Manganese and lead levels in settled dust in elementary schools are correlated with biomarkers of exposure in school-aged children

A comprehensive analysis of children's blood lead levels in Latin America and the Caribbean over the last eight years: Progress and recommendations

In 2017 we published a review on blood lead levels (BLL) in children from Latin America and the Caribbean (LAC) for data available up to 14th of March 2014 and recommended the identification and control of "lead hot spots". In the present study, an evaluation of progress toward reducing BLL in the region was carried out. A systematic review of the latest literature on lead exposure in the LAC region held on the PubMed, Web of Science and LILACS databases (January 2014 to March 2022) was conducted using the PRISMA methodology. Only original papers published in peer-reviewed English, Spanish, or Portuguese journals were eligible. A total of 558 papers were retrieved, 77 of which met the selection criteria and 31 (40.25 %) were carried out in Mexico. The prevalence of children with BLL above 10 μg. dL-1 was 22.08 % in the previous review versus 6.78 % in the current study. In the present review, the prevalence of children with BLL above 5 μg. dL-1 was 29.62 %, and only one study reported a BLL prevalence rate between 3.3 and 5 μg. dL-1. The highest BLLs were associated with well-known sources or occupational exposures. The number of countries (n = 13) that published data on BLL in children was lower compared to the previous review (n = 16). Most studies were conducted in areas with known lead exposure sources, similar to the earlier review. The percentage of children at risk of lead poisoning in the region remains unknown because few studies have published data on environmental exposure levels and most samples were relatively small. The recommendation to identify and control sources of lead exposure was maintained, while further suggestions for establishing a systematic public health surveillance system for lead were proposed to help reduce the knowledge gap and inform public health policy-making in LAC.

Child and Adolescent Manganese Biomarkers and Adolescent Postural Balance in Marietta CARES Cohort Participants

BACKGROUND

Manganese (Mn) plays a significant role in both human health and global industries. Epidemiological studies of exposed populations demonstrate a dose-dependent association between Mn and neuromotor effects ranging from subclinical effects to a clinically defined syndrome. However, little is known about the relationship between early life Mn biomarkers and adolescent postural balance.

OBJECTIVES

This study investigated the associations between childhood and adolescent Mn biomarkers and adolescent postural balance in participants from the longitudinal Marietta Communities Actively Researching Exposures Study (CARES) cohort.

METHODS

Participants were recruited into CARES when they were 7-9 y old, and reenrolled at 13-18 years of age. At both time points, participants provided samples of blood, hair, and toenails that were analyzed for blood Mn and lead (Pb), serum cotinine, hair Mn, and toenail Mn. In adolescence, participants completed a postural balance assessment. Greater sway indicates postural instability (harmful effect), whereas lesser sway indicates postural stability (beneficial effect). Multivariable linear regression models were conducted to investigate the associations between childhood and adolescent Mn biomarkers and adolescent postural balance adjusted for age, sex, height-weight ratio, parent/caregiver intelligence quotient, socioeconomic status, blood Pb, and serum cotinine.

RESULTS

CARES participants who completed the adolescent postural balance assessment (n = 123 ) were 98% White and 54% female and had a mean age of 16 y (range: 13-18 y). In both childhood and adolescence, higher Mn biomarker concentrations were significantly associated with greater adolescent sway measures. Supplemental analyses revealed sex-specific associations; higher childhood Mn biomarker concentrations were significantly associated with greater sway in females compared with males.

DISCUSSION

This study found childhood and adolescent Mn biomarkers were associated with subclinical neuromotor effects in adolescence. This study demonstrates postural balance as a sensitive measure to assess the association between Mn biomarkers and neuromotor function. https://doi.org/10.1289/EHP13381.

Assessment of human health risks associated with airborne arsenic, nickel and lead exposure in particulate matter from vehicular sources in Sao Paulo city

Air pollution is a critical public health concern. The present study assessed the risk to human health of airborne Potentially Toxic Elements (PTE) arsenic, nickel and lead exposure in particulate matter (PM10-2.5) in Sao Paulo, Brazil. Statistical analysis was performed using R Software and the risk assessment for human health was carried out according to the methods of the United States Environmental Protection Agency. The results for mean annual concentration of PTE (ng m-3) were within the limits stipulated for air-quality by international agencies (arsenic <6, nickel <20 and lead <150). Airborne arsenic and lead showed higher mean concentrations during the winter than the other seasons (p < 0.05). However, the results showed a greater health risk for the adult population and during the winter season. These findings highlight the importance of air pollution as a risk factor for population health.

