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Khalid M, Abdollahi M. Role of lead in dental diseases. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART C, TOXICOLOGY AND CARCINOGENESIS 2020; 38:329-361. [PMID: 33382012 DOI: 10.1080/26896583.2020.1834313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Lead (Pb) is ubiquitous in our environment and causes many pathophysiological health effects, including dental diseases. Dental Pb levels are considered good biological indicators of environmental and occupational Pb exposure. Pb in blood and saliva causes imbalances in the growth of oral microflora. The pH of saliva decreases, interferes with and interacts with bone-seeking elements, changes oral inflammatory parameters, generates reactive oxygen species, causes oxidative damage, and delays the mineralization process, leading to dental diseases. Pb's dental diseases include periodontitis, enamel lesions and defects, fluorosis, Burton's line, and tooth loss. Environmental and physiological factors, including age, gender, tooth type and position, pregnancy and lactation, eating and drinking habits, smoking habits, and exposures from Pb-contaminated residential and occupational areas, affect the distribution of Pb in blood, bone, and saliva, which contributes to dental diseases. However, living and working in Pb free areas can prevent environmental and occupational Pb exposure. Healthy lifestyles and eating habits, prohibiting smoking and alcohol drinking, further help prevent Pb exposure. Also, the fluoridation of water, salt, and milk provide nutritional supplements of trace elements, which can help prevent teeth from absorbing Pb from the environment, thereby reducing the risk of dental diseases.
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Affiliation(s)
- Madiha Khalid
- Toxicology and Diseases Group, Pharmaceutical Sciences Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS) and Department of Toxicology and Pharmacology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Abdollahi
- Toxicology and Diseases Group, Pharmaceutical Sciences Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS) and Department of Toxicology and Pharmacology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
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Olympio KPK, Silva JPDR, Silva ASD, Souza VCDO, Buzalaf MAR, Barbosa F, Cardoso MRA. Blood lead and cadmium levels in preschool children and associated risk factors in São Paulo, Brazil. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 240:831-838. [PMID: 29783200 DOI: 10.1016/j.envpol.2018.04.124] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 04/24/2018] [Accepted: 04/25/2018] [Indexed: 06/08/2023]
Abstract
In Brazil, there are scarce data on lead (Pb) and cadmium (Cd) contamination, especially for more vulnerable populations such as preschool children. In this paper, we answer two questions: (1) What are the exposure levels of lead and cadmium in preschool children, in Sao Paulo, Brazil? and (2) What are the risk factors associated with this exposure? This cross-sectional study included 50 day care centers (DCCs), totaling 2463 children aged 1-4 years. Venous blood samples were analyzed by ICP-MS. Questionnaires were administered to the parents. Multiple logistic regression models were used to identify associations between blood lead levels (BLLs) and blood cadmium levels (BCLs) and potential risk factors. The geometric mean for BLLs was 2.16 μg/dL (95% CI: 2.10-2.22 μg/dL), and the 97.5th percentile was 13.9 μg/dL (95% CI: 10.0-17.3 μg/dL). For cadmium exposure, the geometric mean for BCLs was 0.48 μg/L (95% CI: 0.47-0.50 μg/L), and the 95th percentile was 2.57 μg/L (95% CI: 2.26-2.75 μg/L). The DCCs' geographic region was associated with high BLLs and BCLs, indicating hot spots for lead and cadmium exposures. In addition, it was found that the higher the vehicles flow, the higher were the BLLs in children. Red lead in household gates was also an important risk factor for lead exposure. Comparing these results with the findings of the Fourth National Report on Human Exposure to Environmental Chemicals by CDC-2013, it was found that in Brazilian preschool children the BLLs are almost three times higher (97.5th percentile) and the BCLs are almost twelve times higher (95th percentile) than those in U.S. children. This information is essential to formulate public health policies.
