The biokinetics of inorganic cobalt in the human body

Prosthetic Metals: Release, Metabolism and Toxicity

The development of metallic joint prostheses has been ongoing for more than a century alongside advancements in hip and knee arthroplasty. Among the materials utilized, the Cobalt-Chromium-Molybdenum (Co-Cr-Mo) and Titanium-Aluminum-Vanadium (Ti-Al-V) alloys are predominant in joint prosthesis construction, predominantly due to their commendable biocompatibility, mechanical strength, and corrosion resistance. Nonetheless, over time, the physical wear, electrochemical corrosion, and inflammation induced by these alloys that occur post-implantation can cause the release of various metallic components. The released metals can then flow and metabolize in vivo, subsequently causing potential local or systemic harm. This review first details joint prosthesis development and acknowledges the release of prosthetic metals. Second, we outline the metallic concentration, biodistribution, and elimination pathways of the released prosthetic metals. Lastly, we discuss the possible organ, cellular, critical biomolecules, and significant signaling pathway toxicities and adverse effects that arise from exposure to these metals.

Magnetic particle based MRI thermometry at 0.2 T and 3 T

This study provides insight into the advantages and disadvantages of using ferrite particles embedded in agar gel phantoms as MRI temperature indicators for low-magnetic field scanners. We compare the temperature-dependent intensity of MR images at low-field (0.2 T) to those at high-field (3.0 T). Due to a shorter T₁ relaxation time at low-fields, MRI scanners operating at 0.2 T can use shorter repetition times and achieve a significant T₂^⁎ weighting, resulting in strong temperature-dependent changes of MR image brightness in short acquisition times. Although the signal-to-noise ratio for MR images at 0.2 T MR is much lower than at 3.0 T, it is sufficient to achieve a temperature measurement uncertainty of about ±1.0 °C at 37 °C for a 90 μg/mL concentration of magnetic particles.

Toxicity and Metabolomic Impact of Cobalt, Chromium, and Nickel Exposure on HepaRG Hepatocytes

Cobalt, chromium, and nickel are used in orthopedic prostheses. They can be released, accumulate in many organs, and be toxic. The aim of this study is to evaluate the cytotoxicity of these metals on human hepatocytes and to improve our knowledge of their cellular toxicity mechanisms by metabolomic analysis. HepaRG cells were incubated for 48 h with increasing concentrations of metals to determine their IC₅₀. Then, a nontargeted metabolomic study using liquid chromatography-high-resolution mass spectrometry (LC-HRMS) was done at IC₅₀ and at a lower concentration (100 nM), near to those found in the blood and liver of patients with prostheses. IC₅₀ were defined at 940, 2, and 1380 μM for Co, Cr, and Ni, respectively. In vitro, Cr appears to be much more toxic than Co and Ni. Metabolomic analysis revealed the disruption of metabolic pathways from the low concentration of 100 nM, in particular tryptophan metabolism and lipid metabolism illustrated by an increase in phenylacetylglycine, a marker of phospholipidosis, for all three metals. They also appear to be responsible for oxidative stress. Dysregulation of these pathways impacts hepatocyte metabolism and may result in hepatotoxicity. Further investigations on accessible biological matrices should be conducted to correlate our in vitro results with the clinical data of prostheses-bearing patients.

Influence of chromium (III), cobalt (II) and their mixtures on cell metabolic activity

Chromium (III) and cobalt (II) are necessary elements required for the proper functioning of the organism, but their excess can cause toxic effects. They are the basic components of implants and are also commonly used in medicine as components of dietary supplements, vitamin and mineral products and energy drinks. The aim of this study was to investigate the effect of cobalt (II) and chromium (III) and their combination on BJ cells. In the study, BJ cells were exposed to CoCl2 or CrCl3 at concentrations ranging from 100 to 1400 µM, and the cytotoxicity of chromium (III) and cobalt (II) and their mixtures was assessed by MTT reduction, LDH release and NRU assays. The outcome of this work reveals the cytotoxic effects of chromium (III) and cobalt (II) and their mixtures on BJ cells. In the cytotoxicity assays, at low concentrations of CoCl2 and CrCl3, stimulation of cell proliferation was observed. In higher concentrations, the cell viability decreased for the tested line in all the assays. During the simultaneous incubation of fibroblasts with 200 µM of CrCl3 and 1000 µM of CoCl2, antagonism was observed: chromium (III) at the concentration of 200 µM induced protection from cobalt (II) toxicity; in the case of interaction of chromium chloride at 1000 µm and cobalt chloride at 200 µM, the protective effect of CrCl3 on CoCl2 was not observed. In the latter case, synergism between these elements was noted. Our work indicates that cobalt (II) and chromium (III) show cytotoxic properties. These metals have a destructive effect on the cell membrane, lysosomes and mitochondria, which leads to disorders of cell metabolism.

