Mercury, lead and cadmium levels in the urine of 170 Spanish adults: A pilot human biomonitoring study

Reference values for metal(loid)s concentrations in the urine samples of healthy Iranian adults: Results from the first nationally representative human biomonitoring study

BACKGROUND

This study measured the concentrations of arsenic (As), aluminum (Al), cadmium (Cd), chromium (Cr), mercury (Hg), nickel (Ni), and lead (Pb) in the urine samples of the Iranian adult population.

METHODS

This nationally representative study was conducted on 490 participants in six provinces of Iran who were selected based on the clustering method. Participants included healthy Iranian adults aged above 25 years without a history of illness and non-smokers. Fasting urine sampling, body composition, and demographic measurements were performed for each participant. Urine samples were analyzed by acid digesting method using Inductively Coupled Plasma Mass Spectrometry (ICP-MS). The analysis included descriptive statistics and multiple linear regression using Python programming language.

RESULTS

The geometrical mean (with corresponding reference values, µg/l) concentrations of metal(loid)s in urine for women, men, and both were 198.2 (625.3), 163.5 (486.1), and 192.5(570.4) for Al, 15.6(51.7), 28.8(71.1), and 21.9 (61.64) for As, 18.5(55.2), 20.7(56.5), and 19.22(55.75) for Pb, 17.9(57.6), 17.9 (53.9), and 17.9(56) for Ni, 13.95(47.5), 20.3(62.2) and 16(51.6) for Cr, 3.5(12.2), 2.9(11.5), and 3.3(12) for Hg, 0.74(2.7), 0.95 (3.6), and 0.81(3.1) for Cd. There was a direct relationship between the concentration of metal(loid)s and demographic indicators and body composition (P<0.05). Moreover, there was a direct relationship between the concentration of As, Cr, Hg, Ni, and Pb with age and wealth index (P<0.05).

CONCLUSIONS

The concentrations found could be used as the reference range for As, Al, Cd, Cr, Hg, Ni, and Pb for human biomonitoring studies on the Iranian adult population.

What are exposure biomarkers of rare earth elements for the ionic rare earth occupational population?

Rare earth elements (REEs) are widely utilized in industries. However, The specific exposure features of REEs and potential biomarkers of exposure in occupational populations remain unclear. In this study, we evaluated the external and internal REEs exposure levels among the participants working in the ionic rare earth smelting plant. For the external exposure, the concentrations of 14 REEs and total rare earth elements (ΣREEs) in airborne particles were significantly elevated in the REEs-exposed versus non-exposed group (P < 0.05). Meanwhile, the levels of Yttrium (Y), Gadolinium (Gd), Terbium (Tb), Dysprosium (Dy), Holmium (Ho), Thulium (Tm), Ytterbium (Yb), and ΣREEs in urine were higher in the REEs-exposed group compared to the non-exposed group (P < 0.05). Notably, a significant positive correlation was observed between Y in both the airborne particles and urine samples as well as Gd, and the Spearman correlation coefficient was 0.53 and 0.39 respectively, both P < 0.05. Conversely, no statistically significant differences were found in the levels of 15 REEs or ΣREEs in the blood samples between the REEs-exposed group and non-exposed group. Moreover, the concentrations of ΣREEs and 9 REEs in nail samples of the exposed group were significantly higher than those of the non-exposed group (P < 0.05), and the composition ratios of REEs in the nail samples closely resembled those found in individual airborne particles. Therefore, nail and urine samples were proposed to reflect long-term and short-term exposure to ionic rare earth respectively. Exposure biomarkers confirmed by external and internal exposure characteristics accurately provide the situation of human exposure to REEs environment, and have profound significance for monitoring and evaluating the level of REEs pollution in human body. It also provides a vital basis to find out the effect biomarkers, susceptible biomarkers and the health effects of rare earth environment for the future research.

Association of Urinary Lead and Cadmium Levels, and Serum Lipids with Subclinical Arteriosclerosis: Evidence from Taiwan

BACKGROUND

Exposure to lead and cadmium has been linked to changes in lipid metabolism and the development of arteriosclerosis, but the role of lipoprotein profiles in this relationship is not well understood, including the potential role of novel lipid biomarkers.

METHODS

In this study, we enrolled 736 young Taiwanese subjects aged 12 to 30 years to assess the correlation between urine levels of lead and cadmium, lipoprotein profiles, and carotid intima-media thickness (CIMT).

RESULTS

Higher levels of lead and cadmium were significantly associated with higher levels of low-density lipoprotein cholesterol (LDL-C), small dense LDL-C (sdLDL-C), LDL-triglyceride (LDL-TG), and CIMT. Participants with higher levels of lead and cadmium had the highest mean values of CIMT, LDL-C, sdLDL-C, and LDL-TG. In a structural equation model, lead had a direct and indirect association with CIMT through LDL-C and sdLDL-C, whereas cadmium had a direct association with CIMT and an indirect association through LDL-C.

CONCLUSION

Our results suggest higher levels of lead and cadmium are associated with abnormal lipid profiles and increased CIMT. These heavy metals could have additive effects on lipids and CIMT, and the relationship between them may be mediated by lipoprotein levels. Further research is needed to determine the causal relationship.

Long-term monitoring of mercury in young German adults: Time trend analyses from the German Environmental Specimen Bank, 1995-2018

As highlighted in the Minamata Convention, Mercury (Hg) in its various forms poses a substantial risk to human health and the environment. The health relevance of Hg is also recognized by the European Human Biomonitoring Initiative (HBM4EU), which classifies Hg as a priority substance, since considerable knowledge and data gaps on Hg exposure levels and their changes over time still exist in Europe. The German Environmental Specimen Bank (German ESB) provides valuable policy relevant data and long-term trends of substance exposure on a national level for international comparison and evaluation. In this study we analysed data of the German ESB on Hg exposure of young adults aged 20 to 29 including data on urinary Hg levels from 1995 to 2018 and whole blood Hg levels from 2001 to 2010. Results show a clear decrease in both, about 86% in urine total daily Hg excretion from 1995 (0.76 μg/L) to 2018 (0.11 μg/L) (n = 10,069) and about 57% in blood concentrations of Hg from 2001 (1.76 μg/L) to 2010 (0.77 μg/L) (n = 4085). Over the investigated timeframe only a few values exceeded the toxicologically derived health based guidance value HBM I for blood and urine, with these exceedances decreasing over time in line with the general trend. The factors mostly influencing Hg excretion identified in this study are dental amalgam as well as fish and seafood consumption. Besides other factors (e.g. age and sex), also airborne Hg exposure appears to be a low but evident influencing factor in Germany. Although a considerable decrease in internal Hg exposure is recognized in the last decades, the current low-level exposure may cause adverse health effects especially to vulnerable groups such as pregnant women and children. To further elucidate and evaluate current exposure sources and to reduce human exposure to Hg, continuous environmental and human biomonitoring is needed.

Biological monitoring and health assessment of 21 metal(loid)s in children and adolescents in Liuzhou City, Southwest China

Exposure to metal(loid)s is associated with adverse effects on human health, especially for children and adolescents. This study was designed to evaluate metal(loid)s exposure in 2050 children and adolescents aged 6-18 years from Liuzhou City, Southwest China. The detection rates of 21 elements were all above 99%. We found that age was an important predictor for most elements, and that children exhibited more exposure than adolescents, expect for strontium (p < 0.05). Interestingly, urinary levels were higher in girls for 13 of our study elements. Multiple regression models also showed that dietary habits also affected the distribution of elements. Moreover, we estimated exposure risk by generating the hazard quotient (HQ) for single metal and the hazard index (HI) for the co-occurrence of metals. The HQ of cadmium was > 1 at the P95 value and that the risk of the mixed effect of cadmium, mercury, and thallium was not negligible, and indicated that the associated risk was of concern. Our results provide basic data on the reference values of urinary metal(loid) levels and an assessment of health risks for children and adolescents that reside in industrial areas.

