Effects of lead, cadmium, arsenic, and mercury co-exposure on children's intelligence quotient in an industrialized area of southern China

Effects of Blood Lead Levels <10 µg/dL in School-Age Children and Adolescents: A Scoping Review

CONTEXT

Lead exposures among school-age children are a major public health issue. Although the harmful effects of lead exposure during the first years of life are well known, there is not as much understanding of the effects of low levels of lead exposure during later childhood.

OBJECTIVES

To review the effects of blood lead levels (BLLs) <10 µg/dL in school-age children and adolescents.

DATA SOURCES

We searched Medline, Embase, Global health, CINAHL, Scopus, and Environmental Science Collection databases between January 1, 2000, and May 11, 2023.

STUDY SELECTION

We included peer-reviewed English-language articles that presented data on the effects of BLLs <10 µg/dL in individuals ages 5 through 18 years.

DATA EXTRACTION

Data on country, population, analytic design, sample size, age, BLLs, outcomes, covariates, and results were extracted.

RESULTS

Overall, 115 of 3180 screened articles met the inclusion criteria. The reported mean or median BLL was <5 µg/dL in 98 articles (85%). Of the included articles, 89 (77%) presented some evidence of an association between BLLs <10 µg/dL during school age and detrimental outcomes in a wide range of categories. The strongest evidence of an association was for the outcomes of intelligence quotient and attention-deficit/hyperactivity disorder diagnoses or behaviors.

LIMITATIONS

Few articles controlled for BLLs at age <5 years, limiting conclusions about the relation between later BLLs and outcomes.

CONCLUSIONS

BLLs <10 µg/dL in school-age children and adolescents may be associated with negative outcomes. This review highlights areas that could benefit from additional investigation.

High lead contamination in Mother's breastmilk in Bihar (India): Health risk assessment of the feeding children

Lead poisoning in the recent times has caused serious health threats in the exposed human population. It is estimated that about 815 million people are exposed to lead poisoning worldwide and in India total 275 million children are exposed to blood lead contamination. The present study was carried outed in 6 districts of Bihar to know the extent of lead exposure in the children through their mother's breastmilk. The biological samples such as breastmilk, mother's urine, child's urine, and mother's blood samples were collected for quantitative lead estimation. Moreover, the selected household water sources (handpump) and the food consumed by the individuals-wheat, rice and potato samples were also collected for lead quantification. The study reveals that the breastmilk had high lead content in 92% of the samples (highest value 1309 μg/L), in blood presence of lead was observed in 87% studied samples (highest value 677.2 μg/L). In mother's urine the highest lead value was 4168 μg/L (62%) and in child's urine the highest value was 875.4 μg/L (62%) respectively of the studied samples. Moreover, in the studied food samples, wheat had lead content in 45% the studied samples (highest value 7910 μg/kg). In rice in 40% of the studied samples (highest value 6972 μg/kg) and in potato 90% of the studied samples (highest value = 13786 μg/kg) were found with elevated lead content respectively. The hazard quotient (HQ) and the cancer risk (CR) for lead contamination was very much higher in mothers followed by their children. The entire study indicated that lead exposure through food (wheat, rice and potato) has reached the mother's breastmilk and from their it has reached their child's body. This could cause serious hazards in the exposed children causing serious neurological damages, low IQ, low memory, and low mental growth in them. Therefore, a strategic action is required to control the present problem.

Urinary cadmium levels in China (1982-2021): Regional trends and influential factors

Despite the significant threat of cadmium exposure in China, a national-level assessment has been conspicuously absent. This study bridges this critical gap by collecting, geospatial analyzing and multivariable regression analyzing published studies on urinary cadmium levels in Chinese from 1982 to 2021. Our research reveals a notable decline trend in cadmium exposure among Chinese populations. However, this trend varies by region, age and gender group, higher levels are seen in the South (1.04 μg/g cr) compared to the North (0.48 μg/g cr), and in adults (1.08 μg/g cr) relative to children (0.33 μg/g cr), with higher levels being more pronounced in females (6.17 μg/g cr). Urinary cadmium is significantly correlated with rice consumption (P < 0.001), while mining activities have been identified as the dominant factor for cadmium exposure in most regions of China, a trend that is evident both in past decades and is expected to continue into the next decade. These findings underscore the need for region-specific environmental and public health strategies, designed to effectively address the distinct cadmium exposure risks in various regions and among different population groups, thus enhancing protection against the adverse effects of cadmium.

Standards for levels of lead in soil and dust around the world

Lead poisoning is a serious environmental health problem in every country in the world. Exposure to lead results in neurocognitive and behavioral changes, has adverse effects on the immune system, causes anemia, hypertension and perturbs other organ systems. The effects of lead poisoning are most critical for children because their bodies are growing and developing, and particularly because agents that reduce cognitive function and attention span as well as promote disruptive behavior will have life-long consequences. Lead exposure, especially to children, is a major health disparity issue. If the next generation starts with reduced cognitive ability, there will be significant barriers for development of skills and country-wide development. While there are many sources of exposure to lead, the commonest source is lead in soil and dust. Since lead is an element, it does not go away and past releases of lead into the environment remain as soil and dust contamination. This is an especially important route of exposure to children because children regularly play in soil and are exposed via hand-to-mouth activity. In addition to indoor sources of lead, contaminated soil is tracked on shoes or feet and blown by air currents into homes, accumulating in household dust which is a major source of exposure for both children and adults. The purpose of this review is to determine standards presumed to be health protective for lead and dust in different countries. We find that many countries have no standards for lead in soil and dust and rely on standards set by the World Health Organization or the US Environmental Protection Agency, and these standards may or may not be enforced. There is considerable variation in standards set by other countries.

Trace elements in commercially available infant formulas in Iran: Determination and estimation of health risks

Infants are significantly more vulnerable to trace elements from their foods. The objective of the present study was to ascertain the concentrations of some trace elements namely; arsenic, cadmium, chromium, copper, nickel and lead in infant formulas sold in Iran and to estimate the potential health risks to the infants through consumption of these products. The mean concentrations of As, Cd, Cr, Cu, Ni and Pb in infant formula samples were 0.006, 0.040, 0.3980, 2.014, 0.166 and 0.285 mg/kg, respectively. The mean levels of the trace elements were in the following order: Cu > Cr > Pb > Ni > Cd > As. For arsenic, cadmium and copper, calculated EWIs (estimated weekly intakes) were within the PTWIs (provisional tolerated weekly intakes) recommended by FAO/WHO. For chromium, nickel and lead, the calculated EWIs were higher than the PTWIs in 88.8 %, 75 %, and 61.1 % of the formulas. HQs of Pb, Cu, Cd and As were above the safe limits, indicating health concerns from the consumption of some infant formulas. Based on the CR classification, CR values of some elements including Cd, Cr and Ni were above 1 × 10-4 in some brands, indicating that exposure to these elements from infant formulas may cause health risks. Therefore, regular monitoring of all the raw materials, stages of production and storage of infant formulas is essential to limit the exposure of this vulnerable age group to toxic trace elements.

Sodium butyrate alleviates lead-induced neuroinflammation and improves cognitive and memory impairment through the ACSS2/H3K9ac/BDNF pathway

Lead is an environmentally widespread neurotoxic pollutant. Although the neurotoxicity of lead has been found to be closely associated with metabolic disorders, the effects of short-chain fatty acids on the neurotoxicity of lead and its mechanisms have not yet been explored. In this study, the results of open field tests and Morris water maze tests demonstrated that chronic lead exposure caused learning and memory deficits and anxiety-like symptoms in mice. The serum butyric acid content of lead-treated mice decreased in a dose-dependent manner, and oral administration of butyrate significantly improved cognitive memory impairment and anxiety symptoms in lead-exposed mice. Moreover, butyrate alleviated neuroinflammation caused by lead exposure by inhibiting the STAT3 signaling in microglia. Butyrate also promoted the expression of acetyl-CoA synthetase ACSS2 in hippocampal neurons, thereby increasing the content of acetyl-CoA and restoring the expression of both histone H3K9ac and the downstream BDNF. We also found that the median butyric acid concentration in high-lead exposure humans was remarkably lower than that in the low-lead exposure humans (45.16 μg/L vs. 60.92 μg/L, P < 0.01), and that butyric acid significantly mediated the relationship of lead exposure with the Montreal cognitive assessment scores, with a contribution rate of 27.57 %. In conclusion, our results suggest that butyrate supplementation is a possible therapeutic strategy for lead-induced neurotoxicity.

