Impact of refining the assessment of dietary exposure to cadmium in the European adult population

Paternal cadmium exposure affects estradiol synthesis by impairing intracellular cholesterol homeostasis and mitochondrial function in offspring female mice

Cadmium (Cd) is a toxic heavy metal commonly found in nature and an endocrine disrupting chemical (EDC). Previous studies found that Cd can damage several organs, including the kidneys, bones, cardiovascular system and reproductive system. However, the effect of paternal Cd exposure on the offspring is unclear. In this study, 1 mg/kg of cadmium chloride (CdCl2) was injected intraperitoneally every other day in 8-week-old C57BL/6 J male mice to study the effects on their female offspring. Our results showed an increase in body weight, water intake and food intake in F1 female mice from the Cd-exposed group. The development of secondary follicles and antral follicles in the ovaries of Cd-treated was inhibited. Serum estradiol (E2) was found to be decreased. Further analysis revealed significant downregulation of StAR, P450scc, 17β-HSD, CYP17A1 and CYP19A1, which are related to E2 synthesis. Serum total cholesterol was increased and free cholesterol was reduced. Total cholesterol in ovarian tissue was decreased. qRT-PCR and Western blot analysis revealed a decrease in the mRNA and protein expression of HMGCR, LDLR, and ABCA1, which are associated with cholesterol homeostasis. Oil red O staining indicated that lipid droplets (LDs) were accumulated in ovarian tissues, while the expression of ATGL and HSL proteins associated with lipid droplet degradation was significantly downregulated. In juvenile female mice, ultrastructural alterations of mitochondria in the ovaries were observed by transmission electron microscopy (TEM). In adult female mice, the expression of proteins associated with mitochondrial dynamics (DRP1 and MFN2) was significantly reduced in the ovaries. Overall, our study suggests that paternal Cd exposure inhibits follicular development, and affects serum E2 synthesis by impairing cholesterol homeostasis and affecting mitochondrial function.

Cadmium Exposure in Aquatic Products and Health Risk Classification Assessment in Residents of Zhejiang, China

Cadmium (Cd) pollution of food safety is a prominent food safety concern worldwide. The concentration of Cd in six aquatic food categories collected from 2018 to 2022 was analyzed using inductively coupled plasma mass spectrometry, and the Cd exposure levels were calculated by combining the Cd concentration and food consumption data of 18913 urban and rural residents in Zhejiang Province in 2015-2016. The mean Cd concentration was 0.699 mg/kg and the mean Cd exposure of aquatic foods was 0.00951 mg/kg BW/month for the general population. Marine crustaceans were the largest Cd contributor, corresponding to 82.7%. The regional distribution results showed that the average Cd exposure levels of 11 cities did not exceed the provisional tolerable monthly intake (PTMI). According to the subgroups, the Cd mean exposure level of 2-3-year-old children was significantly higher than that of the other age groups but did not exceed the PTMI. Health risk classification assessment demonstrated that the final risk score was six, and the health risk level of Cd exposure in aquatic products in the Zhejiang population was medium. These results demonstrated that the risk of Cd exposure in certain food types or age groups should be given more concern.

The Effect of Cadmium on Sleep Parameters Assessed in Polysomnographic Studies: A Case-Control Study

Cadmium is a heavy metal that accumulates in the body due to environmental and occupational exposure. The main form of environmental exposure to cadmium is related to cigarette smoking. The primary aim of this study was to evaluate the effect of cadmium on numerous sleep parameters with the use of polysomnography. The secondary aim of this study was to investigate if environmental exposure to cadmium is a risk factor for the intensity of sleep bruxism (SB).

METHODS

A total of 44 adults underwent a full night of polysomnographic examination. The polysomnograms were assessed according to guidelines set out by the American Academy of Sleep Medicine (AASM). The concentration of cadmium in the blood and urine was determined spectrophotometrically.

