Alteration of the number and percentage of innate immune cells in preschool children from an e-waste recycling area

E-waste: mechanisms of toxicity and safety testing

Currently, information on the toxicity profile of the majority of the identified e-waste chemicals, while extensive and growing, is admittedly fragmentary, particularly at the cellular and molecular levels. Furthermore, the toxicity of the chemical mixtures likely to be encountered by humans during and after informal e-waste recycling, as well as their underlying mechanisms of action, is largely unknown. This review paper summarizes state-of-the-art knowledge of the potential underlying toxicity mechanisms associated with e-waste exposures, with a focus on toxic responses connected to specific organs, organ systems, and overall effects on the organism. To overcome the complexities associated with assessing the possible adverse outcomes from exposure to chemicals, a growing number of new approach methodologies have emerged in recent years, with the long-term objective of providing a human-based and animal-free system that is scientifically superior to animal testing, more effective, and acceptable. This encompasses a variety of techniques, typically regarded as alternative approaches for determining chemical-induced toxicities and holds greater promise for a better understanding of key events in the metabolic pathways that mediate known adverse health outcomes in e-waste exposure scenarios. This is crucial to establishing accurate scientific knowledge on mixed e-waste chemical exposures in shorter time frames and with greater efficacy, as well as supporting the need for safe management of hazardous chemicals. The present review paper discusses important gaps in knowledge and shows promising directions for mechanistically anchored effect-based monitoring strategies that will contribute to the advancement of the methods currently used in characterizing and monitoring e-waste-impacted ecosystems.

Impact of heavy metals exposure on herpes simplex virus type I infection: A population-based cross-sectional study

This study aims to investigate the significant relationship between serum heavy metals (lead [Pb], cadmium [Cd], mercury [Hg]) and the risk of herpes simplex virus type 1 (HSV-1) infection. Data were derived from the National Health and Nutrition Examination Survey (NHANES) conducted in the United States from 2007 to 2016. This nationally representative survey, conducted by the National Center for Health Statistics, assessed the health status of participants through interviews, physical examinations, and laboratory tests. After excluding participants lacking serum Pb, Cd, and Hg data, as well as those missing HSV-1 testing data and pregnant women, the analysis included 13 772 participants, among whom 3363 were adolescents. A survey-weighted multivariate logistic regression model was used to evaluate the association between heavy metal exposure and the risk of HSV-1 infection, and to explore the dose-response relationship between them. In adults and adolescents, serum concentrations of Pb and Cd were higher in those infected with HSV-1 than in those not infected. However, an increase in serum Hg concentration was observed only in infected adolescents. After adjusting for potential confounders, elevated serum Pb and Cd concentrations in adults were associated with an increased risk of HSV-1 infection. Higher serum Pb and Cd concentrations were associated with an increased risk of HSV-2 infection, irrespective of HSV-1 infection status. In adults, serum concentrations of Pb and Hg showed an approximately linear relationship with HSV-1 infection risk (p for nonlinearity > 0.05), whereas the dose-response relationship between serum Cd concentration and HSV-1 infection was nonlinear (p for nonlinearity = 0.004). In adolescents, serum concentrations of heavy metals (Pb, Cd, Hg) showed an approximately linear relationship with HSV-1 infection (p for nonlinearity > 0.05). Furthermore, the study examined the relationship between serum heavy metal levels and the risk of HSV-1 infection across different genders, races, income levels, weight statuses, and immune statuses. In conclusion, there is a significant association between serum heavy metal concentrations and HSV-1 infection, which warrants further investigation into the causal relationship between them.

Systematic literature review of heavy metal contamination of the Nigerian environment from e-waste management: Associated health and carcinogenic risk assessment

E-waste -the aftermath of large amount of electrical and electronic equipment ferried into Africa from which Nigeria receives a significant chunk, is composed of components known to be hazardous to health. Composition of series of heavy metals (HMs) in e-waste is traceable to many health conditions including cancer which is hitherto incompletely understood. This study harmonizes primary data on HMs from e-waste in different Nigerian environmental media including the air, soil, surface dust, water and plant. We estimated the possible health implications, single and aggregative soil and water pollution indices both in adult and children categories, carcinogenic and non-carcinogenic risks secondary to HM exposure and mapped out the possible mechanism of carcinogenesis. Analysis showed that soil, water, surface dust and plant matrices in Nigerian environment are variedly but considerably contaminated with combination of HMs. The significantly high values of the hazard quotient and hazard index of both water and surface dust matrices are indicative of adverse health effect of the non-carcinogenic risk. The highest HQ is generated by Pb and Cr through dermal exposure to soil and surface dust with mean values of 1718.48, 1146.14, 1362.10 and 1794.61 respectively among Nigerian children followed by the oral exposure. This pattern of observation is similar to that obtained for adult category. HI due to Pb and Cr in soil constitutes the highest HI (2.05E+03 and 1.18E+03 respectively) followed by surface dust. However, this study precipitates the observation that children are more at health risk than adults in contaminated environment. Carcinogenic risk also follows the same pattern of expression in the Nigerian environment. We conclude that exposure to e-waste poses significant carcinogenic and non-carcinogenic health risks and the induction of toxicity may be mediated via DNA damage, oxidative stress and inflammatory/immune cells dysfunction in Nigerian environment.

