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Rahati S, Hashemi M, Orooji A, Afshari A, Sany SBT. Health risk assessments of heavy metals and trace elements exposure in the breast milk of lactating mothers in the Northeastern Iran. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:25892-25906. [PMID: 38488912 DOI: 10.1007/s11356-024-32795-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 02/29/2024] [Indexed: 03/17/2024]
Abstract
Mother's breast milk is a natural and complete food for infants but can be a main source of exposure to toxic pollutants. These pollutants can negatively affect the health of the infant. Therefore, conducting biomonitoring surveys is essential to evaluate such health effects in toxicological research. This study aimed to estimate the probable health risks for infants exposed to essential and non-essential trace elements through breast milk ingestion. This descriptive-analytical, cross-sectional study was performed on 90 breastfeeding mothers referred to the health centers in Mashhad, Iran in January 2021. The health risk assessments (carcinogenic and non-carcinogenic risk) were estimated using chronic daily intake (CDI), hazard quotient (HQ), hazard index (HI), and lifetime carcinogenic risk (CR), which were recommended by the US Environmental Protection Agency (US EPA). The results of the HQ values of trace elements through ingestion exposure for arsenic (90%), copper (90%), zinc (40%), and iron (10%) exceeded the threshold of HQ, and arsenic (66.59%), copper (16.91%), and zinc (9.68%) and iron (4.57%) had the highest contribution to increasing the HI index. The average value of CR was 5. 08 × 10-3. Chromium and iron showed significant relationships (P<0.05) with education level and disease background in this study, and the concentration of chromium, iron, and zinc in the breast milk samples significantly changed during lactation stages (P<0.05). Overall, the risk of carcinogenicity through exposure to breast milk for infants was higher than the safety level of US EPA risk. Therefore, there could be a potential health risk of trace elements, particularly arsenic, copper, and zinc for infants in Mashhad, Iran through the consumption of mothers' breast milk. More efforts are required to control and reduce routes of receiving trace elements in breastfeeding mothers by the competent authorities.
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Affiliation(s)
- Shiva Rahati
- Department of Food Sciences and Technology, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Hashemi
- Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Arezoo Orooji
- Department of Epidemiology and Biostatistics, Faculty of Health Sciences, Mashhad University of Medical Sciences, Mashhad, 13131-99137, Iran
| | - Asma Afshari
- Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyedeh Belin Tavakoly Sany
- Department of Health, Safety, Environment Managment, School of Health Mashhad University of Medical Sciences, Mashhad, Iran.
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, 13131-99137, Iran.
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Liao KW, Lee WJ, Lin SC, Tsao YN, Lin HY, Liu C, Chin WS. Probabilistic risk assessment for determining nonessential metals in commercial infant formula products in Taiwan. J Food Sci 2024; 89:1804-1813. [PMID: 38258895 DOI: 10.1111/1750-3841.16929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/06/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024]
Abstract
During the early months of life, infant formula plays a crucial role as a primary source of both food and essential nutrients for infants, serving as a replacement for or supplement to breast milk. However, nonessential metals in infant formulas are a concern because infants are highly vulnerable to chemical exposure. The aim of this study was to investigate infant exposure to nonessential metals in infant formula products in Taiwan and assess the associated health risks. In this study, concentrations of arsenic (As), barium (Ba), cadmium (Cd), manganese (Mn), lead (Pb), and vanadium (V) in 45 formula products for 0-1-year-old infants were determined by inductively coupled plasma mass spectrometry. The mean As, Ba, Cd, Mn, Pb, and V concentrations were 6.42, 280, 3.72, 1425, 20.4, and 21.9 µg/kg, respectively. According to our probabilistic simulation of the estimated daily intake of metals, the proportion of hazard quotients exceeding one was 7.69% for As and 3.29% for Mn, and that of hazard index (HI) values exceeding 1 was >17% for metals. Arsenic had the largest HI contribution (46.9%), followed by Mn (22.3%) and Pb (12.7%). The nonessential metals content in infant formula raises potential noncarcinogenic health concerns for infants in Taiwan. Therefore, regulations for nonessential metals must be imposed on related food products in Taiwan, with a particular focus on As and Mn.
