Seafood, wine, rice, vegetables, and other food items associated with mercury biomarkers among seafood and non-seafood consumers: NHANES 2011-2012

Maternal diet quality during pregnancy and biomarkers of potentially toxic trace element exposure: Data from the ELFE cohort

The contribution of the diet to potentially toxic trace element exposure in pregnancy has been rarely addressed. The objective of the present study was to determine the association between the maternal diet during pregnancy and biomarkers of exposure for arsenic (As), mercury (Hg) and lead (Pb) at delivery. As was assessed in maternal urine, Hg in maternal hair, and Pb in cord blood, as a proxy for in utero exposure. Based on 2995 women from the ELFE nationwide birth cohort, higher scores for dietary patterns considered healthy were associated with higher concentrations of As and Hg in maternal matrices. Levels of cord blood Pb were inconsistently associated with dietary patterns considered healthy, and lower with a dietary pattern driven by milk and breakfast cereals. Lower levels of Hg were associated with higher Western dietary pattern scores. In conclusion, higher levels of maternal urinary As and hair Hg are associated with diets considered as "Healthy", while cord blood Pb was not strongly correlated with dietary exposure.

Nutritional epigenetics education improves diet and attitude of parents of children with autism or attention deficit/hyperactivity disorder

BACKGROUND

Unhealthy maternal diet leads to heavy metal exposures from the consumption of ultra-processed foods that may impact gene behavior across generations, creating conditions for the neurodevelopmental disorders known as autism and attention deficit/hyperactivity disorder (ADHD). Children with these disorders have difficulty metabolizing and excreting heavy metals from their bloodstream, and the severity of their symptoms correlates with the heavy metal levels measured in their blood. Psychiatrists may play a key role in helping parents reduce their ultra-processed food and dietary heavy metal intake by providing access to effective nutritional epigenetics education.

AIM

To test the efficacy of nutritional epigenetics instruction in reducing parental ultra-processed food intake.

METHODS

The study utilized a semi-randomized test and control group pretest-posttest pilot study design with participants recruited from parents having a learning-disabled child with autism or ADHD. Twenty-two parents who met the inclusion criteria were randomly selected to serve in the test (n = 11) or control (n = 11) group. The test group participated in the six-week online nutritional epigenetics tutorial, while the control group did not. The efficacy of the nutritional epigenetics instruction was determined by measuring changes in parent diet and attitude using data derived from an online diet survey administered to the participants during the pre and post intervention periods. Diet intake scores were derived for both ultra-processed and whole/organic foods. Paired sample t-tests were conducted to determine any differences in mean diet scores within each group.

RESULTS

There was a significant difference in the diet scores of the test group between the pre- and post-intervention periods. The parents in the test group significantly reduced their intake of ultra-processed foods with a pre-intervention diet score of 70 (mean = 5.385, SD = 2.534) and a post-intervention diet score of 113 (mean = 8.692, SD = 1.750) and the paired t-test analysis showing a significance of P < 0.001. The test group also significantly increased their consumption of whole and/or organic foods with a pre-intervention diet score of 100 (mean = 5.882, SD = 2.472) and post-intervention diet score of 121 (mean = 7.118, SD = 2.390) and the paired t-test analysis showing a significance of P < 0.05.

CONCLUSION

Here we show nutritional epigenetics education can be used to reduce ultra-processed food intake and improve attitude among parents having learning-disabled children with autism or ADHD.

Characterizing variability in total mercury hair:blood ratio in the general Canadian population

BACKGROUND/OBJECTIVES

The body burden of mercury in humans can be measured through hair or blood biomarkers. To compare results from different studies, it is often required to convert mercury in hair to an equivalent level in blood, using a default hair:blood ratio of 250:1 by the World Health Organization (WHO). However, the actual ratio may vary within and between populations. The objectives of this study were to analyze the hair:blood mercury ratio in the general Canadian population, explore factors associated with higher/lower ratios, and determine if the standard ratio of 250:1 is supported.

METHODS

The Canadian Health Measures Survey (CHMS) Cycle 5 (2016-2017) measured total mercury (THg) in both hair and blood of 1168 participants 20-59 years of age. We calculated geometric mean (GM) concentrations of THg for this entire sample and subgroups. The subgroups included biological sex, women of childbearing age, race, hair treatments, categories of blood and hair selenium, urinary arsenobetaine/arsenocholine, categories of blood and hair mercury, and food consumption. We calculated a hair:blood ratio for each participant and determined population-level ratios from the GMs of the distributions. Differences by subgroups, and agreement with the WHO ratio of 250:1, were tested. The combined effect of factors on the THg hair:blood ratio was explored using staged regression analysis.

