Arsenic, cadmium, lead and mercury levels in blood of Finnish adults and their relation to diet, lifestyle habits and sociodemographic variables

Health risk assessment for human mercury exposure from Cinnabaris-containing Baizi Yangxin Pills in healthy volunteers Po administration

BACKGROUND

Cinnabaris (α-HgS), a mineral traditional Chinese material medica, has been used in combination with other herbs manifesting some definite therapeutic effects for thousands of years. But the currently reported mercury poisoning incidents raised the doubts about the safety of Cinnabaris-containing traditional Chinese medicines (TCMs). Baizi Yangxin Pills (BZYXP) is a Cinnabaris-containing TCM widely used in clinical practice. This study evaluated the health risk of mercury exposure from BZYXP in healthy volunteers based on the total mercury and mercury species analysis of blood and urine after single and multiple doses of BZYXP.

METHODS

Blood pharmacokinetics and urinary excretion studies of mercury were compared between single (9 g, once daily) and multiple doses (9 g, twice daily, continued for 7 days) of BZYXP. The whole blood and urine samples were collected at the specific points or periods after the administration of BZYXP. The total mercury and mercury species in blood and urine samples were determined by cold vapor-atomic fluorescence spectrometry (CV-AFS) and HPLC-CV-AFS, respectively.

RESULTS

The mercury was excreted slowly and accumulated obviously after continuous exposure of BZYXP. Moreover, the well-known neurotoxin methylmercury (MeHg) was detected in blood samples after 7 days' administration of BZYXP. In the urine samples, only Hg(II) was detected. Therefore, long-term use of BZYXP will cause mercury poisoning due to mercury's high accumulative properties and MeHg formation.

CONCLUSION

Cinnabaris-containing TCMs such as BZYXP should be restricted to cases in which alternatives are available, and the blood mercury species profile should be monitored during the long-term clinical medication.

Blood lead, cadmium and hair mercury concentrations and association with soil, dust and occupational factors in e-waste recycling workers in Bangladesh

BACKGROUND

Electronic waste (e-waste) recycling activities release toxic metals, which pose substantial hazard to the environment and human health. We evaluated metal concentrations in biological and environmental samples, and examined the associations between biological lead (Pb), cadmium (Cd), and mercury (Hg) with soil and dust metals, and other possible determinants, among populations exposed and non-exposed to e-waste in Bangladesh.

METHODS

A total of 199 e-waste workers and 104 non-exposed individuals were recruited. We measured blood Pb (BPb) and Cd (BCd) concentrations and total Hg (THg) from hair samples. Data were collected on occupational, and behavioral factors. We fitted an elastic net regression (ENET) to model the relationship between a set of influencing factors and metals as outcome variables while controlling for potential covariates.

RESULTS

The median concentrations of BPb (11.89 μg/dL) and BCd (1.04 μg/L) among exposed workers were higher than those of non-exposed workers (BPb: 3.63 μg/dL and BCd: 0.83 μg/L respectively). A 100 ppm increment in soil Pb level was associated with an increase in ln-Pb (transformed) in blood (β = 0.002; 95% CI = 0.00, 0.02). Similarly, ln-BCd level increased (β = 0.02; 95% CI = 0.001, 0.07) with every ppm increase in dust Cd level. The number of years worked in e-waste activities was associated with elevated ln-BPb (β = 0.01; 95% CI = 0.01, 0.02) and ln-BCd levels (β = 0.003; 95% CI = 0.00, 0.05). Smoking significantly contributed to elevated levels of ln-BCd (β = 0.46; 95% CI = 0.43, 0.73). An increment of 100 kg of e-waste handling per week led to an increase in ln-BPb levels (β = 0.002; 95% CI = 0.00, 0.01), while respondents knowledge about adverse impact on e-waste reduced the ln-BPb level (β = -0.14; 95% CI = -0.31, -0.03). Fish consumption frequency had a positive association with THg in hair.

CONCLUSIONS

Our data show the need for workplace controls to reduce exposure to Pb and Cd with a broader view of exposure source taken.