Associations between prenatal multiple metal exposure and preterm birth: Comparison of four statistical models

BACKGROUND

Exposure to some heavy metals has been demonstrated to be related to the risk of preterm birth (PTB). However, the effects of multi-metal mixture are seldom assessed. Thus, we aimed to investigate the associations of maternal exposure to metal mixture with PTB, and to identify the main contributors to PTB from the mixture.

METHODS

The population in the nested case-control study was from a prospective cohort enrolled in Wuhan, China between 2012 and 2014. Eighteen metals were measured in maternal urine collected before delivery. Logistic regression, elastic net regularization (ENET), weighted quantile sum regression (WQSR), and Bayesian kernel machine regression (BKMR) were used to estimate the overall effect and identify important mixture components that drive the associations with PTB.

RESULTS

Logistic regression found naturally log-transformed concentrations of 13 metals were positively associated with PTB after adjusting for the covariates, and only V, Zn, and Cr remained the significantly positive associations when additionally adjusting for the 13 metals together. ENET identified 11 important metals for PTB, and V (β = 0.23) had the strongest association. WQSR determined the positive combined effect of metal mixture on PTB (OR: 1.44, 95%CI: 1.32, 1.57), and selected Cr and V (weighted 0.41 and 0.32, respectively) as the most weighted metals. BKMR analysis confirmed the overall mixture was positively associated with PTB, and the independent effect of V was the most significant. Besides, BKMR showed the non-linear relationships of V and Cu with PTB, and the potential interaction between Zn and Cu.

CONCLUSION

Applying different statistical models, the study found that exposure to the metal mixture was associated with a higher risk of PTB, and V was identified as the most important risk factor among co-exposed metals for PTB.

Human serum elements' levels and leukemia: A first pilot study from an adult Greek cohort

BACKGROUND

The present study focuses on the evaluation of potential relationships between trace elements and acute and chronic types of leukemia, via the determination of their levels in human blood serum.

METHODS

A total of 199 serum samples from a Greek cohort were examined, including both leukemia cases and controls. Elements' analysis was carried out using inductively coupled plasma mass spectrometry (ICP-MS) and demographic features such as age, gender, smoking habits and area of residence were recorded and statistically treated applying Shapiro-Wilk, Kolmogorov-Smirnov, Mann Whitney and Kruskal Wallis tests (p < 0.05). Spearman correlation and principal component analysis (PCA) were also performed to investigate possible associations.

RESULTS

The results demonstrated significantly higher (p < 0.05) trace elements concentrations in cases' serum compared to that of controls excluding Ba, with Cu (median concentration 1295 μg L^-1) being the most abundant in cases. Additionally, concentration of toxic Pb and Cd were found at seven and four fold higher concentrations in cases, respectively. Among the trace elements examined, only Rb (164 μg L^-1) was detected in higher concentrations in controls. Ba, Cd and Co presented the lowest concentrations (lower than 1 μg L^-1). PCA was performed for overall and classified data, indicating a stronger relation among the toxic As, Cd, Ni and Pb in cases than controls, particularly referring to smokers and industrial sites' residents. Hematological parameters and factors such as age and gender did not present any significant outcome or correlation.

CONCLUSIONS

The findings from this pilot study suggest a potential relationship between metals and leukemia, especially concerning the toxic ones. Results from the employed source apportionment tools imply that smoking and atmospheric degradation may be positively related with higher metal serum levels in leukemia patients.

Exposure and Risk Assessment of Hg, Cd, As, Tl, Se, and Mo in Women of Reproductive Age Using Urinary Biomonitoring

The present study analyzed the exposure and risk assessment of 4 toxic (Hg, Cd, As, Tl) and 2 essential (Se, Mo) elements in 119 Spanish women of reproductive age. The focus was on the elements for which risk-based benchmark, biomonitoring equivalents, or health-related human biomonitoring values have already been established. All elements presented frequencies of detection of 100% (greater than the limit of detection), except for Cd (99%). The 95th percentile concentrations were, for the toxic metals, 358.37 µg/L (total As), 1.10 µg/L (Cd), 0.41 µg/L (Tl), and 3.03 µg/L (total Hg) and, for the essential elements, 68.95 µg/L (total Se) and 154.67 (Mo). We examined sociodemographic factors and dietary habits of women as predictors of urinary metal concentrations. Arsenic was positively associated with fish, shellfish, and canned fish consumption, whereas Mo was found to be associated with the consumption of cereals and pastry products. Maternal urine levels of As were negatively correlated with gestational age. In a risk-assessment context, hazard quotients (HQs) using the 95th percentile ranged from 0.08 (Tl) to 15.1 (urinary speciated As), with Cd presenting an HQ of 1.1 (95th percentile). None of the essential metals presented concentrations higher than their upper intake level; however, 3% of the mothers showed lower levels of Se than the estimated average requirement (EAR) biomonitoring equivalent, and 20% of the mothers were found to have lower levels of Mo than the EAR biomonitoring equivalent, suggesting a nutritionally inadequate diet. Environ Toxicol Chem 2021;40:1477-1490. © 2021 SETAC.

Interlaboratory comparison investigations (ICI) and external quality assurance schemes (EQUAS) for cadmium in urine and blood: Results from the HBM4EU project

Human biomonitoring (HBM) of cadmium is essential to assess and prevent toxic exposure. Generally, low cadmium levels in urine and blood of the general population place particularly high demands on quality assurance and control measures (QA/QC) for cadmium determination. One of the aims of the HBM4EU project is to harmonize and advance HBM in Europe. Cadmium is one of the chemicals selected as a priority substance for HBM implementation in the 30 European countries under HBM4EU. For this purpose, analytical comparability and accuracy of the analytical laboratories of participating countries was investigated in a QA/QC programme comprising interlaboratory comparison investigations (ICI) and external quality assurance schemes (EQUAS). This paper presents the evaluation process and discusses the results of four ICI/EQUAS rounds for the determination of cadmium in urine and blood. The majority of the 43 participating laboratories achieved satisfactory results, although low limits of quantification were required to quantify Cd concentrations at general population exposure levels. The relative standard deviation of the participants' results obtained from all ICI and EQUAS runs ranged from 8 to 36% for cadmium in urine and 8-28% for cadmium in blood. Applying inductively-coupled plasma mass spectrometry (ICP-MS), using an internal standard, and eliminating molybdenum oxide interferences was favourable for the accurate determination of cadmium in urine and blood. Furthermore, the analysis of cadmium in urine was found to have a critical point at approximately 0.05 μg/l, below which variability increased and laboratory proficiency decreased. This QA/QC programme succeeded in establishing a network of laboratories with high analytical comparability and accuracy for the analysis of cadmium across 20 European countries.

Urinary Mercury Levels and Predictors of Exposure among a Group of Italian Children

Urinary mercury (Hg) levels are suitable to assess long-term exposure to both elemental and inorganic Hg. In this study, the urinary Hg levels of 250 children (aged 6–11 years) from three areas with different anthropogenic impacts in the Rieti province, central Italy, were assessed. The Hg concentrations were in the range of 0.04–2.18 µg L⁻¹ with a geometric mean equal to 0.18 µg L⁻¹ [95% confidence interval (CI), 0.17–0.20 µg L⁻¹] or 0.21 µg g⁻¹ creatinine (95% CI, 0.19–0.23 µg g⁻¹ creatinine), and a reference value calculated as 95th percentile of 0.53 µg L⁻¹ (95% CI, 0.44–0.73 µg L⁻¹) or 0.55 µg g⁻¹ creatinine (95% CI, 0.50–0.83 µg g⁻¹ creatinine). In all cases, urinary Hg data were below the HBM-I values (7 µg L⁻¹ or 5 µg g⁻¹ creatinine) established for urine, while the 95th percentile was above the German Human Biomonitoring Commission’s RV95 (0.4 µg L⁻¹) set for children without amalgam fillings. A significant correlation (p < 0.05) was found between creatinine-corrected results and residence area, with higher urinary Hg levels in children living in the industrial area. Multiple linear regression analysis showed that creatinine was the main predictor of urinary Hg.