HERisk: An improved spatio-temporal human health risks assessment software

Risk assessment is considered an essential tool to assist in the management and mitigation of polluted areas, especially those associated with economic activities that significantly degrade the environment, such as mining. However, most of the methodologies of risk assessment adopt the deterministic approach of using a fixed value for ascertaining the hazards derived from exposure to chemical pollutants. However, this is not the case of the Human, Ecological and Radiological Risk (HERisk) code, which allows space-time assessments of ecological, radiological, and human health risks. Indeed, this work aims to describe this new software (enhanced version of HHRISK), which not only improves the performance of the code but also increases its applicability and versatility. To showcase its usefulness in evaluating ecological pollution and human health risk were studied the contents of potentially toxic elements (Co, Cu, Fe, Mn, Ni, Pb, and Zn) in soils and surface waters from the nickel mining area in the municipality of Itagibá (Bahia, Brazil). The obtained results showed that metals are non-homogeneous distributed, suggesting the presence of local enrichment sources, mainly related to human activities. The statistical analyses carried out revealed that mining and agricultural activities are possibly responsible for the contents of these pollutants in both soils and surface waters. The calculated ecological indices of pollution confirmed anthropogenic pollution around the mining area, especially in the locations closest to sterile waste piles. The results of the human health risk assessment revealed that the ingestion of meat and contaminated water are the main routes for entering the potentially toxic elements to the human body and that Co is the chemical specie that poses the highest risk in the entire region. The hazard index (HI) values indicated that the whole area around the mine should be considered as a high risk for human health.

Differential susceptibility of PC12 and BRL cells and the regulatory role of HIF-1α signaling pathway in response to acute methylmercury exposure under normoxia

Hypoxia-inducible factor 1 (HIF-1) is a critical nuclear transcription factor for adaptation to hypoxia; its regulatable subunit, HIF-1α, is a cytoprotective regulatory factor. We examined the effects of methylmercury (MeHg) in rat adrenal pheochromocytoma (PC12) cells and the rat hepatocyte cell line BRL. MeHg treatment led to time- and concentration-dependent toxicity in both lines with statistically significant cytotoxic effects at 5 μM and 10 μM in PC12 and BRL, respectively, at 0.5 h. HIF-1α protein levels were significantly decreased at 2.5 (PC12) and 5 (BRL) μM MeHg. Furthermore, MeHg reduced the protein levels of HIF-1α and its target genes (glucose transporter-1, vascular endothelial growth factor-A and erythropoietin). Overexpression of HIF-1α significantly attenuated MeHg-induced toxicity in both cell types. Notably, cobalt chloride, a pharmacological inducer of HIF-1α, significantly attenuated MeHg-induced toxicity in BRL but not PC12. In both cell lines, an inhibitor of prolyl hydroxylase, 3, 4-dihydroxybenzoic acid, and the proteasome inhibitor carbobenzoxy-L-leucyl-L-leucyl-L-leucinal(MG132), antagonized MeHg toxicity, while 2-methoxyestradiol, a HIF-1α inhibitor, significantly increased it. These data establish that: (a) neuron-like PC12 cells are more sensitive to MeHg than non-neuronal BRL cells; (b) HIF-1α plays a similar role in MeHg-induced toxicity in both cell lines; and (c) upregulation of HIF-1α offers general cytoprotection against MeHg toxicity in PC12 and BRL cell lines.

Cobalt-containing dust exposures: Prediction of whole blood and tissue concentrations using a biokinetic model

Biokinetic models estimating cobalt (Co) tissue burden can help assess the potential for systemic effects. Such models, however, have not been used to estimate remote tissue concentrations associated with inhalation exposure to Co-containing dust in general environments, work spaces, or animal toxicity tests. We have therefore updated a Co biokinetic model previously developed for oral dosing to include the inhalation pathway by incorporating the International Commission on Radiological Protection (ICRP) Human Respiratory Tract Model. Further, data from animal studies allowed for characterization of testes Co tissue concentration supplementing previous predictions for the liver, heart and blood. Reasonable agreement (within a factor of two) was found between modeled and measured blood, liver, testes and tissue concentrations when animal doses were modeled using human equivalent concentrations to account for species differences in regional lung deposition. We applied the updated model to occupational inhalation exposure scenarios, and found that upper-bound plausible human systemic body burden associated with Co ingestion is much higher than the burden associated with Co inhalation. Chronic ingestion of Co at a previously proposed oral reference dose (RfD) of 0.03 mg/kg-day resulted in predicted tissue levels of 22-54 μg/L (blood), 0.05-0.1 μg/g (heart), 0.01-0.02 μg/g (testes), and 0.2-0.5 μg/g (liver), which were at least 5-fold more than the systemic burden associated with various Co inhalation occupational exposure limits (OELs) of 0.1 mg/m³ or less (for 8 h/d and 5 d/w). Overall, our analysis indicated that Co-metal or dust induced systemic health effects, including myocardial damage, are unlikely for the inhalation pathway when personal exposures levels are below concentrations associated with local respiratory effects such as pulmonary fibrosis.

