Association between personal exposure to ambient metals and respiratory disease in Italian adolescents: a cross-sectional study

Association between exposure to airborne endocrine disrupting chemicals and asthma in children or adolescents: A systematic review and meta-analysis

Various studies have explored the association between Endocrine Disrupting Chemicals (EDCs) exposure and children's and adolescents' respiratory health, showing potential long-term effects and links to asthma. This systematic review explores the association between exposure to seven EDC groups during school age and adolescence and asthma onset or exacerbation while highlighting the predominant compounds underlying these potential associations. PubMed, Web of Science, Scopus, and Cochrane Library databases were searched with no time restriction. The risk of bias and heterogeneity across the included studies were assessed using the Newcastle Ottawa scale and I2 test, respectively. Pooled Odds Ratios (OR) and their 95% Confidence Intervals (CI) were calculated using the random effect model, and the quality of evidence for each outcome was measured using the GRADE approach. The review included 64851 children and adolescents from 61 observational studies, most with a low risk of bias in the studied domains. The pooled OR for asthma onset was significant for phthalates in dust samples (OR:1.21, CI:1.02; 1.44). Due to limited studies, the overall pooled effects for the other groups were not computed. Individual compounds demonstrating significant associations with asthma onset included airborne nickel (OR:1.10, CI:1.03; 1.18) and zinc (OR:1.13, CI:1.11; 1.15), urinary Bisphenol S (OR:1.40, CI:1.13; 1.73), Bisphenol A (OR:1.57, CI:1.02; 2.40) and arsenic (OR:2.08, CI:1.33; 3.26), and DiBP (OR:1.41, CI:1.08; 1.82), DEHP (OR:1.89, CI:1.00; 3.57), and TBOEP (OR:2.61, CI:1.08; 6.30) in the dust. Individual compounds with significant associations with greater asthma exacerbation odds comprised airborne nickel (OR:1.08, CI:1.01; 1.16) and zinc (OR:1.09, CI:1.01; 1.17), and urinary MEHHP (OR:1.24, CI:1.02; 1.51), MECPP (OR:1.30, CI:1.07; 1.57), MEOHP (OR:1.30, CI:1.09; 1.55), and MCOP (OR:1.32, CI:1.11; 1.57). Exposure to EDCs was significantly associated with asthma onset and exacerbation in children and adolescents, namely for phthalates, bisphenols A and S, arsenic, nickel, and zinc. Further research is recommended to focus on the impact of synergistic and co-exposure to other indoor air pollutants.

Nickel removal from synthetic wastewater by novel zeolite-doped magnesium- iron- and zinc-oxide nanocomposites by hydrothermal-calcination technique

This study aims to modify raw zeolite with metal oxide nanocomposites to remove nickel (Ni) ions from synthetic wastewater. Novel zeolite-doped magnesium oxide (MgO), iron oxide (Fe3O4), and zinc oxide (ZnO) nanocomposites were synthesized by hydrothermal-calcination methods. The novel zeolite-doped metal oxide nanocomposites were used as adsorbents to remove Ni (II) ions from synthetic wastewater. Several advanced techniques, including X-ray diffraction (XRD), transmission electron microscopy (TEM), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), X-ray photoelectron spectroscopy (XPS), and vibrating sample magnetometer (VSM) were applied to study the structural, morphological, chemical, and magnetic properties of the prepared materials. Doped zeolite with ZnO, MgO, and Fe3O4 significantly enhances the removal of Ni (II) ions from synthetic wastewater. The zeolite-doped MgO + Fe3O4 + ZnO sample achieved a Ni (II) ions removal efficiency of 99.6%, compared to 58.9% for raw zeolites. The removal efficiencies of Ni (II) ions (Ci = 30 mg/L) from highest to lowest were 99.56%, 99.53%, 91.4%, 67.8%, and 58.93% by zeolite-doped MgO + Fe3O4 + ZnO, zeolite-doped MgO, zeolite-doped ZnO, zeolite-doped Fe3O4, and raw zeolite sample, respectively. The highest adsorption capacity was 17.13 mg/g of zeolite-doped MgO + Fe3O4 + ZnO samples. The experimental adsorption data collected were fitted using five isotherm models, and four kinetic models. The Langmuir adsorption isotherm model and the pseudo-second-order kinetic model provided the best fit for the experimental adsorption data. This suggests that the adsorption process is complex, possibly involving electron interactions between the active sites of doped zeolite and Ni (II) species. The obtained data indicates that zeolite-doped with MgO, Fe3O4, and ZnO notably enhances the adsorptive properties of Ni (II) from synthetic wastewater. The obtained thermodynamic values confirmed that the adsorption process is spontaneous and endothermic, with increased randomness at the solid-solution interface during the adsorption process.

