Blood morphology and the levels of selected cytokines related to hematopoiesis in occupational short-term exposure to lead

Association between urinary multiple metals and platelet-related parameters: A cross-sectional study in a metal-contaminated area of China

Previous works have shown that hematological system can be affected by exposure to lead; however, the effects of multiple metals on platelets remain elusive within the population from metal-contaminated areas. Hence, the study enrolled 609 participants, with 396 from a metal-exposed area and 213 from a control area. Platelet count (PLT), mean platelet volume (MPV), thrombocytocrit (PCT), platelet to large cell ratio (P-LCR), and platelet distribution width (PDW) were selected to evaluate platelet function. Stepwise regression and Lasso regression were utilized to identify the most influential metals. Moreover, the generalized linear model (GLM), Bayesian kernel machine regression (BKMR) models, and quantile g-computation were employed to estimate the individual or combined effects associations between 12 urinary metals and platelet indices. The results revealed all metals except vanadium, copper, strontium, and molybdenum were significantly higher in the exposed group. The GLM models indicated that urinary metals, including lead, antimony, and arsenic, exhibited associations with PLT, MPV, P-LCR, and PDW. Quantile g-computation and BKMR demonstrated negative correlations between metal mixtures and MPV as well as PDW. In conclusion, the study highlights the associations between multiple metal exposures and platelet indices, suggesting that elevated levels of the metal mixture may impede platelet activation in the population in metal-contaminated areas.

Adaptive changes in redox response and decreased platelet aggregation in lead-exposed workers

Chronic lead exposure can generate pro-oxidative and pro-inflammatory conditions in the blood, related to high platelet activation and aggregation, altering cell functions. We studied ADP-stimulated aggregation and the oxidant/antioxidant system of platelets from chronically lead-exposed workers and non-exposed workers. Platelet aggregation was low in lead-exposed workers (62 vs. 97%), who had normal platelet counts and showed no clinical manifestations of hemostatic failure. ADP-activated platelets from lead-exposed workers failed to increase superoxide release (3.3 vs. 6.6 µmol/g protein), had low NADPH concentration (60 vs. 92 nmol/mg protein), high concentration of hydrogen peroxide (224 vs. 129 nmol/mg protein) and high plasma PGE₂ concentration (287 vs. 79 pg/mL). Altogether, those conditions, on the one hand, could account for the low platelet aggregation and, on the other, indicate an adaptive mechanism for the oxidative status of platelets and anti-aggregating molecules to prevent thrombotic problems in the pro-oxidant and pro-inflammatory environment of chronic lead exposure.

Biochemical and Hematological Markers in Workers with Chronical Exposure to Lead and Cadmium in Colombia

The aim of the present study was to find if workers chronically exposed to lead (Pb) and cadmium (Cd) presented changes in their general health and in the clinical parameters of the population under study. We carried out a cross-sectional survey in a sample of informal workers in Cartagena, Colombia. The population under study was composed of male informal workers (≥18 years of age), with experience in their job, selected from occupational settings with potential exposure to Pb and Cd (i.e., mechanics, battery and garbage recyclers, and welders). The median age was 45 years (interquartile range (IQR), 33−53). The median blood Pb level (BLL) was 2 μg/dL (IQR, 0.76−6.22), and the median of blood Cd level (BCL) was 1.22 μg/L (IQR, 0.33−2.01). The study found that 33% of high exposure jobs with BLL > 5 μg/dL (n = 57), whereas in ‘control’ workers, this was 15.3% (n = 9). The highest BLLs were found in battery recyclers (82.1%; n = 23), followed by mechanics (37.3%, n = 22). In the logistic regression model adjusted by age, time on the job, smoking and elevated BCL and BLL increased 3.2 times (95% CI, 1.1−9.7) in mechanics and 29.6 times (95% CI, 7.2−145.6) in battery recyclers. This study found negative changes in the health of workers with higher chronic exposure to lead in Cartagena, Colombia.

