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McPartland J, Shaffer RM, Fox MA, Nachman KE, Burke TA, Denison RA. Charting a Path Forward: Assessing the Science of Chemical Risk Evaluations under the Toxic Substances Control Act in the Context of Recent National Academies Recommendations. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:25003. [PMID: 35195451 PMCID: PMC8865089 DOI: 10.1289/ehp9649] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND In 2016, Congress enacted the Frank R. Lautenberg Chemical Safety for the 21st Century Act ("the Lautenberg Act"), which made major revisions to the main U.S. chemical safety law, the 1976 Toxic Substances Control Act (TSCA). Among other reforms, the Lautenberg Act mandates that the U.S. Environmental Protection Agency (U.S. EPA) conduct comprehensive risk evaluations of chemicals in commerce. The U.S. EPA recently finalized the first set of such chemical risk evaluations. OBJECTIVES We examine the first 10 TSCA risk evaluations in relation to risk science recommendations from the National Academies to determine consistency with these recommendations and to identify opportunities to improve future TSCA risk evaluations by further implementing these key approaches and methods. DISCUSSION Our review of the first set of TSCA risk evaluations identified substantial deviations from best practices in risk assessment, including overly narrow problem formulations and scopes; insufficient characterization of uncertainty in the evidence; inadequate consideration of population variability; lack of consideration of background exposures, combined exposures, and cumulative risk; divergent approaches to dose-response assessment for carcinogens and noncarcinogens; and a flawed approach to systematic review. We believe these deviations result in underestimation of population exposures and health risks. We are hopeful that the agency can use these insights and have provided suggestions to produce chemical risk evaluations aligned with the intent and requirements of the Lautenberg Act and the best available science to better protect health and the environment-including the health of those most vulnerable to chemical exposures. https://doi.org/10.1289/EHP9649.
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Affiliation(s)
| | - Rachel M. Shaffer
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, Washington, USA
| | - Mary A. Fox
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Johns Hopkins Risk Sciences and Public Policy Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Keeve E. Nachman
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Johns Hopkins Risk Sciences and Public Policy Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Thomas A. Burke
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Johns Hopkins Risk Sciences and Public Policy Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Pelletier G, Feng YL, Leingartner K, Black P. Co-administration of a Rhododendron tomentosum extract does not affect mercury tissue concentrations and excretion rate in methylmercury-treated adult male rats. BMC Res Notes 2019; 12:369. [PMID: 31262338 PMCID: PMC6604137 DOI: 10.1186/s13104-019-4409-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 06/26/2019] [Indexed: 11/26/2022] Open
Abstract
Objectives Consumption of fish/seafood is clearly linked to higher mercury levels in human tissue samples. However, correlations between methylmercury (MeHg) intakes calculated from dietary surveys and mercury body burdens are usually weak and can vary across populations. Different factors may affect MeHg absorption, distribution, metabolism and excretion, including co-exposures to phytochemicals and antibiotics, which were shown to affect mercury body burdens in rodents. Based on the observation that rat pups developmentally exposed to MeHg and a Rhododendron tomentosum extract (Labrador Tea) presented significantly higher blood mercury levels at weaning compared to pups exposed to MeHg alone, the modulation of MeHg toxicokinetics by Labrador Tea was further investigated in adult rats. Results Total mercury levels were quantified in the blood, liver, kidney and feces of adult male rats exposed to MeHg (1.2 mg/kg bodyweight/day, for 3 weeks) administered either alone or in combination with Labrador Tea (100 mg/kg bodyweight/day) or with an antibiotics cocktail (to inhibit MeHg demethylation by gut bacteria). While the reduced fecal excretion and higher blood mercury levels expected from antibiotics-treated rats were observed, mercury levels in samples from Labrador Tea-treated rats were not significantly different from those measured in samples from rats exposed to MeHg alone. Electronic supplementary material The online version of this article (10.1186/s13104-019-4409-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Guillaume Pelletier
- Hazard Identification Division, Environmental Health Science and Research Bureau, Health Canada, Environmental Health Centre, 50 Colombine Driveway, P.L. 0803B, Tunney's Pasture, Ottawa, ON, K1A 0K9, Canada.