RESULTS

The polysomnographic examination confirmed that cadmium, age, male gender and smoking status are independent risk factors for an increase in the apnea-hypopnea index (AHI). Cadmium alters sleep architecture by favoring sleep fragmentation and decreasing the duration of the rapid eye movement (REM) phase of sleep. However, cadmium exposure is not a risk factor for the development of sleep bruxism.

CONCLUSIONS

In summary, this study demonstrates that cadmium affects sleep architecture and is a risk factor for the development of obstructive sleep apnea; however, it does not affect sleep bruxism.

Probabilistic modelling techniques in dietary exposure assessment: application on the risk assessment of cadmium for Austrian adults

Probabilistic exposure and risk assessment of chemical hazards in the diet have increasingly gained ground in recent years as a pragmatic approach for the approximation of reality. This work presents the outcomes of a project which aimed at applying probabilistic techniques for basic modelling of chronic dietary exposure to food contaminants following EFSA guidance. These techniques, based on Monte Carlo Risk Assessment (MCRA) software and on the programming language R, were employed for the risk assessment of cadmium for Austrian adults, enabling the validation and the critical comparison of the two approaches. Harmonisation and optimisation of procedures, refinement of exposure assessment skills and confidence in the results were the main benefits. Data amount and validity were identified as critical parameters, influencing the precision of the results. Cadmium was selected as a case study due to its toxicological properties, its ubiquitous presence in food and the availability of Austrian occurrence data. Similar exposure and risk estimates were generated through MCRA and R in alternative optimistic and pessimistic exposure scenarios, suggesting low levels of concern, except for vegetarians, whose upper tail exposures are close to the established Tolerable Weekly Intake. However, as occurrence data gaps have been identified as the major element of uncertainty, the estimated exposure and risk levels are characterised as underestimated. Grains and grain-based products, potatoes and leafy vegetables are the main contributors to the intake. The results will contribute to risk management and to a future refinement of the assessment.

Maternal Diet During Pregnancy and Blood Cadmium Concentrations in an Observational Cohort of British Women

Few studies have investigated the extent to which diet predicts body Cd concentrations among women of reproductive age, and pregnant women in particular. The aim of this study was to examine diet as a predictor of blood Cd concentrations in pregnant women participating in the UK Avon Longitudinal Study of Parents and Children (ALSPAC). Whole blood samples were analysed for Cd (median 0.26 (IQR 0.14–0.54) µg/L). Dietary pattern scores were derived from principal components analysis of data from a food frequency questionnaire. Associations between dietary pattern scores and foods/food groups with blood Cd ≥ median value were identified using adjusted logistic regression (n = 2169 complete cases). A health conscious dietary pattern was associated with a reduced likelihood of B-Cd ≥0.26 µg/l (OR 0.56 (95% CI 0.39–0.81)). There were similarly reduced likelihoods for all leafy green and green vegetables (0.72 (0.56–0.92) when consumed ≥4 times/week vs ≤1 to ≥3 times/week) and with all meats (0.66 (0.46–0.95) when consumed ≥4 times/week vs ≤ once in 2 weeks). Sensitivity analysis excluding smokers showed similar results. The evidence from this study provides continued support for a healthy and varied diet in pregnancy, incorporating foods from all food groups in accordance with national recommendations, without the need for specific guidance.

The Occurrence and Dietary Exposure Assessment of Mycotoxins, Biogenic Amines, and Heavy Metals in Mould-Ripened Blue Cheeses

The occurrence and dietary exposure assessment of 16 mycotoxins, 6 biogenic amines (BAs), and 13 metallic elements in blue-veined cheeses (n = 46) is reported. Co-occurrence of mycophenolic acid (≤599 µg·kg-1) with roquefortine C (≤5454 µg·kg-1) was observed in 63% of the tested cheeses, while BAs were frequently present at concentrations between 0.2 and 717 mg kg-1. The concentrations of heavy metals in cheeses were very low. Chronic/acute exposure assessment based on consumption data from different European populations indicated that the levels of mycotoxins and heavy metals are safe to consumers, whereas, rather high hazard indexes (HI up to 0.77) were determined for BAs according to the worst-case scenario based on high consumption and 95th percentile occurrence. A more detailed acute dietary intake study indicated that histamine and tyramine were predominant among these BAs, reaching 27 and 41% of the acute oral intake reference doses.

