Effects of environmental levels of cadmium, lead and mercury on human renal function evaluated by structural equation modeling

Hormonal, liver, and renal function associated with electronic waste (e-waste) exposure in Dhaka, Bangladesh

Electronic waste (e-waste) contains numerous metals and organic pollutants that have detrimental impacts on human health. We studied 199 e-waste recycling workers and 104 non-exposed workers; analyzed blood, urine, and hair samples to measure heavy metals, hormonal, liver, and renal function. We used quantile regression models to evaluate the impact of Pb, Cd, and Hg on hormonal, liver and renal function, and the role of DNA oxidative damage in mediating the relationship between exposures and outcomes. Exposed workers had higher blood lead (Pb) (median 11.89 vs 3.63 µg/dL), similar blood cadmium (Cd) (1.04 vs 0.99 µg/L) and lower total mercury (Hg) in hair (0.38 vs 0.57 ppm) than non-exposed group. Exposed workers also had elevated median concentrations of total triiodothyronine (TT3), aspartate aminotransferase (AST), alanine aminotransferase (ALT), urinary albumin, albumin creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR) were significantly higher than non-exposed group (p≤0.05). Sex hormones including luteinizing hormone, follicle stimulating hormone, estrogen, progesterone and testosterone concentrations were not significantly different between exposed and non-exposed (all p≥0.05). The median concentration of ALT was 4.00 (95% CI: 0.23, 7.77), urinary albumin was 0.09 (95% CI: 0.06, 0.12) and ACR was 1.31 (95% CI: 0.57, 2.05) units higher in the exposed group compared to non-exposed group. Pb was associated with a 3.67 unit increase in the ALP (95% CI: 1.53, 5.80), 0.01 unit increase in urinary albumin (95% CI: 0.002, 0.01), and 0.07 unit increase in ACR (95% CI: 0.01, 0.13). However, no hormonal, renal, and hepatic parameters were associated with Cd or Hg. Oxidative DNA damage did not mediate exposure-outcome relationships (p≥0.05). Our data indicate e-waste exposure impairs liver and renal functions secondary to elevated Pb levels. Continuous monitoring, longitudinal studies to evaluate the dose-response relationship and effective control measure are required to protect workers from e-waste exposure.

A critical review on the migration and transformation processes of heavy metal contamination in lead-zinc tailings of China

The health risks of lead-zinc (Pb-Zn) tailings from heavy metal (HMs) contamination have been gaining increasing public concern. The dispersal of HMs from tailings poses a substantial threat to ecosystems. Therefore, studying the mechanisms of migration and transformation of HMs in Pb-Zn tailings has significant ecological and environmental significance. Initially, this study encapsulated the distribution and contamination status of Pb-Zn tailings in China. Subsequently, we comprehensively scrutinized the mechanisms governing the migration and transformation of HMs in the Pb-Zn tailings from a geochemical perspective. This examination reveals the intricate interplay between various biotic and abiotic constituents, including environmental factors (EFs), characteristic minerals, organic flotation reagents (OFRs), and microorganisms within Pb-Zn tailings interact through a series of physical, chemical, and biological processes, leading to the formation of complexes, chelates, and aggregates involving HMs and OFRs. These interactions ultimately influence the migration and transformation of HMs. Finally, we provide an overview of contaminant migration prediction and ecological remediation in Pb-Zn tailings. In this systematic review, we identify several forthcoming research imperatives and methodologies. Specifically, understanding the dynamic mechanisms underlying the migration and transformation of HMs is challenging. These challenges encompass an exploration of the weathering processes of characteristic minerals and their interactions with HMs, the complex interplay between HMs and OFRs in Pb-Zn tailings, the effects of microbial community succession during the storage and remediation of Pb-Zn tailings, and the importance of utilizing process-based models in predicting the fate of HMs, and the potential for microbial remediation of tailings.

Synergistic impact of co-exposures to whole blood metals on chronic kidney disease in general US adults: a cross‑sectional study of the National Health and Nutrition Examination Survey 2011-2020

The impact of exposure to metals on chronic kidney disease (CKD) has only been investigated in two-way or single metal interactions in previous studies. We investigated the associations between five single metals in blood and their mixed exposure and CKD by using the machine learning approach. Relevant data were extracted from the National Health and Nutrition Examination Survey (NHANES 2011-2020), and the level of five metals in blood detected by inductively coupled plasma mass spectrometry was considered as exposures, namely, cadmium (Cd), lead (Pb), total mercury (Hg), manganese (Mn), and selenium (Se). The correlations between individual metal and metal mixtures and CKD were then evaluated by survey-multivariable logistic regression (SMLR), generalized weighted quantile sum (WQS), and Bayesian kernel machine regression (BKMR). Altogether, our study included 12,412 participants representing 572.6 million non-institutionalized US adults. Several single metals with the high quartile of exposure showed a positive association with the CKD ratio including Cd [(AOR = 1.873, 95% CI: 1.537, 2.284), Q4], Pb [(AOR = 1.559, 95% CI: 1.295, 1.880), Q4], and total Hg [(AOR = 1.169, 95% CI: 1.018, 1.343), Q2], while Mn [(AOR = 0.796, 95% CI: 0.684, 0.927), Q2] and Se [(AOR = 0.805, 95% CI: 0.664, 0.976), Q4] were negatively associated with the CKD ratio. In light of the positive fit of the WQS regression model, a significantly positive correlation was found between mixed metals and CKD (AOR = 1.373, 95% CI: 1.224, 1.539) after full covariate adjustment, and a similar finding was also detected in the BKMR model. Our study revealed that each single metal including Cd, Pb, and total Hg might have a positive association with CKD while this association was negative for both Mn and Se. The five metals might have a positive joint effect on CKD.

