Occupational exposure to hexavalent chromium and cancers of the gastrointestinal tract: a meta-analysis

Biogeochemical behaviour and toxicology of chromium in the soil-water-human nexus: A review

Chromium (Cr) affects human health if it accumulates in organs to elevated concentrations. The toxicity risk of Cr in the ecosphere depends upon the dominant Cr species and their bioavailability in the lithosphere, hydrosphere, and biosphere. However, the soil-water-human nexus that controls the biogeochemical behaviour of Cr and its potential toxicity is not fully understood. This paper synthesizes information on different dimensions of Cr ecotoxicological hazards in the soil and water and their subsequent effects on human health. The various routes of environmental exposure of Cr to humans and other organisms are also discussed. Human exposure to Cr(VI) causes both carcinogenic and non-carcinogenic health effects via complicated reactions that include oxidative stress, chromosomal and DNA damage, and mutagenesis. Chromium (VI) inhalation can cause lung cancer; however, incidences of other types of cancer following Cr(VI) exposure are low but probable. The non-carcinogenic health consequences of Cr(VI) exposure are primarily respiratory and cutaneous. Research on the biogeochemical behaviour of Cr and its toxicological hazards on human and other biological routes is therefore urgently needed to develop a holistic approach to understanding the soil-water-human nexus that controls the toxicological hazards of Cr and its detoxification.

Trace Element Levels in Nails of Residents of Addis Ababa Are Shaped by Social Factors and Geography

The Akaki catchment in Ethiopia is home to Addis Ababa and about five million people. Its watercourses receive a variety of wastes released by the residents and industries. River water is being used for irrigation, livestock watering, and other domestic purposes. This study tested the hypothesis that the river pollution would be reflected in higher levels of trace elements in the nails of residents living in Akaki-Kality Sub-City in the downstream, as compared to those living in Gullele Sub-City in the upstream of the Akaki catchment. Samples were taken and subsequently analysed for metals using inductively coupled plasma optical emission spectrometry (ICP-OES). The mean concentrations of Fe, Zn, Cu, Mn, Ni, Cr, Pb, and As in nails from Akaki-Kality were 488 ± 49, 106 ± 10, 5.2 ± 0.3, 13 ± 1.5, 11 ± 8, 2.2 ± 0.3, 0.09 ± 0.01, and 0.16 ± 0.01 μg/g, respectively. Likewise, the concentrations of Fe, Zn, Cu, Mn, Ni, Cr, Pb, and As in nails from Gullele were 1035 ± 135, 251 ± 10, 6.6 ± 0.4, 31 ± 3.7, 7.4 ± 1.7, 2.0 ± 0.3, 0.63 ± 0.01, and 0.25 ± 0.01 μg/g, respectively. Co and Cd were not detected. Contrary to the initial hypothesis, higher metal levels were found in nails of residents living in the upstream rather than the downstream area of the catchment. In particular, the concentrations of Fe (p = 0.000), Zn (p = 0.01), and Mn (p = 0.000) were significantly elevated in nails from Gullele and also high in comparison with internationally reported values. Besides, geography and social factors, especially education level, correlated to trace metals in nails. Most of the elements were significantly lower in the nails of individuals with a university degree compared to those who were illiterate or only completed primary school.

Crypt and Villus Transcriptomic Responses in Mouse Small Intestine Following Oral Exposure to Hexavalent Chromium

Oral exposure to hexavalent chromium (Cr(VI)) induces tumors in the mouse duodenum. Previous microarray-based transcriptomic analyses of homogenized mouse duodenal tissue have demonstrated Cr(VI)-induced alterations in various cellular pathways and processes. However, X-ray fluorescence microscopy indicates that chromium localizes primarily to the duodenal villi following exposure to Cr(VI), suggesting that previous transcriptomic analyses of homogenized tissue provide an incomplete picture of transcriptomic responses in the duodenum. Herein, transcriptomic analyses were conducted separately on crypt and villus tissue from formalin-fixed paraffin-embedded transverse duodenal sections from the same study in which microarray-based analyses were previously conducted. A total of 28 groups (7 doses × 2 timepoints × 2 tissue compartments) were analyzed for differential gene expression, dose-response, and gene set enrichment. Tissue compartment isolation was confirmed by differences in expression of typical markers of crypt and villus compartments. Fewer than 21 genes were altered in the crypt compartment of mice exposed to 0.1-5 ppm Cr(VI) for 7 or 90 days, which increased to hundreds or thousands of genes at ≥20 ppm Cr(VI). Consistent with histological evidence for crypt proliferation, a significant, dose-dependent increase in genes that regulate mitotic cell cycle was prominent in the crypt, while subtle in the villus, when compared with samples from time-matched controls. Minimal transcriptomic evidence of DNA damage response in either the crypts or the villi is consistent with published in vivo genotoxicity data. These results are also discussed in the context of modes of action that have been proposed for Cr(VI)-induced small intestine tumors in mice.

Evaluating tissue levels of the eight trace elements and heavy metals among esophagus and gastric cancer patients: A comparison between cancerous and non-cancerous tissues

BACKGROUND

Considering the affecting role of environmental factors including trace elements and heavy metals on the upper gastrointestinal (GI) cancers, there is paucity of empirical research in tissue evaluations.

OBJECTIVES

The present study aimed to measure the tissue content of some trace elements and heavy metals such as zinc (Zn), chromium (Cr), manganese (Mn), tin (Sn), copper (Cu), aluminum (Al), lead (Pb), and iron (Fe) in esophagus and gastric cancerous tissues compared to the adjacent healthy tissues.

METHODS

In a cross-sectional study, the aforementioned trace elements and heavy metals were evaluated among patients with esophagus and gastric cancers. During endoscopy, multiple samples were taken from cancerous lesions and the adjacent healthy tissues. The classic flame atomic absorption spectroscopy (FAAS) method was employed as the study framework.

RESULTS

Fifty patients with the mean age of 53.92 ± 8.73 were enrolled in the current study. Thirteen patients suffered from esophageal cancer and thirty-seven patients were afflicted with gastric cancer. The results revealed significant differences in the median concentrations of Zn, Cr, Sn and, Cu (P < 0.05) between the two groups. Although there were no significant changes in the tissue content in the esophageal samples, in the median concentrations of Zn, Cr and, Sn (P < 0.05) in gastric tissues, significant differences were observed. Further, the results indicated that gender enacted an affecting role in the level of some trace elements and heavy metals.

