in the concentration of these ions between preterm (weeks 15-37) and term pregnancies (starting at week 37). Another objective was to compare pregnancies from two cities with different industry levels. Two sample lots from two Romanian cities were analyzed. A total of 100 patients from Timisoara were compared with 60 from Petrosani, a heavy industry city in Romania. Demographic data were collected, and amniocentesis was performed on all women. Lead (Pb), copper (Cu), nickel (Ni), cadmium (Cd), arsenic (As), iron (Fe) and zinc (Zn) concentrations were assessed. Descriptive and analytical statistics were performed using the Mann-Whitney U test for non-parametric data and the Fisher's exact test for categorical data. In addition, categorical data was represented graphically. In the Timisoara cohort, the differences in heavy metal concentrations between preterm and term pregnancies were not statistically significant. In the Petrosani cohort, however, the concentrations of Zn (P=0.02606) and Cd (P=0.01512) were higher in preterm than in term pregnancies. When comparing the two cohorts as a whole, the concentration of Pb (P=0.04513), Cd (P=0.00002), As (P=0.03027) and Zn (P<0.00001) were higher in the patients from Petrosani than in those from Timisoara. Only Cu concentrations were higher in the Timisoara cohort (P<0.00001). The concentrations of Ni (P=0.78150) and Fe (P=0.44540) did not differ statistically. Thus, amniocentesis is an important diagnostic and exploratory tool in determining differences in the concentrations of elements such as heavy metal ions. Research over a longer period of time should be carried out to examine the relation between heavy metal ions concentration and possible postnatal health outcomes.

Pollution characteristics and human health risk assessments of toxic metals and particle pollutants via soil and air using geoinformation in urbanized city of Pakistan

Toxic metals and particle pollutants in urbanized cities have significantly increased over the past few decades mainly due to rapid urbanization and unplanned infrastructure. This research aimed at estimating the concentration of toxic metals and particle pollutants and the associated risks to public health across different land-use settings including commercial area (CA), urban area (UA), residential area (RA), and industrial area (IA). A total of 47 samples for both soil and air were collected from different land-use settings of Faisalabad city in Pakistan. Mean concentrations of toxic metals such as Mn, Zn, Pb, Ni, Cr, Co, and Cd in all land-use settings were 92.68, 4.06, 1.34, 0.16, 0.07, 0.03, and 0.02 mg kg^-1, respectively. Mean values of PM₁₀, PM_2.5, and Mn in all land-use settings were found 5.14, 1.34, and 1.9 times higher than the World Health Organization (WHO) guidelines. Mn was found as the most hazardous metal in terms of pollution load index (PLI) and contamination factor (CF) in the studied area. Health risk analysis for particle pollutants using air quality index (AQI) and geoinformation was found in the range between good to very critical for all the land-use settings. The hazard quotient (HQ) and hazard index (HI) were higher for children in comparison to adults, suggesting that children may be susceptible to potentially higher health risks. However, the cancer risk (CR) value for Pb ingestion (1.21 × 10^-6) in children was lower than the permissible limit (1 × 10^-4 to 1 × 10^-6). Nonetheless, for Cr inhalation, CR value (1.09 × 10^-8) was close to tolerable limits. Our findings can be of valuable assistance toward advancing our understanding of soil and air pollutions concerning public health in different land-use settings of the urbanized cities of Pakistan.

Pre-conception serum ferritin concentrations are associated with metal concentrations in blood during pregnancy: A cohort study in Benin

BACKGROUND

Iron deficiency is a common nutritional deficiency that impacts maternal health and fetal development and is also associated with increased uptake of toxic metals. Women in sub-Saharan Africa are highly exposed to both iron deficiency and metals in the environment. As research on the developmental origins of health and disease increasingly shows impacts of pre-conception maternal health on pregnancy and fetal health, these environmental exposures are of concern.

OBJECTIVES

This study investigated the association between iron status pre-pregnancy and blood metal concentrations in the first trimester of pregnancy with potential implications for iron supplementation.

