Evaluation of toxic and essential elements in whole blood from 0- to 6-year-old children from Jinan, China

Predictors of urinary heavy metal concentrations among pregnant women in Jinan, China

BACKGROUND

Toxic heavy metal exposure and insufficiency or excess of essential heavy metals may have negative effects on pregnant women's health and fetal growth. To date, the predictors of pregnant women's heavy metal exposure levels remain unclear and vary with different regions. The study intended to explore potential predictors of exposure to heavy metals individually and high co-exposure to heavy metal mixtures.

METHODS

We recruited 298 pregnant women in first trimester from prenatal clinics in Jinan, Shandong Province, China, and collected spot urine samples and questionnaire data on their demographic characteristics, lifestyle habits, consumption of food and dietary supplement, and residential environment. All urine samples were analyzed for seven heavy metals: cobalt (Co), molybdenum (Mo), strontium (Sr), arsenic (As), cadmium (Cd), lead (Pb) and mercury (Hg).

RESULTS

Factors associated with single heavy metal concentration were as follows: a) urinary As, Sr and Cd increased with women's age respectively; b) pregnant women with higher monthly household income per capita had lower Sr and Mo levels; c) pregnant women with intermittent folic acid supplementation and those not taking tap water as domestic drinking water had lower Sr concentrations; d) Cd was positively linked with consumption frequency of rice; e) Hg was adversely related to consumption frequency of egg and the women who took purified water as domestic drinking water had lower Hg exposure. In addition, pregnant women's age was positively associated with odds of high co-exposure to Co, As, Sr, Mo, Cd and Pb; while those with an educational level of college had lower odds of high exposure to such a metal mixture compared with those whose educational levels were lower than high school.

CONCLUSION

Predictors of single urinary heavy metal concentration included pregnant women's age (As, Sr and Cd), monthly household income per capita (Sr and Mo), folic acid supplementation (Sr), rice consumption frequency (Cd), egg consumption frequency (Hg) and the type of domestic drinking water (Sr and Hg). Pregnant women with older age, lower educational level tended to have high co-exposure to Co, As, Sr, Mo, Cd and Pb.

Distribution of blood lead and cadmium levels in healthy children aged 0 to 18 years and analysis of related influencing factors in Henan, China: data findings from 2017 to 2022

BACKGROUND

There is still a lack of data on blood lead levels (BLLs) and blood lead levels (BLLs) in healthy children of all ages from 0 to 18 years in China. This study was performed to analyze the BLLs and BCLs in healthy children aged 0-18 years from 2017 to 2022 in urban and rural areas of Henan Province, Central China, as well as their relationships with socio-demographic variables and certain relevant exposure factors. To provide a basis for evaluating public health policy development and exposure risk management.

METHODS

This was an observational study containing data from 17 prefecture-level cities in Henan, China. Blood Pb and Cd levels were determined using a triple quadrupole inductively coupled plasma mass spectrometer equipped with an autosampler. We first calculated the concentrations of Pb and Cd elements in participants of different genders, ages and years, and then created visual graphs depicting the distribution of each element in terms of gender, age and year (2017-2022). The rates between different groups were compared using the Chi-square test or Fisher exact test (if applicable). The means were compared by one-way ANOVA, medians were compared with the Kruskal-Wallis rank-sum test. Generalized linear models (GLM) were performed to estimate the effects of various factors on blood Pb and Cd concentrations in children.

RESULTS

We recruited a total of 25,920 children (16,142 boys and 9,778 girls) aged 0.01 to 18.00 years (2.58 (1.00,6.25)). The median of BLLs was 23.48µg/L, around 9.39% of studied children had elevated BLLs. The median of BCLs was 0.66µg/L, around 1.84% of studied children had elevated BCLs. The median blood Pb concentration was higher in boys (23.90µg/L) than in girls (22.75µg/L) (P<0.001). The median blood Pb concentration was highest in the 3-7 years group (24.51µg/L) and the median blood Cd concentration was highest in the 1-3 years group (0.66µg/L) among all age groups. Both BLLs and BCLs were substantially higher in children in 2020-2022 compared to 2017-2019. Rural children had lower BLLs and higher BCLs. The results of the generalized linear model showed that children in households using Oil, coal, pellet or other wood as a fuel for heating, children with higher frequency of exposure to tobacco smoke and beverage intake had significantly increased chances of elevated BLLs and BCLs.

CONCLUSIONS

Pb and Cd exposure of children in this area is relatively low, but associated risk factors continue to exist in vulnerable populations. This study is the first big data analysis of Pb and Cd in children in Henan, China, and provides baseline information for future research.