Exposure to multiple neonicotinoid insecticides, oxidative stress, and gestational diabetes mellitus: Association and potential mediation analyses

As the most extensively used insecticides worldwide, neonicotinoid insecticides (NNIs) have received a growing global concern over their adverse health effects. This study aimed to assess the associations of urinary concentrations of NNIs in early pregnancy with gestational diabetes mellitus (GDM) and the mediation roles of oxidative DNA damage, RNA damage, and lipid peroxidation in the associations. With a prospective nested case-control study, 519 GDM cases and 519 controls were matched on the infant's sex and maternal age. Urinary biomarkers of NNIs exposure and oxidative stress were measured in early pregnancy. We estimated the associations of single and the mixture of NNIs and their metabolites with GDM by conditional logistic regression and quantile g-computation models, respectively. The mediating roles of oxidative stress were evaluated by the structural equation model. The odds of GDM significantly increased by 15 %, 18 %, 26 %, 42 %, 49 %, and 13 % in each unit increment of ln-transformed concentrations of urinary imidacloprid (IMI), imidacloprid-olefin (IMI-olefin), desnitro-imidacloprid (DN-IMI), thiamethoxam (THM), clothianidin, and desmethyl-clothianidin, respectively. Exposure to the mixture of NNIs was associated with increased odds of GDM (adjusted OR: 1.76; 95 %CI: 1.45, 2.13). Advanced maternal age enhanced the associations of 5-hydroxy-IMI, DN-IMI, and IMI-olefin with GDM (P < 0.05), and being overweight/obese before pregnancy strengthened the effects of IMI, IMI-olefin, and THM on GDM (P < 0.05). In the association of NNIs exposure and GDM, the proportions mediated by oxidative DNA damage, RNA damage, and overall oxidative stress were 9.8 %, 11.8 %, and 14.5 %, respectively (P < 0.05). Exposure to individual NNIs and a mixture of NNIs were associated with GDM, and maternal age and pre-pregnancy BMI may modify the association. The possible mechanism underlying the association between NNIs and GDM may involve oxidative damage to nucleic acids.

Human exposure to a mixture of endocrine disruptors and serum levels of thyroid hormones: A cross-sectional study

Exposure to endocrine disruptors (EDCs) could disrupt thyroid hormone homeostasis. However, human epidemiological studies reported inconsistent observations, and scarce information on the effect of a mixture of chemicals. The aim of the present study was to examine the associations of multiple chemicals with thyroid hormones among adults from China. We measured serum levels of thyroid hormones and urinary levels of 11 EDCs, including six phthalate metabolites, bisphenol A (BPA), bisphenol F (BPF), bisphenol S (BPS), perchlorate, and thiocyanate among 177 healthy adults without occupational exposure. Associations of multiple urinary analytes with serum thyroid hormones were examined by performing general linear regression analysis and bayesian kernal machine regression analysis. These EDCs were detected in almost all samples. After adjusting for various covariates, we observed only BPF significantly associated with total thyroxin (TT4) (β=-0.27, 95% confidence interval (CI) [-0.41, -0.14]), total triiodothyronine (TT3) (β=-0.02 95% CI [-0.03, -0.01]), free T4 (fT4) (β=-0.02, 95% CI [-0.03, -0.01]), and free T3 (fT3) (β=-0.04, 95% CI [-0.07, -0.01]), and mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP) and monoethyl phthalate (MEP) positively associated with TT4 (β=0.24, 95% CI [0.01, 0.48]) and fT4 (β=0.02, 95% CI [0.01, 0.04]), respectively. Moreover, we observed significant dose-response relationships between TT4 and the mixture of 11 EDCs, and BPF was the main contributor to the mixture effect, suggesting the priority of potential effect of BPF on disrupting thyroid function under a real scenario of human exposure to multiple EDCs. Our findings supported the hypothesis that human exposure to low levels of EDCs could alter thyroid hormones homeostasis among non-occupational healthy adults.

Urinary cadmium and peripheral blood telomere length predict the risk of renal function impairment: a study of 547 community residents of Shanxi, China

Few reports have investigated the predictive value of urinary cadmium (UCd) and telomere length on renal function impairment. Therefore, we constructed nomogram models, using a cross-sectional survey to analyze the potential function of UCd and telomere length in renal function impairment risk. We randomly selected two community populations in Shanxi, China, and general information of the subjects was collected through face-to-face questionnaire surveys. Venous blood of subjects was collected to detect absolute telomere length (ATL) by real-time quantitative chain reaction (RT-PCR). Collecting urinary samples detected UCd and urinary N-acetyl-β-d-glucosaminidase (UNAG). Estimated glomerular filtration rate (eGFR) was obtained based on serum creatinine (SCr). Nomogram models on risk prediction analysis of renal function impairment was constructed. After adjusting for other confounding factors, UCd (β = 0.853, 95% confidence interval (CI): 0.739 ~ 0.986) and ATL (β = 1.803, 95%CI: 1.017 ~ 1.154) were independent risk influencing factors for increased UNAG levels, and the risk factors for eGFR reduction were UCd (β = 1.011, 95%CI: 1.187 ~ 1.471), age (β = 1.630, 95%CI: 1.303 ~ 2.038), and sex (β = 0.181, 95%CI: 0.105 ~ 0.310). Using UCd, ATL, sex, and age to construct the nomogram, and the C-statistics 0.584 (95%CI: 0.536 ~ 0.632) and 0.816 (95%CI: 0.781 ~ 0.851) were obtained by internal verification of the calibration curve, C-statistics revealed nomogram model validation was good and using decision curve analysis (DCA) confirmed a good predictive value of the nomogram models. In a nomogram model, ATL, UCd, sex, and age were detected as independent risk factors for renal function impairment, with UCd being the strongest predictor.

