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de Melo NC, Sampaio E Souza PC, Marques RC, Bernardi JVE, Bastos WR, Cunha MPL. Environmental exposure to metal(loid)s and hypertensive disorders of pregnancy: A systematic review. ENVIRONMENTAL RESEARCH 2024; 257:119391. [PMID: 38857855 DOI: 10.1016/j.envres.2024.119391] [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: 01/03/2024] [Revised: 05/27/2024] [Accepted: 06/07/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND Environmental exposure to metal(loid)s has been associated with adverse effects on human health, but the systemic repercussion of these elements on the development of hypertensive disorders of pregnancy (HDP) is still poorly understood. OBJECTIVE To summarize evidence published about the influence of environmental exposure to aluminum, arsenic, barium, cadmium, lead, strontium and mercury on the development of HDP. METHODS We conducted a systematic literature review according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The search strategy was validated by the Peer Review of Electronic Search Strategies. We searched for articles published up to February 2023 in seven databases without language restriction. Two researchers conducted the steps for selection, data extraction and evaluation of the methodological quality of the instruments for epidemiological studies of the Joanna Briggs Institute. Any disagreements were resolved by a third researcher. RESULTS We obtained 5076 records, of which 37 articles met the inclusion criteria moderate to high methodological quality. Single exposure to metal(loid)s was predominant, and the leading biological matrix analyzed to detect the concentrations from exposure was maternal blood. Lead was the metal investigated the most, and had the largest number of studies showing positive association with HDP. In relation to the other metal(loid)s, higher levels were found in women with HDP in comparison with healthy women, but the finding of a cause-effect relationship was inconsistent. CONCLUSIONS Although we found evidence of harmful effects of the metal(loid)s studied on human health, the results were inconclusive with regard to HDP. Longitudinal studies that consider prospective investigation, adjustment of confounding factors and the interference of other contaminants in the exacerbation of oxidative stress in women from the preconception phase to the puerperal period should be encouraged.
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Affiliation(s)
- Nayra Carla de Melo
- Postgraduate Program in Regional Development and Environment, Federal University of Rondônia Foundation, Porto Velho, Rondônia, 76801-059, Brazil; WCP Environmental Biogeochemistry Laboratory, Federal University of Rondônia Foundation, Porto Velho, Rondônia, 76815-800, Brazil.
| | - Priscilla Cristovam Sampaio E Souza
- Postgraduate Program in Regional Development and Environment, Federal University of Rondônia Foundation, Porto Velho, Rondônia, 76801-059, Brazil
| | - Rejane Correa Marques
- Postgraduate Program in Environmental Sciences and Conservation, Federal University of Rio de Janeiro Janeiro (UFRJ), Macaé, Rio de Janeiro, 27965-045, Brazil
| | - José Vicente Elias Bernardi
- Geostatistics and Geodesy Laboratory, UnB Planaltina College, University of Brasília, Planaltina, Federal District, 73345-010, Brazil
| | - Wanderley Rodrigues Bastos
- Postgraduate Program in Regional Development and Environment, Federal University of Rondônia Foundation, Porto Velho, Rondônia, 76801-059, Brazil; WCP Environmental Biogeochemistry Laboratory, Federal University of Rondônia Foundation, Porto Velho, Rondônia, 76815-800, Brazil
| | - Mônica Pereira Lima Cunha
- Postgraduate Program in Regional Development and Environment, Federal University of Rondônia Foundation, Porto Velho, Rondônia, 76801-059, Brazil; WCP Environmental Biogeochemistry Laboratory, Federal University of Rondônia Foundation, Porto Velho, Rondônia, 76815-800, Brazil
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Carretero VJ, Liccardi N, Tejedor MA, de Pascual R, Campano JH, Hernández-Guijo JM. Lead exerts a depression of neurotransmitter release through a blockade of voltage dependent calcium channels in chromaffin cells. Toxicology 2024; 505:153809. [PMID: 38648961 DOI: 10.1016/j.tox.2024.153809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 04/08/2024] [Accepted: 04/17/2024] [Indexed: 04/25/2024]
Abstract