Process intensification for sustainable extraction of metals from e-waste: challenges and opportunities

The electrical and electronic waste is expected to increase up to 74.7 million metric tons by 2030 due to the unparalleled replacement rate of electronic devices, depleting the conventional sources of valuable metals such as rare earth elements, platinum group metals, Co, Sb, Mo, Li, Ni, Cu, Ag, Sn, Au, and Cr. Most of the current techniques for recycling, recovering, and disposing of e-waste are inappropriate and therefore contaminate the land, air, and water due to the release of hazardous compounds into the environment. Hydrometallurgy and pyrometallurgy are two such conventional methods used extensively for metal recovery from waste electrical and electronic equipment (WEEE). However, environmental repercussions and higher energy requirements are the key drawbacks that prevent their widespread application. Thus, to ensure the environment and elemental sustainability, novel processes and technologies must be developed for e-waste management with enhanced recovery and reuse of the valued elements. Therefore, the goal of the current work is to examine the batch and continuous processes of metal extraction from e-waste. In addition to the conventional devices, microfluidic devices have been also analyzed for microflow metal extraction. In microfluidic devices, it has been observed that the large specific surface area and short diffusion distance of microfluidic devices are advantageous for the efficient extraction of metals. Additionally, cutting-edge technologies have been proposed to enhance the recovery, reusability, and recycling of e-waste. The current study may support decision-making by researchers in deciding the direction of future research and moving toward sustainable development.

Naphthaleneoxypropargyl-Containing Piperazine as a Regulator of Effector Immune Cell Populations upon an Aseptic Inflammation

This study investigated the effects of aseptic inflammation and heavy metal exposure on immune responses, as well as the potential immunomodulatory properties of the newly synthesized 1-[1-(2,5-dimethoxyphenyl)-4-(naphthalene-1-yloxy)but-2-ynyl]-4-methylpiperazine complexed with β-cyclodextrin (β-CD). Aseptic inflammation was induced by a subcutaneous injection of turpentine in rats, while heavy metal exposure was achieved through a daily administration of cadmium chloride and lead acetate. The levels of immune cell populations, including cytotoxic T lymphocytes (CTL), monocytes, and granulocytes, were assessed in the spleen. The results showed that aseptic inflammation led to decreased levels of CTL, monocytes, and granulocytes on the 14th day, indicating an inflammatory response accompanied by a migration of effector cells to the inflamed tissues. The exposure to cadmium chloride and lead acetate resulted in systemic immunotoxic effects, with reduced levels of B cells, CD4+ Th cells, monocytes, and granulocytes in the spleen. Notably, piperazine complexed with β-CD (the complex) exhibited significant stimulatory effects on CD4+, CD8+, and myeloid cell populations during aseptic inflammation, even in the presence of heavy metal exposure. These findings suggest the potential immunomodulatory properties of the complex in the context of aseptic inflammation and heavy metal exposure.

Chronic exposure to electronic waste poses risk to liver toxicity with molecular interaction of GSTM1, GSTT1 null variants, and GSTP1

Chronic exposure to electronic waste (e-waste) is becoming a serious concern for health among individuals exposed to it. E-waste has been reported to contain heavy metals, trace elements, and persistent organic pollutants which can trigger health issues through different biological pathways. The liver is a major metabolic and detoxifying organ in the body. Glutathione S-transferase (GST) is a liver enzyme for phase II detoxification that catalyzes glutathione (GSH) conjugation with environmental pollutants. This research aimed to investigate the liver toxicity caused by long-term exposure to e-wastes, exploring the potential association with null variants of GSTT1 and GSTMI, as well as GSTP1. The study was designed as a cross-sectional investigation, in which 256 adult males who were chronically exposed to e-waste and 200 non-exposed control participants, matched for age and gender, were recruited randomly. Standard colorimetric and enzymatic methods were used to analyze biochemical parameters such as serum alkaline phosphatase (ALP), alanine transaminase (ALT), total bilirubin (T. Bil), albumin, and reduced glutathione. Genotypic analysis of the null variant GSTM1, GSTT1, and GSTP1 genes was conducted by standard molecular methods. The study findings indicated a notable surge in ALP, ALT, and albumin levels while T. Bil and GSH levels showed a reduction, suggesting a potential risk of liver toxicity. Additionally, analysis of GSTM1, GSTT1, and GSTP1 genotypes revealed a possible association with GSH levels and the hepatotoxicity risk. The study concluded that the individuals exposed to e-waste exhibited dysregulation of liver enzymes that results in liver toxicity. Moreover, analysis of GSTM1, GSTT1, and GSTP1 at a molecular level revealed that these genes could potentially serve as risk factors for liver toxicity in e-waste chronic exposure.

Blood lead levels of children exposed to e-waste: a systematic review and meta-analysis

Blood lead levels (BLLs) have been decreasing worldwide for decades. However, systematic reviews and quantitative syntheses of BLLs in electronic waste (e-waste)-exposed children are lacking. To summarize temporal trend of BLLs among children in e-waste-recycling areas. Fifty-one studies met the inclusion criteria and included participants from six countries. Meta-analysis was performed using the random-effects model. Results showed that among e-waste-exposed children, the total geometric mean (GM) BLL was 7.54 μg/dL (95% CI: 6.77, 8.31). Children's BLLs displayed a decreasing temporal trend, from 11.77 μg/dL in phase I (2004-2006) to 4.63 μg/dL in phase V (2016-2018). Almost 95% of eligible studies found that children exposed to e-waste had significantly higher BLLs than reference groups. The difference of children's BLLs between the exposure group and the reference group was from 6.60 μg/dL (95% CI: 6.14, 7.05) in 2004 to 1.99 μg/dL (95% CI: 1.61, 2.36) in 2018. For subgroup analyses, except for Dhaka and Montevideo, the BLLs of children from Guiyu in the same survey year were higher than those of children from other regions. Our findings indicate that the gap between BLLs of children exposed to e-waste and those of reference group children is closing, and we appeal that the critical value for blood lead poisoning in children should be lowered in key e-waste-dismantling areas of developing countries, such as Guiyu.

