Trends and variability in blood lead concentrations among US adults aged 20-64 years and senior citizens aged ≥65 years

Lead exposure induced transgenerational developmental neurotoxicity by altering genome methylation in Drosophila melanogaster

Heavy metal toxicity is a significant global health concern, with particular attention given to lead (Pb) exposure due to its adverse effects on cognitive development, especially in children exposed to low concentrations. While Pb neurotoxicity has been extensively studied, the analysis and molecular mechanisms underlying the transgenerational effects of Pb exposure-induced neurotoxicity remain poorly understood. In this study, we utilized Drosophila, a powerful developmental animal model, to investigate this phenomenon. Our findings demonstrated that Pb exposure during the developmental stage had a profound effect on the neurodevelopment of F0 fruit flies. Specifically, we observed a loss of correlation between the terminal motor area and muscle fiber area, along with an increased frequency of the β-lobe midline crossing phenotype in mushroom bodies. Western blot analysis indicated altered expression levels of synaptic vesicle proteins, with a decrease in Synapsin (SYN) and an increase in Bruchpilot (BRP) expression, suggesting changes in synaptic vesicle release sites. These findings were corroborated by electrophysiological data, showing an increase in the amplitude of evoked excitatory junctional potential (EJP) and an increase in the frequency of spontaneous excitatory junctional potential (mEJP) following Pb exposure. Importantly, our results further confirmed that the developmental neurotoxicity resulting from grandparental Pb exposure exhibited a transgenerational effect. The F3 offspring displayed neurodevelopmental defects, synaptic function abnormalities, and repetitive behavior despite lacking direct Pb exposure. Our MeDIP-seq analysis further revealed significant alterations in DNA methylation levels in several neurodevelopmental associated genes (eagle, happyhour, neuroglian, bazooka, and spinophilin) in the F3 offspring exposed to Pb. These findings suggest that DNA methylation modifications may underlie the inheritance of acquired phenotypic traits resulting from environmental Pb exposure.

Variability of lead in urine and blood in healthy individuals

BACKGROUND

Lead is a non-essential toxic trace element. Lead in blood (BPb) is the most common biomarker of lead exposure but lead in urine (UPb) has also been used. There is, however, limited data on the variability of UPb in the general population and the association with BPb.

OBJECTIVES

Our aims were to assess variability of lead in repeated blood and urine samples. The diurnal variation of UPb was also examined as well as associations with BPb.

METHODS

We established an openly available biobank including 60 healthy non-smoking individuals, 29 men and 31 women, 21-64 years of age (median 31 years), with repeated sampling of blood and urine. Timed urine samples were collected at six fixed time points in two 24 h periods, about one week apart, and adjusted for creatinine and specific gravity (SG). BPb and UPb were analyzed by inductively coupled plasma mass spectrometry. The within- and between-individual variabilities and intra-class correlation coefficients (ICCs; ratios of the between-individual to total observed variances) were calculated using mixed-effects models.

RESULTS

The ICCs for UPb samples were mostly above 0.5, when adjusted for creatinine or SG, and higher for overnight samples compared with daytime samples. The highest ICCs were obtained for BPb (ICC = 0.97) and for urine samples corrected for dilution by SG or creatinine. The ICC was 0.66 for overnight samples adjusted for creatinine. High correlations with BPb were found for 24 h UPb (r_s = 0.77) and overnight samples, e.g. r_s = 0.74 when adjusted for SG. There was diurnal variation of UPb with lowest excretion rate in overnight samples. There was also a significant association between the Pb excretion rate and urinary flow rate.

CONCLUSIONS

In addition to BPb, UPb adjusted for creatinine or SG seems to be a useful biomarker for exposure assessment in epidemiological studies.

Serum klotho and its associations with blood and urine cadmium and lead across various stages of glomerular function: data for US adults aged 40-79 years