The present work, using chromaffin cells of bovine adrenal medullae (BCCs), aims to describe what type of ionic current alterations induced by lead (Pb2+) underlies its effects reported on synaptic transmission. We observed that the acute application of Pb2+ lead to a drastic depression of neurotransmitters release in a concentration-dependent manner when the cells were stimulated with both K+ or acetylcholine, with an IC50 of 119,57 μM and of 5,19 μM, respectively. This effect was fully recovered after washout. Pb2+ also blocked calcium channels of BCCs in a time- and concentration-dependent manner with an IC50 of 6,87 μM. This blockade was partially reversed upon washout. This compound inhibited the calcium current at all test potentials and shows a shift of the I-V curve to more negative values of about 8 mV. The sodium current was not blocked by acute application of high Pb2+ concentrations. Voltage-dependent potassium current was also shortly affected by high Pb2+. Nevertheless, the calcium- and voltage-dependent potassium current was drastically depressed in a dose-dependent manner, with an IC50 of 24,49 μM. This blockade was related to the prevention of Ca2+ influx through voltage-dependent calcium channels coupled to Ca2+-activated K+-channels (BK) instead a direct linking to these channels. Under current-clamp conditions, BCCs exhibit a resting potential of -52.7 mV, firing spontaneous APs (1-2 spikes/s) generated by the opening of Na+ and Ca2+-channels, and terminated by the activation of K+ channels. In spite of the effect on ionic channels exerted by Pb2+, we found that Pb2+ didn't alter cellular excitability, no modification of the membrane potential, and no effect on action potential firing. Taken together, these results point to a neurotoxic action evoked by Pb2+ that is associated with changes in neurotransmitter release by blocking the ionic currents responsible for the calcium influx.
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Affiliation(s)
- Victoria Jiménez Carretero
- Department of Pharmacology and Therapeutic, Facultad de Medicina, Univ. Autónoma de Madrid, Av. Arzobispo Morcillo 4, Madrid 28029, Spain
| | - Ninfa Liccardi
- Department of Pharmacology and Therapeutic, Facultad de Medicina, Univ. Autónoma de Madrid, Av. Arzobispo Morcillo 4, Madrid 28029, Spain
| | - Maria Arribas Tejedor
- Department of Pharmacology and Therapeutic, Facultad de Medicina, Univ. Autónoma de Madrid, Av. Arzobispo Morcillo 4, Madrid 28029, Spain
| | - Ricardo de Pascual
- Department of Pharmacology and Therapeutic, Facultad de Medicina, Univ. Autónoma de Madrid, Av. Arzobispo Morcillo 4, Madrid 28029, Spain
| | - Jorge Hernández Campano
- Department of Pharmacology and Therapeutic, Facultad de Medicina, Univ. Autónoma de Madrid, Av. Arzobispo Morcillo 4, Madrid 28029, Spain
| | - Jesús M Hernández-Guijo
- Department of Pharmacology and Therapeutic, Facultad de Medicina, Univ. Autónoma de Madrid, Av. Arzobispo Morcillo 4, Madrid 28029, Spain; Ramón y Cajal Institute for Health Research, IRYCIS, Hospital Ramón y Cajal, Ctra. de Colmenar Viejo, Km. 9,100, Madrid 28029, Spain.
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3
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Zhong Z, Yang Q, Li C, Chen X, Zhou F. A global perspective of correlation between maternal blood lead levels and risks of preeclampsia: An updated systematic review and meta-analysis. Front Public Health 2022; 10:1072052. [PMID: 36620238 PMCID: PMC9816335 DOI: 10.3389/fpubh.2022.1072052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Background Preeclampsia (PE) is a specific hypertensive disorder in pregnancy. Lead (Pb) is a heavy metal that affects women's reproductive health. However, it is unclear whether lead exposure during can predispose maternal risk of developing preeclampsia. This systematic review and meta-analysis study aimed to explore the association. Methods We searched studies from three databases (PubMed, Web of Science, Embase). Only case-control, cross-sectional, and cohort studies reporting maternal blood lead levels (BLL) and PE were included from database inception to 31st July 2022. Pregnant women with blood lead levels measured were eligible. Those healthy pregnant women who did not develop preeclampsia were assessed as comparators. Letters, comments, case reports, and reviews were excluded. Newcastle-Ottawa Scale (NOS) and its adaptive form were applied for assessment. The random-effects method (REM) was applied to calculate the standardized mean difference (SMD) with a 95% confidence interval (CI). Stata 16.0 and RevMan 5.3 were the software used for data extraction and analysis. Results 25 studies out of 1,808 articles made the finalist for systematic reviews, of which 21 underwent further quantity analysis. A total of 1,533 preeclamptic women and 10,998 healthy pregnant controls were included in the meta-analysis. The overall result revealed that maternal lead exposure was significantly higher in women with preeclampsia (SMD: 1.06, 95% CI 0.69, 1.43); (I 2 = 96.40%; P = 0.000). Conclusion This study demonstrates that maternal lead exposure is associated with preeclampsia during pregnancy. The association is present even in low blood lead levels. The conclusion should be taken seriously and women should avoid unexpected exposure to a lead-containing environment as much as possible. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=347220, identifier: CRD42022347220.