The association between hemoglobin level and osteoporosis in a Chinese population with environmental lead and cadmium exposure

Low hemoglobin (Hb) level or anemia is associated with osteoporosis and bone fracture. Cadmium (Cd) and lead (Pb) exposure are also risk factors of osteoporosis and anemia. However, the role of anemia in Cd/Pb related bone loss remains unclear. The aim of present study was to investigate the association between Hb level and bone loss in a population with environmental lead and cadmium exposure. One hundred and ninety-four women and 108 men with different levels of Cd/Pb exposure were included in our study. The Cd/Pb exposure was determined using graphite-furnace atomic absorption spectrometry. Forearm bone mineral density (BMD) was determined by peripheral dual-energy X-ray absortiometry. Hb concentration was determined using an automatic blood cellcounter. A logistic model was established to predict the risk of osteoporosis. The BMDs of women that had the highest quartile BCd and BPb were markedly lower than that with the lowest quartile (p < 0.05). The BMD and the prevalence of osteoporosis in men with anemia were lower and higher than that with normal Hb (p < 0.05), respectively. In men, age, BPb and anemia were independent risk factors for osteoporosis. The odds ratio (OR) of men with anemia was 11.28 (95%confidence interval (CI):1.94-65.54) and 19.56 (95%CI: 2.98-128.78) compared to those with normal Hb after adjusting for potential cofounders. No such association was found in women. The area under the curve was 0.88 (95%CI: 0.82-0.96) in predicting osteoporosis using the logistic model in men. Linear discriminant analysis also showed that 90.7% of osteoporosis was correctly classified. Our data show that anemia is associated with incident of osteoporosis in men but not in women that environmentally exposed to Pb and Cd.

Pb and Cd exposure linked with Il-10 and Il-13 gene polymorphisms in asthma risk relevant immunomodulation in children

Genetic variants and environmental factor of heavy metal exposure accelerate the risk of immune-mediated respiratory diseases, including asthma in children. This study aims to investigate the effects and interaction of Pb, Cd exposure from e-waste and interleukin (IL)-10, IL-13 gene polymorphisms on interleukin expressions in children. Pb, Cd levels, Il-10 (rs1800871, rs1800872, rs1800896) and Il-13 (rs20541, rs1800925) polymorphisms were determined in blood or urine of 155 children (75 from e-waste-exposed area, Guiyu and 80 from reference area, Haojiang). Blood Pb and urine Cd levels of e-waste-exposed children were both higher (mean: 5.89 vs. 3.35 μg/dL; 6.04 vs. 1.82 μg/g, both P < 0.05). Exposed children had a larger proportion of high blood Pb level (> 5.00 μg/dL) (66.67% vs. 4.11%, P < 0.001), but they had no statistically different proportion of high urine Cd level (> 1.00 μg/g creatinine). Median levels of IL-13 decreased (3.674 vs. 4.410 ng/L, P < 0.01), but of IL-10 did not vary in serum of exposed children. The analyses revealed no significant associations of Pb or Cd with Il-10 or Il-13 gene polymorphisms. The high blood Pb and urine Cd level were respectively associated with the low IL-13 ( < 3.696 ng/L) and low IL-10 ( < 0.361 ng/L) level, after adjustment for children's age, gender, and BMI (both P ≤ 0.05). Children homozygous carrying major allele for Il-13 (rs20541 and rs1800925) had additive interactions with high blood Pb level on low IL-13 expression (OR = 5.37, 95% CI: 1.96, 14.73 and OR = 8.45, 95% CI: 2.61, 27.32; both P ≤ 0.001). In contrast, no interaction was observed amongst Pb or Cd with Il-10 gene polymorphisms on its expression. Our findings suggest that Pb exposure interacting with Il-13 gene polymorphisms negatively regulates IL-13 expression, which may pose a risk to abnormal asthma-relevant immunomodulation in preschool children.

Platelet Mitochondrial DNA Methylation as Epigenetic Biomarker of Short-Term Air Pollution Exposure in Healthy Subjects

Air pollution exposure is now considered a growing concern for global public health. RNA or DNA methylation changes caused by air pollution may be related to the development of cardiovascular disease. To investigate the early biomarkers of air pollution exposure, a panel study of eight college students recorded after a business trip from Qingdao to Shijiazhuang and back to Qingdao was performed in this work. The concentration of PM_2.5, PM₁₀, SO₂, NO₂, and CO in Shijiazhuang was higher than that in Qingdao during the study period. The platelet count was positively correlated with air pollutants of 0–6 day moving averages (β_PM2.5 = 88.90; β_PM10 = 61.83; β_SO2 = 41.13; β_NO2 = 57.70; β_CO = 62.99, respectively, for an IQR increased). Additionally, internal dose biomarkers 2-OHNa, 1-OHNa, 2-OHFlu, 2,3-OHPhe, and ∑PAHs were also significantly associated with platelet count in participants. Furthermore, PM_2.5 and PM₁₀ are positively linked with methylation of one CpG site at platelet mitochondrial gene CO2 (PM_2.5 = 0.47; PM₁₀ = 0.25, respectively, for an IQR increase). Both platelet counts and methylation levels returned to their pre-exposure levels after leaving the highly contaminated area. In short, this study investigated the relationship between platelet properties and air pollution exposure, revealing that short-term exposure to air pollution might increase the risk of thrombosis. Our research suggests that platelet count and mitochondrial DNA methylation of mtCO2 site 2 in platelets from healthy adults may be the novel biomarker for acute exposure to air pollution.