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Affiliation(s)
- Kai-Wei Liao
- School of Food Safety, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Wei-Ju Lee
- School of Food Safety, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Shao-Chi Lin
- School of Food Safety, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Yi-Ning Tsao
- School of Food Safety, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Hsin-Ying Lin
- School of Food Safety, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Chen Liu
- Master Program in Food Safety, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Wei-Shan Chin
- School of Nursing, College of Medicine, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan
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Butler EE, Karagas MR, Demidenko E, Bellinger DC, Korrick SA. In utero arsenic exposure and early childhood motor development in the New Hampshire Birth Cohort Study. FRONTIERS IN EPIDEMIOLOGY 2023; 3:1139337. [PMID: 38455900 PMCID: PMC10910989 DOI: 10.3389/fepid.2023.1139337] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 04/21/2023] [Indexed: 03/09/2024]
Abstract
Introduction High-level prenatal and childhood arsenic (As) exposure characteristic of several regions in Asia (e.g., Bangladesh), may impact motor function. However, the relationship between lower-level arsenic exposure (characteristic of other regions) and motor development is largely unstudied, despite the potential for deficient motor skills in childhood to have adverse long-term consequences. Thus, we sought to investigate the association between prenatal As exposure and motor function among 395 children in the New Hampshire Birth Cohort Study, a rural cohort from northern New England. Methods Prenatal exposure was estimated by measuring maternal urine speciated As at 24-28 weeks of gestation using high-performance liquid chromatography (HPLC) inductively coupled plasma mass spectrometry (ICP-MS) and summing inorganic As, monomethylarsonic acid, and dimethylarsinic acid to obtain total urinary As (tAs). Motor function was assessed with the Bruininks-Oseretsky Test of Motor Proficiency, 2nd Edition (BOT-2) at a mean (SD) age of 5.5 (0.4) years. Results Children who completed this exam were largely reported as white race (97%), born to married mothers (86%) with a college degree or higher (67%). The median (IQR) gestational urine tAs concentration was 4.0 (5.0) µg/L. Mean (SD) BOT-2 scores were 48.6 (8.4) for overall motor proficiency and 48.2 (9.6) for fine manual control [standard score = 50 (10)], and were 16.3 (5.1) for fine motor integration and 12.5 (4.1) for fine motor precision [standard score = 15 (5)]. We found evidence of a non-linear dose response relationship and used a change-point model to assess the association of tAs with overall motor proficiency and indices of fine motor integration, fine motor precision, and their composite, fine manual control, adjusted for age and sex. In models adjusted for potential confounders, each doubling of urine tAs decreased overall motor proficiency by -3.3 points (95% CI: -6.1, -0.4) for tAs concentrations greater than the change point of 9.5 µg/L and decreased fine motor integration by -4.3 points (95% CI: -8.0, -0.6) for tAs concentrations greater than the change point of 17.0 µg/L. Discussion In summary, we found that levels of prenatal As exposure above an empirically-derived threshold (i.e., the change point) were associated with decrements in childhood motor development in a US population.
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Affiliation(s)
- Erin E. Butler
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Margaret R. Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
- Children’s Environmental Health and Disease Prevention Research Center, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Eugene Demidenko
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - David C. Bellinger
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Susan A. Korrick
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
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Ventre S, Desai G, Roberson R, Kordas K. Toxic metal exposures from infant diets: Risk prevention strategies for caregivers and health care professionals. Curr Probl Pediatr Adolesc Health Care 2022; 52:101276. [PMID: 36266220 DOI: 10.1016/j.cppeds.2022.101276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Concerns are growing regarding the presence of toxic elements such as arsenic (As), cadmium (Cd), mercury (Hg), and lead (Pb) in the ingredients and prepared foods for infants and young children. There are few clear, evidence-based, guidelines on the maximum tolerable limits of toxicants in foods and little understanding of toxicant exposure or adverse health effects attributable to dietary exposure. Caregivers are faced with the burden of making decisions about which foods to select, how often to feed them to their children, and what foods to limit. This article reviews the current literature and existing recommendations on dietary exposure to toxic elements in children under 2 years of age, and their health effects in early childhood-focusing on growth, neurodevelopment, and immune function. The article also outlines best practices for healthcare providers to address the concerns of toxic element exposure through the diet in young children. Several foods consistently appear in the literature as potential sources of toxic element exposure. Contaminated drinking and cooking water, including water used to prepare infant formula, could also be a major exposure source. In the absence of stronger evidence on effects of dietary modification, exclusive breastfeeding until six months of age, followed by a diverse diet are some strategies to reduce dietary toxic element exposure while ensuring an adequate and balanced nutrient intake. Healthcare providers can support families by sharing information and encouraging blood Pb testing, the only element for which such testing is currently recommended.