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Affiliation(s)
- Zixing Zhong
- Center for Reproductive Medicine, Department of Obstetrics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
| | - Qingmei Yang
- Graduate School, Bengbu Medical University, Bengbu, Anhui, China,Center for Reproductive Medicine, Department of Reproductive Endocrinology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Chu Li
- The Second Clinical College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiaohong Chen
- Department of Pediatrics, Central Hospital of Haining, Haining, Zhejiang, China,*Correspondence: Xiaohong Chen ✉
| | - Feifei Zhou
- Center for Reproductive Medicine, Department of Traditional Chinese Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China,Feifei Zhou ✉
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Moghaddasi R, Rezayi M, Darroudi M, Sahebkar A, Haghiralsadat F. Fabrication of Novel Potentiometric Sensor for Lead Ion Detection in Blood Samples: Experimental and Theoretical Approaches. Microchem J 2022. [DOI: 10.1016/j.microc.2022.107383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Lead Levels in Non-Occupationally Exposed Women with Preeclampsia. Molecules 2021; 26:molecules26103051. [PMID: 34065439 PMCID: PMC8160711 DOI: 10.3390/molecules26103051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/15/2021] [Accepted: 05/17/2021] [Indexed: 11/29/2022] Open
Abstract
There are many controversies regarding the relationship between lead exposure andcomplications in pregnancy. Preeclampsia (PE) is a maternal hypertensive disorder which is one of the main causes of maternal and foetal mortality. The aim of our study was to assess blood lead level (BLL) in Polish women with PE (PE group, n = 66) compared with healthy, non-pregnant women (CNP group, n = 40) and healthy pregnant women (CP group, n = 40). BLL was determined by inductively coupled plasma mass spectrometry (ICP-MS). The systolic blood pressure (SBP), diastolic blood pressure (DBP) and BLL in the CP group were significantly lower than in the PE group (p < 0.001). Logistic regression analyses of BLL showed a significant positive relationship with the presence of PE. Furthermore, both the SBP and DBP values were positively associated with BLL. This study indicates that preeclamptic women tend to present with significantly higher BLL compared to healthy pregnant women. There were no differences in the BLL between the CP and CNP groups.
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Khoshnamvand N, Azizi N, Hassanvand MS, Shamsipour M, Naddafi K, Oskoei V. Blood lead level monitoring related to environmental exposure in the general Iranian population: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:10.1007/s11356-021-14148-2. [PMID: 33948843 DOI: 10.1007/s11356-021-14148-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/22/2021] [Indexed: 06/12/2023]
Abstract
Exposure to lead can cause adverse health problems incorporating hypophosphatemia, heart and liver disease, cancers, neurological and cardiovascular diseases, central nervous disorders, and sensory disorders. This study investigated the blood lead level in the general Iranian population with environmental exposure to lead. In the presented systematic review and meta-analysis, the authors searched Iranian dataset, including Magiran, SID, Iranmedex, and Nopa, and the main dataset, comprising PubMed, Scopus, Embase, and Web of Science, all available articles until 12 January 2019, and extracting 55 studies (with 63 data for analysis) to a meta-analysis. A comprehensive meta-analysis software, pooled standard deviation, mean, sample size, and the utterly random effects model was analyzed in this study. The results showed that the overall mean BLL (95% CI) in total inquiries was 6.41 μg/dL (5.96 to 6.87). Besides, the results for gender and age subgroups were as follows: mean BLL, 6.47 μg/dL, 95% CI, 5.79, to 7.15, mean BLL, 6.44 μg/dL, 95% CI, 5.96, to 6.91, respectively. Conclusively the mean BLL in the Iranian population was higher than the recommended level by the US Centers for Disease Control and Prevention (CDC). Results indicated that the mean BLL in men and adults was more elevated than in women and children, respectively. Therefore, BLL monitoring and screening of the general Iranian population are is necessary to determine a reference value.