Co-exposure to perfluoroalkyl acids and heavy metals mixtures associated with impaired kidney function in adults: A community-based population study in China

BACKGROUND

Previous studies have separately linked either perfluoroalkyl acid (PFAA) or heavy metal exposure with kidney dysfunction. However, the relationships of co-exposure to PFAAs and heavy metals with kidney function are still unclear.

OBJECTIVES

To explore the associations between exposure to PFAAs and heavy metals mixtures and kidney function in adults.

METHODS

We conducted a cross-sectional community-based population study in Guangzhou, China, enrolling 1312 adults from November 2018 to August 2019. We quantified 13 PFAAs in serum and 14 heavy metals in plasma. We chose estimated glomerular filtration rate (eGFR) and chronic kidney disease (CKD) as outcomes of interest. Distributed lag non-linear models (DLNMs) were used to check nonlinearity of individual pollutant with kidney function. Joint associations of pollutant mixtures on kidney function were assessed by Bayesian Kernel Machine Regression (BKMR) models. We further explored modification effects of gender.

RESULTS

Most individual PFAA and heavy metal were associated with declined kidney function in single-pollutant models. We also observed significant dose-response relationships of pollutant mixtures with reduced eGFR levels and increased odds of CKD in BKMR models. Perfluoroheptanesulfonic acid (PFHpS), arsenic (As) and strontium (Sr) were the predominant contributors among pollutant mixtures. A change in log PFHpS, As and Sr concentrations from the 25th to the 75th percentile were associated with a decrease in eGFR of -5.42 (95% confidence interval (CI): -6.86, -3.98), -2.14 (95% CI: -3.70, -0.58) and -1.87 (95% CI: -3.03, -0.72) mL/min/1.73 m², respectively, when other pollutants were at their median values. In addition, the observed associations were more obvious in females.

CONCLUSIONS

We provided new evidence that co-exposure to PFAAs and heavy metals mixtures was associated with reduced kidney function in adults and PFHpS, As and Sr appeared to be the major contributors. Further studies are warranted to confirm our findings and elucidate the underlying mechanisms.

Short-term exposure to fine particulate matter and its constituents may affect renal function via oxidative stress: A longitudinal panel study

Exposure to fine particulate matter (PM_2.5) has been reported to increase the risks of chronic kidney disease. However, limited research has assessed the effect of PM_2.5 and its constituents on renal function, and the underlying mechanism has not been well characterized. We aimed to evaluate the association of PM_2.5 and its constituents with kidney indicators and to explore the roles of systematic oxidative stress and inflammation in the association. We conducted a longitudinal panel study among 35 healthy adults before-, intra- and after-the 2019 Wuhan Military World Games. We repeatedly measured 6 renal function parameters and 5 circulating biomarkers of oxidative stress and inflammation at 6 rounds of follow-ups. We monitored hourly personal PM_2.5 concentrations with 3 consecutive days and measured 10 metals (metalloids) and 16 polycyclic aromatic hydrocarbons (PAHs) components. The linear mixed-effect models were applied to examine the association between PM_2.5 and renal function parameters, and the mediation analysis was performed to explore potential bio-pathways. PM_2.5 concentrations across Wuhan showed a slight decrease during the Military Games. We observed significant associations between elevated blood urea nitrogen (BUN) levels and PM_2.5 and its several metals and PAHs components. For an interquartile range (IQR) increase of PM_2.5, BUN increased 0.42 mmol/L (95% CI: 0.14 to 0.69). On average, an IQR higher of lead (Pb), cadmium (Cd), arsenic (As), selenium (Se), thallium (Tl) and Indeno (1,2,3-cd) pyrene (IPY) were associated with 0.90, 0.65, 0.29, 0.27, 0.26 and 0.90 mmol/L increment of BUN, respectively. Moreover, superoxide dismutase was positively associated with PM_2.5 and mediated 18.24% association. Our research indicated that exposure to PM_2.5 might affect renal function by activating oxidative stress pathways, in which the constituents of Pb, Cd, As, Se, Tl and IPY might contribute to the associations.

Determination of spatial mercury concentration by laser ablation-inductively coupled plasma mass spectrometry

Laser ablation-inductively coupled plasma mass spectrometry (LA-ICP-MS) is capable of metal imaging by acquiring local spatial information. However, the preparation of an appropriate standard for quantitative analysis is difficult because the matrices between the standard and the sample should match, and homogeneity of metal concentration in the standard is required. Hence, the aim of this study was to establish a highly quantitative mercury imaging method that utilizes LA-ICP-MS and an appropriate mercury standard consisting of rat tissue. Our standard showed homogeneous mercury concentration and good linearity between concentration and signal intensity, and met the qualifications for quantitative imaging by LA-ICP-MS. Mercury concentration in MeHg-exposed rat kidneys obtained by LA-ICP-MS measurement of the standard (7.84 ± 0.57 µg/g) was comparable to that obtained by cold vapor atomic absorption spectrophotometry (AAS, 7.27 ± 0.46 µg/g). The results indicate that LA-ICP-MS enabled quantitative imaging with the appropriate standard.