Selenium Status: Its Interactions with Dietary Mercury Exposure and Implications in Human Health

Selenium is an essential trace element in humans and animals and its role in selenoprotein and enzyme antioxidant activity is well documented. Food is the principal source of selenium, and it is important that selenium status in the body is adequately maintained for physiological functions. There has been increasing attention on the role of selenium in mitigating the toxic effects of mercury exposure from dietary intake in humans. In contrast, mercury is a neurotoxin, and its continuous exposure can cause adverse health effects in humans. The interactions of selenium and mercury are multi-factorial and involve complex binding mechanisms between these elements at a molecular level. Further insights and understanding in this area may help to evaluate the health implications of dietary mercury exposure and selenium status. This review aims to summarise current information on the interplay of the interactions between selenium and mercury in the body and the protective effect of selenium on at-risk groups in a population who may experience long-term mercury exposure.

Blood lead levels in 2018/2019 compared to 1987/1988 in the German population-based KORA study

INTRODUCTION

Lead exposure remains of continuing concern due to its known and suspected impacts on human health and has been designated as a priority substance for investigation in human biomonitoring studies by the EU. The aims of this study were to measure blood lead levels (BLL) in a population based cohort of middle-aged individuals without major current exposures to lead, and to compare these to historical blood lead levels obtained thirty years earlier.

METHODS

The population-based KORA study from 1984 to 2001 included inhabitants of the Augsburg Region, Germany. During 2018 to 2019, a subsample of these participants (KORA-Fit) was invited for interview regarding demographic and lifestyle factors, physical examination and blood withdrawal. Blood samples were stored at -80C prior to measurement of BLL via graphite furnace atomic absorption spectroscopy (GF-AAS). Descriptive and multivariable analyses were performed.

RESULTS

BLLs were measured in 3033 eligible persons aged 54 to 73, establishing a geometric mean (GM) BLL of 24.8 μg/l in 2018/19. Of these, 555 (18%) had BLL above proposed 95th percentile reference values of the German Environment Agency. Only small differences were found in BLL stratified by sociodemographic categories, however regular smokers had higher GM BLL (26.1 μg/l) compared to never smokers (23.7 μg/l), and an increasing BLL with increased wine consumption was noted. For 556 individuals, BLLs (GM: 54.0 μg/l) reduced by 35% in men and 50% in women compared to levels in 1987/88 with only 1.4% of individuals having an unchanged or increased BLL.

DISCUSSION

KORA-Fit provided contemporary normative data for BLL in a Western European population without major current sources of lead exposure. Mean BLLs have fallen since the 1980s using historical BLL data which is likely linked to the ban of leaded gasoline. Nevertheless, BLLs in this population remain elevated at levels associated with morbidity and mortality.

Higher R2* in the Red Nucleus Is Associated With Lead Exposure in an Asymptomatic Welder Cohort

Lead is a nonessential metal and may be a coexposure in welding fumes. Preclinical data indicate lead may affect iron regulation. The current study investigated blood lead concentrations and their association with brain iron accumulation in workers with chronic welding fume exposure, with a focus on iron-rich subcortical regions of the cerebellum and basal ganglia. Occupational exposure, whole blood metal, and brain MRI data were obtained from 29 controls and 42 welders. R2* (1/T2*) and R1 (T1 relaxation rate) values were used to estimate brain iron and manganese content, respectively. Blood metals and brain R2* (in the red nucleus [RN], dentate nucleus, caudate, putamen, globus pallidus, and substantia nigra) were compared between groups. Associations between brain R2* values and exposure metrics were tested within each group, and analyses were adjusted for potential confounders. Welders had significantly higher levels of whole blood lead, manganese, iron, and copper. Welders also had higher R2* RN (p = .002), but not R1. A 2nd-order polynomial modeled the association between R2* RN and a long-term welding exposure metric. In welders, but not controls, R2* RN was associated positively with whole blood lead (r = 0.54, p = .003), and negatively with whole blood manganese (r = -0.43, p = .02). Higher blood Pb and lower blood Mn independently accounted for variance in high RN R2*. Together, these data suggest that higher RN R2* values may mark lead exposure in welders. Because lead is a known neurotoxicant, additional studies are warranted to confirm this finding, and ascertain its scientific and public/occupational health implications.

