Contribution of lead from calcium supplements to blood lead

Lead exposure and its relationship with fecal cortisol levels in black howler monkeys (Alouatta pigra)

Efficiently detecting early environmental threats to wildlife is vital for conservation. Beyond obvious dangers like habitat loss or deforestation, our study focuses on one of the most hazardous toxic metals for wildlife: lead (Pb). Pb is a widespread, cumulative, and insidious environmental pollutant that can trigger a wide range of physiological, biochemical, and behavioral disorders. In fact, Pb can cause permanent dysfunction of the major stress system, the hypothalamic pituitary adrenal (HPA) axis. We analyzed Pb and cortisol concentrations in fecal samples from Alouatta pigra in southern Mexico. Fecal samples were collected across six sites categorized as free-ranging (n = 65; conserved and disturbed) and from captive animals (n = 58). Additionally, we collected soil samples (n = 35). We found that Pb was present in 28% of fecal samples and 83% of soil samples. There was a positive relation between fecal and soil Pb levels, and fecal Pb concentration was negatively associated with cortisol levels. However, the claim of Pb being a direct interference with HPA axis requires further investigation. Given our findings, assessing wildlife exposure can be a valuable tool for understanding potential Pb exposure levels in the environment and its possible implications for human health. It can also serve as an early warning system of these consequences.

Isotopic ratio based source apportionment of children's blood lead around coking plant area

Lead exposure in the environment is a major hazard affecting human health, particularly for children. The blood lead levels in the local children living around the largest coking area in China were measured, and the source of blood lead and the main pathways of lead exposure were investigated based on lead isotopic ratios ((207)Pb/(206)Pb and (208)Pb/(206)Pb) in blood and in a variety of media, including food, airborne particulate matter, soil, dust and drinking water. The children's blood lead level was 5.25 (1.59 to 34.36 as range) μg dL(-1), lower than the threshold in the current criteria of China defined by the US Centers for Disease Control (10 μg dL(-1)). The isotopic ratios in the blood were 2.111±0.018 for (208)Pb/(206)Pb and 0.864±0.005 for (207)Pb/(206)Pb, similar to those of vegetables, wheat, drinking water, airborne particulate matter, but different from those of vehicle emission and soil/dust, suggesting that the formers were the main pathway of lead exposure among the children. The exposure pathway analysis based on the isotopic ratios and the human health risk assessment showed that dietary intake of food and drinking water contributed 93.67% of total exposed lead. The study further indicated that the coal used in the coking plant is the dominant pollution source of lead in children's blood.

Estimation of dietary Pb and Cd intake from Pb and Cd in blood or urine

Successful trials were made to estimate the dietary daily intake of lead (Pb) and cadmium (Cd) via foods from the levels of the metals in blood or urine. In practice, 14 and 15 reports were available for Pb and Cd in blood (Pb-B and Cd-B), urine (Pb-U and Cd-U) and 24-h diet duplicates (Pb-D and Cd-D), respectively, from which 68 pairs each of Pb or Cd in blood and food duplicates [each being geometric mean (GM) values for the survey sites] were obtained. Regression analysis revealed that there was a significant correlation between Pb-B and Pb-D, and also between Cd-B and Cd-D, suggesting that it should be possible to estimate both Pb-D and Cd-D from Pb-B and Cd-B, respectively. For Cd-U, the number of available cases was limited (20 pairs), but a significant correlation was detected between Cd-U (as Cd-U(cr), or Cd levels in urine as corrected for creatinine concentration) and Cd-D. Care should be taken in estimating Pb-D from Pb-B, as the ratio of Pb-D over Pb-B may decrease as a function of increasing Pb-B levels. The Pb-D (μg/day) for typical Japanese women with Pb-B of 15 μg/l was best estimated to be 13.5 μg/day. No Cd-B- or Cd-U(cr)-dependent change was detected in case of Cd. The best estimate of Cd-D for Cd-B at 1.5 μg/l should be about 19.4 μg/day.

