Unprecedentedly High Dust Ingestion Estimates for the General Population in a Mining District of DR Congo

Cottage industry as a source of high exposure to lead: A biomonitoring study among people involved in manufacturing cookware from scrap metal

In low-income countries, a widespread but poorly studied type of cottage industry consists of melting scrap metal for making cookware. We assessed the exposure to lead (Pb) among artisanal workers, and their families, involved in manufacturing cookware from scrap metal. In a cross-sectional survey, we compared artisanal cookware manufacturing foundries with carpentry workshops (negative controls) and car battery repair workshops (positive controls), all located in residential areas, in Lubumbashi (DR Congo). We collected surface dust in the workspaces, and blood and urine samples among workers, as well as residents living in the cookware workshops. Trace elements were quantified in the samples by Inductively Coupled Plasma Mass Spectrometry (ICP-MS). In surface dust, median Pb concentrations were higher in cookware foundries (347 mg/kg) than in carpentries (234 mg/kg) but lower than in battery repair workshops (22,000 mg/kg). In workers making the cookware (n = 24), geometric mean (GM) Pb blood cencentration was 118 μg/L [interquartile range (IQR) 78.4-204], i.e. nearly twice as high as among carpenters [60.2 μg/L (44.4-84.7), n = 33], and half the concentration of battery repair workers [255 μg/L (197-362), n = 23]. Resident children from the cookware foundries, had higher urinary Pb [6.2 μg/g creatinine (2.3-19.3), n = 6] than adults [2.3 (2.2-2.5), n = 3]. Our investigation confirms the high Pb hazard linked to car battery repair and reveals a high exposure to Pb among artisanal cookware manufacturers and their families, especially children, in residential areas of a city in a low-income country.

Dietary Galactooligosaccharides Supplementation as a Gut Microbiota-Regulating Approach to Lower Early Life Arsenic Exposure

Prebiotics may stimulate beneficial gut microorganisms. However, it remains unclear whether they can lower the oral bioavailability of early life arsenic (As) exposure via regulating gut microbiota and altering As biotransformation along the gastrointestinal (GI) tract. In this study, weanling mice were exposed to arsenate (iAsV) via diet (7.5 μg As g-1) amended with fructooligosaccharides (FOS), galactooligosaccharides (GOS), and inulin individually at 1% and 5% (w/w). Compared to As exposure control mice, As concentrations in mouse blood, liver, and kidneys and As urinary excretion factor (UEF) were reduced by 43.7%-74.1% when treated with 5% GOS. The decrease corresponded to a significant proliferation of Akkermansia and Psychrobacter, reduced percentage of inorganic arsenite (iAsIII) and iAsV by 47.4% and 65.4%, and increased proportion of DMAV in intestinal contents by 101% in the guts of mice treated with 5% GOS compared to the As control group. In contrast, FOS and inulin either at l% or 5% did not reduce As concentration in mouse blood, liver, and kidneys or As UEF. These results suggest that GOS supplementation may be a gut microbiota-regulating approach to lower early life As exposure via stimulating the growth of Akkermansia and Psychrobacter and enhancing As methylation in the GI tract.

Transplacental transfer of cobalt: Evidence from a study of mothers and their neonates in the African Copperbelt

BACKGROUND

Transfer of the trace metal cobalt (Co) from mother to foetus has not been documented in populations with high environmental exposure to Co, as is the case in the African Copperbelt mining region. We analysed data obtained from 246 mother-infant pairs included (at delivery) in a previously published case-control study on birth defects, done in Lubumbashi (Democratic Republic of Congo) between March 1, 2013, and Feb 28, 2015.

METHODS

Co was measured by Inductively Coupled Plasma Mass Spectrometry in maternal blood, maternal urine, umbilical cord blood and placental tissue, as available.