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Affiliation(s)
- Sarah Ventre
- Department of Pediatrics, University at Buffalo, USA; New York State Children's Environmental Health Center, USA.
| | - Gauri Desai
- Department of Epidemiology and Environmental Health, University at Buffalo, USA
| | | | - Katarzyna Kordas
- Department of Epidemiology and Environmental Health, University at Buffalo, USA
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Signes-Pastor AJ, Sayarath V, Jackson B, Cottingham KL, Punshon T, Karagas MR. Dietary Exposure to Essential and Non-essential Elements During Infants' First Year of Life in the New Hampshire Birth Cohort Study. EXPOSURE AND HEALTH 2022; 15:269-279. [PMID: 36873246 PMCID: PMC9971144 DOI: 10.1007/s12403-022-00489-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/29/2022] [Accepted: 05/10/2022] [Indexed: 06/18/2023]
Abstract
Even the low levels of non-essential elements exposure common in the US may have health consequences especially early in life. However, little is known about the infant's dynamic exposure to essential and non-essential elements. This study aims to evaluate exposure to essential and non-essential elements during infants' first year of life and to explore the association between the exposure and rice consumption. Paired urine samples from infants enrolled in the New Hampshire Birth Cohort Study (NHBCS) were collected at approximately 6 weeks (exclusively breastfed) and at 1 year of age after weaning (n = 187). A further independent subgroup of NHBCS infants with details about rice consumption at 1 year of age also was included (n = 147). Urinary concentrations of 8 essential (Co, Cr, Cu, Fe, Mn, Mo, Ni, and Se) and 9 non-essential (Al, As, Cd, Hg, Pb, Sb, Sn, V, and U) elements were determined as a measure of exposure. Several essential (Co, Fe, Mo, Ni, and Se) and non-essential (Al, As, Cd, Hg, Pb, Sb, Sn, and V) elements had higher concentrations at 1 year than at 6 weeks of age. The highest increases were for urinary As and Mo with median concentrations of 0.20 and 1.02 µg/L at 6 weeks and 2.31 and 45.36 µg/L at 1 year of age, respectively. At 1 year of age, As and Mo urine concentrations were related to rice consumption. Further efforts are necessary to minimize exposure to non-essential elements while retaining essential elements to protect and promote children's health. Supplementary Information The online version contains supplementary material available at 10.1007/s12403-022-00489-x.