Exploring the link between the pediatric exposome, respiratory health, and executive function in children: a narrative review

Asthma is a highly prevalent inflammatory condition, significantly affecting nearly six million U.S. children and impacting various facets of their developmental trajectories including neurodevelopment. Evidence supports a link between pediatric environmental exposures in two key areas: asthma and executive function (E.F.). E.F.s are a collective of higher-order cognitive processes facilitating goal-oriented behaviors. Studies also identify asthma-associated E.F. impairments in children. However, limited research has evaluated the inter-relationships among environmental exposures, asthma, and E.F. in children. This review explored relevant research to identify and connect the potential mechanisms and pathways underlying these dynamic associations. The review suggests that the role of the pediatric exposome may function through (1) several underlying biological pathways (i.e., the lung-brain axis, neuroendocrine system, and hypoxia), which could drive asthma and maladaptive E.F. in children and (2) the relationships between the exposome, asthma, and E.F. is a bidirectional linkage. The review reveals essential synergistic links between asthma and E.F. deficits, highlighting the potential role of the pediatric exposome.

Independent and joint associations of multiple metals exposure with vital capacity index: a cross-sectional study in Chinese children and adolescents

OBJECTIVE

The current study aimed to explore the relationships between urinary metals and vital capacity index (VCI) in 380 children and adolescents in Northeast China using a variety of statistical methods.

METHODS

A cross-sectional survey was conducted among 380 children and adolescents in Liaoning Province, China. To assess the relationships between urinary metals and VCI, Elastic-net (ENET) regression, multivariate linear regression, weighted quantile sum (WQS), bayesian kernel machine regression (BKMR) and quantile-based g computation (qgcomp) were adopted.

RESULTS

The ENET model selected magnesium (Mg), vanadium (V), manganese (Mn), arsenic (As), tin (Sn) and lead (Pb) as crucial elements. In multiple linear regression, we observed urinary Pb, Mn was negatively correlated with VCI individually in both total study population and adolescents (all p values < 0.05) in the adjustment model. The WQS indices were negatively related with VCI in total study population (β=-3.19, 95%CI: -6.07, -0.30) and adolescents (β=-3.46, 95%CI: -6.58, -0.35). The highest weight in total study population was Pb (38.80%), in adolescents was Mn (35.10%). In the qgcomp, Pb (31.90%), Mn (27.20%) were the major negative contributors to the association in the total population (β=-3.51, 95%CI: -6.29, -0.74). As (42.50%), Mn (39.90%) were the main negative contributors (β=-3.95, 95% CI: -6.68, -1.22) among adolescents. The results of BKMR were basically consistent with WQS and qgcomp analyses.

CONCLUSIONS

Our results indicated that Pb and Mn were priority toxic materials on VCI. The cumulative effect of metals was negatively related to VCI, and this relationship was more pronounced in adolescents.

Assessing the impact of specific PM2.5-Bound metallic elements on asthma emergency department visits: A case-crossover study in Taiwan

OBJECTIVES

This study aims to assess the specific PM2.5-bound metallic elements that contribute to asthma emergency department visits by using a case-crossover study design.

METHODS

This study analyzed data from 11,410 asthma emergency department visits as case group and 22,820 non-asthma onset dates occurring one week and two weeks preceding the case day as controls from 2017 to 2020. PM2.5 monitoring data and 35 PM.2.5-bound metallic elements from six different regions in Taiwan were collected. Conditional logistic regression models were used to assess the relationship between asthma and PM2.5-bound metallic elements.

RESULTS

Our investigation revealed a statistically significant risk of asthma emergency department visits associated with PM2.5 exposure at lag 0, 1, 2, and 3 during autumn. Additionally, PM2.5-bound hafnium (Hf), thallium (Tl), rubidium (Rb), and aluminum (Al) exhibited a consistently significant positive correlation with asthma emergency department visits at lags 1, 2, and 3. In stratified analyses by area, age, and sex, PM2.5-bound Hf showed a significant and consistent correlation.

CONCLUSIONS

This study provides evidence of PM2.5-bound metallic elements effects in asthma exacerbations, particularly for Hf. It emphasizes the importance of understanding the origins of these metallic elements and pursuing emission reductions to mitigate regional health risks.