Lead and mercury levels in repeatedly collected urine samples of young children: A longitudinal biomonitoring study

Early life exposures to lead (Pb) and mercury (Hg) were reported to be associated with various adverse health outcomes. However, limited data was available for urinary Pb and Hg levels in young children and the proportion of children at risk by age, as well as inter- and intra-subject variations of urinary Pb and Hg levels. Therefore, we collected total 491 urine samples from 241 children by urine collection at birth and at intervals of 3 months until 27 months of age for each child (at 10 monitoring time points), measured urinary Pb and Hg levels, and then evaluated the proportion of children at risk by age and the intra-class correlation (ICC) of the urinary Pb and Hg levels. Both the urinary Pb and Hg levels were significantly different according to the monitoring time points (p < 0.0001 for both Pb and Hg). The number of children with Hg level over the Human BioMonitoring (HBM) I (7 μg/L) and II (25 μg/L) in the first urine at birth were 3 (2.2%) and 1 (0.7%), respectively, while the urinary samples at the other time points did not show Hg level over HBM I or HBM II. However, the exceedance rate for urinary Pb based on HBM values was not calculated due to unavailable HBM values. On the other hands, the proportion of the children with Pb and Hg levels over the reference value derived on the 95th percentile of representative samples (RV₉₅) (1.7 μg/L for Canadian Pb and 0.4 μg/L for German Hg) was relatively high, ranging from 20.0% to 100.0% for Pb and from 13.6% to 100.0% for Hg. The ICC of the repeated measurements from birth to 27 months was 0 for Pb and 0.89 for Hg, while the ICC after the exclusion of the first urine at birth was 0.13 for Pb and 0.47 for Hg. Furthermore, the Pb and Hg exposures were consistent among the high-exposure group for Pb and among all population for Hg. Our data showed Korean children were exposed to relatively high levels of Pb and Hg. However, our Pb and Hg levels in children were based on only urine samples without urinary correction and without consideration of the levels in any other bio-samples such as bloods. Therefore, to explore the Pb and Hg exposures using urine samples warrant further investigation with large sample size considering urinary correction and other bio-samples in the future.

The associations among lead exposure, bone mineral density, and FRAX score: NHANES, 2013 to 2014

Lead exposure has been suspected as a risk factor for osteoporosis. However, in epidemiological studies, the association between environmental lead exposure and bone health were inconsistent. With the decrease of lead exposure in recent decades, we evaluated the association between lead exposure and bone mineral density (BMD) in the general US population in this study. We analyzed data on 1859 adults (aged ≥40 years) from the National Health and Nutrition Examination Survey (NHANES) conducted in 2013-2014 to determine the relationship among lead exposure measured by both blood and urine lead concentration, BMD of total spine and femur, and FRAX score in a cross-sectional study. In premenopausal women, the results showed a 1-unit increase in natural log-transformed blood and urine lead levels was associated with a decrease in total femur BMD of 0.061 g/cm² (S.E. = 0.015; p = 0.001) and 0.046 g/cm² (S.E. = 0.018; p = 0.020), respectively. Moreover, in premenopausal women, a 1-unit increase in natural log-transformed blood level was associated with a decrease in total spine BMD of 0.054 g/cm² (S.E. = 0.019; p = 0.013). Both FRAX scores were positively correlated with blood and urine lead levels in subjects without fractures, while the 10-year hip fracture risk score was positively associated with lead exposure in subjects with a history of fracture or vertebral fracture. In conclusion, lead exposure was associated with decreased total femur and spine BMD, and FRAX score in the general US population. Further research is needed to elucidate the causal relationship among lead exposure, BMD, and fracture risk.

Association of exposure to multiple metals with papillary thyroid cancer risk in China

Papillary thyroid cancer (PTC) has inflicted huge threats to the health of mankind. Metal pollution could be a potential risk factor of PTC occurrence, but existing relevant epidemiological researches are limited. The current case-control study was designed to evaluate the relationships between exposure to multiple metals and the risk of PTC. A total of 262 histologically confirmed PTC cases were recruited. Age- and gender-matched controls were enrolled at the same time. Urine samples were used as biomarkers to reflect the levels of environmental exposure to 13 metals. Conditional logistic regression models were adopted to assess the potential association. Single-metal and multi-metal models were separately conducted to evaluate the impacts of single and co-exposure to 13 metals. The increased concentration of urinary Cd, Cu, Fe, and Pb quartiles was found significant correlated with PTC risk. We also found the decreased trends of urinary Se, Zn, and Mn quartiles with the ORs for PTC. These dose-response associations between Pb and PTC were observed in the single-metal model and remained significant in the multi-metal model (OR_25-50th=1.39, OR_50-75th=3.32, OR_>75th=7.62, p for trend <0.001). Our study suggested that PTC was positively associated with urinary levels of Cd, Cu, Fe, Pb, and inversely associated with Se, Zn, and Mn. Targeted public health policies should be made to improve the environment and the recognition of potential risk factors. These findings need additional studies to confirm in other population.

Levels and temporal variations of urinary lead, cadmium, cobalt, and copper exposure in the general population of Taiwan

Toxic metal contamination in food products and the environment is a public health concern. Therefore, understanding human exposure to cadmium (Cd), lead (Pb), cobalt (Co), and copper (Cu) levels in the general population of Taiwan is necessary and urgent. We aimed to establish the human biomonitoring data of urine toxic metals, exposure profile changes, and factors associated with metal levels in the general population of Taiwan. We randomly selected 1601 participants older than 7 years of age (36.9 ± 18.7 years (7-84 years)) from the Nutrition and Health Survey in Taiwan (NAHSIT) conducted during 1993-1996 (93-96) and 2005-2008 (05-08) periods and measured the levels of four metals in the participants' urine samples using inductively coupled plasma-mass spectrometry. The median (range) levels of urinary Cd, Pb, Co, and Cu in participants from the NAHSIT 93-96 (N = 821)/05-08 (N = 780) were 0.60 (ND-13.90)/0.72 (ND-7.44), 2.28 (ND-63.60)/1.09 (0.04-48.88), 0.91 (0.08-17.30)/1.05 (0.05-22.43), and 16.87 (2.62-158.28)/13.66 (1.67-189.70) μg/L, respectively. We found that the urinary median levels of Pb and Cu in our participants were significantly lower in the NAHSIT 05-08 (Pb 1.09 μg/L, Cu 13.66 μg/L) than in the NAHSIT 93-96 (Pb 2.28 μg/L, Cu 16.87 μg/L; P < 0.01), whereas those of Cd and Co were significantly higher in the NAHSIT 05-08 (Cd 0.72 μg/L, Co 1.05 μg/L; P < 0.01). Youths had higher exposure levels of Pb, Co, and Cu than adults. Participants with alcohol consumption, betel quid chewing, or cigarette smoking had significantly higher median levels of urinary Pb or Cu (P < 0.01) than those without. Principal components and cluster analysis revealed that sex had different exposure profiles of metals. We concluded that levels of urinary Cd, Pb, Co, and Cu exposure in the general Taiwanese varied by age, sex, and lifestyles.