| | - Yong-Lai Feng
- Exposure and Biomonitoring Division, Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada
| | - Karen Leingartner
- Hazard Identification Division, Environmental Health Science and Research Bureau, Health Canada, Environmental Health Centre, 50 Colombine Driveway, P.L. 0803B, Tunney's Pasture, Ottawa, ON, K1A 0K9, Canada
| | - Paleah Black
- Hazard Identification Division, Environmental Health Science and Research Bureau, Health Canada, Environmental Health Centre, 50 Colombine Driveway, P.L. 0803B, Tunney's Pasture, Ottawa, ON, K1A 0K9, Canada.,Department of Biology, University of Ottawa, Ottawa, ON, Canada
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Wyatt L, Permar SR, Ortiz E, Berky A, Woods CW, Amouou GF, Itell H, Hsu-Kim H, Pan W. Mercury Exposure and Poor Nutritional Status Reduce Response to Six Expanded Program on Immunization Vaccines in Children: An Observational Cohort Study of Communities Affected by Gold Mining in the Peruvian Amazon. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16040638. [PMID: 30795575 PMCID: PMC6406457 DOI: 10.3390/ijerph16040638] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 02/09/2019] [Accepted: 02/15/2019] [Indexed: 01/02/2023]
Abstract
Background: Poor nutritional status combined with mercury exposure can generate adverse child health outcomes. Diet is a mediator of mercury exposure and evidence suggests that nutritional status modifies aspects of mercury toxicity. However, health impacts beyond the nervous system are poorly understood. This study evaluates antibody responses to six vaccines from the expanded program on immunization (EPI), including hepatitis B, Haemophilus influenzae type B, measles, pertussis, tetanus, and diphtheria in children with variable hair mercury and malnutrition indicators. Methods: An observational cohort study (n = 98) was conducted in native and non-native communities in Madre de Dios, Peru, a region with elevated mercury exposure from artisanal and small-scale gold mining. Adaptive immune responses in young (3–48 months) and older children (4–8 year olds) were evaluated by vaccine type (live attenuated, protein subunits, toxoids) to account for differences in response by antigen, and measured by total IgG concentration and antibody (IgG) concentrations of each EPI vaccine. Mercury was measured from hair samples and malnutrition determined using anthropometry and hemoglobin levels in blood. Generalized linear mixed models were used to evaluate associations with each antibody type. Results: Changes in child antibodies and protection levels were associated with malnutrition indicators, mercury exposure, and their interaction. Malnutrition was associated with decreased measles and diphtheria-specific IgG. A one-unit decrease in hemoglobin was associated with a 0.17 IU/mL (95% CI: 0.04–0.30) decline in measles-specific IgG in younger children and 2.56 (95% CI: 1.01–6.25) higher odds of being unprotected against diphtheria in older children. Associations between mercury exposure and immune responses were also dependent on child age. In younger children, one-unit increase in log10 child hair mercury content was associated with 0.68 IU/mL (95% CI: 0.18–1.17) higher pertussis and 0.79 IU/mL (95% CI: 0.18–1.70) higher diphtheria-specific IgG levels. In older children, child hair mercury content exceeding 1.2 µg/g was associated with 73.7 higher odds (95% CI: 2.7–1984.3) of being a non-responder against measles and hair mercury content exceeding 2.0 µg/g with 0.32 IU/mL (95% CI: 0.10–0.69) lower measles-specific antibodies. Log10 hair mercury significantly interacted with weight-for-height z-score, indicating a multiplicative effect of higher mercury and lower nutrition on measles response. Specifically, among older children with poor nutrition (WHZ = −1), log10 measles antibody is reduced from 1.40 to 0.43 for low (<1.2 µg/g) vs. high mercury exposure, whereas for children with good nutritional status (WHZ = 1), log10 measles antibody is minimally changed for low vs. high mercury exposure (0.72 vs. 0.81, respectively). Conclusions: Child immune response to EPI vaccines may be attenuated in regions with elevated mercury exposure risk and exacerbated by concurrent malnutrition.