METHODS

Pre-conception and first trimester blood samples taken from 262 Beninese women were tested for serum ferritin, inflammation markers, manganese (Mn), cadmium (Cd), lead (Pb), copper, zinc, selenium, mercury and arsenic. Associations between serum ferritin adjusted for inflammation and metal concentrations were analyzed using multivariate linear regression.

RESULTS

Women with iron deficiency before conception (13%) were more likely to remain iron deficient in the first trimester (4%) (adjusted OR = 41.2, 95%CI 6.2; 275.0) even within the context of routine iron supplementation during pregnancy. Lower pre-pregnancy serum ferritin concentrations were significantly related to higher concentrations of Mn, Cd and Pb in the first trimester. Every 1% increase in serum ferritin concentration was associated with a 0.13% decrease in Mn (adjusted β = -0.13, 95%CI -0.18; -0.07), a 0.22% decrease in Cd (adjusted β = -0.22, 95%CI -0.28; -0.15) and a 0.06% decrease in Pb concentration (adjusted β = -0.06, 95%CI -0.12; -0.006).

DISCUSSION

These results suggest that increasing iron stores prior to pregnancy may prevent excessive uptake of toxic concentrations of the metals Mn, Cd and Pb and argue in favour of testing the effects of iron supplementation prior to pregnancy on metal concentrations.

Impacts of the linear flowing industrial wastewater on the groundwater quality and human health in Swabi, Pakistan

The present study aimed to probe the extent and mobility of contamination in wastewater and its impact on groundwater and human health in the Swabi region in Pakistan. Representative samples (n = 86) were collected from both wastewater streams and groundwater in an analogous environmental setting. The result showed that pH, color, hardness, alkalinity, chemical oxygen demand, chloride, suspended solids, total dissolved solids, Cr, Cd, Pb, Cu, Fe, Mg, Na, Ca, and K in industrial wastewater were higher than the Pak-EPA (Pakistan Environmental Protection Agency) and the United State Environmental Protection Agency (US-EPA) devised standards. In groundwater, the concentration (μg L^-1) of trace elements, namely, Cd (1.16), Pb (17.4), Fe (12426), Mn (320), Mg (129784), Na (33630), Ca (177944), and K (9558) was significantly higher than the WHO (World Health Organization) acceptable level, showing decreasing tendency with increasing distance from the industrial zone. The study perceived that wastewater caused permanent hardness, while groundwater hardness was decreased from permanent to temporary at a distance from industries. Integrated health risk assessment revealed that Cu, Zn, and Co may cause low risk, Na, Mn, Ni, Pb, and Cr cause medium risk, whereas Cd, Fe, Mg, Ca, and K may cause a high health risk. Moreover, the average daily intake of Fe, Mn, Mg, Na, Ca, and K was comparably higher than Cr, Cd, Pb, Ni, Cu, Zn, and Co in both adults and children. The mode of occurrence of contaminants in groundwater was due to the leaching of contaminated wastewater and the oxidation of metals. Furthermore, carbonates, chloride, and SAR (sodium adsorption ratio) precipitation have a key role in groundwater contamination and influencing the natural water quality. The study concluded that the health problems in the surrounding areas were due to the use of contaminated water for drinking and household purpose. The study suggests filtering the drinking water and treating the wastewater before releasing it into the environment.

Health repercussions of environmental exposure to lead: Methylation perspective

Lead (Pb) exposure has been a major public health concern for a long time now due to its permanent adverse effects on the human body. The process of lead toxicity has still not been fully understood, but recent advances in Omics technology have enabled researchers to evaluate lead-mediated alterations at the epigenome-wide level. DNA methylation is one of the widely studied and well-understood epigenetic modifications. Pb has demonstrated its ability to induce not just acute deleterious health consequences but also alters the epi-genome such that the disease manifestation happens much later in life as supported by Barkers Hypothesis of the developmental origin of health and diseases. Furthermore, these alterations are passed on to the next generation. Based on previous in-vivo, in-vitro, and human studies, this review provides an insight into the role of Pb in the development of several human disorders.