Quantitative estimation of mercury intake by toxicokinetic modelling based on total mercury levels in humans

Mercury is a toxic metal that can be disseminated into the environment from both natural and anthropogenic sources. Human exposure to the metal stems mainly from food, and more particularly from the consumption of fish and other seafoods. Examining dietary exposure and measuring mercury levels in body tissues are two ways of estimating exposure to mercury. In this study, we utilized a modelling system consisting of three linear toxicokinetic models for describing the fate of methyl mercury, inorganic mercury, and metallic mercury in the body, in order to estimate daily intake of mercury as measured through total mercury concentrations in the blood. We then compared the results stemming from our modelling system to those of the detailed semi-quantitative food frequency questionnaire (FFQ) of the Norwegian Fish and Game (NFG) Study, a project that focused on dietary mercury exposure. The results indicate that toxicokinetic modelling based on blood levels gave higher daily intake values of mercury compared to those of the FFQ. Furthermore, the former had a wider range of estimates than the latter. The properties of the toxicokinetic model or limitations in the dietary exposure assessment could be posited as reasons for the differences between the respective methods. Moreover, the results may have been influenced by sources of mercury exposure that cannot be described as dietary, such as amalgam fillings.

Association between human exposure to heavy metals/metalloid and occurrences of respiratory diseases, lipid peroxidation and DNA damage in Kumasi, Ghana

Heavy metals and metalloids contamination in soils, water, food and livers of wild rats have been studied in Kumasi, Ghana and despite the estimated risks to residents, there is no epidemiological study to ascertain these projections. In addition, the World Health Organization and International Agency for Research on Cancer have reported an increase in respiratory diseases and cancers, in Ghana. The study's purpose was therefore to explore the potential associations between metal exposure and occurrences of respiratory diseases, lipid peroxidation and/or DNA damage to different age groups and sexes in Kumasi. Human urine was collected from the general population in urban and control sites in Kumasi and nine metals were measured in each sample. Results showed that although Zn was the most abundant total urinary As concentration was higher in 83% of samples compared to reference values. Urinary concentrations of metals, malondialdehyde (MDA) and 8-hydroxy-2-deoxy-guanosine (8-OHdG) were higher in urban sites compared to the control site. Based on the results obtained, there was no significant correlation between urinary metals and age. However, urinary Cd and MDA were highest in age groups 61-85 and 3-20 years, respectively. Significantly higher levels of urinary Co, As and Cd were detected in female participants. The study revealed that exposure to As was significantly associated with increased odds of asthma (odds ratio (OR) = 2.76; CI: 1.11-6.83) and tachycardia (OR = 3.93; CI: 1.01-15.4). Significant association was observed between urinary metals and MDA and 8-OHdG indicating possibility of lipid peroxidation and/or DNA damage in Kumasi residents.

Morphological and clinical findings in Sri Lankan patients with chronic kidney disease of unknown cause (CKDu): Similarities and differences with Mesoamerican Nephropathy

In Sri Lanka, an endemic of chronic kidney disease of unknown origin (CKDu) is affecting rural communities. The endemic has similarities with Mesoamerican Nephropathy (MeN) in Central America, however it has not yet been clarified if the endemics are related diagnostic entities. We designed this study of kidney biopsies from patients with CKDu in Sri Lanka to compare with MeN morphology. Eleven patients with CKDu were recruited at the General Hospital, Polonnaruwa, using similar inclusion and exclusion criteria as our previous MeN studies. Inclusion criteria were 20–65 years of age and plasma creatinine 100–220 μmol/L. Exclusion criteria were diabetes mellitus, uncontrolled hypertension and albuminuria >1g/24h. Kidney biopsies, blood and urine samples were collected, and participants answered a questionnaire. Included participants were between 27–61 years of age and had a mean eGFR of 38±14 ml/min/1.73m². Main findings in the biopsies were chronic glomerular and tubulointerstitial damage with glomerulosclerosis (8–75%), glomerular hypertrophy and mild to moderate tubulointerstitial changes. The morphology was more heterogeneous and interstitial inflammation and vascular changes were more common compared to our previous studies of MeN. In two patients the biopsies showed morphological signs of acute pyelonephritis but urine cultures were negative. Electrolyte disturbances with low levels of serum sodium, potassium, and/or magnesium were common. In the urine, only four patients displayed albuminuria, but many patients exhibited elevated α-1-microglobulin and magnesium levels. This is the first study reporting detailed biochemical and clinical data together with renal morphology, including electron microscopy, from Sri Lankan patients with CKDu. Our data show that there are many similarities in the biochemical and morphological profile of the CKDu endemics in Central America and Sri Lanka, supporting a common etiology. However, there are differences, such as a more mixed morphology, more interstitial inflammation and vascular changes in Sri Lankan patients.

Environmental exposure to cadmium-a risk for health of the general population in industrialized countries and preventive strategies

Cadmium (Cd) is a heavy metal belonging to the group of the main chemical pollutants of the natural and occupational environment in economically developed countries. The forecasts indicate that contamination of the environment with this toxic metal, and thus the exposure of the general population, will increase. Food (particularly plant products) is the main source of the general population exposure to this element. Moreover, an important, and often the main, source of intoxication with Cd is habitual tobacco smoking. Recent epidemiological studies have provided numerous evidence that even low-level environmental exposure to this toxic metal, nowadays occurring in numerous economically developed countries, creates a risk for health of the general population. The low-level lifetime exposure to this metal may lead to the damage to the kidneys, liver, skeletal system, and cardiovascular system, as well as to the deterioration of the sight and hearing. Moreover, it has been suggested that environmental exposure to this xenobiotic may contribute to the development of cancer of the lung, breast, prostate, pancreas, urinary bladder, and nasopharynx. Taking the above into account, the aim of this review article is to draw more attention to Cd as an environmental risk factor for the health of the general population and the need to undertake preventive actions allowing to reduce the risk of health damage due to a lifetime exposure to this toxic metal.

Human biomonitoring of eight trace elements in urine of residents living in rural areas along the Yangtze River, China

The rapid economic development and industrialization have made heavy metal contamination a great public concern, especially in China. However, the levels of heavy metals in human body, especially those susceptible to the effect of industrial progression, are rarely explored. In this study, eight elements in 2643 urinary samples of individuals living in rural areas along the Yangtze River were determined through inductively coupled plasma optical emission spectrometry (As, Cr, Cu, Fe, Mn, Pb, and Zn) and TAS-990 atomic absorption spectrophotometry (Cd). Two-level regression model was applied to explore the potential factors associated with the level of the eight trace elements. After adjusting for urinary creatinine, the geometric means were 77.5, 10.98, 14.39, 13.00, 0.59, 1.51, 489.62, and 1.80 μg/g for As, Cr, Cu, Fe, Mn, Pb, Zn, and Cd, respectively. The level of eight elements varied among individual and familial characteristics. Compared with domestic and international results, the rural residents living in riverside areas had higher level of As, Cd, Cr, Fe, and Zn. Therefore, industrial progression followed by economic development has resulted in high body burden of heavy metals. Targeted public health policies should be made to improve the local environment and the recognition of potential risk factors.

Biomonitoring of mercury in hair of breastfeeding mothers living in the Valencian Region (Spain). Levels and predictors of exposure

This study focused on the evaluation of the levels of total mercury in hair among 120 breastfeeding mothers aged 20 to 45 -. The concentrations of Hg ranged from 0.07 to 6.87 μg/g with a geometric mean (GM) of 1.22 μg/g. This GM is six times higher than the average internal exposure of mothers from other 17 European countries (0.225 μg/g). Near 70% of mothers presented levels of Hg above the USA EPA internal exposure guideline of 1 μg/g, and 27% exceeded the EFSA health-based guidance value of 1.9 μg/g. The multivariate regression analysis revealed that age, smoking and fish consumption (sword fish, small fat fish, small lean fish) were the major predictors of mercury in hair.