Mycotoxins and human disease: a largely ignored global health issue

Aflatoxins and fumonisins (FB) are mycotoxins contaminating a large fraction of the world's food, including maize, cereals, groundnuts and tree nuts. The toxins frequently co-occur in maize. Where these commodities are dietary staples, for example, in parts of Africa, Asia and Latin America, the contamination translates to high-level chronic exposure. This is particularly true in subsistence farming communities where regulations to control exposure are either non-existent or practically unenforceable. Aflatoxins are hepatocarcinogenic in humans, particularly in conjunction with chronic hepatitis B virus infection, and cause aflatoxicosis in episodic poisoning outbreaks. In animals, these toxins also impair growth and are immunosuppressive; the latter effects are of increasing interest in human populations. FB have been reported to induce liver and kidney tumours in rodents and are classified as Group 2B 'possibly carcinogenic to humans', with ecological studies implying a possible link to increased oesophageal cancer. Recent studies also suggest that the FB may cause neural tube defects in some maize-consuming populations. There is a plausible mechanism for this effect via a disruption of ceramide synthase and sphingolipid biosynthesis. Notwithstanding the need for a better evidence-base on mycotoxins and human health, supported by better biomarkers of exposure and effect in epidemiological studies, the existing data are sufficient to prioritize exposure reduction in vulnerable populations. For both toxins, there are a number of practical primary and secondary prevention strategies which could be beneficial if the political will and financial investment can be applied to what remains a largely and rather shamefully ignored global health issue.

Environmental exposure measurement in cancer epidemiology

Environmental exposures, used in the broadest sense of lifestyle, infections, radiation, natural and man-made chemicals and occupation, are a major cause of human cancer. However, the precise contribution of specific risk factors and their interaction, both with each other and with genotype, continues to be difficult to elucidate. This is partially due to limitations in accurately measuring exposure with the subsequent risk of misclassification. One of the primary challenges of molecular cancer epidemiology therefore is to improve exposure assessment. Progress has been made with biomarkers such as carcinogens and their metabolites, DNA and protein adducts and mutations measured in various tissues and body fluids. Nevertheless, much remains to be accomplished in order to establish aetiology and provide the evidence base for public health decisions. This review considers some of the principles behind the application of exposure biomarkers in cancer epidemiology. It also demonstrates how the same biomarkers can contribute both to establishing the biological plausibility of associations between exposure and disease and be valuable endpoints in intervention studies. The potential of new technologies such as transcriptomics, proteomics and metabonomics to provide a step change in environmental exposure assessment is discussed. An increasing recognition of the role of epigenetic changes in carcinogenesis presents a fresh challenge as alterations in DNA methylation, histone modification and microRNA in response to environmental exposures demand a new generation of exposure biomarker. The overall importance of this area of research is brought into sharp relief by the large prospective cohort studies (e.g. UK Biobank) which need accurate exposure measurement in order to shed light on the complex gene:environment interactions underlying common chronic disorders including cancer. It is suggested that a concerted effort is now required, with appropriate funding, to develop and validate the required exposure assessment methodology before these cohorts come to maturity.

Stable lead isotopes in environmental health with emphasis on human investigations

There has been widespread use of stable lead isotopes in the earth sciences for more than 40 years focussed on the origin and age of rocks and minerals with lesser application in environmental investigations where the emphasis has been directed typically to the source of lead in environmental media such as air, water and soils. In contrast, the number of environmental health investigations focussed on humans (and primates) is limited in spite of the demonstrated utility of the approach in pioneering studies in the early 1970's. This paper reviews the status of lead isotopes in human investigations especially over the past 2 decades, the period over which most activity has taken place. Following a brief introduction to the method, examples are provided illustrating the use of lead isotopes in a wide spectrum of activities including sources and pathways of lead in diverse environments from urban to mining communities, various applications associated with pregnancy, the contribution of bone lead to blood lead including in the elderly, the half-life of lead in blood, and lead in bones and other media. A brief outline of critical research on non-human primates is also given. The lead isotope method is a powerful technique for tracing lead and could be employed more widely in human investigations.

Lead content of dietary calcium supplements available in Brazil

The lead and calcium content of calcium supplements available in Brazil were determined by graphite furnace and flame atomic absorption spectrometry, respectively. Samples were microwave-digested in concentrated HNO(3). Citric acid was used as a chemical modifier in the lead analysis. Supplements were classified into six categories: oyster industrialized (OI, n=4), oyster prepared in pharmacy (OP, n=3), refined industrialized (RI, n=6), refined prepared in pharmacy (RP, n=3), bone meal (B, n=3), and dolomite (D, n=4). Lead levels (microg g(-1) of measured calcium) were higher in D products (2.33), followed by OI, RP, OP, and RI products (1.46, 1.32, 1.29, 0.75), while B products had levels lower than the limit of quantification (0.02 microg g(-1) unit weight). Daily lead intake of eight supplements exceeded the limit of California, USA (1.5 microg g(-1) calcium), but none exceeded the federal limit of USA (7.5 microg g(-1) calcium) or the provisional tolerable lead intake by FAO/WHO (25 microg kg(-1) per week).