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Affiliation(s)
- Lauren Wyatt
- Nicholas School of the Environment, Duke University, Durham, NC 27710, USA.
| | - Sallie Robey Permar
- Duke Human Vaccine Institute, Duke University Medical Center, Durham, NC 27710, USA.
| | - Ernesto Ortiz
- Global Health Institute, Duke University, Durham, NC 27710, USA.
| | - Axel Berky
- Nicholas School of the Environment, Duke University, Durham, NC 27710, USA.
| | - Christopher W Woods
- Department of Medicine, Duke University School of Medicine, Durham, NC 27710, USA.
| | | | - Hannah Itell
- Duke Human Vaccine Institute, Duke University Medical Center, Durham, NC 27710, USA.
| | - Heileen Hsu-Kim
- Department of Civil and Environmental Engineering, Duke University, Durham, NC 27710, USA.
| | - William Pan
- Nicholas School of the Environment, Duke University, Durham, NC 27710, USA.
- Global Health Institute, Duke University, Durham, NC 27710, USA.
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Elevated Arsenic Exposure Is Associated with an Increased Risk of Chronic Hepatitis B Virus Infection: NHANES (2003-2014) in U.S. Adults. Curr Med Sci 2018; 38:610-617. [PMID: 30128869 DOI: 10.1007/s11596-018-1921-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 04/09/2018] [Indexed: 12/28/2022]
Abstract
Studies concerning the association between arsenic exposure and hepatitis B virus (HB V) infection have been lacking. The present study aimed to examine the association between total urinary arsenic (TUA) and infection of HBV. A total of 5186 participants from National Health and Nutrition Examination Survey (NHANES) 2003-2014 were included in the analysis. We used logistic regression to evaluate the association. We defined two measures of TUA. TUAI was the sum of arsenous acid, arsenicacid, monomethylarsonic acid and dimethylarsenic acid. TUA2 was defined as TUA minus arsenobetaine and arsenocholine. The results showed that the weighted overall prevalence of HBV infection was 6.08%. For NHANES 2003-2014, the medians (interquartile range) of TUAI and TUA2 were 5.60 μg/L (3.97-8.09 μg/L) and 4.91 μg/L (2.36-9.11 μg/L), respectively. Comparing the highest quartile to the lowest quartile after multivariable adjustment showed that the odds ratios (ORs) and 95% confidence intervals (CIs) for TUAI and TUA2 were 2.44 (1.40-4.27) and 2.84 (1.60-5.05), respectively. In conclusion, elevated urinary arsenic was associated with the risk of HBV infection. Further studies, especially prospective studies, are needed to confirm the causal relationship between arsenic exposure and HBV infection.
