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Qi T, Yuan Z, Meng F. Highly sensitive and highly selective lead ion electrochemical sensor based on zn/cu-btc-nh 2 bimetallic MOFs with nano-reticulated reinforcing microstructure. Anal Chim Acta 2024; 1318:342896. [PMID: 39067908 DOI: 10.1016/j.aca.2024.342896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 06/03/2024] [Accepted: 06/21/2024] [Indexed: 07/30/2024]
Abstract
Identifying ultra-trace amounts of divalent lead ions (Pb2+) with high response and selectivity, continues to be a pressing issue in identifying environmental pollutants and preventing health complications. This paper details how the in-situ electrodeposited Zn/Cu-BTC-NH2 metal-organic frameworks (MOFs) boosts Pb2+ concentration for amino adsorption and facilitates ion transfer between Cu element and Pb2+. The modified coating of the glassy carbon electrode (GCE) exhibits a unique nano-reticulated structure loaded with octahedron particles, the nano-reticulated structure ensures the structural strength of the modified electrode layer, while the loaded octahedral particles enhancing electrocatalytic activity. The ultra-trace detection of Pb2+ at concentrations below μg·L-1 is accomplished by using the square wave anodic stripping voltammetry (SWASV) method, the fabricated Zn/Cu-BTC-NH2 modified electrode signifies a detection threshold of 0.021 μg L-1 and a clearly ascending linear interval prior to the rise in Pb2+ concentration to 120 μg L-1. The reported electrochemical method for the precise identification of Pb2+ in water-based solutions offers a practical approach for modifying MOFs materials and detecting heavy metal ions.
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Affiliation(s)
- Tianyao Qi
- College of Information Science and Engineering, Northeastern University, Shenyang, 110819, China
| | - Zhenyu Yuan
- College of Information Science and Engineering, Northeastern University, Shenyang, 110819, China.
| | - Fanli Meng
- College of Information Science and Engineering, Northeastern University, Shenyang, 110819, China; Hebei Key Laboratory of Micro-Nano Precision Optical Sensing and Measurement Technology, Qinhuangdao, 066004, China; National Frontiers Science Center for Industrial Intelligence and Systems Optimization, Northeastern University, Shenyang, 110819, China; Key Laboratory of Data Analytics and Optimization for Smart Industry (Northeastern University), Ministry of Education, China.
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2
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Lin JJY, Kuiper JR, Dickerson AS, Buckley JP, Volk HE, Rohlman DS, Lawrence KG, Braxton Jackson W, Sandler DP, Engel LS, Rule AM. Associations of a toenail metal mixture with attention and memory in the Gulf long-term follow-up (GuLF) study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 935:173387. [PMID: 38788945 PMCID: PMC11170656 DOI: 10.1016/j.scitotenv.2024.173387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/31/2024] [Accepted: 05/18/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Research on metal-associated neurodegeneration has largely focused on single metals. Since metal exposures typically co-occur as combinations of both toxic and essential elements, a mixtures framework is important for identifying risk and protective factors. This study examined associations between toenail levels of an eight-metal mixture and attention and memory in men living in US Gulf states. METHODS We measured toenail concentrations of toxic (arsenic, chromium, lead, and mercury) and essential (copper, manganese, selenium, and zinc) metals in 413 non-smoking men (23-69 years, 46 % Black) from the Gulf Long-Term Follow-Up (GuLF) Study. Sustained attention and working memory were assessed at the time of toenail sample collection using the continuous performance test (CPT) and digit span test (DST), respectively. Associations between toenail metal concentrations and performance on neurobehavioral tests were characterized using co-pollutant adjusted general linear models and Bayesian Kernel Machine Regression. RESULTS Adjusting for other metals, one interquartile range (IQR) increase in toenail chromium was associated with a 0.19 (95 % CI: -0.31, -0.07) point reduction in CPT D Prime score (poorer ability to discriminate test signals from noise). One IQR increase in toenail manganese was associated with a 0.20 (95 % CI, -0.41, 0.01) point reduction on the DST Reverse Count (fewer numbers recalled). Attention deficits were greater among Black participants compared to White participants for the same increase in toenail chromium concentrations. No evidence of synergistic interaction between metals or adverse effect of the overall metal mixture was observed for either outcome. CONCLUSIONS Our findings support existing studies of manganese-related memory deficits and are some of the first to show chromium related attention deficits in adults. Longitudinal study of cognitive decline is needed to verify chromium findings. Research into social and chemical co-exposures is also needed to explain racial differences in metal-associated neurobehavioral deficits observed in this study.
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Affiliation(s)
- Joyce J Y Lin
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Jordan R Kuiper
- Department of Environmental and Occupational Health, The George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Aisha S Dickerson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jessie P Buckley
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Heather E Volk
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Diane S Rohlman
- Department of Occupational and Environmental Health, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Kaitlyn G Lawrence
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | | | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Lawrence S Engel
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA; Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Ana M Rule
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Han P, Li H, Park SK, Mukherjee B, Taylor JMG. Improving prediction of linear regression models by integrating external information from heterogeneous populations: James-Stein estimators. Biometrics 2024; 80:ujae072. [PMID: 39101548 PMCID: PMC11299067 DOI: 10.1093/biomtc/ujae072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 06/19/2024] [Accepted: 07/18/2024] [Indexed: 08/06/2024]
Abstract
We consider the setting where (1) an internal study builds a linear regression model for prediction based on individual-level data, (2) some external studies have fitted similar linear regression models that use only subsets of the covariates and provide coefficient estimates for the reduced models without individual-level data, and (3) there is heterogeneity across these study populations. The goal is to integrate the external model summary information into fitting the internal model to improve prediction accuracy. We adapt the James-Stein shrinkage method to propose estimators that are no worse and are oftentimes better in the prediction mean squared error after information integration, regardless of the degree of study population heterogeneity. We conduct comprehensive simulation studies to investigate the numerical performance of the proposed estimators. We also apply the method to enhance a prediction model for patella bone lead level in terms of blood lead level and other covariates by integrating summary information from published literature.
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Affiliation(s)
- Peisong Han
- Biostatistics Innovation Group, Gilead Sciences, 333 Lakeside Drive, Foster City, CA 94404, United States
| | - Haoyue Li
- Department of Biostatistics, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States
| | - Sung Kyun Park
- Department of Epidemiology, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States
| | - Bhramar Mukherjee
- Department of Biostatistics, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States
| | - Jeremy M G Taylor
- Department of Biostatistics, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States
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Kuiper JR, Liu SH, Lanphear BP, Calafat AM, Cecil KM, Xu Y, Yolton K, Kalkwarf HJ, Chen A, Braun JM, Buckley JP. Estimating effects of longitudinal and cumulative exposure to PFAS mixtures on early adolescent body composition. Am J Epidemiol 2024; 193:917-925. [PMID: 38400650 DOI: 10.1093/aje/kwae014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 02/07/2024] [Accepted: 02/20/2024] [Indexed: 02/25/2024] Open
Abstract
Few methods have been used to characterize repeatedly measured biomarkers of chemical mixtures. We applied latent profile analysis (LPA) to serum concentrations of 4 perfluoroalkyl and polyfluoroalkyl substances (PFAS) measured at 4 time points from gestation to age 12 years. We evaluated the relationships between profiles and z scores of height, body mass index, fat mass index, and lean body mass index at age 12 years (n = 218). We compared LPA findings with an alternative approach for cumulative PFAS mixtures using g-computation to estimate the effect of simultaneously increasing the area under the receiver operating characteristic curve (AUC) for all PFAS. We identified 2 profiles: a higher PFAS profile (35% of sample) and a lower PFAS profile (relative to each other), based on their average PFAS concentrations at all time points. The higher PFAS profile had generally lower z scores for all outcomes, with somewhat larger effects for males, though all 95% CIs crossed the null. For example, the higher PFAS profile was associated with a 0.50-unit lower (β = -0.50; 95% CI, -1.07 to 0.08) BMI z score among males but not among females (β = 0.04; 95% CI, -0.45 to 0.54). We observed similar patterns with AUCs. We found that a higher childhood PFAS profile and higher cumulative PFAS mixtures may be associated with altered growth in early adolescence. This article is part of a Special Collection on Environmental Epidemiology.
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Affiliation(s)
- Jordan R Kuiper
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20037, United States
| | - Shelley H Liu
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Bruce P Lanphear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
| | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30333, United States
| | - Kim M Cecil
- Department of Radiology, College of Medicine, and Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45267, United States
| | - Yingying Xu
- Department of Pediatrics, College of Medicine, and Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45267, United States
| | - Kimberly Yolton
- Department of Pediatrics, College of Medicine, and Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45267, United States
- Department of Environmental and Public Health Sciences, College of Medicine, and Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45267, United States
| | - Heidi J Kalkwarf
- Department of Pediatrics, College of Medicine, and Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45267, United States
| | - Aimin Chen
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Joseph M Braun
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI 02903, United States
| | - Jessie P Buckley
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
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Farmer JG, Specht A, Punshon T, Jackson BP, Bidlack FB, Bakalar CA, Mukherjee R, Davis M, Steadman DW, Weisskopf MG. Lead exposure across the life course and age at death. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 927:171975. [PMID: 38547974 PMCID: PMC11069331 DOI: 10.1016/j.scitotenv.2024.171975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/22/2024] [Accepted: 03/23/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Lead (Pb) exposure has been associated with an increased risk of all-cause mortality, even at low levels. Little is known about how the timing of Pb exposure throughout life may influence these relationships. Quantifying the amount of Pb present in various tissues of the body provides measurements of exposure from different periods of life. These include bone, tooth enamel, which is the hard outer layer of the crown, and tooth cementum, which is the calcified connective tissue covering the tooth root. The purpose of the study was to examine Pb exposure at multiple periods throughout life, including childhood (enamel), adulthood (cementum), and later life (bone), and to estimate their associations with age at death. METHODS 208 skeleton donors (born 1910-1960) from an ongoing case-control study were included in this study. Pb was measured in tibia (shin), bone using X-Ray Florescence and in teeth using Laser-Ablation Inductively Coupled Plasma Mass Spectroscopy. After excluding unusually high measurements (>2sd), this resulted in a final sample of 111 with all exposure measures. Correlations across measures were determined using partial Spearman correlations. Associations between Pb exposure and age at death were estimated using Multivariable Linear Regression. RESULTS Pb measures across exposure periods were all significantly correlated, with the highest correlation between cementum and tibia measures (r = 0.61). Donors were largely female (63.0 %), White (97.3 %), and attended some college (49.5 %). Single exposure models found that higher tooth cementum Pb (-1.27; 95 % CI: -2.48, -0.06) and tibia bone Pb (-0.91; 95 % CI: -1.67, -0.15) were significantly associated with an earlier age at death. When considered simultaneously, only cementum Pb remained significant (-1.51; 95 % CI: -2.92, -0.11). Secondary analyses suggest that the outer cementum Pb may be especially associated with an earlier age at death. CONCLUSION Results suggest that higher Pb exposure is associated with an earlier age at death, with adulthood as the life period of most relevance. Additional studies using Pb exposure measures from different life stages should be conducted.
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Affiliation(s)
- Justin G Farmer
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Boston, MA, United States.
| | - Aaron Specht
- School of Health Sciences, Purdue University, 550 W Stadium Ave, West Lafayette, IN, United States
| | - Tracy Punshon
- Department of Biological Sciences, Dartmouth College, Hanover, NH, United States
| | - Brian P Jackson
- Department of Earth Sciences, Dartmouth College, Hanover, NH, United States
| | | | - Charlotte A Bakalar
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Boston, MA, United States
| | - Rajarshi Mukherjee
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Boston, MA, United States
| | - Mary Davis
- Department of Anthropology, University of Tennessee Knoxville, 1621 Cumberland Avenue, Knoxville, TN, United States
| | - Dawnie W Steadman
- Department of Anthropology, University of Tennessee Knoxville, 1621 Cumberland Avenue, Knoxville, TN, United States
| | - Marc G Weisskopf
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Boston, MA, United States
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Park SK, Wang X, Lee S, Hu H. Do we underestimate risk of cardiovascular mortality due to lead exposure? THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 923:171511. [PMID: 38453073 DOI: 10.1016/j.scitotenv.2024.171511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 12/21/2023] [Accepted: 03/03/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Studies using data from the National Health and Nutrition Examination Survey-III (NHANES-III) have demonstrated significant prospective associations between blood lead levels and increased mortality. Bone lead represents cumulative lead burden and thus is a better biomarker for assessing chronic impacts, but its in vivo assessment requires special K-x-ray fluorescence (KXRF) instrumentation. Our team recently developed an algorithm predicting bone lead levels from a combination of blood lead levels, age and other socioeconomic and behavioral variables. We examined the associations of our algorithm-estimated bone lead levels and mortality in NHANES-III. METHODS We included 11,628 adults followed up to December 31, 2019. Estimated tibia lead and patella lead levels were calculated using our prediction algorithms. We used survey-weighted Cox proportional hazards models to compute hazard ratios (HRs) and 95 % confidence intervals (CIs). RESULTS During the median follow-up of 26.8 years, 4900 participants died (mortality rate = 1398 per 100,000 adults/year). Geometric means (95 % CIs) of blood lead, predicted tibia lead, and predicted patella lead were 2.69 μg/dL (2.54, 2.84), 6.73 μg/g (6.22, 7.25), and 16.3 μg/g (15.9, 16.8), respectively. The associations for all-cause mortality were similar between blood lead and bone lead. However, the associations for cardiovascular mortality were much greater with predicted bone lead markers compared to blood lead: for comparing participants at the 90th vs. 10th percentiles of exposure, HR = 3.32 (95 % CI: 1.93-5.73) for tibia lead, 2.42 (1.56-3.76) for patella lead, 1.63 (1.25-2.14) for blood lead. The population attributable fractions for cardiovascular disease mortality if everyone's lead concentrations were declined to the 10th percentiles were 45.8 % (95 % CI: 28.1-59.4) for tibia lead, 33.1 % (18.1-45.8) for patella lead, and 22.8 % (10.4-33.8) for blood lead. CONCLUSIONS These findings suggest that risk assessment for cardiovascular mortality based on blood lead levels may underestimate the true mortality risk of lead exposure.