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Affiliation(s)
- Antonio J. Signes-Pastor
- Department of Epidemiology, Geisel Medical School at Dartmouth College, Lebanon, NH USA
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), Alicante, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Vicki Sayarath
- Department of Epidemiology, Geisel Medical School at Dartmouth College, Lebanon, NH USA
| | - Brian Jackson
- Department of Earth Sciences, Dartmouth College, Hanover, NH USA
| | | | - Tracy Punshon
- Department of Biological Sciences, Dartmouth College, Hanover, NH USA
| | - Margaret R. Karagas
- Department of Epidemiology, Geisel Medical School at Dartmouth College, Lebanon, NH USA
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Mohammadi S, Shafiee M, Faraji SN, Rezaeian M, Ghaffarian-Bahraman A. Contamination of breast milk with lead, mercury, arsenic, and cadmium in Iran: a systematic review and meta-analysis. Biometals 2022; 35:711-728. [PMID: 35575819 DOI: 10.1007/s10534-022-00395-4] [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: 03/08/2022] [Accepted: 04/29/2022] [Indexed: 12/29/2022]
Abstract
Breast milk is a complete food for the development of the newborn, but it can also be an important route for environmental pollutants transmission to the infants. This study was aimed to evaluate the status of heavy metals including lead (Pb), mercury (Hg), cadmium (Cd) and arsenic (As) in the breast milk of Iranian mothers. The international databases including Scopus, PubMed, Web of Science and the Persian electronic databases including Scientific Information Database, IranMedex and Magiran were examined to find relevant articles published until July 2021. A total of 23 studies examined the levels of toxic metals in Iranian breast milk samples. According to the findings, the pooled average concentrations (µg/L) of Pb, Cd, Hg and As were 25.61, 2.40, 1.29 and 1.16, respectively. The concentration of Hg and Pb in colostrum milk was more than twice of mature milk. The Hg mean concentration in the breast milk of mothers with at least one amalgam-filled tooth was approximately three times that of mothers without amalgam-filled teeth. Risk assessment analysis indicated that the intake of Pb and Hg by infants through breastfeeding can be considered a health concern in Iran. It seems necessary to reduce the Pb exposure of pregnant and lactating women in Iran. However, more extensive studies are needed to clarify the toxic metals' exposure status of infants through breast milk in other parts of the country.
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Affiliation(s)
- Salman Mohammadi
- Nutritional Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Maryam Shafiee
- Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Nooreddin Faraji
- School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Rezaeian
- Department of Epidemiology and Biostatistics, Occupational Environment Research Center, Medical School, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Ali Ghaffarian-Bahraman
- Occupational Environment Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
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Canale S, Blute N, Xia T, Thomas M, Gee M, Chang CH. Arsenic, Cadmium, Lead, and Mercury in Lactation Foods and Prenatal Vitamins: Potentially Avoidable Exposure for Breastfeeding Mothers and Infants. Breastfeed Med 2021; 16:558-563. [PMID: 33567220 DOI: 10.1089/bfm.2020.0359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Human milk is a biofluid that can contain heavy metals such as arsenic, cadmium, lead, and mercury. These toxins can adversely affect endocrine, respiratory, immune, and nervous systems. Infants may have higher dietary arsenic exposure than adults due to their more restricted diets and greater intake per unit body mass. We identified commonly purchased vitamins, lactation bars, and supplements, to measure the concentration of heavy metals. The goal of the study was to measure and determine if vitamins and lactation foods could be a source of exposure. Methods: We tested 9 popular vitamins and 16 lactation bars and supplements all marketed toward breastfeeding mothers to determine the presence of heavy metals. All vitamins, bars, and supplements were analyzed using inductively coupled plasma mass spectrometry, for the total concentration of arsenic, mercury, cadmium, and lead, with the lowest detection limit of 0.001 μg/L. Results: The majority of the samples had total arsenic levels below detectable quantities (detection limit of 1 part per trillion [0.001 μg/L]), one sample of syrup had a concentration of 0.112 ± 0.005, 0.132 ± 0.009, and 0.108 ± 0.010 μg of arsenic/g. We also tested nine popular prenatal vitamins for the amount of arsenic in one serving of vitamins per day and showed exposure to arsenic in one vitamin of 7.108 μg of arsenic/day. All lactation foods and vitamins tested had undetectable amounts of cadmium, mercury, and lead. Conclusion: Most of the vitamins and bars that were tested had below the detectable limit of arsenic, cadmium, lead, and mercury; we did find one vitamin and one rice syrup that had significantly higher levels. Our data suggest that it is highly feasible to manufacture vitamins and lactation foods and supplements with significantly lower concentrations of heavy metals.