RESULTS

For participants with paired hair and blood mercury measurements, the GM of the hair:blood THg ratio was 293 (95%CI:273-316), and significantly >250. In women of childbearing age, the ratio did not differ from 250. The GMs of the ratio were higher (i.e.>300) for second tertile blood selenium (365, 95%CI:307-433), third and fourth quartiles hair mercury (347, 95%CI:308-390 and 376, 95%CI:336-422), and consumers of shellfish (338, 95%CI:308-371). Shellfish consumption was the only statistically significant factor associated with the hair:blood ratio as identified in the regression model.

CONCLUSIONS

The mean hair:blood THg ratio among Canadians generally exceeded the default ratio of 250:1. Higher ratios were observed in certain subgroups, such as seafood consumers, and shellfish consumption was the most important variable associated with the ratio. Our results suggest that population-specific hair:blood THg ratios be considered, if possible, when converting mercury levels from hair to blood to better characterize the variation around the conversion.

Higher rates of autism and attention deficit/hyperactivity disorder in American children: Are food quality issues impacting epigenetic inheritance?

In the United States, schools offer special education services to children who are diagnosed with a learning or neurodevelopmental disorder and have difficulty meeting their learning goals. Pediatricians may play a key role in helping children access special education services. The number of children ages 6-21 in the United States receiving special education services increased 10.4% from 2006 to 2021. Children receiving special education services under the autism category increased 242% during the same period. The demand for special education services for children under the developmental delay and other health impaired categories increased by 184% and 83% respectively. Although student enrollment in American schools has remained stable since 2006, the percentage distribution of children receiving special education services nearly tripled for the autism category and quadrupled for the developmental delay category by 2021. Allowable heavy metal residues remain persistent in the American food supply due to food ingredient manufacturing processes. Numerous clinical trial data indicate heavy metal exposures and poor diet are the primary epigenetic factors responsible for the autism and attention deficit hyperactivity disorder epidemics. Dietary heavy metal exposures, especially inorganic mercury and lead may impact gene behavior across generations. In 2021, the United States Congress found heavy metal residues problematic in the American food supply but took no legislative action. Mandatory health warning labels on select foods may be the only way to reduce dietary heavy metal exposures and improve child learning across generations.

Targeted Intracellular Demethylation of Methylmercury Enhances Elimination Kinetics and Reduces Developmental Toxicity in Transgenic Drosophila

Methylmercury (MeHg) persists today as a priority public health concern. Mechanisms influencing MeHg metabolism, kinetics, and toxicity outcomes are therefore essential knowledge for informing exposure risks. Evidence points to different toxic potencies of MeHg and inorganic mercury (Hg2+), highlighting the role for biotransformation (demethylation) in regulating MeHg toxicokinetics/dynamics. Whereas microbial MeHg demethylation in the gut is seen to influence elimination kinetics, the potential for systemic demethylation in tissues and target organs to influence MeHg toxicity remains uncertain. To investigate the consequences of systemic MeHg demethylation across development, we engineered transgenic Drosophila to express the bacterial organomercurial lyase enzyme (merB) in a targeted and tissue-specific manner. With all combinations of merB-induced demethylation, ubiquitously (via an actin promoter) or in a tissue-specific manner (ie, gut, muscle, neurons), we observe a rescue of MeHg-induced eclosion failure at the pupal to adult transition. In MeHg-fed larvae with ubiquitous or targeted (gut and muscle) merB expression, we see a significant decrease in MeHg body burden at the pupal stage relative to control flies. We also observe a significant increase in the MeHg elimination rate with merB demethylation induced in adults (control, t1/2 = 7.2 days; merB flies, t1/2 = 3.1 days). With neuronal-specific merB expression, we observe a rescue of MeHg-induced eclosion failure without a decrease in Hg body burden, but a redistribution of Hg away from the brain. These results demonstrate the previously unidentified potential for intracellular MeHg demethylation to promote transport and elimination of Hg, and reduce developmental MeHg toxicity. Impact Statement: These findings demonstrate the potential for MeHg demethylation in situ to contribute significantly to the MeHg elimination and distribution kinetics of whole animals and thereby affords a means of protection against the toxic insult of MeHg. Therefore, this study reveals important insight into processes that can determine an individual's resistance or susceptibility to MeHg and provides rationale for therapies targeting a novel metabolism-based pathways to alleviate toxicity risk stemming from MeHg exposure.

