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Dong Q, Xiao C, Cheng W, Yu H, Liu G, Liu Y, Guo Y, Liang Y, Shi J, Yin Y, Cai Y, Jiang G. Phytoavailability, translocation, and accompanying isotopic fractionation of cadmium in soil and rice plants in paddy fields. JOURNAL OF HAZARDOUS MATERIALS 2024; 477:135321. [PMID: 39068886 DOI: 10.1016/j.jhazmat.2024.135321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 07/18/2024] [Accepted: 07/24/2024] [Indexed: 07/30/2024]
Abstract
Rice consumption is a major pathway for human cadmium (Cd) exposure. Understanding Cd behavior in the soil-rice system, especially under field conditions, is pivotal for controlling Cd accumulation. This study analyzed Cd concentrations and isotope compositions (δ114/110Cd) in rice plants and surface soil sampled at different times, along with urinary Cd of residents from typical Cd-contaminated paddy fields in Youxian, Hunan, China. Soil water-soluble Cd concentrations varied across sampling times, with δ114/110Cdwater lighter under drained than flooded conditions, suggesting supplementation of water-soluble Cd by isotopically lighter Cd pools, increasing Cd phytoavailability. Both water-soluble Cd and atmospheric deposition contributed to rice Cd accumulation. Water-soluble Cd's contribution increased from 28-52% under flooded to 58-87% under drained conditions due to increased soil Cd phytoavailability. Atmospheric deposition's contribution (12-72%) increased with potential atmospheric deposition flux among sampling areas. The enrichment of heavy Cd isotopes occurred from root-stem-grain to prevent rice Cd accumulation. The different extent of enrichment of heavy isotopes in urine indicated different Cd exposure sources. These findings provide valuable insights into the speciation and phytoavailability changes of Cd in the soil-rice system and highlight the potential application of Cd isotopic fingerprinting in understanding the environmental fate of Cd.
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Affiliation(s)
- Qiang Dong
- Laboratory of Green Innovation, Advanced Institute of Natural Sciences, Beijing Normal University, Zhuhai 519087, China; Laboratory of Environmental Nanotechnology and Health Effect, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Cailing Xiao
- Hubei Key Laboratory of Environmental and Health Effects of Persistent Toxic Substances, School of Environment and Health, Jianghan University, Wuhan 430056, China
| | - Wenhan Cheng
- School of Resource & Environment, Anhui Agricultural University, Hefei 230036, China
| | - Huimin Yu
- CAS Key Laboratory of Crust-Mantle Materials and Environments, School of Earth and Space Sciences, University of Science and Technology of China, Hefei 230026, China
| | - Guangliang Liu
- Department of Chemistry and Biochemistry, Florida International University, Miami, FL 33199, United States
| | - Yanwei Liu
- Laboratory of Environmental Nanotechnology and Health Effect, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Yingying Guo
- Laboratory of Environmental Nanotechnology and Health Effect, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Yong Liang
- Hubei Key Laboratory of Environmental and Health Effects of Persistent Toxic Substances, School of Environment and Health, Jianghan University, Wuhan 430056, China.
| | - Jianbo Shi
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Yongguang Yin
- Laboratory of Environmental Nanotechnology and Health Effect, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; School of Environment, Hangzhou Institute for Advanced Study, UCAS, Hangzhou 310024, China.
| | - Yong Cai
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; Department of Chemistry and Biochemistry, Florida International University, Miami, FL 33199, United States
| | - Guibin Jiang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
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de la Bastide C, Soares L, Lui LY, Harrington J, Cawthon P, Orwoll E, Kado D, Meliker J. A protocol for the prospective study of urinary cadmium with risk of fracture, bone loss, and muscle loss. JBMR Plus 2024; 8:ziad006. [PMID: 38505523 PMCID: PMC10945722 DOI: 10.1093/jbmrpl/ziad006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 11/11/2023] [Accepted: 11/17/2023] [Indexed: 03/21/2024] Open
Abstract
Cadmium (Cd) is a heavy metal and natural element found in soil and crops with increasing concentrations linked to phosphate fertilizers and sewage sludge applied to crop lands. A large fraction of older US men and woman have documented Cd exposure. Cd exposure has proven health concerns such as risk of lung cancer from inhalation and impaired renal function; however, growing evidence suggests it also influences bone and muscle health. Given that low levels of Cd could affect bone and muscle, we have designed prospective studies using the two largest and most detailed US studies of bone health in older men and women: the Osteoporotic Fractures in Men Study and the Study of Osteoporotic Fractures. We are investigating the association of urinary cadmium (U-Cd), as a surrogate for long-term Cd exposure, with bone and muscle health. Building off suggestive evidence from mechanistic and cross-sectional studies, this will be the first well-powered prospective study of incident fracture outcomes, bone loss, and muscle loss in relation to U-Cd, an established biomarker of long-term Cd exposure. The following is a proposed protocol for the intended study; if successful, the proposed studies could be influential in directing future US policy to decrease Cd exposure in the US population similar to recent policies adopted by the European Union to limit Cd in fertilizers.
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Affiliation(s)
| | - Lissa Soares
- Program in Public Health, Stony Brook University, Stony Brook, NY 11790, United States
| | - Li-Yung Lui
- California Pacific Medical Center Research Institute, San Francisco, CA 94107, United States
| | - James Harrington
- Analytical Science Division, RTI International, Research Triangle Park, NC 27709-2194, United States
| | - Peggy Cawthon
- California Pacific Medical Center Research Institute, San Francisco, CA 94107, United States
| | - Eric Orwoll
- Department of Medicine, School of Medicine, Oregon Health Sciences University, Portland, OR 97239, United States
| | - Deborah Kado
- Department of Medicine, School of Medicine, Stanford University, Palo Alto, CA 94305, United States
- Geriatric Research, Education, and Clinical Center (GRECC), VA Health Care System, Palo Alto, CA 94303, United States
| | - Jaymie Meliker
- Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11790, United States
- Program in Public Health, Stony Brook University, Stony Brook, NY 11790, United States
- Department of Family, Population, & Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11790, United States
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Gunasekara TDKSC, Herath C, De Silva PMCS, Jayasundara N. Exploring the Utility of Urinary Creatinine Adjustment for KIM-1, NGAL, and Cystatin C for the Assessment of Kidney Function: Insights from the C-KidnEES Cohort. CHILDREN (BASEL, SWITZERLAND) 2023; 11:15. [PMID: 38255329 PMCID: PMC10814906 DOI: 10.3390/children11010015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/21/2023] [Accepted: 10/26/2023] [Indexed: 01/24/2024]
Abstract
Normalization of urinary biomarkers of kidney injury is a common practice in clinical and research settings to account for variations in urine concentration, and urinary creatinine is often used as a reference. However, to date, there is no consensus on the adjustment of urinary biomarkers with creatinine, and both absolute and creatinine-adjusted biomarker levels are adopted for making interpretations of kidney health. Hence, the present study aimed to investigate the associations of urinary creatinine with three widely used kidney injury biomarkers, KIM-1, NGAL, and cystatin C, to validate the applicability of urinary creatinine as a reference for normalization. A cross-sectional study was performed with 2100 students, 10-18 years of age in the Children's Kidney Environmental Exposure Study (C-KidnEES) cohort established in Sri Lanka. As identified in linear regression analyses, normalization of urinary KIM-1, NGAL, and Cys-C to urinary creatinine did not result in significant under-adjustment or over-adjustment to the absolute urinary concentrations, giving no specific rationale for creatinine adjustment. Hence, absolute urinary concentrations of the above biomarkers can be adopted for the characterization of subclinical kidney injury in adolescents in community studies where early morning urine sampling is practiced. However, for spot urine samples, consideration of both absolute and creatinine-adjusted biomarker levels would be a better approach.
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Affiliation(s)
| | - Chula Herath
- Department of Nephrology, Sri Jayewardenepura General Hospital, Colombo 10100, Sri Lanka;
| | | | - Nishad Jayasundara
- Nicholas School of the Environment, Duke University, Durham, NC 27708, USA;
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Sallsten G, Ellingsen DG, Berlinger B, Weinbruch S, Barregard L. Variability of lead in urine and blood in healthy individuals. ENVIRONMENTAL RESEARCH 2022; 212:113412. [PMID: 35523277 DOI: 10.1016/j.envres.2022.113412] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/12/2022] [Accepted: 04/29/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Lead is a non-essential toxic trace element. Lead in blood (BPb) is the most common biomarker of lead exposure but lead in urine (UPb) has also been used. There is, however, limited data on the variability of UPb in the general population and the association with BPb. OBJECTIVES Our aims were to assess variability of lead in repeated blood and urine samples. The diurnal variation of UPb was also examined as well as associations with BPb. METHODS We established an openly available biobank including 60 healthy non-smoking individuals, 29 men and 31 women, 21-64 years of age (median 31 years), with repeated sampling of blood and urine. Timed urine samples were collected at six fixed time points in two 24 h periods, about one week apart, and adjusted for creatinine and specific gravity (SG). BPb and UPb were analyzed by inductively coupled plasma mass spectrometry. The within- and between-individual variabilities and intra-class correlation coefficients (ICCs; ratios of the between-individual to total observed variances) were calculated using mixed-effects models. RESULTS The ICCs for UPb samples were mostly above 0.5, when adjusted for creatinine or SG, and higher for overnight samples compared with daytime samples. The highest ICCs were obtained for BPb (ICC = 0.97) and for urine samples corrected for dilution by SG or creatinine. The ICC was 0.66 for overnight samples adjusted for creatinine. High correlations with BPb were found for 24 h UPb (rs = 0.77) and overnight samples, e.g. rs = 0.74 when adjusted for SG. There was diurnal variation of UPb with lowest excretion rate in overnight samples. There was also a significant association between the Pb excretion rate and urinary flow rate. CONCLUSIONS In addition to BPb, UPb adjusted for creatinine or SG seems to be a useful biomarker for exposure assessment in epidemiological studies.
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Affiliation(s)
- Gerd Sallsten
- Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg & Sahlgrenska University Hospital, Sweden.
| | | | - Balazs Berlinger
- National Institute of Occupational Health, Oslo, Norway; Department of Animal Hygiene, Herd Health and Mobile Clinic, University of Veterinary Medicine, István U. 2., H-1078, Budapest, Hungary
| | - Stephan Weinbruch
- National Institute of Occupational Health, Oslo, Norway; Institute of Applied Geosciences, Technical University Darmstadt, Schnittspahnstr. 9, D-64287, Darmstadt, Germany
| | - Lars Barregard
- Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg & Sahlgrenska University Hospital, Sweden
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Pouillot R, Farakos SS, Spungen J, Schaefer HR, Flannery BM, Van Doren JM. Cadmium physiologically based pharmacokinetic (PBPK) models for forward and reverse dosimetry: Review, evaluation, and adaptation to the U.S. population. Toxicol Lett 2022; 367:67-75. [PMID: 35901988 DOI: 10.1016/j.toxlet.2022.07.812] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/20/2022] [Accepted: 07/22/2022] [Indexed: 11/19/2022]
Abstract
The goal of this study was to assess a cadmium (Cd) physiologically based pharmacokinetic (PBPK) model to evaluate Cd toxicological reference values (e.g. reference dose, tolerable intake, minimum risk level) adapted to the U.S. population. We reviewed and evaluated previously published Cd PBPK models and developed further adaptations to the 1978 Kjellström and Nordberg (KN) model. Specifically, we propose adaptations with updated U.S.-specific bodyweight, kidney weight and creatinine excretion models by using NHANES data as well as a stochastic PBPK model that provides credible intervals of uncertainty around mean populational estimates. We provide our model review and adaptations as well as present estimates from the newly adapted models using observed U.S. urinary Cd values as a function of gender and age and given dietary exposure as evaluated from NHANES/WWEIA and U.S. Total Diet Study data. Results show all newly adapted models provide acceptable mean estimates of urinary Cd in the U.S. The stochastic model provides credible intervals to further inform regulatory decision making. Validation of the estimated K-Cd concentration values was not possible as data for a representative population was not available. We developed a web-based tool implementing these models and other potential adaptations to facilitate PBPK model estimate comparisons.