Nickel in ambient particulate matter and respiratory or cardiovascular outcomes: A critical review

Exposure to ambient particulate matter (PM) has been associated with respiratory and cardiovascular outcomes, and nickel has been more frequently associated with these outcomes than other metal constituents of ambient PM. Because of this, we evaluated whether the evidence to date supports causal relationships between exposure to nickel in ambient PM and respiratory or cardiovascular outcomes. We critically reviewed 38 studies in human populations published between 2012 and 2022. Although a large variety of respiratory and cardiovascular outcomes were examined, data were sparse for many. As a result, we focused our evaluation on seven respiratory outcomes and three cardiovascular outcomes that were each examined in ≥3 studies. Of these health outcomes, exposure to nickel in ambient PM has been statistically significantly associated with respiratory mortality, respiratory emergency hospital visits, asthma, lung function (i.e., forced expiratory volume in 1 s, forced vital capacity), cardiovascular mortality, and ischemic heart disease mortality. Studies of the health outcomes of focus are subject to multiple methodological limitations, primarily ecological fallacy (short-term exposure studies), exposure measurement error, confounding, model misspecification, and multiple comparisons issue. While some statistically significant associations were reported, they were not strong, precise, or consistent. Statistically significant findings for long-term exposure to nickel in PM were largely reported in studies that could not establish temporality, despite their cohort study design. Statistically significant findings for short-term exposure to nickel in PM were largely reported in studies that could establish temporality, although this cannot inform causal inference at the individual level due to the aggregate level data used. The biological plausibility of the associations is only supported at high concentrations not relevant to ambient exposures. Overall, the literature to date does not provide adequate support for a causal relationship between nickel in ambient PM and respiratory or cardiovascular outcomes.

Human Health and Ecological Risks Associated with Total and Bioaccessible Concentrations of Cadmium and Lead in Urban Park Soils

This study investigated the total and bioaccessible concentrations of cadmium (Cd) and lead (Pb) in urban soils and their associated human health and ecological risk. Total and bioaccessible metal concentrations were found within the safe limits except for Cd, surpassing the State Environmental Protection Administration (SEPA) China limit in 9.5% of parks. Bioaccessible concentrations were higher in the gastric (G) phase than the intestinal (I) phase, while Cd showed more bioaccessibility compared to Pb. Bioaccessible concentrations reduced Hazard Quotient (HQ_ing) values by 2-22 times and 0-2 times for children and adults, respectively, while hazard index (HI) declined by 1.7 times, and the mean total bioaccessible risk of Pb decreased by 20.8 times. Further, the study revealed a low level of contamination factor (CF < 1) and a low degree of contamination (CD < 6), and Potential Ecological Risk Index (PERI) values for all the cities were less than 150, indicating low ecological risk.

Association between Exposure to Selected Heavy Metals and Blood Eosinophil Counts in Asthmatic Adults: Results from NHANES 2011-2018

(1) Background: Heavy metals are widely used and dispersed in the environment and people's daily routines. Many studies have reported an association between heavy metal exposure and asthma. Blood eosinophils play a crucial role in the occurrence, progression, and treatment of asthma. However, there have thus far been few studies that aimed to explore the effects of heavy metal exposure on blood eosinophil counts in adults with asthma. Our study aims to discuss the association between metal exposure and blood eosinophil counts among asthmatic adults. (2) Methods: A total of 2026 asthmatic individuals were involved in our research from NHANES with metal exposure, blood eosinophils, and other covariates among the American population. A regression model, the XGBoost algorithm, and a generalized linear model (GAM) were used to explore the potential correlation. Furthermore, we conducted a stratified analysis to determine high-risk populations. (3) Results: The multivariate regression analysis indicated that concentrations of blood Pb (log per 1 mg/L; coefficient β, 25.39; p = 0.010) were positively associated with blood eosinophil counts. However, the associations between blood cadmium, mercury, selenium, manganese, and blood eosinophil counts were not statistically significant. We used stratified analysis to determine the high-risk group regarding Pb exposure. Pb was identified as the most vital variable influencing blood eosinophils through the XGBoost algorithm. We also used GAM to observe the linear relationship between the blood Pb concentrations and blood eosinophil counts. (4) Conclusions: The study demonstrated that blood Pb was positively correlated with blood eosinophil counts among asthmatic adults. We suggested that long-time Pb exposure as a risk factor might be correlated with the immune system disorder of asthmatic adults and affect the development, exacerbation, and treatment of asthma.