Sources of toxic elements in indoor dust sample at export processing zone (EPZ) area: Dhaka, Bangladesh; and their impact on human health

In industrial areas, increased human activities generate high emissions of metals that contaminate the environment, and eventually affect human health. Therefore, this study aims to investigate the sources of toxic elements in indoor dust samples, and to evaluate possible health risks due to expose of human body through dermal contact, inhalation, and ingestion. A total 36 indoor dust samples were collected from the windows of twelve (12) industrial buildings, which are facing the main roads in the biggest export process zone (DEPZ) in Dhaka City, Bangladesh. The indoor dust samples were analyzed using X-ray fluorescence (XRF) technique for the determination of Cu, Zn, As, Pb, Fe, Cr, Co, Ni, K, Ca, Ti, Rb, and Sr. This investigation revealed that Cu, Zn, Pb, Fe, and Sr concentrations were slightly higher in various degree than that of the background value in soil recommended by the Chinese Environmental Protection Administration (CEPA). Subsequently, ANOVA (α = 0.05, p < 0.001) test and %RSD values (33% to 168%) showed that the concentrations of these metals were present non-homogeneously in different sampling points. However, statistical analysis and several geochemical indices have been proposed that these heavy metals might be come in indoor dust samples because of anthropogenic events. This investigation also showed that the most-extreme permissible hazard index (HIs) levels known as non-cancer risk for As, Mn, and Zn because of dust exposure in the study area were below than that of the safe limit (HI = 1) but with an exception of Pb (HI = 1.9E+00) for children. On the other hand, the degree of cancer-causing risk linked with exposure to arsenic in indoor dust (i.e., 0.502E-06 to 0.121E-05) falls within the range of threshold values (10^-6 to 10^-4). Therefore, following USEPA health risk models, it has been suggested that these metals present in indoor dust samples might not have significant impact on causing non-cancer and cancer risk to children and to adult at this moment in the DEPZ area, Bangladesh. However, a continuous monitoring should be needed to assess more accurately the non-cancer and cancer risk to children and adult.

Paternal and/or maternal preconception-induced neurobehavioral teratogenicity in animal and human models

Prenatal insult exposure effects on the offspring, have and are still considered the main interest of most teratological studies, while paternal and maternal preconception effects have received relatively little interest. Once thought to be a myth, paternal exposure to insults leading to numerous detrimental effects in the offspring, has been confirmed on several occasions and is gaining increased attention. These effects could be demonstrated molecularly, biochemically and/or behaviorally. Different epigenetic mechanisms have been proposed for these effects to occur, including DNA methylation, histone modification and sperm RNA transmission. Paternal insult exposure has been shown to cause several neurobehavioral and developmental defects in the offspring. Findings on parental insult exposure effects on the progeny will be discussed in this review, with the main focus being on neurobehavioral effects after parental preconceptional exposure. The exposure to the insults induced long-lasting, mostly marked, defects. A few pioneering, prevention and reversal studies were published. Interestingly, most studies were conducted on paternal exposure and, at the present state of this field, on animal models. Clinical translation remains the subsequent challenge.

Prenatal blood levels of some toxic metals and the risk of spontaneous abortion

High-level toxic metal exposure has become rare in the recent years. Although, it has not known whether relatively lower exposure may adversely affect human reproductive system. Spontaneous abortion (SA) is a serious reproductive problem, which, in many cases, the cause(s) is not clearly understood. To assess the relationship between prenatal blood level of metals and SA risk, we compared blood concentration of some heavy metals in samples taken from mothers recruited in Tehran Environment and Neurodevelopmental Defects (TEND) study conducted on apparently healthy pregnant women in Tehran, Iran who subsequently experienced spontaneous abortion with mothers who their pregnancy ended to live births. During early gestation, 206 women were enrolled to the survey and followed up till fetal abortion or baby deliveries occur. Blood metal concentrations were measured using an inductively coupled plasma mass spectrometer. The mean blood levels of lead, antimony, and nickel were higher in SA than ongoing pregnancy; however, this difference was not statistically significant. When adjusted for covariates, the logistic regression analysis showed significant association between maternal age and the risk of SA in all models. Among toxic metals only antimony had a noticeable positive relation with the risk of SA (OR: 1.65, 95% CI:1.08-2.52, P value: 0.02). Pearson's correlation coefficient showed significant (P < 0.05) positive correlations among prenatal blood metals levels, except for nickel. Although the present study failed to provide strong evidence for the effects of toxic metals on the occurrence of SA at the relatively low-levels, these metals should be avoided in women who plan pregnancy and/or during the early stages of gestation to prevent the chance of adverse effects.