Changes in the lead isotopic composition of blood, diet and air in Australia over a decade: globalization and implications for future isotopic studies

Source apportionment in biological or environmental samples using the lead isotope method, where there are diverse sources of lead, relies on a significant difference between the isotopic composition in the target media and the sources. Because of the unique isotopic composition of Australian lead, source apportionment has been relatively successful in the past. Over the period of a decade, the 206Pb/204Pb ratio for Australian (mainly female) adults has shown an increase from a geometric mean of 16.8-17.3. Associated with this increase, there has been a decrease in mean blood lead concentration from 4.7 to 2.3 microg/dL, or about 5% per year, similar to that observed in other countries. Lead in air, which up until 2000 was derived largely from the continued use of leaded gasoline, showed an overall increase in the 206Pb/204Pb ratio during 1993-2000 from 16.5 to 17.2. Since 1998 the levels of lead in air were less than 0.2 microg/m3 and would contribute negligibly to blood lead. Over the 10-year period, the 206Pb/204Pb ratio in diet, based mainly on quarterly 6-day duplicate diets, increased from 16.9 to 18.3. The lead concentration in diet showed a small decrease from 8.7 to 6.4 microg Pb/kg although the daily intake increased markedly from 7.4 to 13.9 microg Pb/day during the latter part of the decade probably reflecting differences in demographics. The changes in blood lead from sources such as lead in bone or soil or dust is not dominant because of the low 206Pb/204Pb ratios in these media. Unless there are other sources not identified and analysed for these adults, it would appear that in spite of our earlier conclusions to the contrary, diet does make an overall contribution to blood lead, and this is certainly the case for specific individuals. Certain population groups from south Asia, south-east Asia, the Middle East and Europe (e.g. UK) are unsuitable for some studies as their isotopic ratios in blood are converging towards the increasing Australian values. The increases in blood 206Pb/204Pb ratio combined with globalization, which has resulted in the increases in 206Pb/204Pb ratio for diet, means that isotopic studies undertaken with a high degree of certainty of outcomes over a decade ago, are now considerably more difficult, not only in Australia but also in other countries where the isotopic differences are even less than in Australia.

Blood lead changes during pregnancy and postpartum with calcium supplementation

Pregnancy and lactation are times of physiologic stress during which bone turnover is accelerated. Previous studies have demonstrated that there is increased mobilization of lead from the maternal skeleton at this time and that calcium supplementation may have a protective effect. Ten immigrants to Australia were provided with either calcium carbonate or a complex calcium supplement (approximately 1 g/day) during pregnancy and for 6 months postpartum. Two immigrant subjects who did not conceive acted as controls. Sampling involved monthly venous blood samples throughout pregnancy and every 2 months postpartum, and quarterly environmental samples and 6-day duplicate diets. The geometric mean blood lead at the time of first sampling was 2.4 microg/dL (range, 1.4-6.5). Increases in blood lead during the third trimester, corrected for hematocrit, compared with the minimum value observed, varied from 10 to 50%, with a geometric mean of 25%. The increases generally occurred at 6-8 months gestation, in contrast with that found for a previous cohort, characterized by very low calcium intakes, where the increases occurred at 3-6 months. Large increases in blood lead concentration were found during the postpartum period compared with those during pregnancy; blood lead concentrations increased by between 30 and 95% (geometric mean 65%; n = 8) from the minimum value observed during late pregnancy. From late pregnancy through postpartum, there were significant increases in the lead isotopic ratios from the minimum value observed during late pregnancy for 3 of 8 subjects (p < 0.01). The observed changes are considered to reflect increases in mobilization of lead from the skeleton despite calcium supplementation. The identical isotopic ratios in maternal and cord blood provide further confirmation of placental transfer of lead. The extra flux released from bone during late pregnancy and postpartum varies from 50 to 380 microg lead (geometric mean, 145 microg lead) compared with 330 microg lead in the previous cohort. For subjects replete in calcium, the delay in increase in blood lead and halving of the extra flux released from bone during late pregnancy and postpartum may provide less lead exposure to the developing fetus and newly born infant. Nevertheless, as shown in several other studies on calcium relationships with bone turnover, calcium supplementation appears to provide limited benefit for lead toxicity during lactation.