CONCLUSION

The tissue contents of some elements were altered in gastric and esophageal cancers; this difference may reflect the underlying mechanism of cellular changing during the tumorigenesis or direct exposure of these elements. It seems that under the shade of other coexisting risk factors, larger cohort studies are suggested to be conducted to investigate other probable aspects in this area of interest.

p62 functions as a signal hub in metal carcinogenesis

A number of metals are toxic and carcinogenic to humans. Reactive oxygen species (ROS) play an important role in metal carcinogenesis. Oxidative stress acts as the converging point among various stressors with ROS being the main intracellular signal transducer. In metal-transformed cells, persistent expression of p62 and erythroid 2-related factor 2 (Nrf2) result in apoptosis resistance, angiogenesis, inflammatory microenvironment, and metabolic reprogramming, contributing to overall mechanism of metal carcinogenesis. Autophagy, a conserved intracellular process, maintains cellular homeostasis by facilitating the turnover of protein aggregates, cellular debris, and damaged organelles. In addition to being a substrate of autophagy, p62 is also a crucial molecule in a myriad of cellular functions and in molecular events, which include oxidative stress, inflammation, apoptosis, cell proliferation, metabolic reprogramming, that modulate cell survival and tumor growth. The multiple functions of p62 are appreciated by its ability to interact with several key components involved in various oncogenic pathways. This review summarizes the current knowledge and progress in studies of p62 and metal carcinogenesis with emphasis on oncogenic pathways related to oxidative stress, inflammation, apoptosis, and metabolic reprogramming.

Occupational exposure to hexavalent chromium. Part II. Hazard assessment of carcinogenic effects

Hexavalent chromium (Cr(VI)) compounds have been studied extensively and several agencies have described their toxicological profile. In the past, personnel of the Dutch Ministry of Defence may have been exposed to Cr(VI) during maintenance activities on NATO equipment. To investigate if this exposure may have caused irreversible adverse health effects, the Dutch National Institute for Public Health and the Environment (RIVM) summarized all available knowledge from previous evaluations. This information was complemented with a scoping review to retrieve new scientific literature. All scientific evidence was evaluated in workshops with external experts to come to an overview of irreversible adverse health effects that could be caused by occupational exposure to Cr(VI) compounds. This review provides the hazard assessment for occupational exposure to Cr(VI) and carcinogenic effects by integrating and weighting evidence provided by international agencies complemented with newly published studies. It was concluded that occupational exposure to Cr(VI) can cause lung cancer, nose and nasal sinus cancer in humans. Cr(VI) is suspected to cause stomach cancer and laryngeal cancer in humans. It is currently insufficiently clear if Cr(VI) can cause cancer of the small intestine, oral cavity, pancreas, prostate or bladder in humans.

Amberlite IRC-718 ion chelating resin extraction of hazardous metal Cr (VI) from aqueous solutions: equilibrium and theoretical modeling

Under varied conditions, the IRC 718 ion-exchange resin is used to extract chromium (VI) ions from aqueous solutions. On chromium (VI) removal effectiveness, the effects of adsorption dosage, contact time, beginning metal concentration, and pH were examined. The batch ion exchange process reached equilibrium after around 90 minutes of interaction. With an initial chromium (VI) concentration of 0.5 mg/dm³, the pH-dependent ion-exchange mechanism revealed maximal removal in the pH 2.0-10 range. The adsorption mechanism occurs between Cr (VI) determined as the electron acceptor, and IRC 718 determined as the electron donor. The equilibrium ion-exchange potential and ion transfer quantities for Amberlite IRC 718 were calculated using the Langmuir adsorption isotherm model. The overall ion exchange capacity of the resin was determined to be 187.72 mg of chromium (VI)/g of resin at an ideal pH of 6.0.

Association between heavy metals and colon cancer: an ecological study based on geographical information systems in North-Eastern Iran

Background

Colorectal cancer has increased in Middle Eastern countries and exposure to environmental pollutants such as heavy metals has been implicated. However, data linking them to this disease are generally lacking. This study aimed to explore the spatial pattern of age-standardized incidence rate (ASR) of colon cancer and its potential association with the exposure level of the amount of heavy metals existing in rice produced in north-eastern Iran.

Methods

Cancer data were drawn from the Iranian population-based cancer registry of Golestan Province, north-eastern Iran. Samples of 69 rice milling factories were analysed for the concentration levels of cadmium, nickel, cobalt, copper, selenium, lead and zinc. The inverse distance weighting (IDW) algorithm was used to interpolate the concentration of this kind of heavy metals on the surface of the study area. Exploratory regression analysis was conducted to build ordinary least squares (OLS) models including every possible combination of the candidate explanatory variables and chose the most useful ones to show the association between heavy metals and the ASR of colon cancer.

Results

The highest concentrations of heavy metals were found in the central part of the province and particularly counties with higher amount of cobalt were shown to be associated with higher ASR of men with colon cancer. In contrast, selenium concentrations were higher in areas with lower ASR of colon cancer in men. A significant regression equation for men with colon cancer was found (F(4,137) = 38.304, P < .000) with an adjusted R² of 0.77. The predicted ASR of men colon cancer was − 58.36 with the coefficients for cobalt = 120.33; cadmium = 80.60; selenium = − 6.07; nickel = − 3.09; and zinc = − 0.41. The association of copper and lead with colon cancer in men was not significant. We did not find a significant outcome for colon cancer in women.

Conclusion

Increased amounts of heavy metals in consumed rice may impact colon cancer incidence, both positively and negatively. While there were indications of an association between high cobalt concentrations and an increased risk for colon cancer, we found that high selenium concentrations might instead decrease the risk. Further investigations are needed to clarify if there are ecological or other reasons for these discrepancies. Regular monitoring of the amount of heavy metals in consumed rice is recommended.

Challenges and recommendations on the conduct of systematic reviews of observational epidemiologic studies in environmental and occupational health

Systematic reviews are powerful tools for drawing causal inference for evidence-based decision-making. Published systematic reviews and meta-analyses of environmental and occupational epidemiology studies have increased dramatically in recent years; however, the quality and utility of published reviews are variable. Most methodologies were adapted from clinical epidemiology and have not been adequately modified to evaluate and integrate evidence from observational epidemiology studies assessing environmental and occupational hazards, especially in evaluating the quality of exposure assessments. Although many reviews conduct a systematic and transparent assessment for the potential for bias, they are often deficient in subsequently integrating across a body of evidence. A cohesive review considers the impact of the direction and magnitude of potential biases on the results, systematically evaluates important scientific issues such as study sensitivity and effect modifiers, identifies how different studies complement each other, and assesses other potential sources of heterogeneity. Given these challenges of conducting informative systematic reviews of observational studies, we provide a series of specific recommendations based on practical examples for cohesive evidence integration to reach an overall conclusion on a body of evidence to better support policy making in public health.