Elucidating temporal trends in trace element exposure of green turtles (Chelonia mydas) using the toxicokinetic differences of blood and scute samples

Blood is considered a suitable biomonitoring matrix for evaluating relatively recent exposure to environmental contaminants since abrupt changes in exposure regimes are rapidly reflected in blood. On the other hand, keratinized tissues, such as turtle scutes, are known to integrate trace element exposure over relatively long time periods. This study aimed to test the use of the differences in blood and scute to inform on the historical trace element exposure of green turtles. We propose a blood-scute kinetic model to predict how an increase in exposure would affect the concentrations in these two matrices over time. We then tested the relationship between blood and scute concentrations for 19 trace elements in two green turtle populations presumed to experience relatively constant exposure conditions. Significant log-log and linear correlations were observed between blood and scute concentrations for Co, As, Mo, Sb, and Cd. We then analysed blood-scute ratios in turtles from two coastal sites with known elevated exposure to various trace elements from previous studies. Deviations from the steady-state were clearly evident in these coastal turtles (for Co and Cd) and were consistent with the model prediction of changes in exposure. These field data provide evidence that blood-scute ratios can provide a valuable tool for examining the historical trace element exposure of turtles. We further present a method by which the general model may be refined and validated, by using data from individual turtles that had been recaptured across multiple years. Although the timeframe and number of recaptured samples available for this study were limited, the temporal changes in blood-scute ratios in these animals were generally consistent with those suggested by the model. Thus, the ratio between paired blood and scute trace element concentrations could be used to establish a temporal exposure index in turtles.

A Method for Assessing the Retention of Trace Elements in Human Body Using Neural Network Technology

Models that describe the trace element status formation in the human organism are essential for a correction of micromineral (trace elements) deficiency. A direct trace element retention assessment in the body is difficult due to the many internal mechanisms. The trace element retention is determined by the amount and the ratio of incoming and excreted substance. So, the concentration of trace elements in drinking water characterizes the intake, whereas the element concentration in urine characterizes the excretion. This system can be interpreted as three interrelated elements that are in equilibrium. Since many relationships in the system are not known, the use of standard mathematical models is difficult. The artificial neural network use is suitable for constructing a model in the best way because it can take into account all dependencies in the system implicitly and process inaccurate and incomplete data. We created several neural network models to describe the retentions of trace elements in the human body. On the model basis, we can calculate the microelement levels in the body, knowing the trace element levels in drinking water and urine. These results can be used in health care to provide the population with safe drinking water.

Layered double hydroxide-enhanced luminescence in a Fenton-like system for selective sensing of cobalt in Hela cells

This work presented a facile and eco-friendly method for the determination of cobalt ions (Co(II)) in living cells based on layered double hydroxides (Mg-Al CO₃-LDHs) enhanced chemiluminescence (CL) emission of a Co(II)-hydrogen peroxide-sodium hydroxide system. The enhanced CL emission was attributed to the large specific surface area of Mg-Al CO₃-LDHs, which facilitates the generation of an excited-stated intermediate. The proposed method displayed high selectivity toward Co(II) over other metal ions. Under the optimal conditions, the increased CL intensity showed a linear response versus Co(II) concentration in the range of 5.0-1000 nM with a detection limit of 3.7 nM (S/N = 3). The relative standard deviation for nine repeated measurements of 100 nM Co(II) was 3.2%. Furthermore, the proposed method was successfully applied to detect Co(II) in living cell samples, and the results were agreed with those obtained by the standard ICP-MS method.

Characterization and risk of exposure to elements from artisanal gold mining operations in the Bolivian Andes

Artisanal and small-scale gold mining (ASGM) offers low-skilled workers an opportunity to elevate themselves out of poverty. However, this industry operates with little to no pollution controls and the cost to the environment and human health can be large. The objectives of this study were to measure levels of arsenic (As), manganese (Mn), cobalt (Co), lead (Pb), and mercury (Hg) in the environment and characterize health risks to miners and residents in an area with active ASGM operations. An exposure assessment was conducted at two different mining sites and a nearby village in the Bolivian Anders. The resulting measurements were then used to quantify cancerous and noncancerous health risks to children and adults working at and living near ASGM areas. Soil concentrations of As were well above background levels and showed great variations between the village and mining area. Mercury vapor levels at the two mining sites were approximately 30 times larger than the EPA reference concentration. The risk of developing non-cancerous health effects were primarily due to exposure to As and Hg. The probability of individuals developing cancer was considerably increased with adult miners having a probability of 1.3 out of 100. Cancer potential was driven by exposure to As, with de minimus cancer risk from all other elements. Based on the environmental characterization of elements in soils and Hg vapors, the risk of developing cancerous and non-cancerous health outcomes were above a level of concern based on EPA risk assessment guidance. Personal protective equipment was not worn by workers and Hg amalgam is commonly heated in workers' homes. Better education of the risks of ASGM is needed as well as simple controls to reduce exposure.

Molecular Mechanisms of Nickel Allergy

Allergic contact hypersensitivity to metals is a delayed-type allergy. Although various metals are known to produce an allergic reaction, nickel is the most frequent cause of metal allergy. Researchers have attempted to elucidate the mechanisms of metal allergy using animal models and human patients. Here, the immunological and molecular mechanisms of metal allergy are described based on the findings of previous studies, including those that were recently published. In addition, the adsorption and excretion of various metals, in particular nickel, is discussed to further understand the pathogenesis of metal allergy.

Mesoporous hydroxylapatite/activated carbon bead-on-string nanofibers and their sorption towards Co(ii)

We fabricated mesoporous hydroxylapatite/activated carbon bead-on-string nanofibers from electrospun nanofibers by a hydrothermal method and evaluated their sorption towards Co(ii)viasorption kinetics and isotherms.