Maternal Exposure to Potentially Toxic Metals and Birth Weight: Preliminary Results from the DSAN-12M Birth Cohort in the Recôncavo Baiano, Brazil

Prenatal exposure to potentially toxic metals (PTM) may impair fetal growth (FG). We investigated the relationship between maternal exposure to lead (Pb), cadmium (Cd) and manganese (Mn) and birth weight (BW) of 74 newborns. Blood was collected during the second trimester of pregnancy to determine Pb (PbB) and Cd (CdB), while hair (MnH) and toenails (MnTn) were used for Mn. Samples were analyzed by graphite furnace atomic absorption spectrophotometry (GFAAS). Sociodemographic and BW data were collected from questionnaires and maternity records, respectively. The medians (P25th-P75th) of PbB, CdB, MnH, and MnTn were, respectively, 0.9 (0.5-1.8) µg/dL; 0.54 (0.1-0.8) µg/L; 0.18 (0.1-0.4) µg/g; and 0.65 (0.37-1.22) µg/g. The means (standard deviation) of birth weight according to sex were 3067 (426.3) and 3442 (431) grams, respectively, for girls and boys. MnTn presented an inverse correlation with the BW/gestational age ratio for girls (rho = -0.478; p = 0.018), suggesting the effect of sex modification. Although BW correlation with CdB was not statistically significant, hierarchical linear regression (beta = -2.08; 95% CI-4.58 to 0.41) suggested a fetotoxic effect. These results confirmed the threat PTMs may represent and the need for more extensive research to elucidate their role in inadequate FG in developing countries.

Determinants of Exposure to Potentially Toxic Metals in Pregnant Women of the DSAN-12M Cohort in the Recôncavo Baiano, Brazil

Exposure to potentially toxic metals (PTM) threatens maternal and child health. We investigated the determinants of exposure to lead (Pb), cadmium (Cd), arsenic (As), and manganese (Mn) in 163 pregnant women from the Recôncavo Baiano, Brazil, enrolled in the DSAN-12M cohort. We measured these metals in biological samples (blood, toenails, and hair) and the Pb dust loading rates (RtPb) at their homes by graphite furnace atomic absorption spectrophotometry (GFAAS). Questionnaires were applied to collect sociodemographic and general habits data. Only 2.91% (n = 4) of the pregnant women had As levels above the detection limit. Few participants had levels above the recommended reference values for blood Pb (5.1; 95% CI: 2.1-10.1%), and Mn in hair or toenails (4.3; 95% CI: 2.3-10.1%). On the other hand, 61.1 (95% CI: 52.4-69.3%) had elevated blood Cd levels. After binary logistic regression, low socioeconomic status, domestic waste burning, being a passive smoker, multiparity, and renovating the house significantly increased the chances of having high levels of Mn, Pb, and Cd. We detected a worrying situation related to exposure to Cd, showing the urgency of implementing human biomonitoring in the general population, especially in situations of social vulnerability.

Short- and long-term exposure to trace metal(loid)s from the production of ferromanganese alloys by personal sampling and biomarkers

The environmental exposure to trace metal(loid)s (As, Cd, Cu, Fe, Mn, Pb, and Zn) was assessed near a ferromanganese alloy plant using filters from personal particulate matter (PM) samplers (bioaccessible and non-bioaccessible fine and coarse fractions) and whole blood as short-term exposure markers, and scalp hair and fingernails as long-term biomarkers, collected from volunteers (n = 130) living in Santander Bay (northern Spain). Bioaccessible and non-bioaccessible metal(loid) concentrations in coarse and fine PM from personal samplers were determined by ICP-MS after extraction/digestion. Metal(loid) concentration in biomarkers was measured after alkaline dilution (whole blood) and acid digestion (fingernails and scalp hair) by ICP-MS as well. Results were discussed in terms of exposure, considering the distance to the main Mn source, and sex. In terms of exposure, significant differences were found for Mn in all the studied fractions of PM, As in whole blood, Mn and Cu in scalp hair and Mn and Pb in fingernails, with all concentrations being higher for those living closer to the Mn source, with the exception of Cu in scalp hair. Furthermore, the analysis of the correlation between Mn levels in the studied biomarkers and the wind-weighted distance to the main source of Mn allows us to conclude that scalp hair and mainly fingernails are appropriate biomarkers of long-term airborne Mn exposure. This was also confirmed by the significant positive correlations between scalp hair Mn and bioaccessible Mn in coarse and fine fractions, and between fingernails Mn and all PM fractions. This implies that people living closer to a ferromanganese alloy plant are exposed to higher levels of airborne metal(loid)s, mainly Mn, leading to higher levels of this metal in scalp hair and fingernails, which according to the literature, might affect some neurological outcomes. According to sex, significant differences were observed for Fe, Cu and Pb in whole blood, with higher concentrations of Fe and Pb in males, and higher levels of Cu in females; and for Mn, Cu, Zn, Cd and Pb in scalp hair, with higher concentrations in males for all metal(loid)s except Cu.