RESULTS

The Co concentrations [geometric mean (GM) with interquartile range (IQR)] in maternal blood (GM 1.77 µg/L, IQR 1.07-2.93) and urine (GM 7.42 µg/g creatinine, IQR 4.41-11.0) were highly correlated (Spearman r = 0.71, n = 166; p < 0.001) and considerably higher than reference values determined for general populations elsewhere in the world. The concentrations of Co in umbilical cord blood (GM 2.41 µg/L) were higher (Wilcoxon test, p < 0.001) than in maternal blood (GM 1.37 µg/L), with a correlation between both values (Spearman r = 0.34; n = 127, p < 0.001). Co concentrations in placental tissue (geometric mean 0.02 µg/g wet weight) correlated with concentrations in maternal blood (Spearman r = 0.50, n = 86, p < 0.001) and in neonatal blood (Spearman r = 0.23, n = 83, p = 0.039).

CONCLUSION

This first study of maternal and neonatal Co concentrations in the African Copperbelt provides strong evidence of a high transfer of Co from mother to foetus.

Occurrence of microplastics and disturbance of gut microbiota: a pilot study of preschool children in Xiamen, China

BACKGROUND

Microplastics (MPs) have garnered widespread attention because of their presence in human placenta, stool, and even blood. Ingestion is considered the major route of human exposure to MPs. It has been found that the consumption of food and water is associated with more MP abundance in human stools. The usage of plastic containers, particularly feeding bottles, may be a major contributor to MP contamination. However, human exposure to MPs and potential factors that influence exposure, especially for preschoolers, remains largely unknown. When exposed to MPs, mice exhibited gut microbiota dysbiosis, including alterations in diversity indices, a decreased relative abundance of probiotics and an increased abundance of pathogenic bacteria. Such results have also been observed in human gut in vitro models, however, the actual association between MP exposure and human intestinal microbiota remains unclear. Therefore, this study aimed to evaluate MP concentrations in preschoolers' stools, explore possible dietary factors that influence preschooler exposure to MPs, and investigate their potential association with the gut microbiota.

METHODS

A cross-sectional study was conducted in Xiamen, China in October 2022. We investigated the feeding behaviours and dietary habits of preschool children. A total of 69 couples of stool samples were collected and analyzed for MPs test and gut microbiota analysis. Pyrolysis-gas chromatography coupled with mass spectrometry (Py-GC/MS) was used for quantifying 11 types of MPs. The gut microbiota composition was analyzed by 16S rRNA gene sequencing.

FINDINGS

The results showed that only polyvinyl chloride (PVC), polyethylene terephthalate (PET), polyethylene (PE), and polyamide 6 (PA6) were detected in 85.5% stool samples, with concentrations of 317.4 (152.0, 491.9) μg/g dw, 299.0 (196.1, 619.9) μg/g dw, 206.2 (154.1, 240.3) μg/g dw, and 17.9 (13.4, 18.6) μg/g dw, respectively. The median estimated daily intake (EDI) for preschoolers was 425.9 (272.5, 762.3) μg/kg-bw/d. Dairy intake may influence MP concentration in preschoolers' stools, and the usage of feeding bottles may be a specific source of MP contamination. Moreover, higher PVC concentrations were observed in the stools when the children took more time to eat a meal. MP exposure was inversely associated with alpha indices and possibly affected certain probiotic taxa, such as Parabacteroides and Alistipes, in preschool children.

INTERPRETATION

Our data provided baseline evidence for MP exposure doses and potential dietary factors that may influence MP exposure in preschoolers. These findings supported the perspective that MP exposure might be associated with the disturbance of gut microbiota. Further studies focusing on sensitive populations with larger sample sizes are needed.

FUNDING

This study was funded by the National Natural Science Foundation of China (grant number: 82003412), the Shanghai Municipal Health Commission (grant number: 20214Y0019), and the Project of Shanghai Municipal Financial Professional foundation (Food Safety Risk Assessment) (grant number: RA-2022-06).