Long-term PM2.5 exposure in association with chronic respiratory diseases morbidity: A cohort study in Northern China

Several literatures have examined the risk of chronic respiratory diseases in association with short-term ambient PM2.5 exposure in China. However, little evidence has examined the chronic impacts of PM2.5 exposure on morbidity of chronic respiratory diseases in cohorts from high pollution countries. Our study aims to investigate the associations. Based on a retrospective cohort among adults in northern China, a Cox regression model with time-varying PM2.5 exposure and a concentration-response (C-R) curve model were performed to access the relationships between incidence of chronic respiratory diseases and long-term PM2.5 exposure during a mean follow-up time of 9.8 years. Individual annual average PM2.5 estimates were obtained from a satellite-based model with high resolution. The incident date of a chronic respiratory disease was identified according to self-reported physician diagnosis time and/or intake of medication for treatment. Among 38,047 urban subjects analyzed in all-cause chronic respiratory disease cohort, 482 developed new cases. In CB (38,369), asthma (38,783), and COPD (38,921) cohorts, the onsets were 276, 89, and 14, respectively. After multivariable adjustment, hazard ratio and 95% confidence interval for morbidity of all-cause chronic respiratory disease, CB, asthma, and COPD were 1.15 (1.01, 1.31), 1.20 (1.00, 1.42), 0.76 (0.55, 1.04), and 0.66 (0.29, 1.47) with each 10 μg/m3 increment in PM2.5, respectively. Stronger effect estimates were suggested in alcohol drinkers across stratified analyses. Additionally, the shape of C-R curve showed an increasing linear relationship before 75.00 μg/m3 concentrations of PM2.5 for new-onset all-cause chronic respiratory disease, and leveled off at higher levels. These findings indicated that long-term exposure to high-level PM2.5 increased the risks of incident chronic respiratory diseases in China. Further evidence of C-R curves is warranted to clarify the associations of adverse chronic respiratory outcomes involving air pollution.

Association between prenatal metal exposure and adverse respiratory symptoms in childhood

INTRODUCTION

Manganese and lead have been cross-sectionally associated with adverse respiratory outcomes in childhood but there is limited data on their combined effects starting in utero. We examined associations between in utero exposure to metals and childhood respiratory symptoms.

METHODS

We assessed 633 mother-child dyads enrolled in the Programming Research in Obesity, Growth, Environment, and Social Stressors (PROGRESS) birth cohort in Mexico City. Blood manganese (BMn) and lead (BPb) were measured in mothers at 2^nd and 3^rd trimester. Ever wheeze, current wheeze and asthma diagnosis were ascertained at 4-5 and 6-7 year visits through the International Study of Asthma and Allergies in Childhood survey. Logistic mixed model regression was used to assess the association between prenatal metals and respiratory outcomes in children across the 4-5 and 6-7 year visits. Covariates included mother's age, education and asthma, environmental tobacco smoke, child's sex and assessment time.

RESULTS

In adjusted models, higher 2^nd trimester BPb had a significant association with elevated odds of ever wheeze (Odds Ratio (OR): 1.97, 95% CI: 1.05, 3.67). BMn at 2nd trimester was associated with decreased (OR: 0.06, 95% CI: 0.01, 0.35) odds of current wheeze. We did not find any statistically significant associations with 3rd trimester blood metals.

CONCLUSION

Prenatal exposure to Pb was associated with higher odds of ever wheeze while Mn was negatively associated with odds of current wheeze. These findings underscore the need to consider prenatal metal exposure, including low exposure levels, in the study of adverse respiratory outcomes.

Critical windows of susceptibility in the association between manganese and neurocognition in Italian adolescents living near ferro-manganese industry

INTRODUCTION

Understanding the neurodevelopmental effects of manganese (Mn) is complicated due to its essentiality for growth and development. While evidence exists for the harmful effects of excess Mn, pediatric epidemiologic studies have observed inconsistent associations between Mn and child cognition.

OBJECTIVE

We sought to estimate prospective associations between Mn measured in three different early-life time windows with adolescent cognition using deciduous teeth biomarkers.

METHODS

Deciduous teeth were collected from 195 participants (ages 10-14 years) of the Public Health Impact of Manganese Exposure (PHIME) study in Brescia, Italy. Measurements of tooth Mn represented prenatal (∼14 weeks gestation - birth), early postnatal (birth - 1.5 years) and childhood (∼1.5 - 6 years) time windows. Neuropsychologists administered the Wechsler Intelligence Scale for Children, 3rd edition (WISC-III), to obtain composite IQ and subtest scores. Associations between tooth Mn at each time window and adolescent WISC-III scores were estimated using multivariable linear regression. We tested differences in associations between Mn and outcomes across time windows using multiple informant models. Sex-specific associations were explored in stratified models.

RESULTS

Adjusted associations between tooth Mn and composite IQ scores were positive in the prenatal period and negative in the childhood period. Associations were strongest for subtest scores that reflect working memory, problem solving, visuospatial ability and attention: prenatal Mn was positively associated with Digits backward [SD change in score per interquartile range increase in Mn: β = 0.20 (95 % CI: 0.02, 0.38)] and Block design [β = 0.21 (0.01, 0.41)] and early postnatal Mn was positively associated with Digits forward [β = 0.24 (0.09, 0.40)], while childhood Mn was negatively associated with Coding [β = -0.14 (-0.28, -0.001)]. Sex-stratified analyses suggested different Mn-cognition associations for boys and girls and was also dependent on the time window of exposure.