Biomarkers of environmental manganese exposure

We conducted a critical review on biomarkers of environmental manganese (Mn) exposure to answer the following questions: 1) are there reliable biomarkers of internal Mn exposure (Mn in biological matrices) associated with external metrics of Mn exposure (Mn in environmental media)? and 2) are there accurate reference values (RVs) for Mn in biological matrices? Three bibliographic databases were searched for relevant references and identified references were screened by two independent reviewers. Of the 6342 unique references identified, 86 articles were retained for data abstraction. Our analysis of currently available evidence suggests that Mn levels in blood and urine are not useful biomarkers of Mn exposure in non-occupational settings. The strength of the association between Mn in environmental media and saliva was variable. Findings regarding the utility of hair Mn as a biomarker of environmental Mn exposure are inconsistent. Measurements of Mn in teeth are technically challenging and findings on Mn in tooth components are scarce. In non-occupationally exposed individuals, bone Mn measurements using in vivo neutron activation analysis (IVNAA) are associated with large uncertainties. Findings suggest that Mn in nails may reflect Mn in environmental media and discriminate between groups of individuals exposed to different environmental Mn levels, although more research is needed. Currently, there is no strong evidence for any biological matrix as a valid biomarker of Mn exposure in non-occupational settings. Because of methodological limitations in studies aimed at derivation of RVs for Mn in biological materials, accurate RVs are scarce.

Executive functions in school-aged children exposed to airborne manganese: A multilevel analysis

Neuropsychological alterations have been identified in populations heavily exposed to metals with neurotoxic potential, such as manganese (Mn). This study examined the associations between Mn environmental exposure in school-aged children and executive functions, using structural equation modeling. Children, aged between 7 and 12 years (N = 181), were recruited from four elementary schools located in a region that is under the influence of atmospheric emissions from a ferro-manganese alloy plant in the municipality of Simões Filho, Bahia, Brazil. The following cognitive functions were evaluated: Intelligence, Inhibitory Control, Cognitive Flexibility, Verbal and Design Fluency, Verbal and Visual Working Memory and Attention. We performed structural equation modeling to identify the following executive functions latent variables: working memory, inhibitory control and cognitive flexibility. We further analyzed the relations between executive functions and Mn measured in hair (MnH) and toenails (MnTn) with linear mixed models, after controlling for co-variables. A positive effect at the individual level on working memory, inhibition control and cognitive flexibility was observed with MnTn after controlling for co-variables, but no association was found with MnH levels. However, children attending school most environmentally exposed to Mn emissions, which had the highest rate of Mn dust deposition, had the poorest scores on working memory. These findings suggest both benefits and risk of Mn on children's cognitive development.

Validation of an Analytical Method for the Determination of Manganese and Lead in Human Hair and Nails Using Graphite Furnace Atomic Absorption Spectrometry

This article describes the validation of analytical methods for the determination of Manganese (Mn) and lead (Pb) by graphite furnace atomic absorption spectrometry (GFAAS) in human hair and nail samples. Method validation parameters such as linearity, repeatability, reproducibility, and precision were determined. In addition, the limit of detection (LOD), the limit of quantification (LOQ), and measurement uncertainty were calculated. The developed method was linear in the concentration ranges of 0.001–0.015 and 0.002–0.020 µg·L−1 of Mn and Pb, respectively. The determination coefficients obtained were greater than 0.995. The recoveries obtained after the addition of the standard concentration for the metals ranged from 84.80–107.98%, with a precision not exceeding 12.97% relative standard deviation. The calculated LOD and LOQ for Mn and Pb are within the ranges established by Commission Regulation (EU) No. 836/2011. The expanded uncertainty was estimated to be less than 9.93–6.59% for Mn and Pb. Matrix effects were also studied, finding a smooth effect in both matrices. The analysis of 30 samples of each type revealed the presence of Mn in 30 and Pb in 13 samples. Overall, the proposed validation method was considered optimal for the determination of Mn and Pb.

Manganese and Lead Exposure and Early Puberty Onset in Children Living near a Ferromanganese Alloy Plant

Manganese (Mn) and lead (Pb) have been associated with the deregulation of the neuroendocrine system, which could potentially favor the appearance of precocious puberty (PP) in environmentally exposed children. This study aims to evaluate the exposure to Mn and Pb and their potential effects in anticipating puberty in school-aged children living near a ferromanganese alloy plant in Bahia, Brazil. Toenail, occipital hair and blood samples were collected from 225 school-aged children. Tanner’s scale was used for pubertal staging. Mn in blood (MnB), toenail (MnTn) and hair (MnH) and blood lead (PbB) levels were measured by graphite furnace atomic absorption spectrometry. Puberty-related hormone concentrations were determined by chemiluminescence. The age at which girls’ breasts began to develop was inversely correlated with weight-for-age, height-for-age and BMI-for-age Z-scores (p < 0.05); pubarche also had similar results. Mn biomarker levels did not present differences among pubertal classification nor among children with potential PP or not. Furthermore, Mn exposure was not associated with the age of onset of sexual characteristics for either girls or boys. However, PbB levels were positively correlated with boys’ pubic hair stages (rho = 0.258; p = 0.009) and associated with the age of onset of girls’ pubarche (β = 0.299, 95%CI = 0.055−0.542; p = 0.017). Testosterone and LH concentrations were statistically higher in boys with an increased PbB (p = 0.09 and p = 0.02, respectively). Prospective studies are needed to better assess the association between exposure to Mn and Pb and the early onset of puberty.