Indicative and complementary effects of human biological indicators for heavy metal exposure assessment

Although human biological indicators have been widely utilized for biomonitoring environmental pollutants in health exposure assessment, the relationship between internal and external exposure has not yet been adequately established. In this study, we collected and analyzed 61 rice, 56 pepper, and 58 soil samples, together with 107 hair, 107 blood, and 107 urine samples from residents living in selected intensive mining areas in China. Concentrations of most of the four elements considered (Pb, Cd, Hg, and Se) exceeded national standards, implying high exposure risk in the study areas. Regression analysis also revealed a correlation (0.33, P < 0.001) between the concentration of Pb in soil and that in human hair (as well as in human blood); to some extent, Pb content in hair and blood could therefore be used to characterize external Pb exposure. The correlation between Hg in rice and in human hair (up to 0.5, P < 0.001) further confirmed a significant indicative effect of human hair for Hg exposure. A significant correlation was also noted between concentrations of some elements in different human samples, for example, between Hg in hair and blood (0.641, P < 0.01) and between Cd in urine and blood (0.339, P < 0.01). To some extent, there could thus be mutual reflectance of the same heavy metal in different samples, with the possibility for complementary use in assessing heavy metal exposure.

Prenatal cadmium exposure and preterm low birth weight in China

Early studies have investigated the effect of prenatal cadmium (Cd) exposure on birth outcomes, such as preterm birth and low birth weight, although the results of these studies are inconsistent. The aim of the present study was to investigate the association between prenatal exposure to Cd and the risk of preterm low birth weight (PLBW). A total of 408 mother-infant pairs (102 PLBW cases and 306 pair matched controls) were selected from the participants enrolled in the Healthy Baby Cohort (HBC) study between 2012 and 2014 in Hubei province, China. Concentrations of Cd in maternal urine collected before delivery were measured by inductively coupled plasma mass spectrometry and adjusted by creatinine. A significant association was observed between higher maternal urinary Cd levels and risk of PLBW (adjusted odds ratio (OR)=1.75 for the medium tertile, 95% confidence interval (CI): 0.88, 3.47; adjusted OR=2.51 for the highest tertile, 95% CI: 1.24, 5.07; P trend=0.03). The association was more pronounced among female infants than male infants. Our study suggested that prenatal exposure to Cd at the current level encountered in China may potentially increase the risk of delivering PLBW infants, particularly for female infants.

Distribution and health risk assessment to heavy metals near smelting and mining areas of Hezhang, China

Mining and smelting areas in Hezhang have generated a large amount of heavy metals into the environment. For that cause, an evaluative study on human exposure to heavy metals including Co, Ni, Cu, Zn, Cr, As, Cd, Pb, Sb, Bi, Be, and Hg in hair and urine was conducted for their concentrations and correlations. Daily exposure and non-carcinogenic and carcinogenic risk were estimated. Sixty-eight scalp hair and 66 urine samples were taken from participants of different ages (6-17, 18-40, 41-60, and ≥ 65 years) living in the vicinity of an agricultural soil near mine and smelting areas. The results compared to the earlier studies showed an elevated concentration of Pb, Be, Bi, Co, Cr, Ni, Sb, and Zn in hair and urine. These heavy metals were more elevated in mining than in smelting. Considering gender differences, females were likely to be more affected than male. By investigating age differences in this area, high heavy metal concentrations in male's hair and urine existed in age of 18-40 and ≥ 66, respectively. However, females did not present homogeneous age distribution. Hair and urine showed a different distribution of heavy metals in different age and gender. In some cases, significant correlation was found between heavy metals in hair and urine (P > 0.05 and P > 0.01) in mining area. The estimated average daily intake of heavy metals in vegetables showed a great contribution compared to the soil and water. Non-carcinogenic and carcinogenic risk values of total pathways in mining and smelting areas were higher than 1 and exceeded the acceptable levels. Thus, the obtained data might be useful for further studies. They can serve as a basis of comparison and assessing the effect of simultaneous exposure from heavy metals in mining and smelting areas, and potential health risks from exposure to heavy metals in vegetables need more consideration.

Current health risk assessment practice for dietary cadmium: Data from different countries

Cadmium (Cd) is an environmental toxicant with high rates of soil-to-plant transference. This makes exposure to Cd through the food-chain contamination a public health concern. Cd accumulates in kidneys, and the most frequently reported adverse effect of long-term Cd intake is injury to kidneys. The FAO/WHO Joint Expert Committee on Food Additives established a tolerable dietary intake level and a threshold to safeguard population health. The FAO/WHO tolerable intake was set at 25 μg per kg body weight per month (58 μg per day for a 70-kg person) with urinary Cd threshold at 5.24 μg/g creatinine. Worldwide population data indicate that urinary Cd excretion reflects cumulative Cd exposure or body burden more accurately than estimated Cd intake, derived from total diet study (TDS). For the adult population, TDS estimated Cd intake of 8-25 μg/day, while urinary Cd levels suggest higher intake levels (>30 μg/day). These Cd intake estimates are below the FAO/WHO intake guideline, but they exceed the levels that are associated with distinct pathologies in many organ systems. A wide diversity of Cd toxicity targets and Cd toxicity levels argue for a more restrictive dietary Cd intake guideline and the measures that minimize Cd levels in foodstuffs.

A new method for quasi-reagent-free biomonitoring of mercury in human urine

A novel analytical method for sampling and extraction of mercury (Hg) from human urine is presented in this work. The method is based on selective accumulation and separation of Hg from fresh urine sample onto active nanogold-coated silica material by highly efficient solid-phase extraction. After thermal desorption of Hg from the extractant, detection is performed by atomic fluorescence spectrometry (AFS). The feasibility and validity of the optimized, quasi-reagent-free approach was confirmed by recovery experiments in spiked real urine (recovery rate 96.13 ± 5.34%) and by comparison of found Hg concentrations in real urine samples - originating from occupationally exposed persons - with values obtained from reference methods cold vapor - atomic absorption spectrometry (CVAAS) and cold vapor - atomic fluorescence spectrometry (CV-AFS). A very good agreement of the found values reveals the validity of the proposed approach. The limit of detection (LOD) was found to be as low as 0.004 μg Hg L^-1 and a high reproducibility with a relative standard deviations ≤4.2% (n = 6) is given. Moreover, storage of the samples for up to one week at an ambient temperature of 30 °C reveals no analyte losses or contamination. In conclusion, the proposed method enables easy-to-handle on-site extraction of total Hg from human urine ensuring at the same time reagent-free sample stabilization, providing quick and safe sampling, which can be performed by untrained persons.

Human biomonitoring pilot study DEMOCOPHES in Germany: Contribution to a harmonized European approach

Human biomonitoring (HBM) is an effective tool to assess human exposure to environmental pollutants, but comparable HBM data in Europe are lacking. In order to expedite harmonization of HBM studies on a European scale, the twin projects COPHES (Consortium to Perform Human Biomonitoring on a European Scale) and DEMOCOPHES (Demonstration of a study to Coordinate and Perform Human Biomonitoring on a European Scale) were formed, comprising 35 partners from 27 European countries. In COPHES a research scheme and guidelines were developed to exemplarily measure in a pilot study mercury in hair, cadmium, cotinine and several phthalate metabolites in urine of 6-11year old children and their mothers in an urban and a rural region. Seventeen European countries simultaneously conducted this cross-sectional DEMOCOPHES feasibility study. The German study population was taken in the city of Bochum and in the Higher Sauerland District, comprising 120 mother-child pairs. In the present paper features of the study implementation are presented. German exposure concentrations of the pollutants are reported and compared with European average concentrations from DEMOCOPHES and with those measured in the representative German Environmental Survey (GerES IV). German DEMOCOPHES concentrations for mercury and cotinine were lower than the European average. However, 47% of the children were still exposed to environmental tobacco smoke (ETS) outside their home, which gives further potential for enhancing protection of children from ETS. Compared with samples from the other European countries German participating children had lower concentrations of the phthalate metabolites MEP and of the sum of 3 DEHP-metabolites (MEHP, 5OH-MEHP and 5oxo-MEHP), about the same concentrations of the phthalate metabolites MBzP and MiBP and higher concentrations of the phthalate metabolite MnBP. 2.5% of the German children had concentrations of the sum of 4 DEHP-metabolites and 4.2% had concentrations of MnBP that exceeded health based guidance values, indicating reasons for concern. Continuous HBM is necessary to track changes of pollutant exposure over time. Therefore Germany will continue to cooperate on the harmonisation of European human biomonitoring to support the chemicals regulation with the best possible exposure data to protect Europe's people against environmental health risks.