Metal mixtures and kidney function: An application of machine learning to NHANES data

BACKGROUND

Exposure to heavy metals may increase risk of kidney disease, but most studies have examined individual metals or two-way interactions. There is increasing recognition of the importance of studying exposure to metal mixtures and health outcomes.

OBJECTIVES

We used Bayesian kernel machine regression (BKMR) to examine associations between a mixture of four heavy metals and indicators of kidney function.

METHODS

We used NHANES 2015-16 data on 1435 adults aged 40 and over to study cross-sectional associations between blood levels of four heavy metals (Co, Cr, Hg and Pb) and kidney function. Kidney function was assessed by estimated glomerular filtration rate (eGFR) and by albumin to creatinine ratio (ACR), measured continuously and dichotomized into indicators of chronic kidney disease (CKD) and albuminuria, respectively. BKMR tested for non-linearity in the exposure-specific responses to evaluate dose-response relationships between mixtures and outcomes and possible interaction effects among exposures. Interactions among continuous outcomes were identified using the NLinteraction package in R.

RESULTS

A higher metals mixture was significantly associated with all four measures of kidney function in dose-response patterns. Pb had the strongest association with eGFR, albuminuria and ACR, and the second strongest association with CKD. We also observed an interaction between Pb and Co for eGFR and an interaction between Pb and Cd for ACR.

CONCLUSIONS

Exposure to a co-occurring heavy metals mixture was associated with indicators of poor kidney function. Within this mixture, Pb, Co and Cd considered singly and jointly made the greatest contributions to the observed effects. Future prospective study is needed to confirm the association between metal mixtures and kidney function.

Lead and kidney: Concentrations, variabilities, and associations across the various stages of glomerular function

Data (N = 9882) from National Health and Nutrition Examination Survey for 2003-2014 for US adults aged ≥20 years were analyzed to evaluate the variabilities in concentrations of blood and urine lead across various stages of glomerular function. Those who had estimated glomerular filtration rate (eGFR) >90 mL/min/1.73 m² were defined to be in glomerular function stage 1 (GF-1), those who had eGFR between 60 and 90 mL/min/1.73 m² were defined to be in GF-2, those who had eGFR between 45 and 60 mL/min/1.73 m² were defined to be in GF-3A, those who had eGFR between 15 and 45 mL/min/1.73 m² were defined to be in GF-3B/4. There were consistent increases in adjusted geometric means (AGM) for both blood and urine lead from GF-1 to GF-3A even though increases were not uniform from one GF stage to another. For the total population, AGMs for blood lead were 1.23, 1.78, 2.25, and 2.25 μg/dL for GF-1, GF-2, GF-3A, and GF-3B/4 respectively. AGMs for urine lead were 0.49, 0.61, 0.68, and 0.47 μg/L for GF-1, GF-2, GF-3A, and GF-3B/4 respectively. Thus, from GF-3A to GF-3B/4, AGMs for both blood and urine lead decreased. However, percent increases from GF-1 to GF-3A for urine lead were smaller than for blood lead and percent decreases from GF-3A to GF-3B/4 for urine lead were larger than for blood lead. Females had lower AGMs than males for both blood and urine lead. Also, smoker-nonsmoker differences for blood lead narrowed as kidney function deteriorated but smoker-nonsmoker differences for urine cadmium lead as kidney function deteriorated. Smokers had sharper increases in AGMs for blood and urine lead than nonsmokers from GF-1 to GF-3A but at GF-3B/4, this difference was reduced to 0.17 μg/dL.

The association between lead and cadmium co-exposure and renal dysfunction

Both cadmium (Cd) and lead (Pb) exposure can induce kidney damage. However, the effects of combined exposure to Cd and Pb on renal function at environmental levels have not been fully clarified. In this study we investigated the renal function in a Chinese population co-exposed to Cd and Pb. A total of 331 subjects (215 women and 116 men), living in either a control or a polluted area, were included in this study. Cd and Pb in blood and urine (BCd, BPb, UCd, and UPb), and kidney effect markers including urinary N-acetyl-β-D-glucosaminidase (UNAG) and estimated glomerular filtration rate (eGFR), were determined, and the association between exposure markers and renal effect biomarkers were analyzed. The exposure levels in the polluted area were significantly higher than in the control area (all p < 0.01). The eGFR of subjects in the polluted area was decreased compared with that in the control area (p < 0.01). The subjects with high BCd/BPb (BCd ≥ 2 μg/L, BPb ≥ 100 μg/L) or high UCd/UPb (UCd ≥ 3 μg/g creatinine, UPb ≥ 10 μg/g creatinine) showed higher UNAG and UALB levels compared with other subgroups (p < 0.01). The probability of having elevated UNAG in subjects with high BCd/BPb was greater than those with low BCd/BPb [odds ratio (OR) = 2.6, 95% confidence interval (CI): 1.4-4.7), low BCd/high BPb (OR =3.1, 95% CI: 1.4-6.6), and high BCd/low BPb (OR = 1.7, 95% CI: 0.9-3.2). The OR of subjects with low UCd and high UPb, high UCd and low UPb, and high UCd/UPb were 2.9 (95% CI: 1.4-5.7), 3.3 (95% CI: 1.5-7.2), and 7.7 (95% CI: 4.0-14.7), respectively, compared with those with low UCd/UPb. The risk of decrease in eGFR was also higher in subjects with high UCd/UPb than for those with low UCd/UPb (OR = 7.2, 95% CI: 0.8-62.2). Our data demonstrate that Cd and Pb exposure, alone or in combination, are associated with renal impairment. In addition, co-exposure to Pb and Cd propagates the renal tubular dysfunction compared with Cd or Pb exposure alone.