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Jain RB. Trends in and factors affecting the observed levels of urinary inorganic and total blood mercury among US children, adolescents, adults, and senior citizens over 2005-2012. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2017; 56:268-281. [PMID: 29055217 DOI: 10.1016/j.etap.2017.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 09/02/2017] [Accepted: 09/04/2017] [Indexed: 06/07/2023]
Abstract
Data from National Health and Nutrition Examination Survey (NHANES) for 2005-2012 were used to (i) study adjusted and unadjusted trends in the levels of urinary inorganic mercury (UIHG) and total blood mercury (TBHG) and (ii) factors that affect the observed levels of UIHG and TBHG among children aged 1-5 (CHLD15) and 6-11 (CHLD611) years, adolescents aged 12-19 years (ADOL), adults aged 20-64 years (ADLT), and senior citizens aged >=65 years (SNR). Decrease in adjusted levels of UIHG for each 2-year NHANES cycle for CHLD611 was 0.08114ng/L, 0.08379ng/L for ADOLs, and 0.12ng/L for ADLTs. Decreases in adjusted levels (AGM) of TBHG for each 2-year NHANES cycle were: 0.0632ng/L for CHLD15, 0.10239ng/L for CHLD611, 0.06424ng/L for ADOLs, and 0.056088ng/L for ADLTs. Among CHLD15 (0.34 vs. 0.39μg/L, p<0.01) and CHLD611 (0.42 vs. 0.44μg/L, p=0.04), males had lower AGMs for TBHG than females but among ADLTs (0.84 vs. 0.80μg/L, p<0.01) and SNRs (0.82 vs. 0.71μg/L, p<0.01) the reverse was true. For UIHG, for ADLTs (0.33 vs. 0.45μg/L, p<0.01) and SNRs (0.27 vs. 0.35μg/L, p<0.01) males had lower AGMs than females. Irrespective of age, those who were in unclassified race/ethnic group had the highest AGMs when compared with non-Hispanic whites, non-Hispanic blacks, and Mexican Americans and the differences, more often than not, were statistically significant (p<0.01). Irrespective of age, fish and shellfish consumption during the last 30days was associated with higher AGMs for both UIHG and TBHG than when fish and shellfish were not consumed and the differences were always statistically significant (p<0.01). Nonsmoker ADLTs (0.86 vs. 0.78μg/L, p<0.01) and SNRs (0.83 vs. 0.71μg/L, p<0.01) were found to have higher adjusted levels of TBHG than smokers. It is hypothesized that constituents in tobacco smoke may accelerate excretion of mercury from the body.
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Affiliation(s)
- Ram B Jain
- Private Consultant, Dacula, 2959 Estate View Ct, Dacula GA 30019, USA.
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Krueger WS, Wade TJ. Elevated blood lead and cadmium levels associated with chronic infections among non-smokers in a cross-sectional analysis of NHANES data. Environ Health 2016; 15:16. [PMID: 26864738 PMCID: PMC4750187 DOI: 10.1186/s12940-016-0113-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 02/04/2016] [Indexed: 05/21/2023]
Abstract
BACKGROUND Experimental animal studies, in vitro experiments, and clinical assessments have shown that metal toxicity can impair immune responses. We analyzed data from a United States representative National Health and Nutrition Examination Survey (NHANES) to explore associations between chronic infections and elevated blood concentrations of lead and cadmium among non-smoking NHANES participants. METHODS NHANES data from 1999 to 2012 were examined and weighted to represent the United States population. Multivariable logistic regression was used to estimate adjusted odds ratios (AOR) and 95 % confidence intervals (CI) for heavy metal associations with seropositivity for Helicobacter pylori, Toxoplasma gondii, and Hepatitis B virus (HBV) infections. RESULTS Available 2-year survey cycles for infection seroprevalence varied by pathogen, from 1 to 7 cycles. Available sample size, disease seroprevalence, and participant age range also varied by pathogen of interest. After controlling for demographic characteristics and general health condition, an elevated blood lead level above the survey population median was significantly associated with seropositivity for all three pathogens (AORs = 1.2-1.5). In addition, an elevated blood cadmium level above the median was significantly associated with HBV (AOR = 1.5; 95 % CI = 1.2-2.0) and H. pylori (AOR = 1.5; 95 % CI = 1.2-1.7) seropositivity. Age-specific analyses for H. pylori and T. gondii indicated stronger associations among children under 13 years of age, particularly for lead exposure and H. pylori seropositivity, and weaker associations among those over 35 years of age. CONCLUSIONS The results of this cross-sectional human health survey suggest that the immunological effects of lead and cadmium toxicity may be associated with an increased susceptibility to chronic infections.