Selected aspects of the action of cobalt ions in the human body

Cobalt is widespread in the natural environment and can be formed as an effect of anthropogenic activity. This element is used in numerous industrial applications and nuclear power plants. Cobalt is an essential trace element for the human body and can occur in organic and inorganic forms. The organic form is a necessary component of vitamin B₁₂ and plays a very important role in forming amino acids and some proteins in nerve cells, and in creating neurotransmitters that are indispensable for correct functioning of the organism. Its excess or deficiency will influence it unfavourably. Salts of cobalt have been applied in medicine in the treatment of anaemia, as well as in sport as an attractive alternative to traditional blood doping. Inorganic forms of cobalt present in ion form, are toxic to the human body, and the longer they are stored in the body, the more changes they cause in cells. Cobalt gets into the body in several ways: firstly, with food; secondly by the respiratory system; thirdly, by the skin; and finally, as a component of biomaterials. Cobalt and its alloys are fundamental components in orthopaedic implants and have been used for about 40 years. The corrosion of metal is the main problem in the construction of implants. These released metal ions may cause type IV inflammatory and hypersensitivity reactions, and alternations in bone modelling that lead to aseptic loosening and implant failure. The ions of cobalt released from the surface of the implant are absorbed by present macrophages, which are involved in many of the processes associated with phagocytose orthopaedic biomaterials particles and release pro-inflammatory mediators such as interleukin-1 (IL-1), interleukin-6 (IL-6), tumour necrosis factor α (TNF-α), and prostaglandin.

Human metabolism of orally administered radioactive cobalt chloride

This study investigated the human gastrointestinal uptake (f1) and subsequent whole-body retention of orally administered inorganic radioactive cobalt. Of eight adult volunteers aged between 24 and 68 years, seven were given solutions of (57)Co (T1/2 = 272 d) containing a stable cobalt carrier, and six were given carrier-free (58)Co (T1/2 = 71 d). The administered activities ranged between 25 and 103 kBq. The observed mean f1, based on 6 days accumulated urinary excretion sampling and whole-body counting, was 0.028 ± 0.0048 for carrier-free (58)Co, and 0.016 ± 0.0021 for carrier-associated (57)Co. These values were in reasonable agreement with values reported from previous studies involving a single intake of inorganic cobalt. The time pattern of the total retention (including residual cobalt in the GI tract) included a short-term component with a biological half-time of 0.71 ± 0.03 d (average ± 1 standard error of the mean for the two nuclides), an intermediate component with a mean half-time of 32 ± 8.5 d, and a long-term component (observed in two volunteers) with half-times ranging from 80 to 720 d for the two isotopes. From the present data we conclude that for the short-lived (57)Co and (58)Co, more than 95% of the internal absorbed dose was delivered within 7 days following oral intake, with a high individual variation influenced by the transit time of the unabsorbed cobalt through the gastro-intestinal tract.

Rapid and equivalent systemic bioavailability of the antidotes HI-6 and dicobalt edetate via the intraosseous and intravenous routes

BACKGROUND

Rapid and effective administration of antidotes by emergency medical responders is needed to improve the survival of patients severely poisoned after deliberate release of chemical weapons, but intravenous access is difficult to obtain while wearing personal protective equipment and in casualties with circulatory collapse. To test the hypothesis that rapid and substantial bioavailability of the antidotes HI-6 oxime and dicobalt edetate can be achieved via the intraosseous (IO) route, plasma concentration-time profiles of these antidotes were compared after administration by the intravenous and IO routes in a minipig animal model.

METHODS

12 male Göttingen minipigs were randomly allocated to receive 7.14 mg/kg of HI-6 (by rapid bolus) then 4.28 mg/kg of dicobalt edetate (over 1 min) via the intravenous or IO route. Plasma concentrations of each antidote were measured over 360 min following administration and plasma concentration-time profiles plotted for each drug by each route.

RESULTS

Peak HI-6 and cobalt concentrations occurred within 2 min of administration by both the intravenous and IO routes. Mean areas under the concentration-time curves (SD) to the end of the experiment (area under the concentration-time curve, AUC (0-t)) for cobalt were 430 (47, intravenous) and 445 (40, IO) μg-min/mL (mean difference 15, 95% CI -41 to 70, p=0.568) and for HI-6 were 2739 (1038, intravenous) and 2772 (1629, IO) μg-min/mL (mean difference 0.33, 95% CI -1724 to 1790, p=0.97). Increases in heart rate (by 50 beats/min intravenous and 27 beats/min IO) and BP, (by 67/58 mm Hg intravenous and 78/59 mm Hg IO), were observed after dicobalt edetate, consistent with the known adverse effects of this antidote.

DISCUSSION

This study demonstrates rapid and similar systemic bioavailability of HI-6 and dicobalt edetate when given by the IO and intravenous routes. IO delivery of these antidotes is appropriate in the acute management of patients with organophosphate and cyanide intoxication when the intravenous route is impractical.

