Correlation between concentration in urine and in blood of cadmium and lead among women in Asia

Associations between environmental heavy metals exposure and preserved ratio impaired spirometry in the U.S. adults

We examined 9556 individuals aged 18 to 79 years who had information on spirometry testing and heavy metals and used multivariable logistic or linear regression to evaluate associations between serum levels of cadmium, lead, and mercury and PRISm and lung function in U.S. adults, which were conducted first in all participants, and then separately in never/former smokers and current smokers. The overall prevalence of PRISm was 7.02%. High levels of serum cadmium were significantly associated with PRISm in all individuals, no matter in never/former smokers (quartile 4 vs 1, the OR = 2.517, 95% CI = 1.376-4.604, p-trend = 0.0077) and current smokers (quartile 4 vs 1, the OR = 2.201, 95% CI = 1.265-3.830, p-trend = 0.0020). Serum lead and mercury were not significantly correlated with PRISm, regardless of smoking status. Serum cadmium was strongly correlated with lower FEV1/FVC, regardless of smoking status. Besides, serum cadmium was also significantly related to lower FVC % predicted in never/former smokers and lower FEV1% predicted in current smokers. Serum lead was strongly correlated with lower FVC % predicted and FEV1/FVC in all individuals and never/former smokers. And serum mercury was significantly associated with decrements in FVC % predicted in all individuals and current smokers. These findings demonstrate that serum cadmium is associated with a higher risk of PRISm and lower lung function, with the most significant effect on FEV1/FVC in particular. Our results also indicate that exposure to lead and mercury negatively affects lung function in never/former smokers and current smokers, respectively.

Independent and combined associations of multiple-heavy-metal exposure with lung function: a population-based study in US children

Previous research has found relationships between some single metals and lung function parameters. However, the role of simultaneous multi-metal exposure is poorly understood. The crucial period throughout childhood, when people are most susceptible to environmental dangers, has also been largely ignored. The study aimed to evaluate the joint and individual associations of 12 selected urinary metals with pediatric lung function measures using multi-pollutant approaches. A total of 1227 children aged 6-17 years from the National Health and Nutrition Examination Survey database of the 2007-2012 cycles were used. The metal exposure indicators were 12 urine metals adjusted for urine creatinine, including arsenic (As), barium (Ba), cadmium (Cd), cesium (Cs), cobalt (Co), mercury (Hg), molybdenum (Mo), lead (Pb), antimony (Sb), thallium (Tl), tungsten (Tu), and uranium (Ur). The outcomes of interest were lung function indices, including the 1st second of a forceful exhalation (FEV₁), forced vital capacity (FVC), forced expiratory flow between 25 and 7% of vital capacity (FEF_25-75%), and peak expiratory flow (PEF). Multivariate linear regression, quantile g-computation (QG-C), and Bayesian kernel machine regression models (BKMR) were adopted. A significantly negative overall effect of metal mixtures on FEV₁ (β = - 161.70, 95% CI - 218.12, - 105.27; p < 0.001), FVC (β = - 182.69, 95% CI - 246.33, - 119.06; p < 0.001), FEF_25-75% (β = - 178.86 (95% CI - 274.47, - 83.26; p < 0.001), and PEF (β = - 424.17, 95% CI - 556.55, - 291.80; p < 0.001) was observed. Pb had the largest negative contribution to the negative associations, with posterior inclusion probabilities (PIPs) of 1 for FEV₁, FVC, and FEF_25-75%, and 0.9966 for PEF. And Pb's relationship with lung function metrics showed to be nonlinear, with an approximate "L" shape. Potential interactions between Pb and Cd in lung function decline were observed. Ba was positively associated with lung function metrics. Metal mixtures were negatively associated with pediatric lung function. Pb might be a crucial element. Our findings highlight the need for prioritizing children's environmental health to protect them from later respiratory disorders and to guide future research into the toxic mechanisms of metal-mediated lung function injury in the pediatric population.