Arsenic Ingested Early in Life Is More Readily Absorbed: Mechanistic Insights from Gut Microbiota, Gut Metabolites, and Intestinal Morphology and Functions

Early-life arsenic (As) exposure is a particular health concern. However, it is unknown if As ingested early in life is more readily absorbed from the gastrointestinal (GI) tract, i.e., higher in oral bioavailability. Here, weanling (3-week) and adult (6-week-old) female mice were exposed to arsenate in the diet (10 μg g^-1) over a 3-week period with As oral bioavailability estimated using As urinary excretion as the bioavailability endpoint. The As urinary excretion factor was 1.54-fold higher in weanling mice compared to adult mice (82.2 ± 7.29 versus 53.1 ± 3.73%), while weanling mice also showed 2.28-, 1.50-, 1.48-, and 1.89-fold higher As concentration in small intestine tissue, blood, liver, and kidneys, demonstrating significantly higher As oral bioavailability of early-life exposure. Compared to adult mice, weanling mice significantly differed in gut microbiota, but the difference did not lead to remarkable differences in As biotransformation in the GI tract or tissue and in overall gut metabolite composition. Although the expression of several metabolites (e.g., atrolactic acid, hydroxyphenyllactic acid, and xanthine) was up-regulated in weanling mice, they had limited ability to elevate As solubility in the intestinal tract. Compared to adult mice, the intestinal barrier function and intestinal expression of phosphate transporters responsible for arsenate absorption were similar in weanling mice. However, the small intestine of weanling mice was characterized by more defined intestinal villi with greater length and smaller width, providing a greater surface area for As to be absorbed across the GI barrier. The results highlight that early-life As exposure can be more readily absorbed, advancing the understanding of its health risk.

Ca Minerals and Oral Bioavailability of Pb, Cd, and As from Indoor Dust in Mice: Mechanisms and Health Implications

BACKGROUND

Elevating dietary calcium (Ca) intake can reduce metal(loid)oral bioavailability. However, the ability of a range of Ca minerals to reduce oral bioavailability of lead (Pb), cadmium (Cd), and arsenic (As) from indoor dust remains unclear.

OBJECTIVES

This study evaluated the ability of Ca minerals to reduce Pb, Cd, and As oral bioavailability from indoor dust and associated mechanisms.

METHODS

A mouse bioassay was conducted to assess Pb, Cd, and As relative bioavailability (RBA) in three indoor dust samples, which were amended into mouse chow without and with addition of CaHPO4,  CaCO3, Ca gluconate, Ca lactate, Ca aspartate, and Ca citrate at 200-5,000μg/g Ca. The mRNA expression of Ca and phosphate (P) transporters involved in transcellular Pb, Cd and As transport in the duodenum of mice was quantified using real-time polymerase chain reaction. Serum 1,25-Dihydroxyvitamin D3 [1,25(OH)2D3], parathyroid hormone (PTH), and renal CYP27B1 activity controlling 1,25(OH)2D3 synthesis were measured using ELISA kits. Metal(loid) speciation in the feces of mice was characterized using X-ray absorption near-edge structure (XANES) spectroscopy.

RESULTS

In general, mice exposed to each of the Ca minerals exhibited lower Pb-, Cd-, and As-RBA for three dusts. However, RBAs with the different Ca minerals varied. Among minerals, mice fed dietary CaHPO4 did not exhibit lower duodenal mRNA expression of Ca transporters but did have the lowest Pb and Cd oral bioavailability at the highest Ca concentration (5,000μg/g Ca; 51%-95% and 52%-74% lower in comparison with the control). Lead phosphate precipitates (e.g., chloropyromorphite) were observed in feces of mice fed dietary CaHPO4. In comparison, mice fed organic Ca minerals (Ca gluconate, Ca lactate, Ca aspartate, and Ca citrate) had lower duodenal mRNA expression of Ca transporters, but Pb and Cd oral bioavailability was higher than in mice fed CaHPO4. In terms of As, mice fed Ca aspartate exhibited the lowest As oral bioavailability at the highest Ca concentration (5,000μg/g Ca; 41%-72% lower) and the lowest duodenal expression of P transporter (88% lower). The presence of aspartate was not associated with higher As solubility in the intestine.