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Affiliation(s)
- Régis Pouillot
- Division of Risk and Decision Analysis, Center for Food Safety and Applied Nutrition, US Food and Drug Administration, College Park, MD, United States
| | - Sofia Santillana Farakos
- Division of Risk and Decision Analysis, Center for Food Safety and Applied Nutrition, US Food and Drug Administration, College Park, MD, United States.
| | - Judith Spungen
- Division of Risk and Decision Analysis, Center for Food Safety and Applied Nutrition, US Food and Drug Administration, College Park, MD, United States
| | - Heather R Schaefer
- Division of Risk and Decision Analysis, Center for Food Safety and Applied Nutrition, US Food and Drug Administration, College Park, MD, United States
| | - Brenna M Flannery
- Division of Risk and Decision Analysis, Center for Food Safety and Applied Nutrition, US Food and Drug Administration, College Park, MD, United States
| | - Jane M Van Doren
- Division of Risk and Decision Analysis, Center for Food Safety and Applied Nutrition, US Food and Drug Administration, College Park, MD, United States
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6
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Exposure variability and determining factors of urinary metals for schoolchildren in Taiwan. Int J Hyg Environ Health 2022; 243:113976. [DOI: 10.1016/j.ijheh.2022.113976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 04/14/2022] [Accepted: 04/26/2022] [Indexed: 11/22/2022]
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Bimonte VM, Besharat ZM, Antonioni A, Cella V, Lenzi A, Ferretti E, Migliaccio S. The endocrine disruptor cadmium: a new player in the pathophysiology of metabolic diseases. J Endocrinol Invest 2021; 44:1363-1377. [PMID: 33501614 DOI: 10.1007/s40618-021-01502-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 01/05/2021] [Indexed: 12/13/2022]
Abstract
Cadmium (Cd), a highly toxic heavy metal, is found in soil, environment and contaminated water and food. Moreover, Cd is used in various industrial activities, such as electroplating, batteries production, fertilizers, while an important non-occupational source is represented by cigarette smoking, as Cd deposits in tobacco leaves. Since many years it is clear a strong correlation between Cd body accumulation and incidence of many diseases. Indeed, acute exposure to Cd can cause inflammation and affect many organs such as kidneys and liver. Furthermore, the attention has focused on its activity as environmental pollutant and endocrine disruptor able to interfere with metabolic and energy balance of living beings. Both in vitro and in vivo experiments have demonstrated that the Cd-exposure is related to metabolic diseases such as obesity, diabetes and osteoporosis even if human studies are still controversial. Recent data show that Cd-exposure is associated with atherosclerosis, hypertension and endothelial damage that are responsible for cardiovascular diseases. Due to the large environmental diffusion of Cd, in this review, we summarize the current knowledge concerning the role of Cd in the incidence of metabolic and cardiovascular diseases.
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Affiliation(s)
- V M Bimonte
- Department of Movement, Human and Health Sciences, Section of Health Sciences, Foro Italico University, Piazza Lauro De Bosis 6, 00195, Rome, Italy
| | - Z M Besharat
- Department of Experimental Medicine, Section of Medical Pathophysiology, Endocrinology and Food Sciences, Sapienza University of Rome, Viiale Regina Elena 324, 00161, Rome, Italy
| | - A Antonioni
- Department of Experimental Medicine, Section of Medical Pathophysiology, Endocrinology and Food Sciences, Sapienza University of Rome, Viiale Regina Elena 324, 00161, Rome, Italy
| | - V Cella
- Department of Movement, Human and Health Sciences, Section of Health Sciences, Foro Italico University, Piazza Lauro De Bosis 6, 00195, Rome, Italy
| | - A Lenzi
- Department of Experimental Medicine, Section of Medical Pathophysiology, Endocrinology and Food Sciences, Sapienza University of Rome, Viiale Regina Elena 324, 00161, Rome, Italy
| | - E Ferretti
- Department of Experimental Medicine, Section of Medical Pathophysiology, Endocrinology and Food Sciences, Sapienza University of Rome, Viiale Regina Elena 324, 00161, Rome, Italy
| | - S Migliaccio
- Department of Movement, Human and Health Sciences, Section of Health Sciences, Foro Italico University, Piazza Lauro De Bosis 6, 00195, Rome, Italy.
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8
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Sears CG, Poulsen AH, Eliot M, Howe CJ, James KA, Harrington JM, Roswall N, Overvad K, Tjønneland A, Raaschou-Nielsen O, Wellenius GA, Meliker J. Urine cadmium and acute myocardial infarction among never smokers in the Danish Diet, Cancer and Health cohort. ENVIRONMENT INTERNATIONAL 2021; 150:106428. [PMID: 33571817 PMCID: PMC7940585 DOI: 10.1016/j.envint.2021.106428] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 01/25/2021] [Accepted: 01/27/2021] [Indexed: 05/11/2023]
Abstract
Cadmium exposure has been associated with cardiovascular disease. Cigarette smoking is a key source of cadmium exposure and thus a potential confounder in observational studies of environmental cadmium and cardiovascular disease that include tobacco smokers. We leveraged up to 20 years of follow-up in the Danish Diet, Cancer and Health cohort to test the hypothesis that cadmium exposure is associated with acute myocardial infarction (AMI) among people who never smoked. Between 1993 and 1997, 19,394 never-smoking participants (ages 50-64 years) were enrolled and provided a urine sample. From this sample, we randomly selected a subcohort of 600 males and 600 females. We identified 809 AMI cases occurring between baseline and the end of 2015 using the Danish National Patient Registry. We quantified cadmium, creatinine, and osmolality in baseline urine samples. Using an unweighted case-cohort approach, we estimated adjusted hazard ratios (aHR) for AMI in Cox proportional hazards models with age as the time axis. Participants had relatively low concentrations of urinary cadmium, as expected for never smokers (median = 0.20; 25th, 75th = 0.13, 0.32 μg cadmium/g creatinine). We did not find strong evidence to support an association between higher urinary cadmium and AMI when comparing the highest versus lowest quartile (aHR = 1.16; 95% CI: 0.86 - 1.56) and per IQR increment in cadmium concentration (aHR = 1.02; 95% CI: 0.93 - 1.12). Results were not materially different across strata defined by sex. Results were generally similar using creatinine or osmolality to account for differences in urine dilution. While cadmium exposure has been identified as a risk factor for cardiovascular disease, we did not find strong evidence that urinary cadmium at relatively low-levels is associated with AMI among people who have never smoked.
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Affiliation(s)
- Clara G Sears
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.
| | | | - Melissa Eliot
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Chanelle J Howe
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Katherine A James
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, CO, USA
| | - James M Harrington
- Center for Analytical Science, Research Triangle Institute, Research Triangle Park, NC, USA
| | - Nina Roswall
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Kim Overvad
- Department of Public Health, Aarhus University, Aarhus, Denmark; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ole Raaschou-Nielsen
- Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Gregory A Wellenius
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA; Department of Environmental Health, Boston University, Boston, MA, USA
| | - Jaymie Meliker
- Program in Public Health, Department of Family, Population, & Preventive Medicine, Stony Brook University, Stony Brook, NY, USA
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Xiao L, Zhu C, Yang S, Zhou M, Wang B, Wang X, Wang D, Ma J, Zhou Y, Chen W. Assessment of the variability of urinary cadmium for general adults. CHEMOSPHERE 2021; 269:128752. [PMID: 33127101 DOI: 10.1016/j.chemosphere.2020.128752] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/21/2020] [Accepted: 10/23/2020] [Indexed: 06/11/2023]
Abstract
Cadmium (Cd) exposure has become a growing public health issue and the level of urinary Cd is commonly used as the internal biomarker of overall Cd exposure. There has been raised a concern whether the level of Cd in a single spot urine actually reflects individual internal exposure over a long-term period. We aimed to examine the variability of urinary Cd levels over three years. Levels of urinary Cd were determined repeatedly in 2238 general adults during a follow-up of three-year from a community-based prospective study. We estimated the intra-class correlation coefficients (ICCs) of urinary Cd level over three years using the three-level random-effects mixed models to assess their variations. We found that the Pearson correlations for urinary Cd over three years were 0.521 for uncorrected Cd, 0.632 for creatinine (Cr)-corrected Cd, and 0.551 for specific gravity (SG)-corrected Cd, respectively (all P < 0.001). Moderate reproducibility was obtained for urinary Cd over three years, where ICCs of the three methods all exceeded 0.50. Of note, Cr-corrected urinary Cd levels achieved high reproducibility [0.773, 95%CI (0.750-0.794)]. Additionally, positive dose-response associations of smoking amount with Cr-corrected urinary Cd level were observed (P trend <0.05). Our findings suggest that Cr-corrected urinary Cd level in a single measurement was a credible biomarker for the relatively long-term levels of urinary Cd in the general population and cigarette smoking plays a part of urinary Cd exposure.
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Affiliation(s)
- Lili Xiao
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Chunmei Zhu
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Shijie Yang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Min Zhou
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Bin Wang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Xing Wang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Dongming Wang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Jixuan Ma
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Yun Zhou
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Weihong Chen
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
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10
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Sallsten G, Barregard L. Variability of Urinary Creatinine in Healthy Individuals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063166. [PMID: 33808539 PMCID: PMC8003281 DOI: 10.3390/ijerph18063166] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/16/2021] [Accepted: 03/17/2021] [Indexed: 11/16/2022]
Abstract
Many urinary biomarkers are adjusted for dilution using creatinine or specific gravity. The aim was to evaluate the variability of creatinine excretion, in 24 h and spot samples, and to describe an openly available variability biobank. Urine and blood samples were collected from 60 healthy non-smoking adults, 29 men and 31 women. All urine was collected at six time points during two 24 h periods. Blood samples were also collected twice and stored frozen. Analyses of creatinine in urine was performed in fresh urine using an enzymatic method. For creatinine in urine, the intra-class correlation (ICC) was calculated for 24 h urine and spot samples. Diurnal variability was examined, as well as association with urinary flow rate. The creatinine excretion rate was lowest in overnight samples and relatively constant in the other five samples. The creatinine excretion rate in each individual was positively correlated with urinary flow rate. The creatinine concentration was highest in the overnight sample and at 09:30. For 24 h samples the ICC was 0.64, for overnight samples it was 0.5, and for all spot samples, it was much lower. The ICC for urinary creatinine depends on the time of day of sampling. Frozen samples from this variability biobank are open for researchers examining normal variability of their favorite biomarker(s).
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Gaitens JM, Brown CH, Strathmann FG, Xu H, Lewin-Smith MR, Velez-Quinones MA, McDiarmid MA. The Utility of Spot vs 24-Hour Urine Samples for Metal Determination in Veterans With Retained Fragments. Am J Clin Pathol 2021; 155:428-434. [PMID: 33083816 DOI: 10.1093/ajcp/aqaa144] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The objective of this investigation is to explore the utility of using a spot urine sample in lieu of a 24-hour collection in assessing fragment-related metal exposure in war-injured veterans. METHODS Twenty-four veterans collected each urine void over a 24-hour period in separate containers. Concentrations of 13 metals were measured in each void and in a pooled 24-hour sample using inductively coupled plasma mass spectrometry. To assess the reliability of spot sample measures over time, intraclass correlations (ICCs) were calculated across all spot samples. Lin's concordance correlation coefficient was used to assess agreement between a randomly selected spot urine sample and each corresponding 24-hour sample. RESULTS In total, 149 spot urine samples were collected. Ten of the 13 metals measured had ICCs more than 0.4, suggesting "fair to good" reliability. Concordance coefficients were more than 0.4 for all metals, suggesting "moderate" agreement between spot and 24-hour concentrations, and more than 0.6 for seven of the 13 metals, suggesting "good" agreement. CONCLUSIONS Our fair to good reliability findings, for most metals investigated, and moderate to good agreement findings for all metals, across the range of concentrations observed here, suggest the utility of spot urine samples to obtain valid estimates of exposure in the longitudinal surveillance of metal-exposed populations.