Pathways of human exposure to cobalt in Katanga, a mining area of the D.R. Congo

Human exposure biomonitoring in the African Copperbelt (Katanga, southern D.R. Congo) revealed elevated cobalt (Co) exposure in the general population. This study was designed to identify the Co exposure routes for the non-occupationally exposed population in that area. The concentration of Co was measured in environmental and urine samples collected in urban and rural communities close to metal mining and/or refining plants, villages near a lake receiving effluents from metal refining plants, and control rural areas without industrial pollution. Drinking water, uncooked food items (maize flour, washed vegetables, fish and meat), indoor and outdoor dust samples were collected at each location. A food questionnaire was used to estimate dietary Co intake for adults and children. Geometric mean urine-Co (U-Co) concentrations were 4.5-fold (adults) and 6.6-fold (children) higher in the polluted than in the control area, with U-Co values being intermediate in the lakeside area. Average Co concentrations in environmental samples differed 6-40-fold between these areas. U-Co was positively correlated with most environmental Co concentrations, the highest correlations being found with Co in drinking water, vegetables and fruit. Estimated average total Co intake for adults was 63 (±42) μg/day in the control area, 94 (±55) μg/day in the lakeside villages and 570 (±100) μg Co/day in the polluted areas. U-Co was significantly related to modelled Co intake (R(2)=0.48, adults and R(2)=0.47, children; log-log relationship). Consumption of legumes, i.e. sweet potato leaves (polluted) and cereals+fish (lakeside) was the largest contributor to Co intake in adults, whereas dust ingestion appeared to contribute substantially in children in the polluted area. In conclusion, dietary Co is the main source of Co exposure in the polluted area and Co is efficiently transferred from soil and water in the human food chain.

Preparation, characterization of electrospun meso-hydroxylapatite nanofibers and their sorptions on Co(II)

In this work, mesoporous hydroxylapatite (meso-HA) nanofibers were prepared via calcination process with polyvinyl alcohol/HA (PVA/HA) hybrid nanofibers fabricated by electrospinning technique as precursors, and the removal efficiency of meso-HA nanofibers toward Co(II) was evaluated via sorption kinetics and sorption isotherms. Furthermore, the sorption behaviors of Co(II) on meso-HA nanofibers were explored as a function of pH, ionic strength, and thermodynamic parameters. There existed hydrogen bonds between HA and PVA matrix in precursor nanofibers which could change into meso-HA nanofibers with main pore diameter at 27nm and specific surface area at 114.26m(2)/g by calcination process. The sorption of Co(II) on meso-HA was strongly dependent on pH and ionic strength. Outer-sphere surface complexation or ion exchange was the main mechanisms of Co(II) adsorption on meso-HA at low pH, whereas inner-sphere surface complexation was the main adsorption mechanism at high pH. The sorption kinetic data were well fitted by the pseudo-second-order rate equation. The sorption isotherms could be well described by the Langmuir model. The thermodynamic parameters (ΔH°, ΔS° and ΔG°) calculated from the temperature-dependent sorption isotherms suggested that the sorption process of Co(II) on meso-HA nanofibers was spontaneous and endothermic.

Exposure to cobalt causes transcriptomic and proteomic changes in two rat liver derived cell lines

Cobalt is a transition group metal present in trace amounts in the human diet, but in larger doses it can be acutely toxic or cause adverse health effects in chronic exposures. Its use in many industrial processes and alloys worldwide presents opportunities for occupational exposures, including military personnel. While the toxic effects of cobalt have been widely studied, the exact mechanisms of toxicity remain unclear. In order to further elucidate these mechanisms and identify potential biomarkers of exposure or effect, we exposed two rat liver-derived cell lines, H4-II-E-C3 and MH1C1, to two concentrations of cobalt chloride. We examined changes in gene expression using DNA microarrays in both cell lines and examined changes in cytoplasmic protein abundance in MH1C1 cells using mass spectrometry. We chose to closely examine differentially expressed genes and proteins changing in abundance in both cell lines in order to remove cell line specific effects. We identified enriched pathways, networks, and biological functions using commercial bioinformatic tools and manual annotation. Many of the genes, proteins, and pathways modulated by exposure to cobalt appear to be due to an induction of a hypoxic-like response and oxidative stress. Genes that may be differentially expressed due to a hypoxic-like response are involved in Hif-1α signaling, glycolysis, gluconeogenesis, and other energy metabolism related processes. Gene expression changes linked to oxidative stress are also known to be involved in the NRF2-mediated response, protein degradation, and glutathione production. Using microarray and mass spectrometry analysis, we were able to identify modulated genes and proteins, further elucidate the mechanisms of toxicity of cobalt, and identify biomarkers of exposure and effect in vitro, thus providing targets for focused in vivo studies.