Cadmium, Lead, Chronic Physiological Stress and Endometrial Cancer: How Environmental Policy Can Alter the Exposure of At-Risk Women in the United States

The health and life outcomes of individuals are intertwined with the context in which they grow and live. The totality of exposures one experiences affects health in the short term and throughout the life course. Environmental exposure to multiple contaminants can increase stress levels in individuals and neighborhoods with psychosocial stressors such as crime, drug and alcohol misuse, and violence also taking a toll on individual and neighborhood wellbeing. In addition, the availability, organization, and quality of local institutions and infrastructure all affect health in the short and long term. The role of these factors in endometrial cancer will be explored in this paper. In addition, policy implications regarding lead, chronic physiological stress, and endometrial cancer will be explored to ascertain the impact of these factors on at-risk women.

Epidemiological evidence for the effect of environmental heavy metal exposure on the immune system in children

Heavy metals exist widely in daily life, and exposure to heavy metals caused by environmental pollution has become a serious public health problem worldwide. Due to children's age-specific behavioral characteristics and imperfect physical function, the adverse health effects of heavy metals on children are much higher than in adults. Studies have found that heavy metal exposure is associated with low immune function in children. Although there are reviews describing the evidence for the adverse effects of heavy metal exposure on the immune system in children, the summary of evidence from epidemiological studies involving the level of immune molecules is not comprehensive. Therefore, this review summarizes the current epidemiological study on the effect of heavy metal exposure on childhood immune function from multiple perspectives, emphasizing its risks to the health of children's immune systems. It focuses on the effects of six heavy metals (lead (Pb), cadmium (Cd), arsenic (As), mercury (Hg), nickel (Ni), and manganese (Mn)) on children's innate immune cells, lymphocytes and their subpopulations, cytokines, total and specific immunoglobulins, and explores the immunotoxicological effects of heavy metals. The review finds that exposure to heavy metals, particularly Pb, Cd, As, and Hg, not only reduced lymphocyte numbers and suppressed adaptive immune responses in children, but also altered the innate immune response to impair the body's ability to fight pathogens. Epidemiological evidence suggests that heavy metal exposure alters cytokine levels and is associated with the development of inflammatory responses in children. Pb, As, and Hg exposure was associated with vaccination failure and decreased antibody titers, and increased risk of immune-related diseases in children by altering specific immunoglobulin levels. Cd, Ni and Mn showed activation effects on the immune response to childhood vaccination. Exposure age, sex, nutritional status, and co-exposure may influence the effects of heavy metals on immune function in children.

Urban particulate air pollution linked to dyslipidemia by modification innate immune cells

Air particulate matter (PM) is an essential risk factor for lipid metabolism disorders. However, the underlying mechanism remains unclear. In this cross-sectional study, 216 healthcare workers were recruited to estimate the associations among the daily exposure dose (DED) of air PM, innate immune cells, and plasma lipid levels. All participants were divided into two groups according to the air particulate combined DED (DED-PMC). The peripheral white blood cell counts, lymphocyte counts, and monocyte counts and percentages were higher in the higher-exposure group (HEG) than in the lower-exposure group (LEG), whereas the percentage of natural-killer cells was lower in the HEG than in the LEG. The plasma concentrations of the total cholesterol, triglycerides, LDL-C, and apolipoprotein B were higher in the HEG than in the LEG, whereas the HDL-C and apolipoprotein A1 were lower in the HEG than in the LEG. A dose-effect analysis indicated that when the DED of the air PM increased, there were increased peripheral monocyte counts and percentages, a decreased NK cell percentage, elevated plasma concentrations of total cholesterol, triglycerides, LDL-C, and apolipoprotein B, and reduced plasma levels of HDL-C and apolipoprotein A1. In addition, the modification of the innate immune cells was accompanied by alterations in the plasma lipid levels in a dose-dependent manner. Mediation effect analysis suggested innate immune cells were the potential mediators for the associations among air PM exposure on abnormal lipid metabolism. These results indicated that chronic exposure to air PM may disturb lipid metabolism by altering the distribution of innate immune cells in the peripheral blood, ultimately advancing cardiovascular disease risk.

The Cd/Zn Axis: Emerging Concepts in Cellular Fate and Cytotoxicity

Cadmium (Cd) is a toxic and carcinogenic substance that is present in the natural environment. The underlying biomolecular mechanisms of Cd toxicity are not completely understood, and it continues to be a significant research target due to its impact on public health. The primary routes of exposure are through ingestion of contaminated food and water and inhalation. Cd's long biological half-life of 10-30 years allows it to accumulate in the body, leading to organ dysfunction notably in the kidney, liver, bone, and lungs. Cd has similar biochemical characteristics to Zinc (Zn). It shares the import transporters, ZIP8 and ZIP14, to enter the cells. This competitive behavior can be observed in multiple instances throughout the progression of Cd toxicity. Future studies on the biochemical interactions of Cd and Zn will elucidate the potential protective effects of Zn supplementation in reducing the effects of Cd toxicity. In addition, research can be focused on discovering key proteins and effective pathways for Cd elimination that confer fewer adverse effects than current antioxidant therapies.