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Affiliation(s)
- Stephanie Canale
- Department of Family Medicine, University of California, Los Angeles, California, USA
| | | | - Tian Xia
- Division of Nanomedicine, Department of Medicine, University of California, Los Angeles, California, USA
| | - Mathew Thomas
- Department of Physical Sciences, University of California, Los Angeles, California, USA
| | - Melissa Gee
- Department of Family Medicine, University of California, Los Angeles, California, USA
| | - Chong Hyun Chang
- UC Center for Environmental Implications of Nanotechnology, University of California, Los Angeles, California, USA
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Lorenzetti S, Plösch T, Teller IC. Antioxidative Molecules in Human Milk and Environmental Contaminants. Antioxidants (Basel) 2021; 10:550. [PMID: 33916168 PMCID: PMC8065843 DOI: 10.3390/antiox10040550] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 12/21/2022] Open
Abstract
Breastfeeding provides overall beneficial health to the mother-child dyad and is universally recognized as the preferred feeding mode for infants up to 6-months and beyond. Human milk provides immuno-protection and supplies nutrients and bioactive compounds whose concentrations vary with lactation stage. Environmental and dietary factors potentially lead to excessive chemical exposure in critical windows of development such as neonatal life, including lactation. This review discusses current knowledge on these environmental and dietary contaminants and summarizes the known effects of these chemicals in human milk, taking into account the protective presence of antioxidative molecules. Particular attention is given to short- and long-term effects of these contaminants, considering their role as endocrine disruptors and potential epigenetic modulators. Finally, we identify knowledge gaps and indicate potential future research directions.
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Affiliation(s)
- Stefano Lorenzetti
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità (ISS), 00161 Rome, Italy;
| | - Torsten Plösch
- Perinatal Neurobiology, Department of Human Medicine, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, 26129 Oldenburg, Germany;
- Department of Obstetrics and Gynaecology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
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Bauer JA, Fruh V, Howe CG, White RF, Henn BC. Associations of metals and neurodevelopment: a review of recent evidence on susceptibility factors. CURR EPIDEMIOL REP 2020; 7:237-262. [PMID: 33777647 PMCID: PMC7993302 DOI: 10.1007/s40471-020-00249-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2020] [Indexed: 12/22/2022]
Abstract
PURPOSE OF REVIEW Epidemiologic evidence exists that many metals are associated with adverse neurobehavioral effects in young children, including lead (Pb), methylmercury (meHg), manganese (Mn) and arsenic (As)5-8. Importantly, chemical insult can vary depending on host factors and exposure circumstance. This systematic review summarizes the recent literature investigating modifying factors of the associations between metals and neurodevelopment, including immutable traits (sex or genetics) or exposure conditions (timing or co-exposures). RECENT FINDINGS Of the 53 studies included in this review, the number investigating modification of exposure effects were: 30 for sex, 21 for co-exposures, 12 for timing of exposure, and six for genetic modifiers. Sex-specific effects of metal-neurobehavioral associations were inconclusive for all metals, likely due to the heterogeneity of outcome domains assessed and the exposure time points measured. Seven studies evaluated both sex and exposure timing as modifying factors using deciduous teeth or other biomarkers with repeated measures to characterize metals exposure over time. Only five studies used statistical methods for mixtures to evaluate associations of more than two metals with neurobehavioral domains. SUMMARY Despite the expansion of research on susceptibility to the neurodevelopmental effects of metals exposure, considerable gaps remain. This work remains critical, as characterizing susceptible subpopulations can aid in identifying biological mechanisms and is fundamental for the protection of public health.