A cinética do chumbo no organismo humano e sua importância para a saúde

O chumbo é um dos contaminantes ambientais mais comuns, tóxico para os homens e animais, e sem nenhuma função fisiológica conhecida no organismo. Seus efeitos nocivos podem afetar praticamente todos os órgãos e sistemas do organismo humano. O chumbo entra no corpo principalmente por inalação ou ingestão, sendo diretamente absorvido, distribuído e excretado. Os tratos gastrointestinal e respiratório são os principais sítios de absorção do chumbo que, uma vez absorvido, é encontrado no sangue, tecidos moles e mineralizados. Cerca de 90% do chumbo corpóreo se armazena nos ossos, principal depósito do metal no corpo. Aproximadamente 5% da concentração do chumbo no sangue se situa no plasma, representando a fração lábil e biologicamente ativa do chumbo, capaz de cruzar as membranas celulares e causar seus efeitos tóxicos. O chumbo absorvido é excretado principalmente pela urina e fezes. Assim, o conhecimento da cinética do chumbo é importante para maior compreensão da toxicidade deste metal, uma vez que os riscos de efeitos adversos à saúde estão relacionados com o conteúdo corpóreo total do chumbo.

Skeletal lead release during bone resorption: effect of bisphosphonate treatment in a pilot study

There has been renewed interest in impacts on physiologic systems in the middle and older age groups, especially from fractures and hypertension. Increased blood lead (BPb) levels in postmenopausal females, which are thought to arise from bone demineralization, may also relate to other health effects including hypertension. Taking advantage of natural differences in lead isotope signature between Australian sources of lead and those from other countries, a 2-year pilot study was performed in premenopausal and postmenopausal females and male partners in which the subjects were administered a bisphosphonate, alendronate, for 6 months. The aim of the study was to determine how lead isotopes and lead concentrations changed in relation to bone remodeling processes. Premenopausal subjects were a woman (and male partner) from Bosnia and two women from Colombia. The postmenopausal subject was a woman from Russia. Her male partner and one man from Sri Lanka were included. Multigenerational Australian subjects were 2 perimenopausal women and 1 postmenopausal woman. Each subject had blood and urine samples collected for markers of bone turnover and for lead isotope studies monthly for 7-9 months before, for 3 months during, and for up to 6 months after treatment with alendronate to inhibit bone resorption. Each subject thus acted as his or her own control. As predicted, there were significant decreases in the lead isotope ratio, (206)Pb/(204)Pb, for the migrant subjects during treatment compared with the pretreatment period (p < 0.01). After cessation of treatment, an increasing isotope ratio for the postmenopausal subject (and older male partner) occurred later than for premenopausal subjects, indicative of prolonged efficacy of the alendronate for the older subjects. The average BPb concentrations in migrant subjects decreased by about 20% during the treatment compared with the pretreatment period (p < 0.01). To our knowledge, these are the first BPb concentrations reported over monthly to quarterly intervals for environmentally exposed adults over an extended period. The changes in lead isotopic composition and lead concentration are consistent with a decrease in bone resorption and associated mobilization of lead during alendronate therapy. Older subjects at risk of fractures may benefit from treatment with antiresorptive therapy, such as the potent bisphosphonates, with the added bonus of lower release of lead from bones and thus less risk of the potential adverse health effects of increased BPb levels.

Changes in blood lead of a recreational shooter

We have measured the concentration and isotopic composition of lead in blood over a 15-month period for a subject who undertook recreational shooting in outdoor and indoor firing ranges on an irregular basis. We have also measured the isotopic composition in cast lead, Cu-jacketed and Teflon-coated bullets, propellant and primer from which he assembled the cartridges. Blood lead concentration increased from 3.2 to 6.7 microg/dl with use of dominantly cast lead bullets in the outdoor range. In two intervals when no firing was undertaken for 3-4 months, the blood lead concentrations either decreased towards a baseline value in the case where only Cu-jacketed bullets were fired or remained elevated when dominantly cast lead bullets were fired. The propellants contained <2 ppm Pb and contribute negligibly to blood lead. The isotopic composition of the primer used for all bullets was consistent with a source from the US. The bullets were of different materials and made in Australia and the US, with lead from sources of different geological age and hence different isotopic signatures. Variations in blood lead concentration and isotopic composition appear most strongly influenced by the bullets. Although more expensive, the use of Cu-jacketed bullets, non-lead primers and well-ventilated indoor firing ranges would lessen the health impacts of recreational shooting.