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Yang M, Yoo H, Kim SY, Kwon O, Nam MW, Pan KH, Kang MY. Occupational Risk Factors for Stroke: A Comprehensive Review. J Stroke 2023; 25:327-337. [PMID: 37813670 PMCID: PMC10574301 DOI: 10.5853/jos.2023.01011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/27/2023] [Accepted: 08/01/2023] [Indexed: 10/11/2023] Open
Abstract
For primary prevention, it is important for public health and clinical medicine to identify and characterize modifiable risk factors of stroke. In existing literature, the impact of occupational variables on ischemic and hemorrhagic stroke has been extensively studied. This review summarizes the available data on the significance of occupational variables in stroke. The results of this review suggest that there is sufficient evidence for the relationship between increased risk of stroke and job stress, working in extreme temperatures, long working hours, and/or shift work. The association between long working hours and occupational exposure to noise and chemicals remains inconclusive although several studies have reported this finding. This review will act as a step toward future research and provide information that may serve as a baseline for developing targeted interventions to prevent stroke in the working population.
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Affiliation(s)
- Munyoung Yang
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyoungseob Yoo
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seo-Young Kim
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ohwi Kwon
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Min-Woo Nam
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Seoul, Korea
| | - Kwang Hyun Pan
- Department of Neurology, Anam Hospital, Korea University, Seoul, Korea
| | - Mo-Yeol Kang
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Lopes-Araújo A, Arrifano GP, Macchi BM, Augusto-Oliveira M, Santos-Sacramento L, Rodríguez Martín-Doimeadios RC, Jiménez-Moreno M, Martins Filho AJ, Alvarez-Leite JI, Oriá RB, do Nascimento JLM, Crespo-Lopez ME. Hair mercury is associated with dyslipidemia and cardiovascular risk: An anthropometric, biochemical and genetic cross-sectional study of Amazonian vulnerable populations. ENVIRONMENTAL RESEARCH 2023; 229:115971. [PMID: 37105291 DOI: 10.1016/j.envres.2023.115971] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/15/2023] [Accepted: 04/20/2023] [Indexed: 05/06/2023]
Abstract
This cross-sectional study evaluated the association between human exposure to mercury and cardiovascular risk using lipid profile (including apolipoproteins) and genetic analysis of Amazonian riverine population. Anthropometric data (gender, age, height, weight, blood pressure, and neck and waist circumferences) of the participants were recorded. Total mercury and methylmercury (MeHg) content were quantified in hair by ICP-MS and GC-pyro-AFS system. Polymorphisms rs662799, rs693, rs429358 and rs7412 (of genes of apolipoproteins A-V, B, and E at positions 112 and 158, respectively) were genotyped by real-time PCR. The population presented a dyslipidemia profile significantly correlated with high mercury levels. The apolipoprotein B/apolipoprotein A-I (ApoB/ApoA-I) index was also positively correlated with mercury, supporting a possible causal relationship. Allelic distributions were similar to those described in other populations, suggesting that genetic susceptibility may not have a significant role in the lipid alterations found in this work. This study demonstrated for the first time: i) the relationship between mercury exposure and cardiovascular risk-related apolipoproteins in humans, ii) the ApoB levels and the ApoB/ApoA-I index as the risk factors more strongly associated to the mercury-related dyslipidemia in humans, and iii) the prevalence of high/moderate risk of acute myocardial infarction in the vulnerable and chronically exposed-populations of the Amazon, in addition to the genotypic profile of the three most frequent polymorphisms in apolipoproteins of relevance for cardiovascular risk. This early detection of lipid alterations is essential to prevent the development of cardiovascular diseases (CVD), especially in chronically exposed populations such as those found in the Amazon. Therefore, in addition to provide data for the Minamata Convention implementation, our work is in line with the efforts joined by all members of the World Health Organization committed to reducing premature deaths originating from non-communicable diseases by 25% in 2025, including CVD.