Quantitative relationships of FAM50B and PTCHD3 methylation with reduced intelligence quotients in school aged children exposed to lead: Evidence from epidemiological and in vitro studies

At present, the application of DNA methylation (DNAm) biomarkers in environmental health risk assessment (EHRA) is more challenging due to the unclearly quantitative relationship between them. We aimed to explore the role of FAM50B and PTCHD3 at the level of signaling pathways, and establish the quantitative relationship between them and children's intelligence quotients (IQs). DNAm of target regions was measured in multiple cell models and was compared with the human population data. Then the dose-response relationships of lead exposure with neurotoxicity and DNAm were established by benchmark dose (BMD) model, followed by potential signaling pathway screening. Results showed that there was a quantitative linear relationship between children's IQs and FAM50B/PTCHD3 DNAm (DNAm between 51.40 % - 78.78 % and 31.41 % - 74.19 % for FAM50B and PTCHD3, respectively), and this relationship was more significant when children's IQs > 90. The receiver operating characteristic (ROC) and calibration curves showed that FAM50B/PTCHD3 DNAm had a satisfying accuracy and consistency in predicting children's IQs, which was confirmed by sensitivity analysis of gender and CpG site grouping data. In cell experiments, there was also a quantitative linear relationship between FAM50B DNAm and reactive oxygen species (ROS) production, which was mediated by PI3K-AKT signaling pathway. In addition, the lead BMD of ROS was close to that of FAM50B DNAm, suggesting that FAM50B DNAm was a suitable biomarker for the risk assessments of adverse outcomes induced by lead. Taken collectively, these results suggest that FAM50B/PTCHD3 can be applied to EHRA and the prevention/intervention of adverse effects of lead on children's IQs.

Associations between parental and postnatal metal mixture exposure and developmental delays in a Taiwanese longitudinal birth cohort of preschool children

Studies have evaluated the impact of environmental exposure to neurotoxic metals on developmental delays (DDs). However, comprehensive understanding regarding the associations between parental and postnatal exposure to metal mixtures and the occurrence of DDs in offspring is limited. In this study, we assessed the relationships between parental and postnatal exposure to three metals (arsenic [As], cadmium [Cd], and lead [Pb], levels of which were measured in toenails) and suspected DDs (SDDs) in preschool children within a Taiwanese longitudinal birth cohort. In total between 2017 and 2021, 154 pairs of parents and their children under the age of 6 years were recruited, and 462 toenail samples and 154 completed questionnaires were collected. Metal concentrations in toenails were quantified using inductively coupled plasma-mass spectrometry after acid digestion of the toenails. We applied multivariable logistic regression and Bayesian kernel machine regression to evaluate the overall effect and to identify key components of the metal mixture that were associated with the SDD risk. Higher concentrations of As, Cd, and Pb were found in the toenails of the parents of children with SDDs compared with the toenails of the parents of children without SDDs. Our examination of the combined effects of exposure to the metal mixture revealed that As concentration in the father's toenail and Cd concentration in the mother's toenail were positively correlated with the risk of SDDs in their offspring. Notably, the effect of exposure to the metal mixture on the risk of SDDs was stronger in boys than in girls. Our findings suggest that parents taking measures to minimize their exposure to metals might enhance their children's developmental outcomes.

Prenatal and concurrent blood mercury concentrations and associations with IQ in canadian preschool children

BACKGROUND

Prenatal and childhood mercury (Hg) exposures have been associated with negative impacts on child neurodevelopment. It is unclear if associations persist at the low Hg exposures typical in Western countries.

OBJECTIVE

To examine associations between prenatal/childhood blood Hg concentrations and child IQ in Canadian male and female children while considering the potential modifying role of prenatal fish consumption.

METHODS

We analyzed data from the Maternal-Infant Research on Environmental Chemicals study. Hg was measured in first trimester (n = 527), cord (n = 430), and child (at 3-4 years of age, n = 355) blood and examined sex-stratified associations between blood Hg and children's Full Scale IQ (FSIQ), Verbal IQ (VIQ), Performance IQ (PIQ), and General Language Composite (GLC) scores (assessed with WPPSI-III). Prenatal Hg analyses were further stratified by prenatal fish consumption (low: 0-2, moderate: 3-7, or high: ≥8 times/month).

RESULTS

Higher cord blood Hg concentrations were associated with lower PIQ (ß = -3.27; 95%CI: 6.44, -0.09) in male children with the lowest prenatal fish consumption. Progressively stronger positive associations were observed with PIQ in male children for moderate (ß = 1.08; 95%CI: 0.10, 2.26) and high (ß = 3.07; 95%CI: 1.95, 4.19) prenatal fish consumption. Cord blood Hg concentrations were positively associated with female children's FSIQ (ß = 1.29; 95% CI: 0.77, 1.81) and PIQ (ß = 2.01; 95% CI: 1.19, 2.83); however, when stratified only in the highest fish consumption subgroup. Among female children, higher child blood Hg concentrations were associated with an approximately 1-point increase in FSIQ, VIQ, and GLC.

CONCLUSIONS

Prenatal exposure to low levels of Hg was associated with lower PIQ scores in male children with low prenatal fish intake. Positive associations between cord and child blood Hg concentrations and IQ were primarily observed in female children and may be due to beneficial effects of prenatal fish intake.

Effects of preterm birth and postnatal exposure to metal mixtures on neurodevelopment in children at 24 months of age

The effects of early-life metal exposure on neurodevelopment in very low birth weight preterm (VLBMP) children (with a birth weight of <1500 g and a gestational age of <37 weeks) have not been clearly established. We aimed to investigate associations of childhood exposure to multiple metals and preterm low birth weight with neurodevelopment among children at 24 months of corrected age. VLBWP children (n = 65) and normal birth weight term (NBWT) children (n = 87) were enrolled from Mackay Memorial Hospital in Taiwan between December 2011 and April 2015. Lead (Pb), cadmium (Cd), arsenic (As), methylmercury (MeHg), and selenium (Se) concentrations in the hair and fingernails were analyzed as biomarkers for metal exposure. The Bayley Scale of Infant and Toddler Development, Third Edition, was used to determine neurodevelopment levels. VLBWP children had significantly lower scores in all development domains compared to NBWT children. We also investigated preliminary exposure levels of VLBWP children to metals as reference values for future epidemiological and clinical survey. Fingernails are a useful biomarker for metal exposure to evaluate the effects on neurological development. A multivariable regression analysis revealed that fingernail Cd concentrations were significantly negatively associated with cognition (β = -0.63, 95% confidence interval (CI): -1.17 to -0.08) and receptive language function (β = -0.43, 95% CI: -0.82 to -0.04) among VLBWP children. VLBWP children with a 10-μg/g increase in the As concentration in their nails had a 8.67-point lower composite score in cognitive ability and a 1.82-point lower score in gross-motor functions. Effects of preterm birth and postnatal exposure to Cd and As were associated with poorer cognitive, receptive language, and gross-motor abilities. VLBWP children are at risk for neurodevelopmental impairments when exposed to metals. Further large-scale studies are needed assess to the risk of neurodevelopmental impairments when vulnerable children are exposed to metal mixtures.

Health risk study of cadmium, chromium, lead and arsenic in reservoir water of Changzhou, China

Accurately assessing the health risks of human exposure to heavy metals via water is of great importance for performing targeted health risk prevention measures. To better understand the concentration characteristics and potential harm to human health of cadmium, chromium, lead and arsenic in the main drinking water-type reservoirs of Changzhou city, we collected samples from the Haidi Reservoir, Dongjin Reservoir, Xinfushan Reservoir, Maodong Reservoir and Xiangyang Reservoir of Changzhou in the summer of 2019. The results showed that the daily average comprehensive exposure level of metals was much lower than the provisional tolerated daily intake (PTDI), i.e., Cd: 1 µg kg^-1 d^-1; Cr: 3 µg kg^-1 d^-1; Pb: 3.57 µg kg^-1 d^-1; and As: 2.14 µg kg^-1 d^-1. The comprehensive non-carcinogenic risk levels of four metals under water-drinking exposure and water-skin exposure routes ranged from 4.68E - 3 to 1.69E - 1, and the carcinogenic risk ranged from 2.09E - 5 to 7.30E - 5, which were all at acceptable risk levels. Although lead and chromium were present at acceptable health risk levels, they still represented the main pollutants of potential health risk in the local water environment from a non-carcinogenic or carcinogenic perspective, and they should be listed as the primary targets for water environmental risk management.

Health risk assessment of some selected heavy metals in infant food sold in Wa, Ghana

Infants remain a high-risk group as far as exposure to toxic metals is concerned. The levels of lead (Pb), cadmium (Cd), nickel (Ni), chromium (Cr), antimony (Sb), mercury (Hg), and arsenic (As) in twenty-two (22) samples of baby foods and formulas were determined using inductively coupled plasma mass spectrometry. The concentrations in (mg/kg) of As, Cd, Cr, Hg, Mn, Ni, Pb, and Sb were in the ranges 0.006-0.057, 0.043-0.064, 0.113-0.33, 0.000-0.002, 1.720-3.568, 0.065-0.183, 0.061-0.368 and 0.017-0.1 respectively. Health risk assessment indices like the Estimated Daily Intake (EDI), Target Hazard Quotient (THQ), Cancer Risk (CR) and Hazard Index (HI) were calculated. EDI values of Hg, Cr, and As were below their recommended tolerable daily intake, that of Ni and Mn were lower in 95% of samples, and Cd was also lower in 50% of the samples. THQ values for As, Cd, Cr, Hg, Mn, Ni, and Pb were 0.32-3.21, 0.75-1.10, 0.65-1.94, 0.00-0.37, 0.21-0.44, 0.08-0.12 and 0.26-1.13 respectively. The CR values were greater than 10^-6, making them unacceptable for human consumption. HI values were between 2.68 and 6.83 (greater than 1), which implied that these metals are likely to pose non-carcinogenic health risks to infants.