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Affiliation(s)
- Joanna M Gaitens
- Department of Veterans Affairs, Baltimore VA Medical Center, Baltimore, MD
- Department of Medicine, Division of Occupational and Environmental Medicine
| | - Clayton H Brown
- Department of Epidemiology & Public Health, University of Maryland School of Medicine, Baltimore
| | | | - Hanna Xu
- The Joint Pathology Center, Environmental Toxicology Laboratory, Silver Spring, MD
| | | | | | - Melissa A McDiarmid
- Department of Veterans Affairs, Baltimore VA Medical Center, Baltimore, MD
- Department of Medicine, Division of Occupational and Environmental Medicine
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12
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Barregard L, Ellingsen DG, Berlinger B, Weinbruch S, Harari F, Sallsten G. Normal variability of 22 elements in 24-hour urine samples - Results from a biobank from healthy non-smoking adults. Int J Hyg Environ Health 2021; 233:113693. [PMID: 33581414 DOI: 10.1016/j.ijheh.2021.113693] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/29/2020] [Accepted: 01/16/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Urine is often used for biomonitoring the exposure to elements. However, most studies report concentrations in spot urine samples, which may not accurately mirror the "gold standard" of complete 24-h (24 h) urine samples. There are relatively few data published for 24 h samples, and little information on the within- and between person variability. OBJECTIVES The present study aimed at assessing variability within and between individuals in 24 h excretion for a number of elements in adults from the general population and the typical 24 h excretion of these elements. In addition, we assessed concentrations adjusted for creatinine and specific gravity (SG), and associations between elements. METHODS 60 healthy non-smokers (31 women and 29 men) from Sweden, aged 21-64 years, collected all urine during 24 h (split into six separate samples) on two occasions, about one week apart. Concentrations of As, Br, Cd, Co, Cr, Cu, Fe, Hg, Li, Mn, Mo, Ni, P, Pb, S, Sb, Se, Sn, U, V, W, and Zn in urine were analyzed by inductively coupled plasma sector-field mass spectrometry (ICP-SF-MS) and 24 h excretion rates were calculated for each day. The ratio of between-individual variance and the total variance, the intra-class correlation (ICC) was calculated based on natural log-transformed 24 h excretion. Correlation coefficients were calculated between excretion rates (mass/24 h), and concentrations adjusted for creatinine and SG. RESULTS Geometric means (GM), and 90-percentiles are presented for each element. The 24 h excretion was higher in men than in women for most elements, and the difference was statistically significant for Cr, Cu, Fe, Li, P, Pb, S, Se, U, V, and Zn. However, for Cd and Co, the excretion was higher in women. Variability between days was low for Cd, Co, Hg, Pb, Sn, Se, V, and Zn (ICC 0.75-0.90), highest for Cr (ICC = 0.3) and Sb (ICC = 0.18), and moderate for the other elements. Spearman's rank correlation coefficients were about 0.8-0.9 for 17 elements, and 0.3-0.7 for Br, Cu, P, S, Se. Excretion of P and S were highly correlated, and also associated with excretion of most of the other elements, especially Cu, Se, V, and Zn. A high correlation was also found between As and Hg, between Mo and W, as well as between Cr, Fe and Mn. CONCLUSIONS These data present normal variability of 24 h excretion of a number of elements, and can also be used as updated reference levels for elements with no or limited previous literature available. Information on variability within- and between individuals is important to know when designing studies with urine levels of elements used as exposure biomarker in studies of associations with health outcomes.
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Affiliation(s)
- Lars Barregard
- Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg & Sahlgrenska University Hospital, Sweden.
| | | | - Balazs Berlinger
- National Institute of Occupational Health, Oslo, Norway; Soos Research and Development Center, University of Pannonia, Zrinyi Miklos str. 18, H-8800, Nagykanizsa, Hungary
| | - Stephan Weinbruch
- National Institute of Occupational Health, Oslo, Norway; Institute of Applied Geosciences, Technical University Darmstadt, Schnittspahnstr. 9, D-64287, Darmstadt, Germany
| | - Florencia Harari
- Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg & Sahlgrenska University Hospital, Sweden
| | - Gerd Sallsten
- Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg & Sahlgrenska University Hospital, Sweden
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Yang K, Chen C, Brockman J, Shikany JM, He K. Low- and moderate- levels of arsenic exposure in young adulthood and incidence of chronic kidney disease: Findings from the CARDIA Trace Element Study. J Trace Elem Med Biol 2021; 63:126657. [PMID: 33069098 PMCID: PMC7722195 DOI: 10.1016/j.jtemb.2020.126657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 09/23/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND It is unclear whether arsenic exerts adverse health effects on the kidney at low- and moderate- levels of exposure. We prospectively examined toenail arsenic concentrations measured during young adulthood in relation to incidence of chronic kidney disease (CKD) in midlife. METHODS A total of 3768 participants (53 % female and 48 % blacks) in the Coronary Artery Risk Development in Young Adults (CARDIA) study were included. Arsenic concentration in toenail clippings was assessed by using inductively coupled plasma mass spectrometry at CARDIA exam year 2. Incident CKD was identified if having estimated glomerular filtration rate <60 mL/min per 1.73 m² or albuminuria >30 mg/g. The association between toenail arsenic levels and CKD incidence over a mean of 24 years of follow-up was examined using multivariable-adjusted Cox proportional hazards models. RESULTS After controlling for potential confounders, including demographics, socioeconomics, lifestyle factors, clinical measurements of blood pressure, lipids, and glucose, and medical history, arsenic exposure measured in toenails was not associated with CKD incidence (quintile 5 versus quintile 1: hazard ratio = 1.04, 95 % confidence interval = 0.78-1.40, P for trend = 0.38). CONCLUSION This longitudinal study does not support the hypothesis that low- and moderate- levels of arsenic exposure are associated with elevated incidence of CKD in the US general population. Further studies are need to investigate species of arsenic biomarkers in relation to nephrotoxicity.
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Affiliation(s)
- Kefeng Yang
- Department of Nutrition, Xin Hua Hospital Affiliated to School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Cheng Chen
- Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - John Brockman
- Columbia Research Reactor, University of Missouri, Columbia, MO, USA
| | - James M Shikany
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ka He
- Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
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Jalili C, Kazemi M, Taheri E, Mohammadi H, Boozari B, Hadi A, Moradi S. Exposure to heavy metals and the risk of osteopenia or osteoporosis: a systematic review and meta-analysis. Osteoporos Int 2020; 31:1671-1682. [PMID: 32361950 DOI: 10.1007/s00198-020-05429-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 04/22/2020] [Indexed: 01/21/2023]
Abstract
The relationship between heavy metal exposure and risk of osteopenia or osteoporosis has biological plausibility, yet it remains inconclusive; therefore, we conducted a systematic review and meta-analysis to evaluate the associations between exposure to heavy metals (i.e., cadmium, lead, and mercury) and the risk of osteopenia or osteoporosis. Databases of MEDLINE, Embase, Scopus, and Web of Science were searched through November 2019, to identify studies that evaluated the relationship between exposure to cadmium, lead, and mercury and risk of osteopenia or osteoporosis in adults. Fourteen eligible studies were included. Effect sizes expressed as pooled odds ratios (OR) and 95% confidence intervals (CI) were estimated using weighted random-effect models. Exposure to cadmium (OR = 1.35; 95% CI: 1.17 to 1.56; P ≤ 0.001) and lead (OR = 1.15; 95% CI: 1.00 to 1.32; P = 0.05) was associated with an increased risk of osteopenia or osteoporosis, unlike mercury. Subgroup analyses showed cadmium exposure increased the risk of osteopenia or osteoporosis in older (> 65 yrs.; OR = 1.43; 95%CI: 1.08 to 1.88, P = 0.01) compared with younger (18-65 yrs.; OR = 1.24; 95% CI: 1.02 to 1.52, P = 0.03) adults. Also, lead exposure increased the risk in men (OR = 1.55; 95% CI: 1.15 to 2.09, P = 0.007) unlike in women. By contrast to urinary levels, blood (OR = 1.26; 95% CI: 1.08 to 1.47, P = 0.003) and dietary (OR = 1.46; 95% CI: 1.28 to 1.67, P < 0.001) levels of cadmium were associated with an increased risk of osteopenia or osteoporosis. Exposure to cadmium and lead may be associated with an increased risk of osteopenia or osteoporosis, although high heterogeneity was detected.
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Affiliation(s)
- C Jalili
- Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - M Kazemi
- Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, USA
| | - E Taheri
- Environment Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - H Mohammadi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - B Boozari
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - A Hadi
- Halal Research Center of IRI, FDA, Tehran, Iran
| | - S Moradi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
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Chen X, Wang Z, Zhu G, Nordberg GF, Jin T, Ding X. The association between cumulative cadmium intake and osteoporosis and risk of fracture in a Chinese population. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2019; 29:435-443. [PMID: 30185939 DOI: 10.1038/s41370-018-0057-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 02/28/2018] [Accepted: 06/14/2018] [Indexed: 06/08/2023]
Abstract
Bone is one of the target organs for cadmium toxicity. However, few studies have shown the association between cumulative cadmium intake and prevalence of osteoporosis and bone fracture. In the present study, we evaluated the association between cumulative cadmium intake and osteoporosis and risk of fracture in a Chinese population. A total of 790 subjects (488 women and 302 men) living in a control area and two cadmium-polluted areas were included. The cumulative cadmium intake was estimated by a food survey. The bone mineral density was determined by using single-photon absorptiometry. The cumulative cadmium intakes were 0.48, 2.14, and 11.00 g for men, and 0.42, 2.11, and 11.12 g in women in control, and moderately and heavily polluted areas, respectively. In women, the odds ratios (ORs) of subjects with a cadmium intake between 2.21 and 10.63 g and >10.63 g were 1.30 (95% CI: 0.58-2.94) and 2.36 (95% CI: 1.14-5.16), compared with those with a cadmium intake < 0.58 g after adjusting to the confounders for osteoporosis. The ORs of subjects with a cadmium intake >10.63 g were 2.34 (95% CI: 1.23-4.38) for all of the women and 2.62 (95% CI: 1.02-5.58) in women ≥ 60 years old, compared with those with a cadmium intake <10.63 g after adjusting to the confounders for bone fractures. In men, similar trends were observed, but no statistical significance was found. In addition, those subjects with renal tubular dysfunction showed high risk of bone fracture. Our results indicate that a high level of cumulative cadmium intake is associated with an increased rate of osteoporosis and fractures among women.
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Affiliation(s)
- Xiao Chen
- Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, 155 # hanzhong Road, Nanjing, 210029, China
- Department of Nephrology, Zhongshan Hospital Fudan University, Shanghai Institute of Kidney Disease and Dialysis, Shanghai, 200032, China
| | - Zhongqiu Wang
- Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, 155 # hanzhong Road, Nanjing, 210029, China
| | - Guoying Zhu
- Institute of Radiation Medicine, Fudan University, 2094 Xietu Road, Shanghai, 200032, China.
| | - Gunnar F Nordberg
- Department of Public Health and Clinical Medicine, Umeå University, 901 87, Umeå, Sweden
| | - Taiyi Jin
- Department of Occupational Medicine, School of Public Health, Fudan University, 150 Dongan Road, Shanghai, 200032, China
| | - Xiaoqiang Ding
- Department of Nephrology, Zhongshan Hospital Fudan University, Shanghai Institute of Kidney Disease and Dialysis, Shanghai, 200032, China.
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Meliker JR, Vacchi-Suzzi C, Harrington J, Levine K, Lui LY, Bauer DC, Orwoll E, Kado DM. Temporal stability of urinary cadmium in samples collected several years apart in a population of older persons. Int J Hyg Environ Health 2018; 222:230-234. [PMID: 30401599 DOI: 10.1016/j.ijheh.2018.10.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 10/10/2018] [Accepted: 10/30/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVES There is growing evidence that urine cadmium is a temporally stable biomarker indicative of long-term cadmium exposure; however questions remain with regard to generalizability to older persons, the impact of changes in smoking behavior, and the degree of temporal stability when repeat sample collection spans years instead of weeks or months. METHODS Using archived samples from cohorts of older men (Osteoporotic Fractures in Men (MrOS-US)) and women (Study of Osteoporotic Fractures (SOF)) (mean age = 80 at study visit 2), we analyzed two morning urine samples each from 39 men and 18 women with a diverse self-reported smoking history. For MrOS, samples were collected approximately 6 years apart, and 4 years apart for SOF. Intra-class correlations were computed to assess temporal stability, and adjusted for age and body mass index. RESULTS The median creatinine-adjusted urinary cadmium levels (0.39 μg/g for men, 0.89 μg/g for women) were similar to levels expected for these age/sex groups in the US according to the National Health and Nutrition Examination Survey. The overall intra-class correlation was high (ICC = 0.85; 95% CI: 0.76-0.91) and similar between cohorts (MrOS: ICC = 0.74; 95% CI: 0.58-0.86; SOF: ICC = 0.81; 95% CI: 0.59-0.93), but slightly lower among those who stopped smoking between visits of sample collection (ICC = 0.64; 95% CI: 0.31-0.87) or among former smokers who quit prior to the first sample collection (ICC = 0.68; 95% CI: 0.25-0.93). CONCLUSIONS We report good-to-excellent reproducibility of urine cadmium using morning urine samples collected 4-6 years apart from older men and women, but slightly lower correlations among those with a history of smoking. Single measures of urine cadmium are a reliable biomarker in older men and women.