Combined exposure to multiple metals on cardiovascular disease in NHANES under five statistical models

BACKGROUND

It is well-documented that heavy metals are associated with cardiovascular disease (CVD). However, there is few studies exploring effect of metal mixture on CVD. Therefore, the primary objective of present study was to investigate the joint effect of heavy metals on CVD and to identify the most influential metals in the mixture.

METHODS

Original data for study subjects were obtained from the National Health and Nutrition Examination Survey. In this study, adults with complete data on 12 kinds of urinary metals (antimony, arsenic, barium, cadmium, cobalt, cesium, molybdenum, mercury, lead, thallium, tungsten, and uranium), cardiovascular disease, and core covariates were enrolled. We applied five different statistical strategies to examine the CVD risk with metal exposure, including multivariate logistic regression, adaptive elastic net combined with Environmental Risk Score, Quantile g-computation, Weighted Quantile Sum regression, and Bayesian kernel machine regression.

RESULTS

Higher levels of cadmium, tungsten, cobalt, and antimony were significantly associated with Increased risk of CVD when covariates were adjusted for multivariate logistic regression. The results from multi-pollutant strategies all indicated that metal mixture was positively associated with the risk of CVD. Based on the results of multiple statistical strategies, it was determined that cadmium, tungsten, cobalt, and antimony exhibited the strongest positive correlations, whereas barium, lead, molybdenum, and thallium were most associated with negative correlations.

CONCLUSION

Overall, our study demonstrates that exposure to heavy metal mixture is linked to a higher risk of CVD. Meanwhile, this association may be driven primarily by cadmium, tungsten, cobalt, and antimony. Further prospective studies are warranted to validate or refute our primary findings as well as to identify other important heavy metals linked with CVD.

Cadmium exposure and risk of diabetes and prediabetes: A systematic review and dose-response meta-analysis

BACKGROUND

Cadmium exposure has been associated with increased diabetes risk in several studies, though there is still considerable debate about the magnitude and shape of the association.

OBJECTIVE

To perform a systematic review and meta-analysis of observational studies investigating the relation between cadmium exposure and risk of type 2 diabetes and prediabetes, and to summarize data on the magnitude and shape of the association.

DATA SOURCE

After conducting an online literature search through October 1, 2021, we identified 42 eligible studies investigating the association between cadmium exposure and risk of diabetes and prediabetes.

STUDY ELIGIBILITY CRITERIA

We included studies that assessed cadmium exposure through biomarker levels; examined type 2 diabetes or prediabetes among outcomes; and reported effect estimates for cadmium exposure for meta-analysis only.

STUDY APPRAISAL AND SYNTHESIS METHODS

Studies were evaluated using ROBINS-E risk of bias tool. We quantitively assessed the relation between exposure and study outcomes using one-stage dose-response meta-analysis with a random effects meta-analytical model.

RESULTS

In the meta-analysis, comparing highest-versus-lowest cadmium exposure levels, summary relative risks (RRs) for type 2 diabetes were 1.24 (95% confidence interval 0.96-1.59), 1.21 (1.00-1.45), and 1.47 (1.01-2.13) for blood, urinary, and toenail matrices, respectively. Similarly, there was an increased risk of prediabetes for cadmium concentrations in both urine (RR = 1.41, 95% CI: 1.15-1.73) and blood (RR = 1.38, 95% CI: 1.16-1.63). In the dose-response meta-analysis, we observed a consistent linear positive association between cadmium exposure and diabetes risk, with RRs of 1.25 (0.90-1.72) at 2.0 µg/g of creatinine. Conversely for blood cadmium, diabetes risk appeared to increase only above 1 µg/L. Prediabetes risk increased up to approximately 2 µg/g creatinine above which it reached a plateau with RR of 1.42 (1.12-1.76) at 2 µg/g creatinine.

LIMITATIONS AND CONCLUSIONS

This analysis provides moderate-certainty evidence for a positive association between cadmium exposure (measured in multiple matrices) and risk of both diabetes and prediabetes.