Slight transition in Chinese atmospheric Pb isotopic fingerprinting due to increasing foreign Pb

Atmospheric lead (Pb) pollution negatively affects human health and ecosystem, and extensive research is required to identify its sources and develop robust mitigation methods. In this study, the concentration and isotopic composition of Pb in fine particulate matter (PM_2.5) at five sites in the China's Beijing-Tianjin-Hebei (BTH) region were analyzed. The results showed that the Pb concentration in the BTH region declined along the northwest direction in winter owing to the East Asian monsoon. Pb isotopic signatures confirmed that anthropogenic activities significantly contributed to Pb pollution, compared with natural sources. With the increasing import of foreign Pb (with a relatively lower ²⁰⁸Pb/²⁰⁶Pb ratio) to China, we hypothesized that the unique isotopic signature of Pb in Chinese aerosols may decline over time. Therefore, the application of the isotopic approach for quantifying Pb transported from China should be carefully appraised in future research to provide a realistic estimate of the contribution of local sources and the transboundary effect consistent with air mass trajectories analysis. This study provides a theoretical reference for supporting the utilization of Δ²⁰⁸Pb values for better clarify the transboundary impact of Pb pollution and to reduce international disputes.

Evaluation of School-Age Children's Intelligence Quotient and Their Chronic Exposure to Trace Elements in Ambient Air

Background Children's exposure to different trace elements in their air, water, and food or even present in paints or toys can affect their intelligence quotient (IQ) score. However, this correlation needs to be analyzed and evaluated in different contexts. This study aimed to investigate the associations between airborne concentrations of lead (Pb), manganese (Mn), cadmium (Cd), chromium (Cr), and arsenic (As) and intellectual function in school-age children in Makkah, Kingdom of Saudi Arabia. Methodology Our cohort study aimed to explore the link between exposure to various trace elements in the surrounding air and the IQ scores of children residing in the vicinity of Makkah. We included 430 children in the study and collected information about demographic and lifestyle factors using a structured questionnaire. We employed a mini volume sampler (MiniVol, AirMetrics, Springfield, OR, USA) to collect 24-hour PM10 samples from five locations in Makkah, representing various residential areas with small-to-medium industrial activities and traffic load. We analyzed the samples for Pb, Mn, Cd, Cr, and As concentrations using inductively coupled plasma-mass spectrometry with Perkin Elmer 7300 (Perkin Elmer, Waltham, MA, USA). The combined impact of heavy metals on continuous outcomes was assessed using the Bayesian kernel machine regression model. Results The mean atmospheric concentrations of Pb, Mn, Cd, Cr, and As in summer were 0.093, 0.006, 0.36, 0.15, and 0.017 µg/m³, respectively, while in winter, they were 0.004, 0.003, 0.12, 0.006, and 0.01 µg/m³, respectively. The findings of our study revealed that children's IQ scores were independently associated with co-exposure to the five metals, namely, Pb, Mn, Cd, Cr, and As. Conclusions This study demonstrates a link between combined exposure to five heavy metals (Pb, Mn, Cd, Cr, and As) and children's IQ scores. Regularly evaluating trace elements in children's biological samples is crucial to comprehend their effects on cognitive growth. To explore the possible future health risks of multimetal exposures and their interaction effects, it is imperative to conduct additional studies that involve repeated biological measurements of metal concentrations.

Cognitive outcomes caused by low-level lead, cadmium, and mercury mixture exposure at distinct phases of brain development

Contaminated water and food are the main sources of lead, cadmium, and mercury in the human body. Long-term and low-level ingestion of these toxic heavy metals may affect brain development and cognition. However, the neurotoxic effects of exposure to lead, cadmium, and mercury mixture (Pb + Cd + Hg) at different stages of brain development are rarely elucidated. In this study, different doses of low-level Pb + Cd + Hg were administered to Sprague-Dawley rats via drinking water during the critical stage of brain development, late stage, and after maturation, respectively. Our findings showed that Pb + Cd + Hg exposure decreased the density of memory- and learning-related dendritic spines in the hippocampus during the critical period of brain development, resulting in hippocampus-dependent spatial memory deficits. Only the density of learning-related dendritic spines was reduced during the late phase of brain development and a higher-dose of Pb + Cd + Hg exposure was required, which led to hippocampus-independent spatial memory abnormalities. Exposure to Pb + Cd + Hg after brain maturation revealed no significant change in dendritic spines or cognitive function. Further molecular analysis indicated that morphological and functional changes caused by Pb + Cd + Hg exposure during the critical phase were associated with PSD95 and GluA1 dysregulation. Collectively, the effects of Pb + Cd + Hg on cognition varied depending on the brain development stages.

Temporal changes of blood mercury concentrations in Chinese newborns and the general public from 1980s to 2020s

Mercury (Hg) is a global pollutant that threatens the environment and human health. As a major producer, emitter and consumer of Hg, China is currently taking different measures to curb mercury pollution in accordance with the requirements of the Minamata Convention on Mercury. Blood Hg can reflect the human body's recent exposure to Hg. This review summarized the temporal changes in blood Hg concentrations in newborns and the general public in China from 1980 s to 2020 s. It was shown that the blood Hg concentrations of newborns showed the downward trend, although it was not significant. The general public Hg concentrations showed a trend of first increase and then decrease trend. Most of the cord blood Hg and venous blood Hg concentrations in China were lower than the USEPA reference concentration of 5.8 µg/L. Since low-dose prenatal Hg exposure can affect fetal and neonatal development, continuous attention needs to be paid to reduce maternal and neonatal Hg exposure. The information provided in this review may lay a basis for the effectiveness evaluation on the implementation of Minamata Convention on Mercury.

A soybean based-diet prevents Cadmium access to rat cerebellum, maintaining trace elements homeostasis and avoiding morphological alterations

Cadmium (Cd) is one of the most dangerous heavy metals that exists. A prolonged exposure to Cd causes toxic effects in a variety of tissues, including Central Nervous System (CNS), where it can penetrate the Blood Brain Barrier (BBB). Cd exposure has been linked to neurotoxicity and neurodegenerative diseases. Soy isoflavones have a strong antioxidant capacity, and they have been shown to have positive effects on cognitive function in females. However, the mechanisms underlying Cd neurotoxicity remain completely unresolved. The purpose of this study was to characterize the potential protective effect of a soy-based diet vs. a casein-based diet against Cd toxicity in rat cerebellum. Female Wistar rats were fed with casein (Cas) or soybean (So) as protein sources for 60 days. Simultaneously, half of the animals were administered either 15 ppm of Cadmium (CasCd and SoCd groups) in water or regular tap water as control (Cas and So groups). We analyzed Cd exposure effects on trace elements, oxidative stress, cell death markers, GFAP expression and the histoarchitecture of rat cerebellum. We found that Cd tissue content only augmented in the Cas intoxicated group. Zn, Cu, Mn and Se levels showed modifications among the different diets. Expression of Nrf-2 and the activities of CAT and GPx decreased in Cas and So intoxicated groups,while 3-NT expression increased only in the CasCd group. Morphometry analyses revealed alterations in the purkinje and granular cells morphology, decreased number of granular cells and reduced thickness of the granular layer in Cd-intoxicated rats, whereas no alterations were observed in animals under a So diet. In addition, mRNA expression of apoptotic markers BAX/Bcl-2 ratio and p53 expression increased only in the CasCd group, a finding confirmed by positive TUNEL staining in the cerebellum granule cell layer in the same group. Also, Cd intoxication elicited overexpression of GFAP by astrocytes, which was prevented by soy. White matter alterations were only subtle and characterized by intramyelinic edema in the CasCd group. Overall, these results unmask an irreversible toxic effect of a subchronic Cd intoxication on the cerebellum, and identify a protective role by a soy-based diet with potential as a therapeutic strategy for those individuals exposed to this dangerous environmental contaminant.

Arsenic and fluoride co-exposure through drinking water and their impacts on intelligence and oxidative stress among rural school-aged children of Lahore and Kasur districts, Pakistan

Arsenic (As), and fluoride (F^-) are potent contaminants with established carcinogenic and non-carcinogenic impacts on the exposed populations globally. Despite elevated groundwater As and F^- levels being reported from various regions of Pakistan no biomonitoring study has been reported yet to address the co-exposure impact of As and F^- among school children. We aimed to investigate the effects of these two contaminants on dental fluorosis and intelligence quotient (IQ) along with the induction of oxidative stress in rural children under co-exposed conditions. A total of 148 children (5 to 16 years old) from the exposed and control group were recruited in the current study from endemic rural areas of Lahore and Kasur districts, Pakistan having elevated As and F^- levels in drinking water than permissible limits. We monitored malondialdehyde and its probable association with antioxidants activity (SOD, CAT, and GR) as a biomarker of oxidative stress. GSTM1/T1 polymorphisms were measured to find the impact of As on health parameters. Mean urinary concentrations of As (2.70 vs. 0.016 µg/L, P < 0.000) and F^- (3.27 vs. 0.24 mg/L, P < 0.000) as well as the frequency of dental fluorosis were found elevated among the exposed group. The cases of children with lower IQ were observed high in the exposed group. Additionally, lower concentrations of antioxidants (SOD, CAT, and GR) were found suggesting high susceptibility to F^- toxicity. The findings suggest that F^- accounted for high variations in health parameters of children under the co-exposure conditions with As.