Perfluoroalkyl acids serum concentrations and their relationship to biomarkers of renal failure: Serum and urine albumin, creatinine, and albumin creatinine ratios across the spectrum of glomerular function among US adults

Associations between selected perfluoroalkyl acids (PFAAs) and biomarkers of renal function were evaluated for US adult aged ≥ 20 years (N = 8220) in the National Health and Nutrition Examination Survey for 2005-2014. Glomerular filtration (GF) stage-stratified regression models were classified by estimated glomerular filtration rate (eGFR) with GF-1 (eGFR > 90 mL/min/1.73 m²), GF-2 (eGFR 60-89 mL/min/1.73 m²), GF-3A (45-59 mL/min/1.73 m²), and GF-3B/4 (15-44 mL/min/1.73 m²). For GF-1, PFOA, PFOS, and PFHxS were positively and significantly associated with serum creatinine. Serum albumin levels were positively associated with the PFAA considered at all stages and most associations were significant. Further, PFAS serum concentration associations to serum albumin were about 2-3 times stronger at GF-3B/4 than at GF-1. In contrast, urine albumin was negatively and significantly associated with PFOA and PFHxS serum concentrations at all stages of renal function, while, PFOS and PFNA were negatively and significantly associated to urine albumin at GF-3A and GF-3B/4. Urine albumin/creatinine ratios were negatively and significantly associated with PFOA, PFOS, and, and PFHxS serum concentrations at all stages of renal function, as well as with PFNA and PFDA at GF-3A and GF-3B/4. Recent work revealed that serum PFAAs have an inverted U-shaped association to the calculated stages of renal failure based on eGFR; this work adds that albuminuria makes additional negative contributions to already existing negative associations of PFAA to eGFR in advancing stages of renal failure. We hypothesize that both progressive renal failure per se and especially renal failure with albuminuria cause the kidneys to reabsorb less and to excrete more of the PFAAs studied. We suspect this finding may generalize to some other perfluoroalkyl substances (PFAS). The findings also imply study design considerations for evaluating associations to diseases and biomarkers associated with renal failure, such as diabetes.

Dose-response relationships between urinary phthalate metabolites and serum thyroid hormones among waste plastic recycling workers in China

BACKGROUND

Exposure to phthalates may affect thyroid hormone status. However, there were inconsistent observations for the associations of phthalates exposure with altered thyroid hormones.

OBJECTIVES

The aim of this study was to investigate effects of urinary excretion of phthalate metabolites on the levels of thyroid hormones among workers engaged in waste plastic recycling in China.

METHODS

We measured serum levels of thyroid hormones and urinary levels of eight phthalate metabolites among 317 participants (165 workers engaged in waste plastic recycling and 152 farmers), analyzed relationships between urinary phthalate metabolites and thyroid function parameters by multivariate linear regression analysis and structural equation modelling as well as assessed the dose-response relationships between them by restricted cubic spline functions.

RESULTS

Maximum urinary values of eight phthalate metabolites in the occupational exposed workers were higher than the controls. Compared with the controls, the workers had higher levels of urinary monobenzyl phthalate (MBzP, 1.12 vs. 0.92 μg/g creatinine), mono (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP, 38.84 vs. 32.55 μg/g creatinine), mono-n-octyl phthalate (MOP, .11 vs. 0.09 μg/g creatinine), serum total triiodothyronine (T3, 1.04 vs. 0.92 ng/mL) and the T3 to thyroxine (T4) ratio (1.44 vs. 1.09) (all P < 0.05). The results from structural equation modelling analysis showed that phthalates metabolites were positively associated with total T3 (β = 0.044, SE = 0.021, P < 0.05) or the T3/T4 ratio (β = 0.053, SE = 0.022, P < 0.05) among all participants. Among the workers, there were the non-monotonic dose-response associations between urinary monomethyl phthalate (MMP) and serum total T3 or the T3/T4 ratio, as well as between urinary monoethyl phthalate (MEP) and the T3/T4 ratio (all P < 0.05).

CONCLUSIONS

The dose-response relationships between urinary phthalate metabolites and thyroid hormone parameters may be non-monotonic among the workers. Further investigations are needed to corroborate these findings.

A cross sectional study of urinary phthalates, phenols and perchlorate on thyroid hormones in US adults using structural equation models (NHANES 2007-2008)

BACKGROUND

Biomonitoring data shows that people are exposed to phthalates, phenols and perchlorates. Many of these compounds are endocrine disrupting compounds that affect thyroid hormone levels. Yet the effect of these compounds on thyroid hormone levels are often evaluated individually rather than as a mixture. Our objective was to examine the association between 11 urinary endocrine disrupting compounds and thyroid hormones using structural equation models.

METHODS

Using data from the National Health and Nutrition and Examination Survey 2007-2008, we fit a latent variable utilizing urinary measurements of 9 compounds in females (perchlorate, bisphenol A, benzophenone-3, mono-2ethyl5carboxypentyl phthalate, mono-n-butyl phthalate, mono-(3-carboxypropyl) phthalate, mono(2ethyl5hydroxyhexyl) phthalate, mono-benzyl phthalate, and mono-isobutyl phthalate) and 8 compounds in males (without benzophenone-3). The association of the latent variable with serum thyroid hormones (Total T3, Total T4, and Thyroid Stimulating Hormones) was assessed in females (N = 710) and males (N = 850) over the age of 12 controlling for age, race, and urinary creatinine.