Exposures to cadmium and lead can cause oxidative stress, leading to tissue damage resulting in kidney and cardiovascular diseases. The antiaging protein klotho, on the other hand, is known to act as an anti-oxidative agent. How klotho homeostasis interacts with exposure to cadmium and lead has not been reported. Thus, this study was carried to investigate associations of serum klotho with blood and urine cadmium and lead in US adults aged 40-79 years across stages of eGFR-based kidney function and albuminuria defined as urinary albumin/creatinine ratio of > 30 mg/g creatinine. As long as the kidney function was normal (eGFR ≥ 90 mL/min/1.73 m²) or near normal (60 ≤ eGFR < 90 mL/min/1.73 m²), there was no evidence of an association between cadmium exposure and klotho concentrations irrespective of the presence/absence of albuminuria. During kidney dysfunction (15 ≤ eGFR < 60 mL/min/1.73 m²), 10% increases in blood cadmium concentrations resulted in decreases in klotho concentrations between 0.27 and 0.84%. In addition, during severe kidney dysfunction (15 ≤ eGFR < 45 mL/min/1.73 m²), a positive association between urine cadmium and serum klotho concentrations was observed. In the absence of albuminuria and when kidney function was normal or near normal, 10% increases in blood lead concentrations were observed to be associated with modest decreases between 0.28% and 0.37% in serum klotho concentrations. Similar results were observed between the concentrations of urine lead and serum klotho during kidney dysfunction.

Blood lead levels and their associated risk factors in Chinese adults from 1980 to 2018

In China, studies on lead exposure to grownup are scarce compared to children, although relevant disease burdens for adults are much severe than that in developed countries. The present study evaluated blood lead levels (BLLs) in Chinese adults by data mining using Monte Carlo simulation. A total of 115 scientific studies published between January 1980 and March 2021 reflecting 45,514 Chinese adults were included in the study. After a continuous increase in Chinese adult BLLs from 1980-1983 (GM 74.84 μg/L) to 1994-1996 (GM 92.27 μg/L), BLLs began to decline from 2000--2002 (GM 80.32 μg/L) to 2016-2018 (GM 21.57 μg/L). This decline implied that the lead phase-out policy in gasoline was effective over the past two decades. The study indicated that North, South, and Southwest China were still relatively high compared to other regions in the past decade. Statistical analysis showed that BLLs of males (GM 68.45 μg/L) were higher than females (GM 56.51 μg/L), smokers (GM 80.96 μg/L) higher than nonsmokers (GM 58.95 μg/L), and populations over 40 (GM 40.43 μg/L) higher than younger populations (GM 40.37 μg/L). The significantly positive correlation between the concentrations of PM2.5 and topsoil lead and BLLs in Chinese adults indicated that air and soil pollution affect adult BLLs. Taken together, our results showed that strict lead control strategies and regular bio-monitoring are needed to maintain low BLLs in the population.

Metabolomic signatures of lead exposure in the VA Normative Aging Study

BACKGROUND

Lead (Pb) is widespread and exposure to this non-essential heavy metal can cause multiple negative health effects; however the mechanisms underlying these effects remain incompletely understood.

OBJECTIVES

To identify plasma metabolomic signatures of Pb exposure, as measured in blood and toenails.

METHODS

In a subset of men from the VA Normative Aging Study, mass-spectrometry based plasma metabolomic profiling was performed. Pb levels were measured in blood samples and toenail clippings collected concurrently. Multivariable linear regression models, smoothing splines and Pathway analyses were employed to identify metabolites associated with Pb exposure.

RESULTS

In 399 men, 858 metabolites were measured and passed QC, of which 154 (17.9%) were significantly associated with blood Pb (p < 0.05). Eleven of these passed stringent correction for multiple testing, including pro-hydroxy-pro (β(95%CI): 1.52 (0.93,2.12), p = 7.18x10^-7), N-acetylglycine (β(95%CI): 1.44 (0.85,2.02), p = 1.12x10^-6), tartarate (β(95%CI): 0.68 (0.35,1.00), p = 4.84x10^-5), vanillylmandelate (β(95%CI): 1.05 (0.47,1.63), p = 4.44x10^-7), and lysine (β(95%CI): 1.88 (-2.8,-0.95), p = 9.10x10^-5). A subset of 48 men had a second blood sample collected a mean of 6.1 years after their first. Three of the top eleven metabolites were also significant in this second blood sample. Furthermore, we identified 70 plasma metabolites associated with Pb as measured in toenails. Twenty-three plasma metabolites were significantly associated with both blood and toenail measures, while others appeared to be specific to the biosample in which Pb was measured. For example, benzanoate metabolism appeared to be of importance with the longer-term exposure assessed by toenails.

DISCUSSION

Pb exposure is responsible for 0.6% of the global burden of disease and metabolomics is particularly well-suited to explore its pathogenic mechanisms. In this study, we identified metabolites and metabolomic pathways associated with Pb exposure that suggest that Pb exposure acts through oxidative stress and immune dysfunction. These findings help us to better understand the biology of this important public health burden.