Urinary Pb levels in schoolchildren from the largest coal mining area in Brazil and its associated factors: a cross-sectional study

Candiota region has the largest coal reserve in Brazil, and previous studies have shown moderate-high levels of metals in the environment, including Pb. On the other hand, there are no studies investigating the factors associated with high levels of urinary Pb in children in the region. To investigate this issue, a cross-sectional study was conducted with 92 schoolchildren from 7 cities comprising this coal-mining region. Socioeconomic and demographic information and parental life habits and children's health information were collected using a semi-structured questionnaire. Diurnal urine samples were collected to quantify Pb levels (µg/g creatinine). Bi- and multivariate Poisson regression with a robust estimator was used to assess factors associated with high levels of Pb. Urinary Pb levels in children in the region vary from not detected to 21.6 µg/g of creatinine. The spatial distribution of urinary Pb levels in children indicated an influence of proximity to mining areas, and this factor was confirmed by Poisson regression analysis (bivariate). Other factors associated with high levels of urinary Pb were non-white mothers, paternal occupational exposure, and low BMI. The findings of this study reveal that the Candiota region is a hotspot for high levels of urinary Pb in children (geometric mean: 3.82 µg/g creatinine) and that, in addition to the proximity to mining areas, factors socioeconomic and health conditions may be associated with these high levels.

Recognition of Heavy Metals by Using Resorcin[4]arenes Soluble in Water

The complexing properties of two water-soluble resorcin[4]arenes (tetrasodium 5,11,17,23-tetrakissulfonatemethylen 2,8,14,20-tetra(butyl)resorcin[4]arene, Na₄BRA, and tetrasodium 5,11,17,23-tetrakissulfonatemethylen-2,8,14,20-tetra(2-(methylthio)ethyl)resorcin[4]arene, Na₄SRA) with polluting heavy metals such as Cu²⁺, Pb²⁺, Cd²⁺ and Hg²⁺ were studied by conductivity, and the findings were confirmed by using other techniques to try to apply this knowledge to removing them. The results indicate that Na₄BRA is able to complex Cu²⁺ in a 1:1 ratio and Pb²⁺ in a 1:2 ratio, while Na₄SRA complexes Hg²⁺ in a 1:1 ratio. On the contrary, no indications have been observed that either of the resorcin[4]arenes studied complexes the Cd²⁺ ions. The results suggest that the bonds established between the sulfur atoms located at the lower edge of the SRA^4- and the solvent hydrogens could prevent the entry of the guest into the host cavity. However, in the case of Hg²⁺ ions, the entry is favoured by the interactions between the sulfur donor atoms present on the lower edge of Na₄SRA and the Hg²⁺ ions. Therefore, it can be said that Na₄BRA is selective for Cu²⁺ and Pb²⁺ ions and Na₄SRA is selective for Hg²⁺ ions.

Cadmium exposures and deteriorations of cognitive abilities: estimation of a reference dose for mixture risk assessments based on a systematic review and confidence rating

To support a mixture risk assessment with a focus on developmental neurotoxicity we evaluated the strength of evidence for associations of cadmium exposures with declines in IQ by conducting a systematic review and confidence rating. We searched peer-reviewed studies published in English between 2012 and July 2021 and identified 15 eligible studies (11 prospective cohort studies, and 4 cross-sectional studies). Of the 10 studies that observed associations of cadmium exposure with child IQ declines, two achieved an overall "High (H)" confidence rating, five a "Medium to High (M/H)", one a "Medium (M)" and two a "Low (L)" confidence rating. Five studies did not detect significant associations between cadmium exposure and reduced cognitive ability; of these, two received a "High (H)" confidence rating, two an overall rating of "Medium to High (M/H)" and one a "Medium (M)" rating. The null findings reported by the "High (H)" and Medium to High (M/H)" studies could partly be explained by low exposures to cadmium or confounding with high levels of lead. By using a one-compartment toxicokinetic model in a reverse dosimetry approach, we estimated that a daily intake of 0.2 μg/kg body weight/day corresponds to urinary cadmium levels no longer associated with cognitive declines observed in a "High (H)"-confidence study. This estimate is 1.8-fold lower than the current health-based guidance value (HBGV) for kidney toxicity of 0.36 μg/kg bodyweight/day established by the European Food Safety Authority (EFSA). Our value does not have the normative character associated with health-based guidance values and is intended only as a reasonable estimate for the purpose of mixture risk assessments. However, with cadmium exposures in Europe between 0.28 (middle bound) and up to 0.52 μg/kg bodyweight/day (95^th percentile), our review suggests that pregnant women and children are poorly protected against neurodevelopmental effects. This warrants a revision of the current HBGV.

Correlation between As, Cd, Hg, Pb and Sn concentration in human milk and breastfeeding mothers' food consumption: a systematic review and infants' health risk assessment

Mothers' food and water consumption appear to be determining factors for infants' potentially toxic elements exposure through human milk. Therefore, this systematic review aimed to assess correlations between As, Cd, Hg, Pb and/or Sn concentration in human milk and breastfeeding mothers' food consumption, with later infants' health risk assessment. Estimated Daily Intakes of such elements by infants were also calculated and compared with reference values (RfD or BMDL01). Among 5.663 identified studies, 23 papers remained for analysis. Potentially toxic elements concentration in human milk presented positive correlation with seafood (As, Hg), fresh vegetables (Hg, Cd), cereals (Hg, Cd), cheese, rice, potatoes, private and well-water supply (Pb), wild meat (Pb, Cd) and milk, dairy products, dried fruits and oilseeds (Cd) mothers' consumption. Red meat, caffeinated drinks, and dairy products consume presented negative correlations (Pb). No correlations were found for Sn. Infants from three studies presented high Hg exposition through human milk (> 0. 1 μg/kg PC-1 day-1), as well as observed for Pb in one study (> 0. 5 μg/kg PC-1 day-1). Potentially toxic elements can damage infants' health when they are present in mothers' diet due to the infants' high vulnerability. Therefore, these results raise important issues for public health.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2022.2056869 .

Role of endocrine disrupting chemicals in children's neurodevelopment

Environmental stressors, like endocrine disrupting chemicals (EDC), are considered important contributors to the increased rates of neurodevelopmental dysfunctions. Considering the cumulative research on adverse neurodevelopmental effects associated with prenatal exposure to EDC, the purpose of this study was to review the available limited literature about the effects of postnatal exposure to EDC on child neurodevelopment and behaviour. Despite widespread children's exposure to EDC, there are a limited number of epidemiological studies on the association of this exposure with neurodevelopmental disorders, in particular in the postnatal period. The available research suggests that postnatal EDC exposure is related to adverse neurobehavioral outcomes in children; however the underlying mechanisms of action remain unclear. Timing of exposure is a key factor determining potential neurodevelopmental consequences, hence studying the impact of multiple EDC co-exposure in different vulnerable life periods could guide the identification of sensitive subpopulations. Most of the reviewed studies did not take into account sex differences in the EDC effects on children neurodevelopment. We believe that the inclusion of sex in the study design should be considered as the role of EDC on children neurodevelopment are likely sex-specific and should be taken into consideration when determining susceptibility and potential mechanisms of action.

IQ alteration induced by lead in developed and underdeveloped/developing countries: A systematic review and a meta-analysis

The aim of this study was to evaluate the effects of Pb exposure on full-scale IQ score in pediatric subjects. Following PRISMA guidelines, the data from January 2010 to April 2020 were systematically searched and collected on electronic databases (PubMed, Scopus, and Embase). The eligibility criteria included cross-sectional, cohort, and case-control studies that were published in English, from 2010 to 2020, that analyzed the blood Pb levels of pediatric subjects (0-19 years) and possible changes in the full-scale IQ score. In this study, 2174 scientific papers were collected from three electronic databases. From those, 726 were duplicates and 1421 were excluded because they did not meet the eligibility criteria, resulting in a total of 27 papers, from which, seven were used to perform the meta-analysis. The 27 scientific papers systematically selected for this study were separated by the country where the study was realized in developed and underdeveloped/developing countries. In the underdeveloped/developing countries the blood Pb levels are higher and showed a greater variation (1.30-11.66 μgPb/dL of blood) than in countries with higher development index (0.57-4.80 μgPb/dL of blood). The full-scale IQ score are inversely proportional to the blood Pb values, and it is possible to see that in the underdeveloped/developing countries the full-scale IQ score showed lower values and greater variation (59.2-111) compared to the individuals from developed countries (91.9-114.5). In conclusion, it was observed that blood Pb levels alter the full-scale IQ score. Thus, policies for the prevention of environmental contamination and the reduction of Pb exposure must be taken, mainly, in underdeveloped/developing countries.