31-day study of cobalt(II) chloride ingestion in humans: pharmacokinetics and clinical effects

The United Kingdom Expert Group on Vitamins and Minerals concluded that ingesting cobalt (Co)-containing supplements up to 1400 μg Co/d is unlikely to produce adverse health effects. However, the associated blood Co concentrations and safety of Co-containing dietary supplements have not been fully characterized. Thus, blood Co kinetics and a toxicological assessment of hematological and biochemical parameters were evaluated following Co dietary supplementation in 5 male and 5 female volunteers who ingested approximately 1000 μg Co/d (10-19 μg Co/kg-d) as cobalt(II) chloride for a period of 31 d. Supplement intake was not associated with significant overt adverse events, alterations in clinical chemistries including blood counts and indicators of thyroid, cardiac, liver, or kidney functions, or metal sensitization. A non-clinically significant (<5%) increase in hemoglobin, hematocrit, and red blood cell (RBC) counts were observed in males but not females 1 wk after dose termination. Mean Co concentrations in whole blood/serum after 31 d of dosing were approximately two-fold higher in females (33/53 μg/L) than in males (16/21 μg/L). In general, steady-state concentrations of Co were achieved in whole blood and/or red blood cells (RBC) within 14-24 d. Temporal patterns of whole blood and serum Co concentrations indicated metal sequestration in RBC accompanied by slower whole blood clearance compared to serum. Data also indicated that peak whole blood Co concentrations up to 91.4 μg/L were not associated with clinically significant changes in clinical chemistries. In addition, Co blood concentrations and systemic uptake via ingestion were generally higher in females.

Cobalt metabolism and toxicology--a brief update

Cobalt metabolism and toxicology are summarized. The biological functions of cobalt are updated in the light of recent understanding of cobalt interference with the sensing in almost all animal cells of oxygen deficiency (hypoxia). Cobalt (Co(2+)) stabilizes the transcriptional activator hypoxia-inducible factor (HIF) and thus mimics hypoxia and stimulates erythropoietin (Epo) production, but probably also by the same mechanism induces a coordinated up-regulation of a number of adaptive responses to hypoxia, many with potential carcinogenic effects. This means on the other hand that cobalt (Co(2+)) also may have beneficial effects under conditions of tissue hypoxia, and possibly can represent an alternative to hypoxic preconditioning. Cobalt is acutely toxic in larger doses, and in mammalian in vitro test systems cobalt ions and cobalt metal are cytotoxic and induce apoptosis and at higher concentrations necrosis with inflammatory response. Cobalt metal and salts are also genotoxic, mainly caused by oxidative DNA damage by reactive oxygen species, perhaps combined with inhibition of DNA repair. Of note, the evidence for carcinogenicity of cobalt metal and cobalt sulfate is considered sufficient in experimental animals, but is as yet considered inadequate in humans. Interestingly, some of the toxic effects of cobalt (Co(2+)) have recently been proposed to be due to putative inhibition of Ca(2+) entry and Ca(2+)-signaling and competition with Ca(2+) for intracellular Ca(2+)-binding proteins. The tissue partitioning of cobalt (Co(2+)) and its time-dependence after administration of a single dose have been studied in man, but mainly in laboratory animals. Cobalt is accumulated primarily in liver, kidney, pancreas, and heart, with the relative content in skeleton and skeletal muscle increasing with time after cobalt administration. In man the renal excretion is initially rapid but decreasing over the first days, followed by a second, slow phase lasting several weeks, and with a significant long-term retention in tissues for several years. In serum cobalt (Co(2+)) binds to albumin, and the concentration of free, ionized Co(2+) is estimated at 5-12% of the total cobalt concentration. In human red cells the membrane transport pathway for cobalt (Co(2+)) uptake appears to be shared with calcium (Ca(2+)), but with the uptake being essentially irreversible as cobalt is effectively bound in the cytosol and is not itself extruded by the Ca-pump. It is tempting to speculate that this could perhaps also be the case in other animal cells. If this were actually the case, the tissue partitioning and biokinetics of cobalt in cells and tissues would be closely related to the uptake of calcium, with cobalt partitioning primarily into tissues with a high calcium turn-over, and with cobalt accumulation and retention in tissues with a slow turn-over of the cells. The occupational cobalt exposure, e.g. in cobalt processing plants and hard-metal industry is well known and has probably been somewhat reduced in more recent years due to improved work place hygiene. Of note, however, adverse reactions to heart and lung have recently been demonstrated following cobalt exposure near or slightly under the current occupational exposure limit. Over the last decades the use of cobalt-chromium hard-metal alloys in orthopedic joint replacements, in particular in metal-on-metal bearings in hip joint arthroplasty, has created an entirely new source of internal cobalt exposure. Corrosion and wear produce soluble metal ions and metal debris in the form of huge numbers of wear particles in nanometric size, with systemic dissemination through lymph and systemic vascular system. This may cause adverse local reactions in peri-prosthetic soft-tissues, and in addition systemic toxicity. Of note, the metal nanoparticles have been demonstrated to be clearly more toxic than larger, micrometer-sized particles, and this has made the concept of nanotoxicology a crucial, new discipline. As another new potential source of cobalt exposure, suspicion has been raised that cobalt salts may be misused by athletes as an attractive alternative to Epo doping for enhancing aerobic performance. The cobalt toxicity in vitro seems to reside mainly with ionized cobalt. It is tempting to speculate that ionized cobalt is also the primary toxic form for systemic toxicity in vivo. Under this assumption, the relevant parameter for risk assessment would be the time-averaged value for systemic cobalt ion exposure that from a theoretical point of view might be obtained by measuring the cobalt content in red cells, since their cobalt uptake reflects uptake only of free ionized cobalt (Co(2+)), and since the uptake during their 120 days life span is practically irreversible. This clearly calls for future clinical studies in exposed individuals with a systematic comparison of concurrent measurements of cobalt concentration in red cells and in serum.