The Effects of Lead and Cadmium Co-exposure on Serum Ions in Residents Living Near a Mining and Smelting Area in Northwest China

In this study, we investigated the associations between cadmium (Cd) and lead (Pb) co-exposure, and serum ion levels in two populations living near a mining/smelting area and a nature reserve (control area), respectively. A total of 445 participants were included in this study. Their blood cadmium (BCd), blood lead (BPb), and serum ion levels were determined, and the association between exposure levels and serum ion levels was analyzed. The exposure levels of subjects living in the polluted area were significantly higher (p < 0.001). Lower levels of potassium, inorganic phosphorus, and iron were observed in subjects from the polluted area, whereas their sodium and chloride levels were higher (p < 0.01). The anion gap in their serum was also significantly lower. We observed positive dose-effect relationships between Cd and/or Pb exposure and serum sodium and chloride, and negative dose-effect relationships between Cd and/or Pb exposure and serum inorganic phosphorus, iron, as well as the anion gap. High Cd-Pb, high Cd, and high Pb exposure led to modification effects in potassium, calcium, inorganic phosphorus, and iron levels, and the anion gap. No synergistic effects were observed in our results. In conclusion, our data demonstrate that Cd and Pb exposure, alone or in combination, can lead to serum ion imbalances.

Evaluation of Essential and Toxic Elements in the Blood of 0–14-Year-Old Children in Hunan, China From 2013 to 2019: A Retrospective Analysis

Objective

The aim was to investigate the distribution and correlation of Ca, Mg, Zn, Cu, Fe, Pb, and Cd in the blood of children aged 0–14 years in Hunan, China, which may serve to provide a basis for clinical guidance on child health.

Study Design

A retrospective analysis was carried out. Concentrations of all elements were determined by atomic absorption spectrophotometry. Distributions were analyzed and compared among different age, sex, and year groups by the Kruskal–Wallis test, the chi-square test, and the Fisher's exact test. Spearman's rank correlation coefficient was used to evaluate the association between every pair of elements.

Results

A total of 46,951 children were involved in this study from 2013 to 2019. The median blood levels of elements were 13.51 μmol/L (Cu), 58.69 μmol/L (Zn), 1.70 mmol/L (Ca), 1.40 mmol/L (Mg), 7.46 mmol/L (Fe), 35.00 μg/L (Pb), and 1.00 μg/L (Cd). Girls had a higher level of Ca and lower levels of Pb and Cd than boys. Cu and Ca showed an upward trend, and Mg and Pb showed a downward trend by year. Zn and Fe increased and Ca decreased significantly with age. The deficiency rates of Fe and Zn decreased significantly by year, while Ca and Cu increased significantly by year. Cd exposure in this area was relatively low.

Conclusion

Most children had normal levels of the essential elements Ca, Cu, and Mg and the toxic elements Pb and Cd. Severe deficiencies in Zn and Fe were observed in the relatively younger children but improved with age. Persistent efforts in reducing Pb exposure might still be needed.

Determination of 11 minerals in children using inductively coupled plasma mass spectrometry

BACKGROUND

Minerals play an important role in children's growth and cognition. In this study, our aim was to establish reference intervals of mineral level in Children of Liaoning province (China) and provide a reliable basis for future preventive healthcare guidelines.

METHODS

Random samples of 2217 healthy children aged 0-15 years who were referred for routine hospital laboratory examinations in the cities of Shenyang, Fushun, Fuxin, Benxi, Chaoyang and Lingyuan were invited to participate in the study. Serum levels of Calcium (Ca), Iron (Fe), Zinc (Zn), Magnesium (Mg), Copper (Cu), Manganese (Mn), Selenium (Se), Mercury (Hg), Nickel (Ni), Cobalt (Co), and Lithium (Li) were determined by inductively coupled plasma mass spectrometer(ICP-MS).

RESULTS

Sex-related significant differences in the serum concentrations of the Mg and Cu (P < 0.05). Age-related significant differences were found in serum levels of Ca, Fe, Zn, Mg, Cu and Mn (P < 0.05) and the concentrations of 9 minerals (Ca, Mg, Cu, Mn,Se,Hg,Ni,Co and Li in serum varied from season to season (P < 0.05). The Spearman correlation matrix of 11 minerals was shown as a heat map, the correlations between Ca-Zn, Ca-Mg, Fe-Zn, Fe-Se, Mn-Ni, Se-Hg, Se-Ni, Hg-Ni, and Ni-Co, Ni-Li were the strongest compared with others.