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Affiliation(s)
| | | | - Agnes Soares da Silva
- Communicable Diseases and Environmental Determinants of Health (CDE), Pan American Health Organization, PAHO/WHO, Washington, DC, USA
| | - Vanessa Cristina de Oliveira Souza
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Marília Afonso Rabelo Buzalaf
- Departamento de Ciências Biológicas, Faculdade de Odontologia de Bauru, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Fernando Barbosa
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Maria Regina Alves Cardoso
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil
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da Rocha Silva JP, Salles FJ, Leroux IN, da Silva Ferreira APS, da Silva AS, Assunção NA, Nardocci AC, Sayuri Sato AP, Barbosa F, Cardoso MRA, Olympio KPK. High blood lead levels are associated with lead concentrations in households and day care centers attended by Brazilian preschool children. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 239:681-688. [PMID: 29715687 DOI: 10.1016/j.envpol.2018.04.080] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 02/26/2018] [Accepted: 04/18/2018] [Indexed: 05/07/2023]
Abstract
BACKGROUND A previous study observed high blood lead levels (BLL) in preschool children attending 50 day care centers (DCC) in São Paulo, Brazil. OBJECTIVE To identify whether lead levels found in both homes and DCC environments are associated with high blood lead levels. METHODS Children attending 4 DCCs, quoted here as NR, VA, PS and PF, were divided into two groups according to BLL: high exposure (HE: ≥13.9 μg/dL; 97.5 percentile of the 2013 year sample) and low exposure (LE: <5 μg/dL). For in situ lead measurements (lead paint mode: mg/cm2 and ROHS mode: μg/g) in the children's households and in the DCC environments, a field portable X-ray-fluorescence analyzer was used. Multiple logistic regressions were performed to control for confounding factors. Odds ratios were adjusted for age, sex, day care center's measured lead, and tobacco. RESULTS In an NR DCC building, 33.8% of the measurements had lead levels >600 μg/g, whereas such levels were observed in 77.1% of NR playground measurements. In VA DCC, 22% and 23% of the measurements in the building and in the playgrounds had levels higher than 600 μg/g, respectively. The percentage of high lead levels in the children's houses of the LE group was 5.9% (95% CI: 4.3-7.6%) and 13.2 (95% CI: 8.3-18.0%) in the HE group. Moreover, a significant association was found between high BLLs and lead levels found both in households and DCCs (p < 0.001). Most of the high lead measurements were found in tiles and playground equipment. CONCLUSIONS Lead exposure estimated from the DCCs, where children spend about 10 h/day, can be as relevant as their household exposure. Therefore, public authorities should render efforts to provide a rigorous surveillance for lead-free painting supplies and for all objects offered to children.
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Affiliation(s)
- Júlia Prestes da Rocha Silva
- Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, CEP 01246-904, São Paulo, SP, Brazil.
| | - Fernanda Junqueira Salles
- Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, CEP 01246-904, São Paulo, SP, Brazil.
| | - Isabelle Nogueira Leroux
- Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, CEP 01246-904, São Paulo, SP, Brazil.
| | - Ana Paula Sacone da Silva Ferreira
- Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, CEP 01246-904, São Paulo, SP, Brazil.
| | - Agnes Soares da Silva
- Sustainable Development and Health Equity, Pan American Health Organization, Washington, DC, United States
| | - Nilson Antonio Assunção
- Departamento de Química, Instituto de Ciências Ambientais, Químicas e Farmacêuticas. Universidade Federal de São Paulo, Diadema, SP, Brazil.
| | - Adelaide Cassia Nardocci
- Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, CEP 01246-904, São Paulo, SP, Brazil.
| | - Ana Paula Sayuri Sato
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil.
| | - Fernando Barbosa
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, São Paulo, SP, Brazil.
| | - Maria Regina Alves Cardoso
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil.
| | - Kelly Polido Kaneshiro Olympio
- Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, CEP 01246-904, São Paulo, SP, Brazil.
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Olympio KPK, Huila MFG, de Almeida Baldini Cardoso C, da Silva Ferreira APS, Ortiz AG, Toma HE, da Silva RHA, Luz MS, Cardoso MRA, Kelmer GAR, de Oliveira PV, Bechara EJH, Günther WMR, Buzalaf MAR. Can in vivo surface dental enamelmicrobiopsies be used to measure remote lead exposure? ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:9322-9329. [PMID: 29264857 DOI: 10.1007/s11356-017-0988-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 12/10/2017] [Indexed: 06/07/2023]
Abstract
Measuring lead in the surface dental enamel (SDE) using biopsies is a rapid, safe, and painless procedure. The dental enamel lead levels (DELLs) decrease from the outermost superficial layer to the inner layer of dental enamel, which becomes crucial for the biopsy depth (BD) measurement. However, whether the origin of lead found in SDE is fully endogenous is not yet established. There is also controversy about the biopsy protocol. The aims of this study were to investigate if DELLs are altered by extrinsic contamination (A) and to evaluate the real geometric figure formed by the erosion provoked by biopsy procedure and the respective BD in SDE (B). To accomplish the aim A, lead from 90 bovine incisor crowns lead was determined by graphite furnace atomic absorption spectrometer as a function of exposure time and lead concentration. Two biopsies were performed in each tooth, before and after lead exposure. Six 15-tooth groups differed by exposure time (1 or 30 min) and lead concentrations (A. 0 mg/L-placebo, B. 0.01 mg/L-standard for drinking water, or C. 0.06 mg/L-concentration found in contaminated groundwater). Phosphorus was determined by an inductively coupled plasm optical emission spectrometer to quantify the enamel removed. To compare intakes/losses of lead in SDE among the groups, values of DELL differences between before and after lead exposure were compared by ANOVA (p < 0.05). To attain the objective B, one extracted human permanent tooth was studied by confocal Raman microscopy. Lead measurements and the surface profile were determined. There was no difference in DELL among the groups (p = 0.964). The biopsy bottom surface area, analyzed by microscopy, showed an irregular area, with regions of peaks and valleys, where areas with depth ranging from 0.2 (peaks) to 1.8 μm (valleys) (± 0.1 μm) could be found. BD carried out in vivo is commonly calculated using the cylinder height formula. The real BD was shown to be very similar to already published data. In conclusion, the SDE of erupted teeth does not seem to be susceptible to environmental lead intake, being thus reliable to measure remote exposures to lead.