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Affiliation(s)
- Jaymie R Meliker
- Program in Public Health, Department of Family, Population, & Preventive Medicine, USA; Stony Brook University School of Medicine, USA.
| | | | | | - Keith Levine
- Trace Inorganics Laboratory, RTI International, USA
| | | | - Douglas C Bauer
- University of California San Francisco School of Medicine, USA
| | - Eric Orwoll
- Oregon Health & Science University School of Medicine, USA
| | - Deborah M Kado
- Department of Family Medicine & Public Health and Medicine, University of California San Diego, USA
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MacPherson S, Arbuckle TE, Fisher M. Adjusting urinary chemical biomarkers for hydration status during pregnancy. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2018; 28:481-493. [PMID: 29880833 PMCID: PMC8075920 DOI: 10.1038/s41370-018-0043-z] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 03/02/2018] [Accepted: 03/23/2018] [Indexed: 05/17/2023]
Abstract
One way of assessing a population's exposure to environmental chemicals is by measuring urinary biomarker concentrations, which can vary depending on the hydration status of the individual. The physiological changes that occur during pregnancy can impact the hydration adjustment approaches, such as calculating the individual's urinary flow rate (UFR), or adjusting concentrations using specific gravity (SG) or creatinine. A total of 1260 serial spot urine samples were collected from 80 women, averaging 32.4 years of age, throughout and shortly after pregnancy. The relationship between each approach was examined and time of day and across pregnancy differences were tested using linear mixed models. The correlation between the calculated excretion rate and each of the adjustment techniques was examined on a selection of seven phthalate metabolites. Based on the linear mixed model results, we found that UFR and creatinine excretion rates differed systematically across the population, with respect to body mass index (BMI) and time. SG differed with respect to BMI, but there were no systematic time trends. SG had the highest within-person reproducibility, according to the intraclass correlation coefficient (ICC). The excretion rate of each of the phthalates was most strongly correlated with the SG-standardized concentration. This analysis showed that SG showed a slightly better within-person reproducibility and the least amount of systematic variation when compared to creatinine adjustment. Therefore, SG correction appears to be a favorable approach for correcting for the hydration status of the pregnant women from this cohort.
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Affiliation(s)
- Susan MacPherson
- Population Studies Division, Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, ON, Canada.
| | - Tye E Arbuckle
- Population Studies Division, Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, ON, Canada
| | - Mandy Fisher
- Population Studies Division, Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, ON, Canada
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18
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The references level of cadmium intake for renal dysfunction in a Chinese population. Sci Rep 2018; 8:9011. [PMID: 29899356 PMCID: PMC5998016 DOI: 10.1038/s41598-018-27411-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 05/30/2018] [Indexed: 11/08/2022] Open
Abstract
Recent several studies indicated that a more restrictive dietary intake guideline for cadmium should be made for sufficient health protection. In the present study, we showed the references level of food cadmium intake (FCd) and total cadmium intake (TCd) for renal dysfunction by using benchmark dose (BMD) approach. 342 subjects living in a control and a cadmium polluted area were included in this study. The FCd, TCd and cadmium in urine (UCd) and blood (BCd) were calculated or determined. Urinary β2Microglobulin (UBMG) was determined as indicator of renal function. The median FCd, TCd, UCd and BCd were 1.4 g, 1.4 g, 3.1 μg/g creatinine(cr) and 1.3 μg/L in control and 3.3 g, 3.6 g, 13.5 μg/g cr and 12.1 μg/L in polluted area. The 95% lower confidence bounds of BMD (BMDLs) of FCd for renal dysfunction were 1.36-1.55 g (BMR = 10%) and 0.88-1.11 g (BMR = 5%). The BMDLs of TCd were 1.29-1.46 g (BMR = 10%) and 0.73-0.95 g (BMR = 5%). FCd and TCd are valuable markers for the predication of renal dysfunction induced by cadmium. The BMDLs of FCd were close to previous report in Japan and the BMDLs of TCd were lower than the critical standard previously reported, in particular at BMR of 5% which can be interpreted as representing the influence of smoking.
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Chen X, Zhu G, Wang Z, Liang Y, Chen B, He P, Nordberg M, Nordberg GF, Ding X, Jin T. The association between dietary cadmium exposure and renal dysfunction - the benchmark dose estimation of reference levels: the ChinaCad study. J Appl Toxicol 2018; 38:1365-1373. [PMID: 29888394 DOI: 10.1002/jat.3647] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 04/22/2018] [Accepted: 04/24/2018] [Indexed: 11/08/2022]
Abstract
The tolerable dietary intake of cadmium was recommended at provisional tolerable monthly intake of 25 μg kg-1 body weight. However, several studies indicated that this tolerable level should be re-evaluated for sufficient health protection. In this study, we show the reference levels of dietary cadmium intake for renal dysfunction by using a benchmark dose (BMD) approach. A total of 790 subjects (302 men and 488 women) living in control and cadmium-polluted areas were included. The dietary cadmium intake was estimated by a food survey. Blood cadmium, urinary cadmium and renal function markers (microalbuminuria, N-acetyl-β-d-glucosaminidase [NAG] and its isoform B [NAGB], β2 -microglobulin and retinol binding protein) in urine were measured. We calculated the 95% lower confidence bounds of BMD (BMDLs) of cumulative cadmium intake. In control and two polluted areas, the median cumulative cadmium intake was 0.5, 2.1 and 11.1 g. The odds ratio of the intermediate (1.0-3.0 g), second highest (3.0-11.0 g) and the highest cumulative cadmium intake (>11.0 g) compared with the lowest cumulative cadmium intake (<1.0 g) were 2.8 (95% CI: 1.4-5.8), 8.1 (95% CI: 3.8-17.2) and 11.4 (95% CI: 6.5-26.4) for urinary NAG and 6.6 (95% CI: 3.2-13.8), 14.8 (95% CI: 6.8-32.2) and 22.5 (95% CI: 10.7-47.5) for urinary NAGB. The BMDLs of cumulative cadmium intake were 1.1-1.2 g (benchmark response [BMR] = 5%) for urinary NAG, and were 0.7-0.9 g (BMR = 5%) for urinary NAGB, and were 1.3-1.4 g (BMR = 5%) for urinary β2 -microglobulin. The BMDLs of cumulative cadmium intake in a Chinese population were lower than the critical standard previously reported. Further evaluations are needed for sufficient health protection.
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Affiliation(s)
- Xiao Chen
- Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China.,Department of Nephrology, Zhongshan Hospital Fudan University, Key Laboratory of Kidney and Dialysis, Shanghai, 200032, China
| | - Guoying Zhu
- Institute of Radiation Medicine, Fudan University, Shanghai, 200032, China
| | - Zhongqiu Wang
- Department of Nephrology, Zhongshan Hospital Fudan University, Key Laboratory of Kidney and Dialysis, Shanghai, 200032, China
| | - Yihuai Liang
- Department of Occupational Medicine, School of Public Health, Fudan University, Shanghai, 200032, China
| | - Bo Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Fudan University, Shanghai, 200032, China
| | - Ping He
- Department of Nutrition and Food Hygiene, School of Public Health, Fudan University, Shanghai, 200032, China
| | - Monica Nordberg
- Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Gunnar F Nordberg
- Department of Public Health and Clinical Medicine, Umeå University, 901 87, Umeå, Sweden
| | - Xiaoqiang Ding
- Department of Nephrology, Zhongshan Hospital Fudan University, Key Laboratory of Kidney and Dialysis, Shanghai, 200032, China
| | - Taiyi Jin
- Department of Occupational Medicine, School of Public Health, Fudan University, Shanghai, 200032, China
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Cui X, Cheng H, Liu X, Giubilato E, Critto A, Sun H, Zhang L. Cadmium exposure and early renal effects in the children and adults living in a tungsten-molybdenum mining areas of South China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:15089-15101. [PMID: 29557043 DOI: 10.1007/s11356-018-1631-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 02/28/2018] [Indexed: 06/08/2023]
Abstract
Adverse health effects related to accumulative cadmium (Cd) exposure have aroused widespread attention from the public in China. Knowledge on the relationships between Cd exposure and early renal effects is particularly limited for children, who are more susceptible to absorbing metals than adults. A typical Cd-polluted area of South China was selected to determine the Cd exposure and related early renal effects of the general population, including children. In total, 211 children and 806 adults were enrolled in the study. The urinary levels of Cd (U-Cd), β2-microglobulin (U-BMG), retinol binding protein (U-RBP), and N-acetyl-β-D-glucosaminidase (U-NAG) were measured. The relationship between U-Cd and ranked indicators of early renal effects was examined by multiple regression analysis. The average U-Cd ranged from 7.01 μg/g creatinine (boys) to 13.55 μg/g creatinine (women) in the Cd-polluted areas. These values are much higher than those of the control group and those that have been reported by other countries. In agreement with previous studies, environmental Cd pollution resulted in elevated Cd accumulation in the bodies of children, and it increased the concentration of NAG in their urine. Similarly, environmental Cd pollution increased NAG and BMG in the urine of adults. Multivariate models showed that the urinary excretion of BMG, RBP, and NAG was positively associated with Cd levels in the urine of both children and adults. The reference thresholds of U-Cd in relation to elevated U-BMG, U-RBP, and U-NAG were higher in children than adults after standardization for other covariates. These results reinforce the need to control and regulate the sources of environmental Cd contamination and to promote more effective risk management measures, especially for vulnerable groups.
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Affiliation(s)
- Xiangfen Cui
- School of Environment, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing, 100875, People's Republic of China
| | - Hongguang Cheng
- School of Environment, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing, 100875, People's Republic of China.
| | - Xuelian Liu
- Green Development Institute, Beijing Normal University, Beijing, 100875, People's Republic of China
| | - Elisa Giubilato
- Department of Environmental Sciences, Informatics and Statistics, University Ca' Foscari, Venice, Italy
| | - Andrea Critto
- Department of Environmental Sciences, Informatics and Statistics, University Ca' Foscari, Venice, Italy.
| | - Haixu Sun
- School of Environment, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing, 100875, People's Republic of China
| | - Lei Zhang
- School of Environment, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing, 100875, People's Republic of China
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21
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Wang H, Dumont X, Haufroid V, Bernard A. The physiological determinants of low-level urine cadmium: an assessment in a cross-sectional study among schoolchildren. Environ Health 2017; 16:99. [PMID: 28899425 PMCID: PMC5596934 DOI: 10.1186/s12940-017-0306-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 09/03/2017] [Indexed: 05/22/2023]
Abstract
BACKGROUND Recent studies in children have reported associations of urinary cadmium (U-Cd), used as biomarker of Cd body burden, with renal dysfunction, retarded growth and impaired cognitive development in children. Little is known, however, about factors influencing U-Cd in children and likely to act as confounders. METHODS In a cross-sectional study involving 249 schoolchildren (mean age, 5.72 years; 138 boys), we measured the urine concentrations of cadmium, zinc, lead, albumin, alpha1-microglobulin (A1M), retinol-binding protein, β2-microglobulin and club cell protein (CC16). Determinants of U-Cd expressed per creatinine or adjusted to specific gravity were identified by multiple regression analyses. RESULTS Girls and boys had similar median concentrations of U-Cd (0.22 and 0.24 μg/L, 0.33 and 0.35 μg/g creatinine, respectively). When models were run without including creatinine or specific gravity among independent variables, urinary zinc, urinary A1M and age emerged as the strongest predictors of U-Cd expressed per g creatinine or adjusted to SG. When adding creatinine among predictors, urinary creatinine emerged as an additional strong predictor correlating negatively with U-Cd per g creatinine. This strong residual influence of diuresis, not seen when adding specific gravity among predictors, linked U-Cd to U-A1M or U-CC16 through secondary associations mimicking those induced by Cd nephrotoxity. CONCLUSIONS In young children U-Cd largely varies with diuresis, zinc metabolism and urinary A1M. These physiological determinants, unrelated to Cd body burden, may confound the child renal and developmental outcomes associated with low-level U-Cd.