Evaluating postnatal exposure to six heavy metals in a Chinese e-waste recycling area

This study is the first to assess postnatal exposure to heavy metals using breast milk in an electronic waste (e-waste) recycling area. From January to April 2021, 102 and 97 breastfeeding women were recruited from an e-waste recycling area and a control area, respectively. Four weeks after delivery, medical staff collected 20 mL of breast milk from each participant. The breast milk was tested for six heavy metals (lead, cadmium, chromium, arsenic, copper, and manganese) using inductively coupled plasma mass spectrometry (ICP-MS). The estimated daily intake (EDI) of infants during breastfeeding was calculated to assess the impact of postnatal exposure to heavy metals on infant health. The concentrations of chromium and lead in the breast milk were significantly higher in the e-waste recycling area than in the control area. Chromium concentrations in breast milk was 34.3%, exceeding the permissible limits set by the World Health Organization (WHO), in the e-waste recycling area, which is 16 times higher than that in the control areas. The EDIs of lead and chromium in the e-waste area were twice as those in the control area. This strongly indicates that the potential impact of postnatal exposure to lead and chromium on infant and child health in e-waste recycling areas cannot be ignored. Infants and children in e-waste recycling areas are at risk of long-term exposure to heavy metals. Therefore, ongoing health monitoring is necessary.

Safety Concerns for the Management of End-of-Life Lithium-Ion Batteries

Lithium-ion battery (LIB) usage is growing dramatically worldwide. Relatedly, there is a need for the management of end-of-life (EOL) LIBs. EOL requires closed-loop systems and supply chains. Although many studies related to managing EOL in closed-loop supply chains exist, one especially pernicious issue is overlooked-safety. This study seeks to address this major safety oversight for EOL LIBs using closed-loop supply chains that are critical to a larger circular economy environment. The evaluation is completed along a technology-organization-environment (TOE) framework; potential research directions for mitigating safety issues are part of the analysis of this study. Specific and general research questions pertaining to secure management of EOL LIBs are put forward to help advance academic research. Practical concerns are also described for policymakers and organizations. This study reveals implications of these questions for the intersection of materials science, supply chain management, and fire-protection engineering.

The association of co-exposure to polycyclic aromatic hydrocarbon and phthalates with blood cell-based inflammatory biomarkers in children: A panel study

The association of co-exposure to polycyclic aromatic hydrocarbons (PAHs) and phthalates (PAEs) with blood cell-based inflammatory biomarkers is largely unknown. We conducted a panel study of 144 children aged 4-12 years, with up to 3 repeated visits across 3 seasons. For each visit, we collected the first-morning urine for 4 consecutive days and fasting blood on the day of physical examination. We developed a gas chromatography/tandem mass spectrometry method to detect the metabolites of 10 PAHs (OH-PAHs) and 10 PAEs (mPAEs) in urine samples. We employed linear mixed-effects models to evaluate the individual associations of each OH-PAH and mPAE with blood cell-based inflammatory biomarkers over different lag times. Bayesian kernel machine regression (BKMR) and quantile g-computation were used to evaluate the overall associations of OH-PAHs and mPAEs mixtures with blood cell-based inflammatory biomarkers. After multiple adjustments, we found positive associations of summed hydroxylphenanthrene (∑OHPHE), summed OH-PAHs, and mono-n-butyl phthalate with inflammatory biomarkers such as neutrophil count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and the systemic immune-inflammation index (SII) at lag 0 (the day of physical examination). Each 1% increase in ∑OHPHE was related to a 0.18% (95% confidence interval: 0.10%, 0.25%) increase in SII, which was the strongest among the above associations. The results of BKMR and quantile g-computation suggested that co-exposure to PAHs and PAEs mixture was associated with an elevated white blood cell count, neutrophil count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and SII, to which ∑OHPHE and 1-hydroxypyrene (1-OHPYR) might be the major contributors. In addition, gender and age modified the associations of ∑OHPHE and 1-OHPYR with inflammatory biomarkers, where girls and younger children were more susceptible. In conclusion, co-exposure to PAHs and PAEs was associated with elevated inflammation in children, in which ∑OHPHE and 1-OHPYR might play important roles.

Pb and Cd exposure linked with Il-10 and Il-13 gene polymorphisms in asthma risk relevant immunomodulation in children

Genetic variants and environmental factor of heavy metal exposure accelerate the risk of immune-mediated respiratory diseases, including asthma in children. This study aims to investigate the effects and interaction of Pb, Cd exposure from e-waste and interleukin (IL)-10, IL-13 gene polymorphisms on interleukin expressions in children. Pb, Cd levels, Il-10 (rs1800871, rs1800872, rs1800896) and Il-13 (rs20541, rs1800925) polymorphisms were determined in blood or urine of 155 children (75 from e-waste-exposed area, Guiyu and 80 from reference area, Haojiang). Blood Pb and urine Cd levels of e-waste-exposed children were both higher (mean: 5.89 vs. 3.35 μg/dL; 6.04 vs. 1.82 μg/g, both P < 0.05). Exposed children had a larger proportion of high blood Pb level (> 5.00 μg/dL) (66.67% vs. 4.11%, P < 0.001), but they had no statistically different proportion of high urine Cd level (> 1.00 μg/g creatinine). Median levels of IL-13 decreased (3.674 vs. 4.410 ng/L, P < 0.01), but of IL-10 did not vary in serum of exposed children. The analyses revealed no significant associations of Pb or Cd with Il-10 or Il-13 gene polymorphisms. The high blood Pb and urine Cd level were respectively associated with the low IL-13 ( < 3.696 ng/L) and low IL-10 ( < 0.361 ng/L) level, after adjustment for children's age, gender, and BMI (both P ≤ 0.05). Children homozygous carrying major allele for Il-13 (rs20541 and rs1800925) had additive interactions with high blood Pb level on low IL-13 expression (OR = 5.37, 95% CI: 1.96, 14.73 and OR = 8.45, 95% CI: 2.61, 27.32; both P ≤ 0.001). In contrast, no interaction was observed amongst Pb or Cd with Il-10 gene polymorphisms on its expression. Our findings suggest that Pb exposure interacting with Il-13 gene polymorphisms negatively regulates IL-13 expression, which may pose a risk to abnormal asthma-relevant immunomodulation in preschool children.