Appraisal of Metal Imbalances in the Blood of Thyroid Cancer Patients in Comparison with Healthy Subjects

Cancer incidence and mortality rates have been increasing rapidly worldwide. A growing body of evidence revealed that exposure to trace metals is the most important aetiology for development of the cancer. Therefore, present study was intended to evaluate the imbalances in the concentrations of selected metals (Na, K, Ca, Mg, Sr, Li, Fe, Zn, Cu, Co, Mn, Ag, Cd, Cr, Ni and Pb) in the blood of newly diagnosed thyroid cancer patients in comparison with counterpart healthy subjects/controls. Concentrations of the metals were quantified by flame atomic absorption spectrometry by employing nitric acid/perchloric acid-based wet digestion method. Average concentrations of Pb (774.6 μg/dL), Cr (757.9 μg/dL), Cd (472.5 μg/dL) and Ni (360.5 μg/dL) were found to be significantly higher in the blood of cancer patients than controls. Correlation study and multivariate analysis showed strong mutual relationships among Fe-Cd-Ca-Mg-Pb, Co-Sr-Zn, Li-Ag-Na-K and Cu-Ni in the blood of thyroid cancer patients while Na-K-Fe-Co-Pb, Zn-Sr-Cr, Ca-Mg and Li-Ag-Cu-Ni exhibited strong mutual associations in the blood of healthy donors. Significant variations in the trace metal levels were observed with the age, gender, habitat, food habits and smoking habits of both donor groups. Metal levels also exhibited considerable disparities with the stages and types of thyroid cancer. Multivariate analysis of the metal data revealed significantly divergent apportionment of the metals in the blood of cancer patients compared with the healthy group.

A review on fly ash from coal-fired power plants: chemical composition, regulations, and health evidence

Throughout the world, coal is responsible for generating approximately 38% of power. Coal ash, a waste product, generated from the combustion of coal, consists of fly ash, bottom ash, boiler slag, and flue gas desulfurization material. Fly ash, which is the main component of coal ash, is composed of spherical particulate matter with diameters that range from 0.1 μm to >100 μm. Fly ash is predominately composed of silica, aluminum, iron, calcium, and oxygen, but the particles may also contain heavy metals such as arsenic and lead at trace levels. Most nations throughout the world do not consider fly ash a hazardous waste and therefore regulations on its disposal and storage are lacking. Fly ash that is not beneficially reused in products such as concrete is stored in landfills and surface impoundments. Fugitive dust emissions and leaching of metals into groundwater from landfills and surface impoundments may put people at risk for exposure. There are limited epidemiological studies regarding the health effects of fly ash exposure. In this article, the authors provide an overview of fly ash, its chemical composition, the regulations from nations generating the greatest amount of fly ash, and epidemiological evidence regarding the health impacts associated with exposure to fly ash.

An adverse outcome pathway for small intestinal tumors in mice involving chronic cytotoxicity and regenerative hyperplasia: a case study with hexavalent chromium, captan, and folpet

Small intestinal (SI) tumors are relatively uncommon outcomes in rodent cancer bioassays, and limited information regarding chemical-induced SI tumorigenesis has been reported in the published literature. Herein, we propose a cytotoxicity-mediated adverse outcome pathway (AOP) for SI tumors by leveraging extensive target species- and site-specific molecular, cellular, and histological mode of action (MOA) research for three reference chemicals, the fungicides captan and folpet and the transition metal hexavalent chromium (Cr(VI)). The gut barrier functions through highly efficient homeostatic regulation of SI epithelial cell sloughing, regenerative proliferation, and repair, which involves the replacement of up to 10¹¹ cells per day. This dynamic turnover in the SI provides a unique local environment for a cytotoxicity mediated AOP/MOA. Upon entering the duodenum, cytotoxicity to the villous epithelium is the molecular initiating event, as indicated by crypt elongation, villous atrophy/blunting, and other morphologic changes. Over time, the regenerative capacity of the gut epithelium to compensate declines as epithelial loss accelerates, especially at higher exposures. The first key event (KE), sustained regenerative crypt proliferation/hyperplasia, requires sufficient durations, likely exceeding 6 or 12 months, due to extensive repair capacity, to create more opportunities for the second KE, spontaneous mutation/transformation, ultimately leading to proximal SI tumors. Per OECD guidance, biological plausibility, essentiality, and empirical support were assessed using modified Bradford Hill considerations. The weight-of-evidence also included a lack of induced mutations in the duodenum after up to 90 days of Cr(VI) or captan exposure. The extensive evidence for this AOP, along with the knowledge that human exposures are orders of magnitude below those associated with KEs in this AOP, supports its use for regulatory applications, including hazard identification and risk assessment.

Residential proximity to industrial pollution sources and colorectal cancer risk: A multicase-control study (MCC-Spain)

BACKGROUND

Colorectal cancer is the third most frequent tumor in males and the second in females worldwide. In Spain, it is an important and growing health problem, and epidemiologic research focused on potential risk factors, such as environmental exposures, is necessary.

OBJECTIVES

To analyze the association between colorectal cancer risk and residential proximity to industries, according to pollution discharge route, industrial groups, categories of carcinogens and other toxic substances, and specific pollutants released, in the context of a population-based multicase-control study of incident cancer carried out in Spain (MCC-Spain).

METHODS

MCC-Spain included 557 colorectal cancer cases and 2948 controls in 11 provinces, frequency matched by sex, age, and region of residence. Distances were computed from subjects' residences to each of the 134 industries located in the study area. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95%CIs) for categories of distance (from 1 km to 3 km) to industrial facilities, adjusting for matching variables and other confounders.

RESULTS

Excess risk (OR; 95%CI) of colorectal cancer was detected near industries overall for all distances analyzed, from 1 km (2.03; 1.44-2.87) to 3 km (1.26; 1.00-1.59). In general, industries releasing pollutants to air showed higher excess risks than facilities releasing pollution to water. By industrial sector, excess risk (OR; 95%CI) was found near (≤3 km) production of metals (2.66; 1.77-4.00), surface treatment of metals (1.48; 1.08-2.02), glass and mineral fibers (2.06; 1.39-3.07), organic chemical industry (4.80; 3.20-7.20), inorganic chemical industry (6.74; 4.38-10.36), food/beverage sector (3.34; 2.38-4.68), and surface treatment using organic solvents (6.16; 4.06-9.36). By pollutants, the main excess risks (OR; 95%CI) were found near (≤3 km) industries releasing nonylphenol (9.19; 5.91-14.28), antimony (5.30; 3.45-8.15), naphthalene (3.11; 2.16-4.49), organotin compounds (2.64; 1.76-3.98), manganese (2.53; 1.63-3.93), dichloromethane (2.52; 1.74-3.66), and vanadium (2.49; 1.59-3.91).

CONCLUSIONS

Our results support the hypothesis that residing in the proximity of industries may be a risk factor for colorectal cancer.

Arsenic and chromium levels in hair correlate with actinic keratosis/non-melanoma skin cancer: results of an observational controlled study

BACKGROUND

The role of heavy metals in carcinogenetic process has been widely established; however, information on the most common environmental metals that serve as major risk factors for actinic keratosis (AK)/non-melanoma skin cancer (NMSC) are still lacking. The aim of this study was to evaluate levels of the most common environmental heavy metals in hair of patients with AK/NMSC as compared to healthy controls.