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Affiliation(s)
- Sung Kyun Park
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MA, USA; Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MA, USA.
| | - Xin Wang
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MA, USA
| | - Seulbi Lee
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MA, USA
| | - Howard Hu
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MA, USA; Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Chu MT, Fenelon A, Adamkiewicz G, Zota AR. Federal Housing Assistance and Blood Lead Levels in a Nationally Representative US Sample Age 6 and Older: NHANES, 1999-2018. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:37004. [PMID: 38477610 DOI: 10.1289/ehp12645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
BACKGROUND Federal housing assistance is an important policy tool to ensure housing security for low-income households. Less is known about its impact on residential environmental exposures, particularly lead. OBJECTIVES We conducted a quasi-experimental study to investigate the association between federal housing assistance and blood lead levels (BLLs) in a nationally representative US sample age 6 y and older eligible for housing assistance. METHODS We used the 1999-2018 National Health and Nutrition Examination Survey (NHANES) linked with US Department of Housing and Urban Development (HUD) administrative records to assess BLLs of NHANES participants with concurrent HUD housing assistance (i.e., current recipients, n = 3 , 0 71 ) and those receiving assistance within 2 y after the survey (i.e., pseudo-waitlist recipients, n = 1,235 ). We estimated BLL least squares geometric means (LSGMs), odds ratio (OR) for BLL ≥ 3.5 μ g / dL , and percent differences in LSGMs by HUD housing assistance status adjusting for age, sex, family income-to-poverty ratio, education, country of birth, race/ethnicity, region, and survey year. We also examined effect modification using interaction terms and stratified analyses by program type [i.e., public housing, multifamily, housing choice vouchers (HCV)], and race/ethnicity. RESULTS Current HUD recipients had a significantly lower LSGM [1.07 μ g / dL ; 95% confidence interval (CI): 1.02, 1.12] than pseudo-waitlist recipients (1.21 μ g / dL ; 95% CI: 1.14, 1.28), with an adjusted OR of 0.60 (95% CI: 0.42, 0.87) for BLL ≥ 3.5 μ g / dL . Some effect modification were observed: The protective association of HUD assistance on BLL was strongest among public housing (- 19.5 % LSGM; 95% CI: - 27.5 % , - 1 0 . 7 % ), multifamily (- 12.5 % LSGM; 95% CI: - 2 0 . 7 % , - 3.5 % ), and non-Hispanic White (- 2 0 . 6 % LSGM; 95% CI: - 29.8 % , - 1 0 . 3 % ) recipients. It was weaker to null among HCV (- 5.7 % LSGM; 95% CI: - 12.7 , 1.7%), non-Hispanic Black (- 1.6 % LSGM; 95% CI: - 8.1 % , 5.4%), and Mexican American (-12.5% LSGM; 95% CI: - 31.9 % , 12.5 % ) recipients. DISCUSSION Our research underscores the importance of social-structural determinants like federal housing assistance in providing affordable, stable, and healthy housing to very low-income households. More attention is needed to ensure housing quality and racial equity across HUD's three major housing assistance programs. https://doi.org/10.1289/EHP12645.
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Affiliation(s)
- MyDzung T Chu
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts, USA
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia, USA
| | - Andrew Fenelon
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Gary Adamkiewicz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ami R Zota
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia, USA
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
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Wang Y, Han J, Ren Q, Liu Z, Zhang X, Wu Z. The Involvement of Lactic Acid Bacteria and Their Exopolysaccharides in the Biosorption and Detoxication of Heavy Metals in the Gut. Biol Trace Elem Res 2024; 202:671-684. [PMID: 37165259 DOI: 10.1007/s12011-023-03693-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 05/01/2023] [Indexed: 05/12/2023]
Abstract
Heavy metal pollution has become one of the most important global environmental issues. The human health risk posed by heavy metals encountered through the food chain and occupational and environmental exposure is increasing, resulting in a series of serious diseases. Ingested heavy metals might disturb the function of the gut barrier and cause toxicity to organs or tissues in other sites of the body. Probiotics, including some lactic acid bacteria (LAB), can be used as an alternative strategy to detoxify heavy metals in the host body due to their safety and effectiveness. Exopolysaccharides (EPS) produced by LAB possess varied chemical structures and functional properties and take part in the adsorption of heavy metals via keeping the producing cells vigorous. The main objective of this paper was to summarize the roles of LAB and their EPS in the adsorption and detoxification of heavy metals in the gut. Accumulated evidence has demonstrated that microbial EPS play a pivotal role in heavy metal biosorption. Specifically, EPS-producing LAB have been reported to show superior absorption, tolerance, and efficient abatement of the toxicity of heavy metals in vitro and/or in vivo to non-EPS-producing species. The mechanisms underlying EPS-metal binding are mainly related to the negatively charged acidic groups and unique steric structure on the surface of EPS. However, whether the enriched heavy metals on the bacterial cell surface increase toxicity to local mammal cells or tissues in the intestine and whether they are released during excretion remain to be elucidated.
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Affiliation(s)
- Yitian Wang
- State Key Laboratory of Dairy Biotechnology, Shanghai Engineering Research Center of Dairy Biotechnology, Dairy Research Institute, Bright Dairy & Food Co., Ltd, Shanghai, 200436, China
- State Key Laboratory of Microbial Metabolism, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai, 200240, China
| | - Jin Han
- State Key Laboratory of Dairy Biotechnology, Shanghai Engineering Research Center of Dairy Biotechnology, Dairy Research Institute, Bright Dairy & Food Co., Ltd, Shanghai, 200436, China
| | - Quanlu Ren
- State Key Laboratory of Dairy Biotechnology, Shanghai Engineering Research Center of Dairy Biotechnology, Dairy Research Institute, Bright Dairy & Food Co., Ltd, Shanghai, 200436, China
| | - Zhenmin Liu
- State Key Laboratory of Dairy Biotechnology, Shanghai Engineering Research Center of Dairy Biotechnology, Dairy Research Institute, Bright Dairy & Food Co., Ltd, Shanghai, 200436, China
| | - Xuehong Zhang
- State Key Laboratory of Microbial Metabolism, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai, 200240, China
| | - Zhengjun Wu
- State Key Laboratory of Dairy Biotechnology, Shanghai Engineering Research Center of Dairy Biotechnology, Dairy Research Institute, Bright Dairy & Food Co., Ltd, Shanghai, 200436, China.
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Song J, Pan T, Xu Z, Yi W, Pan R, Cheng J, Hu W, Su H. A systematic analysis of chronic kidney disease burden attributable to lead exposure based on the global burden of disease study 2019. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 908:168189. [PMID: 37907111 DOI: 10.1016/j.scitotenv.2023.168189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/07/2023] [Accepted: 10/27/2023] [Indexed: 11/02/2023]
Abstract
AIM As an important toxic heavy metal, lead exposure can lead to the occurrence of chronic kidney disease (CKD). However, the analysis of its disease burden pattern on a global scale is lacking. This study aimed to analyze the CKD burden attributable to lead exposure globally, regionally and temporally, as well as to examine the role of socio-economic factors. METHOD This study used data from the Global Burden of Disease (GBD) study 2019. We obtained the global burden of CKD caused by lead exposure between 1990 and 2019, and stratified this burden according to factors such as gender, age, GBD regions, and countries. From 1990 to 2019, the changing trend of the disease burden of CKD attributed to lead exposure was estimated using Joinpoint regression model with the average annual percent change (AAPC) estimated. Finally, the relationship between country-level socio-economic factors and lead exposure related CKD burden was explored using a panel data model analysis. RESULTS In 2019, worldwide, there were 52.94 thousand deaths (95 % uncertainty interval (UI): 31.64, 76.23) and 1225.2 thousand disability-adjusted life years (DALYs) (95 % UI: 707.88, 1818) of CKD caused by lead exposure, accounting for 3.71 % of total CKD deaths and 2.95 % of total CKD DALYs. The age-standardized death and DALY rates per 100,000 population were 0.68 (95 % UI: 0.40, 0.98) and 15.02 (95 % UI: 8.68, 22.26) respectively, indicating an upward trend and stable trend between 1990 and 2019. However, the age-standardized rates attributed to lead exposure showed a wide variability across regions, with the highest rates in Central Latin America and the lowest in Eastern Europe. Moreover, the results of panel model analysis indicated that GDP growth was positively associated with lead exposure related CKD death rate and DALY rate. However, there were inverse associations between life expectancy at birth and hospital beds (per 1000 people) with lead exposure-related CKD DALY rate. CONCLUSION In summary, a significant burden of CKD can be attributed to lead exposure, with noticeable regional discrepancies. Findings here are valuable to deploy efficient measures at curbing lead exposure worldwide.
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Affiliation(s)
- Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, No.81 Meishan road, Shushan District, Hefei, Anhui 230031, China; Ecosystem Change and Population Health Research Group, School of Public Health and Social Work, Queensland University of Technology, Australia
| | - TianRong Pan
- Department of Endocrinology, The Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Jingkai District, Hefei 230061, Anhui Province, China; Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Jingkai District, Hefei 230061, Anhui Province, China
| | - Zhiwei Xu
- School of Medicine and Dentistry, Griffith University, Gold Coast Campus, QLD 4222, Australia
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, No.81 Meishan road, Shushan District, Hefei, Anhui 230031, China; School of Medicine and Dentistry, Griffith University, Gold Coast Campus, QLD 4222, Australia
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, No.81 Meishan road, Shushan District, Hefei, Anhui 230031, China
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, No.81 Meishan road, Shushan District, Hefei, Anhui 230031, China
| | - Wenbiao Hu
- Ecosystem Change and Population Health Research Group, School of Public Health and Social Work, Queensland University of Technology, Australia.
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, No.81 Meishan road, Shushan District, Hefei, Anhui 230031, China.
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Martinez-Morata I, Sobel M, Tellez-Plaza M, Navas-Acien A, Howe CG, Sanchez TR. A State-of-the-Science Review on Metal Biomarkers. Curr Environ Health Rep 2023; 10:215-249. [PMID: 37337116 PMCID: PMC10822714 DOI: 10.1007/s40572-023-00402-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2023] [Indexed: 06/21/2023]
Abstract
PURPOSE OF REVIEW Biomarkers are commonly used in epidemiological studies to assess metals and metalloid exposure and estimate internal dose, as they integrate multiple sources and routes of exposure. Researchers are increasingly using multi-metal panels and innovative statistical methods to understand how exposure to real-world metal mixtures affects human health. Metals have both common and unique sources and routes of exposure, as well as biotransformation and elimination pathways. The development of multi-element analytical technology allows researchers to examine a broad spectrum of metals in their studies; however, their interpretation is complex as they can reflect different windows of exposure and several biomarkers have critical limitations. This review elaborates on more than 500 scientific publications to discuss major sources of exposure, biotransformation and elimination, and biomarkers of exposure and internal dose for 12 metals/metalloids, including 8 non-essential elements (arsenic, barium, cadmium, lead, mercury, nickel, tin, uranium) and 4 essential elements (manganese, molybdenum, selenium, and zinc) commonly used in multi-element analyses. RECENT FINDINGS We conclude that not all metal biomarkers are adequate measures of exposure and that understanding the metabolic biotransformation and elimination of metals is key to metal biomarker interpretation. For example, whole blood is a good biomarker of exposure to arsenic, cadmium, lead, mercury, and tin, but it is not a good indicator for barium, nickel, and uranium. For some essential metals, the interpretation of whole blood biomarkers is unclear. Urine is the most commonly used biomarker of exposure across metals but it should not be used to assess lead exposure. Essential metals such as zinc and manganese are tightly regulated by homeostatic processes; thus, elevated levels in urine may reflect body loss and metabolic processes rather than excess exposure. Total urinary arsenic may reflect exposure to both organic and inorganic arsenic, thus, arsenic speciation and adjustment for arsebonetaine are needed in populations with dietary seafood consumption. Hair and nails primarily reflect exposure to organic mercury, except in populations exposed to high levels of inorganic mercury such as in occupational and environmental settings. When selecting biomarkers, it is also critical to consider the exposure window of interest. Most populations are chronically exposed to metals in the low-to-moderate range, yet many biomarkers reflect recent exposures. Toenails are emerging biomarkers in this regard. They are reliable biomarkers of long-term exposure for arsenic, mercury, manganese, and selenium. However, more research is needed to understand the role of nails as a biomarker of exposure to other metals. Similarly, teeth are increasingly used to assess lifelong exposures to several essential and non-essential metals such as lead, including during the prenatal window. As metals epidemiology moves towards embracing a multi-metal/mixtures approach and expanding metal panels to include less commonly studied metals, it is important for researchers to have a strong knowledge base about the metal biomarkers included in their research. This review aims to aid metals researchers in their analysis planning, facilitate sound analytical decision-making, as well as appropriate understanding and interpretation of results.
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Affiliation(s)
- Irene Martinez-Morata
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, 1107, New York, NY, 10032, USA.
| | - Marisa Sobel
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, 1107, New York, NY, 10032, USA
| | - Maria Tellez-Plaza
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, 1107, New York, NY, 10032, USA
| | - Caitlin G Howe
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Tiffany R Sanchez
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, 1107, New York, NY, 10032, USA
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11
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Chettle DR, Dietrich KN, Bhattacharya A, Kalkwarf HJ, Altmann L, Wei C, Cox C, Ying J. Early childhood lead exposure is not reflected in adult bone lead: Results of a sub-cohort of African American women in the Cincinnati lead study. ENVIRONMENTAL RESEARCH 2023; 231:115956. [PMID: 37105282 PMCID: PMC10330609 DOI: 10.1016/j.envres.2023.115956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 04/14/2023] [Accepted: 04/18/2023] [Indexed: 05/10/2023]
Abstract
INTRODUCTION Pb in bone may serve as a biomarker for cumulative Pb dose over decades. We hypothesized that adult female bone Pb concentrations (BoPb) would be significantly associated with average childhood blood Pb levels (BlPb) in a birth cohort exposed to relatively high levels of Pb from Pb paint residues. METHODS 94 African American women with a mean age of 32.7 years were recruited from the Cincinnati Lead Study (CLS) cohort. Subjects were born to women residing where there had been a high incidence of childhood Pb poisoning. Biomarkers of Pb exposure were serial BlPb concentrations spanning the prenatal period to approximately 6.5 years of age. BoPb was assessed in the tibia using the McMaster 109Cd K-XRF fourth generation system. Covariates included nutritional variables related to bone health. RESULTS BlPb concentrations began to rise around 6 months of age and declined at later ages. Study participants were obese with a mean Body Mass Index of 34.4 and suboptimal vitamin D status as indicated by a mean 25-OH-D of 18.5 ng/ml. Average tibia Pb was -2.0 ± 8.6 μgPb/g bone mineral. In multiple linear regression, there was no significant association between BoPb at approximately age 30 and childhood cumulative BlPb(CumBlPb). DISCUSSION Collectively, BoPb of this group of subjects was not detectable. We suggest that the reason these subjects' BoPb did not reflect their early exposure was that a significantly smaller proportion of Pb body burden resides in bone in young children. As the child grows what Pb there was in bone is diluted and any remaining signal is weak. It has been claimed that BoPb in older children, adolescents, and adults can recapitulate historical exposure to Pb during earlier development; however, in some populations, BoPb at later ages may not be an adequate biomarker to capture childhood exposure to Pb.