Low-level lead exposure is associated with aberrant sperm quality and reproductive hormone levels in Chinese male individuals: Results from the MARHCS study low-level lead exposure is associated with aberrant sperm quality

Studies in animals suggest an adverse effect of high-level lead exposure on male reproductive outcomes. However, evidence of the effects of low-level lead exposure is inconsistent. The purpose of our study was to explore the relationship between low-level lead exposure from daily environmental contaminants and semen quality in a community population without occupational exposure. We recruited 751 students in the Male Reproductive Health in Chongqing College Students (MARHCS) study and 190 community males from Bishan, Chongqing. Eight urinary metals (Pb, Cd, As, Cu, Zn, Ni, Mn, and Cr), semen quality, and serum sex hormones were detected. Even if the blood lead concentration was below the US lead poisoning standard for children (100 μg/L), a significant dose-response relationship was found between lead exposure and a decrease in semen quality. Multilinear regression showed that urinary Pb was negatively associated with sperm concentration, total sperm count, progressive motility and total sperm motility (regression coefficient: -0.074, -0.103, -0.024, and -0.014, respectively; p: <0.001, <0.001, 0.007, and <0.001, respectively), accompanied by decreased serum follicle-stimulating hormone, serum testosterone and the testosterone/luteinizing hormone ratio (β coefficient: -0.090, -0.082, and -0.020, respectively; p: 0.002, <0.001, and 0.021, respectively). Logistic regression also indicated that the risk of having abnormal semen quality was higher in the high Pb group (OR: 2.501, 95% CI: 1.411, 4.435, p = 0.002) than in the low Pb group after adjusting for confounders, with a dose-response relationship in the trend test (p = 0.007). Our results revealed an inverse association between Pb exposure at low levels and semen quality.

Association of plasma and urine metals levels with kidney function: A population-based cross-sectional study in China

OBJECTIVES

Although environmental exposure to multiple metals is common, epidemiological studies on the associations of exposure to 23 metals with kidney function have not been analyzed. We aimed to investigate the associations of 23 metals levels with renal function.

METHODS

We conducted a cross-sectional study in four rural regions of Hunan province. Plasma and urine metals levels were determined by inductively coupled plasma mass spectrometer (ICP-MS). Two-level logistic regression was used to investigate the associations of metals levels with estimated glomerular filtration rate (eGFR) with adjustment for confounding factors. We conducted a sensitivity analysis of the results using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation.

RESULTS

A total of 3553 participants completed the investigation. Five metals (plasma arsenic and molybdenum; urine copper, rubidium, and strontium) were identified to be significantly associated with renal function. Participants in the highest quartile of plasma arsenic and molybdenum were at 17.95 (95% CI: 6.35-50.76) and 24.23 (95% CI: 7.42-79.19) fold risk of abnormal eGFR, respectively, compared with the lowest quartile. The highest quartiles of urine copper, rubidium, and strontium were associated with 3.70 (95% CI:1.92-7.14), 0.16 (95% CI:0.07-0.37) and 0.08 (95% CI: 0.03-0.21) fold risk of abnormal eGFR. The sensitivity analysis revealed that plasma arsenic, molybdenum and urine copper, rubidium and strontium levels retained similar associations with abnormal eGFR.

CONCLUSION

Plasma arsenic and molybdenum, and urine copper are risk factors for abnormal renal function, while urine rubidium and strontium are protective factors for renal function.