Validation of blood arsenic and manganese assessment from archived clotted erythrocyte fraction in an urban cohort of mother-child dyads

Exposure to arsenic (As) and manganese (Mn) from contaminated food, drinking water and dust are linked to a host of adverse health effects. The recent discovery of unmonitored community exposures to hazardous levels of metals, as seen in the Flint Water Crisis and East Chicago, have demonstrated a need for novel biomonitoring methods utilizing samples other than whole blood. Here, we present a method utilizing clotted erythrocyte fraction samples, a blood component commonly archived in biorepositories, to predict whole blood levels of As and Mn. This method would allow for innovative retrospective assessments of environmental exposures in previously unused samples. Whole blood and clotted erythrocyte fraction samples were simultaneously collected from 84 participants in the Airborne Exposure to Semivolatile Organic Pollutants (AESOP) cohort study of mother-child dyads in East Chicago. Clotted erythrocyte fraction samples were prepared by alkaline dilution and subsequently analyzed using inductively coupled plasma-mass spectrometry. A strong linear relationship was observed between whole blood and clotted erythrocyte fraction with Pearson correlation coefficients (r, p < 0.001) of 0.74, and 0.82 for As and Mn, respectively. Modeled whole blood Mn levels predicted from clotted erythrocyte fractions evaluated at a test threshold representing the NHANES median of 9.7 μg/L, were found to have diagnostic sensitivity of 88% and specificity of 71%. Clotted erythrocyte partitioning of As was tested on a wide range of oral gavage doses using a rat model. Results from this investigation demonstrate clotted erythrocyte fraction samples are a viable alternative biological sample for retrospective public health surveillance of environmental exposure to As and Mn.

Biomonitoring and bioaccessibility of environmental airborne manganese in relation to motor function in a healthy adult population

BACKGROUND/AIM

Santander, the capital of Cantabria, Spain (172,000 inhabitants) is 7 km from an industrial emission source (IES) of Mn located in a 10,000 inhabitants town (Maliaño) (annual air Mn arithmetic mean = 231.8 ng/m³; reference WHO guideline = 150 ng/m³). Our objective was to compare the motor function of adult healthy volunteers living in both places.

METHODS

Cross-sectional study analyzing 130 consecutive participants. Exposure to Mn was assessed in terms of source distance from the IES, by Personal Environmental Monitors (PEMs) carried for 24 h by participants consisting of a portable impactor connected to a personal pump, and by biomarkers (blood, hair and fingernails). The impactor allowed the separation of fine (PM2.5) and coarse (PM10-2.5) particles and for each particle size in-vitro bioaccessibility tests with biologically active fluids were performed to separate the soluble (bioaccessible) from the insoluble (non-bioaccessible) fraction. Mean Differences (MDs) adjusted for age, sex, and study level, were obtained for motor function tests results.

RESULTS

Regarding Grooved Pegboard, overall mean time to complete the test was 59.31 and 65.27 seconds (Standard Deviation = 10.11 and 11.69) for dominant and nondominant hands respectively. Statistically significant higher times (indicating worse function) were observed when living near the IES in both hands but MDs of only 1.22 and 2.05 seconds were obtained after adjusting for the predefined confounders (p = 0.373 and 0.221 respectively). Regarding Mn levels in their PEMs (in both bioaccessible and non-bioaccessible coarse&fine fractions) higher times were computed in participants with higher levels for the bioaccessible-fine fraction, with a MD that diminished but still yielded statistical significance after controlling for confounding: adjusted MD = 3.01 more seconds; 95%CI (0.44-5.38), p = 0.022. Poorer results were also observed for fingernails levels. Regarding Finger Tapping Test, no statistically significant differences were found with the exception of Mn fingernails levels.

CONCLUSIONS

Our results suggest poorer motor function as assessed by Grooved Pegboard test in relation to "proximity to IES", "bioaccessible-fine fraction as determined by PEMs and "Mn fingernails levels". However, our findings were affected by confounding, and only the adjusted MD for the Mn bioaccessible-fine fraction remained of sufficient magnitude to maintain statistical significance.

Metal-mixtures in toenails of children living near an active industrial facility in Los Angeles County, California

BACKGROUND

Children residing in communities near metalworking industries are vulnerable to multiple toxic metal exposures. Understanding biomarkers of exposure to multiple toxic metals is important to characterize cumulative burden and to distinguish potential exposure sources in such environmental justice neighborhoods impacted by industrial operations. Exposure to metal mixtures has not been well-characterized among children residing in the United States, and is understudied in communities of color.