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Affiliation(s)
- David R Chettle
- McMaster University, Department of Physics & Astronomy, Hamilton, Ontario, Canada.
| | - Kim N Dietrich
- University of Cincinnati College of Medicine, Department of Environmental and Public Health Sciences, Cincinnati, OH, USA.
| | - Amit Bhattacharya
- Biomedical Engineering Society, University of Cincinnati College of Medicine, Department of Environmental and Public Health Sciences, Cincinnati, OH, USA.
| | - Heidi J Kalkwarf
- Cincinnati Children's Hospital Medical Center, Division of Gastroenterology, Hepatology, and Nutrition, University of Cincinnati College of Medicine, Department of Pediatrics, Cincinnati, OH, USA.
| | - Lorenna Altmann
- University of Cincinnati College of Medicine, Department of Environmental and Public Health Sciences, Cincinnati, OH, USA.
| | - Chi Wei
- University of Cincinnati College of Medicine, Department of Environmental and Public Health Sciences, Cincinnati, OH, USA.
| | - Cyndy Cox
- University of Cincinnati College of Medicine, Department of Environmental and Public Health Sciences, Cincinnati, OH, USA.
| | - Jun Ying
- University of Arkansas for Medical Sciences, Department of Biostatistics, Little Rock, AR, USA.
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12
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Specht AJ, Steadman DW, Davis M, Bartell SM, Weisskopf MG. Bone lead variability in bone repository skeletal samples measured with portable x-ray fluorescence. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 880:163197. [PMID: 37001655 DOI: 10.1016/j.scitotenv.2023.163197] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/27/2023] [Accepted: 03/27/2023] [Indexed: 05/27/2023]
Abstract
Bone lead serves as a better, more accessible biomarker to many communities experiencing chronic exposure to lead. A new method using low energy x-ray fluorescence in a handheld device (portable XRF) allows us to measure this chronic biomarker in only a few minutes. However, many unknowns remain about this biomarker measured using a new low energy x-ray technique. The low energy of the new method was theorized to measure a slightly different portion of the bone than previous techniques, which could influence measurements at different bone sites and types. We tested how bone measurements varied across five bone sites: mid-tibial shaft, proximal tibia, distal tibia (ankle), ilium, and cranium. We found bone lead measurements are not significantly different between skeletal elements when measured using a portable XRF. On average, bone lead in the repository samples was measured to be 21.6 ± 21.3 μg/g with an XRF detection limit of 2.1 ± 0.5 μg/g. Cumulative lead exposure can be effectively measured using the portable XRF on a variety of bone types, but the tibia should be preferentially measured to compare between studies and individuals.
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Affiliation(s)
- Aaron J Specht
- School of Health Sciences, Purdue University, West Lafayette, IN, United States of America; Harvard T.H. Chan School of Public Health, Boston, MA, United States of America.
| | - Dawnie W Steadman
- Department of Anthropology, University of Tennessee, Knoxville, TN, United States of America
| | - Mary Davis
- Department of Anthropology, University of Tennessee, Knoxville, TN, United States of America
| | - Scott M Bartell
- Department of Environmental and Occupational Health, Department of Statistics, University of California, Irvine, CA, United States of America
| | - Marc G Weisskopf
- Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
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13
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Zhang J, Xu C, Guo Y, Jin X, Cheng Z, Tao Q, Liu L, Zhan R, Yu X, Cao H, Tao F, Sheng J, Wang S. Increased hypertension risk for the elderly with high blood levels of strontium and lead. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2023; 45:1877-1888. [PMID: 35727389 DOI: 10.1007/s10653-022-01317-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 05/28/2022] [Indexed: 06/15/2023]
Abstract
Hypertension has long been recognized as the global health burden. Heavy metal pollution may be one of the environmental risk factors of hypertension. However, the association remains unclear. We studied the levels of aluminum (Al), vanadium (V), manganese (Mn), arsenic (As), selenium (Se), strontium (Sr), barium (Ba), titanium (Ti), lead (Pb) and cobalt (Co) in whole blood, and the relationship between trace element exposure and hypertension in the elderly community-based Chinese population. A total of 1013 participants from the west of Anhui Province in China were consecutively enrolled in this study in 2016. The general sociodemographic characteristics, lifestyles, disease history and physical examination information were collected by face-to-face survey and physical examination. The levels of ten trace elements were determined by inductively coupled plasma mass spectrometry (ICP-MS). Multivariable logistic regression model was used to assess the association of trace element exposure with the risk of hypertension. Results showed that the odds ratio of hypertension in the highest quartile was 1.811 (95% CI 1.175-2.790, P trend = 0.005) and 1.772 (95% CI 1.121-2.800, P trend = 0.022), respectively, after adjusting for potential confounders, as compared with the lowest quartile of blood Pb and Sr levels.
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Affiliation(s)
- Jiebao Zhang
- School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Hefei, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics/Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei, Anhui, China
| | - Chunfang Xu
- School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yan Guo
- School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Xingyi Jin
- School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Zi Cheng
- School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Qi Tao
- School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Lin Liu
- School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Rui Zhan
- School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Xuemin Yu
- School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Hongjuan Cao
- Lu'an Center of Disease Control and Prevention, Lu'an, Anhui, China
| | - Fangbiao Tao
- School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Hefei, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics/Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei, Anhui, China
| | - Jie Sheng
- School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Hefei, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics/Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei, Anhui, China
| | - Sufang Wang
- School of Public Health, Anhui Medical University, Hefei, Anhui, China.
- Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Hefei, Anhui, China.
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China.
- Anhui Provincial Key Laboratory of Population Health and Aristogenics/Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei, Anhui, China.
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ACOEM Position Statement: Workplace Health and Safety Necessitates an Update to Occupational Lead Standard Provisions for Medical Removal Protection, Medical Surveillance Triggers, and the Action Level and Permissible Exposure Level for Lead in Workplace Air: ACOEM Response to OSHA. J Occup Environ Med 2023; 65:e170-e176. [PMID: 36603060 DOI: 10.1097/jom.0000000000002774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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15
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Pollack AZ, Marroquin JM. Invited Perspective: Metals and Menarche. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:21301. [PMID: 36729393 PMCID: PMC9894152 DOI: 10.1289/ehp12555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 06/18/2023]
Affiliation(s)
- Anna Z. Pollack
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, Virginia, USA
| | - Joanna M. Marroquin
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, Virginia, USA
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16
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Pan K, Tu R, Cai Z, Huang Y, Zhang C. Association of blood lead with estradiol and sex hormone-binding globulin in 8-19-year-old children and adolescents. Front Endocrinol (Lausanne) 2023; 14:1096659. [PMID: 36843598 PMCID: PMC9944751 DOI: 10.3389/fendo.2023.1096659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 01/30/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Metals can interfere with hormonal functioning through indirect mechanisms and by binding at the receptor site; thus, they may be associated with hormonal changes. However, there have been few studies on the health impact of metal exposure among children and adolescents. Thus, we aimed to examine the associations of blood lead level (BLL) with estradiol (E2) and sex hormone-binding globulin (SHBG) among children and adolescents aged 8-19 years in the National Health and Nutrition Examination Survey (NHANES) database. METHODS This was a cohort study of 2188 individuals from the NHANES. BLL was taken as independent variables, E2 and SHBG as dependent variable. We conducted weighted multivariate linear regression models and smooth curve fittings to evaluate the association between them. RESULTS The BLL was significantly positively associated with serum SHBG level in females, especially when the LnBLL quartiles are between Q3 and Q4. There was an inverted U-shaped association between BLL and E2 with the point of inflection at 1.86 μg/L and a U-shaped association between BLL and SHBG with the point of inflection at 1.86 μg/L in female adolescents aged 16-19 years. Meanwhile, In males, there was a positive trend of correlation between BLL and E2 in the 8-11 years, and 16-19 years groups. CONCLUSIONS This study found an inverted U-shaped association of BLL with E2 and a U-shaped association between BLL and SHBG in female adolescents aged 16-19 years. This indicates that adjusting blood lead exposure to mitigate the effects of lead on growth and development is important for adolescents aged 16-19 years. Controlling the BLL below 1.86 μg/L may minimize the damage to E2.
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Affiliation(s)
- Kaiyu Pan
- Department of Paediatrics, The First People’s Hospital of Xiaoshan District, Hangzhou, Zhejiang, China
| | - Rongliang Tu
- Department of Neonatology, Zhejiang Xiaoshan Hospital, Hangzhou, Zhejiang, China
| | - Zixiu Cai
- Department of Paediatrics, The First People’s Hospital of Xiaoshan District, Hangzhou, Zhejiang, China
| | - Yingdan Huang
- Department of Paediatrics, The Second People's Hospital of Xiaoshan District, Hangzhou, Zhejiang, China
| | - Chengyue Zhang
- Xiangya School of Medicine, Central South University, Changsha, Hunan, China
- *Correspondence: Chengyue Zhang,
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17
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Wang X, Bakulski KM, Mukherjee B, Hu H, Park SK. Predicting cumulative lead (Pb) exposure using the Super Learner algorithm. CHEMOSPHERE 2023; 311:137125. [PMID: 36347347 PMCID: PMC10160242 DOI: 10.1016/j.chemosphere.2022.137125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 09/08/2022] [Accepted: 10/31/2022] [Indexed: 05/06/2023]
Abstract
Chronic lead (Pb) exposure causes long term health effects. While recent exposure can be assessed by measuring blood lead (half-life 30 days), chronic exposures can be assessed by measuring lead in bone (half-life of many years to decades). Bone lead measurements, in turn, have been measured non-invasively in large population-based studies using x-ray fluorescence techniques, but the method remains limited due to technical availability, expense, and the need for licensing radioactive materials used by the instruments. Thus, we developed prediction models for bone lead concentrations using a flexible machine learning approach--Super Learner, which combines the predictions from a set of machine learning algorithms for better prediction performance. The study population included 695 men in the Normative Aging Study, aged 48 years and older, whose bone (patella and tibia) lead concentrations were directly measured using K-shell-X-ray fluorescence. Ten predictors (blood lead, age, education, job type, weight, height, body mass index, waist circumference, cumulative cigarette smoking (pack-year), and smoking status) were selected for patella lead and 11 (the same 10 predictors plus serum phosphorus) for tibia lead using the Boruta algorithm. We implemented Super Learner to predict bone lead concentrations by calculating a weighted combination of predictions from 8 algorithms. In the nested cross-validation, the correlation coefficients between measured and predicted bone lead concentrations were 0.58 for patella lead and 0.52 for tibia lead, which has improved the correlations obtained in previously-published linear regression-based prediction models. We evaluated the applicability of these prediction models to the National Health and Nutrition Examination Survey for the associations between predicted bone lead concentrations and blood pressure, and positive associations were observed. These bone lead prediction models provide reasonable accuracy and can be used to evaluate health effects of cumulative lead exposure in studies where bone lead is not measured.
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Affiliation(s)
- Xin Wang
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Kelly M Bakulski
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Bhramar Mukherjee
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Howard Hu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sung Kyun Park
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA; Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
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18
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Early life exposure to lead and its association with parent-reported aggression and conduct problems during childhood and adolescence. Neurotoxicology 2022; 93:265-271. [DOI: 10.1016/j.neuro.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 10/04/2022] [Accepted: 10/11/2022] [Indexed: 11/05/2022]
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19
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Han K, Ju MJ, Kim DH, Choi YH. Environmental exposures to lead, cadmium, and mercury and pterygium in Korean adults. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:55058-55068. [PMID: 35314935 DOI: 10.1007/s11356-022-19250-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/11/2022] [Indexed: 06/14/2023]
Abstract
Pterygium, one of the most common eye disorders, is an abnormal fibrovascular proliferation extending from the conjunctiva to the cornea. The mechanism of development in pterygium has not been fully elucidated; however, oxidative stress is suggested to be one of the major causes. Heavy metals such as lead (Pb), cadmium (Cd), and mercury (Hg) enter the human body and induce oxidative stress. However, no study has investigated the association of these heavy metals with pterygium. Therefore, this study aimed to evaluate the associations of environmental exposures to Pb, Cd, and Hg with pterygium in the Korean general adults. We analyzed data from 6,587 adults (≥ 20 years of age) who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2011. Pterygium was diagnosed as the presence of a wing-shaped fibrovascular growth. The exposures of Pb, Cd, and Hg were estimated by measuring blood concentrations. The prevalence of pterygium in this study population was 4.0% (348 subjects). After adjusting for potential confounders, the Pb level in blood was found to have a significant dose-dependent association with pterygium (p for trend = 0.001), and its highest quintile (vs. the lowest) had an odds ratio (OR) of 2.22 (95% CI: 1.30, 3.78) for pterygium. The Hg level in blood in the second quintile (vs. the lowest) had an OR of 1.64 (95% CI: 1.04, 2.59) for pterygium. In conclusion, this study suggests that environmental exposures to Pb and Hg in the Korean general adults may be related to the development of pterygium.
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Affiliation(s)
- Kyunghee Han
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Korea
| | - Min Jae Ju
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Korea
- Department of Health Sciences and Technology, GAIHST, Gachon University, Incheon, Korea
| | - Dong Hyun Kim
- Department of Ophthalmology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Yoon-Hyeong Choi
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Korea.
- Department of Health Sciences and Technology, GAIHST, Gachon University, Incheon, Korea.
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20
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Meng Y, Zhou M, Wang T, Zhang G, Tu Y, Gong S, Zhang Y, Christiani DC, Au W, Liu Y, Xia ZL. Occupational lead exposure on genome-wide DNA methylation and DNA damage. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 304:119252. [PMID: 35385786 DOI: 10.1016/j.envpol.2022.119252] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/17/2022] [Accepted: 03/30/2022] [Indexed: 02/05/2023]
Abstract
Lead (Pb) exposure can induce DNA damage and alter DNA methylation but their inter-relationships have not been adequately determined. Our overall aims were to explore such relationships and to evaluate underlying epigenetic mechanisms of Pb-induced genotoxicity in Chinese workers. Blood Pb levels (BLLs) were determined and used as individual's Pb-exposure dose and the Comet assay (i.e., % tail DNA) was conducted to evaluate DNA damage. In the screening assay, 850 K BeadChip sequencing was performed on peripheral blood from 10 controls (BLLs ≤100 μg/L) and 20 exposed workers (i.e., 10 DNA-damaged and 10 DNA-undamaged workers). Using the technique, differentially methylated positions (DMPs) between the controls and the exposed workers were identified. In addition, DMPs were identified between the DNA-undamaged and DNA-damaged workers (% tail DNA >2.14%). In our validation assay, methylation levels of four candidate genes were measured by pyrosequencing in an independent sample set (n = 305), including RRAGC (Ras related GTP binding C), USP1 (Ubiquitin specific protease 1), COPS7B (COP9 signalosome subunit 7 B) and CHEK1 (Checkpoint kinase 1). The result of comparisons between the controls and the Pb-exposed workers show that DMPs were significantly enriched in genes related to nerve conduction and cell cycle. Between DNA-damaged group and DNA-undamaged group, differentially methylated genes were enriched in the pathways related to cell cycle and DNA integrity checkpoints. Additionally, methylation levels of RRAGC and USP1 were negatively associated with BLLs (P < 0.05), and the former mediated 19.40% of the effect of Pb on the % tail DNA. These findings collectively indicated that Pb-induced DNA damage was closely related to methylation of genes in cell cycle regulation, and methylation levels of RRAGC were involved in Pb-induced genotoxicity.