Lead and lead-arsenic combined exposure induces mortality and developmental impairments in zebrafish embryos: a study using wild-caught zebrafish from Bangladesh

Heavy metal toxicity has become a global health burden, exerting various physiological effects on aquatic animals and humans. Zebrafish (Danio rerio) has emerged as a real-time model system for toxicological study. We previously reported the effects of arsenic on the embryonic development of zebrafish. The current study aimed to get deep insights into the toxic effects of another heavy metal, lead, on the early embryonic development of wild-caught zebrafish. We exposed freshly collected zebrafish embryos to different lead concentrations and studied different developmental and morphological changes using an inverted microscope. In a separate experiment, embryos were exposed to a combination of lead and arsenic to evaluate the combined effects of the elements. Lead concentration of as low as 0.25 mM resulted in developmental and morphological abnormalities in the zebrafish embryos. Exposure to different concentrations (0.25 mM, 0.5 mM, and 0.75 mM) caused a higher mortality rate of the embryos. Besides, an increased rate of arrested hatching, irregularities in size and shape of the yolk sac, deformed otic vesicle, and body curvature were observed in a dose-dependent manner. Lead exposure also resulted in reduced heart rate and severe pericardial edema. The combined effect of minimum concentrations of lead and arsenic that causes toxicity individually (0.25 mM and 1.0 mM, respectively) revealed a more severe effect than the individual treatments. This study's findings explain the association of heavy metal exposure with an increased rate of miscarriage/abortion incidences in highly polluted areas assisting in proper management and creating public awareness.

Effects of soil lead exposure and land use characteristics on neurodevelopment among children under 3 years of age in northern Taiwan

Lead (Pb) exposure increases the risks of neurodevelopmental disorders in children. Child-specific activities and land use scenarios may lead to elevated opportunities for Pb exposure through the soil. Therefore, we investigated hair and fingernail Pb concentrations among young children in northern Taiwan, in relation to soil Pb pollution and land use characteristics. We also explored the effect of the Pb exposure burden and land use scenarios on neurobehavioral development. In total, 139 healthy children under 3 years of age were recruited in October 2011 to April 2014. Pb levels in hair and fingernail samples were determined using an inductively coupled plasma/mass spectrometer. Pb concentrations in soils and land use types surrounding the children's homes were accessed by a geographic information system to identify any associations with hair Pb levels. The Bayley Scales of Infant and Toddler Development (Bayley-III) were used to evaluate the cognitive, language, and motor development of the children. A multivariable regression model was performed to assess the effects of soil Pb levels and land-use status on Pb exposure in children, as well as associations of Pb exposure and land-use scenarios with neurodevelopmental abilities. Geometric mean Pb concentrations in hair, fingernails, and soil were 2.9 ± 4.8 μg/g, 0.8 ± 5.1 μg/g, and 20.8 ± 4.3 mg/kg, respectively. The multivariable analysis indicated that soil Pb concentrations and green areas around residences had potential links with Pb exposure among children in northern Taiwan. Hair Pb concentrations were negatively associated with expressive language scores. Soil Pb exposure was positively associated with hair Pb concentrations. Land use types around the children's homes in northern Taiwan were associated with their neurodevelopment. Increased green areas were negatively associated with hair Pb concentrations. Living near a highway may have had negative impacts on gross motor scores. A healthy residence can avoid potential health risks for children during their early life.

Association of multi-metals exposure with intelligence quotient score of children: A prospective cohort study

BACKGROUND

Associations between most single metals and children's intelligence quotient (IQ) scores have been evaluated in previous studies. However, associations between multi-metal exposures and children's IQ scores have not been analyzed.

OBJECTIVES

To assess the joint effects of lead (Pb), manganese (Mn), antimony (Sb), tin (Sn) and titanium (Ti) co-exposure on children's IQ scores.

METHODS

A prospective cohort study was conducted in Shimen and Huayuan, Hunan Province, China. Urine metals levels were measured by inductively coupled plasma mass spectrometry (ICP-MS) at baseline. Children's IQ scores were repeatedly measured at baseline and follow-up following the method of Raven's Standard Progressive Matrices (SPM) and standardized as z scores. We fitted linear regression models and Bayesian kernel machine regression (BKMR) models to investigate the associations of metal levels with children's IQ scores after adjusting for covariates.

RESULTS

A total of 633 participants aged 7-10 years completed the survey. Urinary Pb (β = -0.028, P = 0.022) and urinary Ti (β = -0.0003, P = 0.001) were inversely associated with children's IQ scores. The BKMR analyses revealed significant negative overall effects of the five metals on children's IQ scores when all the metals were above their median levels, while significant positive associations were shown when all the metal concentrations were below their median levels. The model also showed negative trends of Sn and Ti on children's IQ. Furthermore, Ti and Sn had a synergistic relationship, with a decline in IQ score when Sn exposure was relatively high. The urinary Sn concentration was significantly higher but the urinary Ti concentration was significantly lower in participants from the Shimen area than in those from the Huayuan area. Decreasing trends of the overall effects were observed in both the Shimen and Huayuan areas.

CONCLUSION

Our findings revealed that multi-metal exposures caused a decline in children's IQ scores according to traditional linear regression models and the BKMR model. Our results provide some evidence of the association between multi-metal exposure and children's IQ. Meanwhile, interactions between multi-metal exposures on children's IQ should be given more attention.

Pollution evaluation and children's multimedia exposure of atmospheric arsenic deposition in the Pearl River Delta, China

The populous Pearl River Delta (PRD) region in China suffers from serious air arsenic (As) pollution. The objective of this study was to explore the pollution situation of atmospheric arsenic deposition in the PRD region, and to evaluate the associated multimedia daily intake in children. The average deposition flux was 3921.7 μg/m²/year during the 2016-2017, and the pollution situation was even worse than that in 2015. A continuously increasing trend of arsenic atmospheric deposition was found. The bioaccessibility of As in the settled dust was determined as about 22% by a physiologically based extraction test (PBET). After corrected with the bioaccessibilities of As in the settled dust and food items, the geometry means (GM) value of daily uptake through multimedia ingestion of produce (dust and diet) originated from arsenic atmospheric deposition was 0.23 μg/kg/day for 1- to 6-year-old children. The contribution of the non-dietary oral exposure (settled dust) was negligible and just accounted for only 0.01% of the daily uptake. This estimated value was much lower than those in the literatures, in which the bioaccessibility of As was not taken into account, concluding that the role of the settled dust in the total daily intake may have been overestimated previously. Milk, eggs and freshwater fish were the dominant pathways for children to intake the products derived from atmospheric arsenic deposition. There still be a concern about the high non-carcinogenic and carcinogenic risk by long-term multimedia ingestion. Special care should be considered toward the emission sources of air arsenic, including the coal combustion from industries and construction dust, etc., to reduce the negative effect of air arsenic in children.

Health risks of potentially toxic trace elements in urban soils of Manaus city, Amazon, Brazil

The city of Manaus is the biggest industrial city of the north Brazilian region, and a haphazard urbanization process characterizes it. The continuous urbanization and industrialization processes have increased the levels of trace elements in the urban environment and have posed great threat on human health. It is, then, essential to assess the pollution levels and the potential risks of the trace elements presence in urban soils. Therefore, the purpose of this study was to investigate the status of trace elements soils pollution and their human health risks to the population of Manaus City. Twenty-two soil samples were collected from the surface layer (0-20 cm), and the contents of Ba, Cr, Mn, Zn, Co, Ni, Cu, Cd and Pb were analyzed. Results showed the predominance of kaolinite, gibbsite and goethite as the main minerals of the clay fraction. The trace elements contents were affected by both natural sources and anthropic activities such as industrial operations and vehicular emissions. The soil contamination assessment by Enrichment Factor showed the existence of eight samples classified as considerably contaminated and two samples classified as highly contaminated. Geoaccumulation index also showed the existence of eight samples exhibiting considerable contamination and one sample showing high contamination. The non-carcinogenic health risk was considered low (HI < 1) to both children and adults. However, the carcinogenic risk of Cd and Pb was higher than the safety limits (CRtotal > 1 × 10^-6), indicating that the long exposure to contaminated soils increases the probability of children's cancer occurrence.

E-Waste in Africa: A Serious Threat to the Health of Children

Waste electronic and electrical equipment (e-waste) consists of used and discarded electrical and electronic items ranging from refrigerators to cell phones and printed circuit boards. It is frequently moved from developed countries to developing countries where it is dismantled for valuable metals in informal settings, resulting in significant human exposure to toxic substances. E-waste is a major concern in Africa, with large sites in Ghana and Nigeria where imported e-waste is dismantled under unsafe conditions. However, as in many developing countries, used electronic and electrical devices are imported in large quantities because they are in great demand and are less expensive than new ones. Many of these used products are irreparable and are discarded with other solid waste to local landfills. These items are then often scavenged for the purpose of extracting valuable metals by heating and burning, incubating in acids and other methods. These activities pose significant health risks to workers and residents in communities near recycling sites. E-waste burning and dismantling activities are frequently undertaken at e-waste sites, often in or near homes. As a result, children and people living in the surrounding areas are exposed, even if they are not directly involved in the recycling. While toxic substances are dangerous to individuals at any age, children are more vulnerable as they are going through important developmental processes, and some adverse health impacts may have long-term impacts. We review the e-waste situation in Africa with a focus on threats to children's health.