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Affiliation(s)
- Amanda Lopes-Araújo
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Brazil.
| | - Gabriela P Arrifano
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Brazil
| | - Barbarella M Macchi
- Laboratório de Neuroquímica Molecular e Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | - Marcus Augusto-Oliveira
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Brazil
| | - Letícia Santos-Sacramento
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Brazil
| | - Rosa C Rodríguez Martín-Doimeadios
- Department of Analytical Chemistry and Food Technology, Faculty of Environmental Sciences and Biochemistry, University of Castilla-La Mancha, Toledo, Spain
| | - María Jiménez-Moreno
- Department of Analytical Chemistry and Food Technology, Faculty of Environmental Sciences and Biochemistry, University of Castilla-La Mancha, Toledo, Spain
| | | | | | - Reinaldo B Oriá
- Laboratório da Biologia da Cicatrização, Ontogenia e Nutrição de Tecidos. Departamento de Morfologia e Instituto de Biomedicina, Escola de Medicina, Universidade Federal do Ceará, Fortaleza, Brazil
| | - José Luiz M do Nascimento
- Laboratório de Neuroquímica Molecular e Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | - Maria Elena Crespo-Lopez
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Brazil.
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Dev P, Gupta P, Mahapatra A, Cyriac M, Kumar A, Singh VK, Mishra VN, Pathak A. Systematic Review and Meta-analysis of Environmental Toxic Metal Contaminants and the Risk of Ischemic Stroke. Ann Indian Acad Neurol 2022; 25:1159-1166. [PMID: 36911452 PMCID: PMC9996531 DOI: 10.4103/aian.aian_530_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/30/2022] [Accepted: 11/10/2022] [Indexed: 03/14/2023] Open
Abstract
Background Stroke is the second largest cause of mortality (WHO 2014) and long-lasting disability worldwide. Many risk factors are associated with stroke, such as age, gender, chronic illnesses, cardiovascular disease, lifestyle, and smoking. With global industrialization, the roles of environmental contaminants and their association with stroke are still unclear and have attracted much more attention. Materials and Methods We conducted a systematic review on the environmental toxic metal contaminants and the risk of ischemic stroke. A comprehensive literature search was carried out till June 30, 2021 from databases such as PubMed, Science Direct, Embase, and Scopus. The quality of all the articles which met our inclusion criteria was assessed using Newcastle-Ottawa scaling, and four eligible studies were included for our systematic review. Results The serum and urine cadmium concentrations were positively associated with the risk of ischemic stroke. There was an inverse association of serum and urine concentrations of mercury (Hg), serum concentration of gold and cerium with ischemic stroke, and the serum and urine concentrations of lead (Pb) had no association with ischemic stroke risk. Conclusion The study showed strong associations between heavy metals and ischemic stroke, but more studies are required to prove the associations.
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Affiliation(s)
- Priya Dev
- Department of Neurology, Institute of Medical Science, Varanasi, UP, India
| | - Priya Gupta
- Department of Zoology, Institute of Science, Banaras Hindu University, Varanasi, UP, India
| | - Archisman Mahapatra
- Department of Zoology, Institute of Science, Banaras Hindu University, Varanasi, UP, India
| | - Mareena Cyriac
- Department of Neurology, Institute of Medical Science, Varanasi, UP, India
| | - Amit Kumar
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Varun Kumar Singh
- Department of Neurology, Institute of Medical Science, Varanasi, UP, India
| | - Vijaya Nath Mishra
- Department of Neurology, Institute of Medical Science, Varanasi, UP, India
| | - Abhishek Pathak
- Department of Neurology, Institute of Medical Science, Varanasi, UP, India
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Bao QJ, Zhao K, Guo Y, Wu XT, Yang JC, Yang MF. Environmental toxic metal contaminants and risk of stroke: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:32545-32565. [PMID: 35190994 DOI: 10.1007/s11356-022-18866-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 01/21/2022] [Indexed: 06/14/2023]
Abstract
The relationship between toxic metals in the environment and clinical stroke risk remains unclear, although their role as immunotoxicants and carcinogens has been well established. We conducted a systematic review of the relationship between five metals (arsenic, mercury, copper, cadmium, and lead) and stroke. First, we comprehensively searched 3 databases (Pubmed, EMBASE, and Cochrane) from inception until June 2021. Random-effects meta-analyses, pooled relative risks (RR) and 95% confidence intervals (CI) were applied to evaluate the effect value. We finally identified 38 studies involving 642,014 non-overlapping participants. Comparing the highest vs. lowest baseline levels, chronic exposure to lead (RR = 1.07; 95%CI,1.00-1.14), cadmium (RR = 1.30; 95%CI,1.13-1.48), and copper (RR = 1.19; 95%CI,1.04-1.36) were significantly associated with stroke risks. However, the other two metals (arsenic and mercury) had less effect on stroke risk. Further analysis indicated that the association was likely in a metal dose-dependent manner. The results may further support the possibility that environmental toxic metal contaminants in recent years are associated with the increased risk of stroke.