Association between occupational lead exposure and immunotoxicity markers: A systematic review and meta-analysis

Recent evidences suggest the role of chronic lead (Pb) exposure in altering immunological parameters. Present study aimed to systematically review existing literature and synthesize quantitative evidence on the association between chronic Pb exposure and changes in immunological markers. Observational studies reporting immunological markers such as leukocyte derivative counts (CD3⁺, CD4⁺, CD8⁺, CD45⁺, CD56⁺, lymphocyte, and total leukocyte), cytokine, Immunoglobulin (Igs), C-reactive protein (CRP) among Pb-exposed and unexposed controls were systematically searched from PubMed, Scopus and Embase digital databases from inception to January 2021. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were adhered during systematic review. Mean differences in the immunological markers between Pb-exposed and control groups were pooled using random-effects model. The heterogeneity was assessed using Cochran-Q test and I² statistic. The review included forty studies reporting immunological markers in Pb-exposed and unexposed control groups. The occupational Pb-exposed group exhibited significantly higher BLL, impaired immunological markers, characterized by a marginal lowering in lymphocyte count, lymphocyte subsets (CD3⁺, CD4⁺, CD4⁺/CD8⁺ ratio), IFN-γ and IgG levels, while CD8⁺, IgM, IgA, IgE, and cytokines (IL-4, IL-6, IL-10, and TNF-α) exhibited a trend of higher values in comparison to the control group. Further, inflammatory marker viz., total leukocyte count was significantly higher among Pb-exposed. The included studies exhibited high levels of heterogeneity. In conclusion, Occupational Pb exposure alters the immunological markers such as the circulating cytokines and leukocyte counts. However, high-quality, multicentered studies are required to strengthen present observations and further understand the Pb's role on the immune system. Prospero Registration ID: CRD42021228252.

Lead exposure induces dysregulation of constitutive heterochromatin hallmarks in live cells

Lead (Pb) is a heavy metal contaminant commonly found in air, soil, and drinking water due to legacy uses. Excretion of ingested Pb can result in extensive kidney damages due to elevated oxidative stress. Epigenetic alterations induced by exposure to Pb have also been implied but remain poorly understood. In this work, we assessed changes in repressive epigenetic marks, namely DNA methylation (meCpG) and histone 3 lysine 9 tri-methylation (H3K9me3) after exposure to Pb. Live cell epigenetic probes coupled to bimolecular fluorescence complementation (BiFC) were used to monitor changes in the selected epigenetic marks. Exposure to Pb significantly lowered meCpG and H3K9me3 levels in HEK293T cells suggesting global changes in constitutive heterochromatin. A heterodimeric pair of probes that tags chromatin regions enriched in both meCpG and H3K9me3 further confirmed our findings. The observed epigenetic changes can be partially attributed to aberrant transcriptional changes induced by Pb, such as overexpression of TET1 after Pb exposure. Lastly, we monitored changes in selected heterochromatin marks after removal of Pb and found that changes in these markers do not immediately recover to their original level suggesting potential long-term damages to chromatin structure.

Early occupational exposure to lead on neutrophil-to-lymphocyte ratio and genotoxicity

BACKGROUND

Lead (Pb) is known to induce detrimental health effects in exposed populations, including hematotoxicity and genotoxicity. Complete blood count (CBC) is a cost-effective and easy way to determine toxicity, and variations in proportion of different types of leukocytes: neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) are further evidence of hematotoxicity. However, few studies have been conducted to systematically evaluate effects of occupational Pb exposure on NLR and LMR, and their associations with genotoxicity.

OBJECTIVES

Our study was aimed to systematically assess the effects of current occupational Pb exposure on NLR and LMR, and their associations with genotoxicity.