Associations of Diet Quality and Heavy Metals with Obesity in Adults: A Cross-Sectional Study from National Health and Nutrition Examination Survey (NHANES)

A poor diet cannot fully explain the prevalence of obesity. Other environmental factors (e.g., heavy metals) have been reported to be associated with obesity. However, limited evidence is available for the combined effect of these factors on obesity. Therefore, we conducted a cross-sectional study and used the data from the National Health and Examination Survey (2007−2018) to explore the associations between diet quality and heavy metals and obesity. Diet quality was evaluated by the Healthy Eating Index-2015 (HEI-2015) score. Heavy metals included serum cadmium (Cd), lead (Pb), and mercury (Hg). We included 15,959 adults, with 5799 of obesity (body mass index ≥ 30 kg/m2). After adjustment for covariates, every interquartile range increase in HEI-2015 scores, Pb, Cd and Hg was associated with a 35% (odds ratios [OR] = 0.65, 95% confidence interval [CI]: 0.60, 0.70), 11% (OR = 0.89, 95% CI: 0.82, 0.98), 9% (OR = 0.91, 95% CI: 0.87, 0.96), 5% (OR = 0.85, 95% CI: 0.82, 0.89) reduction in risk of peripheral obesity, respectively. In addition, the association between the HEI-2015 scores and peripheral obesity was attenuated by higher levels of heavy metals (All p interaction < 0.05). Results remained similar for abdominal obesity. Our study reveals the distinct effects of a high-quality diet and heavy metals on obesity prevalence, and the beneficial effect of a high-quality diet could be weakened by higher levels of heavy metals.

Environmental and occupational exposure of metals and female reproductive health

Untainted environment promotes health, but the last few decades experienced steep upsurge in environmental contaminants posing detrimental physiological impact. The responsible factors mainly include the exponential growth of human population, havoc rise in industrialization, poorly planned urbanization, and slapdash environment management. Environmental degradation can increase the likelihood of human exposure to heavy metals, resulting in health consequences such as reproductive problems. As a result, research into metal-induced causes of reproductive impairment at the genetic, epigenetic, and biochemical levels must be strengthened further. These metals impact upon the female reproduction at all strata of its regulation and functions, be it development, maturation, or endocrine functions, and are linked to an increase in the causes of infertility in women. Chronic exposures to the heavy metals may lead to breast cancer, endometriosis, endometrial cancer, menstrual disorders, and spontaneous abortions, as well as pre-term deliveries, stillbirths. For example, endometriosis, endometrial cancer, and spontaneous abortions are all caused by the metalloestrogen cadmium (Cd); lead (Pb) levels over a certain threshold can cause spontaneous abortion and have a teratogenic impact; toxic amounts of mercury (Hg) have an influence on the menstrual cycle, which can lead to infertility. Impact of environmental exposure to heavy metals on female fertility is therefore a well-known fact. Thus, the underlying mechanisms must be explained and periodically updated, given the growing evidence on the influence of increasing environmental heavy metal load on female fertility. The purpose of this review is to give a concise overview of how heavy metal affects female reproductive health.

Total Blood Mercury Predicts Methylmercury Exposure in Fish and Shellfish Consumers

Many studies evaluating methylmercury (MeHg) toxicity rely on whole blood total mercury (THg) measurements to estimate MeHg exposure. However, whole blood THg includes other forms of mercury (Hg), such as inorganic Hg, which have different exposure sources and toxicological effects than MeHg. Therefore, estimating the whole blood MeHg/THg ratio is critical to predicting MeHg exposure and, subsequently, efforts to establish an exposure-response relationship for use in risk assessment. A large, representative dataset (National Health and Nutrition Examination Survey (NHANES) 2011-2016) was used to determine the whole blood MeHg/THg ratio among (a) self-reported fish and shellfish consumers, ≥ 15 years of age (the "full adult" population (N = 5268 training dataset; N = 2336 test dataset)) and (b) female fish and shellfish consumers, 15-44 years of age (the "women of reproductive age" population (N = 1285 training dataset; N = 560 test dataset)). Unadjusted and adjusted linear and spline models with direct measurements for both THg and MeHg were evaluated. The mean whole blood MeHg/THg ratio was 0.75 (95% confidence interval (CI): 0.74, 0.75). This ratio was significantly higher among those with higher THg concentrations. All models exhibited excellent fit (adjusted R² from 0.957 to 0.982). Performance was slightly improved in spline versus linear models. For the full adult population and women of reproductive age, the unadjusted spline model predicted whole blood MeHg concentrations of 5.65 µg/L and 5.55 µg/L, respectively, when the THg concentration was 5.80 µg/L. These results suggest that whole blood THg is a good predictor of whole blood MeHg among fish and shellfish consumers.