Time and spatial trends of operated cryptorchidism in France and environmental hypotheses: a nationwide study from 2002 to 2014

STUDY QUESTION

Is there an evolution in the risk of operated cryptorchidism in France and does local geographical environment appear as an important trigger for this defect?

SUMMARY ANSWER

We observed an increase of the risk of operated cryptorchidism in boys under the age of 7 years during the period 2002-2014 and a strong spatial heterogeneity, with the detection of spatial clusters suggesting environmental factors.

WHAT IS KNOWN ALREADY

Epidemiologic data on cryptorchidism are scarce and its etiology is poorly understood. As part of the testicular dysgenesis syndrome, cryptorchidism is suspected to be a male genital developmental disorder caused by endocrine disruptor chemical (EDC) exposure during the prenatal period.

STUDY DESIGN, SIZE, DURATION

This was a retrospective and descriptive study using data from the French national hospital discharge database, in the 2002-2014 study period. We built an indicator to reflect incident cases of operated cryptorchidism in boys under the age of 7 years in metropolitan France, with an algorithm using specific codes for diseases (ICD-10 codes) and surgical acts (CCAM codes).

PARTICIPANTS/MATERIALS, SETTING, METHODS

The study population was composed of 89 382 new cases of operated cases of cryptorchidism in boys under the age of 7 years. We estimated the temporal evolution of the incidence rate. We fitted a spatial disease-mapping model to describe the risk of cryptorchidism at the postcode scale. We used Kulldorff's spatial scan statistic and Tango's flexibly shaped spatial scan statistic to identify spatial clusters.

MAIN RESULTS AND THE ROLE OF CHANCE

The estimated increase in the incidence of operated cryptorchidism from 2002 to 2014 was equal to 36.4% (30.8%; 42.1%). Cryptorchidism displayed spatial heterogeneity and 24 clusters (P < 0.0001) were detected. The main cluster was localized in a former coal mining and metallurgic area in northern France, currently an industrial area. The cluster analysis suggests the role of shared socio-economic and environmental factors that may be geographically determined and intertwined. The industrial activities identified in the clusters are potentially the source of persistent environmental pollution by metals, dioxins and polychlorinated biphenyls.

LIMITATIONS, REASONS FOR CAUTION

The indicator we used reflects operated cases of cryptorchidism, with an under-evaluation of the health problem. We cannot exclude a possible role of the evolution and local differences in surgical practices in the observed trends. Our inclusion of boys under 7 years of age minimized the biases related to differences in practices according to age. Regarding the environmental hypothesis, this is an exploratory study and should be considered as a hypothesis-generating process for future research studies.

WIDER IMPLICATIONS OF THE FINDINGS

To our knowledge, this is the first descriptive study to address nationwide trends of operated cryptorchidism with detection of spatial clusters, with a very large sample allowing great statistical power. Our results generate plausible environmental hypotheses, which need to be further tested.

STUDY FUNDING/COMPETING INTEREST(S)

This study was entirely funded by Santé publique France, the French National Public Health Agency. All authors declare they have no actual or potential competing financial interest.

TRIAL REGISTRATION NUMBER

N/A.

Source Apportionment and Health Risk Assessment of Metal Elements in PM2.5 in Central Liaoning’s Urban Agglomeration