METHODS

Our investigation was performed on 1176 workers from a newly built battery factory in North China. The workers had just entered their current job position in recent years and most of them had no previous history of occupational exposure to Pb. Blood lead levels (BLLs) and leukocytes indices were detected for all participants. Cytokinesis-blocked micronucleus assay (MN; n = 675) and alkaline comet assay (% tail DNA; n = 869) were used to assess genotoxicity. Multivariate linear and Poisson regression analyses were conducted to examine associations between leukocytes indices, genotoxic biomarkers and BLLs with adjustment for covariates. Spearman correlation and mediation analyses were used to investigate relationships between NLR and genotoxicity.

RESULTS

Among all the exposed workers, NLR increased with increasing BLLs. However, WBC and LMR did not change significantly. Significant and dose-dependent increases in both MN frequencies and % tail DNA were observed among groups with different exposure doses. Compared with the normal NLR group (1.48 ≤ NLR < 4.58), the high NLR group (NLR ≥ 4.58) had higher % tail DNA. In addition, there was a significant and positive association between NLR and % tail DNA among all the workers, and % tail DNA mediated 15% of the effect of Pb on increasing NLR.

CONCLUSION

Our large-scale population study shows that Pb exposure increased NLR and induced genotoxicity. There was an association between elevated NLR and DNA damage. In addition, the mediation effect of % tail DNA on the relationship between BLLs and NLR provided mechanistic evidence that certain mechanisms, e.g. inflammation, may be involved in elevation of NLR from Pb exposure. Therefore, NLR may be a convenient and sensitive biomarker for indication of Pb toxicity. Further studies are needed to validate the proposed mechanism and NLR as a biomarker.

Evaluation of Blood Lead Levels and Their Effects on Hematological Parameters and Renal Function in Iranian Lead Mine Workers

Background: Lead toxicity has become a growing health concern in countries such as Iran. However, little information is available on the assessment and evaluation of the health effects of lead exposure in mine workers. Objectives: The present study assessed the occupational exposure to lead and examine the association of blood lead (PbB) levels with hematological and kidney function parameters in mine workers. Methods: In this matched case-control study, the level of PbB was measured in 100 workers (70 exposed and 30 non-exposed), and then its relationship was evaluated with complete blood count (CBC) parameters, zinc protoporphyrin (ZPP), urea, blood creatinine levels, urinary δ-aminolevulinic acid (ALA), coproporphyrin, and creatinine levels. Results: The results showed a linear and significant relationship between the PbB level and B-ZPP, U-ALA, U-coproporphyrin, and U-creatinine levels in states of PbB levels > 20 μg/dL in a time and dose-dependent manner. A significant relationship was observed between the PbB level and the years of occupational exposure to lead and the B-urea level (P-value < 0.03). Conclusions: Chronic occupational exposure to lead decreased hematocrit, RDW-CV, MCV, MCH, and HGB values but did not significantly change RBC counts. Therefore, a regular assessment of routine blood parameters (such as CBC and ZPP) and renal function indices can be effectively used to monitor the toxic effects of lead exposure.

Cellular and Molecular Mechanisms of Environmental Pollutants on Hematopoiesis

Hematopoiesis is a complex and intricate process that aims to replenish blood components in a constant fashion. It is orchestrated mostly by hematopoietic progenitor cells (hematopoietic stem cells (HSCs)) that are capable of self-renewal and differentiation. These cells can originate other cell subtypes that are responsible for maintaining vital functions, mediate innate and adaptive immune responses, provide tissues with oxygen, and control coagulation. Hematopoiesis in adults takes place in the bone marrow, which is endowed with an extensive vasculature conferring an intense flow of cells. A myriad of cell subtypes can be found in the bone marrow at different levels of activation, being also under constant action of an extensive amount of diverse chemical mediators and enzymatic systems. Bone marrow platelets, mature erythrocytes and leukocytes are delivered into the bloodstream readily available to meet body demands. Leukocytes circulate and reach different tissues, returning or not returning to the bloodstream. Senescent leukocytes, specially granulocytes, return to the bone marrow to be phagocytized by macrophages, restarting granulopoiesis. The constant high production and delivery of cells into the bloodstream, alongside the fact that blood cells can also circulate between tissues, makes the hematopoietic system a prime target for toxic agents to act upon, making the understanding of the bone marrow microenvironment vital for both toxicological sciences and risk assessment. Environmental and occupational pollutants, therapeutic molecules, drugs of abuse, and even nutritional status can directly affect progenitor cells at their differentiation and maturation stages, altering behavior and function of blood compounds and resulting in impaired immune responses, anemias, leukemias, and blood coagulation disturbances. This review aims to describe the most recently investigated molecular and cellular toxicity mechanisms of current major environmental pollutants on hematopoiesis in the bone marrow.