Relationships among DNA hypomethylation, Cd, and Pb exposure and risk of cigarette smoking-related urothelial carcinoma

Cigarette smoking and environmental exposure to heavy metals are important global health issues, especially for urothelial carcinoma (UC). However, the effects of cadmium and lead exposure, as well as the levels of DNA hypomethylation, on UC risk are limited. We evaluated the possible exposure sources of Cd and Pb and the relationship among DNA hypomethylation, urinary Cd and Pb levels, and UC risk. We recruited 209 patients with UC and 417 control patients for a hospital-based case-control study between June 2011 and August 2014. We collected environmental exposure-related information with questionnaires. Blood and urine samples were analyzed to measure the Cd and Pb exposure and 5-methyl-2'-deoxycytidine levels as a proxy for DNA methylation. Multivariate logistic regression and 95% confidence intervals were applied to estimate the risk for UC. Study participants with high Cd and Pb exposure in blood or urine had significantly increased risk of UC, especially among the smokers. After adjusting for age and gender, the possible connections of individual cumulative cigarette smoking or herb medicine exposure with the increased levels of Cd and Pb were observed in the controls. Participants with 8.66%-12.39% of DNA hypomethylation had significantly increased risk of UC compared with those with ≥12.39% of DNA hypomethylation. Environmental factors including cigarette smoking and herb medicine may contribute to the internal dose of heavy metals levels. Repeat measurements of heavy metals with different study design, detailed dietary information, and types of herb medicine should be recommended for exploring UC carcinogenesis in future studies.

The impact of iron status and smoking on blood divalent metal concentrations in Norwegian women in the HUNT2 Study

Low iron (Fe) stores may result in increased absorption of divalent metals, in particular cadmium (Cd). We have previously shown that in non-smoking women participating in the Norwegian HUNT2 cohort study this also included other divalent metals, e.g. manganese (Mn) and cobalt (Co). The diet is the main source of metals in non-smoking individuals, whereas in smoking individuals tobacco smoke contributes significant amounts of Cd and lead (Pb). The aim of the present study was to investigate the impact of smoking on the relationship between low iron status and divalent metals. Blood concentrations of the divalent metals Cd, Mn, Co, Pb, copper (Cu) and zinc (Zn), determined using an Element 2 sector field mass spectrometer (ICP-MS), were investigated in smoking women of fertile age (range 21-55 years) (n=267) from the HUNT2 cohort. Among these, 82 were iron-deplete (serum ferritin<12μg/L) and 28 had iron deficiency anaemia (serum ferritin<12μg/L & Hb<120g/L). 150 (56%) women smoked 10 or more cigarettes daily, 101 (38%) had smoked for more than 20 years, and 107 (40%) had smoked for 11-20 years. Results from the smoking population were compared with results from our previous study in non-smoking women (n=448) of which 132 were previous smokers, all from the same cohort. Increasing concentrations of Cd in blood were observed for previous smokers, low-to-moderate smokers and high intensity smokers in all subgroups compared to never smokers, and according to age groups, education level, BMI and serum ferritin. Smokers had higher Pb concentrations than non-smokers in all subgroups, but less pronounced than for Cd. Smoking was not associated with Mn and Co concentrations in blood. In multiple regression models, low ferritin was associated with increased blood concentrations of Cd, Pb, Mn and Co. Ferritin was strongly associated with Cd at low smoking intensity, but was not a significant factor in heavy smokers, where intensity and duration of smoking emerged as main determinants. Ferritin associations with Co and Pb varied with tertiles of blood Cd. Ferritin emerged as the main determinant of blood Co and Mn, while for blood Pb, age and smoking intensity had higher impact. Cu and Zn remained within reference values and no significant associations with ferritin were found. Strong positive associations between blood concentrations of Pb, Mn, Cd and Co were observed, also when controlled for their common association with ferritin. Apart from these associations, the models showed no significant interactions between the divalent metals studied. Mild anaemia (110<Hb<120g/L) did not seem to have any effect independent of low ferritin. The results indicate that low serum ferritin facilitates absorption of certain divalent metal ions in female smokers as well as the previously shown effect in non-smokers. Even if smoking provides Pb and Cd, the mutual associations between Cd and other divalent metals in blood persisted in medium and heavy smokers. This indicates that the interrelationship between Cd and divalent metals not only reflect effects on the absorption, but possibly also on kinetic processes such as transportation in blood and other compartments, including excretion.

Mercury concentrations in urine of amerindian populations near oil fields in the peruvian and ecuadorian amazon

BACKGROUND

Mercury is a global contaminant with toxic, persistent effects on human health. Petroleum extraction is an important source of elemental mercury; little is known about human exposure levels near oil fields in the Amazon basin.

OBJECTIVES

To characterize mercury levels in people living near oil production sites in the Peruvian and Ecuadorian Amazon, controlling for fish consumption, occupation, source of water and socio-demographic characteristics.

METHODS

Analyze mercury levels in urine samples using cold vapour atomic fluorescence spectrometry from 76 indigenous men and women in eight riverine communities situated near oil wells or pipelines. Subjects answered a questionnaire soliciting socio-demographic, occupational and dietary information. Data were analyzed using multiple linear regression modeling.

RESULTS

The mean value of U-Hg was 2.61μg/g creatinine (95% CI: 2.14-3.08), with 7% of the sample recording values above the global background standard suggested by The World Health Organization (5μg/g creatinine). Women who used water from a surface source had two and a half times the amount of mercury in their urine (mean=3.70μg/g creatinine, 95% CI: 2.26-5.15) compared with women who used other water sources (mean =1.39μg/g creatinine, 95% CI: 0.51-2.25). Men who were involved in an oil clean-up operation had twice as much mercury in their urine (mean =3.07μg/g creatinine, 95% CI: 1.97-4.16) as did those who worked on other tasks (mean =1.56μg/g creatinine, 95% CI: 1.48-2.65). Mercury levels were not associated with the number of fish meals per week.

CONCLUSIONS

Indigenous peoples of the Peruvian and Ecuadorian Amazon living near oil production sites generally had urine mercury levels within the global background standard suggested by the World Health Organization. Increased levels of mercury in urine were detected for men involved in oil spill remediation and for women who relied on surface water for household needs. These findings signal the need for strict safety measures to limit the amount of oil entering the waterways in Andean Amazonia so as to protect the health of indigenous people.

Assessment of exposure to cadmium, lead, manganese, and nickel in workers from foundries

Objectives:

In this study, biological exposure indicators were used to assess the exposure of workers to cadmium (Cd), lead (Pb), manganese (Mn), and nickel (Ni) in nonferrous metal smelters.

Methods:

A total of 273 male participants (178 exposed and 95 nonexposed control group), working in nonferrous metal foundries located in southern Brazil, were evaluated based on biological indicators, environmental levels, and different types of work performed by the participants. Blood Pb (BPb), urinary Cd (UCd), urinary Mn (UMn), and urinary Ni (UNi) levels were quantified by graphite furnace atomic absorption spectrometry with Zeeman background correction.

Results:

Significant differences between the exposed and nonexposed groups were observed for all of the analyzed elements. The average levels of BPb were higher than the recommended occupational exposure level. Relatively low concentrations were found for UCd, UMn, and UNi.

Conclusions:

Although metal production is an important segment of the Brazilian economy, information related to employee health in this sector is scarce. The environmental levels are determinant in occupational exposure in foundries. In companies where air levels of Pb, Cd, and Mn were above the established limits, the different types of activity did not represent an important influence on the biological levels found among workers. In situations with low air levels of these metals, the workers from the “melting” sector were actually more vulnerable.