Factors associated with blood lead levels in children in Shenyang, China: a cross-sectional study

Background

Although blood lead levels (BLLs) in children are gradually decreasing, low-concentration lead exposure can still exert adverse effects. We studied the factors that affect BLLs in children in Shenyang, China.

Methods

We conducted a cross-sectional study by administering structured questionnaires on family demographics and food intake. The concentrations of lead in venous blood were determined by graphite furnace atomic absorption spectrometry.

Results

A total of 273 children aged 1–6 years were enrolled. The geometric mean (geometric standard deviation) of BLLs was 24.94 (12.70) μg/L in boys and 23.75 (11.34) μg/L in girls. The prevalence of BLLs of ≥35 μg/L was 22.7% and was mainly observed in children aged under 3 years. Often hand washing before meals was protective against BLLs ≥20 μg/L (adjusted OR: 0.427, 95%CI: 0.238–0.767, p = 0.004). Consumption of puffed grains and eggs had an adjusted OR (95%CI) for BLLs ≥20 μg/L of 1.714 (1.012–2.901) (p = 0.045) and 1.787 (1.000–3.192) (p = 0.050), respectively.

Conclusions

BLLs of children in Shenyang are still higher than in developed countries. Consumption of puffed grains and eggs is associated with higher BLLs. Often hand washing before meals may be protective against high BLLs.

Health consequences of exposure to e-waste: an updated systematic review

Electronic waste (e-waste) contains numerous chemicals harmful to human and ecological health. To update a 2013 review assessing adverse human health consequences of exposure to e-waste, we systematically reviewed studies reporting effects on humans related to e-waste exposure. We searched EMBASE, PsycNET, Web of Science, CINAHL, and PubMed for articles published between Dec 18, 2012, and Jan 28, 2020, restricting our search to publications in English. Of the 5645 records identified, we included 70 studies that met the preset criteria. People living in e-waste exposed regions had significantly elevated levels of heavy metals and persistent organic pollutants. Children and pregnant women were especially susceptible during the critical periods of exposure that detrimentally affect diverse biological systems and organs. Elevated toxic chemicals negatively impact on neonatal growth indices and hormone level alterations in e-waste exposed populations. We recorded possible connections between chronic exposure to e-waste and DNA lesions, telomere attrition, inhibited vaccine responsiveness, elevated oxidative stress, and altered immune function. The existence of various toxic chemicals in e-waste recycling areas impose plausible adverse health outcomes. Novel cost-effective methods for safe recycling operations need to be employed in e-waste sites to ensure the health and safety of vulnerable populations.

Human Body Burden of Heavy Metals and Health Consequences of Pb Exposure in Guiyu, an E-Waste Recycling Town in China

Guiyu accommodates millions of tons of e-waste from overseas and domestic sources each year and is notorious for its e-waste dismantling industry. As a consequence, Guiyu has been described as "the world's most toxic place" and "junk town". Informal e-waste recycling activities have caused severe pollution to the local environment and are associated with extensive health problems to the residents. This review provides updated insights on the body burden of heavy metals derived from e-waste and health outcomes resulted from lead (Pb) exposure. The review identified that Guiyu has been highly contaminated by heavy metals, especially Pb. Excessive exposure to Pb has been associated with multi-system and long-term effects in neonates and children, covering nervous, cardiovascular, adaptive immune, and hematologic systems as well as chromosome and DNA damage. Our review indicates strong associations that emphasize the need to develop strong regulations for prevention of exposure and health consequences in Guiyu and similar sites around the world.

High serum IgG subclass concentrations in children with e-waste Pb and Cd exposure

Immunoglobulin G (IgG) is the predominant component of the humoral immune system. Epidemiological studies have shown that lead (Pb) or cadmium (Cd) exposure is associated with changes in human IgG levels, and alteration of IgG subclass production can be induced by differential modulation of Th1 and Th2 cytokines caused by Pb or Cd exposure. However, no study has focused on the adverse effects of Pb and Cd co-exposure on IgG subclass production by regulating Th1/Th2 cytokines in children living in electronic waste (e-waste) areas. This study aims to analyze the associations among Pb and Cd in blood, Th1/Th2 cytokines, and IgG subclasses in serum from children. A total of 181 healthy, 2- to 7-year-old children were examined. Of them, 104 were from Guiyu (e-waste exposed group), and the rest were from Haojiang (reference group) in China. Pb and Cd levels in whole blood, cytokines, and IgG subclasses in serum were determined. Exposed children had higher levels of blood Pb and Cd, serum IgG1, IgG1 + IgG2, serum Th1 cytokine interferon-γ (IFN-γ) and lower levels of the Th2 cytokine interleukin (IL)-13. Increased blood Pb levels were positively associated with serum levels of IFN-γ, and negatively associated with serum levels of IL-13. Adjusted linear regression analysis showed that serum levels of IL-13 were negatively associated with serum levels of IgG1 and IgG1 + IgG2. Mediation models indicated that IL-13 had significant mediating effects on the relationships between blood Pb levels and serum IgG1, as well as between blood Pb levels and serum IgG1 + IgG2. Increased blood Cd levels were positively associated with serum levels of IgG1. Our results show heavy metal (particularly Pb) exposure may affect IgG subclass production by regulating Th1/Th2 cytokines in exposed children, thus providing new evidence for a relationship between humoral immune function and environmental exposure.