Oral antimicrobial activity weakened in children with electronic waste lead exposure

Environmental lead (Pb) exposure can induce dysbacteriosis, impair oral health, and is associated with the development of dental caries. However, the mechanism is unclear. The aim of this study was to explore the effects of Pb toxicity on oral antimicrobial activity in children in an e-waste area. Results showed higher blood Pb levels in e-waste-exposed group children, accompanied by decreased saliva SAG (salivary agglutinin) concentrations, increased peripheral WBC (white blood cell) counts and monocyte counts, and elevated peripheral monocyte percentage. LnPb (natural logarithmic transformation of blood Pb level) was negatively correlated with saliva SAG concentration, while positively correlated with peripheral monocyte percentage. Saliva SAG concentration played a complete mediating role in the correlation of LnPb to peripheral monocyte percentage. To our knowledge, this is the first study on the relationship of environmental Pb exposure and oral antimicrobial activity in children, showing that environmental Pb exposure may weaken oral antimicrobial activity through reducing saliva SAG concentration, which may raise the risk of oral dysbacteriosis and ultimately pathogen infection.

Multiple metal exposure and platelet counts during pregnancy: A repeated measure study

BACKGROUND

Evidence from animal and in vitro studies suggest that some metals interfere with normal platelet counts (PLT). However, limited human studies have investigated the association of metals and PLT, a marker of hematologic and hemostatic, particularly in susceptible populations such as pregnant women.

OBJECTIVES

Our purpose was to investigate the associations of repeated measures of 13 urinary metals with PLT during pregnancy.

METHODS

The present study involved 3911 pregnant women participating in a prospective cohort study in Wuhan, China, from 2013 to 2016. We measured 13 metals in urine and PLT in blood samples collected in the first, second, and third trimester (median = 13, 24, and 35 weeks of gestation, respectively). Mixed linear models and general linear models were applied to analyze the associations between multiple metals and PLT during pregnancy. The odds ratio (OR) for gestational thrombocytopenia was examined using generalized estimating equations.

RESULTS

After adjusting for other metals and covariates, the repeated measure analyses showed that decreased levels of PLT were associated with a 10-fold increase in urinary concentration of cadmium (Cd) [percent difference (%Δ) = -5.02, 95%CI = -9.53, -0.29], manganese (Mn) [percent difference (%Δ) = -4.63, 95%CI = -7.50, -1.67], and arsenic (As) [percent difference (%Δ) = -4.56, 95%CI = -8.11, -0.86]. Cross-sectional analyses by trimesters revealed that Cd was inversely associated with PLT through the three trimesters. In addition, Cd was associated with an increased OR of 1.80 (95%CI: 1.26, 2.56), 1.65 (95%CI: 1.05, 2.59), 1.54 (95%CI: 1.02, 2.33) for gestational thrombocytopenia in the first, second, and third trimester, respectively.

CONCLUSIONS

Our study suggested an association of Cd, Mn, and As with decreased PLT during pregnancy. Particularly, Cd may increase the risk of gestational thrombocytopenia.

Decreased erythrocyte CD44 and CD58 expression link e-waste Pb toxicity to changes in erythrocyte immunity in preschool children

Lead (Pb) toxicity damages blood cells and disturbs the immune micro-environment. When Pb enters the circulatory system, >95% of Pb accumulates in erythrocytes. We therefore conducted this study to explore the long-term effect of Pb exposure on expression of erythrocyte adhesion molecules (CD44 and CD58) and related downstream cytokine concentrations. We enrolled a total of 267 preschool children, 2-7 years of age, from Guiyu (e-waste-exposed group, n = 132) and Haojiang (reference group, n = 135) in November and December 2015. We measured child blood Pb, biomarkers including erythrocyte CD44 and CD58, erythrocyte count, leukocyte count and inflammatory cytokines (IL-1β, IL-12p70 and IFN-γ), and calculated erythrocyte Pb levels. Regression model demonstrated that higher erythrocyte Pb was associated with lower CD44 and CD58. Compared to low erythrocyte Pb levels (quartile 1), high erythrocyte Pb levels (quartile 4) were related to lower levels of erythrocyte CD44 and CD58. Elevated blood Pb correlated with higher IL-12p70 and IFN-γ, and lower IL-2. The mediation effect of erythrocyte CD44 on the relationship of erythrocyte Pb with IL-1β and IL-12p70 was significant, and the effect of erythrocyte Pb on IFN-γ was mediated by erythrocyte CD58. The data provides novel translational insight into the relationship between elevated Pb exposure and the change of erythrocyte immunity and downstream cytokine secretion in preschool children.