Oral Bioaccessibility and Exposure Risk of Metal(loid)s in Local Residents Near a Mining-Impacted Area, Hunan, China

Metal(loid) contamination of food crops and soils resulting from mining activities has been a major concern due to the potential risk to humans. In this study, a total of 36 rice (home-grown and market rice), 38 vegetable, 10 drinking water, 4 river water, 18 soils and 30 urine samples were collected from an abandoned mining area or the local residents in China. Results showed that metal(loid) levels in some of the soil and drinking water samples exceeded the Chinese standard. Rice Cd concentration, rice Pb levels, and vegetable Pb levels exceeded the maximum permissible concentrations in 49%, 68%, and 42% of the samples, respectively. In gastric phases, the average Cd, Pb and As bioaccessibilities in rice were 72%, 70%, and 82%. In gastrointestinal phases, the average Cd, Pb and As bioaccessibilities in rice were 49%, 39%, and 94%. Vegetables (pak choi was selected) showed lower metal(loid) bioaccessibility than rice. The median concentrations of Cd, Pb and As in urine were 3.99, 4.82 and 64.8 µg L⁻¹, respectivley. Rice had the highest contribution rates of Cd and Pb for daily intake, accounting for 114% and 210%, respectively. Vegetables contributed less, and very little contribution came from drinking water. Based on the bioaccessibility data, metal(loid) contamination around the mining area poses a great exposure risk to the local residents through consumption of food crops.

Urinary Lead Concentration Is an Independent Predictor of Cancer Mortality in the U.S. General Population

Lead is a ubiquitous pollutant that constitutes an environmental hazard worldwide. Although lead has been known as a carcinogenic factor in animal models, its role in human carcinogenesis is still a topic of debate with limited epidemiological evidence. Moreover, the association between urinary lead, as the most non-invasive and accessible way for lead measurement in human, and cancer mortality in general population has never been explored. We addressed this subject using continuous National Health and Nutrition Examination Survey 1999-2010 data and its Mortality Follow-Up Study. Of 5,316 subjects in study population, 161 participants died due to cancer. Cancer-specific mortality was associated with urinary lead levels after multivariable adjustment. Kaplan-Meier survival curve and cubic regression spline analyses indicated that high concentration of urinary lead exhibited significant association with raised death rate of cancer. Despite the marked decrease in environmental lead levels over the past three decades, lead exposure is still the significant determinant of cancer mortality in general population in U.S., and quantification of urinary lead may serve as a non-invasive approach to facilitate biomarker discovery and clinical translational research.

Food intake survey of kindergarten children in Korea: Part 3 cadmium and lead burden

OBJECTIVES

This study was initiated to elucidate the extent of dietary exposure of children in Korea to two pollutant metals of cadmium (Cd) and lead (Pb). Possible urban-rural difference was also examined.

METHODS

Food duplicate and morning spot urine samples were collected from 108 children in 4 kindergartens (KG) (1 KG in Seoul and 3 KGs in Jeju Island), as reported in a previous publication. The samples were analyzed for Cd and Pb by ICP-MS.

RESULTS

Cd and Pb in food duplicate and urine samples were distributed approximately log-normally. Geometric means for Cd and Pb in food duplicate samples were 12.4 and 5.8 μg/day, or 0.58 and 0.27 μg/kg body weight/day, respectively, and the values for Cd and Pb in urine (as observed, i.e., with no correction for urine density) were 0.91 and 1.64 μg/L, respectively. 2.41 and 0.30 μg/day of Cd and Pb (accounting for 19.5 and 5.1%) came from boiled rice, the staple food. The levels of Cd and Pb burden among the children in the present survey were essentially the same with the levels reported for children in Pusan. The reasons for difference in the rank in Cd-D and Cd-U among the 4 KGs need further study.

CONCLUSIONS

The observed levels of Cd and Pb exposure were more or less similar to what were reported for children in Pusan. No apparent urban-rural difference could be detected.

Levels and source apportionment of children's lead exposure: could urinary lead be used to identify the levels and sources of children's lead pollution?

As a highly toxic heavy metal, the pollution and exposure risks of lead are of widespread concern for human health. However, the collection of blood samples for use as an indicator of lead pollution is not always feasible in most cohort or longitudinal studies, especially those involving children health. To evaluate the potential use of urinary lead as an indicator of exposure levels and source apportionment, accompanying with environmental media samples, lead concentrations and isotopic measurements (expressed as (207)Pb/(206)Pb, (208)Pb/(206)Pb and (204)Pb/(206)Pb) were investigated and compared between blood and urine from children living in the vicinities of a typical coking plant and lead-acid battery factory. The results showed urinary lead might not be a preferable proxy for estimating blood lead levels. Fortunately, urinary lead isotopic measurements could be used as an alternative for identifying the sources of children's lead exposure, which coincided well with the blood lead isotope ratio analysis.