DISCUSSION

Our study used a mouse model of exposure to household dust with various concentrations and species of Ca to determine whether different Ca minerals can reduce bioavailability of Pb, Cd, and As in mice and elucidate the mechanism(s) involved. This study can contribute to the practical application of optimal Ca minerals to protect humans from Pb, Cd, and As coexposure in the environment. https://doi.org/10.1289/EHP11730.

Contaminant Binding and Bioaccessibility in the Dust From the Ni-Cu Mining/Smelting District of Selebi-Phikwe (Botswana)

We studied the dust fractions of the smelting slag, mine tailings, and soil from the former Ni-Cu mining and processing district in Selebi-Phikwe (eastern Botswana). Multi-method chemical and mineralogical investigations were combined with oral bioaccessibility testing of the fine dust fractions (<48  and <10 μm) in a simulated gastric fluid to assess the potential risk of the intake of metal(loid)s contaminants. The total concentrations of the major contaminants varied significantly (Cu: 301-9,600 mg/kg, Ni: 850-7,000 mg/kg, Co: 48-791 mg/kg) but were generally higher in the finer dust fractions. The highest bioaccessible concentrations of Co, Cu, and Ni were found in the slag and mine tailing dusts, where these metals were mostly bound in sulfides (pentlandite, pyrrhotite, chalcopyrite). On the contrary, the soil dusts exhibited substantially lower bioaccessible fractions of these metals due to their binding in less soluble spinel-group oxides. The results indicate that slag dusts are assumed to be risk materials, especially when children are considered as a target group. Still, this exposure scenario seems unrealistic due to (a) the fencing of the former mine area and its inaccessibility to the local community and (b) the low proportion of the fine particles in the granulated slag dump and improbability of their transport by wind. The human health risk related to the incidental ingestion of the soil dust, the most accessible to the local population, seems to be quite limited in the Selebi-Phikwe area, even when a higher dust ingestion rate (280 mg/d) is considered.

Landscape Analysis of Cobalt Mining Activities from 2009 to 2021 Using Very High Resolution Satellite Data (Democratic Republic of the Congo)

The cobalt mining sector is well positioned to be a key contributor in determining the success of the Democratic Republic of the Congo (DRC) in meeting the Sustainable Development Goals (SDGs) by 2030. Despite the important contribution to the DRC’s economy, the rapid expansion of mining operations has resulted in major social, health, and environmental impacts. The objective of this study was to quantitatively assess the cumulative impact of mining activities on the landscape of a prominent cobalt mining area in the DRC. To achieve this, an object-based method, employing a support vector machine (SVM) classifier, was used to map land cover across the city of Kolwezi and the surrounding mining areas, where long-term mining activity has dramatically altered the landscape. The research used very high resolution (VHR) satellite imagery (2009, 2014, 2019, 2021) to map the spatial distribution of land cover and land cover change, as well as analyse the spatial relationship between land cover classes and visually identified mine features, from 2009 to 2021. Results from the object-based SVM land cover classification produced an overall accuracy of 85.2–90.4% across the time series. Between 2009 and 2021, land cover change accounted to: rooftops increasing by 147.2% (+7.7 km2); impervious surface increasing by 104.7% (+3.35 km2); bare land increasing by 85.4% (+33.81 km2); exposed rock increasing by 56.2% (+27.46 km2); trees decreasing by 4.5% (−0.34 km2); shrub decreasing by 38.4% (−26.04 km2); grass and cultivated land decreasing by 27.1% (−45.65 km2); and water decreasing by 34.6% (−3.28 km2). The co-location of key land cover classes and visually identified mine features exposed areas of potential environmental pollution, with 91.6% of identified water situated within a 1 km radius of a mine feature, and vulnerable populations, with 71.6% of built-up areas (rooftop and impervious surface class combined) situated within a 1 km radius of a mine feature. Assessing land cover patterns over time and the interplay between mine features and the landscape structure allowed the study to amplify the findings of localised on-the-ground research, presenting an alternative viewpoint to quantify the true scale and impact of cobalt mining in the DRC. Filling geospatial data gaps and examining the present and past trends in cobalt mining is critical for informing and managing the sustainable growth and development of the DRC’s mining sector.