CONCLUSIONS

The reference intervals of serum 11 minerals for children should considering the sex, age and season, which may be useful for decisive diagnoses of abnormality of the 11minerals and the related diseases.

Method for Determining Regional Reference Values of Metal Content in Biological Substrates and Their Intake into the Body via Drinking Water

Natural and manmade flows of matter form complex metal associations in the body of residents living in certain territories, which leads to functional disorders in their bodies and the depletion of adaptive reserves. It is possible to assess the distribution of metals in the body only taking into account its biogeochemical localization. The question arises about the methodological approach to the determination of regional reference values of the concentrations of metals in biosubstrates of residents of different territories, to which this study was devoted. A designed and trained neural network was used, reflecting the relationship between the concentrations of metals in consumed drinking water and biosubstrates of the body, taking into account the physiological characteristics of the tested group of children and adolescents, based on the regional reference values obtained. Neural network regression methods allowed the calculation of nonlinear dependences of indicators of the state of the internal environment of an organism with external factors, and localized reference values determined in such calculations the indicators of the base state, being guided by the intensity of external factors, which should be assessed. The results of this study are intended for patient-oriented diagnosis and the treatment of eco-conditioned microelementosis in individual locations.

Blood lead, nutrient intake, and renal function among type 2 diabetic patients

Lead (Pb) exposure has been reported to have nephrotoxicity. However, such an effect has not been well investigated in type 2 diabetes (T2D) patients, especially when taking into account the nutrition status of the patients. Therefore, we explore the association between blood lead levels (BLLs), dietary intake of nutrients, and impaired renal function among patients with T2D. We measured BLLs and biochemical parameters of renal injury in 780 patients. Dietary nutrients intake was assessed by a food frequency questionnaire in 420 of 780 participants. We found high BLLs were significantly associated with certain parameters of renal injury, and dietary intake of specific nutrients (mainly micronutrients) was associated with reduced BLLs at high percentile distribution of concentration. BLLs were also found to have moderation effects on the association between specific dietary nutrients and specific renal function parameters.

Elevated lead levels in relation to low serum neuropeptide Y and adverse behavioral effects in preschool children with e-waste exposure

As a neurotoxicant, lead (Pb) primarily affects central nervous system, and particularly impacts developing brain. This study explores the associations of blood Pb level and children's behavioral health. A total of 213 preschool children aged 3-7 years old were recruited from Guiyu (the e-waste-exposed area) and Haojiang (the reference area). The behavioral health of children was assessed using the 'behavioral symptoms' subscale of the Strengths and Difficulties Questionnaire (SDQ). Results showed that there was a significant difference in percent of children categorized as "at risk" between Guiyu (48.2%) and Haojiang (13.9%) (p < 0.001). The blood Pb level of children in Guiyu was significantly higher than those in Haojiang (median: 5.19 μg/dL vs. 3.42 μg/dL, p < 0.001). The serum Neuropeptide Y (NPY) was significantly lower in Guiyu children than those in Haojiang. Spearman correlation analyses demonstrated that blood Pb levels was negatively correlated with NPY (r_s = -0.25, p < 0.001), but positively correlated with behavioral symptom scores; while serum NPY levels were negatively associated with behavioral symptom scores. Behavioral symptom scores were higher in children with blood Pb level ≥5.00 μg/dL (high) than those with blood Pb level < 5.00 μg/dL (low). After adjusting for confounding factors, children with lower NPY levels were at higher risk of having behavioral difficulties. In conclusion, Pb exposure in e-waste-exposed areas may lead to decrease in serum NPY and increase in the risk of children's behavioral problems. In addition, NPY may mediate the association between Pb exposure and behavioral difficulties.

Blood Magnesium Level and Selected Oxidative Stress Indices in Lead-Exposed Workers

Occupational exposure to lead is one of the important hazards to human global population. Lead interferes with divalent cations, such as calcium, magnesium, and iron. Magnesium is the fourth most common mineral in the human body and a cofactor in more than 325 enzymes. There are many disorders associated with magnesium deficiency. It has been postulated that hypomagnesemia promotes oxidative stress. Study population included 232 male employees of lead-zinc works and was divided into two sub-groups based on the median of magnesium serum level: low magnesium level (L-Mg) group and high magnesium level (H-Mg) group. Magnesium level was significantly higher in the H-Mg group than in the L-Mg group due to the study design. The level of zinc protoporphyrin was significantly higher in the L-Mg group than in the H-Mg group by 13%, while the blood lead levels were similar in the examined groups. The serum level of MDA was significantly higher in the L-Mg group than in the H-Mg group by 12%, while the serum levels of thiol groups, TAC, and bilirubin were significantly lower in that group by 6%, 3%, and 27%, respectively. Similarly, the erythrocyte SOD activity was lower in the L-Mg group than in the H-Mg group by 5%. Low serum magnesium levels contribute to lead-induced oxidative stress, result in unfavorable modification of antioxidant system function, and promote lead-induced impairment of heme synthesis. Obtained results indicate that prevention of hypomagnesemia should be regarded as an important step in ensuring adequate prophylaxis of chronic lead poisoning.