Long-term monitoring of mercury in young German adults: Time trend analyses from the German Environmental Specimen Bank, 1995-2018

As highlighted in the Minamata Convention, Mercury (Hg) in its various forms poses a substantial risk to human health and the environment. The health relevance of Hg is also recognized by the European Human Biomonitoring Initiative (HBM4EU), which classifies Hg as a priority substance, since considerable knowledge and data gaps on Hg exposure levels and their changes over time still exist in Europe. The German Environmental Specimen Bank (German ESB) provides valuable policy relevant data and long-term trends of substance exposure on a national level for international comparison and evaluation. In this study we analysed data of the German ESB on Hg exposure of young adults aged 20 to 29 including data on urinary Hg levels from 1995 to 2018 and whole blood Hg levels from 2001 to 2010. Results show a clear decrease in both, about 86% in urine total daily Hg excretion from 1995 (0.76 μg/L) to 2018 (0.11 μg/L) (n = 10,069) and about 57% in blood concentrations of Hg from 2001 (1.76 μg/L) to 2010 (0.77 μg/L) (n = 4085). Over the investigated timeframe only a few values exceeded the toxicologically derived health based guidance value HBM I for blood and urine, with these exceedances decreasing over time in line with the general trend. The factors mostly influencing Hg excretion identified in this study are dental amalgam as well as fish and seafood consumption. Besides other factors (e.g. age and sex), also airborne Hg exposure appears to be a low but evident influencing factor in Germany. Although a considerable decrease in internal Hg exposure is recognized in the last decades, the current low-level exposure may cause adverse health effects especially to vulnerable groups such as pregnant women and children. To further elucidate and evaluate current exposure sources and to reduce human exposure to Hg, continuous environmental and human biomonitoring is needed.

Environmental Substances Associated with Chronic Obstructive Pulmonary Disease-A Scoping Review

Chronic obstructive pulmonary disease (COPD) is a slowly developing non-communicable disease (NCD), causing non-reversible obstruction and leading to marked morbidity and mortality. Besides traditional risk factors such as smoking, some environmental substances can augment the risk of COPD. The European Human Biomonitoring Initiative (HBM4EU) is a program evaluating citizens’ exposure to various environmental substances and their possible health impacts. Within the HBM4EU, eighteen priority substances or substance groups were chosen. In this scoping review, seven of these substances or substance groups are reported to have an association or a possible association with COPD. Main exposure routes, vulnerable and high-exposure risk groups, and matrices where these substances are measured are described. Pesticides in general and especially organophosphate and carbamate insecticides, and some herbicides, lead (Pb), and polycyclic aromatic hydrocarbons (PAHs) showed an association, and cadmium (Cd), chromium (Cr and CrVI), arsenic (As), and diisocyanates, a possible association with COPD and/or decreased lung function. Due to long latency in COPD’s disease process, the role of chemical exposure as a risk factor for COPD is probably underestimated. More research is needed to support evidence-based conclusions. Generally, chemical exposure is a growing issue of concern, and prompt action is needed to safeguard public health.

Increased intestinal permeability with elevated peripheral blood endotoxin and inflammatory indices for e-waste lead exposure in children

Lead (Pb) entering the body through different channels can damage the function of intestinal mucosal barrier and cause the body stressful inflammatory response to enhance. This study conducted a cross-sectional study to investigate the effects of Pb exposure on intestinal permeability in children by measuring the level of bacterial endotoxin and index of inflammatory cell types in peripheral blood. From November to December 2018, we recruited 187 participants aged 3-6 years by stratified randomization, from an electronic-waste-exposed group (n = 82) and a referent group (n = 105). General demographic information, past history of the digestive system in child, and family situation were informed by children's guardians with questionnaires. Children in the exposed group showed lower weight, height, and body mass index while more diarrhea in a month. Blood Pb and plasma endotoxin were elevated in exposed children than referent children and the positive relationship between them was shown in all children [B (95% CI): 0.072 (0.008, 0.137), P = 0.033]. Peripheral monocyte counts and leukotriene B₄ (LTB₄) levels were significantly increased in the exposed group. Endotoxin levels were positively correlated with neutrophils, monocytes, and LTB₄ [B (95% CI): 0.054 (0.015, 0.093), 0.018 (0.005, 0.031), and 0.049 (0.011, 0.087), respectively, P < 0.05]. To sum up, the exposed children showed lower physical growth levels, poorer gut health, and increased intestinal permeability, which was related to high blood Pb and peripheral inflammatory indices. These results suggest the possible adverse impact of environmental Pb exposure on the intestinal health of children.