Geospatial approach to investigate spatial clustering and hotspots of blood lead levels in children within Kabwe, Zambia

BACKGROUND

Communities around Kabwe, Zambia are exposed to lead due to deposits from an old lead (Pb) and zinc (Zn) mining site. Children are particularly more vulnerable than adults, presenting with greatest risk of health complications. They have increased oral uptake due to their hand to mouth activities. Spatial analysis of childhood lead exposure is useful in identifying specific areas with highest risk of pollution. The objective of the current study was to use a geospatial approach to investigate spatial clustering and hotspots of blood lead levels in children within Kabwe.

METHODS

We analysed existing data on blood lead levels (BLL) for 362 children below the age of 15 from Kabwe town. We used spatial autocorrelation methods involving the global Moran's I and local Getis-Ord Gi*statistic in ArcMap 10.5.1, to test for spatial dependency among the blood lead levels in children using the household geolocations.

RESULTS

BLL in children from Kabwe are spatially autocorrelated with a Moran's Index of 0.62 (p < 0.001). We found distinct hotspots (mean 51.9 μg/dL) in communities close to the old lead and zinc-mining site, lying on its western side. Whereas coldspots (mean 7 μg/dL) where observed in areas distant to the mine and traced on the eastern side. This pattern suggests a possible association between observed BLL and distance from the abandoned lead and zinc mine, and prevailing winds.

CONCLUSION

Using geocoded data for households, we found clustering of childhood blood lead and identified distinct hotspot areas with high lead levels for Kabwe town. The geospatial approach used is especially valuable in resource-constrained settings like Zambia, where the precise identification of high risk locations allows for the initiation of targeted remedial and treatment programs.

Radionuclides and Radiation Exposure in Tantalite Mining, Ethiopia

Tantalite and columbite ores have been reported as containing associated primordial radionuclides, such as uranium and thorium. Ethiopia is one of the world suppliers of tantalite ore through exploitation of Kenticha mine and tantalite production by a large number of artisanal miners. For the purpose of implementing the international standards for radiation protection of workers and members of the public, a preliminary assessment of radionuclides and radiation doses associated to tantalite mining was performed. Results confirmed and quantified the co-occurrence of uranium and thorium and their progeny in tantalite ore. Radiation doses at some workplaces may exceed the effective dose limit recommended by the international radiation safety standards for nonradiation workers and members of the public. Investments to be made in order to expand and modernize tantalite production in Ethiopia shall take into account the radiation hazards and implement a radiation protection program to prevent enhanced occupational radiation exposures and protect the public and the environment.

A Systematic Framework for Collecting Site-Specific Sampling and Survey Data to Support Analyses of Health Impacts from Land-Based Pollution in Low- and Middle-Income Countries

The rise of small-scale and localized economic activities in low- and middle-income countries (LMICs) has led to increased exposures to contaminants associated with these processes and the potential for resulting adverse health effects in exposed communities. Risk assessment is the process of building models to predict the probability of adverse outcomes based on concentration-response functions and exposure scenarios for individual contaminants, while epidemiology uses statistical methods to explore associations between potential exposures and observed health outcomes. Neither approach by itself is practical or sufficient for evaluating the magnitude of exposures and health impacts associated with land-based pollution in LMICs. Here we propose a more pragmatic framework for designing representative studies, including uniform sampling guidelines and household surveys, that draws from both methodologies to better support community health impact analyses associated with land-based pollution sources in LMICs. Our primary goal is to explicitly link environmental contamination from land-based pollution associated with specific localized economic activities to community exposures and health outcomes at the household level. The proposed framework was applied to the following three types of industries that are now widespread in many LMICs: artisanal scale gold mining (ASGM), used lead-acid battery recycling (ULAB), and small tanning facilities. For each activity, we develop a generalized conceptual site model (CSM) that describes qualitative linkages from chemical releases or discharges, environmental fate and transport mechanisms, exposure pathways and routes, populations at risk, and health outcomes. This upfront information, which is often overlooked, is essential for delineating the contaminant zone of influence in a community and identifying relevant households for study. We also recommend cost-effective methods for use in LMICs related to environmental sampling, biological monitoring, survey questionnaires, and health outcome measurements at contaminated and unexposed reference sites. Future study designs based on this framework will facilitate consistent, comparable, and standardized community exposure, risk, and health impact assessments for land-based pollution in LMICs. The results of these studies can also support economic burden analyses and risk management decision-making around site cleanup, risk mitigation, and public health education.