Lead and cadmium in foods/drinking water from Slovenian market/taps: Estimation of overall chronic dietary exposure and health risks

Approximately 3000 food samples from the Slovenian market and 2500 drinking (tap) water samples in the period 2011 - 2016 were evaluated for the presence of toxic elements lead (Pb) and cadmium (Cd) and the overall chronic dietary exposure was assessed for each element. The highest mean concentrations were found for Pb in products for special nutritional use - dietary supplements (0.383 mg/kg) and for Cd in fish and seafood (0.117 mg/kg). The consumption data were obtained from the national study of the household budget and from the European Food Safety Authority (EFSA) summary statistics. Chronic dietary exposure was estimated deterministically. The average Pb and Cd intakes from food and drinking (tap) water ranged for children from 0.90 to 1.021 µg/kg bw/day and 4.65 to 5.65 µg/kg bw/week, respectively, and for adults, including adolescents, from 0.40 to 0.53 µg/kg bw/day and 1.98 to 2.82 µg/kg bw/week, respectively. The high consumption of cereal-based foods and vegetables contributed most to overall Pb and Cd intake in the majority of the age groups. The exposure to Pb was generally lower and that to Cd was higher compared to the average EU values. The most exposed were children, as the health-based guidance values were exceeded for both elements, which indicates a health concern. An important contribution to Cd exposure can be attributed to grains and potatoes grown in Slovenia, where the soil contains more Cd than that in other EU countries. Further efforts to reduce Pb and Cd intake are required to minimize potential health risks.

Heavy metals in fish and its association with autoimmunity in the development of juvenile idiopathic arthritis: a prospective birth cohort study

BACKGROUND

The etiology of Juvenile Idiopathic Arthritis (JIA) is poorly understood. The purpose of this study was to examine the possible influence of early nutrition on later development of JIA.

METHODS

In a population-based prospective birth cohort of 15,740 children we collected nutritional data, including fish consumption, and biological samples during pregnancy, at birth and at different ages. 16 years after study inclusion we identified 42 children with JIA, of whom 11 were positive for Antinuclear Antibodies (ANA). Heavy metals were analysed in cord blood of all 42 JIA patients and 40 age and sex-matched controls. A multivariable logistic regression model, adjusted for relevant factors, was used as well as Mann-Whitney U-test.

RESULTS

Fish consumption more than once a week during pregnancy as well as during the child's first year of life was associated with an increased risk of JIA (aOR 4.5 (1.95-10.4); p < 0.001 and aOR 5.1 (2.1-12.4) p < 0.001) and of ANA-positivity (aOR 2.2 (1.4-3.6); p = 0.002 and p < 0.001). Concentrations of Al, Cd, Hg and Li in cord blood were significantly higher in the JIA-group than in controls. The ANA-positive, all of whom had consumed fish >once/week their first year, had significantly higher concentrations of Al (p < 0.001), Cd (p = 0.003), and Li (p < 0.001) in cord blood than controls. Frequency of fish consumption correlated with concentrations of Cd (p = 0.003), Li (p = 0.015) and Hg (p = 0.011).

CONCLUSIONS

Moderate exposure to heavy metals, associated with fish consumption, during pregnancy and early childhood may cause effects on the immune system of the offspring, resulting in ANA positivity and JIA.