Trace Element Analysis in Whole Blood and Plasma for Reference Levels in a Selected Queensland Population, Australia

The levels of trace elements in whole blood and plasma have been widely used for assessing nutritional status and monitoring exposure and can vary widely in populations from different geographical regions. In this study, whole blood samples (n = 120) and plasma samples (n = 120) were obtained from healthy donors attending the Red Cross Blood Bank (Queensland Red Cross Blood Service), which provided information for age and sex. There were 71 males (age range: 19–73 years) and 49 females (age range: 18–72 years) for whole blood samples, and 59 males (age range: 19–81 years) and 61 females (age range: 19–73 years) for plasma samples. The main aim of the study was to provide information on blood reference levels of 21 trace elements (Ag, Al, As, Bi, Br, Cd, Co, Cr, Cu, Hg, I, Mn, Mo, Ni, Pb, Sb, Se, Tl, U, V, Zn) in Queensland. The study also aimed to assess differences in trace element blood levels between males and females and the effect of age. The trace element levels in blood samples were analysed using inductively coupled plasma mass spectrometry (ICP-MS) and the standard reference materials of Seronorm (Trace Elements Whole Blood) and UTAK (Trace Elements Serum) were used for quality control and assurance. The study found wide variations of trace element levels in whole blood and plasma, and generally the levels were comparable to other countries. No detectable levels were found for Bi, Cr, U and V in whole blood, but V levels were found in plasma samples. There were significant differences between males and females for whole blood Cu (p < 0.001), I (p = 0.009), Tl (p = 0.016) and Zn (p = 0.016). Significant differences were also found for plasma Cu (p < 0.001) and Se (p = 0.003) between males and females. There were trends of increased levels of blood Pb, Se and Zn with age. The study has provided further information on a wide range of trace elements in blood as reference levels for Queensland and Australia which are currently lacking.

Environmental Partitioning, Spatial Distribution, and Transport of Atmospheric Mercury (Hg) Originating from a Site of Former Chlor-Alkali Plant

Mercury (Hg) is one of the trace toxic and bioaccumulative global pollutants, and due to its long atmospheric lifetime, it presents a significant global challenge. The present study (1) utilizes total gaseous mercury (TGM) measurements made around a former Hg-cell chlor-alkali plant (CAP) located in Pavlodar, Kazakhstan, and predicts the spatial distribution of Hg over its premises and the nearby city. It then (2) estimates the environmental repartition of Hg deposited by the CAP using three fugacity models of varying complexity: Level I, QWASI, and HERMES. Finally, it (3) predicts long-range Hg transport via forward trajectory-based cluster analysis. The atmospheric Hg levels measured in Pavlodar and around Lake Balkyldak were elevated: in the range of 1–37 ng/m3 with an urban background level at 4.9 ng/m3. Specifically, concentrations up to 37 ng/m3 close to Lake Balkyldak and up to 22 ng/m3 nearby the city’s industrial zone (where the CAP was located) had been observed. Interpolation maps created using kriging also suggest these locations as the primary sources of atmospheric Hg in the city. The Level I fugacity model indicated that almost all of Hg is expected to end up in the atmosphere. The modeling results obtained using more complex QWASI and HERMES models showed that some significant quantity of Hg would still be associated with the sediments of Lake Balkyldak (a large wastewater discharge pond nearby the CAP). The forward trajectory-based cluster analysis method revealed the long-range atmospheric transportation routes and local, regional, and global impact zones. Furthermore, a source-receptor relationship using air transportation pathways to identify “areas of impact” was addressed. During both heating and non-heating seasons, the frequency-based analysis identified the distribution of Hg reaching the territories of Mongolia, northwest China, southwest Kazakhstan. The Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLIT-4) model forward trajectory analysis has confirmed similar patterns during heating and non-heating seasons, except with shorter impact distances during the non-heating period. Even though the CAP was closed more than 30 years ago and those past remediation efforts cleaned up the site, the residual Hg pollution seems significant and should be further investigated in different environmental media.