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Affiliation(s)
- Yu Meng
- Department of Occupational Health & Toxicology, School of Public Health, Fudan University, Shanghai, China
| | - Mengyu Zhou
- The MOE Key Laboratory of Metabolism and Molecular Medicine, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Tuanwei Wang
- Department of Occupational Health & Toxicology, School of Public Health, Fudan University, Shanghai, China
| | - Guanghui Zhang
- Department of Environmental Health, College of Preventive Medicine, Army Medical University, Chongqing, China; Department of Occupational & Environmental Health, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, China
| | - Yuting Tu
- Department of Occupational Health & Toxicology, School of Public Health, Fudan University, Shanghai, China
| | - Shiyang Gong
- Department of Occupational Health & Toxicology, School of Public Health, Fudan University, Shanghai, China
| | - Yunxia Zhang
- Department of Occupational Health & Toxicology, School of Public Health, Fudan University, Shanghai, China
| | - David C Christiani
- Environmental Medicine and Epidemiology Program, Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - William Au
- University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania, and Shantou University Medical College, Shantou, China
| | - Yun Liu
- The MOE Key Laboratory of Metabolism and Molecular Medicine, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Zhao-Lin Xia
- Department of Occupational Health & Toxicology, School of Public Health, Fudan University, Shanghai, China; School of Public Health, Xinjiang Medical University, Urumqi, China.
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21
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Sotomayor CG, Giubergia F, Groothof D, Ferreccio C, Nolte IM, Navis GJ, Gomes-Neto AW, Kremer D, Knobbe TJ, Eisenga MF, Rodrigo R, Touw DJ, Bakker SJL. Plasma Lead Concentration and Risk of Late Kidney Allograft Failure: Findings From the TransplantLines Biobank and Cohort Studies. Am J Kidney Dis 2022; 80:87-97.e1. [PMID: 34871698 DOI: 10.1053/j.ajkd.2021.10.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 10/15/2021] [Indexed: 11/11/2022]
Abstract
RATIONALE & OBJECTIVE Heavy metals are known to induce kidney damage, and recent studies have linked minor exposures to cadmium and arsenic with increased risk of kidney allograft failure, yet the potential association of lead with late graft failure in kidney transplant recipients (KTRs) remains unknown. STUDY DESIGN Prospective cohort study in The Netherlands. SETTING & PARTICIPANTS We studied outpatient KTRs (n = 670) with a functioning graft for ≥1 year recruited at a university setting (2008-2011) and followed for a median of 4.9 (interquartile range, 3.4-5.5) years. Additionally, patients with chronic kidney disease (n = 46) enrolled in the ongoing TransplantLines Cohort and Biobank Study (2016-2017, ClinicalTrials.gov identifier NCT03272841) were studied at admission for transplant and at 3, 6, 12, and 24 months after transplant. EXPOSURE Plasma lead concentration was log2-transformed to estimate the association with outcomes per doubling of plasma lead concentration and also considered categorically as tertiles of lead distribution. OUTCOME Kidney graft failure (restart of dialysis or repeat transplant) with the competing event of death with a functioning graft. ANALYTICAL APPROACH Multivariable-adjusted cause-specific hazards models in which follow-up of KTRs who died with a functioning graft was censored. RESULTS Median baseline plasma lead concentration was 0.31 (interquartile range, 0.22-0.45) μg/L among all KTRs. During follow-up, 78 (12%) KTRs experienced graft failure. Higher plasma lead concentration was associated with increased risk of graft failure (hazard ratio, 1.59 [95% CI, 1.14-2.21] per doubling; P = 0.006) independent of age, sex, transplant characteristics, estimated glomerular filtration rate, proteinuria, smoking status, alcohol intake, and plasma concentrations of cadmium and arsenic. These findings remained materially unchanged after additional adjustment for dietary intake and were consistent with those of analyses examining lead categorically. In serial measurements, plasma lead concentration was significantly higher at admission for transplant than at 3 months after transplant (P = 0.001), after which it remained stable over 2 years of follow-up (P = 0.2). LIMITATIONS Observational study design. CONCLUSIONS Pretransplant plasma lead concentrations, which decrease after transplant, are associated with increased risk of late kidney allograft failure. These findings warrant further studies to evaluate whether preventive or therapeutic interventions to decrease plasma lead concentration may represent novel risk-management strategies to decrease the rate of kidney allograft failure.
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Affiliation(s)
- Camilo G Sotomayor
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Program of Integrative Biology, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile; Radiology Department, Clinical Hospital University of Chile, University of Chile, Santiago, Chile.
| | - Flavia Giubergia
- Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Dion Groothof
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Catterina Ferreccio
- Advanced Center for Chronic Diseases, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ilja M Nolte
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gerjan J Navis
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Antonio W Gomes-Neto
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Daan Kremer
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Tim J Knobbe
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Michele F Eisenga
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ramón Rodrigo
- Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Daan J Touw
- Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Stephan J L Bakker
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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22
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Prado-Rico JM, Lee EY, Wang EW, Yanosky JD, Kong L, Chen H, Navas-Acien A, Du G, Lewis MM, Mailman RB, Huang X. Higher R2* in the Red Nucleus Is Associated With Lead Exposure in an Asymptomatic Welder Cohort. Toxicol Sci 2022; 187:345-354. [PMID: 35357496 PMCID: PMC9154244 DOI: 10.1093/toxsci/kfac035] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Lead is a nonessential metal and may be a coexposure in welding fumes. Preclinical data indicate lead may affect iron regulation. The current study investigated blood lead concentrations and their association with brain iron accumulation in workers with chronic welding fume exposure, with a focus on iron-rich subcortical regions of the cerebellum and basal ganglia. Occupational exposure, whole blood metal, and brain MRI data were obtained from 29 controls and 42 welders. R2* (1/T2*) and R1 (T1 relaxation rate) values were used to estimate brain iron and manganese content, respectively. Blood metals and brain R2* (in the red nucleus [RN], dentate nucleus, caudate, putamen, globus pallidus, and substantia nigra) were compared between groups. Associations between brain R2* values and exposure metrics were tested within each group, and analyses were adjusted for potential confounders. Welders had significantly higher levels of whole blood lead, manganese, iron, and copper. Welders also had higher R2* RN (p = .002), but not R1. A 2nd-order polynomial modeled the association between R2* RN and a long-term welding exposure metric. In welders, but not controls, R2* RN was associated positively with whole blood lead (r = 0.54, p = .003), and negatively with whole blood manganese (r = -0.43, p = .02). Higher blood Pb and lower blood Mn independently accounted for variance in high RN R2*. Together, these data suggest that higher RN R2* values may mark lead exposure in welders. Because lead is a known neurotoxicant, additional studies are warranted to confirm this finding, and ascertain its scientific and public/occupational health implications.
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Affiliation(s)
- Janina Manzieri Prado-Rico
- Department of Neurology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA
| | - Eun-Young Lee
- Department of Neurology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA
| | - Ernest W Wang
- Department of Neurology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA
| | - Jeff D Yanosky
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA
| | - Lan Kong
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA
| | - Hairong Chen
- Department of Neurology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York City, New York, USA
| | - Guangwei Du
- Department of Neurology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA
| | - Mechelle M Lewis
- Department of Neurology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA
- Department of Pharmacology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA
| | - Richard B Mailman
- Department of Neurology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA
- Department of Pharmacology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA
| | - Xuemei Huang
- Department of Neurology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA
- Department of Pharmacology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA
- Department of Radiology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA
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23
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Ali MM, Islam MS, Islam ARMT, Bhuyan MS, Ahmed ASS, Rahman MZ, Rahman MM. Toxic metal pollution and ecological risk assessment in water and sediment at ship breaking sites in the Bay of Bengal Coast, Bangladesh. MARINE POLLUTION BULLETIN 2022; 175:113274. [PMID: 35066413 DOI: 10.1016/j.marpolbul.2021.113274] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/28/2021] [Accepted: 12/15/2021] [Indexed: 06/14/2023]
Abstract
Quantification of four toxic metals (As, Cr, Cd, and Pb) in water and sediments at the Sitakunda ship breaking area in Bangladesh was studied. Along with this, sediment quality and ecological risk were evaluated for the metal intrusion to the study area. A total sample number of 120 (water; n = 60 and sediment; n = 60) were analyzed for both winter and summer seasons using atomic absorption spectrophotometer (AAS). The trace metal concentration in both water and sediment showed decreasing trend as follows; Cr (mean-W: 0.118 mg/L; mean-S:121.87 mg/kg) > Pb (mean-W: 0.064 mg/L; mean-S: 65.31 mg/kg) > As (mean-W: 0.03 mg/L; mean-S: 32.53 mg/kg) > Cd (mean-W: 0.004 mg/L; mean-S: 4.81 mg/kg). However, in both segments, the concentrations of the toxic metals exceeded the recommended acceptable limits. As and Cd showed significant variation (water and sediment) between the seasons, while Pb and Cr had no seasonal impact. Metal pollution index (MPI) and contamination factor (CF) was evaluated and revealed that the study area exhibited the critical score of water quality (MPI > 100). The cumulative effect of the metal concentrations was high (CI > 3). The assessed mean geoaccumulaiton index (Igeo) revealed that the study area was moderate to strongly polluted except for Cr. According to the contamination factor (CF), the sediment samples were moderate to highly contaminated by Cd, Pb, and As. Moreover, the explored range of pollution load index (PLI) in all sampling sites in the ship breaking region was from 1.75 to 3.10, suggesting that the sediment in the study area was highly polluted by heavy metals (PLI > 1). The risk index and the potential ecological risk index (PERI) suggested that the study area was at high risk due to metals pollution. Therefore, it is obligatory to maintain some crucial efforts for the betterment of the surrounding environment near the investigated sites.
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Affiliation(s)
- Mir Mohammad Ali
- Department of Aquaculture, Sher-e-Bangla Agricultural University, Dhaka 1207, Bangladesh
| | - Md Saiful Islam
- Department of Soil Science, Patuakhali Science and Technology University, Patuakhali 8602, Bangladesh; Environmental Assessment and Technology for Hazardous Waste Management Research Center, Faculty of Environmental Management, Prince of Songkla University, Songkhla 90112, Thailand
| | | | - Md Simul Bhuyan
- Institute of Marine Sciences, Faculty of Marine Sciences & Fisheries, University of Chittagong, Chittagong 4331, Bangladesh
| | - A S Shafiuddin Ahmed
- Department of Fisheries and Marine Science, Noakhali Science and Technology University, Bangladesh
| | - Md Zillur Rahman
- Quality Control Laboratory, Department of Fisheries, Khulna 9000, Bangladesh
| | - Md Mostafizur Rahman
- Department of Environmental Sciences, Jahangirnagar University, Dhaka 1342, Bangladesh.
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24
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Huang W, Shi X, Wu K. Human Body Burden of Heavy Metals and Health Consequences of Pb Exposure in Guiyu, an E-Waste Recycling Town in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312428. [PMID: 34886154 PMCID: PMC8657058 DOI: 10.3390/ijerph182312428] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 02/05/2023]
Abstract
Guiyu accommodates millions of tons of e-waste from overseas and domestic sources each year and is notorious for its e-waste dismantling industry. As a consequence, Guiyu has been described as "the world's most toxic place" and "junk town". Informal e-waste recycling activities have caused severe pollution to the local environment and are associated with extensive health problems to the residents. This review provides updated insights on the body burden of heavy metals derived from e-waste and health outcomes resulted from lead (Pb) exposure. The review identified that Guiyu has been highly contaminated by heavy metals, especially Pb. Excessive exposure to Pb has been associated with multi-system and long-term effects in neonates and children, covering nervous, cardiovascular, adaptive immune, and hematologic systems as well as chromosome and DNA damage. Our review indicates strong associations that emphasize the need to develop strong regulations for prevention of exposure and health consequences in Guiyu and similar sites around the world.
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25
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Hussein ABA, Ahmed MH, Kamal MM, Ayesh NAEA, Fouad MM. Evaluation of the Role of KIM-1 in Detecting Early Nephrotoxicity in Lead-Exposed Workers. J Occup Environ Med 2021; 63:e605-e611. [PMID: 34491970 DOI: 10.1097/jom.0000000000002304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Lead nephropathy usually starts silent. This study aimed to evaluate using kidney injury molecule 1 (KIM-1) as an early nephrotoxicity predictor of long-term low-level occupational lead exposure. METHODS History, examination, and laboratory investigations including: blood lead, urinary KIM-1, serum uric acid, creatinine, urea, sodium, potassium, serum albumin, and urine analysis were done on 35 lead-exposed workers and a matched control group. RESULTS Higher blood lead levels were found among the exposed group compared to the control one. No statistically significant difference was found regarding renal failure manifestations or standard renal functions (uric acid, blood urea, and creatinine). Urinary KIM-1 was statistically significantly increased among the exposed group. CONCLUSION Renal adverse effects were associated to lead fumes exposure. KIM-1 can be used as biomarker for detecting early renal affection among lead-exposed workers.
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Affiliation(s)
- Abo-Bakr Abbas Hussein
- Department of Occupational & Environmental Medicine, Faculty of Medicine, Cairo University, Egypt (Dr Hussein, Dr Ahmed, Dr Ayesh, and Dr Fouad); Department of Clinical & Chemical Pathology, Faculty of Medicine, Cairo University, Egypt (Dr Kamal)
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26
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Wang K, Meng Y, Wang T, Tu Y, Gong S, Zhang G, Au W, Xia Z. Global and gene-specific promoter methylation, and micronuclei induction in lead-exposed workers: A cross-sectional study. ENVIRONMENTAL AND MOLECULAR MUTAGENESIS 2021; 62:428-434. [PMID: 34269489 DOI: 10.1002/em.22451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 06/11/2021] [Accepted: 07/14/2021] [Indexed: 02/05/2023]
Abstract
Perturbation of epigenetic regulation is a well-established mechanism for cancer but its role for lead (Pb)-associated toxicity has not been adequately investigated. We aimed to investigate whether occupational Pb exposure is associated with micronuclei (MN) frequency and to further explored the mediating roles of epigenetic gene regulation. All the Pb-exposed workers recruited from a Chinese acid battery factory, blood lead levels (BLLs) and MN frequency in lymphocytes were measured. In addition, methylation levels of seven genes (Line-1, RASSF1A, RUNX3, p16, CYP26C1, hMLH1, p15) were examined among 230 workers. Robust Poisson regression model was used to investigate the association between BLLs and MN frequency. Mediation analysis was used to explore the mediating role of specific DNA methylation. Among total 677 participants, 71% were male, median BLLs was 229.1 μg/L (P25 = 155.5, P75 = 319.3; ranged from 8.9 to 647.7 μg/L), mean MN frequency was 2.5‰ (SD = 1.8‰; ranged from 0 to 9‰). Results from base model, adjusted for age, sex, and body mass index, showed that MN frequency would increase 1.38 (95%confidential interval: 1.34, 1.43) per 100 μg/L increment in BLLs. Using categorized exposure variable analyses, a BLLs dose-response increase in MN frequency was observed: 2.74 (2.13, 3.51), 3.43 (2.73, 4.32), 4.41 (3.89, 5.01) to 6.86 (6.02, 7.81). Mediation analysis indicated that Line-1 methylation significantly mediated 3.6% of the association of BLLs with MN frequency. Occupational Pb exposure induces MN frequency in a dose-response relationship. Part of this association was mediated by Line-1 promotor methylation.