METHODS

In this study we used toenail clippings, a noninvasive biomarker, to assess exposure to arsenic (As), cadmium (Cd), mercury (Hg), manganese (Mn), lead (Pb), antimony (Sb), selenium (Se), and vanadium (V). We used nonnegative matrix factorization (NMF) to identify "source" signatures and patterns of exposure among predominantly working class Latinx children residing near an industrial corridor in Southeast Los Angeles County. Additionally, we investigated the association between participant demographic, spatial, and dietary characteristics with identified metal signatures.

RESULTS

Through NMF, we identified three groupings (source factors) for the metal concentrations in children's toenails. A grouping composed of Sb, Pb, As, and Cd, was identified as a potential industrial source factor, reflective of known airborne elemental emissions in the industrial corridor. We further identified a manganese source factor primarily composed of Mn, and a potential dietary source factor driven by Se and Hg. We observed differences in the industrial source factor by age of participants, while the dietary source factor varied by neighborhood.

CONCLUSION

Utilizing an unsupervised dimension reduction technique (NMF), we identified a "source signature" of contamination in toenail samples from children living near metalworking industry. Investigating patterns and sources of exposures in cumulatively burdened communities is necessary to identify appropriate public health interventions.

The applicability of fingernail lead and cadmium levels as subchronic exposure biomarkers for preschool children

Preschool children are exposed daily to metals in their homes and at daycare centers (DCC). Metal exposure and health effects are associated even at low levels, and children comprise a group of public health concern. Nail metals have been studied for exposure biomonitoring and compared to other biological media. The aim of this study was to explore the applicability of preschool fingernail lead and cadmium as subchronic exposure biomarkers. Nail lead and cadmium levels (NLL and NCL) of 602 preschool children (age: 1-4 years) who attended 21 DCC in São Paulo, Brazil, in 2013 were analyzed. Results were compared against blood lead and cadmium levels (BLL and BCL) found in a previous study. Inductively coupled plasma mass spectrometry (ICP-MS) analyses were performed for both samples. DCC and metal contaminated sites (MCS) were georeferencing. Logistic regression tests were applied to verify associations between nail metal levels and risk factors (sex, age, maternal education, secondary smoking, DCC geographic district, vehicle flow density, relative altitude and distance between DCC and nearest MCS) (p < 0.05). BLL was stratified by exposure level (low: <5 μg.dL^-1; high: >13.9 μg.dL^-1; medium: ≥5 μg.dL^-1 and ≤13.9 μg.dL^-1) and also tested the associations in order to verify if nail lead levels are affected by exposure intensity defined by blood metals concentrations. Radius distance and relative altitude of DCC to nearest MCS were associated with high NLL and NCL. Abnormal appearance of nails was associated with high NLL and low NCL. Lead and cadmium exposure magnitude had no significant impact on NLL. NLL should only be used for initial screening, and when financial resources are scarce, especially in areas located near contaminated sites. Preschool children were co-exposed to both lead and cadmium, reinforcing the need for broader studies evaluating exposure to environmental pollutants for more than one chemical element.

Assessment of potters' occupational exposure to lead and associated risk factors in Maragogipinho, Brazil: preliminary results

BACKGROUND AND PURPOSE

Lead (Pb) is used as a flux in the glazing process of pottery utensils in several regions of the world. It can affect the nervous and hematopoietic systems; in addition, it is classified as a probable human carcinogen. This work aims to evaluate Pb exposure of potters and describe the main determinants of elevated blood Pb (PbB) levels in this group of workers.

METHODS

This is a cross-sectional study with potters of Maragogipinho Village, Bahia, Brazil, of both sexes, aged 16-72 years (n = 85). Non-exposed workers of the same age range residing in the urban area of Aratuípe town were also recruited (n = 50). We evaluated Pb dust deposition rates (PbDrt) in pottery workshops and PbB levels. All Pb measurements were performed by Graphite Furnace Atomic Absorption Spectrometry.

RESULTS

The median of PbB (min-max) and geometric mean (SD) PbDrt for the exposed group were 7.9 (0.9-49.8) µg/dL and 1463 (± 290,000) μg/m²/30 days, respectively. For the control group, levels were 1.5 (0.1-19.8) μg/dL and 82 (46) μg/m² 30 days, respectively.

CONCLUSION

The data found showed an excessive exposure among artisans, exceeding occupationally safe levels and those reported in the literature. It is important to implement occupational hygiene measures and improvements of the working conditions of these labors, especially the replacement of lead oxide in the pottery-glazing process.