Alterations in biochemical markers due to mercury (Hg) exposure and its influence on infant's neurodevelopment

This study examined the role of oxidative stress due to mercury (Hg) exposure on infant's neurodevelopmental performance. A total of 944 healthy Saudi mothers and their respective infants (aged 3-12 months) were recruited from 57 Primary Health Care Centers in Riyadh City. Total mercury (Hg) was measured in mothers and infants urine and hair samples, as well as mother's blood and breast milk. Methylmercury (MeHg) was determined in the mothers and infants' hair and mother's blood. Urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG), malondialdehyde (MDA), and porphyrins were used to assess oxidative stress. The infant's neurodevelopment was evaluated using Denver Developmental Screening Test II (DDST-II) and Parents' Evaluation of Developmental Status. The median total Hg levels in mother's urine, infant's urine, mother's hair, infant's hair, and mother's blood and breast milk were 0.995μg/l, 0.716μg/l, 0.118μg/g dw, 0.101μg/g dw, 0.635μg/l, and 0.884μg/l respectively. The median MeHg levels in mother's hair, infant's hair, and mother's blood were 0.132μg/g dw, 0.091μg/g dw, and 2.341μg/l respectively. A significant interrelationship between mothers and infants Hg measures in various matrices was noted. This suggests that mother's exposure to different forms of Hg (total and/or MeHg) from various sources contributed significantly to the metal body burden of their respective infants. Even though Hg exposure was low, it induced high oxidative stress in mothers and infants. The influence of multiplicative interaction terms between Hg measures and oxidative stress biomarkers was tested using multiple regression analysis. Significant interactions between the urinary Hg levels in mothers and infants and oxidative stress biomarkers (8-OHdG and MDA) were noted. The MeHg levels in mother-infant hair revealed similar interaction patterns. The p-values for both were below 0.001. These observations suggest that the exposure of our infants to Hg via mothers either during pregnancy and/or neonatal life, promoted oxidative stress that might have played a role in infant neurodevelopmental delays that we reported previously. The results confirmed that the interaction between infant's MeHg in hair and 8-OHdG and MDA levels was significantly associated with a delay in DDST-II performance (ß=-0.188, p=0.028). This finding provides an insight into the potential consequences of Hg-induced oxidative stress to infant's cognitive neurodevelopment for the first time. This observation still needs future studies to be validated. Given the low MeHg levels in our population, these findings are of particular importance.

Human biomonitoring of metals in adults living near a waste-to-energy incinerator in ante-operam phase: Focus on reference values and health-based assessments

The human biomonitoring (HBM) of metals is a part of the ongoing project SPoTT for the longitudinal health surveillance of the population living near a waste-to-energy (WTE) incinerator (Turin, Italy). The HBM of metals in the SPoTT population aimed to evaluate: i) reference values (RVs) before the WTE incinerator started operation; ii) differences in exposure by variables; iii) variations respect to other HBM studies; iv) exposure that exceeds the available health-based benchmarks as the Biomonitoring Equivalents (BEs) for urine Cd and Human Biomonitoring (HBM-I and HBM-II) values for urine Hg, Tl, and blood Pb; v) risk assessment by generating hazard quotients (HQs) for the single metal and hazard index (HI) for the co-occurrence of metals. Eighteen metals in urine and Pb in blood were determined by sector field inductively coupled plasma mass spectrometry. Metal concentrations were comparable with RVs reported in other countries, except for slightly higher As, Be, Ir, Pd, Pt, Rh, and Tl levels. Smoking was associated with Cd; age with Pb; drinking bottled water with As and Cd; consumption of fish with As and Hg; amalgams with Hg and Sn; dental restorations with Pd and Pt; use of jewelry with Co and Rh, and piercing with Ni. While HQs for urine Cd, Hg, Tl and blood Pb suggested that adverse effects were unlikely, the HQ value raised the question of whether additive interactions of these metals could produce health concern. The obtained HBM data can be an early warning for accumulations of metals and identification of subgroups at risk.

Biomonitoring of 20 elements in urine of children. Levels and predictors of exposure

The levels of 20 elements in the urine of one hundred twenty children (Ages 6-11) from an agricultural and an urban area of Valencia Region, Spain, were assessed. The seven essential elements analysed (Co, Cu, Mn, Mo, Se, V, Zn) presented average concentrations (geometric mean) ranging from 0.22 µg L(-1) to 63 µg L(-1) (except Zn with 525 µg L(-1)). Eight out of the 13 toxic elements determined (As, Ba, Cd, Cs, Ni, Pb, Tl, Hg) had frequencies of detection of 100%, with geometric mean concentrations from 0.17 µg L(-1) (Cd) to 33.6 µg L(-1) (As). About 18% of children revealed urinary levels of total As higher than the normal range of 100 µg L(-1) accepted by the ATSDR. The urine analysis was combined with a survey to evaluate variations between subgroups and potential predictors of metal exposure in children population. For socio-demographic variables, age was the main exposure determinant for the majority of selected elements (p < 0.05-0.001), with higher concentrations in younger children (6-8 years). Significant differences were also obtained between the rural and urban area studied for As, Co, Cs, Se, U and Hg, with higher levels in children living in the urban area. In relation to diet, statistically significant higher levels of Hg (p < 0.01, median = 1 µg g(-1) creatinine) and Se (p < 0.05, median = 60.3 µg g(-1) creatinine) were obtained for children with elevated fish consumption, and lower levels of Cd, Ni, Se and V were found (p < 0.05-0.01) in children with high consumption of dairy products.

The extent of mercury (Hg) exposure among Saudi mothers and their respective infants

A total of 1016 healthy Saudi mothers and their respective infants (aged 3-12 months) were recruited from 57 Primary Health Care Centers (PHCCs) in Riyadh, Saudi Arabia, to evaluate the extent of mercury (Hg) exposure and predict its sources in the healthy Saudi population. Total Hg levels were measured in maternal urine, breast milk, blood, and hair and in the infants' urine and hair. Only 1.9% of the mothers had urinary Hg (UHg)>10 μg/l, the limit for asymptomatic adults recommended by the World Health Organization, but the median (0.99 μg/l) was higher than in other countries. Also, 49.3% of the mothers had UHg>1 μg/l, the German reference value for adults. Median infant UHg was 0.729 μg/l, and 77 and 93 % of the infants had levels higher than 0.4 and 0.1 μg/l, the reference values of the Centers for Disease Control and Prevention and for Germany, respectively. The median Hg level in breast milk was 0.884 μg/l. Even though 43.2% of the milk samples were above the background level for Hg in human milk (1 μg/l), our results were lower than those reported from other countries. Median maternal total Hg in blood was 0.637 μg/l, and only 0.4 and 6.9% of samples were higher than the Hg reference levels of 5.8 μg/l of the Environmental Protection Agency (EPA) and of 2 μg/l for Germany, respectively. Total Hg levels in hair (HHg) varied widely among mothers and infants, but only 3.9% of the mothers and 2.8% of the infants had HHg>1 μg/g (the EPA reference level). Median HHg values were 0.117 μg/g dry weight in mothers and 0.1 μg/g dry weight in infants; both were lower than in other countries. The Hg levels in mothers and their respective infants were relatively low, but our results were consistent with other studies indicating that dental amalgam fillings and fish consumption were the main predictors of maternal Hg exposure. Among the several biomarkers of Hg exposure, Hg levels in maternal hair and urine were the strongest predictors of infant exposure. The lack of an association between Hg in breast milk and Hg in infant urine and hair suggested that the infants were exposed to Hg predominately during pregnancy rather than during breastfeeding. We expect that our data can serve as a baseline for further biomonitoring and follow-up studies, particularly of the long-term impact of Hg on childhood neurodevelopment.