METHODS

Thirty-one patients diagnosed with AK/NMSC and 34 healthy controls were enrolled. Patients were interviewed for heavy metals exposure and underwent hair analysis for detection of arsenic (As), cadmium (Cd), chromium (Cr), nickel (Ni) and lead (Pb). Continuous variables were analyzed using Wilcoxon Non-Parametric Rank Test and proportions were compared by Fisher's Exact Test. Statistical significance was determined by P<0.05.

RESULTS

In our cohort we observed 48.4% patients had AKs, 16.1% basal cell carcinoma (BCC), 9.7% squamous cell carcinoma (SCC) and 25.9% of patients presented with a combination of these lesions. There were significantly elevated levels of As and Cr in AK-NMSC group as compared to controls.

CONCLUSIONS

We identified a strong positive correlation between As and Cr concentration and AK/NMSC adding new clues to the scenery of NMSC risk factors that should be taken under consideration in exposed populations.

Study of Trace Metal Imbalances in the Scalp Hair of Stomach Cancer Patients with Different Types and Stages

Stomach cancer is among the most common forms of cancers, and diet and environmental factors play important roles in its malignancy. This study was conducted to evaluate the trace metal contents in the scalp hair of stomach cancer patients and healthy donors to investigate probable relationship between metal imbalances and cancer. The samples were digested in HNO₃-HClO₄ mixture and the metals were quantified by flame atomic absorption spectrophotometry. Median level of Cr was found to be significantly higher in the patients than in the controls, while median levels of Fe, Mn and Cd were considerably reduced. The correlation pattern of metals in the patients manifested significantly divergent mutual relationships compared with the controls. Multivariate analyses showed appreciably diverse apportionment of the metals in the patients and healthy donors. Variations in the metal levels were also observed for various types (adenocarcinoma and gastrointestinal stromal tumour) as well as stages (I, II, III and IV) of stomach cancer patients. Most of the metals revealed noticeable disparities in their levels based on gender, habitat, dietary habit and smoking habit of patients and controls. Accordingly, the essential/toxic metals exhibited significant imbalance due to pathogenesis of stomach among the patients.

The Effect of Hexavalent Chromium on the Incidence and Mortality of Human Cancers: A Meta-Analysis Based on Published Epidemiological Cohort Studies

Background: Hexavalent chromium [Cr(VI)] is an occupational carcinogen that can cause lung and nasal cancers, but its association with mortality and incidence in many other cancers is unclear.

Objectives: In this meta-analysis, we aimed to evaluate the relationship between exposure to Cr(VI) and the mortality and incidence of human cancers.

Methods: We performed a search of the literature and extracted the standardized mortality ratios (SMRs), standardized incidence ratios (SIRs), and their corresponding 95% confidence intervals (CIs), to estimate risk values. Subgroup analyses were conducted by sex, occupation, and types of cancer to identify groups that were at high-risk or predisposed to certain cancers.

Results: A total of 47 cohort studies covering the period 1985–2016 were included (37 studies reporting SMRs and 16 studies reporting SIRs). The summary SMR for all studies combined was 1.07 (95% CI: 1.01–1.15). Summary SMRs were higher among chromate production workers, chrome platers, and masons, and especially male workers. In the subgroup analysis, Cr(VI) exposure was related to a higher risk of death owing to lung, larynx, bladder, kidney, testicular, bone, and thyroid cancer. The meta-SIR of all studies combined was 1.06 (95% CI: 1.04–1.09). Summary SIRs were elevated among cement industry workers and tanners. Cr(VI) exposure was related to an elevated risk of respiratory system, buccal cavity, pharynx, prostate, and stomach cancers.

Conclusions: Cr(VI) might cause cancers of the respiratory system, buccal cavity and pharynx, prostate, and stomach in humans, and it is related to increased risk of overall mortality owing to lung, larynx, bladder, kidney, testicular, bone, and thyroid cancer. In addition, there was a strong association between incidence and mortality risk of cancers and concentration of Cr(VI) in the air and the exposure time.

The crosstalk between trace elements with DNA damage response, repair, and oxidative stress in cancer

DNA damage response (DDR) is a regulatory system responsible for maintaining genome integrity and stability, which can sense and transduce DNA damage signals. The severity of damage appears to determine DDRs, which can include damage repair, cell-cycle arrest, and apoptosis. Furthermore, defective components in DNA damage and repair machinery are an underlying cause for the development and progression of various types of cancers. Increasing evidence indicates that there is an association between trace elements and DDR/repair mechanisms. In fact, trace elements seem to affect mediators of DDR. Besides, it has been revealed that oxidative stress (OS) and trace elements are associated with cancer development. In this review, we discuss the role of some critical trace elements in the risk of cancer. In addition, we provide a brief introduction on DDR and OS in cancer. Finally, we will further review the interactions between some important trace elements including selenium, zinc, chromium, cadmium, and arsenic, and DDR, and OS in cancer.

Cancer mortality and exposure to nickel and chromium compounds in a cohort of Italian electroplaters

BACKGROUND

Nickel and chromium-VI compounds are carcinogens for lung cancer, although it is still debated if there is an increased risk at low levels of exposure and for other cancers.

METHODS

In a cohort of 2991 Italian electroplaters, a proportion of whom were exposed to low levels of nickel and/or chromium, cumulative exposure to their compounds was obtained by multiplying average concentrations of the metals in each electroplating tank by duration of employment in the company. The association of exposure to compounds with mortality was assessed by multivariable Cox models.

RESULTS

No cancer site was associated with chromium exposure controlling for nickel, whereas exposure to nickel significantly increased mortality from lung, rectal, and kidney cancers, even after adjusting for exposure to chromium.

CONCLUSIONS

Study results suggest that exposure to nickel compounds may increase the risk of lung cancer even below its occupational exposure limit and indicate possible associations with other cancer sites.

Quinic acid and hypervalent chromium: a spectroscopic and kinetic study

The redox reaction between an excess of quinic acid (QA) and CrVI involves the formation of intermediates, namely, CrIV and CrV species, which in turn react with the organic substrates. As observed with other substrates that have already been studied, CrIV does not accumulate during this reaction because of the rate of the reaction. Its rate of disappearance is several times higher than that of the reaction of CrVI or CrV with QA. Kinetic studies indicate that the redox reaction proceeds via a combined mechanism that involves the pathways CrVI → CrIV → CrII and CrVI → CrIV → CrIII, which is supported by the observation of superoxo-CrIII (CrO2 2+) ions, free radicals, and oxo-CrV species as intermediates and the detection of CrVI ester species. The present study reports the complete rate laws for the QA/chromium redox reaction.