CONCLUSION

Our results suggest that exposure timing is critical when evaluating Mn associations between Mn and cognition. Higher prenatal Mn was beneficial for adolescent cognition; however, these beneficial associations shifted towards harmful effects in later time windows. Cognitive domains most sensitive to Mn across time windows included visuospatial ability, working memory, attention and problem-solving.

Assessment of Metal Concentrations and Associations with Pulmonary Function among Children with Asthma in Chicago, Illinois

Individuals living in areas with the potential for elevated metal exposure from industrial sources may have reduced pulmonary function. We evaluated cross-sectional associations of toenail concentrations of 17 metals within a community area of residence and asthma control in 75 children, and pulmonary function measures [forced expiratory volume in one second (FEV1; liters), forced vital capacity (FVC; liters), FEV1 to FVC ratio (FEV1:FVC), and mid-exhalation forced expiratory flow rate (FEF 25-75%; liters/second)], in a subsample of 39 children with diagnosed asthma in Chicago, Illinois. Linear regression models were used to estimate adjusted regression coefficients and standard errors (SE) for the associations between ≥ median versus Collapse

Key Words

• asthma
• children
• metals
• pulmonary function
• respiratory function

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MESH Headings

• Asthma/epidemiology
• Chicago/epidemiology
• Child
• Cross-Sectional Studies
• Forced Expiratory Volume
• Humans
• Lung
• Vital Capacity

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Grants

• T42 OH008672 NIOSH CDC HHS
• P42 ES007373 NIEHS NIH HHS
• P30 CA023108 NCI NIH HHS
• R01 ES02442304 NIEHS NIH HHS
• P30 ES027792 NIEHS NIH HHS

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Affiliation(s)

Jessica M. Madrigal Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA; (J.M.M.); (V.P.)
Victoria Persky Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA; (J.M.M.); (V.P.)
Brian P. Jackson Department of Earth Sciences, Dartmouth College, Hanover, NH 03755, USA;
Amy Bain Mobile Care Chicago, Chicago, IL 60609, USA; (A.B.); (M.S.)
Matt Siemer Mobile Care Chicago, Chicago, IL 60609, USA; (A.B.); (M.S.)
Andrea A. Pappalardo Department of Pediatrics, College of Medicine, University of Illinois Chicago, Chicago, IL 60612, USA; Department of Medicine, College of Medicine, University of Illinois Chicago, Chicago, IL 60612, USA
Maria Argos Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA; (J.M.M.); (V.P.)

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Dose-Response Relationship between Environmental Exposure to Nickel and Pulmonary Function in the Korean General Population Aged 40 or Older

Nickel is a well-known skin allergen; however, few studies to date have investigated the association between nickel exposure and lung function impairment. The present study, therefore, evaluated the relationship between blood nickel concentrations and lung function profiles in the Korean general population (n = 1098). Dose–response relationships between blood nickel quartiles and pulmonary function were assessed by sex in multivariate models, after adjustment for potentially confounding factors such as age, height, and smoking status. Quartiles of blood nickel concentrations were significantly associated with markers of pulmonary function in Korean men, such as forced expiratory volume in 1 second (FEV₁) and forced expiratory flow 25–75% (FEF_25–75%). Relative to the first quartile, the estimated coefficients (standard error (SE)) of blood nickel levels for FEV₁ in the third and fourth quartiles of Korean men were −126.6 mL (59.1) and −138.5 mL (59.8), respectively (p < 0.05). Relative to the first quartile, the estimated coefficients (SE) of blood nickel levels for FEF_25–75% in the second and fourth quartiles were −244.9 mL (109.5) and −266.8 mL (111.5), respectively (p < 0.05). Dose–response relationships were observed between quartiles of blood nickel concentrations and the pulmonary function markers FEV₁ and FEF_25–75% in Korean men aged 40 or older.