Role of lead in dental diseases

Lead (Pb) is ubiquitous in our environment and causes many pathophysiological health effects, including dental diseases. Dental Pb levels are considered good biological indicators of environmental and occupational Pb exposure. Pb in blood and saliva causes imbalances in the growth of oral microflora. The pH of saliva decreases, interferes with and interacts with bone-seeking elements, changes oral inflammatory parameters, generates reactive oxygen species, causes oxidative damage, and delays the mineralization process, leading to dental diseases. Pb's dental diseases include periodontitis, enamel lesions and defects, fluorosis, Burton's line, and tooth loss. Environmental and physiological factors, including age, gender, tooth type and position, pregnancy and lactation, eating and drinking habits, smoking habits, and exposures from Pb-contaminated residential and occupational areas, affect the distribution of Pb in blood, bone, and saliva, which contributes to dental diseases. However, living and working in Pb free areas can prevent environmental and occupational Pb exposure. Healthy lifestyles and eating habits, prohibiting smoking and alcohol drinking, further help prevent Pb exposure. Also, the fluoridation of water, salt, and milk provide nutritional supplements of trace elements, which can help prevent teeth from absorbing Pb from the environment, thereby reducing the risk of dental diseases.

Potential dietary factors for reducing lead burden of Chinese preschool children

Dietary approaches to treat children's low lead exposure are implemented routinely in China, while evidence for the effect could not be provided until now. The aim of this study was to examine the relationship between diets including nutrition supplementation and blood lead level of preschool children of China. In total, 17,859 preschool children from 14 cities were recruited, and their social-demography, living environment, and dietary intakes were collected, and capillary blood sample was tested for lead concentration. The average blood lead concentration was 34.5 μg/L, and after adjusting children's social-demography factors, the consumption of milk or dairy production, fruits, and calcium supplementation had negative dose-response relationships with blood lead level. Conversely, intake of iron-rich food and supplementation was not associated. Further studies are needed to prove the causal relationships.

Dietary zinc, calcium and nickel are associated with lower childhood blood lead levels

The potential mitigation of elevated blood lead (PbB) levels with nutrient intake remains debatable. A comprehensive review by Kordas (2017) concluded that careful examination of the links between nutrition (nutritional status, nutrients, diet) and lead (Pb) exposure revealed limited and tenuous evidence. We have measured 20 elements including calcium (Ca), chromium (Cr), copper (Cu), iron (Fe), magnesium (Mg), manganese (Mn), nickel (Ni), zinc (Zn), and Pb from 6-day duplicate diets of 108 young children over a 5-year period and expressed these as intakes per body weight. Bivariate analyses showed a weak positive association between the Pb content in the diets of the participants and the level of Pb in their blood, as might be expected. Weak, but negative, associations occurred between the other elements in the diet and PbB. The associations for Ca, Mg, Ni and Zn were statistically significant for both subject-based (between subjects) and within-subject effects: that is, as the levels of elements in diet increased, the PbB level decreased. The largest percentage of variance of PbB in the context of the bivariate model accounted for was 4.23% for Zn, followed by Ca (3.91%) and Fe (2.20%). Supplementary analyses indicated that the between- and within-subject effects did not vary with the age at which participants entered the study, or with the levels of elements at their first measurement. A multivariable analysis using Weighted Quantile Sum Regressions showed that a weighted composite comprised of all the dietary elements had a significant association with PbB when adjusted for Pb in the diet and other covariates and also when adjusted for Pb in house dust; the latter was found to have the strongest association with PbB in earlier analyses. The highest weights were for Ca (0.29), Ni (0.27) and Zn (0.22); these results are generally consistent with those from the mixed model analyses.