Biomarkers of oxidative stress in electroplating workers exposed to hexavalent chromium

This study evaluates levels of biomarkers of oxidative DNA damage and lipid peroxidation in 105 male workers at 16 electroplating companies who had been exposed to hexavalent chromium (Cr(VI)). The study participants were 230 non-smoking male workers, comprising 105 electroplating workers who had been exposed to chromium and 125 control subjects who performed office tasks. Personal air samples, spot urine samples, hair samples, fingernail samples and questionnaires were used to quantify exposure to Cr(VI), oxidative DNA damage, lipid peroxidation, and environmental pollutants. Both the geometric mean personal concentrations of Cr(VI) of the Cr-exposed workers and the total Cr concentrations in the air to which they were exposed significantly exceeded those for the control subjects. The geometric mean concentrations of Cr in urine, hair and fingernails, and the urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG), and malondialdehyde (MDA) levels in the Cr(VI) exposed workers exceeded those in the control subjects. Daily cumulative Cr(VI) exposure and urinary Cr were significantly correlated with urinary 8-OHdG levels following adjustments for covariates. A ten-fold increase in urinary Cr level was associated with a 1.73-fold increase in urinary 8-OHdG level. Daily cumulative Cr(VI) exposure and urinary Cr level were significantly correlated with urinary MDA level following adjustments for covariates. A ten-fold increase in urinary Cr was associated with a 1.45-fold increase in urinary MDA. Exposure to Cr(VI) increased oxidative DNA injury and the oxidative deterioration of lipids in electroplating workers.

Case–control study to assess the association between colorectal cancer and selected occupational agents using INTEROCC job exposure matrix

Background

Colorectal cancer is the third most prevalent cancer in the world and is twice as common in developed countries when compared with low-income and middle-income countries. Few occupational risk factors for colorectal cancer have been identified. This case–control study aimed to assess the association between colorectal cancer and occupational exposure to selected solvents, combustion products, metals, dusts and other agents.

Methods

Cases (n=918) were enrolled from the Western Australian Cancer Registry from June 2005 to August 2007. Controls (n=1021) were randomly selected from the Western Australian electoral roll. We collected lifetime occupational history from cases and controls, in addition to their demographic and lifestyle characteristics. We applied the INTEROCC job exposure matrix to convert the occupational history to occupational exposure for 18 selected agents. Three exposure indices were developed: (1) exposed versus non-exposed; (2) lifetime cumulative exposure; and (3) total duration of exposure. The associations between colorectal cancer and the selected agents were estimated using logistic regression models adjusting for sex and age.

Results

None of the 18 selected agents showed an association with colorectal cancer. No dose–response relationships with lifetime cumulative exposure or duration of exposure were observed.

Conclusion

There was no evidence to suggest that occupational exposure to 18 selected agents increased the risk of colorectal cancer.

Toenail mineral concentration and risk of esophageal squamous cell carcinoma, results from the Golestan Cohort Study

Studies conducted in China linked selenium deficiency to higher risk of esophageal squamous cell carcinoma (ESCC), but this has not been widely tested outside that selenium-deficient region. The aim of this study was to investigate the association between selenium and other mineral concentrations in toenails and risk of ESCC in a region with high incidence rates. In this nested case-control study, we identified 222 cases of ESCC from the Golestan Cohort Study, Iran, which has followed up 50,045 participants since enrollment (2004-2008). We randomly selected one control for each case matched by age and sex, using incidence density sampling. We used toenail samples collected at baseline to measure the concentration of selenium, zinc, chromium, mercury, and scandium using instrumental neutron activation analysis. Multivariate adjusted logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals. Median nail selenium, zinc, chromium, and mercury levels were 1.01, 74.59, 0.77, and 0.018 μg/g in cases and 1.02, 75.71, 0.71, and 0.023 μg/g in controls, respectively. The adjusted odds ratios comparing each fourth quartile of mineral status versus the first quartile were as follows: selenium = 0.78 (95% CI, 0.41-1.49); zinc=0.80 (95% CI, 0.42-1.53); chromium = 0.91 (95% CI, 0.46-1.80); and mercury=0.61 (95% CI, 0.27-1.38), and all trend tests were non-significant. The nail selenium concentration in our controls reflects relatively high selenium status. No evidence of association between selenium or chromium concentrations in toenails and the risk of ESCC was detected in this population.

Potential health risk of heavy metals in the leather manufacturing industries in Sialkot, Pakistan

This is a systematical report on the potential health risk of heavy metals from the leather industries in Pakistan based on multiple biological matrices of the exposed workers and indoor dust samples. The adverse impacts of heavy metals on the oxidative enzyme and their risks to workers' health were also explored. Our results indicated that the level of Cr in indoor industrial dust was more than twice, compared to the background household dust. Blood, urine and hair samples of exposed workers showed significantly high concentrations of heavy metals, compared to those in the control group. Superoxide dismutase (SOD) level in the blood samples expressed significant positive correlation with Cr and Ni. Total hazard quotients (HQs)/hazard index (HI) were >1, and Cr (VI) exhibited higher cancer risks than that of Cd in the exposed workers. In addition, the PCA-MLR analysis confirmed that the industrial sections; cutting, shivering/crusting, and stitching were the principal contributors of heavy metals in the biological entities of the workers. Taken together, our results highlighted the occupationally exposed groups would likely to experience the potential health risks due to excessive exposure to the heavy metals from the leather industries.

Toxicity and oxidative stress induced by chromium in workers exposed from different occupational settings around the globe: A review

The present review focused on the levels and toxicological status of heavy metals especially chromium (Cr) in the exposed workers from different occupational settings around the globe and in Pakistan. It was found that exposed workers from leather tanning and metal plating units showed elevated levels of Cr than the workers from other occupational settings. Cr and other heavy metals level in biological matrices of the exposed workers in different occupational settings revealed that developing countries are severely contaminated. Occupational settings from the Sialkot district, Pakistan exhibited elevated level of Cr in biological entities of the exposed workers. Review suggested that higher level of Cr exposure to the workers enhance the oxidative stress (reactive oxygen species (ROS) and hydroxyl (OH) radical generation) which may cause; cellular and molecular damage such as genotoxicity and chromosomal aberration formations, and carcinogenic effects. This review will help to understand the Cr contamination mechanisms and associated health implications in different occupational settings around the globe in general and particularly to Pakistan. This study will also assist occupational health and safety management authorities to devise or change the Cr recommended exposure limits (REL) for different occupational settings.

The Nail as a Biomonitor of Trace Element Status in Golestan Cohort Study

BACKGROUND

In the Golestan Cohort Study that was launched to investigate the causes of esophageal cancer, a complete biospecimen bank was established for storage of collected blood, urine, hair, and nail samples. The objective of this study was to evaluate the feasibility of nail samples as a biomarker of selected trace elements status.

METHODS

Thirty toenail samples were selected randomly from the participants of Golestan Cohort Study (GCS). The samples were cleaned and analyzed for selenium, mercury, chromium, iron, zinc, and scandium by instrumental neutron activation analysis at the University of Missouri Research Reactor Center. Pearson correlation coefficients were computed for selected trace elements concentration versus scandium concentration to assess terrestrial contamination.