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Affiliation(s)
- Qiang-Ji Bao
- Graduate School, Qinghai University, Xining, 810016, Qinghai, China
| | - Kai Zhao
- Graduate School, Qinghai University, Xining, 810016, Qinghai, China
| | - Yu Guo
- Graduate School, Qinghai University, Xining, 810016, Qinghai, China
| | - Xin-Ting Wu
- Graduate School, Qinghai University, Xining, 810016, Qinghai, China
| | - Jin-Cai Yang
- Graduate School, Qinghai University, Xining, 810016, Qinghai, China
| | - Ming-Fei Yang
- Department of Neurosurgery, Qinghai Provincial People's Hospital, Xining, 810007, Qinghai, China.
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Yen CC, Chen HH, Hsu YT, Tseng CJ, Lin CH. Effects of heavy metals in acute ischemic stroke patients: A cross-sectional study. Medicine (Baltimore) 2022; 101:e28973. [PMID: 35244065 PMCID: PMC8896421 DOI: 10.1097/md.0000000000028973] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 02/09/2022] [Indexed: 11/26/2022] Open
Abstract
Cerebrovascular disease is the second commonest cause of mortality globally and among the commonest causes of disability. However, research executed to probe the heavy metal exposure-stroke incidence relationship is scarce. Accordingly, we executed our study to probe the relationship of heavy metal concentrations (ie, concentrations of lead [Pb], mercury [Hg], cadmium [Cd], and arsenic) in the serum and urine of acute ischemic stroke (AIS) patients with several patient variables.For enrollment, we chose patients who had a first AIS within 7 days after the onset of a stroke. Thus, 33 newly diagnosed patients with AIS were recruited. We determined the aforementioned metals' concentrations by executing inductively coupled plasma mass spectrometry. We also gauged the association between such metal concentrations and patient variables by employing Spearman correlation coefficient. To examine the differences in metal concentrations between the different variables, we implemented an independent Mann-Whitney U test.In our cohort analysis, we noted serum Pb and Cd concentrations to be positively correlated with serum creatinine and hemoglobin. Serum and urine Cd concentrations had a negative correlation with impaired HbA1c in AIS patients. Urine Hg had a positive correlation with C-reactive protein in the participants. Participants who smoked or consumed alcohol had significantly higher Pb and Cd levels in serum than did those who neither smoked nor drank. Patients with AIS who smoked or consumed alcohol had high levels of serum Pb and serum Cd than did those who did not. Patients with AIS who consumed alcohol had significantly higher Pb and Hg urine concentrations than did those who did not.Our study indicated that serum Cd and Pb elevation increased the AIS risk in southern Taiwan patients.