Atmospheric lead pollution in a typical megacity: Evidence from lead isotopes

Atmospheric lead (Pb) pollution has adverse health effects on humans, while the sources and atmospheric process of Pb are key scientific problems. In this study, the concentrations and isotopic composition of Pb in fine particulate matter (PM_2.5), coal and street dust samples collected from a typical megacity Beijing were analyzed to identify the sources of atmospheric Pb. Results showed that the Pb concentrations in PM_2.5 were high in winter (168.1 ± 32.0 ng/m³) and low in summer (27.7 ± 9.1 ng/m³), whereas Pb isotopic values presented opposite variation trends. The abnormally elevated Pb concentrations in winter were probably related to coal combustion, while declined Pb concentration in summer may be attributed to favorable meteorological parameters such as high temperature, high wind speed, and frequent rain events. Pb isotopic ratios indicated that anthropogenic sources (coal combustion and vehicle exhaust) and natural sources were the main contributors to Pb in PM_2.5. Combined with the binary model, the anthropogenic sources predominantly contributed to Pb in the Beijing atmosphere by approximately 85% annually, while the natural sources accounted for the rest of 15%. More specifically, the contribution of natural sources was about 9.4% in spring, 29.7% in summer, 16.0% in autumn and 6.1% in winter, suggesting that natural sources might contribute more lead into the atmosphere during clear days. Furthermore, the contribution of the vehicle exhaust to atmospheric Pb was nonnegligible in megacity, highlighting that the ownership of motor vehicles in megacity should be regulated and more efforts should be paid to strengthen vehicle emission standard. This study may enrich the reservoir of Pb isotopic composition in nature and provides a new method to investigate the Pb migration and transformation in the environment, and also serve as a theoretical reference for pollution control measures.

Elevated blood lead and metal/metalloid levels and environmental exposure sources in urban Ecuadorian school-age children and mothers

BACKGROUND

Lead and other toxic and potentially toxic metals and metalloids are significant contributors to the global burden of disease and disability. Studies characterizing blood metal/metalloid levels and potential sources of environmental exposures are limited for populations living in the major urban centers of Andean-area countries.

METHODS

We used ICP-MS to quantify blood levels of lead (PbB), cadmium (CdB), manganese (MnB), total arsenic (AsB), and total mercury (HgB) in school-age children (n = 47) and their reproductive-age mothers (n = 49) from low-resource households in Quito, Ecuador. These were compared to published 95th percentile reference values (RV95) and for PbB, also to CDC reference values. We used a detailed environmental questionnaire to examine the contribution of residential and neighborhood environmental exposure sources with participant blood metal/metalloid levels. We used ICP-MS to measure Pb levels in residential windowsill dust, floor dust, and drinking water samples and used XRF for paint samples.

RESULTS

Forty-five percent of the mothers had PbBs ≥ 5 μg/dL; 14.3% had PbBs ≥10 μg/dL. Maternal blood levels exceeded RV95s for PbB (76%), CdB (41%), MnB (88%), HgB (57%), and AsB (90%). Of children, 68% had PbBs ≥ 5 μg/dL, and 21.3% had PbB ≥10 μg/dL. Most child blood levels exceeded the RV95s for PbB (100%), CdB (100%), MnB (94%), and total HgB (94%) and AsB (98%). Most mothers (97%) and all children had blood levels indicating exposure to multiple metal/metalloid mixtures. Maternal and child PbBs were moderately correlated with each other but the other four metals/metalloids were not. Factors associated with maternal blood metal/metalloid levels were residence in a home with an earthen floor (PbB) or bare cement block walls (MnB), living near a dirt-paved or cobblestone street (PbB), <50 m from a heavily trafficked major roadway (PbB, HgB), living in the Los Chillos (PbB) or Cotocollao neighborhoods (PbB, HgB), or in areas where street vendors grilled food using charcoal (MnB). Factors associated with child blood metal/metalloid levels were residence in a dirt floor home (PbB, CdB, AsB), living near a dirt-paved or cobblestone street (PbB), living in the El Camal or Cotocollao neighborhoods (AsB), or in local neighborhoods where scrap metal smelters (MnB) and LPG gas depositories (PbB) were present.

CONCLUSIONS

The elevated blood levels of PbB, other metal/metalloids, and metal/metalloid mixtures identified mothers and children in this exploratory study is an urgent public health and clinical concern. The exposure patterns suggest that traffic-related exposures, especially the resuspension of legacy Pb in dust, as well as other anthropogenic and geogenic sources may be important environmental contributors to metal/metalloid exposures in urban Ecuadorian mothers and children. Future studies are needed to confirm these findings and explore other potential exposure sources. Biomonitoring is also needed in order to formulate effective intervention strategies to reduce population exposure to toxic levels of environmental metals/metalloids.

WITHDRAWN: Co-exposure effects of arsenic and fluoride on intelligence and oxidative stress in school-aged children: A cohort study

This article has been withdrawn at the request of the editor. The Publisher apologizes for any inconvenience this may cause.

Metal mixtures and neurodevelopment: recent findings and emerging principles

Children are constantly exposed to a wide range of environmental factors including essential and non-essential metals. In recent years, the mixtures paradigm has emerged to foster the examination of combined effects that emerge from exposures to multiple elements. In this review, we summarized recent literature studying the relationship between prenatal and childhood metal mixtures with neurodevelopmental outcomes. Our review highlights two basic principles to emerge from this approach. First, recent findings emphasize that the effect of a given exposure is contextual and may be dependent on past or concurrent metal exposures. Second, the timing of exposures is equally critical to the mixture composition in determining neurodevelopmental effects. Our discussion emphasizes how these principles may apply to future exposure-related neurodevelopmental studies.

Relationship between ambient PM2.5 exposure and blood cadmium level in children under 14 years in Beijing, China

Ambient PM_2.5 pollution is a global environmental problem. PM_2.5 can act as a carrier of heavy metals. However, the relationship between PM_2.5 exposure and blood cadmium (Cd) level in children was less understood. Based on the data of hourly collected PM_2.5 and blood Cd level of 13,626 children aged 0-14 years from Apr. 2008 to Feb. 2013 in Beijing of China, we investigated the short-term effects of PM_2.5 exposure on blood Cd level. Generalized linear mixed models (GLMMs) were utilized to explore the potential association between PM_2.5 exposure and blood Cd level of children. The results showed that the mean blood Cd level was 0.64 μg/L. There was a significant association between PM_2.5 exposure and blood Cd level (P < 0.05). Age was negatively associated with blood Cd level (P < 0.05), and the younger children were more sensitive to Cd from PM_2.5 exposure. There wasn't a significant difference in PM_2.5 concentration between heating and non-heating seasons in winter (P > 0.05); there was also no gender difference of children on blood Cd level (P > 0.05). The present study demonstrates the importance of controlling the PM_2.5 bound Cd exposure, and environmental countermeasures should be implemented stringently to reduce their impact on children's health.

Blood lead and mercury levels are associated with low resting heart rate in community adolescent boys

While the neurotoxic effects of heavy metals at even low levels have been well-studied, few studies have examined the cardiovascular effects of heavy metals on resting heart rate and these have focused on adult populations. The present study aimed to examine the association between low-level environmental lead and mercury exposure and resting heart rate in community adolescents. As part of the China Jintan Cohort Study, 532 adolescents aged 12 years (SD = 0.6) were tested for blood levels of lead (BLL) and mercury (BML) and resting heart rate (RHR). Generalized linear models were conducted to test the relationship between BLL and BML and RHR, controlling for children's sex, age, and socioeconomic status. Analyses were clustered at the preschool level when the children were recruited to adjust for standard error. The mean (SD) BLL and BML were 3.14 (SD = 1.19) μg/dL and 1.26 (SD = 0.68) μg/L at age 12 years, respectively. After adjusting for confounders, we found a significant interaction between BML and BLL in predicting RHR in boys (B = -1.27, SE = 0.49, p < 0.01, n = 289). We created BLL and BML groups in boys based on median cut-offs. Boys in the High BLL/High BML group had significantly lower RHR (mean = 84.22 beats per minute [bpm], SD = 8.77, n = 61) than boys in the Low BLL/Low BML group (mean = 89.03 bpm, SD = 10.75, n = 69; p < 0.05). BML and BLL did not interact to predict RHR in girls (B = -0.18, SE = 0.88, p > 0.05, n = 242). Combined high BLL and BML were associated with low RHR in community adolescent boys. Low RHR is an indication of chronic under-arousal and has been implicated in psychopathology, particularly for externalizing behavior. Our findings may stimulate further communication and research in this area.

Analysis of Cadmium, Mercury, and Lead Concentrations in Erythrocytes of Renal Transplant Recipients from Northwestern Poland

Simple Summary

The aim of this study is to determine the blood erythrocyte concentrations of toxic metals (Cd, Pb, and Hg) in renal transplant recipients. Additionally, we analyzed the effect of selected biological and environmental factors, including the intake of various immunosuppressive drug regimens and smoking, on these xenobiotic concentrations. In summary, our data suggest that, smoking is associated with Pb and Cd concentrations, and gender, age change depending on Pb concentration in erythrocytes of renal transplant recipients. Additionally, this is the first research that suggests that immunosuppressive regimen, depending on type of immunosuppressive drugs combination affects Pb concentration in erythrocytes of the mentioned group of patients. It seems to be crucial information for patients who use immunosuppressive drugs.