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Affiliation(s)
- Whitney S Krueger
- RTI Health Solutions, 3040 Cornwallis Road, Post Office Box 12194, Research Triangle Park, NC, 27709-2194, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, 37831, USA
| | - Timothy J Wade
- United States Environmental Protection Agency, Office of Research and Development, National Health & Environmental Effects Research Laboratory, Environmental Public Health Division, Chapel Hill, NC, 27514, USA.
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Rothenberg SE, Korrick SA, Fayad R. The influence of obesity on blood mercury levels for U.S. non-pregnant adults and children: NHANES 2007-2010. ENVIRONMENTAL RESEARCH 2015; 138:173-80. [PMID: 25721244 PMCID: PMC4385493 DOI: 10.1016/j.envres.2015.01.018] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 01/03/2015] [Accepted: 01/28/2015] [Indexed: 05/23/2023]
Abstract
BACKGROUND In animal studies obesity is associated with higher blood and tissue mercury concentrations; however human studies are lacking. Although the mechanism underlying this association is uncertain, obesity may alter the metabolism and distribution of methylmercury. OBJECTIVES We determined whether obesity influenced blood mercury levels, the majority of which was methylmercury, for U.S. non-pregnant adults (≥20 years) and children (2-19 years) after controlling for methylmercury intake through fish and shellfish consumption, and other confounders. METHODS We completed secondary data analysis of the National Health and Nutrition Examination Survey (NHANES) (2007-2010) for participants who consumed fish/shellfish within 24h of blood collection for mercury analysis. Weighted least squares regression models related blood mercury levels (the dependent variable) to methylmercury exposure (μg) from fish consumed in the previous 24h, body mass index (BMI) (for adults), BMI z-scores (for children), and other confounders. RESULTS In adjusted models, blood mercury levels were inversely correlated with BMI for adults [β, 95% confidence interval (CI)=-0.54 (-0.90, -0.18)]. For children, blood mercury levels were inversely correlated with BMI z-scores but the trend was not significant [β (95% CI)=-0.016 (-0.066, 0.035)]. When obese adults or children were compared with those who were overweight/normal weight, blood mercury averaged 22% lower for obese adults (95% CI: -33%, -8.2%), while blood mercury did not differ significantly for obese children [β (95% CI)=-1.7% (-31%, +39%)]. CONCLUSIONS After adjusting for the main, if not exclusive, exogenous source of methylmercury exposure (through fish/shellfish intake) and other confounders, our results support potential changes in the metabolism, distribution or excretion of methylmercury with increasing BMI (for adults).
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Affiliation(s)
- Sarah E Rothenberg
- Department of Environmental Health Sciences, University of South Carolina, Columbia, SC, USA.
| | - Susan A Korrick
- Channing Division of Network 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
| | - Raja Fayad
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
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Lin YS, Ginsberg G, Caffrey JL, Xue J, Vulimiri SV, Nath RG, Sonawane B. Association of body burden of mercury with liver function test status in the U.S. population. ENVIRONMENT INTERNATIONAL 2014; 70:88-94. [PMID: 24908642 DOI: 10.1016/j.envint.2014.05.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Revised: 04/22/2014] [Accepted: 05/12/2014] [Indexed: 06/03/2023]
Abstract
The majority of mercury (Hg) exposure in the US population is from consumption of fish contaminated with methylmercury (MeHg). Since inorganic Hg is the predominant form excreted in the feces and urine, hepatic biotransformation is a critical step in its normal clearance. This study was set to test the hypothesis that compromised liver function is associated with body burden of Hg as indirectly reflected by Hg sampled in blood and urine. From the National Health and Nutrition Examination Survey (NHANES, 2003-2008), 3769 adults aged 20 years and above were selected for analysis. Hepatic function was inferred from the three standard serum liver-related enzyme activities, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and γ-glutamyltransferase (GGT). Multivariate regression models were used to examine the associations of interest. Although urinary Hg was significantly correlated with serum Hg, the blood-urinary Hg relationship was influenced by liver function, which is also a function of demographic and lifestyle factors (e.g., gender). Although the results were only marginally significant for examined enzymes (p=0.06-0.08), urinary Hg tended to be lower among subjects with elevated liver enzymes, as compared to those with normal enzyme measurements. Conversely, MeHg generally represents a higher fraction of the total circulating Hg among those with elevated liver enzyme levels, especially among participants with elevations in all three enzymes (p=0.01). In conclusion, this population-based study identified an association between liver function, serum Hg and urinary Hg. Urinalysis may not be the optimal approach to monitor Hg elimination toxicokinetics or Hg exposure, since the majority of Hg excretion is fecal and the fidelity of urinary excretion may depend on healthy liver function. Future prospective studies are warranted to expand these findings.