Exposure to heavy metals in blood and risk perception of the population living in the vicinity of municipal waste incinerators in Korea

BACKGROUND, AIM, AND SCOPE

The purpose of this study was to monitor and present the heavy metal concentrations in the blood of residents of areas near municipal waste incinerators (MWIs), who are more prone to environmental pollution. We also sought to compare and analyze the residents' perception of environmental pollution as one of the factors affecting heavy metal concentrations in the blood using a survey about the perceived damage caused by the facilities. Since heavy metal levels in the blood can be affected not only by local environmental pollution but also by personal and occupational factors, heavy metal levels in the blood need to be verified and consistently monitored.

METHODS

Residents who live within 300 m of MWIs in Seoul are acknowledged to be under indirect influence according to the Waste Disposal Act. A survey was given to 841 residents living within 300 m of a MWI from 2006 to 2009. The concentrations of heavy metals (lead, cadmium, and mercury) in the blood were measured in the 841 surveyed residents and in 105 residents in reference areas. Additionally, the perception of the damage caused by municipal waste incinerators was investigated using scores from 1 to 5 on a Likert scale.

RESULTS

The measurements of the heavy metal concentrations in the blood showed that the mean concentrations of lead, cadmium, and mercury were 43.1, 1.7, and 1.3 ug/L, respectively. The blood levels of lead and cadmium were slightly higher in the group of the subjects who had resided the longest near the municipal waste incinerators. When compared with the domestic investigation by the Ministry of Environment, the concentrations of lead and cadmium were a little higher, while that of mercury was a little lower. Overall, there was no significant difference in the distribution of heavy metal levels in the blood among age groups. Additionally, the investigation of the perceived damage from municipal waste incinerators showed that the subjects.

Estimation of dietary Pb and Cd intake from Pb and Cd in blood or urine

Successful trials were made to estimate the dietary daily intake of lead (Pb) and cadmium (Cd) via foods from the levels of the metals in blood or urine. In practice, 14 and 15 reports were available for Pb and Cd in blood (Pb-B and Cd-B), urine (Pb-U and Cd-U) and 24-h diet duplicates (Pb-D and Cd-D), respectively, from which 68 pairs each of Pb or Cd in blood and food duplicates [each being geometric mean (GM) values for the survey sites] were obtained. Regression analysis revealed that there was a significant correlation between Pb-B and Pb-D, and also between Cd-B and Cd-D, suggesting that it should be possible to estimate both Pb-D and Cd-D from Pb-B and Cd-B, respectively. For Cd-U, the number of available cases was limited (20 pairs), but a significant correlation was detected between Cd-U (as Cd-U(cr), or Cd levels in urine as corrected for creatinine concentration) and Cd-D. Care should be taken in estimating Pb-D from Pb-B, as the ratio of Pb-D over Pb-B may decrease as a function of increasing Pb-B levels. The Pb-D (μg/day) for typical Japanese women with Pb-B of 15 μg/l was best estimated to be 13.5 μg/day. No Cd-B- or Cd-U(cr)-dependent change was detected in case of Cd. The best estimate of Cd-D for Cd-B at 1.5 μg/l should be about 19.4 μg/day.