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Affiliation(s)
- Cheng-Chang Yen
- Section of Neurology, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Rd., Kaohsiung, Taiwan
- Department of Electrical Engineering, Southern Taiwan University of Science and Technology, No. 1, Nan-Tai Street, Yongkang Dist., Tainan, Taiwan
| | - Hsin-Hung Chen
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Rd., Kaohsiung, Taiwan
| | - Yi-Ting Hsu
- Section of Neurology, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Rd., Kaohsiung, Taiwan
| | - Ching-Jiunn Tseng
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Rd., Kaohsiung, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, No. 2, Yude Rd., Taichung, Taiwan
| | - Ching-Huang Lin
- Section of Neurology, Kaohsiung Veterans General Hospital, No. 386, Ta-Chung 1st Rd., Kaohsiung, Taiwan
- Department of Biological Sciences, National Sun Yat-Sen University, 70 Lienhai Rd., Kaohsiung, Taiwan
- Department of Physical Therapy, Shu-Zen Junior College of Medicine and Management, No. 452, Huanqiu Rd. Luzhu Dist., Kaohsiung, Taiwan
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Guida N, Sanguigno L, Mascolo L, Calabrese L, Serani A, Molinaro P, Lau CG, Annunziato L, Formisano L. The Transcriptional Complex Sp1/KMT2A by Up-Regulating Restrictive Element 1 Silencing Transcription Factor Accelerates Methylmercury-Induced Cell Death in Motor Neuron-Like NSC34 Cells Overexpressing SOD1-G93A. Front Neurosci 2021; 15:771580. [PMID: 34899171 PMCID: PMC8662822 DOI: 10.3389/fnins.2021.771580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
Methylmercury (MeHg) exposure has been related to amyotrophic lateral sclerosis (ALS) pathogenesis and molecular mechanisms of its neurotoxicity has been associated to an overexpression of the Restrictive Element 1 Silencing Transcription factor (REST). Herein, we evaluated the possibility that MeHg could accelerate neuronal death of the motor neuron-like NSC34 cells transiently overexpressing the human Cu2+/Zn2+superoxide dismutase 1 (SOD1) gene mutated at glycine 93 (SOD1-G93A). Indeed, SOD1-G93A cells exposed to 100 nM MeHg for 24 h showed a reduction in cell viability, as compared to cells transfected with empty vector or with unmutated SOD1 construct. Interestingly, cell survival reduction in SOD1-G93A cells was associated with an increase of REST mRNA and protein levels. Furthermore, MeHg increased the expression of the transcriptional factor Sp1 and promoted its binding to REST gene promoter sequence. Notably, Sp1 knockdown reverted MeHg-induced REST increase. Co-immunoprecipitation experiments demonstrated that Sp1 physically interacted with the epigenetic writer Lysine-Methyltransferase-2A (KMT2A). Moreover, knocking-down of KMT2A reduced MeHg-induced REST mRNA and protein increase in SOD1-G93A cells. Finally, we found that MeHg-induced REST up-regulation triggered necropoptotic cell death, monitored by RIPK1 increased protein expression. Interestingly, REST knockdown or treatment with the necroptosis inhibitor Necrostatin-1 (Nec) decelerated MeH-induced cell death in SOD1-G93A cells. Collectively, this study demonstrated that MeHg hastens necroptotic cell death in SOD1-G93A cells via Sp1/KMT2A complex, that by epigenetic mechanisms increases REST gene expression.
