Lead levels in erythrocytes and biomarkers of bone turnover in pregnant and lactating women with marginal calcium intakes

Association between blood erythrocyte lead concentrations and hemoglobin levels in preschool children

Despite decades of intensive research, lead (Pb) toxicity still remains one of the most frequently investigated subjects in environmental health. Whole blood lead (BPb) is usually used to evaluate Pb exposure for both screening and clinical diagnosis. However, it is generally recognized that BPb is not a sensitive biomarker for Pb exposure in hematological studies. Considering hematocrit (HCT) variation in different situations, HCT-adjusted BPb or erythrocyte Pb (EPb) may be more relevant when evaluating the hematotoxicity of blood Pb. Data collected from 855 preschool children, 3-7 years of age, allowed us to examine the relationship between EPb and hemoglobin (Hb) levels. Multivariate linear regression was performed to determine the significance of EPb as predictor of Hb after covariate adjustment; then, mean differences of Hb levels between quartiles of EPb and BPb (1st quartile as reference) were determined using ANOVA followed by Student's t test. The dose-response curve between EPb and HCT was plotted using locally weighted scatterplot smoothing (LOWESS) method. A doubling of EPb was associated with a 2.44 g/L decrease in Hb level. Compared to the 1st quartile group of EPb, the 3rd and 4th quartile groups showed significant decreases in Hb levels (3.01 and 3.97 g/L, respectively). Compared to the 1st quartile group of BPb, the 2nd quartile group showed a decrease in Hb levels (0.63 g/L), while the 3rd and 4th quartile groups showed increases in Hb levels (0.78 and 1.45 g/L, respectively). Increased EPb levels are significantly associated with decreased Hb levels in preschool children. HCT must be taken into consideration in investigating the hematological effects of Pb. Compared to BPb, EPb or HCT-adjusted BPb appear as a more effective biomarker to interpret the hematotoxicity of lead. Furthermore, blood erythrocytes are not only a repository of Pb but also a primary target of its toxicity.

Dispersive liquid-liquid microextraction of lead(II) as 5-(4-dimethylaminobenzylidene) rhodanine chelates from food and water samples

A dispersive liquid-liquid microextraction procedure for lead(II) as its 5-(4-dimethylaminobenzylidene) rhodanine complex has been established prior to its microsampling flame atomic absorption spectrometric determination. The influences of various analytical parameters including pH, solvent type and volume, dispersive solvent type and volume, 5-(4-dimethylaminobenzylidene) rhodanine amount, salt effect, and centrifugation time and speed were investigated. The effects of certain alkali, alkaline earth, and transition metal ions on the quantitative extraction of lead(II) were also studied. Quantitative recoveries were obtained at pH 6. The enrichment factor was calculated as 125. The detection limit for lead is 1.1 μg/L. The accuracy of the method was tested with the additions recovery test and analysis of the standard reference materials (SPS-WW2 waste water, NIST SRM 1515 apple leaves, and TMDA-51.3 fortified water). Applications of the present procedure were tested by analyzing water and food samples.

Exposure to heavy metals (lead, cadmium and mercury) and its effect on the outcome of in-vitro fertilization treatment

We investigated the effect of lead, cadmium and mercury exposure on pregnancy and fertilization rate outcome among 619 Saudi women (age 19-50 years) who sought in-vitro fertilization (IVF) treatment between 2002 and 2003. The concentrations of lead, cadmium and mercury were measured in both blood and follicular fluids. At levels well below the current US occupational exposure limit guidelines (40microg/dL) and even less than the current Centers for Disease Control and Prevention level of concern for preventing lead poisoning in children (10microg/dL), blood lead level was negatively associated with fertilization outcome in both adjusted and unadjusted logistic regression models. We found that among various demographic, socioeconomic and environmental factors, fish consumption was positively associated with blood lead levels. These results support the hypothesis that a raised blood lead level affects infertility and intervention to reduce the lead exposure might be needed for women of reproductive age. The present results also revealed unexpected finding - the positive relationship between follicular cadmium levels and fertilization outcome, which points to the necessity for further investigation. Though adverse effect of mercury on pregnancy outcome or fertilization rate was not evident in this study, mercury5.8microg/L (EPA safety limit) was found in the blood and follicular fluid of 18.7% and 8.3% of the women, respectively. Concerns about its possible adverse effects on the physiology of reproduction or fetal development cannot be ruled out. It should be noted that skin-lightening creams and dental amalgam were important contributors to mercury exposure. Such finding is alarming and priority for further studies are, urgently, needed.