Biokinetics of embedded surrogate radiological dispersal device material

The terrorist use of a radiological dispersal device (RDD) has been described as "not if, but when" (). Exposures from such an event could occur by a number of routes including inhalation, wound contamination, or embedded fragments. Several of the radionuclides thought to be potential RDD components are metals or ceramic material. The use of such material would increase the potential for wounds from embedded fragments of radioactive material. To date, most research in this area has focused on inhalation exposures, while the consequence of embedded fragment exposure has not been investigated. This study modified a previously used rodent model in order to determine the biokinetics of intramuscularly implanted nonradioactive surrogate RDD material. Cobalt, iridium, or strontium titanate was embedded into the gastrocnemius muscle of Sprague Dawley rats. The rats were euthanized at 1, 3, or 6 mo post-implantation. Tissue metal analysis showed that iridium did not solubilize from the implanted pellet, while cobalt and strontium did so rapidly. Cobalt was found in all tissues analyzed, but it was localized mainly to kidney and liver as well as being excreted in the urine. Strontium was found in lung, liver, and spleen, as well as being deposited in bone. However, the greatest strontium concentrations were found in the popliteal lymph nodes, the lymph nodes responsible for draining the area of the gastrocnemius. These results indicate that, depending upon the material, a variety of treatment strategies will be needed when dealing with embedded fragment wounds from a radiological dispersal device event.

Dose-response relationships for blood cobalt concentrations and health effects: a review of the literature and application of a biokinetic model

Cobalt (Co) is an essential component of vitamin B(12). As with all metals, at sufficiently high doses, Co may exert detrimental effects on different organ systems, and adverse responses have been observed in animals, patients undergoing Co therapy, and workers exposed to respirable Co particulates. Although blood Co concentrations are postulated to be the most accurate indicator of ongoing Co exposure, little is known regarding the dose-response relationships between blood Co concentrations and adverse health effects in various organ systems. In this analysis, the animal toxicology and epidemiology literature were evaluated to identify blood Co concentrations at which effects have, and have not, been reported. Where necessary, a biokinetic model was used to convert oral doses to blood Co concentrations. Our results indicated that blood Co concentrations of 300 μg/L and less have not been associated with adverse responses of any type in humans. Concentrations of 300 μg/L and higher were associated with certain hematological and reversible endocrine responses, including polycythemia and reduced iodide uptake. Blood Co concentrations of 700-800 μg Co/L and higher may pose a risk of more serious neurological, reproductive, or cardiac effects. These blood concentrations should be useful to clinicians and toxicologists who are attempting to interpret blood Co concentrations in exposed individuals.

Cobalt, chromium and molybdenum ions kinetics in the human body: data gained from a total hip replacement with massive third body wear of the head and neuropathy by cobalt intoxication

INTRODUCTION

A patient with a total hip replacement developed optic, acoustic and peripheral neuropathy from metal ions intoxication, due to the wear products released from the prosthesis. Subsequently the kinetics of the metal ions was studied.

MATERIALS AND METHODS

Massive wear and acute intoxication allowed a study of the metal ions kinetics and of EDTA treatment.

RESULTS

Plasma and other organic fluids were saturated by each of the metal ions released from the exposed surface according to the solubility of each ion; a larger fraction of Co ions was bound within red cells, while the plasmatic fraction appeared more movable. In a patient with a prosthesis subjected to wear, the ions released are from the prosthetic and from the debris surface (spread in the body). The latter is a function of the number and size of particles.

DISCUSSION

Revision of the prosthesis from the point of view of the metal ions kinetics corresponded to a reduction of the releasing surface because of debris washed out by irrigation and tissue excision; however, the metal particles spread by lymphatic circulation continued to release ions even though the source of wear had been removed. Early diagnosis of high metal wear can be ascertained with mass spectrometry and after revision high levels of metal ions can only be reduced with repeated chelating treatment. It is preferable not to revise fractured ceramic components with a polyethylene-metal articulation.

Association of environmental toxic elements in biological samples of myocardial infarction patients at different stages

The exposure of toxic elements may directly or indirectly associate with different pathogenesis of heart diseases. In the present study, the association of arsenic (As), cadmium (Cd), cobalt (Co), lead (Pb), and nickel (Ni) in biological samples (whole blood and urine) and mortality from myocardial infarction (MI) patients at first, second, and third heart attacks was carried out. Both biological samples of 130 MI patients (77 male and 53 female), with ages ranging from 45 to 60 years, and 61 healthy persons (33 male and 28 female) of the same age group were collected. The elements in biological samples were assessed by electrothermal atomic absorption spectrophotometer, prior to microwave-assisted acid digestion. The validity of methodology was checked by the biological certified reference materials. During this study, 78% of 32 patients aged above 50 years, registered after third MI attack, died. In these subjects, the levels of As, Cd, Co, Ni, and Pb in blood samples were higher in MI patients as compared with referents (p < 0.05), while increased by 11.7%, 12.2%, 5.55%, and 7.2%, respectively, in the blood samples of those patients who tolerated the third MI attack (p = 0.12). The high level of understudied toxic elements may play a role in the mortality of MI patients.