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Affiliation(s)
- Hongyu Wang
- Louvain Centre for Toxicology and Applied Pharmacology, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Avenue Emmanuel Mounier 53.02, B-1200 Brussels, Belgium
| | - Xavier Dumont
- Louvain Centre for Toxicology and Applied Pharmacology, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Avenue Emmanuel Mounier 53.02, B-1200 Brussels, Belgium
| | - Vincent Haufroid
- Louvain Centre for Toxicology and Applied Pharmacology, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Avenue Emmanuel Mounier 53.02, B-1200 Brussels, Belgium
| | - Alfred Bernard
- Louvain Centre for Toxicology and Applied Pharmacology, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Avenue Emmanuel Mounier 53.02, B-1200 Brussels, Belgium
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22
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Vacchi-Suzzi C, Porucznik CA, Cox KJ, Zhao Y, Ahn H, Harrington JM, Levine KE, Demple B, Marsit CJ, Gonzalez A, Luft B, Meliker JR. Temporal variability of urinary cadmium in spot urine samples and first morning voids. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2017; 27:306-312. [PMID: 27168395 PMCID: PMC5461949 DOI: 10.1038/jes.2016.28] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 04/02/2016] [Indexed: 05/25/2023]
Abstract
Cadmium is a carcinogenic heavy metal. Urinary levels of cadmium are considered to be an indicator of long-term body burden, as cadmium accumulates in the kidneys and has a half-life of at least 10 years. However, the temporal stability of the biomarker in urine samples from a non-occupationally exposed population has not been rigorously established. We used repeated measurements of urinary cadmium (U-Cd) in spot urine samples and first morning voids from two separate cohorts, to assess the temporal stability of the samples. Urine samples from two cohorts including individuals of both sexes were measured for cadmium and creatinine. The first cohort (Home Observation of Perinatal Exposure (HOPE)) consisted of 21 never-smokers, who provided four first morning urine samples 2-5 days apart, and one additional sample roughly 1 month later. The second cohort (World Trade Center-Health Program (WTC-HP)) consisted of 78 individuals, including 52 never-smokers, 22 former smokers and 4 current smokers, who provided 2 spot urine samples 6 months apart, on average. Intra-class correlation was computed for groups of replicates from each individual to assess temporal variability. The median creatinine-adjusted U-Cd level (0.19 and 0.21 μg/g in the HOPE and WTC-HP, respectively) was similar to levels recorded in the United States by the National Health and Nutrition Examination Survey. The intra-class correlation (ICC) was high (0.76 and 0.78 for HOPE and WTC-HP, respectively) and similar between cohorts, irrespective of whether samples were collected days or months apart. Both single spot or first morning urine cadmium samples show good to excellent reproducibility in low-exposure populations.
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Affiliation(s)
- Caterina Vacchi-Suzzi
- Program in Public Health, Department of Family, Population and
Preventive Medicine, Stony Brook University, Stony Brook, New York 11794, USA
| | - Christina A. Porucznik
- Department of Family and Preventive Medicine, University of Utah,
Salt Lake City, Utah 84108, USA
| | - Kyley J. Cox
- Department of Family and Preventive Medicine, University of Utah,
Salt Lake City, Utah 84108, USA
| | - Yuan Zhao
- Department of Applied Mathematics and Statistics, Stony Brook
University, Stony Brook, New York 11794, USA
| | - Hongshik Ahn
- Department of Applied Mathematics and Statistics, Stony Brook
University, Stony Brook, New York 11794, USA
| | - James M. Harrington
- Analytical Sciences Department, Innovation, Technology and
Development, RTI International, Research Triangle Park, North Carolina 27709,
USA
| | - Keith E. Levine
- Analytical Sciences Department, Innovation, Technology and
Development, RTI International, Research Triangle Park, North Carolina 27709,
USA
| | - Bruce Demple
- Department of Pharmacological Sciences, Stony Brook University,
Stony Brook, New York 11794, USA
| | - Carmen J. Marsit
- Department of Pharmacology and Toxicology, Norris Cotton Cancer
Center, Dartmouth Medical School, New Hampshire 03755, USA
- Department of Family and Community Medicine, Norris Cotton Cancer
Center, Dartmouth Medical School, New Hampshire 03755, USA
| | - Adam Gonzalez
- Department of Psychiatry, Stony Brook University, Stony Brook, New
York 11794, USA
| | - Benjamin Luft
- Department of Medicine, Stony Brook University, Stony Brook, New
York 11794, USA
| | - Jaymie R. Meliker
- Program in Public Health, Department of Family, Population and
Preventive Medicine, Stony Brook University, Stony Brook, New York 11794, USA
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23
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Mauriello MC, Sbordone C, Montuori P, Alfano R, Triassi M, Iavicoli I, Manno M. Biomonitoring of toxic metals in incinerator workers: A systematic review. Toxicol Lett 2017; 272:8-28. [PMID: 28257910 DOI: 10.1016/j.toxlet.2017.02.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 02/19/2017] [Accepted: 02/22/2017] [Indexed: 11/20/2022]
Abstract
Exposure to chemicals released during urban waste disposal and treatment is increasingly regarded as a potential occupational health issue. Indeed, several toxic metals emitted by an incinerator, including As, Be, Cd, Cr, Pb, Mn, Hg, Ni and V, have potentially toxic properties and their exposure, therefore, may be of concern for the health of the workers involved. The levels of exposure should therefore be carefully measured. Environmental monitoring, however, may be unable, alone, to assess true exposure, due to its intrinsic limitations mainly concerning its inability to assess oral and dermal absorption. In these cases biological monitoring may represent a fundamental supplementary tool for the definition of the workers' true occupational exposure and for the prevention of the related health effects. There is, therefore, an increasing interest in developing and using, in these workers, sensitive and specific biomarkers for health risk assessment, particularly at low or even very low levels of exposure. Despite the large number of original and review articles present in the literature on the biomonitoring of workers exposed to metals, the data on subjects employed in waste treatment activities are scattered and results are sometimes inconsistent. This is the first systematic review, performed according to PRISMA methodology, of the major studies investigating the levels of different toxic metals measured in the main biological matrices (blood, urine, hair) of incinerator workers. The results show that the levels of metals measured in incinerators' workers are generally low, with some notable exceptions for Cd and Pb. These results, though, can be affected by several confounders related either to non-occupational exposure, including diet, area of residence and others, and/or by a number of methodological limitations, as we found in the reported studies. Future work should focus on an integrated approach, using ideally both biological and environmental monitoring. A particular emphasis should be given to the measurement of the different granulometric fractions of the dust containing metals, i.e. inhalable, thoracic, respirable and ultrafine fractions. Moreover, an accurate description of the work tasks and the characteristics and levels of non-occupational exposure should always be provided.
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Affiliation(s)
- Maria Chiara Mauriello
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Naples, Italy
| | - Carmine Sbordone
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Naples, Italy
| | - Paolo Montuori
- Department of Public Health, Section of Hygiene, University of Naples Federico II, Naples, Italy
| | - Rossella Alfano
- Department of Public Health, Section of Hygiene, University of Naples Federico II, Naples, Italy
| | - Maria Triassi
- Department of Public Health, Section of Hygiene, University of Naples Federico II, Naples, Italy
| | - Ivo Iavicoli
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Naples, Italy.
| | - Maurizio Manno
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Naples, Italy
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24
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Vacchi-Suzzi C, Kruse D, Harrington J, Levine K, Meliker JR. Is Urinary Cadmium a Biomarker of Long-term Exposure in Humans? A Review. Curr Environ Health Rep 2016; 3:450-458. [PMID: 27696280 PMCID: PMC5453507 DOI: 10.1007/s40572-016-0107-y] [Citation(s) in RCA: 98] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Cadmium is a naturally-occurring element, and humans are exposed from cigarettes, food, and industrial sources. Following exposure, cadmium accumulates in the kidney and is slowly released into the urine, usually proportionally to the levels found in the kidneys. Cadmium levels in a single spot urine sample have been considered indicative of long-term exposure to cadmium; however, such a potentially exceptional biomarker requires careful scrutiny. In this review, we report good to excellent temporal stability of urinary cadmium (intraclass correlation coefficient 0.66-0.81) regardless of spot urine or first morning void sampling. Factors such as changes in smoking habits and diseases characterized by increased excretion of proteins may produce short-term changes in urinary cadmium levels. We recommend that epidemiologists use this powerful biomarker in prospective studies stratified by smoking status, along with thoughtful consideration of additional factors that can influence renal physiology and cadmium excretion.
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Affiliation(s)
- Caterina Vacchi-Suzzi
- Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY, 11794, USA.
| | - Danielle Kruse
- Stony Brook University School of Medicine, Stony Brook, NY, 11794, USA
| | - James Harrington
- Analytical Sciences Department, Innovation, Technology and Development RTI International, Research Triangle Park, NC, 27709, USA
| | - Keith Levine
- Analytical Sciences Department, Innovation, Technology and Development RTI International, Research Triangle Park, NC, 27709, USA
| | - Jaymie R Meliker
- Program in Public Health, Department of Family, Population and Preventive Medicine Stony Brook University, Stony Brook, NY, 11794, USA
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25
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Eriksen KT, McElroy JA, Harrington JM, Levine KE, Pedersen C, Sørensen M, Tjønneland A, Meliker JR, Raaschou-Nielsen O. Urinary Cadmium and Breast Cancer: A Prospective Danish Cohort Study. J Natl Cancer Inst 2016; 109:djw204. [DOI: 10.1093/jnci/djw204] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 08/05/2016] [Indexed: 11/13/2022] Open
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26
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Cárdenas-González M, Osorio-Yáñez C, Gaspar-Ramírez O, Pavković M, Ochoa-Martínez A, López-Ventura D, Medeiros M, Barbier OC, Pérez-Maldonado IN, Sabbisetti VS, Bonventre JV, Vaidya VS. Environmental exposure to arsenic and chromium in children is associated with kidney injury molecule-1. ENVIRONMENTAL RESEARCH 2016; 150:653-662. [PMID: 27431456 PMCID: PMC5003729 DOI: 10.1016/j.envres.2016.06.032] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 06/08/2016] [Accepted: 06/19/2016] [Indexed: 05/19/2023]
Abstract
Environmental hazards from natural or anthropological sources are widespread, especially in the north-central region of Mexico. Children represent a susceptible population due to their unique routes of exposure and special vulnerabilities. In this study we evaluated the association of exposure to environmental kidney toxicants with kidney injury biomarkers in children living in San Luis Potosi (SLP), Mexico. A cross-sectional study was conducted with 83 children (5-12 years of age) residents of Villa de Reyes, SLP. Exposure to arsenic, cadmium, chromium, fluoride and lead was assessed in urine, blood and drinking water samples. Almost all tap and well water samples had levels of arsenic (81.5%) and fluoride (100%) above the permissible levels recommended by the World Health Organization. Mean urine arsenic (45.6ppb) and chromium (61.7ppb) were higher than the biological exposure index, a reference value in occupational settings. Using multivariate adjusted models, we found a dose-dependent association between kidney injury molecule-1 (KIM-1) across chromium exposure tertiles [(T1: reference, T2: 467pg/mL; T3: 615pg/mL) (p-trend=0.001)]. Chromium upper tertile was also associated with higher urinary miR-200c (500 copies/μl) and miR-423 (189 copies/μL). Arsenic upper tertile was also associated with higher urinary KIM-1 (372pg/mL). Other kidney injury/functional biomarkers such as serum creatinine, glomerular filtration rate, albuminuria, neutrophil gelatinase-associated lipocalin and miR-21 did not show any association with arsenic, chromium or any of the other toxicants evaluated. We conclude that KIM-1 might serve as a sensitive biomarker to screen children for kidney damage induced by environmental toxic agents.