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Affiliation(s)
- Kan Wang
- School of Public Health, and Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Yu Meng
- School of Public Health, and Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Tuanwei Wang
- School of Public Health, and Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Yuting Tu
- School of Public Health, and Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Shiyang Gong
- School of Public Health, and Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Guanghui Zhang
- School of Public Health, Xinxiang Medical University, Henan, China
| | - William Au
- University of Medicine Pharmacy, Science and Technology, Targu Mures, Romania, and Shantou University Medical College, Shantou, China
| | - Zhaolin Xia
- School of Public Health, and Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
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27
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Heavy Metal Toxicity in Chronic Renal Failure and Cardiovascular Disease: Possible Role for Chelation Therapy. Cardiol Rev 2021; 28:312-318. [PMID: 32040019 DOI: 10.1097/crd.0000000000000304] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Exposure to heavy metals is common. This exposure is related to environmental contamination of air, water and soil, occupational exposure, accumulation in food, tobacco, and other factors. Cadmium and lead are notable for their widespread contamination, long-lasting effects in the body, and renal as well as cardiovascular toxicity. Acute toxicity due to high-level exposure, as well as chronic low-level exposure are now well-established pathogenic entities. Both chronic renal failure and ischemic heart disease patients have been treated separately in recent studies with ethylenediaminetetraacetic acid (EDTA) chelation therapy. In patients with chronic kidney disease (serum creatinine: 1.5-4.0 mg/dL) and increased body lead burden, weekly low-dose chelation with calcium EDTA slowed the rate of decline in renal function in patients with diabetes and in non-diabetic patients. In patients with a history of myocardial infarction, the Trial to Assess Chelation Therapy study showed that EDTA chelation decreased the likelihood of cardiovascular events, particularly in patients with diabetes. However, heavy metal levels were not measured in this study. It is clear that more research is needed in this area. There is also a need to more frequently consider and test for the possibility of cadmium and lead toxicity in patients with increased risk, such as those with hypertension, diabetes mellitus, and chronic renal disease.
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28
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Kalahasthi R, Bagepally BS, Barman T. Association between Musculoskeletal Pain and Bone Turnover Markers in Long-Term Pb-Exposed Workers. J Res Health Sci 2021; 21:e00522. [PMID: 34698656 PMCID: PMC8957687 DOI: 10.34172/jrhs.2021.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 06/29/2021] [Accepted: 06/27/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND On chronic exposure, Lead (Pb) deposits in the skeletal system, replaces calcium ions, and alters the normal physiological processes, which in turn, lead to stunting, delayed fracture healing, and high resorption of collagen molecules. The present study aimed to assess the association of musculoskeletal pain and discomfort with bone turnover markers (BTMs) among long-term Pb-exposed workers. STUDY DESIGN A cross-sectional study. METHODS The study recruited 176 male Pb-exposed workers and 80 control subjects who were matched for age, gender, and socio-economic status. Blood lead levels (BLLs), bone growth markers, such as serum osteocalcin (OC), alkaline phosphatase (ALP), bone alkaline phosphatase (BAP), and bone resorption markers: serum pyridinoline (Pry), deoxypyridinoline (DPry), tartrate-resistant acid phosphatase-5b(TRACP-5b), and hydroxyproline in urine (HyP-U) of participants were investigated. Pain and discomfort in the musculoskeletal system were assessed using Nordic Musculoskeletal Questionnaire. RESULTS Pb-exposure was significantly associated with musculoskeletal discomfort of the lower back (P<0.001), upper back (P<0.001), and ankle/foot (P=0.011). Among bone formation markers, serum OC was significantly lower in musculoskeletal discomfort of elbows (P=0.033) and ankle/foot (P=0.042). Among bone resorption markers, serum DPry was significantly lower in musculoskeletal discomfort of the neck (P=0.049) and shoulders (P=0.023). HyP-U was significantly higher in musculoskeletal discomfort of shoulders (P=0.035) and lower back (P=0.036). CONCLUSION As evidenced by the obtained results, Pb-exposure was associated with musculoskeletal discomfort of the lower back, upper back, and ankle/foot. Lower bone formation (serum OC) marker was noted with musculoskeletal discomfort of elbows and ankle/foot. Furthermore, bone resorption markers were associated with musculoskeletal discomfort of the neck, shoulders, and lower back. The findings of the present study suggested that long-term Pb-exposure and BTMs were associated with musculoskeletal discomfort.
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Affiliation(s)
- Ravibabu Kalahasthi
- Department of Biochemistry, Regional Occupational Health Centre (Southern), Indian Council of Medical Research, ICMR Complex, Karnataka, India.
| | | | - Tapu Barman
- Department of Bacteriology, National Institute of Cholera and Enteric Diseases, Beleghata, Kolkata, West Bengal, India
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Bede-Ojimadu O, Orish CN, Bocca B, Ruggieri F, Frazzoli C, Orisakwe OE. Trace elements exposure and risk in age-related eye diseases: a systematic review of epidemiological evidence. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART C, TOXICOLOGY AND CARCINOGENESIS 2021; 39:293-339. [PMID: 34114934 DOI: 10.1080/26896583.2021.1916331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This systematic review aimed to evaluate existing evidence on the associations between trace elements exposure and age-related eye diseases. PubMed and Google scholar databases were searched for epidemiological and postmortem studies on the relationship between exposure to trace elements and Age-related eye diseases such as age-related macular degeneration (AMD), cataract, glaucoma and diabetic retinopathy (DR), in population groups aged 40 years and above. Available evidence suggests that cadmium (Cd) exposure may be positively associated with the risks of AMD and cataract. There is also evidence that exposure to lead (Pb) may be positively associated with higher risk of cataract and glaucoma. There is limited number of relevant studies and lack of prospective studies for most of the investigated associations. Evidence for other trace elements is weak and inconsistent, and the number of available studies is small. Likewise, there are very few relevant studies on the role of trace elements in DR. Chemical elements that affect the distribution and absorption of other trace elements have never been investigated. The suggestive but limited evidence motivates large and quality prospective studies to fully characterize the impact of exposure to trace (toxic and essential) elements on age-related eye diseases.
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Affiliation(s)
- Onyinyechi Bede-Ojimadu
- Department of Chemical Pathology, Faculty of Medicine, Nnamdi Azikiwe University, Nnewi, Nigeria
| | - Chinna N Orish
- Department of Anatomy, Faculty of Basic Medical Sciences, College of Health Sciences University of Port Harcourt, Port Harcourt, Choba, Nigeria
| | - Beatrice Bocca
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Flavia Ruggieri
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Chiara Frazzoli
- Department of Cardiovascular and Endocrine-Metabolic Diseases, and Ageing, Istituto Superiore di Sanità, Rome, Italy
| | - Orish E Orisakwe
- African Centre of Excellence for Public Health and Toxicological Research (ACE-PUTOR), University of Port Harcourt, Port Harcourt, Rivers, Nigeria
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30
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Glicklich D, Frishman WH. The Case For Cadmium and Lead Heavy Metal Screening. Am J Med Sci 2021; 362:344-354. [PMID: 34048724 DOI: 10.1016/j.amjms.2021.05.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 02/18/2021] [Accepted: 05/21/2021] [Indexed: 01/24/2023]
Abstract
Exposure to cadmium and lead is widespread, and is related to environmental contamination, occupational sources, food, tobacco and other consumer products. Lower socioeconomic status increases the risk of heavy metal exposure and the diseases associated with cadmium and lead toxicity. Concurrent toxicity with both cadmium and lead is likely but has not often been assessed. There is now substantial evidence linking cadmium and lead to many diseases including hypertension, diabetes mellitus, obesity, cancer, coronary artery disease, chronic kidney disease (CKD) and lung disease. Both chronic renal failure and ischemic heart disease patients have been treated separately in recent studies with calcium disodium ethylenediaminetetraacetic acid (Ca EDTA) chelation therapy. In patients with CKD, serum creatinine 1.5-4.0 mg/dL, and increased body lead burden, weekly low dose chelation with Ca EDTA slowed the rate of decline in renal function in diabetics and non-diabetics. In patients with a history of myocardial infarction, the Trial to Assess Chelation Therapy (TACT) study showed that Ca EDTA chelation decreased the likelihood of cardiovascular events, particularly in diabetics. Ca EDTA chelation administered carefully at lower dosage (<50 mg/kg per week) is generally safe. In the past, acute renal failure associated with much higher dosage was reported. We suggest that the preponderance of the evidence favors a more activist approach towards diagnosis and possible intervention in heavy metal toxicity.
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Affiliation(s)
- Daniel Glicklich
- Kidney Transplant Division, New York Medical College/Westchester Medical Center, Valhalla, NY, USA.
| | - William H Frishman
- Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, NY, USA
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31
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Li Y, Chen J, Bu S, Wang S, Geng X, Guan G, Zhao Q, Ao L, Qu W, Zheng Y, Jin Y, Tang J. Blood lead levels and their associated risk factors in Chinese adults from 1980 to 2018. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 218:112294. [PMID: 33984660 DOI: 10.1016/j.ecoenv.2021.112294] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/22/2021] [Accepted: 04/25/2021] [Indexed: 06/12/2023]
Abstract
In China, studies on lead exposure to grownup are scarce compared to children, although relevant disease burdens for adults are much severe than that in developed countries. The present study evaluated blood lead levels (BLLs) in Chinese adults by data mining using Monte Carlo simulation. A total of 115 scientific studies published between January 1980 and March 2021 reflecting 45,514 Chinese adults were included in the study. After a continuous increase in Chinese adult BLLs from 1980-1983 (GM 74.84 μg/L) to 1994-1996 (GM 92.27 μg/L), BLLs began to decline from 2000--2002 (GM 80.32 μg/L) to 2016-2018 (GM 21.57 μg/L). This decline implied that the lead phase-out policy in gasoline was effective over the past two decades. The study indicated that North, South, and Southwest China were still relatively high compared to other regions in the past decade. Statistical analysis showed that BLLs of males (GM 68.45 μg/L) were higher than females (GM 56.51 μg/L), smokers (GM 80.96 μg/L) higher than nonsmokers (GM 58.95 μg/L), and populations over 40 (GM 40.43 μg/L) higher than younger populations (GM 40.37 μg/L). The significantly positive correlation between the concentrations of PM2.5 and topsoil lead and BLLs in Chinese adults indicated that air and soil pollution affect adult BLLs. Taken together, our results showed that strict lead control strategies and regular bio-monitoring are needed to maintain low BLLs in the population.
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Affiliation(s)
- Yanan Li
- School of Public Health, Qingdao University, Qingdao 266000, China
| | - Jing Chen
- School of Public Health, Qingdao University, Qingdao 266000, China
| | - Shuhua Bu
- School of Public Health, Qingdao University, Qingdao 266000, China
| | - Shuo Wang
- School of Public Health, Qingdao University, Qingdao 266000, China
| | - Xue Geng
- School of Public Health, Qingdao University, Qingdao 266000, China
| | - Ge Guan
- School of Public Health, Qingdao University, Qingdao 266000, China
| | - Qianwen Zhao
- School of Public Health, Qingdao University, Qingdao 266000, China
| | - Lin Ao
- School of Public Health, Fudan University, Shanghai 200032, China
| | - Weidong Qu
- Department of Environmental Health, College of Preventive Medicine, Third Military Medical University, Chongqing 400038, China
| | - Yuxin Zheng
- School of Public Health, Qingdao University, Qingdao 266000, China
| | - Yuan Jin
- School of Public Health, Qingdao University, Qingdao 266000, China.
| | - Jinglong Tang
- School of Public Health, Qingdao University, Qingdao 266000, China.
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Rhee J, Graubard BI, Purdue MP. Blood lead levels and lung cancer mortality: An updated analysis of NHANES II and III. Cancer Med 2021; 10:4066-4074. [PMID: 33963676 PMCID: PMC8209588 DOI: 10.1002/cam4.3943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 11/07/2022] Open
Abstract
Previous analyses within the National Health and Nutrition Examination Survey (NHANES) II and III cycles suggested an association between blood lead levels (BLLs) and lung cancer mortality, although the evidence was limited by small case numbers. To clarify this relationship, we conducted updated analyses of 4,182 and 15,629 participants in NHANES II and III, respectively, (extending follow-up 20 and 8 years) aged ≥20 with BLL measurements and mortality follow-up through 2014. We fit multivariable Cox models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) relating BLLs and lung cancer with adjustment for smoking and other factors. We did not observe an overall association between BLLs and lung cancer after adjustment for smoking (both surveys) and serum cotinine and environmental tobacco smoke exposure (NHANES III), although suggestive associations were observed among women (NHANES II: HR 2.7, 95% CI 0.7, 10.0 for ≥20.0 µg/dl vs. <10.0 µg/dl, Ptrend = 0.07; NHANES III: HR 11.2, 95% CI 2.1, 59.4 for ≥10.0 µg/dl vs. <2.5 µg/dl, Ptrend = 0.04). After stratifying on smoking status, an association with elevated BLLs was observed in NHANES II only among former smokers (HR 3.2, 95% CI 1.3, 8.0 for ≥15 vs. <15 µg/dl) and in NHANES III only among current smokers (HR 1.7, 95% CI 1.1, 2.8 for ≥5 vs. <5 µg/dl). In summary, we found elevated BLLs to be associated with lung cancer mortality among women in both NHANES II and III. Given the absence of an association among non-smokers, we cannot rule out residual confounding as an explanation for our findings.