To better understand the source and health risk of metal elements in PM2.5, a field study was conducted from May to December 2018 in the central region of the Liaoning province, China, including the cities of Shenyang, Anshan, Fushun, Benxi, Yingkou, Liaoyang, and Tieling. 24 metal elements (Na, K, V, Cr, Mn, Co, Ni, Cu, Zn, As, Mo, Cd, Sn, Sb, Pb, Bi, Al, Sr, Mg, Ti, Ca, Fe, Ba, and Si) in PM2.5 were measured by ICP-MS and ICP-OES. They presented obvious seasonal variations, with the highest levels in winter and lowest in summer for all seven cities. The sum of 24 elements were ranged from to in these cities. The element mass concentration ratio was the highest in Yingkou in the spring (26.15%), and the lowest in Tieling in winter (3.63%). The highest values of elements in PM2.5 were mostly found in Anshan and Fushun among the studied cities. Positive matrix factorization (PMF) modelling revealed that coal combustion, industry, traffic emission, soil dust, biomass burning, and road dust were the main sources of measured elements in all cities except for Yingkou. In Yingkou, the primary sources were identified as coal combustion, metal smelting, traffic emission, soil dust, and sea salt. Health risk assessment suggested that Mn had non-carcinogenic risks for both adults and children. As for Cr, As, and Cd, there was carcinogenic risks for adults and children in most cities. This study provides a clearer understanding of the regional pollution status of industrial urban agglomeration.

Lead Levels in Non-Occupationally Exposed Women with Preeclampsia

There are many controversies regarding the relationship between lead exposure andcomplications in pregnancy. Preeclampsia (PE) is a maternal hypertensive disorder which is one of the main causes of maternal and foetal mortality. The aim of our study was to assess blood lead level (BLL) in Polish women with PE (PE group, n = 66) compared with healthy, non-pregnant women (CNP group, n = 40) and healthy pregnant women (CP group, n = 40). BLL was determined by inductively coupled plasma mass spectrometry (ICP-MS). The systolic blood pressure (SBP), diastolic blood pressure (DBP) and BLL in the CP group were significantly lower than in the PE group (p < 0.001). Logistic regression analyses of BLL showed a significant positive relationship with the presence of PE. Furthermore, both the SBP and DBP values were positively associated with BLL. This study indicates that preeclamptic women tend to present with significantly higher BLL compared to healthy pregnant women. There were no differences in the BLL between the CP and CNP groups.

Association between blood lead level during pregnancy and birth weight: A meta-analysis

BACKGROUND

We aimed to provide a quantitative summary of evidence for a relationship between prenatal lead (Pb) exposure and birth weight.

METHODS

PubMed and Web of Science databases were searched for eligible epidemiological studies. We transformed findings in eligible studies with different effect-size metrics to standardized regression coefficients, and used fixed-effects or random-effects models to assess the pooled effects of prenatal Pb exposure on birth weight.

RESULTS

There was a significant negative association between prenatal Pb exposure and birth weight. Birth weight reduction was associated with elevated lead levels in maternal blood (β = -0.094; 95% confidence interval [CI]: -0.157 to -0.030) and cord blood (β = -0.120; 95% CI: -0.239 to -0.001).

CONCLUSIONS

This meta-analysis is the first to provide a quantitative assessment of Pb exposure during pregnancy and an increased risk of lower birth weight.

Maternal Δ-aminolevulinic acid dehydratase 1-2 genotype enhances fetal lead exposure and increases the susceptibility to the development of cerebral palsy

Limited epidemiologic studies questioned the association between pre- and postnatal lead exposure and the development of cerebral palsy (CP). Moreover, the genotypes of δ-aminolevulinic acid dehydratase (δ-ALAD) in CP patients and their mothers and their association to the blood lead levels (BLLs) were not previously studied. This study aimed to evaluate the association between δ-ALAD gene polymorphism and BLL in cases of CP and their mothers. A case control study was carried out on 23 CP cases and equal number of healthy matched controls. The mothers of the included children were asked to answer a questionnaire involving the baseline clinical and demographic characteristics. Also, questionnaires were done to detect the sources of environmental lead exposure and screen lead exposure during the pregnancy period. BLL, δ-ALAD enzyme activity, and genetic analysis for ALAD G177C were done for each child and his mother. There was significant (p < 0.001) elevation of BLL in CP cases and their mothers that was positively correlated (r = 0.436, p < 0.05). There were progressive decreases in δ-ALAD activity with increasing BLL in both children and mothers (p < 0.05). There were non-significant (p > 0.05) differences between CP and the control group regarding frequency of ALAD G177C genotypes, while there was a significant (p = 0.04) increase in the frequency of ALAD 1-2 (GC) genotype in the mothers of the CP group associated with high BLL and significant decrease in δ-ALAD activity (p < 0.001). The study can indicate the significance of δ-ALAD gene polymorphism in the prenatal exposure to lead and the affection of the developing brain, pointing to the importance of controlling lead in pregnant women especially those with ALAD 1-2 genotype.