Cobalt reduces the Δ⁹-desaturase index of sow milk

The main objective of this study was to examine if cobalt (Co) reduces Δ(9) -desaturase indices in milk and blood lipids in sows. The experimental design consisted of a repeated measurement consisting of a pre-treatment period of a minimum of 9 days, a treatment period of 5 days and a post-treatment period of 6 days. Experimental animals consisted of 10 lactating sows; five sows had an intramuscular injection of 59 mg Co diluted in 5 ml 0.9% saline solution twice a day, whereas the other five had an intramuscular injection of 5 ml 0.9% saline solution twice a day as a control. Milk Δ(9) -desaturase indices for cis-9 18:1, cis-9 16:1 and cis-9 14:1 were significantly reduced (p < 0.0001) as a result of the Co-treatment, contrasting with the plasma Δ(9) -desaturase indices, which were unaffected. Potential mechanisms explaining how Co might reduce milk Δ(9) -desaturase indices are discussed. Moreover, the toxicological level of Co and potential implications of using Co-ethylenediaminetetraacetic acid as a liquid marker in digestibility experiments are addressed.

Evaluation of Cuprimine and Syprine for decorporation of (60)Co and (210)Po

The acknowledged risk of deliberate release of radionuclides into local environments by terrorist activities has prompted a drive to improve novel materials and methods for removing internally deposited radionuclides. These decorporation treatments will also benefit workers in the nuclear industry, should an exposure occur. Cuprimine and Syprine are oral therapeutics based on the active ingredients D-penicillamine and N,N'-bis-(2-aminoethyl)-1,2-ethanediamine dihydrochloride, respectively. These therapeutic drugs have been used for several decades to treat Wilson's disease, a genetic defect leading to copper overload, by chelation and accelerated excretion of internally deposited copper. Studies were undertaken to evaluate these FDA-approved drugs for the in vivo decorporation of radioactive cobalt (Co) and polonium (Po) using male Wistar-Han rats. In these studies, Co or Po was administered to animals by IV injection, followed by oral gavage doses of either Cuprimine or Syprine. Control animals received the radionuclide alone. For Co studies, animals received a single dose of Cuprimine or Syprine, while for Po studies animals were repeatedly dosed at 24-h intervals for a total of 5 doses. Results show that Syprine significantly increased urinary elimination and skeletal concentrations of Co compared to controls. While Cuprimine had little effect on total excretion of Co, the skeletal, kidney, liver, muscle, and stomach tissues had significantly lower radioactivity compared to control animals. The low overall excretion of Po made it difficult to reliably measure urinary or fecal radioactivity and draw a definitive conclusion on the effect of Cuprimine or Syprine treatment on excretion. However, Cuprimine treatment was effective at reducing spleen levels of Po compared to controls. Similarly, Syprine treatment produced statistically significant reductions of Po in the spleen and skeletal tissues compared to control animals. Based on these promising findings, further studies to evaluate the dose-response pharmacokinetic profiles for decorporation are warranted.

Transport and dynamics of toxic pollutants in the natural environment and their effect on human health: research gaps and challenge

The source-pathway-receptor (SPR) approach to human exposure and risk assessment contains considerable uncertainty when using the refined modelling approaches to pollutant transport and dispersal, not least in how compounds of concern might be prioritized, proxy or indicator substances identified and the basic environmental and toxicological data collected. The impact of external environmental variables, urban systems and lifestyle is still poorly understood. This determines exposure of individuals and there are a number of methods being developed to provide more reliable spatial assessments. Within the human body, the dynamics of pollutants and effects on target organs from diffuse, transient sources of exposure sets ambitious challenges for traditional risk assessment approaches. Considerable potential exists in the application of, e.g. physiologically based pharmacokinetic (PBPK) models. The reduction in uncertainties associated with the effects of contaminants on humans, transport and dynamics influencing exposure, implications of adult versus child exposure and lifestyle and the development of realistic toxicological and exposure data are all highlighted as urgent research needs. The potential to integrate environmental with toxicological models provides the next phase of research opportunity and should be used to drive empirical and model assessments.

Evaluation of arsenic, cobalt, copper and manganese in biological Samples of Steel mill workers by electrothermal atomic absorption Spectrometry

The determination of trace and toxic elements in biological samples (blood, urine and scalp hair samples) of human beings is an important clinical test. The aim of our present study was to determine the concentration of arsenic (As), copper (Cu), cobalt (Co) and manganese (Mn), in biological samples of male production workers (PW) and quality control workers (QW) of steel mill, with aged 25–55 years, to assess the possible influence of environmental exposure. For comparison purpose, the same biological samples of unexposed healthy males of same age group were collected as control subjects. The determination of all elements in biological samples was carried out by electrothermal atomic absorption spectrometry, prior to microwave assisted acid digestion. The accuracy of the As, Cu, Co and Mn measurements was tested by simultaneously analyzing certified reference materials (CRMs) and for comparative purposes conventional wet acid digestion method was used on the same CRMs. No significant differences were observed between the analytical results and the certified values, using both methods (paired t-test at P > 0.05). The results indicate that concentrations of As, Cu, Co and Mn in all three biological samples of the exposed workers (QW and PW) were significantly higher than those of the controls. The possible correlation of these elements with the etiology of different physiological disorders is discussed. The results were also demonstrated the need of attention for improvements in workplace, ventilation and industrial hygiene practices.