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Affiliation(s)
- M Cárdenas-González
- Laboratory of Systems Pharmacology, Harvard Program in Therapeutic Sciences, Harvard Medical School, Boston, MA, United States
| | - C Osorio-Yáñez
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - O Gaspar-Ramírez
- Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco, Unidad Noreste (CIATEJ), Nuevo Leon, Mexico
| | - M Pavković
- Laboratory of Systems Pharmacology, Harvard Program in Therapeutic Sciences, Harvard Medical School, Boston, MA, United States; Renal Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - A Ochoa-Martínez
- Laboratorio de Toxicología Molecular, Centro de Investigación Aplicada en Ambiente y Salud (CIAAS), Coordinación para la Innovación y Aplicación de la Ciencia y la Tecnología (CIACYT), Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico
| | - D López-Ventura
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV), México City, Mexico
| | - M Medeiros
- Departamento de Nefrología, Hospital Infantil de México Federico Gómez, Mexico City, Mexico; Departamento de Farmacología, Facultad de Medicina, Universidad Nacional Autónoma de Mexico, Mexico City, Mexico
| | - O C Barbier
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV), México City, Mexico
| | - I N Pérez-Maldonado
- Laboratorio de Toxicología Molecular, Centro de Investigación Aplicada en Ambiente y Salud (CIAAS), Coordinación para la Innovación y Aplicación de la Ciencia y la Tecnología (CIACYT), Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico
| | - V S Sabbisetti
- Renal Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - J V Bonventre
- Renal Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - V S Vaidya
- Laboratory of Systems Pharmacology, Harvard Program in Therapeutic Sciences, Harvard Medical School, Boston, MA, United States; Renal Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
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27
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Adams SV, Shafer MM, Bonner MR, LaCroix AZ, Manson JE, Meliker JR, Neuhouser ML, Newcomb PA. Urinary Cadmium and Risk of Invasive Breast Cancer in the Women's Health Initiative. Am J Epidemiol 2016; 183:815-23. [PMID: 27037269 DOI: 10.1093/aje/kwv285] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 10/13/2015] [Indexed: 12/26/2022] Open
Abstract
Cadmium is a widespread heavy metal pollutant that may act as an exogenous estrogenic hormone. Environmental cadmium exposure has been associated with risk of breast cancer in retrospective studies. We prospectively assessed the relationship between cadmium exposure, evaluated by creatinine-normalized urinary cadmium concentration, and invasive breast cancer among 12,701 postmenopausal women aged ≥50 years in a Women's Health Initiative study of bone mineral density. After a median of 13.2 years of follow-up (1993-2010), 508 cases of invasive breast cancer and 1,050 comparison women were identified for a case-cohort analysis. Multivariable Cox regression was used to calculate hazard ratios and 95% confidence intervals. Risk of breast cancer was not associated with urinary cadmium parameterized either in quartiles (comparing highest quartile with lowest, hazard ratio = 0.80, 95% confidence interval: 0.56, 1.14; P for trend = 0.20) or as a log-transformed continuous variable (per 2-fold higher urinary cadmium concentration, hazard ratio = 0.94, 95% confidence interval: 0.86, 1.03). We did not observe an association between urinary cadmium and breast cancer risk in any subgroup examined, including never smokers and women with body mass index (weight (kg)/height (m)(2)) less than 25. Results were consistent in both estrogen receptor-positive and estrogen receptor-negative tumors. Our results do not support the hypothesis that environmental cadmium exposure is associated with risk of postmenopausal breast cancer.
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28
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Quraishi SM, Adams SV, Shafer M, Meliker JR, Li W, Luo J, Neuhouser ML, Newcomb PA. Urinary cadmium and estimated dietary cadmium in the Women's Health Initiative. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2016; 26:303-8. [PMID: 26015077 PMCID: PMC5077304 DOI: 10.1038/jes.2015.40] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 04/17/2015] [Indexed: 05/04/2023]
Abstract
Cadmium, a heavy metal dispersed in the environment as a result of industrial and agricultural applications, has been implicated in several human diseases including renal disease, cancers, and compromised bone health. In the general population, the predominant sources of cadmium exposure are tobacco and diet. Urinary cadmium (uCd) reflects long-term exposure and has been frequently used to assess cadmium exposure in epidemiological studies; estimated dietary intake of cadmium (dCd) has also been used in several studies. The validity of dCd in comparison with uCd is unclear. This study aimed to compare dCd, estimated from food frequency questionnaires, to uCd measured in spot urine samples from 1,002 participants of the Women's Health Initiative. Using linear regression, we found that dCd was not statistically significantly associated with uCd (β=0.006, P-value=0.14). When stratified by smoking status, dCd was not significantly associated with uCd both in never smokers (β=0.006, P-value=0.09) and in ever smokers (β=0.003, P-value=0.67). Our results suggest that because of the lack of association between estimated dCd and measured uCd, dietary estimation of cadmium exposure should be used with caution in epidemiologic studies.
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Affiliation(s)
- Sabah M Quraishi
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
- Fred Hutchinson Cancer Research Center, Cancer Prevention, Public Health Sciences, Seattle, Washington, USA
| | - Scott V Adams
- Fred Hutchinson Cancer Research Center, Cancer Prevention, Public Health Sciences, Seattle, Washington, USA
| | - Martin Shafer
- Environmental Chemistry and Technology Program, University of Wisconsin-Madison, Madison, WI, USA
| | - Jaymie R Meliker
- Department of Preventive Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Wenjun Li
- Department of Medicine, University of Massachusetts, Worcester, Massachusetts, USA
| | - Juhua Luo
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, USA
| | - Marian L Neuhouser
- Fred Hutchinson Cancer Research Center, Cancer Prevention, Public Health Sciences, Seattle, Washington, USA
| | - Polly A Newcomb
- Fred Hutchinson Cancer Research Center, Cancer Prevention, Public Health Sciences, Seattle, Washington, USA
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29
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Barrett JR. Studies Need More than a Spot Sample: Variability of Urinary Metal Levels over Time. ENVIRONMENTAL HEALTH PERSPECTIVES 2016; 124:A77. [PMID: 27035153 PMCID: PMC4829999 DOI: 10.1289/ehp.124-a77] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Julia R Barrett
- Julia R. Barrett, MS, ELS, a Madison, WI-based science writer and editor, is a member of the National Association of Science Writers and the Board of Editors in the Life Sciences
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30
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Bernard A. Confusion about Cadmium Risks: The Unrecognized Limitations of an Extrapolated Paradigm. ENVIRONMENTAL HEALTH PERSPECTIVES 2016; 124:1-5. [PMID: 26058085 PMCID: PMC4710609 DOI: 10.1289/ehp.1509691] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 06/05/2015] [Indexed: 05/08/2023]
Abstract
BACKGROUND Cadmium (Cd) risk assessment presently relies on tubular proteinuria as a critical effect and urinary Cd (U-Cd) as an index of the Cd body burden. Based on this paradigm, regulatory bodies have reached contradictory conclusions regarding the safety of Cd in food. Adding to the confusion, epidemiological studies implicate environmental Cd as a risk factor for bone, cardiovascular, and other degenerative diseases at exposure levels that are much lower than points of departure used for setting food standards. OBJECTIVE The objective was to examine whether the present confusion over Cd risks is not related to conceptual or methodological problems. DISCUSSION The cornerstone of Cd risk assessment is the assumption that U-Cd reflects the lifetime accumulation of the metal in the body. The validity of this assumption as applied to the general population has been questioned by recent studies revealing that low-level U-Cd varies widely within and between individuals depending on urinary flow, urine collection protocol, and recent exposure. There is also evidence that low-level U-Cd increases with proteinuria and essential element deficiencies, two potential confounders that might explain the multiple associations of U-Cd with common degenerative diseases. In essence, the present Cd confusion might arise from the fact that this heavy metal follows the same transport pathways as plasma proteins for its urinary excretion and the same transport pathways as essential elements for its intestinal absorption. CONCLUSIONS The Cd risk assessment paradigm needs to be rethought taking into consideration that low-level U-Cd is strongly influenced by renal physiology, recent exposure, and factors linked to studied outcomes. CITATION Bernard A. 2016. Confusion about cadmium risks: the unrecognized limitations of an extrapolated paradigm. Environ Health Perspect 124:1-5; http://dx.doi.org/10.1289/ehp.1509691.
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Affiliation(s)
- Alfred Bernard
- Louvain Centre for Toxicology and Applied Pharmacology, Institute of Experimental and Clinical Research (IREC), Catholic University of Louvain, Brussels, Belgium
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31
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Weaver VM, Kotchmar DJ, Fadrowski JJ, Silbergeld EK. Challenges for environmental epidemiology research: are biomarker concentrations altered by kidney function or urine concentration adjustment? JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2016; 26:1-8. [PMID: 25736163 DOI: 10.1038/jes.2015.8] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Revised: 01/07/2015] [Accepted: 01/07/2015] [Indexed: 05/28/2023]
Abstract
Biomonitoring has become a standard approach for exposure assessment in occupational and environmental epidemiology. The use of biological effect markers to identify early adverse changes in target organs has also become widely adopted. However, the potential for kidney function to affect biomarker levels in the body and the optimal approach to adjustment of biomarker concentrations in spot urine samples for hydration status are two important but underappreciated challenges associated with biomarker use. Several unexpected findings, such as positive associations between urine nephrotoxicant levels and estimated glomerular filtration rate (eGFR), have been reported recently in research using biomarkers. These and other findings, discussed herein, suggest an impact of kidney glomerular filtration or tubule processing on biomarker levels. This is more commonly raised in the context of decreased kidney filtration, traditionally referred to as reverse causality; however, recent data suggest that populations with normal kidney filtration may be affected as well. Misclassification bias would result if biomarkers reflect kidney function as well as either exposures or early biological effect outcomes. Furthermore, urine biomarker associations with eGFR that differ markedly by approach used to adjust for urine concentration have been reported. Associations between urine measures commonly used for this adjustment, such as urine creatinine, and specific research outcomes could alter observed biomarker associations with outcomes. Research recommendations to address the potential impact of kidney function and hydration status adjustment on biomarkers are provided, including a range of approaches to study design, exposure and outcome assessment, and adjustment for urine concentration.
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Affiliation(s)
- Virginia M Weaver
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
| | - Dennis J Kotchmar
- National Center for Environmental Assessment, United States Environmental Protection Agency, Research Triangle Park, North Carolina, USA
| | - Jeffrey J Fadrowski
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Ellen K Silbergeld
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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Adams SV, Barrick B, Christopher EP, Shafer MM, Makar KW, Song X, Lampe JW, Vilchis H, Ulery A, Newcomb PA. Genetic variation in metallothionein and metal-regulatory transcription factor 1 in relation to urinary cadmium, copper, and zinc. Toxicol Appl Pharmacol 2015; 289:381-8. [PMID: 26529669 PMCID: PMC4689293 DOI: 10.1016/j.taap.2015.10.024] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 10/27/2015] [Accepted: 10/30/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND Metallothionein (MT) proteins play critical roles in the physiological handling of both essential (Cu and Zn) and toxic (Cd) metals. MT expression is regulated by metal-regulatory transcription factor 1 (MTF1). Hence, genetic variation in the MT gene family and MTF1 might influence excretion of these metals. METHODS 321 women were recruited in Seattle, WA and Las Cruces, NM and provided demographic information, urine samples for measurement of metal concentrations by mass spectrometry and creatinine, and blood or saliva for extraction of DNA. Forty-one single nucleotide polymorphisms (SNPs) within the MTF1 gene region and the region of chromosome 16 encoding the MT gene family were selected for genotyping in addition to an ancestry informative marker panel. Linear regression was used to estimate the association of SNPs with urinary Cd, Cu, and Zn, adjusted for age, urinary creatinine, smoking history, study site, and ancestry. RESULTS Minor alleles of rs28366003 and rs10636 near the MT2A gene were associated with lower urinary Cd, Cu, and Zn. Minor alleles of rs8044719 and rs1599823, near MT1A and MT1B, were associated with lower urinary Cd and Zn, respectively. Minor alleles of rs4653329 in MTF1 were associated with lower urinary Cd. CONCLUSIONS These results suggest that genetic variation in the MT gene region and MTF1 influences urinary Cd, Cu, and Zn excretion.