RESULTS

The selenium, zinc, and mercury were not correlated with scandium, suggesting they were free from substantial contamination. The high correlations of scandium with iron and chromium suggest that the iron and chromium levels may be compromised by terrestrial contamination. The coefficients of variation for duplicate samples for selenium and zinc were 2.6% and 7.2%, respectively.

CONCLUSION

The nail samples from Golestan Cohort Study appears to be useable as a biomarker of selenium, zinc, and mercury and could be considered for use in future studies.

Inhalation cancer risk assessment of hexavalent chromium based on updated mortality for Painesville chromate production workers

The exposure-response for hexavalent chromium (Cr(VI))-induced lung cancer among workers of the Painesville Ohio chromate production facility has been used internationally for quantitative risk assessment of environmental and occupational exposures to airborne Cr(VI). We updated the mortality of 714 Painesville workers (including 198 short-term workers) through December 2011, reconstructed exposures, and conducted exposure-response modeling using Poisson and Cox regressions to provide quantitative lung cancer risk estimates. The average length of follow-up was 34.4 years with 24,535 person-years at risk. Lung cancer was significantly increased for the cohort (standardized mortality ratio (SMR)=186; 95% confidence interval (CI) 145-228), for those hired before 1959, those with >30-year tenure, and those with cumulative exposure >1.41 mg/m(3)-years or highest monthly exposures >0.26 mg/m(3). Of the models assessed, the linear Cox model with unlagged cumulative exposure provided the best fit and was preferred. Smoking and age at hire were also significant predictors of lung cancer mortality. Adjusting for these variables, the occupational unit risk was 0.00166 (95% CI 0.000713-0.00349), and the environmental unit risk was 0.00832 (95% CI 0.00359-0.0174), which are 20% and 15% lower, respectively, than values developed in a previous study of this cohort.

Oral Chromium Exposure and Toxicity

Hexavalent chromium [Cr(VI)] is a known carcinogen when inhaled. However, inhalational exposure to Cr(VI) affects only a small portion of the population, mainly by occupational exposures. In contrast, oral exposure to Cr(VI) is widespread and affects many people throughout the globe. In 2008, the National Toxicology Program (NTP) released a 2-year study demonstrating that ingested Cr(VI) was carcinogenic in rats and mice. The effects of Cr(VI) oral exposure are mitigated by reduction in the gut; however, a portion evades the reductive detoxification and reaches target tissues. Once Cr(VI) enters the cell, it ultimately gets reduced to Cr(III), which mediates its toxicity via induction of oxidative stress during the reduction while Cr intermediates react with protein and DNA. Cr(III) can form adducts with DNA that may lead to mutations. This review will discuss the potential adverse effects of oral exposure to Cr(VI) by presenting up-to-date human and animal studies, examining the underlying mechanisms that mediate Cr(VI) toxicity, as well as highlighting opportunities for future research.

Oxidative Stress Markers and Histological Analysis in Diverse Organs from Rats Treated with a Hepatotoxic Dose of Cr(VI): Effect of Curcumin

Hexavalent chromium [Cr(VI)] compounds are extremely toxic and carcinogenic. Despite the vast quantity of reports about Cr(VI) toxicity, the information regarding its effects when it is intraperitoneally (i.p.) administered is still limited. In contrast, it has been shown that curcumin prevents hepatotoxicity induced by a single intraperitoneal injection of 15 mg/kg body weight (b.w.) of potassium dichromate (K2Cr2O7). This study aims to evaluate oxidative stress markers, the activity of antioxidant enzymes, and the potential histological injury in brain, heart, lung, kidney, spleen, pancreas, stomach, and intestine from rats treated with a hepatotoxic dose of K2Cr2O7 (15 mg/kg b.w.), and the effect of curcumin pretreatment. Rats were divided into four groups: control, curcumin, K2Cr2O7, and curcumin+K2Cr2O7. At the end of the treatment, plasma and ascites fluid were collected and target organs were dissected out for biochemical and histological analysis. K2Cr2O7 induced hepatotoxicity but failed to induce in all the other studied organs either oxidative or histological injury, since levels of malondialdehyde (MDA), glutathione (GSH), and the activity of superoxide dismutase (SOD), catalase (CAT), and related GSH enzymes were unchanged. As expected, curcumin was safe. Lack of K2Cr2O7-induced toxicity in those target organs could be due to the following: (1) route of administration, (2) absorption through the portal circulation, (3) lower dose than needed, (4) short time of exposure, or (5) repeated doses are required to produce damage. Thus, the intraperitoneal injection of 15 mg/kg of K2Cr2O7, that is able to induce hepatotoxicity, was unable to induce histological and oxidative damage in other target organs.

Porous p-NiO/n-Nb2O5 nanocomposites prepared by an EISA route with enhanced photocatalytic activity in simultaneous Cr(VI) reduction and methyl orange decolorization under visible light irradiation

Porous NiO/Nb2O5 nanocomposites with Ni/Nb molar ratio of 0.4, 0.8 and 1.2 have been obtained via the EISA route using P123 copolymer as organic template, and are assigned as NiNb0.4, NiNb0.8 and NiNb1.2, respectively. For comparison, pure Nb2O5 sample assigned as NiNb0.0 was also synthesized by the same method. Structural and textural features of the as prepared samples were investigated by XRD, FTIR, FE-SEM, EDX, UV-vis DRS and BET techniques. The results indicated that the porous p-NiO/n-Nb2O5 junction nanocomposites were formed and coupling of NiO with Nb2O5 resulted a remarkable red shift in the optical response of the nanocomposite samples. The photocatalytic properties of the nanocomposite samples, and also synthesized pure Nb2O5 (NiNb0.0) and commercial Nb2O5 as reference catalysts were evaluated for the first time by simultaneous Cr(VI) reduction and MO decolorization in aqueous suspension under visible light irradiation at pH 2. NiNb0.4 was found to be the most active photocatalyst, which might be attributed to the extended absorption in the visible light region and the effective photogenerated electron-hole separation by the photosynergistic effects of the p-NiO/n-Nb2O5 composite powder. The photocatalytic efficiency of the most active photocatalyst, NiNb0.4, was found to be rather low for either single Cr(VI) solution or single MO solution. However, the photocatalytic reduction of Cr(VI) and photocatalytic decolorization of MO proceed more rapidly for the coexistence system of Cr(VI) and MO than for the single process, showing synergetic effect between the reduction and decolorization reactions. The effects of initial concentration of Cr(VI), MO and the initial pH value on the rate of simultaneous photoreactions over NiNb0.4 sample, were also investigated. The Cr(VI) and MO removal rates were further enhanced by increasing MO and Cr (VI) concentration to an optimal value, respectively, and/or decreasing solution pH.