Co-exposures to toxic metals cadmium, lead, and mercury and their impact on unhealthy kidney function

Cross-sectional data (N = 25427) from the National Health and Nutrition Examination Survey for 2003-2014 for US adults were used to estimate the impact of co-exposure to high levels of cadmium, lead, and mercury on the unhealthy kidney function. If observed concentrations of cadmium, lead, and total mercury were above the 75th percentile of their respective distributions, the exposure to the corresponding metal was considered to be high. Logistic regression models were fitted to estimate the probabilities of an unhealthy kidney function. Two alternate definitions of unhealthy kidney function were used. First, if estimated, glomerular filtration rate (eGFR) was < 60 mL/min/1.73 m² (K_eGFR) and second, if the observed albumin creatinine ratio (ACR) was ≥ 30 mg/g creatinine (K_ACR). As compared with low exposures, adjusted odds ratios (AOR) for unhealthy kidney function when exposed to high levels of lead and cadmium were observed to be 1.567 (1.346-1.823) and 1.663 (1.376-2.010) respectively for K_eGFR. When exposed to high levels of both cadmium and lead, AORs for unhealthy kidney functions K_eGFR and K_ARC were found to be 2.369 (1.868-3.004) and 1.522 (1.216-1.905) respectively. When exposed to high levels of cadmium, lead, and mercury, AORs for unhealthy kidney functions K_eGFR and K_ARC were found to be 2.248 (1.428-3.538) and 1.502 (1.024-2.204) respectively. High exposure to lead along with any level of exposure to cadmium and total mercury was found to adversely affect the health of kidney function. High exposure to mercury does not affect unhealthy kidney function.

Lead and kidney: Concentrations, variabilities, and associations across the various stages of glomerular function

Data (N = 9882) from National Health and Nutrition Examination Survey for 2003-2014 for US adults aged ≥20 years were analyzed to evaluate the variabilities in concentrations of blood and urine lead across various stages of glomerular function. Those who had estimated glomerular filtration rate (eGFR) >90 mL/min/1.73 m² were defined to be in glomerular function stage 1 (GF-1), those who had eGFR between 60 and 90 mL/min/1.73 m² were defined to be in GF-2, those who had eGFR between 45 and 60 mL/min/1.73 m² were defined to be in GF-3A, those who had eGFR between 15 and 45 mL/min/1.73 m² were defined to be in GF-3B/4. There were consistent increases in adjusted geometric means (AGM) for both blood and urine lead from GF-1 to GF-3A even though increases were not uniform from one GF stage to another. For the total population, AGMs for blood lead were 1.23, 1.78, 2.25, and 2.25 μg/dL for GF-1, GF-2, GF-3A, and GF-3B/4 respectively. AGMs for urine lead were 0.49, 0.61, 0.68, and 0.47 μg/L for GF-1, GF-2, GF-3A, and GF-3B/4 respectively. Thus, from GF-3A to GF-3B/4, AGMs for both blood and urine lead decreased. However, percent increases from GF-1 to GF-3A for urine lead were smaller than for blood lead and percent decreases from GF-3A to GF-3B/4 for urine lead were larger than for blood lead. Females had lower AGMs than males for both blood and urine lead. Also, smoker-nonsmoker differences for blood lead narrowed as kidney function deteriorated but smoker-nonsmoker differences for urine cadmium lead as kidney function deteriorated. Smokers had sharper increases in AGMs for blood and urine lead than nonsmokers from GF-1 to GF-3A but at GF-3B/4, this difference was reduced to 0.17 μg/dL.

Case-control investigation of occupational lead exposure and kidney cancer

Objectives

Lead is a suspected carcinogen that has been inconsistently associated with kidney cancer. To clarify this relationship, we conducted an analysis of occupational lead exposure within a population-based study of kidney cancer using detailed exposure assessment methods.

Methods

Study participants (1217 cases and 1235 controls), enrolled between 2002 and 2007, provided information on their occupational histories and, for selected lead-related occupations, answered questions regarding workplace tasks, and use of protective equipment. Industrial hygienists used this information to develop several estimates of occupational lead exposure, including probability, duration and cumulative exposure. Unconditional logistic regression was used to compute ORs and 95% CIs for different exposure metrics, with unexposed subjects serving as the reference group. Analyses were also conducted stratifying on several factors, including for subjects of European ancestry only, single nucleotide polymorphisms in ALAD (rs1805313, rs1800435, rs8177796, rs2761016), a gene involved in lead toxicokinetics.