Lessons learnt on recruitment and fieldwork from a pilot European human biomonitoring survey

Within the European Environment and Health Action Plan an initiative to establish a coherent human biomonitoring approach in Europe was started. The project COPHES (COnsortium to Perform Human biomonitoring on a European Scale ) developed recommendations for a harmonized conduct of a human biomonitoring (HBM) survey which came into action as the pilot study DEMOCOPHES (DEMOnstration of a study to COordinate and Perform Human biomonitoring on a European Scale). Seventeen European countries conducted a survey with harmonized instruments for, inter alia, recruitment, fieldwork and sampling, in autumn/winter 2011/2012. Based on the countries' experiences of conducting the pilot study, following lessons learnt were compiled: the harmonized fieldwork instruments (basic questionnaire, urine and hair sampling) turned out to be very valuable for future HBM surveys on the European scale. A school approach was favoured by most of the countries to recruit school-aged children according to the established guidelines and country specific experiences. To avoid a low participation rate, intensive communication with the involved institutions and possible participants proved to be necessary. The communication material should also include information on exclusion criteria and offered incentives. Telephone contact to the participants the day before fieldwork during the survey can prevent the forgetting of appointments and first morning urine samples. To achieve comparable results on the European scale, training of interviewers in all issues of recruitment, fieldwork and sampling through information material and training sessions is crucial. A survey involving many European countries needs time for preparation and conduct. Materials for quality control prepared for all steps of recruitment, fieldwork and sampling proved to be important to warrant reliable results.

The Danish contribution to the European DEMOCOPHES project: A description of cadmium, cotinine and mercury levels in Danish mother-child pairs and the perspectives of supplementary sampling and measurements

Human biomonitoring (HBM) is an important tool, increasingly used for measuring true levels of the body burdens of environmental chemicals in the general population. In Europe, a harmonized HBM program was needed to open the possibility to compare levels across borders. To explore the prospect of a harmonized European HBM project, DEMOCOPHES (DEMOnstration of a study to COordinate and Perform Human biomonitoring on a European Scale) was completed in 17 European countries. The basic measurements performed in all implemented countries of DEMOCOPHES included cadmium, cotinine and phthalate metabolites in urine and mercury in hair. In the Danish participants, significant correlations between mothers and children for mercury in hair and cotinine in urine were found. Mercury in hair was further significantly associated with intake of fish and area of residence. Cadmium was positively associated with BMI in mothers and an association between cadmium and cotinine was also found. As expected high cotinine levels were found in smoking mothers. For both mercury and cadmium significantly higher concentrations were found in the mothers compared to their children. In Denmark, the DEMOCOPHES project was co-financed by the Danish ministries of health, environment and food safety. The co-financing ministries agreed to finance a number of supplementary measurements of substances of current toxicological, public and regulatory interest. This also included blood sampling from the participants. The collected urine and blood samples were analyzed for a range of other persistent and non-persistent environmental chemicals as well as two biomarkers of effect. The variety of supplementary measurements gives the researchers further information on the exposure status of the participants and creates a basis for valuable knowledge on the pattern of exposure to various chemicals.

Levels of rare earth elements, heavy metals and uranium in a population living in Baiyun Obo, Inner Mongolia, China: a pilot study

The Baiyun Obo deposit is the world's largest rare earth elements (REE) deposit. We aimed to investigate levels of REE, heavy metals (HMs) and uranium (U) based on morning urine samples in a population in Baiyun Obo and to assess the possible influence of rare earth mining processes on human exposure. In the mining area, elevated levels were found for the sum of the concentrations of light REE (LREE) and heavy REE (HREE) with mean values at 3.453 and 1.151 μg g(-1) creatinine, which were significantly higher than those in the control area. Concentrations of HMs and U in the population increased concomitantly with increasing REE levels. The results revealed that besides REE, HMs and U were produced with REE exploitation. Gender, age, educational level, alcohol and smoking habit were major factors contributing to inter-individual variation. Males were more exposed to these metals than females. Concentrations in people in the senior age group and those with only primary education were low. Drinking and smoking were associated with the levels of LREE, Cr, Cu, Cd and Pb in morning urine. Hence this study provides basic and useful information when addressing public and environmental health challenges in the areas where REE are mined and processed.

Anti-smoking legislation and its effects on urinary cotinine and cadmium levels

Anti-smoking legislation has been associated with an improvement in health indicators. Since the cadmium (Cd) body burden in the general population is markedly increased by smoke exposure, we analyzed the impact of the more restrictive legislation that came into force in Spain in 2011 by measuring Cd and cotinine in first morning urine samples from 83 adults in Madrid (Spain) before (2010) and after (2011) introduction of this law. Individual pair-wise comparisons showed a reduction of creatinine corrected Cotinine and Cd levels for non-active smokers, i. e. those which urinary cotinine levels are below 50 μg/L. After the application of the stricter law, cotinine levels in urine only decreased in non-active smokers who self-reported not to be exposed to second-hand smoke. The reduction in second hand smoke exposure was significantly higher in weekends (Friday to Sunday) than in working days (Monday to Thursday). The decrease in U-Cd was highly significant in non-active smokers and, in general, correlated with lower creatinine excretion. Therefore correction by creatinine could bias urinary Cd results, at least for cotinine levels higher than 500 μg/L. The biochemical/toxicological benefits detected herein support the stricter application of anti-smoking legislation and emphasize the need to raise the awareness of the population as regards exposure at home.

Urinary concentrations of toxic and essential trace elements among rural residents in Hainan Island, China

BACKGROUND

Toxic element exposure and essential trace element consumption may have changed after the Chinese economy transformed to a market-oriented system. The objectives of this study were to measure urinary concentrations of toxic (arsenic, cadmium, lead) and essential trace (selenium, zinc, copper) elements among rural residents in Hainan, China and to examine if variations in economic development are linked to differences in toxic and trace element exposure.

METHODS

We conducted a questionnaire-based survey and undertook anthropometric measurements of residents aged ≥20 years (n = 599). Urinary samples were collected and analyzed using inductively coupled plasma mass spectrometry.

RESULTS

The median (μg/g creatinine) element concentrations were: arsenic, 73.2; cadmium, 1.8; lead, 3.1; selenium, 36.5; zinc, 371; and copper, 11.0. Intra-community variation in element concentrations was explained by age (arsenic, cadmium, zinc and copper), sex (arsenic, cadmium and selenium: higher in females; zinc: higher in males), body mass index (cadmium) and individual involvement in the market economy as indexed by agrochemical use (lead and selenium). The degree of community-level economic development, which was determined by the proportion of people living in better housing among the study communities, was positively associated with cadmium concentration.

CONCLUSIONS

The degree of community-level economic development was positively associated with urinary cadmium concentration while individual involvement in the market economy was positively associated with lead and selenium.

Interaction between essential elements selenium and zinc with cadmium and mercury in samples from hypertensive patients

The abnormal metabolism of metal ions plays an important role in health and disease conditions; hence, the studies about them have received much interest. The objective of this study was to evaluate the association between trace and toxic elements zinc (Zn), cadmium (Cd), selenium (Se), and mercury (Hg) in biological samples (scalp hair, blood, and urine) of hypertensive patients (n = 257), residents of Hyderabad, Pakistan. For comparison purpose, the biological samples of age-matched healthy controls were selected as referents. The concentrations of trace and toxic elements were measured by atomic absorption spectrophotometer prior to microwave-assisted acid digestion. The validity and accuracy of the methodology was checked using certified reference materials and by the conventional wet acid digestion method. The recovery of all studied elements was found in the range of 96.4-99.1 % in certified reference materials. The results of this study showed that the mean values of Cd and Hg were significantly higher in scalp hair, blood, and urine samples of hypertensive patients than in referents (P < 0.001), whilst the concentrations of Zn and Se were lower in the scalp hair and blood, but higher in the urine samples of hypertensive patients. The deficiency of Zn and Se and the high exposure of toxic metals may be synergistic with risk factors associated with hypertension.