A possible etiological factor in obesity: element status in blood and tooth of overweight versus normal-weight children

We aimed to assess element status in whole blood and tooth dentin and identify their correlations in overweight or obese children without additional metabolic risk factors. In a case-control study, 40 overweight and 80 normal weight children aged 6-10 years were enrolled. Samples of blood and tooth were collected. While all studied elements were similar in groups in univariate analysis, after adjustment for confounding factors, tooth Mn levels were lower and blood Zn levels were higher in the overweight/obese group (p = 0.049 and p = 0.032, respectively). A significant correlation in blood and tooth dentin levels of Sr and Zn was detected in both groups. In both biological substances, the concentrations of elements did not differ significantly in overweight children without metabolic comorbidities compared to healthy children of normal weight. Presence of low Mn levels in tooth dentin and high Zn levels in blood samples should be explored in further studies.

Elevated inflammatory Lp-PLA2 and IL-6 link e-waste Pb toxicity to cardiovascular risk factors in preschool children

Cardiovascular toxicity of lead (Pb) manifests primarily as an effect on blood pressure and eventual increased risk of atherosclerosis and cardiovascular events. Therefore, we investigated vascular inflammatory biomarkers and cardiovascular effects of Pb-exposed children. A total of 590 children (3-7 years old) were recruited from Guiyu (n = 337), an electronic waste (e-waste)-exposed group, and Haojiang (n = 253), a reference group, from November to December 2016. We measured child blood Pb levels (BPbs), and systolic and diastolic blood pressure. Pulse pressure was calculated for the latter two. Serum biomarkers including lipid profiles and inflammatory cytokines, and plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) were detected. Unadjusted regression analysis illustrated that higher ln-transformed BPb associated with lower systolic blood pressure and pulse pressure. After adjustment for various confounders, the relational degree of lnBPb and blood pressure measures became slightly attenuated or not significant. Elevated BPb was associated with higher Lp-PLA2, interleukin (IL)-6, triglycerides (TG) and lower high-density lipoprotein (HDL). Lp-PLA2 remained inversely associated with pulse pressure and HDL, but positively with ratios of total cholesterol to HDL (Tc/HDL) and low-density lipoprotein to HDL (LDL/HDL). IL-6 was associated negatively with systolic blood pressure, pulse pressure and HDL, and positively associated with TG, Tc/HDL and LDL/HDL. The mediation effect of biomarkers on the association of BPb with pulse pressure was insignificant except for Lp-PLA2. Available data supports the conclusion that e-waste-exposed children with higher BPbs and concomitant abnormal measures of cardiovascular physiology have an augmented prevalence of vascular inflammation, as well as lipid disorder.

Reference Intervals of and Relationships among Essential Trace Elements in Whole Blood of Children Aged 0-14 years

BACKGROUND

Essential trace elements are vital to human health. In this study, our aim was to establish reference intervals of and to evaluate relationships among Ca, Fe, Cu, Mg, and Zn for children.

METHODS

We collected blood samples of 3210 children aged 0-14 years from Lu'an, China, and concentrations of the above elements were determined by atomizer absorption spectrophotometer. A nonparametric method was used to establish the reference intervals.

RESULTS

Gender-related differences in concentrations were not statistically significant for the elements, except for Fe. There were strong positive and negative correlations between age and Fe (R = 0.305, P < 0.001), Zn (R = 0.573, P < 0.001); and age and Ca (R = -0.372, P < 0.001), Cu (R = -0.127, P < 0.001), respectively. Correlations between Ca-Mg (r = 0.222~0.384, P < 0.001), Fe-Mg (r = 0.495~0.614, P < 0.001), and Fe-Zn (r = 0.239~0.471, P < 0.001) were the strongest compared with others. In multivariable linear regression, after adjusted for confounding factors, the associations between Zn-Fe and Mg-Fe were the strongest with per concentration quintile increase of Fe caused Zn and Mg increasing by 4.19% (β = 0.041; 95% CI: 0.037, 0.045; P < 0.001) and 3.87% (β = 0.038; 95% CI: 0.036, 0.040; P < 0.001), respectively.

CONCLUSIONS

Gender- and age-based reference intervals of Ca, Fe, Cu, Mg, and Zn for children were established, and correlations between them were quite complex. More works are needed to illuminate these relationships and their impacts on children's health.

Abnormalities of Selected Trace Elements in Patients with Coronary Artery Disease

BACKGROUND

Coronary artery diseases are multifactorial, and over the last several decades particular consideration and research have been devoted to investigating the imbalance of patient elemental levels. Our current study aimed to investigate the comparative distribution of Ca, Mg, Fe, Zn, Cu, Co, Mn, Cr, Cd and Pb in the blood of coronary artery disease patients and healthy subjects.