Higher Blood Lead Level Is Associated With Increased Likelihood of Abdominal Aortic Calcification

Aims: This study aimed to evaluate the association between blood lead level (BLL) and abdominal aortic calcification (AAC) in US adults aged ≥40 years.

Methods: We obtained data from 2013 to 2014 National Health and Nutrition Examination Survey (NHANES). Participants missing the data of BLL and AAC scores were excluded. BLL was measured using inductively coupled plasma mass spectrometry directly. AAC scores were quantified by Kauppila score system, and severe AAC was defined as AAC score >6. Weighted multivariable regression analysis and subgroup analysis were conducted to explore the independent relationship between BLL with AAC score and severe AAC.

Results: A total of 1,530 participants were included with the mean BLL of 1.45 ± 1.31 ng/dl and mean AAC score of 1.40 ± 3.13. The prevalence of severe AAC was 7.98% overall, and participants in higher BLL quartile showed higher prevalence of severe AAC (Quartile 1: 3.55%, Quartile 2: 7.28%, Quartile 3: 9.88%, Quartile 4: 12.58%, P < 0.0001). BLL was positively associated with higher AAC score (β = 0.15, 95% CI: 0.02, 0.27, P = 0.021) and increased risk of severe AAC (OR = 1.11; 95% CI: 1.00–1.22; P = 0.047). Subgroup analysis and interaction test indicated that the association between BLL and AAC was similar in different population settings.

Conclusions: Higher BLL was associated with higher AAC score and increased risk of severe AAC. Lead burden should be considered for people with AAC in clinical settings.

Concentrations of Lead, Mercury, Selenium, and Manganese in Blood and Hand Grip Strength among Adults Living in the United States (NHANES 2011-2014)

Exposure to lead and mercury can cause deficits in neuromotor function. Selenium and manganese are essential elements, hence both deficiency and excess could result in decreased neuromotor function. We aimed to examine hand grip strength, a marker of neuromotor function, and blood concentrations of lead, mercury, selenium, and manganese in the general U.S. population. We used data from the National Health and Nutrition Examination Survey (NHANES, 2011–2014) on 6199 participants ages 20–79 years. We assessed associations of blood concentration for these elements and grip strength with generalized regression models, and cubic splines to detect possible nonlinear relations, adjusting for confounders. The results showed that mercury and manganese were not associated with grip strength. Lead was associated with weaker grip strength in women (for 10-fold increase in lead, −2.4 kg; 95% CI: −4.2, −0.5), but not in men. Higher selenium was associated with stronger grip strength in women (8.5 kg; 95% CI: 1.9, 15.1) and men (4.6; 95% CI: −11.9, 21.0), although the association was not significant in the latter. In conclusion, lead exposure was associated with weaker grip strength in women, even at the low exposure levels in the population. Furthermore, low blood selenium level was associated with weaker grip strength, suggesting that some individuals might have selenium deficiency manifesting with poorer neuromotor function.

Diet and erythrocyte metal concentrations in early pregnancy-cross-sectional analysis in Project Viva

BACKGROUND

Dietary sources of metals are not well established among pregnant women in the United States.

OBJECTIVE

We aimed to perform a diet-wide association study (DWAS) of metals during the first trimester of pregnancy.

METHODS

In early pregnancy (11.3 ± 2.8 weeks of gestation), 1196 women from Project Viva (recruited 1999-2002 in eastern Massachusetts) completed a validated FFQ (135 food items) and underwent measurements of erythrocyte metals [arsenic (As), barium, cadmium, cesium (Cs), copper, mercury (Hg), magnesium, manganese, lead (Pb), selenium (Se), zinc]. The DWAS involved a systematic evaluation and visualization of all bivariate relations for each food-metal combination. For dietary items with strong associations with erythrocyte metals, we applied targeted maximum likelihood estimations and substitution models to evaluate how hypothetical dietary interventions would influence metals' concentrations.