Endothelial Dysfunction Induced by Cadmium and Mercury and its Relationship to Hypertension

Hypertension is an important public health concern that affects millions globally, leading to a large number of morbidities and fatalities. The etiology of hypertension is complex and multifactorial, and it involves environmental factors, including heavy metals. Cadmium and mercury are toxic elements commonly found in the environment, contributing to hypertension. We aimed to assess the role of cadmium and mercury-induced endothelial dysfunction in the development of hypertension. A narrative review was carried out through database searches. In this review, we discussed the critical roles of cadmium and mercury in the etiology of hypertension and provided new insights into potential mechanisms of their effect, focusing primarily on endothelial dysfunction. Although the mechanisms by which cadmium and mercury induce hypertension have yet to be completely elucidated, evidence for both implicates impaired nitric oxide signaling in their hypertensive etiology.

Blood cadmium levels and sources of exposure in an adult urban population in southern Brazil

BACKGROUND

Cadmium (Cd) is a toxic metal that is widely present in the environment due to geologic and anthropogenic sources. Exposures to high Cd levels may cause nephrotoxicity, carcinogenicity, pulmonary and cardiovascular disease, among others. The goal of this study was to investigate in an adult urban population whether an association exists between sources and levels of Cd exposure and blood Cd concentrations.

METHODS

Using a census-based design, a total of 959 adults, aged 40 years or older, were randomly selected. Information on socio-demographics, dietary, and lifestyle background was obtained by household interviews. Blood Cd levels were measured by inductively coupled-plasma mass spectrometry. Geometric means (GM) (95% CI) and the 50th percentile were determined, stratified by sex, age, race, education, income class, smoking status, consumption of vegetables, red meat and milk, occupation and blood pressure. To assess the association between Cd exposure and the aforementioned variables, we estimated the geometric mean ratio (GMR) (95%CI) of blood Cd concentrations.

RESULTS AND CONCLUSION

The geometric mean (95%CI) of blood Cd levels in the total population was 0.25 (0.22, 0.27) ug/dL. In a univariate analysis, significantly higher blood Cd levels were found in men (p < 0.001), current and former smokers (p < 0.001), alcohol drinkers (p < 0.001), those who never or almost never consumed milk (p < 0.001), and in subjects with higher diastolic blood pressure (p = 0.03). Significant correlations were found between the number of cigarettes consumed daily and blood Cd levels. Multivariate analysis confirmed higher blood Cd concentrations were associated with alcohol consumption (GMR 95%CI = 1.28, 1.04-1.59) and in former and current smokers (GMR 95% IC = 1.33, 1.06-1.67 and 4.23, 3.24-5.52, respectively). Our results shed novel information on variables associated with blood Cd levels in an urban Brazilian population, and should encourage additional research to prevent environmental Cd exposure, both in Brazil and globally.

Depression, changes in peripheral blood cell count, and changes in selected biochemical parameters related to lead concentration in whole blood (Pb-B) of women in the menopausal period

THE AIM

The aim of this study was to assess the severity of depression, vasomotor symptoms, changes in peripheral blood cell count, and selected biochemical parameters in relation to the concentration of lead in whole blood of women in the perimenopausal period.

METHODS

The study sample consisted of 233 women from the general population of the West Pomeranian Province (Poland) in age between 44-65 years. The intensity of menopausal symptoms was examined using the Blatt-Kupperman Index, and the severity of depression using the Beck Depression Inventory. The following biochemical data were evaluated: concentrations of glucose, triglycerides, HDL, C-reactive protein, glycated haemoglobin, cortisol, insulin, blood cell count, and lead concentration in whole blood (Pb-B).