Respiratory Health and Urinary Trace Metals among Artisanal Stone-Crushers: A Cross-Sectional Study in Lubumbashi, DR Congo

Background: Thousands of artisanal workers are exposed to mineral dusts from various origins in the African Copperbelt. We determined the prevalence of respiratory symptoms, pulmonary function, and urinary metals among artisanal stone-crushers in Lubumbashi. Methods: We conducted a cross-sectional study of 48 male artisanal stone-crushers and 50 male taxi-drivers using a standardized questionnaire and spirometry. Concentrations of trace metals were measured by Inductively Coupled - Plasma Mass Spectrometry (ICP-MS) in urine spot samples. Results: Urinary Co, Ni, As, and Se were higher in stone-crushers than in control participants. Wheezing was more prevalent (p = 0.021) among stone-crushers (23%) than among taxi-drivers (6%). In multiple logistic regression analysis, the job of a stone-crusher was associated to wheezing (adjusted Odds Ratio 4.45, 95% Confidence Interval 1.09–18.24). Stone-crushers had higher values (% predicted) than taxi-drivers for Forced Vital Capacity (105.4 ± 15.9 vs. 92.2 ± 17.8, p = 0.048), Forced Expiratory Volume in 1 Second (104.4 ± 13.7 vs. 88.0 ± 19.6, p = 0.052), and Maximum Expiratory Flow at 25% of the Forced Vital Capacity (79.0.1 ± 20.7 vs. 55.7 ± 30.1, p = 0.078). Conclusion: Stone-crushers were more heavily exposed to mineral dust and various trace elements than taxi-drivers, and they had a fourfold increased risk of reporting wheezing, but they did not have evidence of more respiratory impairment than taxi-drivers.

Slag dusts from Kabwe (Zambia): Contaminant mineralogy and oral bioaccessibility

The former Pb-Zn mining town of Kabwe in central Zambia is ranked amongst the worst polluted areas both in Africa and in the world. The fine dust particles from the ISF and Waelz slags deposited in Kabwe represent a health risk for the local population. Here, we combined a detailed multi-method mineralogical investigation with oral bioaccessibility testing in simulated gastric fluid (SGF; 0.4 M glycine, pH 1.5, L/S ratio of 100, 1 h, 37 °C) to evaluate the risk related to the incidental dust ingestion. The slag dust fractions contain up to 2610 mg/kg V, 6.3 wt% Pb and 19 wt% Zn. The metals are mainly bound in a slag glass and secondary phases, which formed during the slag weathering or were windblown from nearby tailing stockpiles (carbonates, Fe and Mn oxides, phosphates, vanadates). The bioaccessible fractions (BAFs) are rather high for all the main contaminants, with the BAF values generally higher for the ISF slags than for the Waelz slags: Pb (24-96%), V (21-100%) and Zn (54-81%). The results clearly indicate the potential risks related to the incidental slag dust ingestion. Even when a conservative value of the dust daily intake (100 mg/day) is considered, the daily contaminant intake significantly exceeds the tolerable daily intake limits, especially for Pb ≫ V > Zn. At higher ingestion rates, other minor contaminants (As, Cd) also become a health risk, especially for children. The slag heaps in Kabwe should be fenced to prevent local people entering and should be covered to limit the dust dispersion.