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Affiliation(s)
- Yu-Sheng Lin
- National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Washington, DC 20460, USA.
| | - Gary Ginsberg
- Connecticut Department of Public Health, Hartford, CT 06134, USA
| | - James L Caffrey
- Department of Integrative Physiology and Cardiovascular Research Institute, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Jianping Xue
- National Exposure Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency, Washington, DC 20460, USA
| | - Suryanarayana V Vulimiri
- National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Washington, DC 20460, USA
| | - Raghu G Nath
- National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Washington, DC 20460, USA
| | - Babasaheb Sonawane
- National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Washington, DC 20460, USA
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Lee H, Kim Y, Sim CS, Ham JO, Kim NS, Lee BK. Associations between blood mercury levels and subclinical changes in liver enzymes among South Korean general adults: analysis of 2008-2012 Korean national health and nutrition examination survey data. ENVIRONMENTAL RESEARCH 2014; 130:14-9. [PMID: 24525240 DOI: 10.1016/j.envres.2014.01.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2013] [Revised: 11/10/2013] [Accepted: 01/15/2014] [Indexed: 05/12/2023]
Abstract
INTRODUCTION We herein used data from the Korean National Health and Nutritional Examination Survey (KNHANES) 2008-2012 to examine the associations between blood mercury levels and subclinical changes of liver function in a representative sample of the adult Korean population. METHODS This study was based on data obtained from KNHANES, in which a rolling sampling design was used to perform a complex, stratified, multistage probability cluster survey of a representative sample of the non-institutionalized civilian population in South Korea. The associations between subclinical hepatic changes and blood mercury levels were assessed after adjustment for various demographic and lifestyle factors. RESULTS Multivariate linear regression analyses revealed that each doubling of blood mercury increased serum aspartate transaminase (AST) by 0.676U/L and serum alanine transaminase (ALT) by 1.067U/L. The mean differences (95% CI) in serum AST and ALT between the lowest and highest quartiles were statistically significant at 1.249 (0.263-2.235)U/L and 2.248 (0.648-3.848), respectively. Logistic regression analysis showed that the odd ratios for having serum AST and ALT levels above the median were statistically significant in both the models according to the increase of blood mercury. The risks of having serum AST and ALT levels higher than the median among subjects in 4th quartile of blood mercury were 1.524 and 1.947, respectively. DISCUSSION The present findings show that subclinical changes of liver function are associated with blood mercury levels. This is the first study to show an association between blood mercury levels and mild liver dysfunction, as a possible proxy measure of nonalcoholic fatty liver disease (NAFLD), in Asian population.
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Affiliation(s)
- Heun Lee
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 682-060, South Korea
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 682-060, South Korea
| | - Chang-Sun Sim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 682-060, South Korea
| | - Jung-O Ham
- Department of Occupational and Environmental Medicine, Soonchunhyang University Hospital, Cheonan 330-721, South Korea
| | - Nam-Soo Kim
- Institute of Environmental & Occupational Medicine, Soonchunhyang University, Asan 336-745, South Korea
| | - Byung-Kook Lee
- Korean Industrial Health Association, Hyesan Bldg., #1490-32 Seocho-3-Dong, Seocho-Gu, Seoul 153-801, South Korea.
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