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Affiliation(s)
- Julia A Bauer
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
| | - Victoria Fruh
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Caitlin G Howe
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Roberta F White
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
- Department of Neurology, Boston University Medical School, Boston, MA, USA
| | - Birgit Claus Henn
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
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de Mendonça Pereira BF, de Almeida CC, Leandro KC, da Costa MP, Conte-Junior CA, Spisso BF. Occurrence, sources, and pathways of chemical contaminants in infant formulas. Compr Rev Food Sci Food Saf 2020; 19:1378-1396. [PMID: 33337090 DOI: 10.1111/1541-4337.12559] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 03/18/2020] [Accepted: 03/21/2020] [Indexed: 01/03/2023]
Abstract
Infant formulas are manufactured products to meet specific nutritional requirements for infants. However, infant formulas can contain harmful substances, such as chemical contaminants and residues, normally due to possible contamination of the raw material or from the production chain. Some studies have demonstrated that veterinary drugs, pesticides, mycotoxins, heavy metals, packaging materials, within other chemicals are found in infant formulas from different sources of contamination. It is known that some of these substances can be hepatotoxic, carcinogenic, teratogenic, mutagenic, immunotoxic, contributing to antibiotic resistance, among other detrimental consequences for consumers' health. The purpose of this review is to assess the scientific evidence concerning the occurrence, sources, and pathways of contamination, as well as the detrimental impacts on infant health due to the possible presence of chemical contaminants and residues in infant formulas. Moreover, strategies to reduce the risk of contamination of infant formulas are presented to ensure the highest standards of quality of infant formulas. The entire infant formula manufacturing process should be monitored and controlled to minimize the risk of contamination during processing, storage, and distribution, besides ensuring the use of raw materials with as low as acceptable levels of harmful substances in order to assure that the final product shall comply with the maximum levels and maximum residue limits, when established, for residues and contaminants in the final product.
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Affiliation(s)
| | - Cristine Couto de Almeida
- Instituto Nacional de Controle de Qualidade em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.,Centro Laboratorial Analítico, Faculdade de Medicina Veterinária, Universidade Federal Fluminense, Niterói, Brazil
| | - Katia Christina Leandro
- Instituto Nacional de Controle de Qualidade em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Marion Pereira da Costa
- Centro Laboratorial Analítico, Faculdade de Medicina Veterinária, Universidade Federal Fluminense, Niterói, Brazil.,Programa de Pós-Graduação em Ciência de Alimentos, Instituto de Química, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.,Laboratório de Inspeção e Tecnologia de Leite e Derivados, Escola de Medicina Veterinária e Zootecnia, Universidade Federal da Bahia, Salvador, Brazil
| | - Carlos Adam Conte-Junior
- Instituto Nacional de Controle de Qualidade em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.,Centro Laboratorial Analítico, Faculdade de Medicina Veterinária, Universidade Federal Fluminense, Niterói, Brazil.,Programa de Pós-Graduação em Ciência de Alimentos, Instituto de Química, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bernardete Ferraz Spisso
- Instituto Nacional de Controle de Qualidade em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
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Muse ME, Li Z, Baker ER, Cottingham KL, Korrick SA, Karagas MR, Gilbert-Diamond D. Relation between in utero arsenic exposure and growth during the first year of life in a New Hampshire pregnancy cohort. ENVIRONMENTAL RESEARCH 2020; 180:108604. [PMID: 31710845 PMCID: PMC7333643 DOI: 10.1016/j.envres.2019.108604] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 07/16/2019] [Accepted: 07/21/2019] [Indexed: 05/11/2023]
Abstract
BACKGROUND We have previously reported that in utero arsenic exposure is associated with increased length and other anthropometric outcomes at birth in a U.S. cohort. However, it is unknown whether these anthropometric differences persist through early life. OBJECTIVES We assessed in utero arsenic exposure in relation to attained anthropometry and growth trajectories through the first year of life. METHODS Among 760 mother-infant pairs from the New Hampshire Birth Cohort Study, we assessed in utero arsenic exposure using maternal second trimester urinary arsenic and assessed infant growth from medical records. RESULTS Median maternal second trimester total urinary arsenic (tAs; inorganic arsenic + monomethylarsonic acid + dimethylarsinic acid) was 3.96 μg/L (IQR: 2.02, 6.72). In adjusted linear mixed effects models, each doubling of maternal urinary tAs was associated with a 0.05 increase in length WHO Z score (95% CI: 0, 0.09) over the first year of life which corresponds to an approximately 0.12 cm increase in males and 0.13 cm increase in females at 12 months. No associations were observed between urinary tAs and attained weight, weight-for-length, or head circumference. In adjusted piecewise linear mixed effects models, each doubling of urinary tAs was associated with a 0.07 (95% CI: 0.02, 0.12) cm per month decreased length growth rate through 3.5 months with no evidence of an association thereafter. No associations were observed between urinary tAs and infant weight gain or change in weight-for-length and head circumference through one year. CONCLUSIONS On average, infants exposed to higher in utero arsenic attained modestly longer length during the first year, despite having slower linear growth in the first 3.5 months of life. This suggests that the previously demonstrated arsenic-associated longer length among study infants at birth persists through the first year of life. No other anthropometric associations with in utero arsenic exposure were observed across the full study population.