Abstract

Cadmium (Cd), mercury (Hg), and lead (Pb) exhibit highly nephrotoxic properties, and their high concentrations can lead to renal failure. Much research has been conducted on the concentrations of heavy metals, microelements, and macroelements in the blood, but little is known about the concentration of Cd, Pb, and Hg in erythrocytes of renal recipients. The aim of this study is to determine the blood erythrocyte concentrations of toxic metals (Cd, Pb, and Hg) in renal transplant recipients (RTRs). Additionally, we analyzed the effect of selected biological and environmental factors, including the intake of various immunosuppressive drug regimens and smoking, on these xenobiotic concentrations. The material consisted of erythrocyte samples from 115 patients of the Department of Nephrology, Transplantology, and Internal Medicine at Independent Public Clinical Hospital No. 2, Pomeranian Medical University, Szczecin, in northwestern Poland. Cd, Hg, and Pb levels in the erythrocytes were quantified by inductively coupled mass spectroscopy (ICP-MS). Equal concentrations of Cd were found in erythrocytes of both female and male transplant recipients. The highest level of Hg was seen in women, and women overall had statistically higher concentrations of Pb than men. Comparison of metal concentrations between those over 50 years and those under it showed that Pb concentration was also significantly higher in renal transplant recipients over 50. Pb concentration was almost twice as high in RTRs who used tacrolimus with mycophenolate mofetil than in RTRs who used cyclosporine A with mycophenolate mofetil. The highest level of Cd was seen in smokers, who had 3.25 µg/L. This value was significantly higher than in ex-smokers (p = 0.001) and with RTRs who had never smoked. There were significantly higher levels of Pb in the erythrocytes of RTRs who were ex-smokers than in those who had never smoked. A statistically significant correlation was found between Cd and Pb concentrations. Additionally, we have noticed significant positive correlation between Pb and age (R = 0.37), gender (R = 0.24) and significant negative correlation of Pb with GFR (R = −0.33). We have also found significant positive correlation between Hg and age (R = 0.21). In summary, our data suggest that, smoking is associated with Pb and Cd concentrations, and gender, age change depending on Pb concentration in erythrocytes of RTRs. Additionally, this is the first research that suggests that immunosuppressive regimen, depending on type of immunosuppressive drugs combination affects Pb concentration in erythrocytes of RTRs. It seems to be crucial information for patients who use immunosuppressive drugs.

DNA Methylation Biomarkers of IQ Reduction are Associated with Long-term Lead Exposure in School Aged Children in Southern China

Although lead associated with intelligence decline in children has long been reported, studies combining intelligence determination, molecular mechanisms exploration, and biomarker screen are quite rare. In this study, based on 333 children aged 9-11, we determined the role of DNA methylation (DNAm) in the relationship of lead exposure with children's intelligence. DNAm was measured from children's blood DNA specimens, and mediation analysis was performed to identify DNAm biomarkers mediating the lead-intelligence relationship. We identified forty-three differentially methylated regions (DMRs), and two fragments (FAM50B1 and PTCHD3) significantly mediated the lead-intelligence relationship, with contribution rates of 30.36% (p = 0.010) and 60.36% (p < 0.001), respectively. In addition, blood lead levels (BLLs) lower than 100 μg/L still adversely affected children's IQs and DNAm of the two fragments. Our data suggests that DNAm mediates lead-associated cognitive delay in children and blood lead reference value for school-aged children (100 μg/L) should be revised, and the candidate biomarkers can be used in related neurological diseases in future.

Integrated measures of lead and manganese exposure improve estimation of their joint effects on cognition in Italian school-age children

Every day humans are exposed to mixtures of chemicals, such as lead (Pb) and manganese (Mn). An underappreciated aspect of studying the health effects of mixtures is the role that the exposure biomarker media (blood, hair, etc.) may play in estimating the effects of the mixture. Different biomarker media represent different aspects of each chemical's toxicokinetics, thus no single medium can fully capture the toxicokinetic profile for all the chemicals in a mixture. A potential solution to this problem is to combine exposure data across different media to derive integrated estimates of each chemical's internal concentration. This concept, formalized as a multi-media biomarker (MMB) has proven effective for estimating the health impacts of Pb exposure, but may also be useful to estimate mixture effects, such as the joint effects of metals like Pb and Mn, while factoring in how the association changes based upon the biomarker media. Levels of Pb and Mn were quantified in five media: blood, hair, nails, urine, and saliva in the Public Health Impact of Metals Exposure (PHIME) project, a study of Italian adolescents aged 10-14 years. MMBs were derived for both metals using weighted quantile sum (WQS) regression across the five media. Age-adjusted Wechsler Intelligence Scale for Children (WISC) IQ scores, measured at the same time as the exposure measures, were the primary outcome and models were adjusted for sex and socioeconomic status. The levels Pb and Mn were relatively low, with median blood Pb of 1.27 (IQR: 0.84) μg/dL and median blood Mn of 1.09 (IQR: 0.45) μg/dL. Quartile increases in a Pb-Mn combination predicted decreased Full Scale IQ of 1.9 points (95% CI: 0.3, 3.5) when Pb and Mn exposure levels were estimated using MMBs, while individual regressions for each metal were not associated with Full Scale IQ. Additionally, a quartile increase in the WQS index of Pb and Mn, measured using MMBs, were associated with reductions in Verbal IQ by 2.8 points (1.0, 4.5). Weights that determine the contributions of the metals to the joint effect highlighted that the contribution of the Pb-Mn was 72-28% for Full Scale IQ and 42-58% for Verbal IQ. We found that the joint effects of Pb and Mn are strongly affected by the medium used to measure exposure and that the joint effects of the Pb and Mn MMBs on cognition were the stronger than any individual biomarker. Thus, increase power and accuracy for measuring mixture effects compared to individual biomarkers. As the number of chemicals in mixtures increases, appropriate biomarker selection will become increasingly important and MMBs are a natural way to reduce bias in such analyses.

Clinical biochemical parameters associated with the exposure to multiple environmental metals in residents from Kabwe, Zambia

Lead (Pb) interferes with various bodily functions. Although high blood Pb (Pb-B) levels in residents from Kabwe, Zambia have been reported, the accumulation pattern of other metals remains unknown. The study was designed to determine the Pb-B, blood cadmium (Cd-B), and zinc (Zn-B) values of 504 representative samples from Kabwe, as well as the potential associated adverse health effects. The Pb-B level ranged from 0.79 to 154.75 μg/dL and generally increased in areas near the mine. A significant elevation of Cd-B was observed in two areas (0.37 ± 0.26 and 0.32 ± 0.30 μg/L) where the two highest mean Pb-B levels were recorded. By contrast, the Zn-B values did not differ greatly with respect to area. Some blood biochemical parameters relating to hepatic and renal functions were out of the normal range in approximately 20-50% of studied adult participants. The δ-aminolevulinic acid dehydratase (δ-ALAD) activity was significantly inhibited in the two areas contaminated by Pb and Cd. A significant negative relationship was observed between metal levels and clinical parameters, e.g., between Pb-B and δ-ALAD for all the age categories and between Cd-B and the estimated glomerular filtration rate for all the age categories except 0-4 years. The elevated Cd-B in areas near the mine relative to the other areas suggested the potential adverse health effects of Cd and/or the interaction of Pb and Cd. A significant association of metal levels with clinical parameters also indicated the effects of metal exposure on hematopoietic, hepatic, and renal systems.

The effect of confounding variables in studies of lead exposure and IQ

Methods proposed to address confounding variables frequently do not adequately distinguish confounding from covariation. A confounder is a variable that correlates both with the outcome and the major exposure variable. Accurate treatment of confounding is crucial to low dose extrapolation of the effects of chemical exposures based on epidemiology studies. This study explores the limitations of current regression models in extrapolation to the low dose region of the dose-response curve due to the existence of unrecognized and uncontrolled confounding, using epidemiological data for lead. Based on the reported data in analyses by Lanphear and colleagues and Crump and colleagues, and drawing on other studies, Wilson and Wilson considered maternal IQ, HOME score, SES, parental education, birthweight, smoking, and race as characteristic variables which may have interaction effects. This analysis identifies confounding variables based on the seven longitudinal cohorts in analyses conducted by Lanphear and colleagues and by Crump and colleagues and confirms maternal IQ, HOME score, maternal education and maternal marital status at birth are "Highly Likely" confounders, while race is a "Likely" confounder. The cohort data were reanalyzed using the methods presented by Crump and colleagues while also considering the interaction among the identified confounding variables. This analysis determined that confounders influence IQ estimates in a quantifiable way that may exceed or at least obscure previously-reported effects of blood lead on IQ with blood lead levels below 5 µg/dL; however, limitations in the datasets make predictions of the low dose dose-response analysis questionable.