RESULTS

Participants' mean ± SD age was 32.5 ± 4.5 y and prepregnancy BMI was 24.8 ± 5.4 kg/m2; they were mostly white (75.9%), college graduates (72.4%), married or cohabitating (94.6%), had a household income >$70,000/y (63.5%), and had never smoked (67.1%). Compared with other US-based cohorts, the overall diet quality of participants was above average, and concentrations of erythrocyte metals were lower. The DWAS identified significant associations of several food items with As, Hg, Pb, Cs, and Se; for example, As was higher for each SD increment in fresh fruit (11.5%; 95% CI: 4.9%, 18.4%), white rice (17.9%; 95% CI: 9.4%, 26.9%), and seafood (50.9%; 95% CI: 42.8%, 59.3%). Following the guidelines for pregnant women to consume ≤3 servings/wk of seafood was associated with lower As (-0.55 ng/g; 95% CI: -0.82, -0.28 ng/g) and lower Hg (-2.67 ng/g; 95% CI: -3.55, -1.80 ng/g). Substituting white rice with bread, pasta, tortilla, and potato was also associated with lower As (35%-50%) and Hg (35%-70%).

CONCLUSIONS

Our DWAS provides a systematic evaluation of diet-metals relations. Prenatal diet may be an important source of exposures to metals.

Connecting inorganic mercury and lead measurements in blood to dietary sources of exposure that may impact child development

Pre-natal and post-natal chemical exposures and co-exposures from a variety of sources including contaminated air, water, soil, and food are common and associated with poorer birth and child health outcomes. Poor diet is a contributing factor in the development of child behavioral disorders. Child behavior and learning can be adversely impacted when gene expression is altered by dietary transcription factors such as zinc insufficiency or deficiency or by exposure to toxic substances permitted in our food supply such as mercury, lead, or organophosphate pesticide residue. Children with autism spectrum disorder and attention deficit hyperactivity disorders exhibit decreased or impaired PON1 gene activity which is needed by the body to metabolize and excrete neurotoxic organophosphate pesticides. In this current review we present an updated macroepigenetic model that explains how dietary inorganic mercury and lead exposures from unhealthy diet may lead to elevated blood mercury and/or lead levels and the development of symptoms associated with the autism and attention deficit-hyperactivity disorders. PON1 gene activity may be suppressed by inadequate dietary calcium, selenium, and fatty acid intake or exposures to lead or mercury. The model may assist clinicians in diagnosing and treating the symptoms associated with these childhood neurodevelopmental disorders. Recommendations for future research are provided based on the updated model and review of recently published literature.

Low-level exposure to lead, mercury, arsenic, and cadmium, and blood pressure among 8-17-year-old participants of the 2009-2016 National Health and Nutrition Examination Survey

BACKGROUND

Dysregulation of systolic, diastolic blood pressure (SBP, DBP), and pulse pressure (PP) in children may predict elevated blood pressure (BP) in adulthood. Toxicant exposure is widely studied as a risk factor for high BP in adults, but not in children. We assessed the joint associations between lead (Pb), mercury (Hg), arsenic (As), and cadmium (Cd) exposure and SBP, DBP, and PP among 8-17 year-old participants (n = 1642) of the 2009-2016 National Health and Nutrition Examination Survey (NHANES).

METHODS

Participants with at least two BP measures were included. Urinary As and Cd were adjusted for urinary creatinine concentrations. Blood Pb, Hg, and urinary As, Cd were natural log-transformed. Bayesian Kernel Machine Regression (BKMR) analyses were conducted to assess the associations between the toxicant mixture and BP measures. Multivariable regression models assessed the associations between individual toxicants, and the four toxicants simultaneously with each of the outcomes. Interactions with sodium intake were tested.

RESULTS

Exposure to all toxicants was low, with median (5%, 95%) level: Pb, 0.57 (0.26, 1.60) μg/dL; Hg, 0.37 (0.19, 2.12) μg/L; As, 5.61 (1.37, 33.2) μg/g creatinine, Cd, 0.06 (0.03, 0.23) μg/g creatinine. Toxicant mixture showed a statistically significant, inverse association with DBP, but not other BP measures. Linear regressions revealed no association between toxicants, individually or together, and BP measures. No evidence of interaction of sodium intake with any of the toxicants was observed.