Metal(loid) bioaccessibility of atmospheric particulate matter from mine tailings at Zimapan, Mexico

Metal(loid)s are contaminants of concern emitted as particulate matter (PM) from several pollution sources. The objective was to characterize potential exposure from local airborne metal(loid)s in a community in proximity to mine tailings. Air samples were collected weekly at five sites around the municipal mine tailings using two Hi-volume samplers for simultaneously collecting PM10 and PM2.5. Total suspended particulates (TSP), concentrations, speciation, and bioaccessibility of metal(loid)s were quantified. The size and form of particles were determined by scanning electron microscopy. The concentration of TSP (μg m-3) in the airborne samples ranged from 21.2 to 64.6 for PM2.5 and 23.6 to 80.1 for PM10. The profiles of analyzed quasi-total metal(loid) concentration from all sampling sites were similar between these aerosols PM sizes except at site 2 for Cd, at site 3 for Cu, and site 4 for Zn. The order of quasi-total metal(loid) concentration, in the airborne samples for both PM sizes, was As > Zn > Fe > Pb > Cu > Mn > Cd. As speciation included As-sulfite, As(III)-O, and As(V)-O with less concentration of As(III)-O in both PM sizes. Bioaccessible metal(loid) concentrations were very high and represented a great percentage from the quasi-total airborne concentrations, for instance, 10% and 37% for Pb and 8% and 6% for As in pulmonary and gastric bioaccessible concentrations, respectively. Knowing the toxic effects of these pollutants, there is an urgent need to establish environmental regulation of bioaccessible pollutant concentrations from PM dislodged from uncovered metal(loid) mine tailings affecting not only nearby human populations but also possible long-distance ecosystem transport.

Maternal metal concentration during gestation and pediatric morbidity in children: an exploratory analysis

Background

The majority of studies linking exposure to metals with certain health outcomes focus on known toxic metals. Alternatively, this study assesses the extent to which exposure to a wider range of metals during gestation is associated with childhood morbidity.

Methods

We analyzed the concentrations of 25 metals found in urine samples of 111 pregnant women of Arab-Bedouin origin collected prior to birth. In addition, we collected medical records on their offspring for six years following birth, including every interaction with HMOs, local hospitals, and pharmacies.

Results

The main types of morbidities diagnosed and treated during this period were preterm births, malformations, asthma-like morbidity, cardiovascular and behavioral problems, and obesity. Multivariable analysis showed that offspring born before term were more likely to have been exposed to elevated maternal concentrations of zinc, thallium, aluminum, manganese, and uranium, all with adjusted relative risk above 1.40 for an increase by each quintile. Likewise, children with asthma had been exposed to higher levels of magnesium, strontium, and barium at gestation, while behavioral outcomes were associated with elevated biometals, i.e., sodium, magnesium, calcium, selenium, and zinc, as well as higher levels of lithium, cobalt, nickel, strontium, cadmium, vanadium, arsenic, and molybdenum. A heatmap of adjusted relative risk estimates indicates the considerable implications that exposure to metals may have for preterm birth and developmental outcomes.

Conclusions

The current study shows that perinatal exposure to metals is adversely associated with pediatric morbidity. Further such analyses on additional samples are warranted.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12199-021-00963-z.

Bioaccessibility of potentially toxic metals in soil, sediments and tailings from a north Africa phosphate-mining area: Insight into human health risk assessment

The risk assessment of phosphate mining/processing industrial activities on the environment and human health is crucial to properly manage and minimize the risks over time. In this work, we studied the inhalation and dermal bioaccessibility of potentially toxic metals (PTM) in different particle-size fractions of urban soil, sediments and tailings from Gafsa-Metlaoui phosphate mining area, to assess afterwards the non-carcinogenic (NCR) and carcinogenic (CR) risks for the health of local citizens and workers constantly exposed to airborne particulate matter (PM) originating from these sources of contamination. Samples were separated in particle-size fractions by centrifugation and consecutive cycles of sedimentation and decanting. The pseudo-total concentrations and bioaccessible fractions of PTM were extracted by aqua regia and in vitro bioaccessibility tests, respectively. Both sediments and tailings showed higher-than-background concentrations of PTM (mainly Cd, Zn and Cr), with a tendency to accumulate these metals in fine particles (<10 μm). In urban soil, only Cd was above the background concentration. The bioaccessibility of PTM via inhalation was significantly higher in artificial lysosomal fluid (ALF) than in simulated epithelial lung fluid (SELF): basically, Cd was the most bioaccessible metal (relative bioaccessibility up to 80%), followed by the medium-to-high bioaccessible Zn (47%), Pb (46%) and Cu (39%), and the least bioaccessible Cr (16%). In synthetic skin surface liquid (NIHS 96-10), only Cd was bioaccessible at worrying extent (20-44%). On the basis of US.EPA risk assessment, the exposure to PTM bioaccessible fractions or pseudo-total concentrations would not cause serious NCR and CR risks for human health. Significant health risks (Hazard Index >1 and CR > 10^-4), especially for children, can occur if ingestion route is also considered. The findings underline the need for adequate protection of contaminated soil, sediments and mine tailings laying nearby urban agglomerates, to reduce the health risks for inhabitants and workers of Gafsa-Metlaoui mining area.