Assessment of lead exposure among automobile technicians in Khyber Pakhtunkhwa, Pakistan

Exposure to Pb among automobile technicians in selected towns of Khyber Pakhtunkhwa Province, Pakistan, was studied using a questionnaire, biological sampling (blood, hair, nails), and analysis of Pb biomonitoring data across various subgroups of occupation, age, and years of exposure. The study population included exposed automobile technicians (n=50) and a control group (n=50). The automobile technicians were further stratified into 4 groups: mechanics, auto-body technicians, electricians, and painters. Mean Pb levels in biological samples of the automobile technicians were significantly higher than in the control group (P<0.01). The Pb concentrations (mean±standard deviation) in whole blood, hair, and nails of automobile technicians were 65.3±41.9μgdL^-1, 23.6±11.2mgkg^-1 and 29.7±14.5mgkg^-1, respectively, whereas concentrations in the control group were 21.7±17.6μgdL^-1, 4.8±3.4mgkg^-1 and 7.2±3.9mgkg^-1. Fifty two percent of the automobile technicians had blood levels >50μgdL^-1, but only 14% of the control group exceeded this level. Considering that Pb blood levels of 50μgdL^-1 exceed maximum concentrations recommended by leading public health organizations, appropriate measures should be taken to protect the welfare of the exposed automobile technicians and their families.

Elevated lead levels and changes in blood morphology and erythrocyte CR1 in preschool children from an e-waste area

Improper dismantling and combustion of electronic waste (e-waste) may release persistent organic pollutants and heavy metals that possess potential risk for human health. Lead (Pb) is carried through the circulatory system by erythrocytes and is known to alter the functions of hematopoietic and immune systems. The aim of the study was to investigate the effect of Pb exposure on blood morphology and erythrocyte complement receptor 1 (CR1) levels as related to immunologic function in preschool children. We recruited 484 preschool children, 2- to 6-years of age, among whom 332 children were from Guiyu, a typical and primitive e-waste processing area, and 152 children from Haojiang (reference area). Results showed that the blood Pb level (BPb) and erythrocyte Pb level (EPb) of exposed children were significantly higher, but, the mean corpuscular hemoglobin concentration (MCHC) and erythrocyte CR1 levels were significantly lower than reference children. Elevated EPb and BPb was related to disadvantageous changes in hematocrit (HCT), mean corpuscular volume (MCV), hemoglobin (HGB), mean corpuscular hemoglobin (MCH), and MCHC, respectively, in children from the e-waste recycling area. Furthermore, in the high Pb-exposed group, the Pb toxicity of erythrocytes was more significant compared to the low Pb-exposed group in e-waste-exposed children. Combine with the BPb and EPb would be better to evaluating the Pb toxicity of erythrocytes. Compared to low Pb exposure, high BPb and EPb were associated with lower erythrocyte CR1 expression in all children. Our data suggests that elevated Pb levels result in adverse changes in blood morphology, hemoglobin synthesis and CR1 expression, which might be a non-negligible threat to erythrocyte immunity development in local preschool children. It is therefore imperative for any intervention to control the Pb exposure of children and actively educate adults to raise their environmental awareness of potential e-waste pollution during the recycling process.

Immunological effects of occupational exposure to lead (Review)

It is well-known that occupational and environmental exposure to several factors, including benzene, heavy metals, chemicals and mineral fibers, is associated with the risk of developing a great number of diseases. Numerous studies have been carried out in order to investigate the mechanisms of toxicity of these substances, with particular regard to the possible toxic effects on the immune system. However, little is known about the influence of heavy metals, such as lead, on the immune system in human populations. Lead is a heavy metal still used in many industrial activities. Human exposure to lead can induce various biological effects depending upon the level and duration of exposure, such as toxic effects on haematological, cardiovascular, nervous and reproductive systems. Several studies demonstrated that exposure to lead is associated to toxic effects also on the immune system, thus increasing the incidence of allergy, infectious disease, autoimmunity or cancer. However, the effects of lead exposure on the human immune system are not conclusive, mostly in occupationally exposed subjects; nevertheless some immunotoxic abnormalities induced by lead have been suggested. In particular, in vivo, in vitro and ex vivo lead is able to improve T helper 2 (Th2) cell development affecting Th1 cell proliferation. Further studies are required to better understand the mechanisms of lead immunotoxicity and the ability of lead to affect preferentially one type of immune response.