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Affiliation(s)
| | - Luca Sanguigno
- Division of Pharmacology, Department of Neuroscience, Reproductive and Dentistry Sciences, School of Medicine, "Federico II" University of Naples, Naples, Italy
| | - Luigi Mascolo
- Division of Pharmacology, Department of Neuroscience, Reproductive and Dentistry Sciences, School of Medicine, "Federico II" University of Naples, Naples, Italy
| | - Lucrezia Calabrese
- Division of Pharmacology, Department of Neuroscience, Reproductive and Dentistry Sciences, School of Medicine, "Federico II" University of Naples, Naples, Italy
| | - Angelo Serani
- Division of Pharmacology, Department of Neuroscience, Reproductive and Dentistry Sciences, School of Medicine, "Federico II" University of Naples, Naples, Italy
| | - Pasquale Molinaro
- Division of Pharmacology, Department of Neuroscience, Reproductive and Dentistry Sciences, School of Medicine, "Federico II" University of Naples, Naples, Italy
| | - C Geoffrey Lau
- Department of Neuroscience, City University of Hong Kong, Hong Kong, China
| | | | - Luigi Formisano
- Division of Pharmacology, Department of Neuroscience, Reproductive and Dentistry Sciences, School of Medicine, "Federico II" University of Naples, Naples, Italy
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Chen C, Xun P, Unverzagt F, McClure LA, Irvin MR, Judd S, Cushman M, He K. Serum magnesium concentration and incident cognitive impairment: the reasons for geographic and racial differences in stroke study. Eur J Nutr 2021; 60:1511-1520. [PMID: 32737612 PMCID: PMC7854858 DOI: 10.1007/s00394-020-02353-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 07/27/2020] [Indexed: 02/03/2023]
Abstract
PURPOSE To examine the prospective association between serum Mg level and the incidence of cognitive impairment. METHODS A random sub-cohort (n = 2063) from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort was included in this study. Baseline serum Mg concentration was measured using inductively coupled plasma mass spectrometry. According to the current reference interval of serum magnesium (0.75-0.95 mmol/L), we classified participants below the interval as Level 1 and used it as the referent. The rest of the study population were equally divided into three groups, named Level 2 to 4. Incident cognitive impairment was identified using the Six-Item Screener. Multivariable-adjusted odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated using logistic regression models. RESULTS After adjustment for potential confounders, an inverse threshold association between serum Mg level and incident cognitive impairment was observed. Compared to those with hypomagnesemia (Level 1: < 0.75 mmol/L), the relative odds of incident cognitive impairment was reduced by 41% in the second level [OR (95% CI) = 0.59 (0.37, 0.94)]; higher serum Mg level did not provide further benefits [Level 3 and 4 versus Level 1: OR (95% CI) = 0.54 (0.34, 0.88) and 0.59 (0.36, 0.96), P for linear trend = 0.08]. CONCLUSIONS Findings from this prospective study suggest that sufficient Mg status within the normal range may be beneficial to cognitive health in the US general population.
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Affiliation(s)
- Cheng Chen
- Department of Obstetrics and Gynecology and Department of Epidemiology, Columbia University Irving Medical Center, New York, NY, USA
| | - Pengcheng Xun
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA
| | - Frederick Unverzagt
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Leslie A McClure
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Marguerite Ryan Irvin
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Suzanne Judd
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mary Cushman
- Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, USA
| | - Ka He
- Department of Obstetrics and Gynecology and Department of Epidemiology, Columbia University Irving Medical Center, New York, NY, USA.
- Department of Obstetrics and Gynecology and Department of Epidemiology, Columbia University Irving Medical Center, 622 W 168th Street, Suite 16-62, New York, NY, 10032, USA.