Association between selected urinary heavy metals and asthma in adults: a retrospective cross-sectional study of the US National Health and Nutrition Examination Survey

Heavy metal in the physical environment may alter immune function and predispose to develop asthma in human. Our study was aimed to investigate associations between urinary heavy metals and asthma in adults. A retrospective cross-sectional study was conducted with 3425 subjects aged 20 years and older in the US National Health and Nutrition Examination Survey (NHANES) 2011-2014. Binary logistic regression was applied to analyze associations between cobalt (Co), tungsten (W), and uranium (U) and asthma. We found positive associations between U and asthma (OR = 1.74, 95%CI: 1.25, 2.44, P for trend < 0.01). U was positively associated with asthma in 20-59 years group (OR = 1.65, 95%CI: 1.11, 2.46), while W and Co were related with asthma among in above 60 years group (OR = 2.39, 95%CI: 1.24, 4.58, P for trend = 0.02; OR = 1.88, 95%CI: 1.02, 3.47, respectively). U was linked with asthma in both males and females (OR = 1.93, 95%CI: 1.16, 3.20; OR = 1.59, 95%CI: 1.01, 2.51, respectively). Positive associations between U and asthma were discovered among adults with family history of asthma or not (OR = 2.15, 95%CI: 1.17, 3.95, P for trend = 0.03; OR = 1.62, 95%CI: 1.08, 2.43, P for trend = 0.03, respectively). Remarkable association was observed between U and asthma in adults without hay fever (OR = 1.79, 95%CI: 1.24, 2.60, P for trend = 0.02). Our findings provide epidemiological evidence to highlight a need to prioritize heavy metals exposure with asthma.

Review of the effect of air pollution exposure from industrial point sources on asthma-related effects in childhood

We reviewed epidemiologic studies of the association between exposure to air pollution from industries and asthma-related outcomes in childhood. We searched bibliographic databases and reference lists of relevant articles to identify studies examining the association between children's exposure to air pollution from industrial point-sources and asthma-related outcomes, including asthma, asthma-like symptoms, wheezing, and bronchiolitis. We extracted key characteristics of each study and when appropriate we performed a random-effects meta-analysis of results and quantified heterogeneity (I ²). Thirty-six studies were included in this review. Meta-analysis was generally not possible and limited to a few studies because of substantial variation across design characteristics and methodologies. In case-crossover studies using administrative health data, pooled odds ratio (OR) of hospitalization for asthma and bronchiolitis in children <5 years were 1.02 [95% confidence intervals (CI): 0.96, 1.08; I ² = 56%] and 1.01 (95% CI: 0.97, 1.05; I ² = 64%) per 10 ppb increase in the daily mean and hourly maximum concentration of sulfur dioxide (SO₂), respectively. For PM_2.5, pooled ORs were 1.02 (95% CI: 0.93, 1.10; I ² = 56%) and 1.01 (95% CI: 0.98, 1.03 I ² = 33%) per 10 μg/m³ increment in the daily mean and hourly maximum concentration. In cross-sectional studies using questionnaires, pooled ORs for the prevalence of asthma and wheezing in relation to residential proximity to industry were 1.98 (95% CI: 0.87, 3.09; I ² =71%) and 1.33 (95% CI: 0.86, 1.79; I ²= 65%), respectively. In conclusion, this review showed substantial heterogeneity across study designs and methods. Meta-analysis results suggested no evidence of an association for short-term asthma-related effects and an indication for long-term effects, but heterogeneity between results and limitations in terms of design and exposure assessment preclude drawing definite conclusions. Further well-conducted studies making use of a longitudinal design and of refined exposure assessment methods are needed to improve risk estimates.

Environmental exposure and health effects in a highly polluted area of Northern Italy: a narrative review

Human health and well-being are strongly linked to the state of the environment. The high industrial pressure present in the Province of Brescia, located in Northern Italy, produced strong environmental and health concerns. This narrative review of the literature aims at identifying the studies focused on the association between exposure to environmental pollutants and health effects in the population living in this area. Thirteen papers fitted the inclusion criteria: five were focused on the connection among pollutants present in air matrix and health effects, seven on both air and soil, and one on soil. No study investigated the relationship with water pollution. The great variability in the analyzed end-points made it difficult to draw precise conclusions, but the fact that, in almost all the studies, the investigated health effects have a positive association with the exposure to different kinds of pollutants, allows us to hypothesize that the considered population is living in an area where the "environmental pressure" could produce significant health effects in the future.

Associations between environmental heavy metal exposure and childhood asthma: A population-based study

BACKGROUND/PURPOSE

The health risks of environmental heavy metals have been of concern are well known. The greater likelihood of heavy metal contamination in the physical environment increases the risk of asthma, especially in children. This cross-sectional, population-based study sought to investigate associations between heavy metal exposure and childhood asthma or wheezing.