Chromium exposure among children from an electronic waste recycling town of China

Guiyu is one of the most heavily chromium-polluted areas in China due to the numerous informal electronic waste (e-waste) recycling activities. A 3-year (2004, 2006, and 2008) independent cross-sectional study on blood chromium (BCr) levels of 711 children from Guiyu and a control area was investigated. Questionnaire completed by parents/guardians was used to assess the risk factors of chromium (Cr) exposure, while physical examination, for the year 2008 only, was used to evaluate the effects of long-term exposure to Cr on child physical development. Children living in Guiyu had significantly higher BCr levels compared with those living in Chendian at the same period from 2004 to 2008 (P < 0.001). The predominant risk factors related to elevated child BCr levels included the use of house as a family workshop, parent involved in e-waste recycling, and child residence in Guiyu. Children's weight and chest circumferences in group with high exposure to Cr (upper quartile) were higher than in the low-exposure group (P < 0.01), although the difference was less significant for boys between the two groups (P < 0.05). The results suggest that elevated child BCr in Guiyu due to informal e-waste recycling activities might be threatening the health of children, with implications on physical growth and development.

Occupational Exposure to Chromium of Assembly Workers in Aviation Industries

Aircraft are constructed by modules that are covered by a "primer" layer, which can often contain hexavalent chromium [Cr(VI)], known carcinogen to humans. While the occupational exposure to Cr(VI) during aircraft painting is ascertained, the exposure assessment of assembly workers (assemblers) requires investigations. Three biological monitoring campaigns (BM-I,II,III) were performed in an aviation industry, on homogeneous groups of assemblers (N = 43) and controls (N = 23), by measuring chromium concentrations in end-shift urine collected at the end of the working week and the chromium concentration difference between end- and before-shift urines. BM-I was conducted on full-time workers, BM-II was performed on workers after a 3-4 day absence from work, BM-III on workers using ecoprimers with lower Cr(VI) content. Samples were analyzed by atomic absorption spectroscopy and mean values were compared by T-test. Even if Cr concentrations measured during BM-I were lower than Biological Exposure Indices by ACGIH, statistically significant differences were found between urinary Cr concentrations of workers and controls. Despite 3-4 days of absence from work, urinary chromium concentrations measured during BM-II were still higher than references from nonoccupationally exposed populations. In the BM-III campaign, the obtained preliminary results suggested the efficacy of using ecoprimers. The healthcare of workers exposed to carcinogenic agents follows the principle of limiting the exposure to "the minimum technically possible". The obtained results evidence that assemblers of aviation industries, whose task does not involve the direct use of primers containing Cr(VI), show an albeit slight occupational exposure to Cr(VI), that must be carefully taken into consideration in planning suitable prevention measures during risk assessment and management processes.

Chromium in drinking water: association with biomarkers of exposure and effect

An epidemiological cross-sectional study was conducted in Greece to investigate health outcomes associated with long-term exposure to chromium via drinking water. The study population consisted of 304 participants. Socio-demographics, lifestyle, drinking water intake, dietary habits, occupational and medical history data were recorded through a personal interview. Physical examination and a motor test were carried out on the individuals. Total chromium concentrations were measured in blood and hair of the study subjects. Hematological, biochemical and inflammatory parameters were determined in blood. Chromium in drinking water ranged from <0.5 to 90 μg·L-1 in all samples but one (220 μg·L-1), with a median concentration of 21.2 μg·L-1. Chromium levels in blood (median 0.32 μg·L-1, range <0.18-0.92 μg·L-1) and hair (median 0.22 μg·g-1, range 0.03-1.26 μg·g-1) were found within "normal range" according to the literature. Personal lifetime chromium exposure dose via drinking water, calculated from the results of the water analyses and the questionnaire data, showed associations with blood and hair chromium levels and certain hematological and biochemical parameters. Groups of subjects whose hematological or biochemical parameters were outside the normal range were not correlated with chromium exposure dose, except for groups of subjects with high triglycerides or low sodium. Motor impairment score was not associated with exposure to chromium.

Chromium VI and stomach cancer: a meta-analysis of the current epidemiological evidence

OBJECTIVES

Chromium VI (hexavalent chromium, Cr(VI)) is an established cause of lung cancer, but its association with gastrointestinal cancer is less clear. The goal of this study was to examine whether the current human epidemiological research on occupationally inhaled Cr(VI) supports the hypothesis that Cr(VI) is associated with human stomach cancer.

METHODS

Following a thorough literature search and review of individual studies, we used meta-analysis to summarise the current epidemiological literature on inhaled Cr(VI) and stomach cancer, explore major sources of heterogeneity, and assess other elements of causal inference.

RESULTS

We identified 56 cohort and case-control studies and 74 individual relative risk (RR) estimates on stomach cancer and Cr(VI) exposure or work in an occupation associated with high Cr(VI) exposure including chromium production, chrome plating, leather work and work with Portland cement. The summary RR for all studies combined was 1.27 (95% CI 1.18 to 1.38). In analyses limited to only those studies identifying increased risks of lung cancer, the summary RR for stomach cancer was higher (RR=1.41, 95% CI 1.18 to 1.69).

CONCLUSIONS

Overall, these results suggest that Cr(VI) is a stomach carcinogen in humans, which is consistent with the tumour results reported in rodent studies.

Assessment of the mode of action for hexavalent chromium-induced lung cancer following inhalation exposures

Inhalation of hexavalent chromium [Cr(VI)] is associated with increased lung cancer risk among workers in several industries, most notably chromate production workers exposed to high concentrations of Cr(VI) (≥100 μg/m(3)), for which clear exposure-response relationships and respiratory irritation and tissue damage have been reported. Data from this industry are used to assess lung cancer risk associated with environmental and current occupational exposures, occurring at concentrations that are significantly lower. There is considerable uncertainty in the low dose extrapolation of historical occupational epidemiology data to assess risk at current exposures because no published or well recognized mode of action (MOA) for Cr(VI)-induced lung tumors exists. We conducted a MOA analysis for Cr(VI)-induced lung cancer evaluating toxicokinetic and toxicological data in humans and rodents and mechanistic data to assess plausibility, dose-response, and temporal concordance for potential MOAs. Toxicokinetic data support that extracellular reduction of Cr(VI), which limits intracellular absorption of Cr(VI) and Cr(VI)-induced toxicity, can be overwhelmed at high exposure levels. In vivo genotoxicity and mutagenicity data are mostly negative and do not support a mutagenic MOA. Further, both chronic bioassays and the epidemiologic literature support that lung cancer occurs at exposures that cause tissue damage. Based on this MOA analysis, the overall weight of evidence supports a MOA involving deposition and accumulation of particulate chromium in the bifurcations of the lung resulting in exceedance of clearance mechanisms and cellular absorption of Cr(VI). Once inside the cell, reduction of Cr(VI) results in oxidative stress and the formation of Cr ligands. Subsequent protein and DNA damage lead to tissue irritation, inflammation, and cytotoxicity. These effects, concomitant with increased cell proliferation, result in changes to DNA sequences and/or methylation status that can lead to tumorigenesis. This MOA supports the use of non-linear approaches when extrapolating lung cancer risk occurring at high concentration occupational exposures to environmentally-relevant exposures.