Hormonal changes and folliculogenesis in female offspring of rats exposed to cadmium during gestation and lactation

It has been suggested that the toxic effects of cadmium (Cd) may disrupt ovarian and uterine functions in adults. However, Cd exposure during gestation and lactation and its effects on the reproductive development in female offspring is still not clear, and the mechanisms underlying exposure toxicology remain mostly unexplored. To investigate how Cd exposure of female rats (F0) during gestation and lactation affects the reproductive development of their female offspring, we studied the steroidogenesis, folliculogenesis, puberty onset, and litter size of the first (F1) and second (F2) filial generations following F0 female rats which had been exposed to CdCl₂. The mechanisms related to the early onset of puberty induced by such exposure in female offspring were explored. Maternal exposure to Cd dramatically increased the biosynthesis of steroid hormones in F1 female offspring by the activation of cAMP/PKA pathway and up-regulated expression of steroidogenesis related proteins such as StAR, CYP11A1, 3β-HSD and CYP19A1. The high levels of steroid hormones contributed to an early puberty onset, promoted the differentiation and maturation of follicles, and led to the proliferation of endometrium that resulted in a uterus weight gain. The increased number of antral follicles eventually caused a big litter size. Despite of being free from additional Cd exposure, the levels of CYP11A1 and CYP19A1 in the ovaries of F2 female rats were also high, which resulted in a high concentration of serum progesterone. These results suggested that hormonal changes induced by exposure to Cd in utero might have a lasting effect beyond the first generation. These findings may help to better understand the origin of female sexual dysfunction in the developmental stages in general.

Exposure to cadmium during gestation and lactation affects development and function of Leydig cells in male offspring

Toxic effects of maternal exposure to Cadmium (Cd) on Leydig cells of male offspring arises much concern recently, but its toxic effects on the development of Leydig cells and androgen synthesis have not been elucidated. In this study, female rats were exposed to Cd during gestation and lactation, and the development of Leydig cells in the first filial-generation (F1) male rats was investigated. The steroidogenic signaling pathway and biomarkers related to the development of Leydig cells were detected to disclose how maternal Cd-exposure caused reproductive damage. F1 male rats with maternal Cd-exposure gained a low relative weight of testis and declined levels of steroid hormones. Maternal Cd-exposure interrupted the development of Leydig cells with high expression of SRD5α and cell morphology of immature Leydig cells in adulthood, inhibited the activation of cyclic adenosine monophosphate/ protein kinase A signaling pathway and down-regulated the steroidogenic enzymes. These results would help to disclose the origin of male sexual dysfunction in the developmental stages of Leydig cells.

Human health risk assessment of cadmium via dietary intake by children in Jiangsu Province, China

The goal of this study was to quantify the exposure to dietary cadmium (Cd) and analyze the major contributors to total Cd intake of children from Jiangsu Province, China. The Cd concentration data were collected by the National Food Contamination Monitoring Program between 2001 and 2009. Consumption data were derived from the Chinese National Nutrition and Health Survey in 2002. The beta-binomial-normal model which included age as a covariate was used to assess the long-term dietary Cd intake assuming lower bound and upper bound concentration scenarios. A tolerable weekly intake of 2.5 µg/kg body weight for Cd was applied in the risk assessment. Cd intake decreased as age increased with almost all mean values and P95 of the estimates exceeding the tolerable weekly intake. Children with high-end exposure may suffer non-carcinogenic effects over a lifetime of exposure. Rice and rice products, wheat flour and wheat flour products, crustaceans, pak-choi, pig meat, and beans and bean products were found to be the major contributors to the total Cd intake in children. These conservative estimates of Cd intake indicate possible public health concerns for children in Jiangsu Province.

Observed distribution of radiocaesium contamination in shiitake lots and variability of test results

Shiitake mushrooms (Lentinula edodes) cultivated on bed-log are known to accumulate radiocaesium. Since the Fukushima-Diichi nuclear power plant accident (2011), the violation rate has been higher for log-cultivated shiitake than that for agricultural products or other foodstuffs. When testing shiitake mushrooms for radionuclide contamination, the validation of the sampling plan can be severely compromised by the heterogeneous contamination within shiitake lots. Currently, few data are available on the statistical properties of the radiocaesium contamination of log-cultivated shiitake. In this paper, shiitake lots contaminated by radiocaesium were identified and the distribution of the radiocaesium concentration within the lots investigated. The risk of misclassifying shiitake lots was predicted from the operating characteristic curve generated from Monte Carlo simulations and the performance of various sampling plans was evaluated. This study provides useful information for deciding on an acceptable level of misclassification risk.