Assessment of blood and urine lead levels of some pregnant women residing in Lagos, Nigeria

Assessment of lead in blood (BLL) and lead in urine (ULL) of some non-occupationally exposed, nonsmoking 214 pregnant Nigerian women, aged 17 to 49 years, and resident in Lagos was carried out using atomic absorption spectrometry with control subjects consisting of 113 nonpregnant women. From results, the mean BLL and ULL (μg/dL) for pregnant women (59.5±2.1; 29.4±1.1) were significantly (p<0.01) higher than the values obtained for nonpregnant women (27.7±1.1; 9.2±0.6). BLL found in women in the first, second, and third trimesters were 57.2±2.3, 61.6±2.2, and 63.1±1.8, respectively. ULL could not serve to predict BLL due to weak correlations (r=-0.06 to +0.15; p>0.10). Study is a contribution to blood and urine lead status of Nigerian pregnant women, being relevant for healthcare management purposes, public health decision making, and possible primary prevention activities.

[Use of urine lead level as an exposure indicator and its relationship to blood lead]

The aim of this work was to verify whether there are statistically significant correlation between the concentrations of lead in blood (Pb-B) and urine (Pb-U). Electrothermal atomic absorption spectrometry was used in the determination of lead concentration in biological material. Venous blood and spot urine were collected from workers occupationally exposed (95), adults (130) and children up to 15 years old (22) environmentally exposed. After a test showing significant differences between Pb-U and the three categories previously determined, cutting points for Pb-U were established to predict Pb-B values by the ROC curve. Thus, it is expected that Pb-B is lower than 10 microg.dL-(1) with Pb-U up to 0.55 microg.dL-(1), whereas lead levels in blood below 27.6 microg.dL-(1) are expected when the amount of the metal in urine is lower than 2.05 microg.dL-(1). So, urine can be used to replace blood for the assessment of the occupational exposure to lead. However, caution is advised in the case of environmental exposure, since urinary lead should be used just as an estimation of the metal content in blood.

A comparison of elementary schoolchildren's exposure to arsenic and lead

One hundred fifty seven fifth-grade students (aged 10-12 years) from three elementary schools in three different towns in Taichung County, Taiwan were chosen as study subjects for the present arsenic and lead exposure study. The three towns--Longgang, Shalach, and Shuntain--are known to be highly, moderately, and lightly (control) polluted by As and Pb, respectively. Spot morning urine samples of students were collected and analyzed for arsenic and lead. The levels of As in the urine of Longgang schoolchildren showed the highest value among the three schools, while those of the control group (Shuntain) had the lowest values. In addition, the levels of Pb in the urine of the schoolchildren in Shuntain were significantly lower than those in Longgang and Shalach, while the levels of Pb in the urine of the schoolchildren in Longgang and Shalach showed no significant difference. Results of daily intake of metals from the different exposure pathways (i.e., ingestion from drinking water, household dust and food, and inhalation from airborne particles) showed that the Longgang area had the highest daily intake of As and Pb among the three areas, while the lowest daily intake of As and Pb occurred in the control area (Shuntain). A significant correlation between the doses of daily intake and urinary concentrations of As (p = 0.002) and Pb (p = 0.020) was observed. This correlation suggests that the increase of unit dose of the daily intake for As resulted in an increase of 0.953 microg g(-1) creatinine of As, whereas the increase of unit dose of the daily intake for Pb led to an increase of 0.053 microg g(-1) creatinine of Pb. These data indicate that the level of As in urine increased about 18 times higher than that of Pb for the same amount of increase in daily intake.

A global perspective on cadmium pollution and toxicity in non-occupationally exposed population

Cadmium is a non-essential element that has high rates of soil to plant transference compared with other non-essential elements, and certain plant species accumulate large amounts of cadmium from low cadmium content soils. In this paper, levels of cadmium found in major food groups are highlighted together with cadmium levels found in liver and kidney samples from non-occupationally exposed populations. Data on human kidney cadmium levels identified recently, including the study in our own laboratory, are compared with older studies. Human-tissue cadmium contents showed large variations among individuals, but sources of the variation remain unknown. Exposure levels of 30-50 microg per day have been estimated for adults and these levels have been linked to increased risk of bone fracture, cancer, kidney dysfunction and hypertension. Increased mortality was found among individuals showing signs of cadmium renal toxicity compared with those without such signs, suggesting that renal toxicity may be an early warning of complications, sub-clinical or clinical morbidity.