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Affiliation(s)
- Scott V Adams
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA 98109, USA.
| | - Brian Barrick
- Department of Plant and Environmental Sciences, New Mexico State University, Box 30003 MSC 3Q, Las Cruces, NM 88003, USA
| | - Emily P Christopher
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA 98109, USA
| | - Martin M Shafer
- Environmental Chemistry and Technology, Wisconsin State Laboratory of Hygiene, University of Wisconsin, 2601 Agriculture Dr., Madison, WI 53718, USA
| | - Karen W Makar
- Public Health Science Biomarker Laboratory, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA 98109, USA
| | - Xiaoling Song
- Public Health Science Biomarker Laboratory, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA 98109, USA
| | - Johanna W Lampe
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA 98109, USA
| | - Hugo Vilchis
- Border Epidemiology and Environmental Health Center, New Mexico State University, Box 30001 MSC 3BEC, Las Cruces, NM 88003, USA
| | - April Ulery
- Department of Plant and Environmental Sciences, New Mexico State University, Box 30003 MSC 3Q, Las Cruces, NM 88003, USA
| | - Polly A Newcomb
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA 98109, USA
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Byber K, Lison D, Verougstraete V, Dressel H, Hotz P. Cadmium or cadmium compounds and chronic kidney disease in workers and the general population: a systematic review. Crit Rev Toxicol 2015; 46:191-240. [DOI: 10.3109/10408444.2015.1076375] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Vacchi-Suzzi C, Eriksen KT, Levine K, McElroy J, Tjønneland A, Raaschou-Nielsen O, Harrington JM, Meliker JR. Dietary Intake Estimates and Urinary Cadmium Levels in Danish Postmenopausal Women. PLoS One 2015; 10:e0138784. [PMID: 26390122 PMCID: PMC4577120 DOI: 10.1371/journal.pone.0138784] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 09/03/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Cadmium is a known carcinogen that can disrupt endocrine signalling. Cigarette smoking and food are the most common routes of non-occupational exposure to cadmium. Cadmium accumulates in the kidney and can be measured in urine, making urine cadmium (U-Cd) a biomarker of long-term exposure. However dietary-cadmium (D-Cd) intake estimates are often used as surrogate indicator of cadmium exposure in non-smoking subjects. It is therefore important to investigate the concordance between D-Cd estimates obtained with Food Frequency Questionnaires and U-Cd. METHODS U-Cd levels were compared with estimated dietary-cadmium (D-Cd) intake in 1764 post-menopausal women from the Danish Diet, Cancer and Health cohort. For each participant, a food frequency questionnaire, and measures of cadmium content in standard recipes were used to judge the daily intake of cadmium, normalized by daily caloric intake. Cadmium was measured by ICP-MS in spot urine sampled at baseline and normalized by urinary creatinine. Information on diet, socio-demographics and smoking were self-reported at baseline. RESULTS Linear regressions between U-Cd and D-Cd alone revealed minimal but significant positive correlation in never smokers (R2 = 0.0076, β = 1.5% increase per 1 ng Cd kcal(-1), p = 0.0085, n = 782), and negative correlation in current smokers (R2 = 0.0184, β = 7.1% decrease per 1 ng Cd kcal(-1) change, p = 0.0006, n = 584). In the full study population, most of the variability in U-Cd was explained by smoking status (R2 = 0.2450, n = 1764). A forward selection model revealed that the strongest predictors of U-Cd were age in never smokers (Δ R2 = 0.04), smoking duration in former smokers (Δ R2 = 0.06) and pack-years in current smokers (Δ R2 = 0.07). Food items that contributed to U-Cd were leafy vegetables and soy-based products, but explained very little of the variance in U-Cd. CONCLUSIONS Dietary-Cd intake estimated from food frequency questionnaires correlates only minimally with U-Cd biomarker, and its use as a Cd exposure indicator may be of limited utility in epidemiologic studies.
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Affiliation(s)
- Caterina Vacchi-Suzzi
- Department of Preventive Medicine and Program in Public Health, Stony Brook University, Stony Brook, New York, United States of America
| | | | - Keith Levine
- RTI International Trace Inorganics Department, Research Triangle Park, North Carolina, United States of America
| | - Jane McElroy
- Family and Community Medicine, University of Missouri, Columbia, Missouri, United States of America
| | | | - Ole Raaschou-Nielsen
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Environmental Science, Aarhus University, Aarhus, Denmark
| | - James M. Harrington
- RTI International Trace Inorganics Department, Research Triangle Park, North Carolina, United States of America
| | - Jaymie R. Meliker
- Department of Preventive Medicine and Program in Public Health, Stony Brook University, Stony Brook, New York, United States of America
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Berglund M, Larsson K, Grandér M, Casteleyn L, Kolossa-Gehring M, Schwedler G, Castaño A, Esteban M, Angerer J, Koch HM, Schindler BK, Schoeters G, Smolders R, Exley K, Sepai O, Blumen L, Horvat M, Knudsen LE, Mørck TA, Joas A, Joas R, Biot P, Aerts D, De Cremer K, Van Overmeire I, Katsonouri A, Hadjipanayis A, Cerna M, Krskova A, Nielsen JKS, Jensen JF, Rudnai P, Kozepesy S, Griffin C, Nesbitt I, Gutleb AC, Fischer ME, Ligocka D, Jakubowski M, Reis MF, Namorado S, Lupsa IR, Gurzau AE, Halzlova K, Jajcaj M, Mazej D, Tratnik JS, Lopez A, Cañas A, Lehmann A, Crettaz P, Den Hond E, Govarts E. Exposure determinants of cadmium in European mothers and their children. ENVIRONMENTAL RESEARCH 2015; 141:69-76. [PMID: 25465922 DOI: 10.1016/j.envres.2014.09.042] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 08/25/2014] [Accepted: 09/07/2014] [Indexed: 05/18/2023]
Abstract
The metal cadmium (Cd) is a widespread environmental pollutant with documented adverse effects on the kidneys and bones from long-term environmental exposure, but with insufficiently elucidated public health consequences such as risk of cardiovascular disease, hormone-related cancer in adults and developmental effects in children. This study is the first pan-European human biomonitoring project that succeeded in performing harmonized measurements of Cd in urine in a comparable way in mother-child couples from 16 European countries. The aim of the study was to evaluate the overall Cd exposure and significant determinants of Cd exposure. A study population of 1632 women (24-52 years of age), and 1689 children (5-12 years of age), from 32 rural and urban areas, was examined within a core period of 6 months in 2011-2012. Women were stratified as smokers and non-smokers. As expected, smoking mothers had higher geometric mean (gm) urinary cadmium (UCd; 0.24 µg/g crea; n=360) than non-smoking mothers (gm 0.18 µg/g crea; n=1272; p<0.0001), and children had lower UCd (gm 0.065 µg/g crea; n=1689) than their mothers at the country level. Non-smoking women exposed to environmental tobacco smoke (ETS) at home had 14% (95% CI 1-28%) higher UCd than those who were not exposed to ETS at home (p=0.04). No influence of ETS at home or other places on UCd levels was detected in children. Smoking women with primary education as the highest educational level of the household had 48% (95% CI 18-86%) higher UCd than those with tertiary education (p=0.0008). The same observation was seen in non-smoking women and in children; however they were not statistically significant. In children, living in a rural area was associated with 7% (95% CI 1-13%) higher UCd (p=0.03) compared to living in an urban area. Children, 9-12 years had 7% (95% CI 1-13%) higher UCd (p=0.04) than children 5-8 years. About 1% of the mothers, and 0.06% of the children, exceeded the tolerable weekly intake (TWI) appointed by EFSA, corresponding to 1.0 µg Cd/g crea in urine. Poland had the highest UCd in comparison between the 16 countries, while Denmark had the lowest. Whether the differences between countries are related to differences in the degree of environmental Cd contamination or to differences in lifestyle, socioeconomic status or dietary patterns is not clear.
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Affiliation(s)
- Marika Berglund
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Kristin Larsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Margaretha Grandér
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | | | | | - Argelia Castaño
- Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Intitute of Health Carlos III (ISCIII), Madrid, Spain
| | - Marta Esteban
- Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Intitute of Health Carlos III (ISCIII), Madrid, Spain
| | - Jürgen Angerer
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance-Institute of the Ruhr-Universität Bochum (IPA), Germany
| | - Holger M Koch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance-Institute of the Ruhr-Universität Bochum (IPA), Germany
| | - Birgit K Schindler
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance-Institute of the Ruhr-Universität Bochum (IPA), Germany
| | - Greet Schoeters
- Flemish Institute for Technological Research (VITO), Environmental Risk and Health, Mol, Belgium
| | - Roel Smolders
- Flemish Institute for Technological Research (VITO), Environmental Risk and Health, Mol, Belgium
| | - Karen Exley
- Public Health England, Oxfordshire, United Kingdom
| | - Ovnair Sepai
- Public Health England, Oxfordshire, United Kingdom
| | - Luies Blumen
- Environmental Health Sciences International, Hulst, The Netherlands
| | | | - Lisbeth E Knudsen
- Department of Public Health, University of Copenhagen (UCPH), Copenhagen, Denmark
| | - Thit A Mørck
- Department of Public Health, University of Copenhagen (UCPH), Copenhagen, Denmark
| | | | | | - Pierre Biot
- Federal Public Service Health, Food Chain Safety and Environment, Brussels, Belgium
| | - Dominique Aerts
- Federal Public Service Health, Food Chain Safety and Environment, Brussels, Belgium
| | - Koen De Cremer
- Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium
| | | | | | - Adamos Hadjipanayis
- Larnaca General Hospital, Ministry of Health, School of Medicine, European University of Cyprus, Larnaca, Cyprus
| | - Milena Cerna
- National Institute of Public Health, Prague, Czech Republic
| | - Andrea Krskova
- National Institute of Public Health, Prague, Czech Republic
| | - Jeanette K S Nielsen
- Department of Public Health, University of Copenhagen (UCPH), Copenhagen, Denmark
| | - Janne Fangel Jensen
- Department of Public Health, University of Copenhagen (UCPH), Copenhagen, Denmark
| | - Peter Rudnai
- National Institute of Environmental Health, Budapest, Hungary
| | | | - Chris Griffin
- Health Service Executive, Dublin Public Analyst's Laboratory, Dublin, Ireland
| | - Ian Nesbitt
- Health Service Executive, Dublin Public Analyst's Laboratory, Dublin, Ireland
| | - Arno C Gutleb
- Centre de Recherche Public-Gabriel Lippmann, Luxemburg
| | | | | | | | | | | | | | | | | | - Michal Jajcaj
- Authority of Public Health, Bratislava, Slovak Republic
| | | | | | - Ana Lopez
- Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Intitute of Health Carlos III (ISCIII), Madrid, Spain
| | - Ana Cañas
- Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Intitute of Health Carlos III (ISCIII), Madrid, Spain
| | | | | | - Elly Den Hond
- Flemish Institute for Technological Research (VITO), Environmental Risk and Health, Mol, Belgium
| | - Eva Govarts
- Flemish Institute for Technological Research (VITO), Environmental Risk and Health, Mol, Belgium
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Weidemann D, Kuo CC, Navas-Acien A, Abraham AG, Weaver V, Fadrowski J. Association of arsenic with kidney function in adolescents and young adults: Results from the National Health and Nutrition Examination Survey 2009-2012. ENVIRONMENTAL RESEARCH 2015; 140:317-24. [PMID: 25909687 PMCID: PMC4492804 DOI: 10.1016/j.envres.2015.03.030] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 03/25/2015] [Accepted: 03/26/2015] [Indexed: 05/25/2023]
Abstract
BACKGROUND Long-term exposure to arsenic is a major public health concern. Emerging evidence suggests adverse health effects even at low levels of exposure. This study examined the association of arsenic exposure with estimated glomerular filtration rate (eGFR) and compared methods of adjustment for urinary dilution in a representative sample of U.S. adolescents and young adults. METHODS We performed a cross-sectional study of 1253 participants ages 12-30 years in the 2009-2012 National Health and Nutrition Examination Survey (NHANES) with available urinary arsenic and eGFR measures. Multivariable linear regression was used to model the association of urinary total arsenic and dimethylarsinate (DMA) with eGFR. RESULTS The median urinary total arsenic and DMA concentrations were 6.3 μg/L (IQR 3.3-12.7 μg/L) and 3.3 μg/L (IQR 1.7-5.7 μg/L), respectively. Median eGFR was 109 mL/min/1.73 m(2). Adjusting arsenic for urine concentration with urinary creatinine, eGFR was 4.0 mL/min/1.73 m(2) higher (95% confidence interval [CI] 1.0-7.1 mL/min/1.73 m(2)) and 4.3mL/min/1.73 m(2) higher (95% CI 0.5-8.0 mL/min/1.73 m(2)) per log-unit increase in total arsenic and DMA, respectively. When using urine osmolality to adjust for urine concentration, a log-unit increase in total arsenic and DMA was associated with a 0.4 mL/min/1.73 m(2) (95% CI -1.8 to 1.1 mL/min/1.73 m(2)) and 0.01 (95% CI -1.9 to 1.9 mL/min/1.73 m(2)) lower eGFR, respectively. CONCLUSIONS Discordant associations were observed between arsenic and eGFR levels depending on whether urinary creatinine or osmolality was used to adjust for urine concentration. Further study should be dedicated to validating the best approach to account for urinary dilution in research in toxicants, and this may have implications for all studies which examine urinary biomarkers.