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Affiliation(s)
- Nahid Khoshnamvand
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Nahid Azizi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Sadegh Hassanvand
- Center for Air Pollution Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Mansour Shamsipour
- Department of Research Methodology and Data Analysis, Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Naddafi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- Center for Air Pollution Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran.
| | - Vahide Oskoei
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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7
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Rygiel CA, Dolinoy DC, Perng W, Jones TR, Solano M, Hu H, Téllez-Rojo MM, Peterson KE, Goodrich JM. Trimester-Specific Associations of Prenatal Lead Exposure With Infant Cord Blood DNA Methylation at Birth. Epigenet Insights 2020; 13:2516865720938669. [PMID: 32734142 PMCID: PMC7372614 DOI: 10.1177/2516865720938669] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 06/03/2020] [Indexed: 12/23/2022] Open
Abstract
Gestational exposure to lead (Pb) adversely impacts offspring health through
multiple mechanisms, one of which is the alteration of the epigenome including
DNA methylation. This study aims to identify differentially methylated CpG sites
associated with trimester-specific maternal Pb exposure in umbilical cord blood
(UCB) leukocytes. Eighty-nine mother-child dyads from the Early Life Exposure in
Mexico to Environmental Toxicants (ELEMENT) longitudinal birth cohorts with
available UCB samples were selected for DNA methylation analysis via the
Infinium Methylation EPIC BeadChip, which quantifies methylation at >850 000
CpG sites. Maternal blood lead levels (BLLs) during each trimester (T1:
6.56 ± 5.35 µg/dL; T2: 5.93 ± 5.00 µg/dL; T3: 6.09 ± 4.51 µg/dL), bone Pb
(patella: 11.8 ± 9.25 µg/g; tibia: 11.8 ± 6.73 µg/g), a measure of cumulative Pb
exposure, and UCB Pb (4.86 ± 3.74 µg/dL) were measured. After quality control
screening, data from 786 024 CpG sites were used to identify differentially
methylated positions (DMPs) and differentially methylated regions (DMRs) by Pb
biomarkers using separate linear regression models, controlling for sex and
estimated UCB cell-type proportions. We identified 3 DMPs associated with
maternal T1 BLL, 2 with T3 BLL, and 2 with tibia bone Pb. We identified one DMR
within PDGFRL associated with T1 BLL, one located at
chr6:30095136-30095295 with T3 BLL, and one within TRHR with
tibia bone Pb (adjusted P-value < .05). Pathway analysis
identified 15 overrepresented gene pathways for differential methylation that
overlapped among all 3 trimesters with the largest overlap between T1 and T2
(adjusted P-value < .05). Pathways of interest include nodal
signaling pathway and neurological system processes. These data provide evidence
for differential methylation by prenatal Pb exposure that may be
trimester-specific.
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Affiliation(s)
- Christine A Rygiel
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Dana C Dolinoy
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA.,Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Wei Perng
- Department of Epidemiology, University of Colorado School of Public Health, Denver, CO, USA
| | - Tamara R Jones
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | | | - Howard Hu
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA
| | | | - Karen E Peterson
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA.,Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Jaclyn M Goodrich
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
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Bede-Ojimadu O, Amadi CN, Orisakwe OE. Blood Lead Levels in Women of Child-Bearing Age in Sub-Saharan Africa: A Systematic Review. Front Public Health 2018; 6:367. [PMID: 30619808 PMCID: PMC6305709 DOI: 10.3389/fpubh.2018.00367] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 11/30/2018] [Indexed: 11/13/2022] Open
Abstract
This paper reported available studies on blood lead level of childbearing age in Sub-Saharan African women. PubMed and Google scholar databases were searched for original articles reporting blood lead levels of women of childbearing age in Sub-Saharan Africa. Searches were not limited to year of study but limited to studies published in English Language. Data were extracted and synthesized by estimating the weighted mean of the reported blood lead levels. Fifteen papers fulfilled the inclusion criteria. Mean blood lead levels of women in the studies ranged from 0.83 to 99 μg/dl. The overall weighted mean of blood lead levels was 24.73 μg/dl. The weighted mean from analyses of data on blood lead levels of pregnant women alone was 26.24 μg/dl. Identified sources of lead exposure included lead mine, informal lead-acid battery recycling, leaded gasoline and piped water. Elevated BLLs were associated with incidence of preeclampsia, hypertension, and malaria. Important contributing factors for elevated blood lead levels (BLL) in these women include poverty, high environmental lead burden, low awareness on lead exposure hazards and lack of regulation for lead in consumer products. BLLs of women of childbearing age in SSA are unacceptably high. There is need therefore, for aggressive programs to address lead exposure in this population.