The urban lead (Pb) burden in humans, animals and the natural environment

Centuries of human activities, particularly housing and transportation practices from the late 19th century through the 1980's, dispersed hundreds of millions of tons of lead into our urban areas. The urban lead burden is evident among humans, wild and domesticated animals, and plants. Animal lead exposures closely mirror and often exceed the lead exposure patterns of their human partners. Some examples: Pigeons in New York City neighborhoods mimicked the lead exposures of neighborhood children, with more contaminated areas associated with higher exposures in both species. Also, immediately following the lead in drinking water crisis in Flint MI in 2015, blood lead levels in pet dogs in Flint were 4 times higher than in surrounding towns. And combining lead's neurotoxicity with urban stress results in well-characterized aggressive behaviors across multiple species. Lead pollution is not distributed evenly across urban areas. Although average US pediatric lead exposures have declined by 90% since the 1970s, there remain well defined neighborhoods where children continue to have toxic lead exposures; animals are poisoned there, too. Those neighborhoods tend to have disproportionate commercial and industrial lead activity; a history of dense traffic; older and deteriorating housing; past and operating landfills, dumps and hazardous waste sites; and often lead contaminated drinking water. The population there tends to be low income and minority. Urban wild and domesticated animals bear that same lead burden. Soil, buildings, dust and even trees constitute huge lead repositories throughout urban areas. Until and unless we begin to address the lead repositories in our cities, the urban lead burden will continue to impose enormous costs distributed disproportionately across the domains of the natural environment. Evidence-based research has shown the efficacy and cost-effectiveness of some US public policies to prevent or reduce these exposures. We end with a series of recommendations to manage lead-safe urban environments.

A Review on the Environmental Exposure to Airborne Manganese, Biomonitoring, and Neurological/Neuropsychological Outcomes

The occupational exposure to airborne manganese (Mn) has been linked for decades with neurological effects. With respect to its environmental exposure, the first reviews on this matter stated that the risk posed to human health by this kind of exposure was still unknown. Later, many studies have been developed to analyze the association between environmental Mn exposure and health effects, most of them including the measure of Mn in selected human biomarkers. This review aims at collecting and organizing the literature dealing with the environmental airborne Mn exposure (other routes of exposure were intentionally removed from this review), the biomonitoring of this metal in different body matrices (e.g., blood, urine, nails, hair), and the association between exposure and several adverse health effects, such as, e.g., neurocognitive, neurodevelopmental, or neurobehavioral outcomes. From the different exposure routes, inhalation was the only one considered in this review, to take into account the areas influenced by industrial activities closely related to the Mn industry (ferromanganese and silicomanganese plants, Mn ore mines, and their processing plants) and by traffic in countries where a fuel additive, methylcyclopentadienyl manganese tricarbonyl (MMT), has been used for years. In these areas, high air Mn levels have been reported in comparison with the annual Reference Concentration (RfC) given by the US EPA for Mn, 50 ng/m³. This review was performed using Scopus and MEDLINE databases with a keyword search strategy that took into account that each valid reference should include at least participants that were exposed to environmental airborne Mn and that were subjected to analysis of Mn in biomarkers or subjected to neurological/neuropsychological tests or both. Overall, 47 references matching these criteria were included in the discussion. Most of them report the measure of Mn in selected biomarkers (N = 43) and the assessment of different neurological outcomes (N = 31). A negative association is usually obtained between Mn levels in hair and some neurological outcomes, such as cognitive, motor, olfactory, and emotional functions, but not always significant. However, other biomarkers, such as blood and urine, do not seem to reflect the chronic environmental exposure to low/moderate levels of airborne Mn. Further studies combining the determination of the Mn exposure through environmental airborne sources and biomarkers of exposure and the evaluation of at least cognitive and motor functions are needed to better understand the effects of chronic non-occupational exposure to airborne Mn.

Environmental exposure to lead and hematological parameters in Afro-Brazilian children living near artisanal glazed pottery workshops

This study aimed to evaluate the exposure to environmental lead (Pb) of children from a traditional community of African descent in Brazil and the effects on hematological parameters. Children (n = 75) aged 5.5-13 years from the exposed areas classified as low (LEx) and moderately (MEx) exposed were compared with children (n = 75) of a control group (CG). Dust Pb loading rates (RtPbs) at children's homes were measured. Peripheral venous blood samples were collected to assess Pb biomarkers of exposure and effects. All Pb determinations were performed by graphite furnace atomic absorption spectrometry. The median (IQR) of RtPb, PbB level, and ALA-D activity were 65 (25-137) μgPb/m²/30 days, 1.0 (0.1-2.8) μg/dL, and 71 (55-86) U/L, respectively. Spearman correlation evidenced the relationship of PbB with RtPb (rho = 0.368, P < 0.001) and ALA-D activity (rho = -0.587; P ˂ 0.001). After adjusting for exposure degree and child's age, a decline of 7.4 U/L in ALA-D activity was associated with a 10-fold increase in PbB. The prevalence ratio of elevated PbB (>5 μg/dL) in LEx and MEx areas were 1.5 and 3.7, respectively. Indoor dust exposure, living near pottery workshops and the secondary exposure were the main determinants of elevated PbB levels, which were associated with hematological effects.