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Affiliation(s)
- Kelly Polido Kaneshiro Olympio
- Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, São Paulo, SP, CEP 01246-904, Brazil.
| | - Manuel Fernando Gonzalez Huila
- Departamento de Química Fundamental, Instituto de Química, Universidade de São Paulo, Av. Prof. Lineu Prestes, 748, Cidade Universitária, Butantã, São Paulo, SP, CEP 05508-000, Brazil
| | - Cristiane de Almeida Baldini Cardoso
- Programa de Pós-Graduação em Odontologia, área de concentração Odontopediatria, Universidade Cruzeiro do Sul (UNICSUL), Rua Galvão Bueno, 868, Liberdade, São Paulo, SP, CEP 01506-000, Brazil
| | - Ana Paula Sacone da Silva Ferreira
- Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, São Paulo, SP, CEP 01246-904, Brazil
| | - Adrielly Garcia Ortiz
- Departamento de Estomatologia, Saúde Coletiva e Odontologia Legal, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Av do Café, s/n, Ribeirão Preto, SP, CEP 14040-904, Brazil
| | - Henrique Eisi Toma
- Departamento de Química Fundamental, Instituto de Química, Universidade de São Paulo, Av. Prof. Lineu Prestes, 748, Cidade Universitária, Butantã, São Paulo, SP, CEP 05508-000, Brazil
| | - Ricardo Henrique Alves da Silva
- Departamento de Estomatologia, Saúde Coletiva e Odontologia Legal, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Av do Café, s/n, Ribeirão Preto, SP, CEP 14040-904, Brazil
| | - Maciel Santos Luz
- Centro de Tecnologia em Metalurgia e Materiais, Laboratório de Processos Metalúrgicos (CTMM/LPM), Instituto de Pesquisas Tecnológicas do Estado de São Paulo (IPT), Av. Prof. Almeida Prado, 532, Cidade Universitária, Butantã, São Paulo, SP, CEP 05508-901, Brazil
| | - Maria Regina Alves Cardoso
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, São Paulo, SP, CEP 01246-904, Brazil
| | - Gislayne Aparecida Rodrigues Kelmer
- Departamento de Química Fundamental, Instituto de Química, Universidade de São Paulo, Av. Prof. Lineu Prestes, 748, Cidade Universitária, Butantã, São Paulo, SP, CEP 05508-000, Brazil
| | - Pedro Vitoriano de Oliveira
- Departamento de Química Fundamental, Instituto de Química, Universidade de São Paulo, Av. Prof. Lineu Prestes, 748, Cidade Universitária, Butantã, São Paulo, SP, CEP 05508-000, Brazil
| | - Etelvino José Henriques Bechara
- Departamento de Química Fundamental, Instituto de Química, Universidade de São Paulo, Av. Prof. Lineu Prestes, 748, Cidade Universitária, Butantã, São Paulo, SP, CEP 05508-000, Brazil
| | - Wanda Maria Risso Günther
- Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, São Paulo, SP, CEP 01246-904, Brazil
| | - Marília Afonso Rabelo Buzalaf
- Departamento de Ciências Biológicas, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Alameda Otávio Pinheiro Brisolla, 9-75, Vila Nova Cidade Universitária, Bauru, SP, CEP 17012-901, Brazil
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