METHODS

Blood samples collected from both groups were digested into a HNO3-HCLO4 (10:1 v/v) mixture in a microwave oven, followed by quantification of the elements by atomic absorption spectrometry.

RESULTS

The average levels of Pb and Cr were markedly higher (p < 0.001) while those of Ca, Fe, Cu and Mn were moderately higher (p < 0.05) in blood of the patients compared to the controls. However, correlation study showed divergent relationships between various elements in the blood of both groups. Multivariate cluster analysis revealed two major clusters of the elements for patients: Ca-Mg-Mn-Co-Cd and Pb-Cu-Fe-Zn-Cr; whereas three common groups were observed for controls: Ca-Mg-Zn-Cu, Cr-Mn-Fe and Co-Cd-Pb. Variations in the elemental levels were also observed to be associated with gender, habitat, food and smoking habits of the subjects.

CONCLUSIONS

Overall, the distribution, correlation and apportionment of elemental data indicated an imbalance of the toxic/essential elements in blood of the patients compared to the controls.

KEY WORDS

AAS; Blood; Cluster analysis; Coronary artery disease; Essential/toxic element.

Relationship of lead and essential elements in whole blood from school-age children in Nanning, China

OBJECTIVES

The aim of this study was to investigate blood lead level and its relationship to essential elements (zinc, copper, iron, calcium and magnesium) in school-age children from Nanning, China.

METHODS

A total of 2457 children aged from 6 to 14 years were enrolled in Nanning, China. The levels of lead (Pb), zinc (Zn), copper (Cu), iron (Fe), calcium (Ca) and magnesium (Mg) were determined by an atomic absorption spectrometer.

RESULTS

The mean blood lead level (BLL) was 57.21±35.00μg/L. 188 (7.65%) asymptomatic children had toxic lead level higher than 100μg/L. The school-age boys had similar lead level among different age groups, while the elder girls had less BLL. The blood Zn and Fe were found to be increased in the boys with elevated BLL, but similar trends were not observed in the girls. Positive correlations between Pb and Fe or Mg (r=0.112, 0.062, respectively, p<0.01) and a negative correlation between Pb and Ca (r=-0.047, p<0.05) were further established in the studied children.

CONCLUSIONS

Lead exposure in school-age children was still prevalent in Nanning. The boys and girls differed in blood levels of lead and other metallic elements. Lead exposure may induce metabolic disorder of other metallic elements in body.

Low concentration toxic metal mixture interactions: Effects on essential and non-essential metals in brain, liver, and kidneys of mice on sub-chronic exposure

The deleterious effects of long term exposure to individual toxic metals in low doses are well documented. There is however, a paucity of information on interaction of low dose toxic metal mixtures with toxic and essential metals. This study reports on interactions between low dose mixtures of lead (Pb), mercury (Hg), arsenic (As) and cadmium (Cd) and toxic and essential metals. For 120d, six groups of forty mice each were exposed to metal mixtures, however, the control group was given distilled water. Exposure to Pb+Cd increased brain Pb by 479% in 30d, whiles Pb+Hg+As+Cd reduced liver Hg by 46.5%, but increased kidney As by 130% in 30d. Brain Cu, increased by 221% on Pb+Hg+As+Cd exposure, however, liver Ca reduced by 36.1% on Pb+Hg exposure in 60-d. Interactions within metal mixtures were largely synergistic. Principal component analysis (PCA) showed that low dose metal exposures influenced greatly levels of Hg (in brain and liver) and As (brain). The influence exerted on essential metals was highest in liver (PC1) followed by kidney (PC2) and brain (PC3). Exposure to low dose metal mixtures affected homeostasis of toxic and essential metals in tissues of mice.

Associations between Blood Zinc Concentrations and Sleep Quality in Childhood: A Cohort Study

Little evidence is available regarding the relationship between zinc and sleep in school children. The present study aimed to examine the cross-sectional and longitudinal associations between blood zinc concentrations and sleep quality throughout childhood. A total of 1295 children from the Jintan Child Cohort in China were included in this study. Venous blood sample of zinc and subjective sleep data were collected when the children were at preschool age (3-5 years old) and early adolescence (11-15 years old). Odds ratios (ORs) reflect the odds of the sleep quality/subdomain being at a greater impairment level associated with 1 unit increase in log zinc concentration. Cross-sectional analyses showed negative correlation of blood zinc concentrations with insufficient sleep duration (OR = 0.432, p = 0.002), sleep disturbances (OR = 0.454, p = 0.009) and poor sleep quality (OR = 0.559, p = 0.049) in adolescence, but no association at preschool age (p > 0.05). Longitudinal analyses indicated that blood zinc concentrations at preschool age predict poor sleep efficiency (OR = 0.186, p = 0.000) and poor sleep quality (OR = 0.358, p = 0.020) in adolescence. Our findings suggest that sufficient zinc concentration is associated with good sleep quality, dependent on the developmental stage in childhood. Future interventional research is warranted to examine the short and long-term effect of zinc status on sleep heath.