Elevated, sustained, and yet reversible biotoxicity effects of lead on cessation of exposure: Melatonin is a potent therapeutic option

Melatonin (Mel) is known to prevent and mitigate lead (Pb)-induced gonadotoxicity. However, there is no report in literature on the endogenous levels of different biomarkers after the cessation of Pb exposure, with or without treatment with Mel. Fifty adult male Wistar rats were divided into five groups (N = 10), which included control ((vehicle (normal saline) - treated) - 0.1 ml/day); lead chloride (PbCl₂) untreated (3 weeks vehicle + 3 weeks Pb); Pb recovery (3 weeks Pb + 3 weeks vehicle); Pb + Mel (3 weeks Pb + 3 weeks Mel); and Mel (3 weeks vehicle + 3 weeks Mel) groups. Pb and Mel were administered at 50 and 10 mg/kg B.W. (p.o.), respectively. The results showed that Pb caused significant decreases in total bilirubin (TB), phospholipids (PLP), superoxide dismutase (SOD), catalase (CAT), and total antioxidant capacity (TAC), but significant elevations in alkaline phosphatase (ALP), aspartate aminotransferase (AST), triglyceride (TG), and malondialdehyde (MDA). Although the adverse effects of Pb on TB, ALP, AST, SOD, MDA, and TAC were sustained after the cessation of exposure, a reversal was observed in total cholesterol (TC), TG, PLP, CAT, and c-reactive protein (CRP) results. Nevertheless, the detrimental effects of Pb on alanine aminotransferase (ALT), albumin, and globulin were only expressed post-exposure. Treatment with Mel caused no significant effect on TB and albumin levels. However, unlike TAC and CRP, the hormone significantly reduced ALP, AST, ALT, TC, low-density lipoprotein cholesterol, PLP, SOD, CAT, MDA, and globulin to levels comparable to the control group. In conclusion, following the cessation of Pb exposure, alterations in physiological balance could be elevated, sustained, or reversible. However, Mel enhanced the reestablishment homeostatic status after Pb administration.

Exposure to lead increases the risk of meningioma and brain cancer: A meta-analysis

OBJECTIVE

To analyze the relationship between environmental lead exposure and various types of brain tumors.

METHODS

Search databases PubMed, Web of Science, Embase and Chinese National Knowledge Infrastructure (CNKI) as of July 1, 2019. Stata 15.0 software was used for analysis.

RESULTS

In the case control, lead exposure was associated with gliomas and meningiomas 0.82 (95 % CI: 0.69, 0.95) and 1.06 (95 % CI: 0.65, 1.46). In the cohort study, lead exposure was associated with brain cancer and meningiomas 1.07 (95 % CI: 0.95, 1.19) and 1.06 (95 % CI: 0.94, 1.17). The risk of childhood brain tumors associated with parental lead exposure was 1.17 (95 % CI: 0.99, 1.34).

CONCLUSIONS

Lead may be a risk factor for meningiomas and brain cancers. However, the glioma results suggest that lead may be a protective factor, which needs to be further studied.

Occupational exposure of lead and cadmium on adolescent and adult workers of battery recycling and welding workshops: Adverse impact on health