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Affiliation(s)
- Jongeun Rhee
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Barry I Graubard
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Mark P Purdue
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
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Lamas GA, Ujueta F, Navas-Acien A. Lead and Cadmium as Cardiovascular Risk Factors: The Burden of Proof Has Been Met. J Am Heart Assoc 2021; 10:e018692. [PMID: 33942628 PMCID: PMC8200701 DOI: 10.1161/jaha.120.018692] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Gervasio A Lamas
- Department of Medicine Mount Sinai Medical Center Miami Beach FL.,Columbia University Division of Cardiology Mount Sinai Medical CenterMiami Beach FL
| | - Francisco Ujueta
- Department of Medicine Mount Sinai Medical Center Miami Beach FL
| | - Ana Navas-Acien
- Department of Environmental Health Sciences Columbia University Mailman School of Public Health New York NY
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Betanzos-Robledo L, Cantoral A, Peterson KE, Hu H, Hernández-Ávila M, Perng W, Jansen E, Ettinger AS, Mercado-García A, Solano-González M, Sánchez B, Téllez-Rojo MM. Association between cumulative childhood blood lead exposure and hepatic steatosis in young Mexican adults. ENVIRONMENTAL RESEARCH 2021; 196:110980. [PMID: 33691159 PMCID: PMC8119339 DOI: 10.1016/j.envres.2021.110980] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/20/2021] [Accepted: 03/03/2021] [Indexed: 05/16/2023]
Abstract
BACKGROUND Exposure to environmental toxicants may play a role in the pathogenesis of Non Alcoholic Fatty Liver Disease (NAFLD). Cumulative exposure to lead (Pb) has chronic and permanent effects on liver function. Pediatric populations are vulnerable to the toxic effects of Pb, even at low exposure levels. The purpose of the study was to estimate the association between cumulative Pb exposure during childhood and hepatic steatosis biomarkers in young Mexican adults. METHODS A subsample of 93 participants from the ELEMENT cohort were included in this study. Childhood blood samples were collected annually from ages 1-4 years and were used to calculate the Cumulative Childhood Blood Lead Levels (CCBLL). Hepatic steatosis during adulthood was defined as an excessive accumulation of hepatic triglycerides (>5%) determined using Magnetic Resonance Imaging (MRI). Liver enzymes were also measured at this time, and elevated liver enzyme levels were defined as ALT (≥30 IU/L), AST (≥30 IU/L), and GGT (≥40 IU/L). Adjusted linear regression models were fit to examine the association between CCBLL (quartiles) and the hepatic steatosis in young adulthood. RESULTS In adulthood, the mean age was 21.4 years, 55% were male. The overall prevalence of hepatic steatosis by MRI was 19%. Elevate levels of the enzymes ALT, AST, and GGT were present in 25%, 15%, and 17% of the sample, respectively. We found a positive association between the highest quartile of CCBLL with the steatosis biomarkers of hepatic triglycerides (Q4 vs. Q1: β = 6.07, 95% CI: 1.91-10.21), elevated ALT (Q4 vs. Q1: β = 14.5, 95% CI: 1.39-27.61) and elevated AST (Q4 vs. Q1: β = 7.23, 95% CI: 0.64-13.82). No significant associations were found with GGT. CONCLUSIONS Chronic Pb exposure during early childhood is associated with a higher levels of hepatic steatosis biomarkers and hepatocellular injury in young adulthood. More actions should be taken to eliminate sources of Pb during the first years of life.
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Affiliation(s)
- Larissa Betanzos-Robledo
- National Council of Science and Technology, National Institute of Public Health, Mexico City, MX, Mexico
| | - Alejandra Cantoral
- Department of Health, Universidad Iberoamericana, Mexico City, MX, Mexico.
| | - Karen E Peterson
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Howard Hu
- Department of Preventive Medicine Keck School of Medicine of University of Southern California, USA
| | | | - Wei Perng
- Department of Epidemiology, Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Erica Jansen
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI, USA
| | | | - Adriana Mercado-García
- National Council of Science and Technology, National Institute of Public Health, Mexico City, MX, Mexico
| | - Maritsa Solano-González
- National Council of Science and Technology, National Institute of Public Health, Mexico City, MX, Mexico
| | - Brisa Sánchez
- Dornsife School of Public Health, Drexel University, USA
| | - Martha M Téllez-Rojo
- National Council of Science and Technology, National Institute of Public Health, Mexico City, MX, Mexico
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Paul KC, Horvath S, Del Rosario I, Bronstein JM, Ritz B. DNA methylation biomarker for cumulative lead exposure is associated with Parkinson's disease. Clin Epigenetics 2021; 13:59. [PMID: 33752746 PMCID: PMC7983295 DOI: 10.1186/s13148-021-01051-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 03/07/2021] [Indexed: 11/20/2022] Open
Abstract
Lead, a known neurotoxicant, has previously received attention in Parkinson’s disease (PD) research, but epidemiologic studies have been limited in sample size and findings are equivocal. We generated two methylation-based biomarkers for cumulative tibia and patella bone-measured lead exposure in 1528 PD patients and 1169 controls. PD status was associated with increased levels of the DNAm biomarker for tibia-lead levels. We estimated a meta-OR for PD of 1.89 per unit DNAm tibia-lead increase (95% CI 1.59, 2.24; p = 8.1E−13). The current study supports the notion that chronic and long-term lead exposure tracked via DNAm may contribute to PD pathogenesis.
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Affiliation(s)
- Kimberly C Paul
- Department of Neurology, David Geffen School of Medicine, 73-320B CHS Campus, Los Angeles, CA, 177220, USA.
| | - Steve Horvath
- Department of Human Genetics, David Geffen School of Medicine, Los Angeles, CA, USA
| | - Irish Del Rosario
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Jeff M Bronstein
- Department of Neurology, David Geffen School of Medicine, 73-320B CHS Campus, Los Angeles, CA, 177220, USA
| | - Beate Ritz
- Department of Neurology, David Geffen School of Medicine, 73-320B CHS Campus, Los Angeles, CA, 177220, USA.,Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
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Colicino E, Just A, Kioumourtzoglou MA, Vokonas P, Cardenas A, Sparrow D, Weisskopf M, Nie LH, Hu H, Schwartz JD, Wright RO, Baccarelli AA. Blood DNA methylation biomarkers of cumulative lead exposure in adults. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2021; 31:108-116. [PMID: 31636367 PMCID: PMC7170756 DOI: 10.1038/s41370-019-0183-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 07/31/2019] [Accepted: 08/15/2019] [Indexed: 05/28/2023]
Abstract
BACKGROUND Lead is a ubiquitous toxicant following three compartment kinetics with the longest half-life found in bones. Patella and tibia lead levels-validated measures of cumulative exposure-require specialized X-ray-fluorescence-spectroscopy available only in a few centers worldwide. We developed minimally invasive biomarkers reflecting individual cumulative lead exposure using blood DNA methylation profiles-obtainable via Illumina 450K or IlluminaEPIC bead-chip assays. METHODS We developed and tested two methylation-based biomarkers from 348 Normative Aging Study (NAS) elderly men. We selected methylation sites with strong associations with bone lead levels via robust regressions analysis and constructed the biomarkers using elastic nets. Results were validated in a NAS subset, reporting specificity, and sensitivity. FINDINGS Participants were 73 years old on average (standard deviation, SD = 6), with moderate lead levels of (mean ± SD patella: 27 ± 18 µg/g; tibia:21 ± 13 µg/g). Methylation-based biomarkers for lead in patella and tibia included 59 and 138 DNA methylation sites, respectively. Estimated lead levels were significantly correlated with actual measured values, (r = 0.62 patella, r = 0.59 tibia) and had low mean square error (MSE) (MSE = 0.68 patella, MSE = 0.53 tibia). Means and distributions of the estimated and actual lead levels were not significantly different across patella and tibia bones (p > 0.05). Methylation-based biomarkers discriminated participants highly exposed (>median) to lead with a specificity of 74 and 73% for patella and tibia lead levels, respectively, with 70% sensitivity. INTERPRETATION DNA methylation-based lead biomarkers are novel tools that can be used to reconstruct decades' worth of individual cumulative lead exposure using only blood DNA methylation profiles and may help identify the consequences of cumulative exposure.
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Affiliation(s)
- Elena Colicino
- Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Allan Just
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Pantel Vokonas
- Veterans Affairs Boston Healthcare System, Boston, MA, USA
| | - Andres Cardenas
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - David Sparrow
- VA Boston Healthcare System and Boston University School of Medicine, Boston, MA, USA
| | - Marc Weisskopf
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Linda H Nie
- School of Health Sciences, Purdue University, West Lafayette, IN, USA
| | - Howard Hu
- School of Public Health, University of Washington, Seattle, WA, F-226B, USA
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37
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Nwanaji-Enwerem JC, Colicino E. DNA Methylation-Based Biomarkers of Environmental Exposures for Human Population Studies. Curr Environ Health Rep 2021; 7:121-128. [PMID: 32062850 DOI: 10.1007/s40572-020-00269-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW This manuscript orients the reader to the underlying motivations of environmental biomarker development for human population studies and provides the foundation for applying these novel biomarkers in future research. In this review, we focus our attention on the DNA methylation-based biomarkers of (i) smoking, among adults and pregnant women, (ii) lifetime cannabis use, (iii) alcohol consumption, and (iv) cumulative exposure to lead. RECENT FINDINGS Prior environmental exposures and lifestyle modulate DNA methylation levels. Exposure-related DNA methylation changes can either be persistent or reversible once the exposure is no longer present, and this combination of both persistent and reversible changes has essential value for biomarker development. Here, we present available biomarkers representing past and cumulative exposures using individual DNA methylation profiles. In the present work, we describe how the field of environmental epigenetics can leverage machine learning algorithms to develop exposure biomarkers and reduce problems of misreporting exposures or limited access technology. We emphasize the crucial role of the individual DNA methylation profiles in those predictions, providing a summary of each biomarker, and highlighting their advantages, and limitations. Future research can cautiously leverage these DNA methylation-based biomarkers to understand the onset and progression of diseases.
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Affiliation(s)
- Jamaji C Nwanaji-Enwerem
- Belfer Center for Science and International Affairs, Harvard Kennedy School of Government, Cambridge, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Elena Colicino
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 17 E 102nd St. West 3rd Floor, New York, NY, 10029, USA.
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Kašuba V, Milić M, Želježić D, Mladinić M, Pizent A, Kljaković-Gašpić Z, Balija M, Jukić I. Biomonitoring findings for occupational lead exposure in battery and ceramic tile workers using biochemical markers, alkaline comet assay, and micronucleus test coupled with fluorescence in situ hybridisation. Arh Hig Rada Toksikol 2020; 71:339-352. [PMID: 33410779 PMCID: PMC7968510 DOI: 10.2478/aiht-2020-71-3427] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/01/2020] [Accepted: 11/01/2020] [Indexed: 01/19/2023] Open
Abstract
Manufacture of lead-containing products has long been associated with various health risks. To get an insight into the related genotoxic risks, we conducted a biomonitoring study in 50 exposed workers and 48 matched controls using a battery of endpoints that sensitively detect the extent of genome instability in peripheral blood lymphocytes. The levels of primary DNA damage were estimated with the alkaline comet assay, while cytogenetic abnormalities were determined with the cytokinesis-block micronucleus (CBMN) cytome assay. Additionally, CBMN slides of 20 exposed and 16 control participants were subjected to fluorescence in situ hybridisation (FISH), coupled with pancentromeric probes to establish the incidence of centromere-positive micronuclei, nuclear buds, and nucleoplasmic bridges. Blood lead levels (B-Pb) were measured with atomic absorption spectrometry. To further characterise cumulative effects of occupational exposure, we measured erythrocyte protoporphyrin (EP) concentrations and delta-aminolevulinic acid dehydratase (ALAD) activity in blood. We also assessed the influence of serum folate (S-folate) and vitamin B12 (S-B12) on genome stability. Compared to controls, occupationally exposed workers demonstrated significantly higher B-Pb (298.36±162.07 vs 41.58±23.02), MN frequency (18.71±11.06 vs 8.98±7.50), centromere positive MN (C+ MN) (8.15±1.8 vs 3.69±0.47), and centromere negative MN (C- MN) (14.55±1.80 vs 4.56±0.89). Exposed women had significantly higher comet tail intensity (TI) and length (TL) than control women. Furthermore, workers showed a positive correlation between age and nuclear buds and MN, between MN and years of exposure, and between S-B12 levels and TI and ALAD activity, while a negative correlation was found between TI and B-Pb. These findings suggest that occupational settings in the manufacture of lead-containing products pose significant genotoxic risks, which calls for developing more effective work safety programmes, including periodical monitoring of B-Pb and genetic endpoints.
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Affiliation(s)
- Vilena Kašuba
- Institute for Medical Research and Occupational Health, Mutagenesis Unit, Zagreb, Croatia
| | - Mirta Milić
- Institute for Medical Research and Occupational Health, Mutagenesis Unit, Zagreb, Croatia
| | - Davor Želježić
- Institute for Medical Research and Occupational Health, Mutagenesis Unit, Zagreb, Croatia
| | | | - Alica Pizent
- Institute for Medical Research and Occupational Health, Analytical Toxicology and Mineral Metabolism Unit, Zagreb, Croatia
| | - Zorana Kljaković-Gašpić
- Institute for Medical Research and Occupational Health, Analytical Toxicology and Mineral Metabolism Unit, Zagreb, Croatia
| | - Melita Balija
- Croatian Institute for Transfusion Medicine, Zagreb, Croatia
| | - Irena Jukić
- Croatian Institute for Transfusion Medicine, Zagreb, Croatia
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Choi JY, Huh DA, Moon KW. Association between blood lead levels and metabolic syndrome considering the effect of the thyroid-stimulating hormone based on the 2013 Korea National health and nutrition examination survey. PLoS One 2020; 15:e0244821. [PMID: 33382832 PMCID: PMC7775085 DOI: 10.1371/journal.pone.0244821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 12/16/2020] [Indexed: 12/03/2022] Open
Abstract
Imbalances in thyroid-stimulating hormone (TSH) levels are associated with metabolic syndrome (MetS), and the underlying mechanism is partly in alignment with that of lead exposure causing MetS. Many studies have reported the association between lead exposure and MetS, but no study has considered the possibility of TSH mediating lead's effect on MetS. Therefore, we aimed to examine the association between lead exposure and MetS considering TSH as a partial mediator. The data of 1,688 adults (age ≥19 years) from the Korea National Health and Nutrition Examination Survey in 2013 were analyzed. The prevalence of MetS in the Korean population was 21.9%, and the geometric mean of blood lead and serum TSH levels were 1.96 μg/dL and 2.17 μIU/mL, respectively. The associations between blood lead levels, serum TSH levels, and MetS were determined through a multiple logistic regression analysis. Blood lead levels were positively associated with high TSH levels (upper 25%) with an odds ratio (OR) and 95% confidence interval (CI) of 1.79 (1.24, 2.58) per doubled lead levels. The increase in blood lead and serum TSH levels both positively increased the odds of developing MetS. The OR of MetS per doubling of blood lead level was 1.53 (1.00, 2.35), and was not attenuated after adjusting for TSH levels. These findings suggest that higher levels of blood lead are positively associated with serum TSH levels and MetS. By exploring the role of TSH as a partial mediator between lead and MetS, we verified that lead exposure has an independent relationship with MetS, regardless of TSH levels.