Pollution characteristics, sources, and health risk assessments of urban road dust in Kuala Lumpur City

Urban road dust contains anthropogenic components at toxic concentrations which can be hazardous to human health. A total of 36 road dust samples from five different urban areas, a commercial (CM), a high traffic (HT), a park (GR), a rail station (LRT), and a residential area (RD), were collected in Kuala Lumpur City followed by investigation into compositions, sources, and human health risks. The concentrations of trace metals in road dust and the bioaccessible fraction were determined using inductively couple plasma-mass spectrometry (ICP-MS) while ion concentrations were determined using ion chromatography (IC). The trace metal concentrations were dominated by Fe and Al with contributions of 53% and 21% to the total trace metal and ion concentrations in road dust. Another dominant metal was Zn while the dominant ion was Ca²⁺ with average concentrations of 314 ± 190 μg g^-1 and 3470 ± 1693 μg g^-1, respectively. The most bioaccessible fraction was Zn followed by the sequence Sr > Cd > Cr > Cu > Ni > Co > Mn > As > V > Pb > Fe > Al > U. The results revealed that the highest trace metal and ion concentrations in road dust and in the bioaccessible fraction were found at the LRT area. Based on the source apportionment analysis, the major source of road dust was vehicle emissions/traffic activity (47%), and for the bioaccessible fraction, the major source was soil dust (50%). For the health risk assessments, hazard quotient (HQ) and cancer risk (CR) values for each element were < 1 and in the tolerable range (1.0E-06 to 1.0E-04), except for As for the ingestion pathway. This result suggests a low risk from non-carcinogenic and probable risk from carcinogenic elements, with higher health risks for children compared to adults.

Biomonitoring of Metals in Children Living in an Urban Area and Close to Waste Incinerators

The impact of waste incinerators is usually examined by measuring environmental pollutants. Biomonitoring has been limited, until now, to few metals and to adults. We explored accumulation of a comprehensive panel of metals in children free-living in an urban area hosting two waste incinerators. Children were divided by georeferentiation in exposed and control groups, and toenail concentrations of 23 metals were thereafter assessed. The percentage of children having toenail metal concentrations above the limit of detection was higher in exposed children than in controls for Al, Ba, Mn, Cu, and V. Exposed children had higher absolute concentrations of Ba, Mn, Cu, and V, as compared with those living in the reference area. The Tobit regression identified living in the exposed area as a significant predictor of Ba, Ni, Cu, Mn, and V concentrations, after adjusting for covariates. The concentrations of Ba, Mn, Ni, and Cu correlated with each other, suggesting a possible common source of emission. Exposure to emissions derived from waste incinerators in an urban setting can lead to body accumulation of specific metals in children. Toenail metal concentration should be considered a noninvasive and adequate biomonitoring tool and an early warning indicator which should integrate the environmental monitoring of pollutants.

Toenail Metal Exposures in Fishermen from Bodo City, Nigeria

We conducted exposure assessment using toenails from 20 fishermen living in Bodo City, a community of the Niger delta region in Nigeria. This community has been affected by over 4000 oil spills and environmental disasters. Fishing is the primary source of food and income for individuals in this community. Previous research in Bodo City found elevated metal levels in fish. Toenails were used as a biomarker to investigate the feasibility for use in risk assessment studies in developing countries. The toenails collected had significantly higher manganese levels (median 5.8 µg/g) and lead levels (median 0.98 µg/g) than those reported in more developed countries, comparable levels to those from other low-middle incomes countries. These exposure levels are likely a direct result of exposures from the environmental disasters the community has experienced and would be related to increased risks for many diseases previously associated with heavy metal exposures.

Assessing the contributions of metals in environmental media to exposure biomarkers in a region of ferroalloy industry

Residential proximity to ferroalloy production has been associated with increased manganese exposure, which can adversely affect health, particularly among children. Little is known, however, about which environmental samples contribute most to internal levels of manganese and other ferroalloy metals. We aimed to characterize sources of exposure to metals and evaluate the ability of internal biomarkers to reflect exposures from environmental media. In 717 Italian adolescents residing near ferromanganese industry, we examined associations between manganese, lead, chromium, and copper in environmental samples (airborne particles, surface soil, indoor/outdoor house dust) and biological samples (blood, hair, nails, saliva, urine). In multivariable regression analyses adjusted for child age and sex, a 10% increase in soil Mn was associated with increases of 3.0% (95% CI: 1.1%, 4.9%) in nail Mn and 1.6% (95% CI: -0.2%, 3.4%) in saliva Mn. Weighted-quantile-sum (WQS) regression estimated that higher soil and outdoor dust Mn accounted for most of the effect on nail Mn (WQS weights: 0.61 and 0.22, respectively, out of a total of 1.0). Higher air and soil Mn accounted for most of the effect on saliva Mn (WQS weights: 0.65 and 0.29, respectively). These findings can help inform biomarker selection in future epidemiologic studies and guide intervention strategies in exposed populations.