RESULTS

A whole blood Pb concentration below 5 μg/dl was found in 55 subjects (23.61 %), in 142 women (60.94 %) it ranged from 5 to 10 μg/dl, while in 36 women (15.45 %) was higher than 10 μg/dl. There was a strong positive correlation between Pb concentration in the blood of the examined women and the severity of depressive symptoms (Rs=+0.60, p = 0.001). The lowest mean values for total leukocytes (5.07 ± 1.22 thousand/μl) and neutrophils (2.76 ± 0.86 thousand/μl) were found in women with Pb concentration above 10 μg/dl (p < 0.05). There was a significant negative correlation between the number of total leukocytes (r=-0.45, p = 0.002) and neutrophils (r=-0.50, p = 0.001) and blood Pb concentration. Analysis showed statistically significant differences in glucose concentration (p < 0.05) between groups. Blood glucose was higher in women with Pb-B <5 and between 5-10 μg/dl than in women with Pb-B >10 μg/dl.

CONCLUSION

Exposure to Pb may be a factor playing a significant role in the development of depressive symptoms in menopausal women. It may also be associated with glucose metabolism disorders and immunosuppression in women during this period of life.

Cadmium, lead and mercury in the blood of workers from recycling sorting facilities in São Paulo, Brazil

Abstract: Approximately 600,000 people work as recycling material collectors in Brazil and few studies evaluate the health risks involved in this occupation. The objective was to evaluate the blood levels of cadmium (Cd), lead (Pb) and mercury (Hg) among workers from recycling sorting facilities (RSF) in the metropolitan region of São Paulo, Brazil, compare the results with a non-occupationally exposed population, and identify factors associated with higher blood metal levels. Four RSF were selected and 226 collectors were examined for their blood metal levels and associated factors. The mean concentration of Cd (arithmetic mean - AM: 0.47µgL-1; geometric mean - GM: 0.34µgL-1) was almost four times higher than those found in a reference study. The generalized linear model (GLM) indicated that the “RSF where the collectors work”, “work in another occupation”, and “smoking” were statistically significant predictors of blood Cd levels. The Pb mean concentration (AM: 39.13µgL-1; GM: 34.11µgL-1) was also higher than the observed in the reference study (about 1.4 times) and its associated factors in the GLM were “the RSF where the collectors work”, “sex”, “smoking”, “age” and “meat consumption”. The Hg mean concentration (AM: 1.46µgL-1; GM: 0.94µgL-1) was not significantly higher than the reference population and its associated factors were “previous work in other RSF”, “fish consumption” and “years of work in the current RSF”. This study indicates that recycling material collectors have higher blood Cd and Pb levels compared to the general population.

Selenium status in lactating mothers-infants and its potential protective role against the neurotoxicity of methylmercury, lead, manganese, and DDT

A total of 206 lactating mothers and their infants (3-12 months) were included in this study to evaluate postnatal exposure to neurotoxic pollutants such as methylmercury (MeHg), lead (Pb), manganese (Mn), dichlorodiphenyltrichloroethane (DDT) and its metabolites [dichlorodiphenyldichloroethane (DDD), and dichlorodiphenyldichloroethylene (DDE)] and their association with delayed neurological development and to explore the protective role of selenium (Se) against chemical neurotoxicity. Neurodevelopmental performance was evaluated using Denver Developmental Screening Test II and Parents' Evaluation of Developmental Status (PEDS). Multivariate log-binomial regression modeling was applied for both single and multiple exposures to chemicals using a principal component analysis that generated six principal components. Both mothers and their infants had been exposed to metals and DDT metabolites, with some exceeding the accepted permissible limits. The geometric means of MeHg, Pb, Mn, DDD, DDE and DDT levels in breast milk were 1.333, 45.327, 15.576, 0.069, 0.542 and 1.08 μg/l, respectively. A single-exposure model identified a high risk of reduced PEDS performance significantly associated with DDD in breast milk [relative risk (RR) = 1.484; 95% confidence interval (95%CI) = 1.091-2.019] and marginally significantly associated with Pb in the mothers' blood (RR = 2.164; 95%CI = 0.87-5.382). We did not find a protective role of Se in neurodevelopment due to its high levels in the mothers. Models of multi-chemical exposure indicated that Mn in blood and breast milk, Se in blood and Pb in the mothers' urine were marginally significantly associated with a high risk of reduced PEDS performance (RR = 0.424; 95%CI = 0.176-1.022). The use of multi-chemical exposure approach in early life risk assessments is important because it indicates real-world exposure. Our results were not conclusive because the sample size was small, so future studies examining the implications to health of the impact of prenatal/postnatal exposure to a mixture of chemicals in the Saudi population are merited.