Relations of blood lead levels to echocardiographic left ventricular structure and function in preschool children

Lead (Pb) has been proved to exert adverse effect on human cardiovascular system. However, the cardiotoxicity of Pb on children is still unclear. The aim of this study was to evaluate left ventricular (LV) structure and function, by using echocardiographic indices, in order to elucidate the effect of Pb on low-grade inflammation related to left ventricle in healthy preschool children. We recruited a total of 486 preschool children, 310 from Guiyu (e-waste-exposed area) and 176 from Haojiang (reference area). Blood Pb levels, complete blood counts, and LV parameters were evaluated. Associations between blood Pb levels and LV parameters and peripheral leukocyte counts were analyzed using linear regression models. The median blood level of Pb and the counts of white blood cells (WBCs), monocytes, and neutrophils were higher in exposed group. In addition, the exposed group showed smaller left ventricle (including interventricular septum, LV posterior wall, and LV mass index) and impaired LV systolic function (including LV fractional shortening and LV ejection fraction) regardless gender. After adjustment for confounding factors, elevated blood Pb levels were significantly associated with higher counts of WBCs and neutrophils, and lower levels of LV parameters. Furthermore, counts of WBCs, monocytes, and neutrophils were negatively correlated with LV parameters. Taken together, smaller left ventricle and impaired systolic function were found in e-waste-exposed children and associated with chronic low-grade inflammation and elevated blood Pb levels. It indicates that the heart health of e-waste-exposed children is at risk due to the long-term environmental chemical insults.

Associations between prenatal and postnatal lead exposure and preschool children humoral and cellular immune responses

Studies have shown that lead exposure affected the immune function, but few studies have examined the relationships between in utero lead exposure, a sensitive period that is important for immune development, and later immune responses. To investigate the effects of prenatal and childhood lead exposure on the preschool-aged children's immune responses, a prospective birth cohort study was established in Wuhan, China, in which lead concentrations were analyzed in maternal urine during the third trimester and in plasma samples from children aged about 3 years. We assessed immune responses by measuring immune cytokines in the children's plasma (n = 326) and peripheral blood T lymphocyte subsets (n = 394) at 3 years of age. Each unit increase in maternal urinary lead concentration (μg/g creatinine) was associated with reduced IL-10 (β = -5.93%, 95%CI: -11.82%, -0.03%) and reduced IL-4 levels (β = -5.62%, 95%CI: -10.44%, -0.80%). Lead in children's plasma (μg/L) was associated with significant increase in TNF-α (β = 10.78%, 95%CI: 3.97%, 17.59%). No statistically significant relationship of childhood lead exposure with T lymphocyte subsets was observed. The study suggested prenatal and childhood lead exposure was associated with changes in preschool children's plasma cytokine levels.

Cellular and Molecular Mechanisms of Environmental Pollutants on Hematopoiesis

Hematopoiesis is a complex and intricate process that aims to replenish blood components in a constant fashion. It is orchestrated mostly by hematopoietic progenitor cells (hematopoietic stem cells (HSCs)) that are capable of self-renewal and differentiation. These cells can originate other cell subtypes that are responsible for maintaining vital functions, mediate innate and adaptive immune responses, provide tissues with oxygen, and control coagulation. Hematopoiesis in adults takes place in the bone marrow, which is endowed with an extensive vasculature conferring an intense flow of cells. A myriad of cell subtypes can be found in the bone marrow at different levels of activation, being also under constant action of an extensive amount of diverse chemical mediators and enzymatic systems. Bone marrow platelets, mature erythrocytes and leukocytes are delivered into the bloodstream readily available to meet body demands. Leukocytes circulate and reach different tissues, returning or not returning to the bloodstream. Senescent leukocytes, specially granulocytes, return to the bone marrow to be phagocytized by macrophages, restarting granulopoiesis. The constant high production and delivery of cells into the bloodstream, alongside the fact that blood cells can also circulate between tissues, makes the hematopoietic system a prime target for toxic agents to act upon, making the understanding of the bone marrow microenvironment vital for both toxicological sciences and risk assessment. Environmental and occupational pollutants, therapeutic molecules, drugs of abuse, and even nutritional status can directly affect progenitor cells at their differentiation and maturation stages, altering behavior and function of blood compounds and resulting in impaired immune responses, anemias, leukemias, and blood coagulation disturbances. This review aims to describe the most recently investigated molecular and cellular toxicity mechanisms of current major environmental pollutants on hematopoiesis in the bone marrow.

E-waste lead exposure and children's health in China

China is one of the countries worldwide confronted with serious e-waste pollution and associated detrimental health effects, which has aroused public, academic and governmental concerns. Most local residents are exposed to hazardous substances such as lead (Pb) and other persistent organic pollutants because of informal e-waste recycling activities. This study reviews recent studies on children exposed to e-waste Pb in China focusing on health-related effects in children (e.g. growth and development, cardiovascular, immune, nervous, respiratory, reproductive, skeletal, and urinary systems) and evaluating the evidence for the association between e-waste Pb exposure and the children health outcomes in China. Children are one of most sensitive and vulnerable groups when facing e-waste Pb exposure. Previous data indicate that exposure to e-waste Pb has adverse effect on human health such as delayed and damaged physical and nervous development. It is the time to take effective measures, such as upgrading e-waste recycling technology, enhancing government policy guidance and support, and strengthening environmental protection and health awareness of the local inhabitants, to prevent the adverse effects of e-waste.

Cytomegalovirus seroprevalence, recurrence, and antibody levels: Associations with cadmium and lead exposures in the general United States population

BACKGROUND

The ubiquitous metals cadmium and lead are immunotoxic, but little is known about their relations to cytomegalovirus (CMV), a widespread herpesvirus. Although CMV infections are mostly asymptomatic, congenital infections are a leading cause of birth defects. In otherwise healthy individuals, there is also some evidence linking subclinical reactivations to accelerated age-related declines in immune function and chronic disease.