Manganese exposure and association with hormone imbalance in children living near a ferro-manganese alloy plant

It has been suggested that manganese (Mn) plays a fundamental role in the reproductive system through interference with the regulation of the secretion of hormones related to puberty. The objective of this study was to evaluate the environmental exposure to Mn and its effects on the endocrine regulation of hormones related to puberty in school-aged children living near a ferro-manganese alloy plant. Toenails, occipital hair, and blood samples were collected from 225 children, between 7 and 12 years of age, in four elementary schools in Simões Filho, Bahia, Brazil, who were exposed to different Mn levels owing to different Mn dust deposition rates. The Mn content was determined in the toenails (MnTn), hair (MnH), and blood (MnB), in addition to blood lead levels (PbB), by using graphite furnace atomic absorption spectrometry. Luteinizing hormone (LH), prolactin (PRL), estradiol (E₂), testosterone (T), and thyroid stimulating hormone (TSH) levels were determined by using a chemiluminescence method. Of the total participants, 50.2% were boys, with an average age of 9 years. PRL values were higher in children attending the school with a higher Mn deposition rate (p < 0.004). We observed that MnTn was positively correlated with PRL levels and exhibited a non-linear association with LH levels. None of the tested Mn biomarkers were associated with E₂, T, or TSH levels. To date, despite several animal studies that have focused on the correlation between Mn exposure and the endocrine regulation of hormones and pubertal development, very few studies have reported a similar relationship between environmental Mn effects and the human endocrine system. Our findings support the hypothesis that elevated exposure to Mn in children may be associated with hormonal imbalances that might trigger the early onset of puberty.

The exposure of children to PM2.5 and dust in indoor and outdoor school classrooms in Kuala Lumpur City Centre

It is important to assess indoor air quality in school classrooms where the air quality may significantly influence school children's health and performance. This study aims to determine the concentrations of PM_2.5 and dust chemical compositions in indoor and outdoor school classroom located in Kuala Lumpur City Centre. The PM_2.5 concentration was measured from 19th September 2017-16th February 2018 using an optical PM_2.5 sensor. Indoor and outdoor dust was also collected from the school classrooms and ion and trace metal concentrations were analysed using ion chromatography (IC) and inductively couple plasma-mass spectrometry (ICP-MS) respectively. This study showed that the average indoor and outdoor 24 h PM_2.5 was 11.2 ± 0.45 µg m^-3 and 11.4 ± 0.44 µg m^-3 respectively. The 8 h PM_2.5 concentration ranged between 3.2 and 28 µg m^-3 for indoor and 3.2 and 19 µg m^-3 for outdoor classrooms. The highest ion concentration in indoor dust was Ca²⁺ with an average concentration of 38.5 ± 35.0 µg g^-1 while for outdoor dust SO₄^2- recorded the highest ion concentration with an average concentration of 30.6 ± 9.37 µg g^-1. Dominant trace metals in both indoor and outdoor dust were Al, Fe and Zn. Principle component analysis-multiple linear regression (PCA-MLR) demonstrated that the major source of indoor dust was road dust (69%), while soil dominated the outdoor dust (74%). Health risk assessment showed that the hazard quotient (HQ) value for non-carcinogenic trace metals was < 1 while the total cancer risk (CR) value for carcinogenic elements was below the acceptable limit for both indoor and outdoor dust through dermal and inhalation pathways, but not the ingestion pathway. This study suggests indoor contributions of PM_2.5 concentrations are due to the activities of the school children while the compositions of indoor and outdoor dust are greatly influenced by the soil/earth source plus industrial and traffic contribution.

Environmental Co-Exposure to Lead and Manganese and Intellectual Deficit in School-Aged Children

Studies have demonstrated that, for urban children, dust represents the main exposure to sources of metals like lead (Pb) and manganese (Mn). We aimed to investigate the exposure to these metals and their association with intellectual deficit in children living in an industrial region. This cross-sectional study recruited volunteers from four elementary schools in the town of Simões Filho, Brazil. We evaluated 225 school-aged children (7⁻12 years) for blood lead (PbB) and manganese hair (MnH) and toenails (MnTn) by graphite furnace atomic absorption spectrometry. Child and maternal IQs were estimated using the Wechsler Abbreviated Scale for Intelligence (WASI). Median and range PbB were 1.2 (0.3⁻15.6) μg/dL. MnH and MnTn medians (ranges) were 0.74 (0.16⁻8.79) μg/g and 0.85 (0.15⁻13.30) μg/g, respectively. After adjusting for maternal IQ, age and Mn exposure, child IQ drops by 8.6 points for a 10-fold increase in PbB levels. Moreover, an effect modification of Mn co-exposure was observed. In children with low MnTn, association between Pb and child IQ was not significant (β = -6.780, p = 0.172). However, in those with high MnTn, the association was increased by 27.9% (β = -8.70, p = 0.036). Low Pb exposure is associated with intellectual deficit in children, especially in those with high MnTn.