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Affiliation(s)
- Ji Yoon Choi
- Department of Health and Safety Convergence Science, Graduate School at Korea University, Seoul, Republic of Korea
- Environmental Health Research Division, National Institute of Environmental Research, Ministry of Environment, Incheon, Republic of Korea
| | - Da-An Huh
- Department of Health Science, Graduate School at Korea University, Seoul, Republic of Korea
| | - Kyong Whan Moon
- BK21 FOUR R&E Center for Learning Health System & Department of Health and Environmental Science, Korea University, Seoul, Republic of Korea
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40
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Ho WC, Lin YS, Caffrey JL, Faramawi MF. Evaluation of lead body burden in US adolescents. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2020; 77:219-226. [PMID: 33357119 DOI: 10.1080/19338244.2020.1864257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The objective was to examine key determinants in the body burden of lead in adolescents as lead poisoning remains a major public health challenge. Data from 2,925 teenagers aged 12-18 older in the National Health and Nutrition Examination Survey (NHANES), 1999-2012 were analyzed. Lead in both blood and urine was significantly correlated among individuals. Despite higher blood lead in males, urinary lead measures corrected for dilution were similar between male and female adolescents. Thus, the urine-to-blood ratio was approximately 30% lower in male than female adolescents, suggesting that differences in renal disposal contributed to the greater body burden for young males. Differences in urinary lead disposal appear to be a key determinant in lead accumulation and thus, the degree of lead poisoning. Direct renal studies should be conducted to determine mechanisms and potential solutions.
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Affiliation(s)
- Wen-Chao Ho
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
- Department of Nursing and Graduate Institute of Nursing, Asia University, Taichung, Taiwan
| | - Yu-Sheng Lin
- University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - James L Caffrey
- University of North Texas Health Science Center, Fort Worth, Texas, USA
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Deubler EL, Gapstur SM, Diver WR, Gaudet MM, Hodge JM, Stevens VL, McCullough ML, Haines LG, Levine KE, Teras LR. Erythrocyte levels of cadmium and lead and risk of B-cell non-Hodgkin lymphoma and multiple myeloma. Int J Cancer 2020; 147:3110-3118. [PMID: 32506449 DOI: 10.1002/ijc.33136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 04/28/2020] [Accepted: 05/26/2020] [Indexed: 12/20/2022]
Abstract
Cadmium and lead are persistent environmental toxins that are known or probable carcinogens, based on evidence for causality for nonhematologic cancers. Associations of these metals with risk of non-Hodgkin lymphoma (NHL) and multiple myeloma (MM) are unknown but biologically plausible. To examine the associations of circulating levels of lead and cadmium exposure with risk of B-cell NHL (B-NHL) and multiple myeloma, we conducted a nested case-control study among 299 incident B-cell NHLs and 76 MM cases within the Cancer Prevention Study-II Nutrition Cohort (CPS-II NC). Each case was incidence-density matched to two eligible controls on age, race, sex and blood draw date. Conditional logistic regression was used to estimate relative risks (RR) and 95% confidence intervals (CI) for lymphoid malignancies overall and stratified by subtype. We observed a significant positive association between high erythrocyte lead concentration and risk of lymphoid malignancies overall (RR = 1.16, 95% CI: 1.02-1.33 per 17.6 μg/L (1 standard deviation [SD])) and follicular lymphoma in particular (RR = 1.80, 95% CI: 1.15-2.80 per SD). In contrast, there was no association between erythrocyte cadmium and risk of B-NHL (RR = 0.89, 95% CI: 0.75-1.06 per 0.37 μg/L [1 SD]), or any B-NHL subtypes; but a strong inverse association with MM risk (RR = 0.59, 95% CI: 0.38-0.89, per SD). Results from our study suggest a positive association between erythrocyte lead level and risk of lymphoid malignancies and a possible inverse association between cadmium and myeloma. Additional research is needed to confirm and further explore these findings.
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Affiliation(s)
- Emily L Deubler
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, Georgia, USA
| | - Susan M Gapstur
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, Georgia, USA
| | - W Ryan Diver
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, Georgia, USA
| | - Mia M Gaudet
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, Georgia, USA
| | - James M Hodge
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, Georgia, USA
| | - Victoria L Stevens
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, Georgia, USA
| | - Marjorie L McCullough
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, Georgia, USA
| | | | | | - Lauren R Teras
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, Georgia, USA
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42
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Shen X, Min X, Zhang S, Song C, Xiong K. Effect of Heavy Metal Contamination in the Environment on Antioxidant Function in Wumeng Semi-fine Wool Sheep in Southwest China. Biol Trace Elem Res 2020; 198:505-514. [PMID: 32076954 DOI: 10.1007/s12011-020-02081-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 02/11/2020] [Indexed: 12/13/2022]
Abstract
Many environmental accidents have led to worldwide heavy metal pollution, raising concern about heavy metal toxicity in Southwest China. To study the effects of Cd and Pb in the environment on antioxidant function in Wumeng semi-fine wool sheep, contents of Cu, Zn, Mn, Mo, Fe, Se, Cd, and Pb were measured in irrigation water, soil, herbage, and animal tissues. Hematological and biochemical parameters were also determined. The concentrations of Cu, Zn, Cd, and Pb in affected samples of irrigation water, soil, herbage, and tissues were significantly higher than those in the control (P < 0.01). There was no significant difference in other element contents between affected pastures and control areas. The occurrence of anemia affected Wumeng semi-fine wool sheep. The activities of SOD, CAT, and GSH-Px in affected animals were significantly decreased than those in the control (P < 0.01). Content of MDA in serum in affected animals was significantly increased than that in control (P < 0.01). Serum T-AOC in affected animal was significantly lower than that in control (P < 0.01). Consequently, it is suggested that heavy metal contamination in natural habitat caused serious harm to antioxidant function in Wumeng semi-fine wool sheep.
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Affiliation(s)
- Xiaoyun Shen
- School of Life Science and Engineering, Southwest University of Science and Technology, Mianyang, 621010, China
- School of Karst Science, Guizhou Normal University/State Engineering Technology Institute for Karst Desertification Control, Guiyang, 550001, China
- World Bank Poverty Alleviation Project Office in Guizhou, Southwest China, Guiyang, 550004, China
| | - Xiaoying Min
- School of Karst Science, Guizhou Normal University/State Engineering Technology Institute for Karst Desertification Control, Guiyang, 550001, China
| | - Shihao Zhang
- School of Karst Science, Guizhou Normal University/State Engineering Technology Institute for Karst Desertification Control, Guiyang, 550001, China
| | - Chunjie Song
- School of Life Science and Engineering, Southwest University of Science and Technology, Mianyang, 621010, China
| | - Kangning Xiong
- School of Karst Science, Guizhou Normal University/State Engineering Technology Institute for Karst Desertification Control, Guiyang, 550001, China.
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Wang T, Tu Y, Wang K, Gong S, Zhang G, Zhang Y, Meng Y, Wang T, Li A, Cui J, Liu H, Tang W, Xi J, Cao Y, Luan Y, Christiani DC, Au W, Xia ZL. Associations of blood lead levels with multiple genotoxic biomarkers among workers in China: A population-based study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 273:116181. [PMID: 33508628 DOI: 10.1016/j.envpol.2020.116181] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 11/16/2020] [Accepted: 11/27/2020] [Indexed: 06/12/2023]
Abstract
Carcinogenic effects from low doses of lead (Pb) exposure to populations have been suspected but not concluded. Therefore, a large-scale cross-sectional study was conducted by us to investigate genotoxic effects from Pb exposure during 2016-2018 in North China. Blood lead levels (BLLs) and cumulative blood lead levels (CBLLs) were measured. Multiple relevant biomarkers were used to assess genotoxicity of Pb: mitochondrial DNA copy number (mtDNAcn, n = 871), Comet Tail Intensity (n = 872), γ-H2AX (n = 345), relative telomere length (rTL, n = 757), micronuclei (MN, n = 934) and phosphatidylinositol glycan class A mutation (PIG-A, n = 362). The BLL data show right-skewed distribution, with increase of the median (P25, P75) from 17.4 (8.9, 26.4) μg/dl in 2016 to 18.5 (10.5, 27.2) μg/dl in 2017, and to 20.8 (11.3, 31.0) μg/dl in 2018. Multivariate regression analyses show that mtDNAcn was non-linearly associated with BLLs or CBLLs, i.e. decreased at low levels but increased at the higher levels. Comet and Micronuclei data show positive dose-response relationships with BLLs as well as CBLLs. γ-H2AX data show an overall increased trend with BLLs while rTL data show a shortening trend. No associations were found for PIG-A mutation with Pb exposure. Our findings indicate that current low dose exposure to Pb can still cause health hazards to occupational populations, and the mechanism may be via the induction of DNA & chromosome damage rather than via the mutagenesis pathway.
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Affiliation(s)
- Tuanwei Wang
- Department of Occupational Health & Toxicology, School of Public Health, Shanghai Medical College of Fudan University, 130 Dongan Road, Shanghai 200032, China
| | - Yuting Tu
- Department of Occupational Health & Toxicology, School of Public Health, Shanghai Medical College of Fudan University, 130 Dongan Road, Shanghai 200032, China
| | - Kan Wang
- Department of Occupational Health & Toxicology, School of Public Health, Shanghai Medical College of Fudan University, 130 Dongan Road, Shanghai 200032, China
| | - Shiyang Gong
- Department of Occupational Health & Toxicology, School of Public Health, Shanghai Medical College of Fudan University, 130 Dongan Road, Shanghai 200032, China
| | - Guanghui Zhang
- Department of Occupational & Environmental Health, School of Public Health, Xinxiang Medical University, 601 Jinsui Road, Xinxiang 453003, Henan Province, China
| | - Yunxia Zhang
- Department of Occupational Health & Toxicology, School of Public Health, Shanghai Medical College of Fudan University, 130 Dongan Road, Shanghai 200032, China
| | - Yu Meng
- Department of Occupational Health & Toxicology, School of Public Health, Shanghai Medical College of Fudan University, 130 Dongan Road, Shanghai 200032, China
| | - Tongshuai Wang
- Department of Occupational Health & Toxicology, School of Public Health, Shanghai Medical College of Fudan University, 130 Dongan Road, Shanghai 200032, China
| | - Anqi Li
- Department of Occupational Health & Toxicology, School of Public Health, Shanghai Medical College of Fudan University, 130 Dongan Road, Shanghai 200032, China
| | - Junpeng Cui
- Department of Occupational & Environmental Health, School of Public Health, Xinxiang Medical University, 601 Jinsui Road, Xinxiang 453003, Henan Province, China
| | - Huan Liu
- Department of Occupational & Environmental Health, School of Public Health, Xinxiang Medical University, 601 Jinsui Road, Xinxiang 453003, Henan Province, China
| | - Weifeng Tang
- School of Public Health, Hongqiao International Institute of Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Jing Xi
- School of Public Health, Hongqiao International Institute of Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Yiyi Cao
- School of Public Health, Hongqiao International Institute of Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Yang Luan
- School of Public Health, Hongqiao International Institute of Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - David C Christiani
- Environmental Medicine and Epidemiology Program, Department of Environmental Health, Harvard University TH Chan School of Public Health, Boston, MA, USA
| | - William Au
- George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania, And University of Texas Medical Branch, Galveston, TX, USA
| | - Zhao-Lin Xia
- Department of Occupational Health & Toxicology, School of Public Health, Shanghai Medical College of Fudan University, 130 Dongan Road, Shanghai 200032, China.
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Cadmium and Lead Exposure, Nephrotoxicity, and Mortality. TOXICS 2020; 8:toxics8040086. [PMID: 33066165 PMCID: PMC7711868 DOI: 10.3390/toxics8040086] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/07/2020] [Accepted: 10/11/2020] [Indexed: 12/11/2022]
Abstract
The present review aims to provide an update on health risks associated with the low-to-moderate levels of environmental cadmium (Cd) and lead (Pb) to which most populations are exposed. Epidemiological studies examining the adverse effects of coexposure to Cd and Pb have shown that Pb may enhance the nephrotoxicity of Cd and vice versa. Herein, the existing tolerable intake levels of Cd and Pb are discussed together with the conventional urinary Cd threshold limit of 5.24 μg/g creatinine. Dietary sources of Cd and Pb and the intake levels reported for average consumers in the U.S., Spain, Korea, Germany and China are summarized. The utility of urine, whole blood, plasma/serum, and erythrocytes to quantify exposure levels of Cd and Pb are discussed. Epidemiological studies that linked one of these measurements to risks of chronic kidney disease (CKD) and mortality from common ailments are reviewed. A Cd intake level of 23.2 μg/day, which is less than half the safe intake stated by the guidelines, may increase the risk of CKD by 73%, and urinary Cd levels one-tenth of the threshold limit, defined by excessive ß2-microglobulin excretion, were associated with increased risk of CKD, mortality from heart disease, cancer of any site and Alzheimer's disease. These findings indicate that the current tolerable intake of Cd and the conventional urinary Cd threshold limit do not provide adequate health protection. Any excessive Cd excretion is probably indicative of tubular injury. In light of the evolving realization of the interaction between Cd and Pb, actions to minimize environmental exposure to these toxic metals are imperative.
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Nonlinear association between blood lead and hyperhomocysteinemia among adults in the United States. Sci Rep 2020; 10:17166. [PMID: 33051568 PMCID: PMC7553908 DOI: 10.1038/s41598-020-74268-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 09/15/2020] [Indexed: 01/15/2023] Open
Abstract
Evidence regarding the association between blood lead levels (BLL) and hyperhomocysteinemia (HHcy) in US adults was limited. We aimed to investigate the association of BLL with the risk of HHcy, and to examine possible effect modifiers using US National Health and Nutrition Examination Survey (NHANES) database. We performed a cross-sectional study using data from up to 9,331 participants aged ≥ 20 years of NHANES from 2001 to 2006. BLL was measured by atomic absorption spectrometry. HHcy was defined as plasma homocysteine level > 15 µmol/L. The weighted prevalence of HHcy was 6.87%. The overall mean BLL was 1.9 μg/dL. Overall, there was a nonlinear positive association between Ln-transformed BLL (LnBLL) and the risk of HHcy. The Odds ratios (95% CI) for participants in the second (0.04–0.49 μg/dL), third (0.5–0.95 μg/dL) and fourth quartiles (> 0.95 μg/dL) were 1.12 (95% CI: 0.71, 1.76), 1.13 (95% CI: 0.73, 1.77), and 1.67 (95% CI: 1.07, 2.61), respectively, compared with those in quartile 1. Consistently, a significantly higher risk of HHcy (OR: 1.49; 95% CI: 1.19, 1.88) was found in participants in quartile 4 compared with those in quartiles 1–3. Furthermore, a strongly positive association between LnBLL and HHcy was observed in participants with estimated glomerular filtration rate (eGFR) < 60 mL/min−1/1.73 m−2. Our results suggested that a higher level of BLL (LnBLL > 0.95 μg/dL) was associated with increased risk of HHcy compared with a lower level of BLL (LnBLL ≤ 0.95 μg/dL) among U.S. adults, and the association was modified by the eGFR.