Towards bio monitoring of toxic (lead) and essential elements in whole blood from 1- to 72-month old children: a cross-sectional study

OBJECTIVES

Minerals such as zinc, copper, selenium, calcium, and magnesium are essential for normal human development and functioning of the body. They have been found to play important roles in immuno-physiologic functions. The study is to evaluate the distribution and correlation of nonessential (lead) and essential elements in whole blood from 1- to 72-month old children.

METHODS

The cross-sectional study was performed in 1551 children. Six element concentrations, including copper (Cu), zinc (Zn), calcium (Ca), magnesium (Mg), iron (Fe) and lead (Pb) in the blood were determined by atomic absorption spectrometry. Distributions and correlations of trace elements in different age groups were analyzed and compared. A Pearson correlation controlled for age and gender was used to assess the relationship of non essential (lead) and essential elements.

RESULTS

Levels of copper and magnesium were 18.09 ± 4.42 µmol/L and 1.42 ± 0.12 mmol/L, respectively. 6.04% of all children showed copper levels below the normal threshold, the levels of Magnesium were stable in different age groups. Though the overall mean blood zinc and iron concentrations (61.19 ± 11.30 µmol/L and 8.24 ± 0.59 mmol/L, respectively) gradually increased with age and the overall deficiency levels (24.1% and 36.0%, respectively) decreased with age, zinc and iron deficiencies were still very stable. Controlling for gender and age, significant positive correlations were found when comparing copper to zinc, calcium, magnesium, and iron ((r = 0.333, 0.241, 0.417, 0.314 ,p < 0.01); zinc to magnesium and iron (r = 0.440, 0.497p < 0.01); and magnesium to Calcium and iron (r = 0.349, 0.645, p < 0.01). The overall mean blood lead levels (41.16 ± 16.10) were relatively unstable among different age groups. The prevalence of lead intoxication in all children was 1.3% .Calcium levels decreased gradually with age, with an overall concentration of 1.78 ± 0.13 mmol/L.

CONCLUSION

Significant negative correlations were also noted between Pb and Zn, Fe (r = -0.179, -0.124.p < 0.01) .The importance of calcium deficiency and supplementation is well realized, but the severity of iron and zinc deficiency is not well recorded. The degree of lead intoxication in all the children studied was low; The established reference intervals for Cu, Zn, Ca and Mg provide an important guidance for the reasonable supplementation of essential elements during different age groups.

Blood lead level and its relationship to essential elements in preschool children from Nanning, China

OBJECTIVE

Our study aimed to assess the distribution of blood lead level and its relationship to essential elements in preschool children in an urban area of China.

DESIGN AND METHODS

A total of 6741 children aged 0- to 6-year-old were recruited. Levels of lead, zinc, copper, iron, calcium, and magnesium in whole blood samples were determined using atomic absorption spectrometry.

RESULTS

The mean blood lead level (BLL) and the prevalence of BLL≥10μg/dl (5.26±4.08μg/dl and 6.84%, respectively) increased with age gradually, and there was a gender-difference for blood lead, copper, zinc and iron levels. Compared with the group of children who had BLLs<5μg/dl, the groups of 5≤BLLs<10μg/dl and 10≤BLLs<15μg/dl showed higher blood zinc, iron and magnesium levels, and a lower blood calcium level. A positive correlation of lead with zinc, iron and magnesium, and a negative correlation of lead with calcium were found in the group of children with BLL<5μg/dl.

CONCLUSION

Age- and gender-differences were found when assessing the BLL and intoxication prevalence in preschool children. Metabolic disorder of essential elements was found even with a low level of lead exposure.

Iron deficiency increases blood concentrations of neurotoxic metals in children

Iron deficiency affects approximately one-third of the world's population, occurring most frequently in children aged 6 months to 3 years. Mechanisms of iron absorption are similar to those of other divalent metals, particularly manganese, lead, and cadmium, and a diet deficient in iron can lead to excess absorption of manganese, lead, and cadmium. Iron deficiency may lead to cognitive impairments resulting from the deficiency itself or from increased metal concentrations caused by the deficiency. Iron deficiency combined with increased manganese or lead concentrations may further affect neurodevelopment. We recently showed that blood manganese and lead concentrations are elevated among iron-deficient infants. Increased blood manganese and lead levels are likely associated with prolonged breast-feeding, which is also a risk factor for iron deficiency. Thus, babies who are breast-fed for prolonged periods should be given plain, iron-fortified cereals or other good sources of dietary iron.