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Affiliation(s)
- Meghan E Muse
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
| | - Zhigang Li
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Emily R Baker
- Children's Environmental Health and Disease Prevention Center at Dartmouth, Hanover, NH, USA; Department of Obstetrics and Gynecology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Kathryn L Cottingham
- Children's Environmental Health and Disease Prevention Center at Dartmouth, Hanover, NH, USA; Department of Biological Sciences, Dartmouth College, Hanover, NH, USA
| | - Susan A Korrick
- Children's Environmental Health and Disease Prevention Center at Dartmouth, Hanover, NH, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA; Children's Environmental Health and Disease Prevention Center at Dartmouth, Hanover, NH, USA
| | - Diane Gilbert-Diamond
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA; Children's Environmental Health and Disease Prevention Center at Dartmouth, Hanover, NH, USA
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Hoen AG, Madan JC, Li Z, Coker M, Lundgren SN, Morrison HG, Palys T, Jackson BP, Sogin ML, Cottingham KL, Karagas MR. Sex-specific associations of infants' gut microbiome with arsenic exposure in a US population. Sci Rep 2018; 8:12627. [PMID: 30135504 PMCID: PMC6105615 DOI: 10.1038/s41598-018-30581-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 07/31/2018] [Indexed: 02/01/2023] Open
Abstract
Arsenic is a ubiquitous environmental toxicant with antimicrobial properties that can be found in food and drinking water. The influence of arsenic exposure on the composition of the human microbiome in US populations remains unknown, particularly during the vulnerable infant period. We investigated the relationship between arsenic exposure and gut microbiome composition in 204 infants prospectively followed as part of the New Hampshire Birth Cohort Study. Infant urine was analyzed for total arsenic concentration using inductively coupled plasma mass spectrometry. Stool microbiome composition was determined using sequencing of the bacterial 16S rRNA gene. Infant urinary arsenic related to gut microbiome composition at 6 weeks of life (p = 0.05, adjusted for infant feeding type and urine specific gravity). Eight genera, six within the phylum Firmicutes, were enriched with higher arsenic exposure. Fifteen genera were negatively associated with urinary arsenic concentration, including Bacteroides and Bifidobacterium. Upon stratification by both sex and feeding method, we found detectable associations among formula-fed males (p = 0.008), but not other groups (p > 0.05 for formula-fed females and for breastfed males and females). Our findings from a US population indicate that even moderate arsenic exposure may have meaningful, sex-specific effects on the gut microbiome during a critical window of infant development.
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Affiliation(s)
- Anne G Hoen
- Department of Epidemiology, The Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
- Children's Environmental Health & Disease Prevention Research Center at Dartmouth, Hanover, New Hampshire, USA.