CONCLUSIONS

In a nationally representative sample of 8-17 year-olds, we found suggestive inverse association of the mixture of low-level Pb, Hg, As, and Cd, with DBP. Longitudinal studies with multiple toxicants are needed to understand the interactive effects of toxicants on children's BP.

Monthly variations in mercury exposure of school children and adults in an industrial area of southwestern China

Recent studies have shown that rice consumption can be the major pathway for human methylmercury (MeHg) exposure in inland China. However, few studies have considered the susceptible population of school children's exposure through rice ingestion. In this study, monthly variations in total Hg (THg)/MeHg concentrations in rice, fish, hair, and urine samples were studied to evaluate the Hg (both THg and MeHg) exposure in Guiyang, a typical industrial area with high anthropogenic emission of Hg. A total of 17 primary school (school A) students, 29 middle school (school B) students, and 46 guardians participated in this study for one year. Hair THg, hair MeHg, and urine THg concentrations ranged from 355-413 ng g^-1, 213-236 ng g^-1, and 469-518 ng g^-1 Creatinine (ng·g^-1 Cr), respectively, and no significant differences were observed between different genders and age groups. Hair and urine Hg concentrations showed slightly higher values in the cold season (October to February) than the hot season (March to September), but without significant difference. High monthly variability of individual hair and urine Hg concentrations suggested that long-term study could effectively decrease the uncertainty. The school students showed significantly higher urine THg concentrations than adults due to children's unique physiological structure and behaviors. Probable daily intake (PDI) of MeHg via rice and fish ingestion averaged at 0.0091, 0.0090, and 0.0079 μg kg^-1 d^-1 for school A students, school B students, and their guardians, respectively, which means that 86%, 84%, and 87% of the PDI were originated from rice ingestion, respectively. Therefore, more attention should be paid to children as a susceptible population. The results indicated low risk of Hg exposure via rice and fish consumption for urban residents in a Chinese industrial city.

Endothelial Dysfunction Induced by Cadmium and Mercury and its Relationship to Hypertension

Hypertension is an important public health concern that affects millions globally, leading to a large number of morbidities and fatalities. The etiology of hypertension is complex and multifactorial, and it involves environmental factors, including heavy metals. Cadmium and mercury are toxic elements commonly found in the environment, contributing to hypertension. We aimed to assess the role of cadmium and mercury-induced endothelial dysfunction in the development of hypertension. A narrative review was carried out through database searches. In this review, we discussed the critical roles of cadmium and mercury in the etiology of hypertension and provided new insights into potential mechanisms of their effect, focusing primarily on endothelial dysfunction. Although the mechanisms by which cadmium and mercury induce hypertension have yet to be completely elucidated, evidence for both implicates impaired nitric oxide signaling in their hypertensive etiology.

Effects of Cadmium, Lead, and Mercury on the Structure and Function of Reproductive Organs

Reproductive organs are essential not only for the life of an individual but also for the survival and development of the species. The response of reproductive organs to toxic substances differs from that of other target organs, and they may serve as an ideal “barometer” for the deleterious effects of environmental pollution on animal and human health. The incidence of infertility, cancers, and associated maladies has increased in the last fifty years or more, while various anthropogenic activities have released into the environment numerous toxic substances, including cadmium, lead, and mercury. Data from epidemiological studies suggested that environmental exposure to cadmium, lead, and mercury may have produced reproductive and developmental toxicity. The present review focused on experimental studies using rats, mice, avian, and rabbits to demonstrate unambiguously effects of cadmium, lead, or mercury on the structure and function of reproductive organs. In addition, relevant human studies are discussed. The experimental studies reviewed have indicated that the testis and ovary are particularly sensitive to cadmium, lead, and mercury because these organs are distinguished by an intense cellular activity, where vital processes of spermatogenesis, oogenesis, and folliculogenesis occur. In ovaries, manifestation of toxicity induced by cadmium, lead, or mercury included decreased follicular growth, occurrence of follicular atresia, degeneration of the corpus luteum, and alterations in cycle. In testes, toxic effects following exposure to cadmium, lead, or mercury included alterations of seminiferous tubules, testicular stroma, and decrease of spermatozoa count, motility and viability, and aberrant spermatozoa morphology.