Early (in uterus and infant) exposure to mercury and lead

Mercury and lead are toxic metals widely spread in the environment with bio-accumulative features that raises public health concerns. Both metals are equally dispersed in the human food chain but exposure and risk of toxicity during early human development are modulated by the diet and nutritional status. Understanding how Hg and Pb occur and interact with nutrients is fundamental to establish guidelines for diminishing exposure and the risk of toxicity. The risk of fetal and infant exposure to Hg can be influenced by maternal amalgam filling (inorganic Hg) and fish consumption (monomethyl Hg), whereas the risk of exposure to Pb is complex: maternal absorption depends on nutrient interactions (Ca and P); and maternal body Pb accumulation responds to all factors known to interact with bone and calcium metabolism. Maternal exposure to Hg and Pb is more important during fetal development than during breastfeeding. Moreover, these metals (especially Pb) are frequently higher in infant formulas which do not carry the nutritional and psychological advantages and protection of breastfeeding. Infant's reference dose is lower for Hg than for Pb, but risk of Pb contamination for fetuses and infant (breast- or formula-fed) is higher and lasts longer than Hg. Breastfeeding is essential to complete infant development. Interruption or suppression of breast-feeding with cow's milk-based formulas is not an option to environmental pollution.

A cinética do chumbo no organismo humano e sua importância para a saúde

O chumbo é um dos contaminantes ambientais mais comuns, tóxico para os homens e animais, e sem nenhuma função fisiológica conhecida no organismo. Seus efeitos nocivos podem afetar praticamente todos os órgãos e sistemas do organismo humano. O chumbo entra no corpo principalmente por inalação ou ingestão, sendo diretamente absorvido, distribuído e excretado. Os tratos gastrointestinal e respiratório são os principais sítios de absorção do chumbo que, uma vez absorvido, é encontrado no sangue, tecidos moles e mineralizados. Cerca de 90% do chumbo corpóreo se armazena nos ossos, principal depósito do metal no corpo. Aproximadamente 5% da concentração do chumbo no sangue se situa no plasma, representando a fração lábil e biologicamente ativa do chumbo, capaz de cruzar as membranas celulares e causar seus efeitos tóxicos. O chumbo absorvido é excretado principalmente pela urina e fezes. Assim, o conhecimento da cinética do chumbo é importante para maior compreensão da toxicidade deste metal, uma vez que os riscos de efeitos adversos à saúde estão relacionados com o conteúdo corpóreo total do chumbo.

Lead in breast milk and maternal bone turnover

OBJECTIVE

Our purpose was to determine whether breast milk lead (Pb) levels are correlated with maternal blood Pb levels, bone loss, or bone turnover during reproduction.

STUDY DESIGN

Data were collected prospectively at 0, 1.5, 3, 6, and 12 months after delivery in 15 lactating and 30 bottle-feeding women. Variables included breast milk Pb (inductively coupled mass spectrometry), maternal blood Pb (atomic absorption spectrophotometry), osteocalcin (radioimmunoassay), and bone mineral density change (dual-energy x-ray absorptiometry).

RESULTS

Mean Pb breast milk concentrations were 6.1, 5.6, 5.9, and 4.3 ng/mL at the 1.5, 3, 6, and 12 months post partum, whereas mean maternal blood Pb concentrations were 1.4, 1.6, 1.7, and 1.4 microg/dL at 0, 3, 6, and 12 months post partum. The 5.6% bone loss and significant bone turnover were related to breast milk Pb levels but not to postpartum maternal blood Pb levels. Maternal and breast milk Pb values were modestly correlated at 1 to 2 months.

CONCLUSIONS

Bone loss and bone turnover were related to breast milk Pb levels. In these women, there was no evidence that either high maternal blood or breast milk Pb concentrations are a major public health concern.

Calcium supplementation during lactation blunts erythrocyte lead levels and delta-aminolevulinic acid dehydratase zinc-reactivation in women non-exposed to lead and with marginal calcium intakes

The purpose of this study was to evaluate the effect of calcium supplementation during lactation on changes in blood lead indices from late pregnancy to early lactation in women with low calcium intakes and low lead-exposure. Forty-seven women, non-occupationally exposed to lead and with habitually low calcium intake ( approximately 600 mg/d), participated in the study from 29 to 38 weeks of pregnancy to 7-8 weeks post-partum, non-supplemented (n=25) and supplemented (n=22) with calcium (500 mg/d) during 6 weeks after delivery. Erythrocyte lead (PbRBC) and in vitro reactivation with zinc of blood delta-aminolevulinic acid dehydratase (Zn-delta-ALAD% reactivation) were used as lead indices. In the non-supplemented group, PbRBC and Zn-delta-ALAD% reactivation increased significantly (P<0.001) from pregnancy (0.202+/-0.049 microg Pb/g protein and 18.3+/-6.0%) to lactation (0.272+/-0.070 microg Pb/g protein and 22.7+/-6.2%). No significant changes of these indices were observed in the calcium-supplemented group from pregnancy (0.203+/-0.080 microg Pb/g protein and 15.8+/-4.5%) to lactation (0.214+/-0.066 microg Pb/g protein and 16.3+/-4.1%). PbRBC levels and Zn-delta-ALAD% reactivation at lactation were lower (P<0.05) and hematocrit levels were higher (P<0.05) in the calcium-supplemented compared to the non-supplemented women. Calcium supplementation during lactation appears to blunt the lactation-induced increase in maternal blood lead and its inhibitory effect on delta-ALAD and possibly on maternal erythropoiesis.