- Department of Biomedical Data Science, The Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
| | - Juliette C Madan
- Department of Epidemiology, The Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
- Children's Environmental Health & Disease Prevention Research Center at Dartmouth, Hanover, New Hampshire, USA
- Division of Neonatology, Department of Pediatrics, Children's Hospital at Dartmouth, Lebanon, New Hampshire, USA
| | - Zhigang Li
- Department of Biomedical Data Science, The Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
- Department of Biostatistics, University of Florida, Gainesville, Florida, USA
| | - Modupe Coker
- Department of Epidemiology, The Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Sara N Lundgren
- Department of Epidemiology, The Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Hilary G Morrison
- Josephine Bay Paul Center, Marine Biological Laboratory, Woods Hole, Massachusetts, USA
| | - Thomas Palys
- Children's Environmental Health & Disease Prevention Research Center at Dartmouth, Hanover, New Hampshire, USA
| | - Brian P Jackson
- Department of Earth Sciences, Dartmouth College, Hanover, New Hampshire, USA
| | - Mitchell L Sogin
- Josephine Bay Paul Center, Marine Biological Laboratory, Woods Hole, Massachusetts, USA
| | - Kathryn L Cottingham
- Children's Environmental Health & Disease Prevention Research Center at Dartmouth, Hanover, New Hampshire, USA
- Department of Biological Sciences, Dartmouth College, Hanover, New Hampshire, USA
| | - Margaret R Karagas
- Department of Epidemiology, The Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
- Children's Environmental Health & Disease Prevention Research Center at Dartmouth, Hanover, New Hampshire, USA
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13
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Signes-Pastor AJ, Cottingham KL, Carey M, Sayarath V, Palys T, Meharg AA, Folt CL, Karagas MR. Infants' dietary arsenic exposure during transition to solid food. Sci Rep 2018; 8:7114. [PMID: 29739998 PMCID: PMC5940663 DOI: 10.1038/s41598-018-25372-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 04/20/2018] [Indexed: 11/08/2022] Open
Abstract
Early-life exposure to inorganic arsenic (i-As) may cause long-lasting health effects, but as yet, little is known about exposure among weaning infants. We assessed exposure before and during weaning and investigated the association between solid food intake and infants' urinary arsenic species concentrations. Following the recording of a comprehensive 3 day food diary, paired urine samples (pre- and post-weaning) were collected and analyzed for arsenic speciation from 15 infants participating in the New Hampshire Birth Cohort Study. Infants had higher urinary i-As (p-value = 0.04), monomethylarsonic acid (MMA) (p-value = 0.002), dimethylarsinic acid (DMA) (p-value = 0.01), and sum of arsenic species (i-As + MMA + DMA, p-value = 0.01) during weaning than while exclusively fed on a liquid diet (i.e., breast milk, formula, or a mixture of both). Among weaning infants, increased sum of urinary arsenic species was pairwise-associated with intake of rice cereal (Spearman's ρ = 0.90, p-value = 0.03), fruit (ρ = 0.70, p-value = 0.03), and vegetables (ρ = 0.86, p-value = 0.01). Our observed increases in urinary arsenic concentrations likely indicate increased exposure to i-As during the transition to solid foods, suggests the need to minimize exposure during this critical period of development.
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Affiliation(s)
- Antonio J Signes-Pastor
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, 1 Medical Center Dr., 7927 Rubin Bldg., Lebanon, NH, 03756, USA.
- Children's Environmental Health and Disease Prevention Research Center at Dartmouth, Lebanon, USA.
| | - Kathryn L Cottingham
- Department of Biological Sciences, Dartmouth College, Hanover, NH, 03755, USA
- Children's Environmental Health and Disease Prevention Research Center at Dartmouth, Lebanon, USA
| | - Manus Carey
- Institute for Global Food Security, Queen's University Belfast, David Keir Building, Malone Road, Belfast, BT9 5BN, Northern Ireland, UK
| | - Vicki Sayarath
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, 1 Medical Center Dr., 7927 Rubin Bldg., Lebanon, NH, 03756, USA
- Children's Environmental Health and Disease Prevention Research Center at Dartmouth, Lebanon, USA
| | - Thomas Palys
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, 1 Medical Center Dr., 7927 Rubin Bldg., Lebanon, NH, 03756, USA
| | - Andrew A Meharg
- Institute for Global Food Security, Queen's University Belfast, David Keir Building, Malone Road, Belfast, BT9 5BN, Northern Ireland, UK
| | - Carol L Folt
- University of North Carolina, Chapel Hill, North Carolina, USA
- Children's Environmental Health and Disease Prevention Research Center at Dartmouth, Lebanon, USA
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, 1 Medical Center Dr., 7927 Rubin Bldg., Lebanon, NH, 03756, USA
- Children's Environmental Health and Disease Prevention Research Center at Dartmouth, Lebanon, USA
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