Metal mixtures in pregnant women and umbilical cord blood at urban populations-Rio de Janeiro, Brazil

This study aims to assess interrelationships between serum lead (Pb), cadmium (Cd), arsenic (As), and mercury (Hg) concentrations in pregnant women in their third trimester and umbilical cord blood, while inter-metal correlations were also determined. This study is part of the PIPA project (Childhood and Environmental Pollutant Project), whose pilot study was carried out from October 2017 to August 2018 and will be presented here. Blood samples were obtained from 117 mother-umbilical cord pairs and analyzed concerning metal concentrations. A positive correlation was found between metal concentrations in mother and cord blood (R > 0.7, p < 0.001). The results indicate that mother metal concentrations are able to determine child metal concentrations (p < 0.001). The correlations between maternal blood metal concentrations were positive for all assessed metals except for As and Hg. The strongest correlations in this matrix were observed between Cd and Pb (R = 0.471 p = 0.000), Cd and Hg (R = 0.425 p = 0.000), and Pb and Hg (R = 0.427 p = 0.000). Umbilical cord correlations were lower compared to mother blood correlations. In general, the four analyzed metals displayed significant correlations to serum concentrations in both maternal and cord blood.

Impact of low-level mercury exposure on intelligence quotient in children via rice consumption

Wanshan is a city in southwest China that has several inactive mercury (Hg) mines. The local population are exposed to methylmercury (MeHg) due to the consumption of Hg contaminated rice. The relationship between Hg exposure and the cognitive functions of local children is unknown. This study investigated the relationship between hair Hg concentrations and the intelligence quotient (IQ) of 314 children aged 8-10 years, recruited from three local primary schools in Wanshan area in 2018 and 2019. IQ was evaluated using Wechsler Intelligence Scale for Children - Fourth Edition (WISC-IV). The average THg concentration in children's hair samples was 1.53 μg g^-1 (range: 0.21-12.6 μg g^-1), and 65.6% exceeded the United States Environment Protection Agency (USEPA) recommended value of 1 μg g^-1. Results of logistic regression analysis showed that children with hair Hg ≥ 1 μg g^-1 were 1.58 times more likely to have an IQ score <80, which is the clinical cut-off for borderline intellectual disability (R² = 0.20, p = 0.03). Increasing of 1 μg g^-1 hair Hg resulted in 1 point of IQ loss in Wanshan children, which was.much higher than that via fish consumption. The economical cost due to Hg exposure was estimated to be $69.8 million (9.43% of total GDP) in the Wanshan area in 2018.

A Comprehensive Characterization of Particulate Matter, Trace Elements, and Gaseous Emissions of Piston-Engine Aircraft

The gaseous and PM₁₀ emissions of a piston-engine aircraft during ground operations at different engine states (six engine speed points and three air/fuel mixtures) representing certain flight phases were concurrently measured from the exhaust duct. PM₁₀ emissions were sampled on a 47 mm-diameter polytetrafluoroethylene (PTFE) filter in order to be analyzed with an inductively coupled plasma mass spectrometry (ICP-MS/MS) to identify the presence and level of forty-eight elements. The most abundant element is found to be Pb (med = 4.6 × 10⁶ ng m^-3), which is 40 times the second most abundant element, Na (med = 1.1 × 10⁵ ng m^-3). The filters used for sampling exhaust gases tend to lighten with an increase in engine speed and leaning of the fuel mixture. The average of measured PM mass concentrations at all engine speeds were calculated to be 27.7 mg m^-3 (full-rich) > 26.7 mg m^-3 (best-power) > 24.7 mg m^-3 (best-economy). The total mass of the trace elements constitutes an average of 24.1 ± 12.8% of the mass of PM. Electron microscope analyses suggest that the particles enriched by Al tend to agglomerate in a needle-shaped structure.

Sex differences in the effects of lead exposure on growth and development in young children

The adverse effects of lead exposure on children's health have been widely investigated. Physical growth is a central indicator of health in early childhood. However, studies on the associations between lead exposure and the physical growth of young children are still equivocal. This study aimed to investigate the effects of lead exposure on young children's growth. A cross-sectional survey was conducted, and a total of 1678 young children were recruited. Blood lead levels were determined by graphite furnace atomic absorption spectrophotometry and anthropometric measurements were obtained by nurses. The weight-for-age Z-score (WAZ), height-for-age Z-score (HAZ) and BMI for-age Z-score (BMIZ) of the children were calculated according to World Health Organization standards. Multivariable linear models after adjustment for potential confounders were used to evaluate the associations between lead exposure and childhood anthropometric characteristics. Meanwhile, the sex differences in these associations were also examined. The median blood lead levels in total subjects, in boys and in girls were 46.44, 49.00 and 43.27 μg/L, respectively. After adjusting for confounders, a significantly negative association of blood lead levels with WAZ and HAZ was observed. After stratification by sex, the blood lead levels in children were negatively associated with WAZ and HAZ in boys but not in girls. Meanwhile, we further provide evidence that blood lead levels below 50 μg/L may also have adverse effects on young children's HAZ. Our findings suggest that lead exposure may have sex-specific effects on physical growth in young children and that blood lead level in a low levels may also have adverse effects on children's physical growth and development.

Evaluating the toxicity of polyurethane during marine clay stabilisation

In civil engineering, many geotechnical and forensic projects employ polyurethane (PU) for ground improvement, and the results have shown to be effective in terms of time and cost savings. However, similar to many other chemical stabilisers, the use of PU for soil stabilisation may have environmental repercussions. Therefore, this paper utilised a toxicity characteristic leaching procedure (TCLP) to investigate the potential for ground contamination resulting from the application of PU for the stabilisation of marine clay. Furthermore, the hazardousness of PU during the stabilisation of marine clay was investigated by testing its reactivity, ignitability, corrosivity and physical properties. The results reveal that the quantity of heavy metals present in PU is far below the regulatory limits. The results further confirm that PU is odourless and non-corrosive and that it is non-cyanide and non-sulphide-bearing. However, PU is capable of igniting. Overall, the potential application of PU for ground improvement is promising due to its environmental friendliness.

Hearing loss risk and DNA methylation signatures in preschool children following lead and cadmium exposure from an electronic waste recycling area

Experimental studies have uncovered chemical exposure-induced ototoxicity, but population-based hearing risk assessment especially for early-life exposure to heavy metals and relevant biological mechanism remains unclear. We aimed to measure lead (Pb) and cadmium (Cd) levels, blood DNA methylations of Rb1, CASP8 and MeCP2 and hearing in 116 preschool children 3- to 7-years of age from an e-waste and a reference area, and to evaluate the association of exposures with hearing loss potentially affected by epigenetic modifications. A higher median Pb level but not Cd was found in the exposed group than the reference group. Average hearing thresholds in either ear of the exposed children were higher. Higher promoter methylation levels at cg02978827 and position +14, and lower at position +4 of Rb1 were found in the exposed group. Pb was positively correlated with chewing pencil habit while negatively correlated with washing hands before dinner. Slightly negative trends of promoter methylations in Rb1 and CASP8, while a strong positive trend of MeCP2 promoter methylation, were found along with increasing Pb and Cd levels. Logistic analyses showed the adjusted OR of Pb for hearing loss in the left ear and both ears was 1.46 (95% CI: 1.12, 1.91) and 1.40 (95% CI: 1.06, 1.84), respectively. Our results show an elevated Pb level, altered promoter DNA methylations and hearing ability in children of e-waste areas, suggesting that epigenetic changes of specific genes involves in the development of the auditory system during early exposure to environmental chemicals.

Blood lead in children and associations with trace elements and sociodemographic factors

BACKGROUND

No safe blood lead concentration in children has been identified. Lead can affect nearly every system in the body and is especially harmful to the developing central nervous system of children. The aim of this study is to analyze blood lead in a population of children and its association with sociodemographic variables, biochemical parameters, copper, iron, selenium and zinc.

METHODS

We recruited 155 children (86 boys and 69 girls) with a mean age of 7.3 (SD:4.1). Blood lead and serum selenium concentrations were measured by electrothermal atomic absorption spectrometry. Serum copper and zinc concentrations were measured by flame atomic absorption spectrometry. Serum iron levels were determined by colorimetric assay. A risk exposure questionnaire for lead was administered to the participants.

RESULTS

The median blood lead level was 1.1 (IQR 0.7-1.6) μg/dL. Regarding risk exposure factors, the youngest children (<2 years) who played outdoors presented a median blood lead concentration of 1.1 μg/dL IQR: 0.48-1.48, compared to the median of 0.3 μg/dL IQR:0.2-0.48 in the children who stated they played at home (p = 0.024). Significant differences were also found when taking into account those parents who smoked (median 1.3 IQR 0.8-1.9 μg/dL vs 0.9 IQR 0.5-1.4 μg/dL of non-smokers, p = 0.002). Children who drank tap water had higher blood lead levels (median 1.2 IQR 0.7-1.6 μg/dL) than those who drank bottled water (median 0.7 IQR 0.2-1.3 μg/dL p = 0.014). In addition, children whose mothers had not finished school had higher blood lead levels (median 1.7 IQR 1.2-2.3 μg/dL) than those whose mothers had finished school (median 1.2 IQR 0.7-1.7 μg/dL) and those whose mothers had gone to university (median 0.9 IQR 0.5-1.4 μg/dL) p = 0.034. In the multivariate lineal regression analysis we continue to observe the association between mother's higher level of education and lower blood levels (p = 0.04) and the interaction between age and outdoor play (p = 0.0145).

CONCLUSIONS

In spite of the decline in blood lead concentrations, associated risk factors continue to exist in vulnerable populations such as children.