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8
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Hu XF, Lowe M, Chan HM. Mercury exposure, cardiovascular disease, and mortality: A systematic review and dose-response meta-analysis. ENVIRONMENTAL RESEARCH 2021; 193:110538. [PMID: 33285155 DOI: 10.1016/j.envres.2020.110538] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/29/2020] [Accepted: 11/23/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND There is evidence that exposure to mercury (Hg) may be a risk factor for cardiovascular disease (CVD). OBJECTIVE To conduct a systematic review of published studies and a meta-analysis of the results to examine the associations between chronic Hg exposure and CVD outcomes. METHODS We searched PubMed, Embase, and TOXLINE using previously developed strategies. Studies were selected according to a priori-defined inclusion criteria, and their qualities were assessed. Study estimates were extracted, and subgroup analyses were conducted to explore potential sources of heterogeneity: 1) fatal vs. nonfatal events, 2) cohort study vs. non-cohort study, and 3) inorganic Hg vs. methyl mercury (MeHg). Dose-response meta-analyses were conducted for MeHg exposure and fatal/nonfatal ischemic heart disease (IHD), stroke, and all CVD. RESULTS A total of 14 studies reporting results collected from more than 34,000 participants in 17 countries were included in the meta-analysis. Hg exposure was associated with an increase in nonfatal IHD (relative risk (RR): 1.21 (0.98, 1.50)), all-cause mortality (RR: 1.21 (0.90, 1.62)), CVD mortality (RR: 1.68 (1.15, 2.45)), and mortality due to other heart diseases (RR: 1.50 (1.07, 2.11)). No association was observed between Hg exposure and stroke. A heterogeneous relationship was found between studies reporting fatal and nonfatal outcomes and between cohort and non-cohort studies. However, these differences were mainly due to differences in Hg exposure level. Occupational inorganic Hg exposure was associated with similar increases in different mortality outcomes. A J-shaped relationship between Hg exposure and different fatal/nonfatal outcomes was observed, with turning points at hair Hg concentrations of 1 μg/g for IHD and 2 μg/g for stroke and all CVD. CONCLUSION Chronic exposure to Hg was associated with an increased risk of all-cause mortality and fatal/nonfatal IHD. The risk of multiple cardiovascular endpoints starts to increase consistently at a hair Hg concentration of 2 μg/g.
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Affiliation(s)
- Xue Feng Hu
- Department of Biology, University of Ottawa (XFH, ML, HMC), Canada
| | - Mackenzie Lowe
- Department of Biology, University of Ottawa (XFH, ML, HMC), Canada
| | - Hing Man Chan
- Department of Biology, University of Ottawa (XFH, ML, HMC), Canada.
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9
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Santos-Sacramento L, Arrifano GP, Lopes-Araújo A, Augusto-Oliveira M, Albuquerque-Santos R, Takeda PY, Souza-Monteiro JR, Macchi BM, do Nascimento JLM, Lima RR, Crespo-Lopez ME. Human neurotoxicity of mercury in the Amazon: A scoping review with insights and critical considerations. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 208:111686. [PMID: 33396018 DOI: 10.1016/j.ecoenv.2020.111686] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/24/2020] [Accepted: 11/17/2020] [Indexed: 06/12/2023]
Abstract
Human exposure to mercury is a major public health concern, causing neurological outcomes such as motor and visual impairment and learning disabilities. Currently, human exposure in the Amazon is among the highest in the world. A recent systematic review (doi:10.1016/j.jtemb.2018.12.001), however, highlighted the lack of high-quality studies on mercury-associated neurotoxicity. There is, therefore, a need to improve research and much to still learn about how exposure correlates with disease. In this review, we discuss studies evaluating the associations between neurological disturbances and mercury body burden in Amazonian populations, to generate recommendations for future studies. A systematic search was performed during July 2020, in Pubmed/Medline, SCOPUS and SCIELO databases with the terms (mercury*) and (Amazon*). Four inclusion criteria were used: original article (1), with Amazonian populations (2), quantifying exposure (mercury levels) (3), and evaluating neurological outcomes (4). The extracted data included characteristics (as year or origin of authorship) and details of the research (as locations and type of participants or mercury levels and neurological assessments). Thirty-four studies, most concentrated within three main river basins (Tapajós, Tocantins, and Madeira) and related to environmental exposure, were found. Mercury body burden was two to ten times higher than recommended and main neurological findings were cognitive, vision, motor, somatosensory and emotional deficits. Important insights are described that support novel approaches to researching mercury exposure and intoxication, as well as prevention and intervention strategies. As a signatory country to the Minamata Convention, Brazil has the opportunity to play a central role in improving human health and leading the research on mercury intoxication.