RESULTS

In males, urinary endocrine disrupting compound levels were negatively associated with thyroxine (β: -0.19, 95% Confidence Interval (95% CI): -0.31, -0.05). In females, urinary endocrine disrupting compound levels were positively associated with triiodothyronine serum concentrations (β: 0.09, 95% CI: -0.03, 0.21) however this association was not statistically significant.

CONCLUSIONS

This cross-sectional analysis provides additional evidence that environmental exposure to phthalates and phenols is associated with endocrine-related processes. Furthermore, these results suggested sex-specific differences in exposure to endocrine disrupting mixtures, and the exposure-response between endocrine disrupting mixtures and thyroid hormone levels. Specifically, higher exposure to a mixture of endocrine disrupting compounds was associated with lower levels of total T4 in males but not in females. While a structural methodological framework was used to assess these complex relationships, the cross sectional nature of this analysis limits causal inference and further research is needed to determine the clinical significance of these findings.

Analysis of influencing factors on public perception in contaminated site management: Simulation by structural equation modeling at four sites in China

Public perception towards contaminated site management, a not readily quantifiable latent parameter, was linked through structural equation modeling in this paper to 22 measurable/observable manifest variables associated with the extent of information dissemination and public knowledge of soil pollution, attitude towards remediation policies, and participation in risk mitigation processes. Data obtained through a survey of 412 community residents at four remediation sites in China were employed in the model validation. The outcomes showed that public perception towards contaminated site management might be explained through selected measurable parameters in five categories, namely information disclosure, knowledge of soil pollution, expectations of remediation and redevelopment outcomes, public participation, and site policy, along with their interactions. Among these, information dissemination and attitude towards management policies exhibited significant influence in promoting positive public perception. Based on these examples, responsible agencies therefore should focus on public accessibility to reliable information, and encourage public inputs into policies for contaminated site management, in order to gain public confidence during remediation and regeneration projects.

Factors affecting the variability in the observed levels of cadmium in blood and urine among former and current smokers aged 20-64 and ≥ 65years

Data from National Health and Nutrition Examination Survey for 1999-2012 were used to evaluate factors that affect observed levels of blood cadmium (BCd) and urine cadmium (UCd) among former and current smokers aged 20-64 and ≥65 years. Adjusted levels (AGM) for BCd and UCd were higher among females as compared to males. The order of AGM for BCd by race/ethnicity for 20-64 years old was non-Hispanic white (NHW) < non-Hispanic black (NHB) and NHW > NHB for ≥65 years old. The order of AGMs for UCd for 20-64-year-old current smokers was NHW > NHB and NHW > NHB for former smokers. For 20-64-year-old current smokers, exposure to environmental tobacco smoke at home was associated with higher levels of BCd. Levels of both UCd and BCd increased with age, but the rate of increase was as much as seven times higher among ≥65 years old than 20-64 years old. For current smokers, the number of cigarettes smoked inside home was positively associated with the levels of BCd. For current smokers aged 20-64 years, the number of cigarettes smoked inside home was positively associated with the levels of UCd (p < 0.01), and the number of cigarettes smoked every day on the days they were smoked was also positively associated with the levels of UCd (p < 0.01). Among former smokers, levels of both UCd and BCd were positively associated (p < 0.1) with the number of cigarettes smoked per day at the time of quitting smoking and negatively associated with the time since smoking was quitted (p < 0.01).

Factors affecting the variability in the observed levels of urinary cadmium among children and nonsmoker adolescents

Data from the National Health and Nutrition Examination Survey for 1999-2012 were used to evaluate factors that affect observed levels of urine cadmium (UCd) among children aged 6-11 years and nonsmoker adolescents aged 12-19 years. Adjusted UCd levels were found to be statistically significantly higher for female nonsmoker adolescents than male nonsmoker adolescents (p < 0.01). Non-Hispanic white (NHW) participants had statistically significantly lower adjusted levels of UCd (<0.01) than non-Hispanic black (NHB) participants for both children (p < 0.01) and adolescents (p < 0.01). Dietary intake of cadmium was not found to affect the levels of UCd. While unadjusted levels of UCd for nonsmoker adolescents declined (p < 0.01) over 1999-2012 by 28.3%, no statistically significant trend was observed for adjusted levels.

Effects of sub-chronic Cd exposure on levels of copper, selenium, zinc, iron and other essential metals in rat renal cortex