Results

In our study, cumulative occupational lead exposure was not associated with kidney cancer (OR 0.9, 95% CI 0.7 to 1.3 for highest quartile vs unexposed; ptrend=0.80). Other lead exposure metrics were similarly null. We observed no evidence of effect modification for the evaluated ALAD variants (subjects of European ancestry only, 662 cases and 561 controls) and most stratifying factors, although lead exposure was associated with increased risk among never smokers.

Conclusions

The findings of this study do not offer clear support for an association between occupational lead exposure and kidney cancer.

Declines in adult blood lead levels in New York City compared with the United States, 2004-2014

OBJECTIVES

To assess changes in lead exposure in the New York City (NYC) adult population over a 10-year period and to contrast changes with national estimates, overall, and by socio-demographics and smoking status.

METHODS

We used measurements of blood lead levels (BLLs) from NYC resident adults who participated in the NYC Health and Nutrition Examination Surveys (HANES) in 2004 and 2013-2014. We compared estimates of geometric means (GM), 95th percentiles, and prevalence of BLL ≥ 5 µg/dL overall and by subgroups over time, with adults who participated in the National HANES (NHANES) 2001-2004 and 2011-2014.

RESULTS

The GM BLLs among NYC adults declined from 1.79 µg/dL in 2004 to 1.13 µg/dL in 2013-2014 (P < .0001). The declines over this period ranged from 30.1% to 43.2% across socio-demographic groups and smoking status (P < .0001 for all comparisons), and were slightly greater than declines observed nationally. The drop in prevalence of elevated BLLs (≥ 5 µg/dL) was also greater in NYC (4.8-0.5%), compared with NHANES (3.8-2.0%). By 2013-2014, NYC adults with lower annual family income (< $20,000) no longer had higher GM BLLs relative to those with higher incomes (≥ $75,000), a disparity improvement not observed nationally. Likewise, GM BLLs and 95th percentiles for non-Hispanic black adults in NYC were lower than GM BLLs for non-Hispanic white adults. Non-Hispanic Asian adults had the highest GM BLLs compared with other racial/ethnic groups, both in NYC in 2013-14 and nationally in 2011-2014 (1.37 µg/dL, P = .1048 and 1.22 µg/dL, P = .0004, respectively).

CONCLUSION

The lessening of disparity in lead exposure across income groups and decreasing exposure at the high end of the distribution among non-Hispanic black and Asian adults in NYC suggest that regulatory and outreach efforts have effectively targeted these higher exposure risk groups. However, Asian adults still had the highest average BLL, suggesting a need for enhanced outreach to this group. Local surveillance remains an important tool to monitor BLLs of local populations and to inform initiatives to reduce exposures in those at highest risk.

Prenatal lead exposure and childhood blood pressure and kidney function

BACKGROUND

Exposure to lead, a common environmental pollutant, is known to cause cardiovascular and nephrotoxic effects in adults. Potential effects of early-life lead exposure on these functions are, however, less well characterized.

OBJECTIVES

To assess blood pressure and kidney function in preschool-aged children in relation to prenatal lead exposure.

METHODS

This prospective study in rural Bangladesh measured children's systolic and diastolic blood pressure in triplicate at the follow-up at 4.5±0.11 years. Their kidney function was assessed by the estimated glomerular filtration rate (eGFR), calculated based on serum cystatin C concentrations, and by kidney volume, measured by sonography. Exposure to lead was assessed by concentrations in the mothers' blood (erythrocyte fraction; Ery-Pb) in gestational weeks (GW) 14 and 30, the effects of which were evaluated separately in multivariable-adjusted linear regression analyses.

RESULTS

We found no associations between maternal exposure to lead [n~1500 for GW14 and 700 for GW30] and children's blood pressure or eGFR. However, we found an inverse association between late gestation lead and kidney volume, although the sample size was limited (n=117), but not with early gestation lead (n=573). An increase of 85µg/kg in Ery-Pb (median concentration at GW30) was associated with a 6.0cm³/m² decrease in kidney volume (=0.4SD; p=0.041). After stratifying on gender, there seemed to be a somewhat stronger association in girls.

CONCLUSIONS

Prenatal lead exposure may cause long-lasting effects on the kidney. This warrants follow-up studies in older children, as well as additional studies in other populations.