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Brown L, Lynch M, Belova A, Klein R, Chiger A. Developing a Health Impact Model for Adult Lead Exposure and Cardiovascular Disease Mortality. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:97005. [PMID: 32965128 PMCID: PMC7510336 DOI: 10.1289/ehp6552] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 08/27/2020] [Accepted: 08/28/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Lead (Pb) is a highly toxic pollutant. Evidence suggests it is associated with cardiovascular disease (CVD)-related mortality. OBJECTIVES We present a rigorous approach for identifying concentration-response functions that relate adult Pb exposures to CVD mortality to inform a health impact model (HIM). We then use the model in a proof-of-concept example. METHODS Building on previously conducted government literature reviews and a de novo supplemental literature review, we compiled and evaluated the available data on Pb and CVD mortality in humans. We applied a set of predefined selection criteria to identify studies that would be most useful in understanding the impact of Pb exposure on CVD mortality risk in adults. Once we identified the studies, we derived a HIM and used each study's concentration-response function in a proof-of-concept example. RESULTS Our literature search identified 15 studies for full-text review. Of those 15 studies, 4 fit our criteria for use in the HIM. Using population and CVD mortality rates for 40- to 80-y-olds in 2014, we estimated that 34,000-99,000 deaths have been avoided due to the lowering of blood Pb levels from 1999 to 2014. Based on these values we estimated that approximately 16%-46% of the decreased CVD-related death rate from 1999 to 2014 may be attributable to decreased blood Pb levels. CONCLUSION Our results demonstrate that decreases in Pb exposure can result in large benefits for the adult population. We have provided a HIM that can be used in a variety of applications from burden-of-disease estimates to regulatory impact assessments and have demonstrated its sensitivity to the choice of concentration-response function. https://doi.org/10.1289/EHP6552.
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Affiliation(s)
- Lauren Brown
- Division of Health and Environment, Abt Associates Inc., Rockville, Maryland, USA
| | - Meghan Lynch
- Division of Health and Environment, Abt Associates Inc., Rockville, Maryland, USA
| | - Anna Belova
- Abt Associates Inc., Rockville, Maryland, USA
| | - Ryan Klein
- Division of Health and Environment, Abt Associates Inc., Rockville, Maryland, USA
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Dressler VL, Ogunmodede OT, Heidrich GM, Neves VM, Schetinger MRC, Morsch VM. Investigative Analysis of Lanthanum Oxide Nanoparticles on Elements in Bone of Wistar Rats After 30 Days of Repeated Oral Administration. Biol Trace Elem Res 2020; 196:153-167. [PMID: 31656980 DOI: 10.1007/s12011-019-01907-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 09/16/2019] [Indexed: 12/28/2022]
Abstract
Accumulation of lanthanum oxide nanoparticles (La2O3NPs) in the femur bone of rats after 30 days of oral administration was explored. Also, the influence of La2O3NPs on macro and trace elements in the rats' femur bone was assessed. Inductively coupled plasma mass spectrometry (ICP-MS) and inductively coupled plasma optical spectrometry (ICP OES) were used for total element determination in the bone after decomposition while laser ablation-ICP-MS (LA-ICP-MS) was used to investigate element distribution (bio-imaging) in the bone. Some differences in element concentrations in the bone between the rats treated with La2O3NPs at 1.0 mg kg-1 (T1), 10.0 mg kg-1 (T2), and 100 mg kg-1 (T3) body weight (bw) and the control rats (CTR) were observed. More differences were observed in the bone of rat treated with 10.0 mg kg-1 La2O3NPs bw. However, the highest change observed was for Mg, which concentration ranged from 5230 ± 12 μg kg-1 for the CTR group to 4130 ± 138 μg kg-1 for the T3 group. Minor changes were observed for Ba, Ca, Cr, Cu, Fe, Mg, Na, Pb, Sr, and Zn between CTR and animals treated with La2O3NPs at the different levels of concentration. It was possible to observe from LA-ICP-MS analysis that La2O3NPs were accumulated only on the surface of the bone, not deeper than about 5 μm. LA-ICP-MS allowed also to investigate the distribution of La and the other elements in a cross section of the femur bone head, where higher amounts of the elements are present at the external part of the bone. Therefore, it was demonstrated that La2O3NPs are incorporated on the surface of the bone and it has a small influence on some of the other elements evaluated.
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Affiliation(s)
- Valderi Luiz Dressler
- Departamento de Química, Universidade Federal de Santa Maria, Santa Maria, RS, 97105-900, Brazil.
| | | | - Graciela Marine Heidrich
- Departamento de Química, Universidade Federal de Santa Maria, Santa Maria, RS, 97105-900, Brazil
| | - Vinicius Machado Neves
- Departamento de Química, Universidade Federal de Santa Maria, Santa Maria, RS, 97105-900, Brazil
| | | | - Vera Maria Morsch
- Departamento de Bioquímica e Biologia Molecular, Universidade Federal de Santa Maria, Santa Maria, RS, 97105-900, Brazil
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Cao Y, Wang T, Xi J, Zhang G, Wang T, Liu W, You X, Zhang X, Xia Z, Luan Y. PIG-A gene mutation as a genotoxicity biomarker in human population studies: An investigation in lead-exposed workers. ENVIRONMENTAL AND MOLECULAR MUTAGENESIS 2020; 61:611-621. [PMID: 32285465 DOI: 10.1002/em.22373] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 03/23/2020] [Accepted: 04/03/2020] [Indexed: 05/21/2023]
Abstract
The rodent Pig-a gene mutation assay has demonstrated remarkable sensitivity in identifying in vivo mutagens, while much less is known about the value of the human PIG-A assay for risk assessment. To obtain more evidence of its potential as a predictive biomarker for carcinogen exposure, we investigated PIG-A mutant frequencies (MFs), along with performing the Comet assay and micronucleus (MN) test, in 267 workers occupationally exposed to lead. Multivariate Poisson regression showed that total red blood cell PIG-A MFs were significantly higher in lead-exposed workers (10.90 ± 10.7 × 10-6 ) than in a general population that we studied previously (5.25 ± 3.6 × 10-6 ) (p < .0001). In contrast, there was no increase in lymphocyte MN frequency or in DNA damage as measured by percentage comet tail intensity in whole blood cells. Current year worker blood lead levels (BLL), an exposure biomarker, were elevated (232.6 ± 104.6 μg/L, median: 225.4 μg/L); a cumulative blood lead index (CBLI) also was calculated based on a combination of current and historical worker BLL data. Chi-square testing indicated that PIG-A MFs were significantly related to CBLI (p = .0249), but independent of current year BLL (p = .4276). However, % comet tail intensity and MN frequencies were better associated with current year BLL than CBLI. This study indicates that the PIG-A assay could serve as biomarker to detect the genotoxic effects of lead exposure and demonstrates that a battery of genotoxicity biomarkers having mechanistic complementarity may be useful for comprehensively monitoring human carcinogenic risk.
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Affiliation(s)
- Yiyi Cao
- School of Public Health, Hongqiao International Institute of Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tuanwei Wang
- Department of Occupational Health & Toxicology, School of Public Health, Shanghai Medical College of Fudan University, Shanghai, China
| | - Jing Xi
- School of Public Health, Hongqiao International Institute of Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guanghui Zhang
- Department of Occupational & Environmental Health, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, China
| | - Tongshuai Wang
- Department of Occupational Health & Toxicology, School of Public Health, Shanghai Medical College of Fudan University, Shanghai, China
| | - Weiying Liu
- School of Public Health, Hongqiao International Institute of Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinyue You
- School of Public Health, Hongqiao International Institute of Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - XinYu Zhang
- School of Public Health, Hongqiao International Institute of Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhaolin Xia
- Department of Occupational Health & Toxicology, School of Public Health, Shanghai Medical College of Fudan University, Shanghai, China
| | - Yang Luan
- School of Public Health, Hongqiao International Institute of Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Shen X, Xia L, Liu L, Jiang H, Shannahan J, Du Y, Zheng W. Altered clearance of beta-amyloid from the cerebrospinal fluid following subchronic lead exposure in rats: Roles of RAGE and LRP1 in the choroid plexus. J Trace Elem Med Biol 2020; 61:126520. [PMID: 32325398 PMCID: PMC7541561 DOI: 10.1016/j.jtemb.2020.126520] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 03/26/2020] [Accepted: 03/31/2020] [Indexed: 02/07/2023]
Abstract
Formation of amyloid plaques is the hallmark of Alzheimer's disease. Our early studies show that lead (Pb) exposure in PDAPP transgenic mice increases β-amyloid (Aβ) levels in the cerebrospinal fluid (CSF) and hippocampus, leading to the formation of amyloid plaques in mouse brain. Aβ in the CSF is regulated by the blood-CSF barrier (BCB) in the choroid plexus. However, the questions as to whether and how Pb exposure affected the influx and efflux of Aβ in BCB remained unknown. This study was conducted to investigate whether Pb exposure altered the Aβ efflux in the choroid plexus from the CSF to blood, and how Pb may affect the expression and subcellular translocation of two major Aβ transporters, i.e., the receptor for advanced glycation end-products (RAGE) and the low density lipoprotein receptor protein-1 (LRP1) in the choroid plexus. Sprague-Dawley rats received daily oral gavage at doses of 0, 14 (low-dose), and 27 (high-dose) mg Pb/kg as Pb acetate, 5 d/wk, for 4 or 8 wks. At the end of Pb exposure, a solution containing Aβ40 (2.5 μg/mL) was infused to rat brain via a cannulated internal carotid artery. Subchronic Pb exposure at both dose levels significantly increased Aβ levels in the CSF and choroid plexus (p < 0.05) by ELISA. Confocal data showed that 4-wk Pb exposures prompted subcellular translocation of RAGE from the choroidal cytoplasm toward apical microvilli. Furthermore, it increased the RAGE expression in the choroid plexus by 34.1 % and 25.1 % over the controls (p < 0.05) in the low- and high- dose groups, respectfully. Subchronic Pb exposure did not significantly affect the expression of LRP1; yet the high-dose group showed LRP1 concentrated along the basal lamina. The data from the ventriculo-cisternal perfusion revealed a significantly decreased efflux of Aβ40 from the CSF to blood via the blood-CSF barrier. Incubation of freshly dissected plexus tissues with Pb in artificial CSF supported a Pb effect on increased RAGE expression. Taken together, these data suggest that Pb accumulation in the choroid plexus after subchronic exposure reduces the clearance of Aβ from the CSF to blood by the choroid plexus, which, in turn, leads to an increase of Aβ in the CSF. Interaction of Pb with RAGE and LRP1 in choroidal epithelial cells may contribute to the altered Aβ transport by the blood-CSF barrier in brain ventricles.
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Affiliation(s)
- Xiaoli Shen
- School of Health Sciences, Purdue University, West Lafayette, IN, USA; School of Public Health, Qingdao University, Qingdao, China.
| | - Li Xia
- School of Health Sciences, Purdue University, West Lafayette, IN, USA.
| | - Luqing Liu
- School of Health Sciences, Purdue University, West Lafayette, IN, USA
| | - Hong Jiang
- Departments of Physiology, Qingdao University Medical College, Qingdao, China.
| | | | - Yansheng Du
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Wei Zheng
- School of Health Sciences, Purdue University, West Lafayette, IN, USA.
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50
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Fan Y, Sheng J, Liang C, Yang L, Liu K, Wang Q, Zhang D, Ma Y, Li X, Xie S, Cao H, Wang S, Tao F. Association of Blood Lead Levels with the Risk of Depressive Symptoms in the Elderly Chinese Population: Baseline Data of a Cohort Study. Biol Trace Elem Res 2020; 194:76-83. [PMID: 31147977 DOI: 10.1007/s12011-019-01755-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 05/15/2019] [Indexed: 01/25/2023]
Abstract
Previous studies have reported an association between blood lead (BPb) levels and depressive symptoms in adults. However, the relationship between BPb levels and depression remains unclear in the old population. Our purpose was to investigate the association of BPb levels with depression among the old population. Data were gathered from 994 elderly persons in the Cohort Study of Elderly Health and Environmental Controllable Factors, which was created in Anhui, China. BPb was measured by inductively coupled plasma mass spectrometry. Our subjects were divided into four groups according to BPb quartiles. Multivariate logistic regressions were used to assess the association between BPb levels and depression. The median (25th-75th) BPb level was 26.94 μg/L (20.34 μg/L-36.13 μg/L). BPb levels in participants with depression were higher than those in participants without depression. The prevalence of depression was 27.64%. After multivariate adjustment for confounding factors, participants with BPb level in the highest quartile had 2.03 times higher risk of depression compared with those in the lowest quartile. In rural areas, the risk of depression in higher BPb quartile was higher than that in the lowest quartile. These findings suggest that higher BPb level was associated with increased odds of depression in the old population. This association was obvious among older people living in rural areas.
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Affiliation(s)
- Yong Fan
- School of Public Health, Anhui Medical University, Hefei, People's Republic of China
| | - Jie Sheng
- School of Public Health, Anhui Medical University, Hefei, People's Republic of China
| | - Chunmei Liang
- School of Public Health, Anhui Medical University, Hefei, People's Republic of China
| | - Linsheng Yang
- School of Public Health, Anhui Medical University, Hefei, People's Republic of China
| | - Kaiyong Liu
- School of Public Health, Anhui Medical University, Hefei, People's Republic of China
| | - Qunan Wang
- School of Public Health, Anhui Medical University, Hefei, People's Republic of China
| | - Dongmei Zhang
- School of Health Management, Anhui Medical University, Hefei, People's Republic of China
| | - Ying Ma
- School of Health Management, Anhui Medical University, Hefei, People's Republic of China
| | - Xiude Li
- Lu'an Center of Disease Control and Prevention, Lu'an, People's Republic of China
| | - Shaoyu Xie
- Lu'an Center of Disease Control and Prevention, Lu'an, People's Republic of China
| | - Hongjuan Cao
- Lu'an Center of Disease Control and Prevention, Lu'an, People's Republic of China
| | - Sufang Wang
- School of Public Health, Anhui Medical University, Hefei, People's Republic of China.
| | - Fangbiao Tao
- School of Public Health, Anhui Medical University, Hefei, People's Republic of China.
- School of Health Management, Anhui Medical University, Hefei, People's Republic of China.
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