Cadmium, lead and mercury in Norwegian obese patients before and 12 months after bariatric surgery

PURPOSE

Previous studies have suggested a role for the toxic elements lead (Pb), mercury (Hg) and cadmium (Cd) in the development of insulin resistance and hypertension. Increased blood Pb levels have been reported after bariatric surgery and weight loss. As about 80% of patients undergoing bariatric surgery are women, most of them of childbearing age, there are concerns regarding fetal exposure to toxic trace elements. We measured whole blood Hg, Pb and Cd concentrations in morbidly obese patients before and 12 months after Roux-en-Y gastric bypass (RYGB).

PATIENTS AND METHODS

Forty-six patients eligible for bariatric surgery were recruited at Innlandet Hospital Trust, Norway (2012-2014). The majority were women and 54% were of reproductive age. Whole blood samples were collected prior to and 12 months after surgery. Trace element concentrations were measured using mass spectrometry (HR-ICP-MS).

RESULTS

Median whole blood Pb concentrations increased by 73% during the 12 months study period while Hg and Cd decreased by 31% and 27%, respectively. We found a negative correlation between Pb levels before surgery and BMI (p = 0.02). Before surgery patients with hypertension had significantly higher median whole blood Hg levels compared to patients with normal blood pressure (p < 0.001).

CONCLUSION

One year after bariatric surgery, the median whole blood Pb concentration was increased, while Hg and Cd concentrations were decreased. The majority of bariatric surgery patients are women of reproductive age and weight loss is associated with improved fertility. As even low dose Pb exposure during fetal life is associated with negative effects on the central nervous system, the observed increase in whole blood Pb after weight loss causes concern. Further studies are needed to elucidate these observations.

Association of maternal arsenic exposure with birth size: A systematic review and meta-analysis

OBJECTIVES

Chronic exposure to arsenic during pregnancy or early life continues to be a major global health problem worldwide, affecting hundreds of millions of people. However, its effects on birth size are uncertain. The aim of this study is to summarized the association between maternal arsenic exposure and birth size.

METHODS

A comprehensive literature search was conducted on the maternal arsenic exposure and birth size (birth weight, birth length, head circumference and chest circumference) through databases (PubMed, Qvid Medline, Web of Science, Cochrane and EMBASE), the last search was in March 2019. Heterogeneity was testes by using the Q statistic and stratifying for epidemiological factors. The possibility of publication bias was assessed through Begg's test.

RESULTS

A total of 12 studies provided sufficient data were included. Meta-analysis revealed that maternal arsenic exposure was associated with the decrease of birth weight (β = -25.0 g; 95% CI: -41.0, -9.0) and head circumference (β = -0.12 cm; 95% CI: -0.24, -0.01) in random-effect model, birth length (β = -0.12 cm; 95% CI: -0.17, -0.07) in fixed-effect model, no significant reduction was suggested in chest circumference (β = -0.74 cm; 95% CI: -1.78, 0.3). In addition, we found that the birth weight decreased stronger in women living in the Americas, or appling the exposure marker of urine.

CONCLUSIONS

Maternal arsenic exposure is associated with the decrease of the birth weight, length and head circumference. Millions of people are still exposured to high-level arsenic, therefore, high quality epidemiologic studies that involve large samples are necessary to determine the precise relationships between maternal arsenic exposure with birth size. And that effective mitigation measures are also need to prevent arsenic exposure in women of reproductive age.