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Affiliation(s)
- Darcy Weidemann
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Division of Nephrology, Department of Pediatrics, Johns Hopkins Medical Institutions, Baltimore, MD, USA; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
| | - Chin-Chi Kuo
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA; Division of Nephrology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Ana Navas-Acien
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Alison G Abraham
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Virginia Weaver
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Jeffrey Fadrowski
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Division of Nephrology, Department of Pediatrics, Johns Hopkins Medical Institutions, Baltimore, MD, USA; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA
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Jenny-Burri J, Haldimann M, Brüschweiler BJ, Bochud M, Burnier M, Paccaud F, Dudler V. Cadmium body burden of the Swiss population. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2015; 32:1265-72. [PMID: 26062765 DOI: 10.1080/19440049.2015.1051137] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Urinary cadmium (Cd) excretion was measured within a representative Swiss collective. With a median of 0.23 µg/24 h (n = 1409) and the 95th percentile at 0.81 µg/24 h, no increased health risk for the general non-exposed population was identified. The independent variables Age, BMI and Smoking habit had a significant effect on urinary Cd excretion. No association was found with the region of residence and sex. A subsample comparison between 24-h and spot urines of the same subjects (n = 90) did not reveal an evident concentration difference for both creatinine-adjusted sample types. Dependencies on age and gender were observed for creatinine, which consequently impacts on the creatinine normalisation of urine samples.
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Affiliation(s)
- Judith Jenny-Burri
- a Federal Food Safety and Veterinary Office , Risk Assessment Division , Bern , Switzerland
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Fagerstrom P, Sallsten G, Akerstrom M, Haraldsson B, Barregard L. Urinary albumin excretion in healthy adults: a cross sectional study of 24-hour versus timed overnight samples and impact of GFR and other personal characteristics. BMC Nephrol 2015; 16:8. [PMID: 25616740 PMCID: PMC4417247 DOI: 10.1186/1471-2369-16-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 01/13/2015] [Indexed: 12/02/2022] Open
Abstract
Background Urinary albumin can be measured in 24 h or spot samples. The 24 h urinary albumin excretion rate is considered the gold standard, but is cumbersome to collect. Instead, often an overnight sample is collected, and adjusted for dilution. Proxies for 24 h excretion rate have been studied in diabetics, but seldom in healthy individuals. Our aims were to compare 24 h and overnight albumin excretion, to assess the impact of personal characteristics, and to examine correlations between the 24 h excretion rate and proxies such as the albumin to creatinine ratio (ACR). Methods Separate 24 h and overnight urine samples were collected from 152 healthy kidney donors. Urinary creatinine, specific gravity, collection time, and sample volume determined. Differences between 24 h and overnight samples were examined, and the effects of age, sex, smoking, body mass, glomerular filtration rate, and urinary flow rate were assessed. Results The 24 h albumin excretion rate and ACR were both significantly higher than their overnight counterparts. Unadjusted albumin was unsurprisingly higher in the more concentrated overnight samples, while concentrations adjusted for specific gravity were similar. In multivariate analysis, the 24 h excretion rate and proxies were positively associated with glomerular filtration rate, as was ACR in overnight samples. There were positive associations between urinary albumin and body mass. Conclusions Proxies for the 24 h albumin excretion rate showed relatively high correlations with this gold standard, but differences due to sampling period, adjustment method, and personal characteristics were large enough to be worth considering in studies of albumin excretion in healthy individuals.
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Affiliation(s)
- Peter Fagerstrom
- Department of Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, PO Box 414, Gothenburg, S-405 30, Sweden.
| | - Gerd Sallsten
- Department of Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, PO Box 414, Gothenburg, S-405 30, Sweden.
| | - Magnus Akerstrom
- Department of Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, PO Box 414, Gothenburg, S-405 30, Sweden.
| | - Borje Haraldsson
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Lars Barregard
- Department of Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, PO Box 414, Gothenburg, S-405 30, Sweden.
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Kawada T. Urinary creatinine adjustment for uranium and kidney outcomes from lead workers. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2015; 25:119-120. [PMID: 25515540 DOI: 10.1038/jes.2014.77] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, Japan
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Sánchez-Rodríguez JE, Bartolomé M, Cañas AI, Huetos O, Navarro C, Rodríguez AC, Arribas M, Esteban M, López A, Castaño A. Anti-smoking legislation and its effects on urinary cotinine and cadmium levels. ENVIRONMENTAL RESEARCH 2015; 136:227-33. [PMID: 25460641 DOI: 10.1016/j.envres.2014.09.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Revised: 09/09/2014] [Accepted: 09/16/2014] [Indexed: 05/13/2023]
Abstract
Anti-smoking legislation has been associated with an improvement in health indicators. Since the cadmium (Cd) body burden in the general population is markedly increased by smoke exposure, we analyzed the impact of the more restrictive legislation that came into force in Spain in 2011 by measuring Cd and cotinine in first morning urine samples from 83 adults in Madrid (Spain) before (2010) and after (2011) introduction of this law. Individual pair-wise comparisons showed a reduction of creatinine corrected Cotinine and Cd levels for non-active smokers, i. e. those which urinary cotinine levels are below 50 μg/L. After the application of the stricter law, cotinine levels in urine only decreased in non-active smokers who self-reported not to be exposed to second-hand smoke. The reduction in second hand smoke exposure was significantly higher in weekends (Friday to Sunday) than in working days (Monday to Thursday). The decrease in U-Cd was highly significant in non-active smokers and, in general, correlated with lower creatinine excretion. Therefore correction by creatinine could bias urinary Cd results, at least for cotinine levels higher than 500 μg/L. The biochemical/toxicological benefits detected herein support the stricter application of anti-smoking legislation and emphasize the need to raise the awareness of the population as regards exposure at home.
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Affiliation(s)
- Jinny E Sánchez-Rodríguez
- Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Instituto de Salud Carlos III, Carretera Majadahonda-Pozuelo Km. 2, Majadahonda, 28220 Madrid, Spain.
| | - Mónica Bartolomé
- Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Instituto de Salud Carlos III, Carretera Majadahonda-Pozuelo Km. 2, Majadahonda, 28220 Madrid, Spain.
| | - Ana I Cañas
- Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Instituto de Salud Carlos III, Carretera Majadahonda-Pozuelo Km. 2, Majadahonda, 28220 Madrid, Spain.
| | - Olga Huetos
- Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Instituto de Salud Carlos III, Carretera Majadahonda-Pozuelo Km. 2, Majadahonda, 28220 Madrid, Spain.
| | - Carmen Navarro
- Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Instituto de Salud Carlos III, Carretera Majadahonda-Pozuelo Km. 2, Majadahonda, 28220 Madrid, Spain.
| | - A Carolina Rodríguez
- Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Instituto de Salud Carlos III, Carretera Majadahonda-Pozuelo Km. 2, Majadahonda, 28220 Madrid, Spain.
| | - Misericordia Arribas
- Servicio de Prevención, Instituto de Salud Carlos III, Majadahonda, 28220 Madrid, Spain.
| | - Marta Esteban
- Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Instituto de Salud Carlos III, Carretera Majadahonda-Pozuelo Km. 2, Majadahonda, 28220 Madrid, Spain.
| | - Ana López
- Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Instituto de Salud Carlos III, Carretera Majadahonda-Pozuelo Km. 2, Majadahonda, 28220 Madrid, Spain.
| | - Argelia Castaño
- Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Instituto de Salud Carlos III, Carretera Majadahonda-Pozuelo Km. 2, Majadahonda, 28220 Madrid, Spain.
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Wallin M, Sallsten G, Lundh T, Barregard L. Low-level cadmium exposure and effects on kidney function. Occup Environ Med 2014; 71:848-54. [PMID: 25286916 PMCID: PMC4251161 DOI: 10.1136/oemed-2014-102279] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Revised: 09/09/2014] [Accepted: 09/17/2014] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The nephrotoxicity of cadmium at low levels of exposure, measured by urinary cadmium, has recently been questioned since co-excretion of cadmium and proteins may have causes other than cadmium toxicity. The aim of this study was to explore the relation between kidney function and low or moderate cadmium levels, measured directly in kidney biopsies. METHODS We analysed cadmium in kidney biopsies (K-Cd), blood (B-Cd) and urine (U-Cd) from 109 living kidney donors in a cross-sectional study. We measured glomerular filtration rate (GFR), cystatin C in serum, albumin, β-2-microglobulin (B2M), retinol-binding protein (RBP), α-1-microglobulin (A1M), N-acetyl-β-d-glucosaminidase and kidney injury molecule 1 (KIM-1) in 24 h and overnight urine. RESULTS We found significant positive associations between A1M excretion and K-Cd in multiple regression models including age, sex, weight, smoking and urinary flow rate. This association was also present in never-smokers. A1M was also positively associated with B-Cd and U-Cd. GFR and the other biomarkers of kidney function were not associated with K-Cd. GFR estimated from serum cystatin C showed a very poor correlation with measured GFR. KIM-1, RBP and possibly albumin were positively associated with U-Cd, but only in overnight urine. No associations were found with B2M. CONCLUSIONS Our results suggest that A1M in urine is a sensitive biomarker for effects of low-level cadmium exposure. A few associations between other renal biomarkers and U-Cd, but not K-Cd, were probably caused by physiological co-excretion or chance.
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Affiliation(s)
- Maria Wallin
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital and Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gerd Sallsten
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital and Academy, University of Gothenburg, Gothenburg, Sweden
| | - Thomas Lundh
- Department of Occupational and Environmental Medicine, Lund University Hospital, Lund, Sweden
| | - Lars Barregard
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital and Academy, University of Gothenburg, Gothenburg, Sweden
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42
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Biological monitoring guidance values for chemical incidents. Toxicol Lett 2014; 231:324-7. [DOI: 10.1016/j.toxlet.2014.06.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 06/12/2014] [Accepted: 06/18/2014] [Indexed: 11/22/2022]
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Barregard L, Bergström G, Fagerberg B. Cadmium, type 2 diabetes, and kidney damage in a cohort of middle-aged women. ENVIRONMENTAL RESEARCH 2014; 135:311-316. [PMID: 25462681 DOI: 10.1016/j.envres.2014.09.017] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 09/23/2014] [Accepted: 09/25/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND It has been proposed that diabetic patients are more sensitive to the nephrotoxicity of cadmium (Cd) compared to non-diabetics, but few studies have examined this in humans, and results are inconsistent. AIM To test the hypothesis that women with type 2 diabetes mellitus (DM) or impaired glucose tolerance (IGT) have higher risk of kidney damage from cadmium compared to women with normal glucose tolerance (NGT). METHODS All 64-year-old women in Gothenburg, Sweden, were invited to a screening examination including repeated oral glucose tolerance tests. Random samples of women with DM, IGT, and NGT were recruited for further clinical examinations. Serum creatinine was measured and used to calculate estimated glomerular filtration rate (eGFR). Albumin (Alb) and retinol-binding protein (RBP) were analyzed in a 12h urine sample. Cadmium in blood (B-Cd) and urine (U-Cd) was determined using inductively coupled plasma mass spectrometry. Associations between markers of kidney function (eGFR, Alb, and RBP) and quartiles of B-Cd and U-Cd were evaluated in models, including also blood pressure and smoking habits. RESULTS The mean B-Cd (n=590) was 0.53 µg/L (median 0.34 µg/L). In multivariable models, a significant interaction was seen between high B-Cd (upper quartile, >0.56 µg/L) and DM (point estimate +0.40 mg Alb/12h, P=0.04). In stratified analyzes, the effect of high B-Cd on Alb excretion was significant in women with DM (53% higher Alb/12h, P=0.03), but not in women with IGT or NGT. Models with urinary albumin adjusted for creatinine showed similar results. In women with DM, the multivariable odds ratio (OR) for microalbuminuria (>15 mg/12h) was increased in the highest quartile of B-Cd vs. B-Cd quartiles 1-3 in women with DM (OR 4.2, 95% confidence interval 1.1-12). No such effect was found in women with IGT or NGT. There were no associations between B-Cd and eGFR or excretion of RBP, and no differences between women with DM, IGT, or NGT regarding effect of B-Cd on eGFR or RBP. CONCLUSION The present study provides support for the hypothesis that women with DM have higher risk of renal glomerular damage from cadmium exposure compared to women without DM.
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Affiliation(s)
- Lars Barregard
- Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg P.O. Box 414, SE-405 30 Gothenburg, Sweden.
| | - Göran Bergström
- Sahlgrenska Center for Cardiovascular and Metabolic Research, Wallenberg Laboratory, Sahlgrenska University Hospital, SE-405 30 Gothenburg, Sweden; Department of Molecular and Clinical Medicine, University of Gothenburg, SE-405 30 Gothenburg, Sweden.
| | - Björn Fagerberg
- Sahlgrenska Center for Cardiovascular and Metabolic Research, Wallenberg Laboratory, Sahlgrenska University Hospital, SE-405 30 Gothenburg, Sweden; Department of Molecular and Clinical Medicine, University of Gothenburg, SE-405 30 Gothenburg, Sweden.
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