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Affiliation(s)
- Leticia Santos-Sacramento
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA 66075-110, Brazil.
| | - Gabriela P Arrifano
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA 66075-110, Brazil.
| | - Amanda Lopes-Araújo
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA 66075-110, Brazil.
| | - Marcus Augusto-Oliveira
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA 66075-110, Brazil.
| | - Raquel Albuquerque-Santos
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA 66075-110, Brazil.
| | - Priscila Y Takeda
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA 66075-110, Brazil.
| | | | - Barbarella M Macchi
- Laboratório de Neuroquímica Molecular e Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA 66075-110, Brazil.
| | - José Luiz M do Nascimento
- Laboratório de Neuroquímica Molecular e Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA 66075-110, Brazil; Programa de Pós-graduação em Ciências Farmacêuticas, Departamento de Ciências Biológicas e da Saúde, Universidade Federal do Amapá (UNIFAP), 68903-419 Macapá, AP, Brazil.
| | - Rafael R Lima
- Laboratório de Biologia Estrutural e Funcional, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA 66075-110, Brazil.
| | - Maria Elena Crespo-Lopez
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA 66075-110, Brazil.
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10
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Crespo-Lopez ME, Augusto-Oliveira M, Lopes-Araújo A, Santos-Sacramento L, Yuki Takeda P, Macchi BDM, do Nascimento JLM, Maia CSF, Lima RR, Arrifano GP. Mercury: What can we learn from the Amazon? ENVIRONMENT INTERNATIONAL 2021; 146:106223. [PMID: 33120229 DOI: 10.1016/j.envint.2020.106223] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/07/2020] [Accepted: 10/16/2020] [Indexed: 06/11/2023]
Abstract
Mercury is among the ten most dangerous chemicals for public health, and is a priority concern for the 128 signatory countries of the Minamata Convention. Mercury emissions to the atmosphere increased 20% between 2010 and 2015, with South America, Sub-Saharan Africa and Southeast Asia as the main contributors. Approximately 80% of the total mercury emissions in South America is from the Amazon, where the presence of the metal is ubiquitous and highly dynamic. The presence of this metal is likely increasing, with global consequences, due to events of the last two years including extensive biomass burning and deforestation, as well as mining activities and the construction of large-scale projects, such as dams. Here we present a concise profile of this mobilization, highlighting the human exposure to this metal in areas without mining history. Mercury reaches the food chain in its most toxic form, methylmercury, intoxicating human populations through the intake of contaminated fish. Amazonian populations present levels over 6 ppm of hair mercury and, according to the 175:250:5:1 ratio for methylmercury intake : mercury hair : mercury brain : mercury blood, consume 2-6 times the internationally recognized reference doses. This exposure is alarmingly higher than that of other populations worldwide. A possible biphasic behavior of the mercury-related phenomena, with consequences that may not be observed in populations with lower levels, is hypothesized, supporting the need of improving our knowledge of this type of chronic exposure. It is urgent that we address this serious public health problem in the Amazon, especially considering that human exposure may be increasing in the near future. All actions in this region carry the potential to have global repercussions.
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Affiliation(s)
- Maria Elena Crespo-Lopez
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA 66075-110, Brazil.
| | - Marcus Augusto-Oliveira
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA 66075-110, Brazil.
| | - Amanda Lopes-Araújo
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA 66075-110, Brazil
| | - Leticia Santos-Sacramento
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA 66075-110, Brazil
| | - Priscila Yuki Takeda
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA 66075-110, Brazil
| | - Barbarella de Matos Macchi
- Laboratório de Neuroquímica Molecular e Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA 66075-110, Brazil
| | - José Luiz Martins do Nascimento
- Laboratório de Neuroquímica Molecular e Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA 66075-110, Brazil; Programa de Pós-graduação em Ciências Farmacêuticas, Departamento de Ciências Biológicas e da Saúde, Universidade Federal do Amapá (UNIFAP), 68903-419 Macapá, AP, Brazil.
| | - Cristiane S F Maia
- Laboratório de Farmacologia da Inflamação e do Comportamento, Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, PA 66075-110, Brazil.
| | - Rafael R Lima
- Laboratório de Biologia Estrutural e Funcional, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA 66075-110, Brazil.