A Review of Metal Exposure and Its Effects on Bone Health

The presence of metals in the environment is a matter of concern, since human activities are the major cause of pollution and metals can enter the food chain and bioaccumulate in hard and soft tissues/organs, which results in a long half-life of the metal in the body. Metal intoxication has a negative impact on human health and can alter different systems depending on metal type and concentration and duration of metal exposure. The present review focuses on the most common metals found in contaminated areas (cadmium, zinc, copper, nickel, mercury, chromium, lead, aluminum, titanium, and iron, as well as metalloid arsenic) and their effects on bone tissue. Both the lack and excess of these metals in the body can alter bone dynamics. Long term exposure and short exposure to high concentrations induce an imbalance in the bone remodeling process, altering both formation and resorption and leading to the development of different bone pathologies.

Predictors of mercury, lead, cadmium and antimony status in Norwegian never-pregnant women of fertile age

Background

The toxic trace elements mercury (Hg), lead (Pb), cadmium (Cd) and antimony (Sb) are transferred over the placenta to the fetus and secreted into the breastmilk. All four elements bioaccumulate in the body and as maternal age at delivery is increasing in industrialized countries, the burden of toxic trace elements in never-pregnant women of fertile age is of concern.

Methods

Healthy, never-pregnant women aged 18 to 40 years (n = 158) were recruited between June 2012 and March 2015 in Bergen, Norway. Clinical data were collected and non-fasting venous blood samples were analyzed for whole blood Hg, Pb and Cd and serum Sb by ICP-MS and related to diet and life style factors.

Results

In a multiple linear regression model, increasing age was associated with higher levels of Hg and Sb, but diet and life style factors were more important predictors. Median whole blood Hg was increased by a factor of 70 in women who had fish for dinner ≥1/week, compared to women who rarely or never ate fish (p<0.001). Alcohol intake was the strongest predictor for whole blood Pb, while use of tobacco was the strongest predictor for whole blood Cd. Being a vegetarian was associated with lower levels of both Hg and Sb.

Conclusions

As toxic trace elements tend to bioaccumulate in the body, increasing maternal age at delivery may represent a threat to the next generation. In a group of healthy Norwegian never-pregnant women, age contributed to Hg and Sb levels, but diet and life style factors were stronger determinants of whole blood Hg, Pb, Cd and serum Sb levels. Continuous public actions are needed to reduce modifiable and preventable sources of potentially deleterious toxins to minimize the exposure in children and fertile women.

The Metal Neurotoxins: An Important Role in Current Human Neural Epidemics?

Many published studies have illustrated that several of the present day neurological epidemics (autism, attention deficit disorder, Alzheimer's) cannot be correlated to any single neurotoxicant. However, the present scientific examination of the numerous global blood monitoring databases for adults that include the concentrations of the neurotoxic elements, aluminum (Al), arsenic (As), lead (Pb), manganese (Mn), mercury (Hg), and selenium (Se) clearly indicate that, when considered in combination, for some, the human body may become easily over-burdened. This can be explained by changes in modern lifestyles. Similar data, solely for pregnant women, have been examined confirming this. All these elements are seen to be present in the human body and at not insignificant magnitudes. Currently suggested minimum risk levels (MRL) for humans are discussed and listed together with averages of the reported distributions, together with their spread and maximum values. One observation is that many distributions for pregnant women are not too dissimilar from those of general populations. Women obviously have their individual baseline of neurotoxin values before pregnancy and any efforts to modify this to any significant degree is not yet clearly apparent. For any element, distribution shapes are reasonably similar showing broad distributions with extended tails with numerous outlier values. There are a certain fraction of people that lie well above the MRL values and may be at risk, especially if genetically susceptible. Additionally, synergistic effects between neurotoxins and with other trace metals are now also being reported. It appears prudent for women of child-bearing age to establish their baseline values well before pregnancy. Those at risk then can be better identified. Adequate instrumental testing now is commercially available for this. In addition, directives are necessary for vaccination programs to use only non-neurotoxic adjuvants, especially for young children and all women of child-bearing ages. Additionally, clearer directives concerning fish consumption must now be reappraised.