METHODS

Data from 5866 subjects, stratified into age groups of 2-5, 6-11, and 12-15 years, from the National Health and Nutrition Examination Survey 2007-2012 conducted by the Centers for Disease Control and Prevention were analyzed retrospectively. The primary outcome was active asthma. Variables included demographics, anthropometric, and clinical data. Univariate and multivariate logistic regression analyses were used to identify associations between blood heavy metal concentrations and adjusted odds (aORs) of active asthma.

RESULTS

Higher concentration of blood lead was associated with higher adjusted odds of having asthma (aOR = 1.08, 95% CI = 1.00-1.16), but no significant effect was shown for current wheezing or whistling. Age-stratified analysis showed that higher blood lead concentration was associated with higher risk for active asthma (aOR = 1.24, 95% CI = 1.08-1.42) and current wheezing or whistling (aOR = 1.19, 95% CI = 1.04-1.38) in the 6-11 years age group, while higher blood mercury concentration was associated with lower risk of current wheezing or whistling (aOR = 0.95, 95% CI = 0.90-0.99). The medium concentration of blood lead was associated with decreased risks of current wheezing or whistling (aOR = 0.54, 95% CI = 0.30-0.96) in the 2-5 years age group.

CONCLUSION

Higher concentrations of blood lead are associated with higher odds of asthma in children aged 2-15 years.

An inhalation-ingestion bioaccessibility assay (IIBA) for the assessment of exposure to metal(loid)s in PM10

Although metal(loid) bioaccessibility of ambient particulate matter, with an aerodynamic diameter of <10μm (PM₁₀), has recently received increasing attention, limited research exists into standardising in-vitro methodologies using simulated lung fluid (SLF). Contradictions exist regarding which assay parameters should be adopted. Additionally, potential continuation of metal(loid) dissolution once PM₁₀ is cleared from the lungs and passed through the gastro-intestinal tract (GIT) has rarely been addressed. The objective of this study was to assess parameters that influence inhalation bioaccessibility in order to develop a conservative assay that is relevant to a human inhalation scenario. To achieve this aim, the effect of solid to liquid (S/L) ratio, extraction time, agitation and five major SLF compositions on the bioaccessibilities of arsenic (As) and lead (Pb) was investigated using PM₁₀ from three Australian mining/smelting impacted regions. Using the biologically relevant parameters that resulted in the most conservative outcomes, bioaccessibility of metal(loid)s in PM₁₀ was assessed in SLF, followed by simulated GIT solutions. Results from this study revealed that fluid composition and S/L ratio significantly affected metal(loid) dissolution (p<0.05). The highest Pb bioaccessibility resulted using simulated lung-gastric solution, while that of As resulted using simulated lung-gastric-small intestinal tract solutions. Compared to SLF alone, metal(loid) dissolution using the inhalation-ingestion bioaccessibility assay (IIBA) was significantly higher (p<0.05) for all PM₁₀ samples.

Determinants of serum manganese levels in an Italian population

Manganese (Mn) is both essential and toxic for humans, mainly depending on the total levels and its species. Main sources of exposure include food and air pollution, particularly motorized traffic. We sought to determine the potential influence of these sources on serum total levels of Mn and Mn species. We selected a random sample of municipality residents from an Italian urban municipality, from whom we collected detailed personal information, dietary habits and a blood sample for serum Mn determination. We also assessed outdoor air Mn exposure, by modeling levels of particulate matter ≤10 µm (PM10) from motorized traffic at the residence of geocoded subjects. Serum Mn species generally showed higher levels in males and positive correlation with age, while no such differences were found according to smoking habits or use of dietary supplements. Among nutrients, only iron intake showed a relation with Mn [an inverse correlation with Mn‑ferritin (Mn‑Fer) and a direct one with inorganic‑Mn (Inorg‑Mn)]. Meat consumption directly correlated and fish and seafood inversely correlated with total Mn, Mn‑transferrin (Mn‑Tf) and Mn-citrate (Mn-Cit). Fruits and vegetables, including legumes and nuts, generally showed a positive correlation with all Mn species, especially Mn‑Cit, and an inverse one with Inorg‑Mn. Odds ratios (ORs) of having serum Mn levels above median value increased with increasing PM10 tertiles, with an OR for highest‑to‑lowest tertile of 7.40 (1.36‑40.25) in multivariate analysis. Analyses for Mn species did not highlight a clear comparable pattern. In conclusion, our results seem to demonstrate that PM10 exposure positively influences total Mn serum levels, while single Mn species show conflicting results.