| | - Gabriela P Arrifano
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA 66075-110, Brazil
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11
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Affiliation(s)
- George Howard
- From the Department of Biostatistics (G.H.), School of Public Health, University of Alabama at Birmingham
| | - Virginia J. Howard
- Department of Epidemiology (V.J.H.), School of Public Health, University of Alabama at Birmingham
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12
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Freire MAM, Santana LNS, Bittencourt LO, Nascimento PC, Fernandes RM, Leão LKR, Fernandes LMP, Silva MCF, Amado LL, Gomes-Leal W, Crespo-Lopez ME, Maia CDSF, Lima RR. Methylmercury intoxication and cortical ischemia: Pre-clinical study of their comorbidity. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2019; 174:557-565. [PMID: 30865911 DOI: 10.1016/j.ecoenv.2019.03.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 03/01/2019] [Accepted: 03/03/2019] [Indexed: 06/09/2023]
Abstract
Stroke is one of the main causes of human disability worldwide. Ischemic stroke is mostly characterized by metabolic collapse and fast tissue damage, followed by secondary damage in adjacent regions not previously affected. Heavy metals intoxication can be associated with stroke incidence, because of their damaging action in the vascular system. Mercury, in particular, possesses a high tropism by metabolically active regions, such as the brain. In the present study we sought to evaluate whether methylmercury (MeHg) intoxication can aggravate the tissue damage caused by an ischemic stroke induced by microinjections of endothelin-1 (ET-1) into the motor cortex of adult rats. Following MeHg intoxication by gavage (0.04 mg/kg/day) during 60 days, the animals were injected with ET-1 (1 μl, 40 pmol/μl) or vehicle (1 μl). After 7 days, all animals were submitted to behavioral tests and then their brains were processed to biochemical and immunohistochemical analyses. We observed that long-term MeHg intoxication promoted a significant Hg deposits in the motor cortex, with concomitant increase of microglial response, followed by reduction of the neuronal population following ischemia and MeHg intoxication, as well as disturbance in the antioxidant defense mechanisms by misbalance of oxidative biochemistry with increase of both lipid peroxidation and nitrite levels, associated to behavioral deficits. MeHg exposure and cortical ischemia demonstrated that both injuries are able of causing significant neurobehavioural impairments in motor coordination and learning accompanied of an exacerbated microglial activation, oxidative stress and neuronal loss in the motor cortex, indicating that MeHg as a source of metabolic disturbance can act as an important increasing factor of ischemic events in the brain.
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Affiliation(s)
| | - Luana Nazaré S Santana
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, PA, Brazil
| | - Leonardo Oliveira Bittencourt
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, PA, Brazil
| | - Priscila Cunha Nascimento
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, PA, Brazil
| | - Rafael Monteiro Fernandes
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, PA, Brazil
| | - Luana Ketlen R Leão
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, PA, Brazil
| | - Luanna Melo P Fernandes
- Laboratory of Pharmacology of Inflammation and Behavior, Institute of Health Sciences, Federal University of Pará, Belém, PA, Brazil
| | - Marcia Cristina F Silva
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, PA, Brazil
| | - Lílian Lund Amado
- Laboratory of Ecotoxicology, Institute of Biological Sciences, Federal University of Pará, Belém, PA, Brazil
| | - Walace Gomes-Leal
- Laboratory of Experimental Neuroprotection and Neuroregeneration, Institute of Biological Sciences, Federal University of Pará, Belém, PA, Brazil
| | - Maria Elena Crespo-Lopez
- Laboratory of Molecular Pharmacology, Institute of Biological Sciences, Federal University of Pará, Belém, PA, Brazil
| | - Cristiane do Socorro F Maia
- Laboratory of Pharmacology of Inflammation and Behavior, Institute of Health Sciences, Federal University of Pará, Belém, PA, Brazil
| | - Rafael Rodrigues Lima
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém, PA, Brazil.
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