A chronic oral reference dose for hexavalent chromium-induced intestinal cancer

High concentrations of hexavalent chromium [Cr(VI)] in drinking water induce villous cytotoxicity and compensatory crypt hyperplasia in the small intestines of mice (but not rats). Lifetime exposure to such cytotoxic concentrations increases intestinal neoplasms in mice, suggesting that the mode of action for Cr(VI)-induced intestinal tumors involves chronic wounding and compensatory cell proliferation of the intestine. Therefore, we developed a chronic oral reference dose (RfD) designed to be protective of intestinal damage and thus intestinal cancer. A physiologically based pharmacokinetic model for chromium in mice was used to estimate the amount of Cr(VI) entering each intestinal tissue section (duodenum, jejunum and ileum) from the lumen per day (normalized to intestinal tissue weight). These internal dose metrics, together with corresponding incidences for diffuse hyperplasia, were used to derive points of departure using benchmark dose modeling and constrained nonlinear regression. Both modeling techniques resulted in similar points of departure, which were subsequently converted to human equivalent doses using a human physiologically based pharmacokinetic model. Applying appropriate uncertainty factors, an RfD of 0.006 mg kg(-1) day(-1) was derived for diffuse hyperplasia-an effect that precedes tumor formation. This RfD is protective of both noncancer and cancer effects in the small intestine and corresponds to a safe drinking water equivalent level of 210 µg l(-1). This concentration is higher than the current federal maximum contaminant level for total Cr (100 µg l(-1)) and well above levels of Cr(VI) in US drinking water supplies (typically ≤ 5 µg l(-1)).

Curcumin pretreatment prevents potassium dichromate-induced hepatotoxicity, oxidative stress, decreased respiratory complex I activity, and membrane permeability transition pore opening

Curcumin is a polyphenol derived from turmeric with recognized antioxidant properties. Hexavalent chromium is an environmental toxic and carcinogen compound that induces oxidative stress. The objective of this study was to evaluate the potential protective effect of curcumin on the hepatic damage generated by potassium dichromate (K₂Cr₂O₇) in rats. Animals were pretreated daily by 9-10 days with curcumin (400 mg/kg b.w.) before the injection of a single intraperitoneal of K₂Cr₂O₇ (15 mg/kg b.w.). Groups of animals were sacrificed 24 and 48 h later. K₂Cr₂O₇-induced damage to the liver was evident by histological alterations and increase in the liver weight and in the activity of alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, and alkaline phosphatase in plasma. In addition, K₂Cr₂O₇ induced oxidative damage in liver and isolated mitochondria, which was evident by the increase in the content of malondialdehyde and protein carbonyl and decrease in the glutathione content and in the activity of several antioxidant enzymes. Moreover, K₂Cr₂O₇ induced decrease in mitochondrial oxygen consumption, in the activity of respiratory complex I, and permeability transition pore opening. All the above-mentioned alterations were prevented by curcumin pretreatment. The beneficial effects of curcumin against K₂Cr₂O₇-induced liver oxidative damage were associated with prevention of mitochondrial dysfunction.

Outline of occupational chromium poisoning in China

The present study analyzed the feature of occupational chromium poisoning in China since the 1980s. The collected data were acquired from 18 previous surveys of chromium poisoning in 14 cities of China. The method of risk assessment was applied to calculate the relative risk and 95% CI, p < 0.05 was considered as a significant risk. The results showed that nasal disease was the most common sign of occupational chromium poisoning, and the prevalence rate of nasal disease was 17.83% in total population of 6,998. Further, the risk analysis showed that occupational chromium poisoning led to an increased risk of lung or liver cancer in male workers due to the definite carcinogenicity of hexavalent chromium. Significantly, an increased risk of spontaneous or threatened abortion was also found in female workers. In conclusion, these studies suggest that early detection of impaired reproductive function or impaired lung or liver function in female or male workers is essential for controlling occupational chromium poisoning in China.

Assessment of the mode of action underlying development of rodent small intestinal tumors following oral exposure to hexavalent chromium and relevance to humans

Abstract Chronic exposure to high concentrations of hexavalent chromium (Cr(VI)) in drinking water causes intestinal adenomas and carcinomas in mice, but not in rats. Cr(VI) causes damage to intestinal villi and crypt hyperplasia in mice after only one week of exposure. After two years of exposure, intestinal damage and crypt hyperplasia are evident in mice (but not rats), as are intestinal tumors. Although Cr(VI) has genotoxic properties, these findings suggest that intestinal tumors in mice arise as a result of chronic mucosal injury. To better understand the mode of action (MOA) of Cr(VI) in the intestine, a 90-day drinking water study was conducted to collect histological, biochemical, toxicogenomic and pharmacokinetic data in intestinal tissues. Using MOA analyses and human relevance frameworks proposed by national and international regulatory agencies, the weight of evidence supports a cytotoxic MOA with the following key events: (a) absorption of Cr(VI) from the intestinal lumen, (b) toxicity to intestinal villi, (c) crypt regenerative hyperplasia and (d) clonal expansion of mutations within the crypt stem cells, resulting in late onset tumorigenesis. This article summarizes the data supporting each key event in the MOA, as well as data that argue against a mutagenic MOA for Cr(VI)-induced intestinal tumors.

Overview of methodological quality of systematic reviews about gastric cancer risk and protective factors

BACKGROUND AND OBJECTIVE

A comprehensive overall review of gastric cancer (GC) risk and protective factors is a high priority, so we conducted the present study.

METHODS

Systematic searches in common medical electronic databases along with reference tracking were conducted to include all kinds of systematic reviews (SRs) about GC risk and protective factors. Two authors independently selected studies, extracted data, and evaluated the methodological qualities and the quality of evidence using R-AMSTAR and GRADE approaches.

RESULTS

Beta- carotene below 20 mg/day, fruit, vegetables, non-fermented soy-foods, whole-grain, and dairy product were GC protective factors, while beta-carotene 20 mg/day or above, pickled vegetables, fermented soy-foods, processed meat 30 g/d or above, or salty foods, exposure to alcohol or smoking, occupational exposure to Pb, overweight and obesity, helicobacter pylori infection were GC risk factors. So we suggested screening and treating H. pylori infection, limiting the amount of food containing risk factors (processed meat consumption, beta-carotene, pickled vegetables, fermented soy-foods, salty foods, alcohol), stopping smoking, avoiding excessive weight gain, avoidance of Pb, and increasing the quantity of food containing protective components (fresh fruit and vegetables, non-fermented soy-foods, whole-grain, dairy products).

CONCLUSIONS

The conclusions and recommendations of our study were limited by including SRs with poor methodological bases and low quality of evidence, so that more research applying checklists about assessing the methodological qualities and reporting are needed for the future.