The occupational exposure of toxic metals is an important concern, because of its potential accumulation in living organisms, leading to long term toxic effects. The occupational and environmental contacts of toxic metals, cadmium (Cd) and lead (Pb) have been evaluated by determination of them in biological samples (blood and scalp hair) of adolescent and adults, workers of battery recycling and welding workshops. The age matched adolescent and adult residing in nonindustrial areas were also selected, termed as referent/control subjects. The blood and scalp hair samples of workers and controls were analyzed for Cd and Pb using graphite furnace atomic absorption spectrometry previously decomposed the matrices using acid mixture. The biochemical parameters of workers of both age groups were also evaluated. The average concentrations of Cd and Pb in blood and scalp hair samples of adolescent workers were three fold higher as compared with control subjects. The drinking water in containers of both workshops contained Pb and Cd in two to four and five to thirteen folds, respectively, higher than recommended permissible limits of WHO. The significant correlations between the blood lead levels and hemoglobin (%) in adolescent (r = -0.78). The positive correlation was observed among incidence of blood pressure with Pb and Cd concentrations in biological samples of workers (adults) (r = 0.65 to 0.83). These findings suggest that occupational exposure of toxic metals might be created adverse impacts on workers due to ill management of workshops.

Blood lead levels in antenatal women and its association with iron deficiency anemia and adverse pregnancy outcomes

OBJECTIVES

Lead is one of the most toxic heavy metal prevalent in the environment, which affects almost all major organs including heart, brain, intestines, kidneys as well as reproductive organs. It has been known that serum iron deficiency is associated with increased serum lead levels as lead is a particularly pernicious element to iron metabolism. Lead is also known to freely cross the placenta too; hence, this study was planned to determine any association between antenatal iron deficiency anemia (IDA), raised blood lead levels (BPb), and adverse pregnancy outcomes.

MATERIALS AND METHODS

This was an observational study done on 99 antenatal women with IDA and 41 nonanemic antenatal women. Lead levels were assessed in these 140 antenatal women and they were followed for adverse pregnancy outcomes. Chi-square test was used to find a difference in quantitative variables and Pearson's correlation test was used to assess association between BPb and hemoglobin levels.

RESULTS

We found that in 11 out of 99 (11.11%) women with IDA, BPb levels were high as compared to high BPb levels in only 1 out of 41 (2.4%) women without IDA and the high BPb levels ranged from 4 μg/dl-16.9 μg/dl with a mean BPb of 8.1 μg/dl. The difference in BPb among anemic and nonanemic antenatal women was significant (P < 0.05) and there was a negative dose effect relationship between BPb levels and hemoglobin levels. This difference in antenatal outcomes among women with and without high BPb levels was also significant with increased incidence of pre-eclampsia, FGR, and preterm deliveries in women with raised BPb levels. The incidence of NICU admission was also higher in the neonates of mothers with high BPb levels.

CONCLUSIONS

We propose screening of high-risk women based on their social, occupational, environmental, and personal factors, with serum lead levels in the preconception period itself. All public and personal measures must be taken to reduce lead consumption and exposure in the preconception and antenatal period.

Before the beginning: environmental exposures and reproductive and obstetrical outcomes

There is growing consensus that preconception exposure to environmental toxins can adversely affect fertility, pregnancy, and fetal development, which may persist into the neonatal and adult periods and potentially have multigenerational effects. Here we review current data on preconception and prenatal exposure to several chemicals, including heavy metals, endocrine-disrupting chemicals, pesticides, and air pollution, and their associated obstetrical and reproductive health effects. Reproductive endocrinologists and affiliated health care providers have a unique opportunity to counsel patients before they get pregnant to minimize exposure to hazardous chemicals with the goal to improve reproductive outcomes and assure a healthy lifestyle overall. We provide practical tools and some publicly available resources for reproductive health professionals to assess a patient's risks and ways to reduce chemical and air pollution exposures during the critical preconception and prenatal periods.

The Impact of the Flint Water Crisis on Fertility

Flint switched its public water source in April 2014, increasing exposure to lead and other contaminants. We compare the change in the fertility rate and in health at birth in Flint before and after the water switch to the changes in other cities in Michigan. We find that Flint fertility rates decreased by 12 % and that overall health at birth decreased. This effect on health at birth is a function of two countervailing mechanisms: (1) negative selection of less healthy embryos and fetuses not surviving (raising the average health of survivors), and (2) those who survived being scarred (decreasing average health). We untangle this to find a net of selection scarring effect of 5.4 % decrease in birth weight. Because of long-term effects of in utero exposure, these effects are likely lower bounds on the overall effects of this exposure.