Comprehensive Urumqi screening for potentially toxic metals in soil-dust-plant total environment and evaluation of children's (0-6 years) risk-based blood lead levels prediction

Environmental contaminations by potentially toxic metals (PTMs) are associated with energy exploitation and present a significant problem in urban areas due to their impacts on human health. The PTMs status in Urumqi total environment inevitably impacted by extensive development of coal and oil industries has been lack of understanding comprehensively. A series of PTMs (As, Ba, Ce, Co, Cr, Cu, Ga, La, Mn, Ni, Pb, Rb, Sr, Th, U, V, Y, Zn, Zr) in the soil-dust-plant (foliage of Ulmus pumila L.) system of Urumqi (NW China) were screened by XRF and ICPMS. Multivariate statistics, risk models, GIS-based geostatistics, Positive Matrix Factorization (PMF) receptor modelling and blood lead levels of 0-6 aged children evaluated by IEUBK model are used to determine the priority pollutants, sources and health effects of the investigated elements. The spatial distribution of PTMs in soil-dust-plant system significantly coincides with coal combustion, traffic emission, and industrial activity. Although all PTM toxicants in soil, dust and tree foliage show some effects, the priority contaminants are observed for Cu, Pb and Zn as single element. The total carcinogenic and non-carcinogenic risks from PTMs are beyond the tolerance range of 0-6 year's old children, and the dust (TCR = 1.07E-04) PTMs pose approximatively equivalent carcinogenic risk to soil PTMs (TCT = 1.09E-04). The predicted BLLs (75-83 μ g·L^-1) of 1-2 years children are most strongly influenced by Pb in soil and dust, and therefore more attention should be focused on sources of Pb to support the primary health care of the toddlers in Urumqi.

Metal mining and birth defects: a case-control study in Lubumbashi, Democratic Republic of the Congo

BACKGROUND

Widespread environmental contamination caused by mining of copper and cobalt has led to concerns about the possible association between birth defects and exposure to several toxic metals in southern Katanga, Democratic Republic of the Congo (DRC). We therefore aimed to assess the possible contribution of parental and antenatal exposure to trace metals to the occurrence of visible birth defects among neonates.

METHODS

We did a case-control study between March 1, 2013, and Feb 28, 2015, in Lubumbashi, DRC. We included newborns with visible birth defects (cases) and healthy neonates born in the same maternity ward (controls). Mothers were interviewed about potentially relevant exposures, including their partners' jobs. Various trace metals were measured by inductively coupled plasma mass spectrometry in maternal urine, maternal blood, umbilical cord blood, placental tissue, and surface dust at home. Multivariable logistic regression analyses were done to calculate adjusted odds ratios and their 95% CIs (CI).

FINDINGS

Our study included 138 neonates with visible birth defects (about 0·1% of the 133 662 births in Lubumbashi during the study period) and 108 control neonates. Potential confounders were similarly distributed between cases and controls. Vitamin consumption during pregnancy was associated with a lower risk of birth defects (adjusted odds ratio 0·2, 95% CI 0·1-0·5). Mothers having paid jobs outside the home (2·8, 1·2-6·9) and fathers having mining-related jobs (5·5, 1·2-25·0) were associated with a higher risk of birth defects. We found no associations for trace metal concentrations in biological samples, except for a doubling of manganese (Mn; 1·7, 1·1-2·7) and zinc (Zn; 1·6, 0·9-2·8) in cord blood. In a separate model including placentas, a doubling of Mn at the fetal side of the placenta was associated with an increased risk of birth defects (3·3, 1·2-8·0), as was a doubling of cord blood Zn (5·3, 1·6-16·6).

INTERPRETATION

To our knowledge, this is the first study of the effects of mining-related pollution on newborns in sub-Saharan Africa. Paternal occupational mining exposure was the factor most strongly associated with birth defects. Because neither Mn nor Zn are mined in Lubumbashi, the mechanism of the association between their increased prenatal concentrations and birth defects is unclear.

FUNDING

Flemish Interuniversity Council-University Development Cooperation, The Coalition of the North-South movement in Flanders 11.11.11.