Cd (Cd) is a nephrotoxic environmental pollutant that causes generalized proximal tubule dysfunction. Even though the specific mechanisms by which Cd damages the kidney have yet to be fully elucidated, there is evidence to suggest that some of these nephrotoxic effects may result from the ability of Cd to alter the levels and function of metals such as Cu, Se, Zn and Fe within the kidney. In order to further explore this issue, we examined the effects of subchronic Cd exposure on tissue levels of a panel of metals (Ca, Cu, Fe, K, Mg, Na, Se and Zn) in the rat renal cortex. Adult male Sprague-Dawley rats were treated with CdCl₂ (0.6 mg Cd/kg body weight in isotonic saline by subcutaneous injection, 5 days per week for 6, 9 or 12 weeks). At each time point, 24 h urine samples were collected and assayed for levels of protein, creatinine, β₂ microglobulin and cystatin C. Samples of renal cortex were removed and assayed for levels of the metals of interest by inductively-coupled mass spectrometry at Michigan State University. Results showed that at 9 and 12 weeks, Cd caused significant increases in urine volume and urinary protein with no change in creatinine excretion. Increases in the excretion of the urinary biomarkers β₂ microglobulin and cystatin C were evident after 6 weeks of Cd exposure. Results of the metal analyses showed that Cd caused significant increases in tissue levels of Cu and Se at all of the time points examined. Tissue levels of Zn were transiently elevated at 6 weeks but declined to control levels at 9 and 12 weeks. Cd caused a significant decrease in levels of Fe at 9 and 12 weeks. Cd had no effects on any of the other metals. Tissue levels of Cd were 530 ± 52, 863 ± 23, 837 ± 23 ppm dry weight at 6, 9 and 12 weeks, respectively. These results indicate that the early stages of Cd nephrotoxicity are associated with alterations in renal tissue levels of Cu, Se, Zn and Fe. The fact that the changes in levels of the metals occurred during the early stages of Cd toxicity raises the possibility that the alterations in renal cortical metal content may play some role in the pathophysiology or Cd-induced injury.

Trends and variability in blood lead concentrations among US adults aged 20-64 years and senior citizens aged ≥65 years

Using data from National Health and Nutrition Examination Survey for the period 2003-2012, the objective of this study was to evaluate trends in blood lead levels (BLL) among adults aged 20-64 years (adults) and seniors aged ≥65 years (seniors). In addition, the contribution of other factors like gender, race/ethnicity, smoking, and exposure to secondhand smoke at home in explaining variability in BLL was also evaluated by fitting regression models with log10 transformed values of BLL as dependent variables. BLL decreased over 2003-2012 (p < 0.01). Irrespective of gender, race/ethnicity, and smoking status, seniors were found to have higher BLL than adults. Based on the magnitude of differences between the 5th and 95th percentiles, variability in the levels of blood lead was found to be substantially higher among seniors than among adults. Males had statistically significantly higher adjusted BLL than females (2.32 vs. 1.76 μg/dL for seniors, p < 0.01 and 1.66 vs. 1.13 μg/dL for adults, p < 0.01). Non-Hispanic whites had statistically significantly lower adjusted BLL than non-Hispanic blacks (1.99 vs. 2.42 μg/dL for seniors, p < 0.01 and 1.22 vs. 1.42 μg/dL for adults, p < 0.01). When compared with non-smokers, smokers had statistically significantly higher BLL (2.19 vs. 1.86 μg/dL for seniors, p < 0.01 and 1.54 vs. 1.22 μg/dL for adults, p < 0.01). Non-obese had statistically significantly higher BLL than obese individuals (2.11 vs. 1.93 μg/dL for seniors, p < 0.01 and 1.48 vs. 1.27 μg/dL for adults, p < 0.01). Exposure to secondhand smoke at home (SHS) was associated with statistically significantly higher BLL than when there was no exposure to SHS (β = 0.0683, p = 0.03 for seniors; β = 0.034, p = 0.034, p < 0.01 for adults).

Structural equation modeling identifies markers of damage and function in the aging male Fischer 344 rat

The male Fischer 344 rat is an established model to study progressive renal dysfunction that is similar, but not identical, to chronic kidney disease (CKD) in humans. These studies were designed to assess age-dependent alterations in renal structure and function at late-life timepoints, 16-24 months. Elevations in BUN and plasma creatinine were not significant until 24 months, however, elevations in the more sensitive markers of function, plasma cystatin C and proteinuria, were detectable at 16 and 18 months, respectively. Interestingly, cystatin C levels were not corrected by caloric restriction. Urinary Kim-1, a marker of CKD, was elevated as early as 16 months. Klotho gene expression was significantly decreased at 24 months, but not at earlier timepoints. Alterations in renal structure, glomerulosclerosis and tubulointerstitial fibrosis, were noted at 16 months, with little change from 18 to 24 months. Tubulointerstitial inflammation was increased at 16 months, and remained similar from 18 to 24 months. A SEM (structural equation modeling) model of age-related renal dysfunction suggests that proteinuria is a marker of renal damage, while urinary Kim-1 is a marker of both damage and function. Taken together, these results demonstrate that age-dependent nephropathy begins as early as 16 months and progresses rapidly over the next 8 months.

Trends and variability in blood lead concentrations among US children and adolescents

Using data from the National Health and Nutrition Examination Survey for the period 2003-2012, the objective of this study was to evaluate trends in blood lead levels (BLL) among children aged 1-5 and 6-11 years and smoker and nonsmoker adolescents aged 12-19 years. Regression models with log10 transformed values of BLLs as dependent variable were fitted to evaluate how gender, race/ethnicity, smoking, and exposure to secondhand smoke at home affect BLLs. Irrespective of age, gender, and race/ethnicity, BLLs declined over the study period (p ≤ 0.01). Overall, adjusted BLLs declined by 0.00114 μg/dL for every 2 years. Children aged 1-5 years had about 50 % higher BLLs than smoker adolescents, about 75 % higher BLLs than nonsmoker adolescents, and about 45 % higher BLLs than children aged 6-11 years. While overall, children aged 1-5 years with BLL ≥ 5 μg/dL made up 3.24 %, 7.8 % non-Hispanic Black children aged 1-5 years had BLL ≥ 5 μg/dL. Males were found to have higher adjusted BLLs than females, and non-Hispanic Blacks were found to have higher adjusted BLLs than non-Hispanic Whites. Higher poverty income ratio was associated with lower adjusted BLLs (β = -0.02916, p < 0.01). Children living in owner-occupied homes had lower adjusted BLLs than children living in renter-occupied homes. BLLs increased with increase in number of smokers smoking inside the home (β = 0.02496, p = 0.02). In conclusion, while BLLs have declined for all age groups, genders, and races/ethnicities, certain races/ethnicities like non-Hispanic Blacks continue to have substantially higher BLLs than non-Hispanic Whites.