Feasibility of dietary assessment methods, other tools and procedures for a pan-European food consumption survey among infants, toddlers and children

PURPOSE

To test the feasibility of tools and procedures for a pan-European food consumption survey among children 0-10 years and to recommend one of two tested dietary assessment methods.

METHODS

Two pilot studies including 378 children were conducted in Belgium and the Czech Republic in the Pilot studies for Assessment of Nutrient intake and food Consumption among Kids in Europe. One protocol included a 3-day food diary which was checked with a parent, and data were entered afterwards using EPIC-Soft. The alternative protocol consisted of two non-consecutive 1-day food diaries followed by EPIC-Soft completion interviews. Both protocols included general and food propensity questionnaires and anthropometric measurements. The protocols were compared using evaluation questionnaires among the participating parents and study personnel.

RESULTS

The parents found the questionnaires and instructions for filling in the food diaries understandable. Food description and food quantification was evaluated as problematic by 29 and 15% of the participants for the 3-day diaries versus 15 and 12% for the 1-day diaries. The protocol with 1-day food diaries was evaluated as less burdensome by the parents and logistically more challenging by the interviewers.

CONCLUSIONS

Both dietary assessment methods with related tools and administration protocols were evaluated as feasible. The administration protocol with two 1-day food diaries with completion interviews offers more advantages for the future pan-European survey in children 0-10 years. The positive evaluation of feasibility of tools and materials is an important step towards harmonised food consumption data at European level among the younger age groups.

Exposure assessment of heavy metals (Cd, Hg, and Pb) by the intake of local foods from Zhejiang, China

Considering the environmental pollution, food safety is of great concern to the consumers. The present study was conducted to assess the health risk of cadmium (Cd), mercury (Hg), and lead (Pb) through the dietary intake in Zhejiang, China. Eight hundred and sixty two food samples including aquatic products, meat, vegetables, milk and dairy products, and cereal grains were analyzed. Only 2.44 % (Cd), 1.39 % (Hg), and 1.51 % (Pb) of the samples exceeded the maximum allowable concentration set by Chinese Ministry of Health. The average dietary intakes of Cd, Hg, and Pb were estimated to be 0.26, 0.14, and 0.55 μg/kg bw/day, respectively. Compared with the reference doses, the mean exposure of Cd, Hg, and Pb was all less than the tolerable intake value. Only at the 95th percentile level, Cd and Hg exposure exceeded the values of tolerable intakes by 40 and 277 %, respectively. It indicates that there is low health risk to the dietary exposure of Cd, Hg, and Pb for general people in Zhejiang province, China.

The use of chemical occurrence data at European vs. national level in dietary exposure assessments: a methodological study

A typical EFSA approach to assess dietary exposure is to combine data from national consumption surveys with chemical occurrence data that have been pooled across the EU Member States (pooled approach). This approach was compared to the case where occurrence data were stratified by country and used for food categories where national data were abundant (semi-pooled approach), using cadmium as a case study. Some differences in estimated dietary exposure were observed between the pooled and semi-pooled approach. They were explained by differences, between the national and the European occurrence data, with respect to (1) contamination values and (2) sample proportions of food items classified in the food categories the assessment was based on. The latter aspect highlighted the sensitivity of the approach of directly aggregating monitoring data into food categories. Both the pooled and semi-pooled approach tended to be conservative relative to approaches used at national level. This appears to be attributed to differences in the way the available occurrence data is aggregated. Refinement of the studied methodologies would include a better separation of the food items with high concentration from those with low concentration.