METHODS

Our objective was to evaluate associations of blood cadmium and lead biomarkers with CMV infection in a representative sample of the United States population. In seropositive individuals, we also examined associations with CMV-specific immunoglobulin G (IgG) antibody levels and suspected CMV recurrences. Using cross-sectional data from the 1999-2004 National Health and Nutrition Examination Surveys, we fit multivariable survey-weighted regression models accounting for potential confounding by sociodemographic and lifestyle factors and stratifying by age group to allow for heterogeneity. CMV recurrences were defined according to (1) the presence of either CMV-specific immunoglobulin M in sera or CMV viral DNA in urine, and (2) high CMV-specific IgG avidity.

RESULTS

We observed null associations for blood cadmium. Increasing blood lead quartiles were related to CMV seropositivity and higher CMV IgG levels (both P trend < 0.01), but not CMV recurrence, only among individuals who were 20-29 years of age.

CONCLUSION

Blood cadmium levels do not appear to be related to immunological markers of CMV infections. The possibility that lead exposures increase the risk of CMV infection and impair immune control of the virus in young adults was suggested. Prospective studies are needed to confirm.

Effects of lead and cadmium on the immune system and cancer progression

In our daily life, we are surrounded by harmful pollutants, including heavy metals that are not visible in the macroscopic view easily. Heavy metals can disrupt different aspects of human health, such as the immune system which has gained a lot of attention in recent decades. This had led to its rapid progression and new insights into its alterations in different diseases especially cancer. Heavy metals are non-biodegradable materials that exist in different parts of the food cycle, such as fruits and vegetables as commonly consumed foods and also unexpected sources such as street dust, that exists in the streets that we pass every day, soil, air, and water. These heavy metals can enter the human body through respiratory, cutaneous, and gastrointestinal pathways and then accumulate in different organs, leading to their encountering with various parts of the body. These sources and natural characteristics of heavy metals facilitate their interaction with the immune system. In this review, we investigated the effect of lead and cadmium, as pollutants that exist in many different parts of the human environment, on the immune system which is known to have a key role in the pathophysiology of cancer.

Neglected, Drug-Induced Platinum Accumulation Causes Immune Toxicity

Previous studies only focused on different adverse reactions caused by various platinum drugs, but not on common immunotoxicity caused by the accumulation of elemental platinum. Here, we determined the serum platinum concentrations of cancer patients after a metabolism period of platinum drug chemotherapy, in addition to hematological indices and subsequent immune-related adverse reactions, then analyzed the correlations between platinum accumulation, immune cell levels, and immune-toxicity. We chose the day before the next round of chemotherapy as the specified time point for blood sampling. Samples were collected at five time points, separately in oxaliplatin and cisplatin groups. The median serum platinum concentrations in all patients was 294.8 (205.6, 440.3) μg/L, and was approximately two-fold greater in the cisplatin group than in the oxaliplatin group (429.3 vs. 211.7 μg/L). The platinum level of both groups peaked at the third time point, with the average of females being higher than males (383.9 vs. 266.5 μg/L), and was positively correlated with leukocyte and platelet counts, but negatively correlated with erythrocyte counts and concentration of hemoglobin. The risks of anemia and adverse reactions were individually increased by 0.002- and 0.007-fold for every μg/L increase of platinum concentration. To our knowledge, this is the first study on the relationship between platinum accumulation, immune cell levels and toxicity, showing that drug-induced platinum accumulation may interfere with immune cells and thus increase the risk of toxicity.

The effects of cadmium exposure in the induction of inflammation

Inflammation is a physiological process essential for maintaining homeostatic mechanisms in human, but however, exaggerated inflammatory responses are closely related to many chronic diseases. Cadmium (Cd) is a heavy metal with high toxicity when present in food, water and air has the potential of eliciting inflammatory reactions, with a major health risk to human. This review aimed to elucidate on the major routes of Cd exposure, the main organs affected by the exposure, the degree of toxicity as well as the roles of the toxic effects on the immune system which results to inflammatory responses. Immune modulation by Cd may cause serious adverse health effects in humans. Various studies have highlighted the ability of Cd as an environmental pollutant involved in the modulation of the innate, adaptive and mucosal immune responses in relations to the release of chemokine, gene expression, and susceptibility to microbial infections.

Alterations in platelet indices link polycyclic aromatic hydrocarbons toxicity to low-grade inflammation in preschool children

BACKGROUND

Environmental exposure to carcinogenic polycyclic aromatic hydrocarbons (PAHs) can disturb the immune response. However, the effect of PAHs on low-grade inflammation related to platelets in humans is unknown.

OBJECTIVES

We investigated the association of PAH exposure with low-grade inflammation and platelet parameters in healthy preschoolers.

METHODS

The present study recruited 239 participants, aged 2-7 years, from an electronic-waste (e-waste)-exposed (n = 118) and a reference (n = 121) area. We measured ten urinary PAH metabolites, four types of immune cells and cytokines, and seven platelet parameters, and compared their differences between children from the two groups. Spearman correlation analysis was performed to explore the potential risk factors for PAH exposure and the associations between urinary monohydroxylated PAHs (OH-PAHs) and biological parameters. Associations between urinary PAH metabolites and platelet indices were analyzed using quantile regression models. Mediation analysis was used to understand the relationship between urinary total hydroxynaphthalene (ΣOHNa) and interleukin (IL)-1β through seven platelet indices, as mediator variables.

RESULTS

We found higher urinary monohydroxylated PAH (OH-PAH) concentrations, especially 1-hydroxynaphthalene (1-OHNa) and 2-hydroxynaphthalene (2-OHNa), in children from the e-waste-exposed group than in the reference group. These were closely associated with child personal habits and family environment. A decreased lymphocyte ratio and increased pro-inflammatory cytokines, such as gamma interferon-inducible protein (IP)-10 and IL-1β, were found in the e-waste-exposed children. After adjustment for confounding factors, significantly negative correlations were found between levels of mean platelet volume (MPV), platelet distribution width (PDW), platelet-large cell ratio (P-LCR) and ratio of mean platelet volume to platelet count (MPVP) and OH-PAHs. In addition, ΣOHNa was positively associated with IL-1β mediated through MPV, PDW, P-LCR, and ratio of platelet count to lymphocyte count (PLR).