Associations of Low Environmental Exposure to Multiple Metals with Renal Tubular Impairment in Korean Adults

Recently several studies reported that the renal toxicity of lead (Pb) and cadmium (Cd) may exist in even a low level exposure. In terms of the deterioration of tubular function, it affects the loss of divalent metals and leads to other complications, so renal tubular effect of heavy metals should be well managed. Considering the exposure to heavy metals in reality, it is hard to find the case that human is exposed to only one heavy metal. We designed a cross-sectional study using Korean Research Project on the Integrated Exposure Assessment (KRIEFS) data to investigate the renal effects of multiple metal exposure in general population. We used blood Pb and urinary Cd as exposure measures, and urinary N-acetyl-β-D-glucosaminidase (NAG) and β₂-microglobulin (β₂-MG) as renal tubular impairment outcome. We conducted linear regression to identify the association between each heavy metal and urinary NAG and β₂-MG. And then, we conducted linear regression including the interaction term. Of 1953 adults in KRIEFS (2010~2011), the geometric mean of blood Pb and urinary Cd concentration was 2.21 μg/dL (geometric SD = 1.49 μg/dL) and 1.08 μg/g cr (geometric SD = 1.98 μg/g cr), respectively. In urinary Cd, the strength of the association was also high after adjusting (urinary NAG: β = 0.44, p < 0.001; urinary β₂-MG: β = 0.13, p = 0.002). Finally, we identified the positive interactions for the two renal biomarkers. The interaction effect of the two heavy metals of β₂-MG was greater than that of NAG. It is very important in public health perspective if the low level exposure to multiple heavy metals has an interaction effect on kidney. More epidemiological studies for the interaction and toxicological studies on the mechanism are needed.

Evaluation of cystatin C as an early biomarker of cadmium nephrotoxicity in the rat

Cadmium (Cd) is a nephrotoxic environmental pollutant that causes insidious injury to the proximal tubule that results in severe polyuria and proteinuria. Cystatin C is a low molecular weight protein that is being evaluated as a serum and urinary biomarker for various types of ischemic and nephrotoxic renal injury. The objective of the present study was to determine if cystatin C might be a useful early biomarker of Cd nephrotoxicity. Male Sprague-Dawley rats were given daily injections of Cd for up to 12 weeks. At 3, 6, 9 and 12 weeks, urine samples were analyzed for cystatin C, protein, creatinine, β2 microglobulin and kidney injury molecule-1. The results showed that Cd caused a significant increase in the urinary excretion of cystatin C that occurred 3-4 weeks before the onset of polyuria and proteinuria. Serum levels of cystatin C were not altered by Cd. Immunolabeling studies showed that Cd caused the relocalization of cystatin C from the cytoplasm to the apical surface of the epithelial cells of the proximal tubule. The Cd-induced changes in cystatin C labelling paralleled those of the brush border transport protein, megalin, which has been implicated as a mediator of cystatin C uptake in the proximal tubule. These results indicate that Cd increases the urinary excretion of cystatin C, and they suggest that this effect may involve disruption of megalin-mediated uptake of cystatin C by epithelial cells of the proximal tubule.

Mitochondrial permeability transition and its regulatory components are implicated in apoptosis of primary cultures of rat proximal tubular cells exposed to lead

Previous studies have already demonstrated that mitochondria play a key role in Pb-induced apoptosis in primary cultures of rat proximal tubular (rPT) cells. To further clarify the underlying mechanism of Pb-induced mitochondrial apoptosis, this study was designed to investigate the role of mitochondrial permeability transition (MPT) and its regulatory components in Pb-induced apoptosis in rPT cells. Mitochondrial permeability transition pore (MPTP) opening together with disruption of mitochondrial ultrastructure, translocation of cytochrome c from mitochondria to cytoplasm and subsequent caspase-3 activation were observed in this study, suggesting that MPT is involved in Pb-induced apoptosis in rPT cells. Simultaneously, Pb-induced caspase-3 activation and apoptosis can be significantly inhibited by three MPTP inhibitors (CsA, DIDS, BA), which target different regulatory components of MPTP (Cyp-D, VDAC, ANT), respectively, demonstrating that Cyp-D, VDAC and ANT participate in MPTP regulation during lead exposure. Moreover, decreased ATP levels and increased ADP/ATP ratio induced by lead treatment can be significantly reversed by BA, indicating that Pb-mediated ANT dysfunction resulted in ATP depletion. In addition, up-regulation of VDAC-1, ANT-1 together with down-regulation of Cyp-D, VDAC-2 and ANT-2 at both the levels of transcription and translation were revealed in rPT cells under lead exposure conditions. In conclusion, Pb-mediated mitochondrial apoptosis in rPT cells is dependent on MPTP opening. Different expression levels in each isoform of three regulatory components contribute to alteration in their functions, which may promote the MPTP opening.