Iron deficiency increases blood cadmium levels in adolescents surveyed in KNHANES 2010-2011

Discrepancies have been reported in the relationships between iron and cadmium concentrations. The distribution of blood cadmium concentrations was assessed in a representative sample of Korean adolescents participating in the Korean National Health and Nutritional Examination Survey (KNHANES) 2010-2011, and the association between blood cadmium and iron concentrations was determined. This study was based on data from KNHANES, in which a rolling sampling design was used to perform a complex, stratified, multistage probability cluster survey of a representative sample of the noninstitutionalized civilian population in South Korea. Serum ferritin was categorized as low (<15.0 μg/L), low normal (15.0-<30.0 μg/L for girls, 15.0-<50.0 μg/L for boys), or normal (≥30.0 μg/L for girls, ≥50.0 μg/L for boys), and the association between serum ferritin and blood cadmium concentrations was assessed after adjustment for various demographic and lifestyle factors. The geometric mean (GM) of blood cadmium was significantly higher among both boys and girls in the low than in the normal ferritin group. After controlling for covariates, multiple regression analysis showed that blood cadmium concentration was inversely correlated with serum ferritin concentration in both boys and girls. In conclusion, iron deficiency is associated with increased blood cadmium concentrations in a representative sample of Korean adolescents, as evaluated in KNHANES.

Association of blood lead level with neurological features in 972 children affected by an acute severe lead poisoning outbreak in Zamfara State, northern Nigeria

BACKGROUND

In 2010, Médecins Sans Frontières (MSF) investigated reports of high mortality in young children in Zamfara State, Nigeria, leading to confirmation of villages with widespread acute severe lead poisoning. In a retrospective analysis, we aimed to determine venous blood lead level (VBLL) thresholds and risk factors for encephalopathy using MSF programmatic data from the first year of the outbreak response.

METHODS AND FINDINGS

We included children aged ≤5 years with VBLL ≥45 µg/dL before any chelation and recorded neurological status. Odds ratios (OR) for neurological features were estimated; the final model was adjusted for age and baseline VBLL, using random effects for village of residence. 972 children met inclusion criteria: 885 (91%) had no neurological features; 34 (4%) had severe features; 47 (5%) had reported recent seizures; and six (1%) had other neurological abnormalities. The geometric mean VBLLs for all groups with neurological features were >100 µg/dL vs 65.9 µg/dL for those without neurological features. The adjusted OR for neurological features increased with increasing VBLL: from 2.75, 95%CI 1.27-5.98 (80-99.9 µg/dL) to 22.95, 95%CI 10.54-49.96 (≥120 µg/dL). Neurological features were associated with younger age (OR 4.77 [95% CI 2.50-9.11] for 1-<2 years and 2.69 [95%CI 1.15-6.26] for 2-<3 years, both vs 3-5 years). Severe neurological features were seen at VBLL <105 µg/dL only in those with malaria.

INTERPRETATION

Increasing VBLL (from ≥80 µg/dL) and age 1-<3 years were strongly associated with neurological features; in those tested for malaria, a positive test was also strongly associated. These factors will help clinicians managing children with lead poisoning in prioritising therapy and developing chelation protocols.

Iron Deficiency is Not Associated with Increased Blood Cadmium in Infants

OBJECTIVES

To determine whether blood cadmium concentration is elevated in iron-deficient infants.

METHODS

Blood cadmium and serum ferritin concentrations, serum iron/total iron-binding capacity (Fe/TIBC) and complete blood counts were measured in 31 iron deficient and 36 control infants, aged 6-24 months. All 31 iron-deficient infants received iron supplementation for 1-6 months.

RESULTS

Blood cadmium concentrations were measured again in 19 of the iron deficient infants after their ferritin levels returned to the normal range. The mean blood cadmium concentration did not differ significantly in iron deficient and control infants. The mean blood cadmium concentration in the 19 iron-deficient infants was not significantly altered by ferric hydroxide treatment, while their hemoglobin, ferritin, and Fe/TIBC (%) concentrations were significantly higher after than before treatment.

CONCLUSION

These findings indicate that iron deficiency does not increase blood cadmium concentrations in infants, in contrast with the effects of iron deficiency on manganese and lead concentrations.