CONCLUSIONS

Platelet indices were significantly associated with the changes in urinary OH-PAH levels, which may can be regarded as effective biomarkers of low-grade inflammation resulting from low PAH exposure in healthy children.

Decreased erythrocyte CD44 and CD58 expression link e-waste Pb toxicity to changes in erythrocyte immunity in preschool children

Lead (Pb) toxicity damages blood cells and disturbs the immune micro-environment. When Pb enters the circulatory system, >95% of Pb accumulates in erythrocytes. We therefore conducted this study to explore the long-term effect of Pb exposure on expression of erythrocyte adhesion molecules (CD44 and CD58) and related downstream cytokine concentrations. We enrolled a total of 267 preschool children, 2-7 years of age, from Guiyu (e-waste-exposed group, n = 132) and Haojiang (reference group, n = 135) in November and December 2015. We measured child blood Pb, biomarkers including erythrocyte CD44 and CD58, erythrocyte count, leukocyte count and inflammatory cytokines (IL-1β, IL-12p70 and IFN-γ), and calculated erythrocyte Pb levels. Regression model demonstrated that higher erythrocyte Pb was associated with lower CD44 and CD58. Compared to low erythrocyte Pb levels (quartile 1), high erythrocyte Pb levels (quartile 4) were related to lower levels of erythrocyte CD44 and CD58. Elevated blood Pb correlated with higher IL-12p70 and IFN-γ, and lower IL-2. The mediation effect of erythrocyte CD44 on the relationship of erythrocyte Pb with IL-1β and IL-12p70 was significant, and the effect of erythrocyte Pb on IFN-γ was mediated by erythrocyte CD58. The data provides novel translational insight into the relationship between elevated Pb exposure and the change of erythrocyte immunity and downstream cytokine secretion in preschool children.

Cardiovascular endothelial inflammation by chronic coexposure to lead (Pb) and polycyclic aromatic hydrocarbons from preschool children in an e-waste recycling area

Lead (Pb) and polycyclic aromatic hydrocarbon (PAH) exposure is positively associated with cardiovascular disease (CVD), and the possible potential mechanism may be caused by damage to the endothelium by modulation of inflammatory processes. No comprehensive research shows co-exposure of Pb and PAH on cardiovascular endothelial inflammation in electronic waste (e-waste) exposed populations. Given this, the aim of this study is to provide evidence for a relationship between Pb and PAH co-exposure and cardiovascular endothelial inflammation, in an e-waste-exposed population, to delineate the link between a potential mechanism for CVD and environmental exposure. We recruited 203 preschool children (3-7 years) were enrolled from Guiyu (e-waste-exposed group, n = 105) and Haojiang (reference group, n = 98). Blood Pb levels and urinary PAH metabolites were measured. Percentages of T cells, CD4⁺ T cells and CD8⁺ T cells, complete blood counts, endothelial inflammation biomarker (serum S100A8/A9), and other inflammatory biomarkers [serum interleukin (IL)-6, IL-12p70, gamma interferon-inducible protein 10 (IP-10)] levels were evaluated. Blood Pb, total urinary hydroxylated PAH (ΣOHPAH), total hydroxynaphthalene (ΣOHNap) and total hydroxyfluorene (ΣOHFlu) levels, S100A8/A9, IL-6, IL-12p70 and IP-10 concentrations, absolute counts of monocytes, neutrophils, and leukocytes, as well as CD4⁺ T cell percentages were significantly higher in exposed children. Elevated blood Pb, urinary 2-hydroxynaphthalene (2-OHNap) and ΣOHFlu levels were associated with higher levels of IL-6, IL-12p70, IP-10, CD4⁺ T cell percentages, neutrophil and monocyte counts. Mediator models indicated that neutrophils exert the significant mediation effect on the relationship between blood Pb levels and S100A8/A9. IL-6 exerts a significant mediation effect on the relationship between blood Pb levels and IP-10, as well as the relationship between urinary ΣOHFlu levels and IP-10. Our results indicate that children with elevated exposure levels of Pb and PAHs have exacerbated vascular endothelial inflammation, which may indicate future CVD risk in e-waste recycling areas.

Increased memory T cell populations in Pb-exposed children from an e-waste-recycling area

Chronic exposure to heavy metals could affect cell-mediated immunity. The aim of this study was to explore the status of memory T cell development in preschool children from an e-waste recycling area. Blood lead (Pb) levels, peripheral T cell subpopulations, and serum levels of cytokines (IL-2/IL-7/IL-15), relevant to generation and homeostasis of memory T cells were evaluated in preschool children from Guiyu (e-waste-exposed group) and Haojiang (reference group). The correlations between blood Pb levels and percentages of memory T cell subpopulations were also evaluated. Guiyu children had higher blood Pb levels and increased percentages of CD4⁺ central memory T cells and CD8⁺ central memory T cells than in the Haojiang group. Moreover, blood Pb levels were positively associated with the percentages of CD4⁺ central memory T cells. In contrast, Pb exposure contributed marginally in the change of percentages of CD8⁺ central memory T cells in children. There was no significant difference in the serum cytokine levels between the e-waste-exposed and reference children. Taken together, preschool children from an e-waste recycling area suffer from relatively higher levels of Pb exposure, which might facilitate the development of CD4⁺ central memory T cells in these children.