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Affiliation(s)
- Onyinyechi Bede-Ojimadu
- Department of Chemical pathology, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria
| | - Cecilia Nwadiuto Amadi
- Department of Experimental Pharmacology & Toxicology, Faculty of Pharmacy, University of Port-Harcourt, Port-Harcourt, Nigeria
| | - Orish Ebere Orisakwe
- Department of Experimental Pharmacology & Toxicology, Faculty of Pharmacy, University of Port-Harcourt, Port-Harcourt, Nigeria
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9
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Mahmoudi N, Latifi AM, Amani MA, Masoumbeigi H, Ghanizadeh G. Data on the environmental exposure to lead in Iran. Data Brief 2018; 20:1133-1141. [PMID: 30225326 PMCID: PMC6139886 DOI: 10.1016/j.dib.2018.08.052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 08/14/2018] [Accepted: 08/22/2018] [Indexed: 10/28/2022] Open
Abstract
The data was obtained to present the environmental and occupational exposure to lead in Iranian populations based on the published articles. To acquire the data, online resources including Google Scholar, Magiran, SID, Iranmedex, PubMed, and Science Direct were searched and 104 articles were found out of which 70 that focused on the level of lead in blood, urine, milk, and hair of different Iranian populations were selected. Since the results of the studies were not homogenous, it was not possible to carry out a meta-analysis. The average blood lead level (BLL) among workers, ordinary people, patients with specific diseases, addicts, and pregnant women, women in labor, infants, and children are presented in this article. The average BLL was compared to the standards.
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Affiliation(s)
- Norouz Mahmoudi
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.,Health Research Center, Life style Institute, Baqiyatallah University of Medical Sciences, Tehran
| | - Ali Mohammad Latifi
- Applied Biotechnology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Amani
- Applied Biotechnology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hossein Masoumbeigi
- Health Research Center, Life style Institute, Baqiyatallah University of Medical Sciences, Tehran
| | - Ghader Ghanizadeh
- Health Research Center, Life style Institute, Baqiyatallah University of Medical Sciences, Tehran
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10
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Matsukawa T, Yokoyama K, Vigeh M, Nishioka E. [Effects of Trace Environmental Chemicals on Child Health-Lead as an Example]. Nihon Eiseigaku Zasshi 2018; 73:210-214. [PMID: 29848873 DOI: 10.1265/jjh.73.210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The low birthrate and aging population of Japan are entering a serious phase. As measures against the declining birthrate, improvement of the environment is promoted to support childbirth and child-rearing, but even if the birthrate increases in the future, it will take time before the effect is observed as an increase in the population. As the number of children and young people is decreasing, in order to maintain a wealthy and sustainable society, we should create an environment wherein each child can grow healthily and demonstrate sufficient abilities in participating in society. The authors have been studying the influence of exposure to environmental chemical substances on the development of children. Lead is especially considered to impair neurological development even at low concentrations of exposure. In this paper, using lead as an example, we discuss risk assessment and countermeasures for the health effects of trace chemical substances on a society with a declining birthrate. Substances that show neurotoxicity increase social costs even at low concentrations of exposure. To preserve and promote social vitality in Japan despite the declining birthrate and aging population, it is essential that measures are taken on the basis of scientifically reasonable cost/benefit assessment. For this purpose, we think that it is necessary to analyze costs and benefits in addition to the risk assessment of low concentrations of chemical substances.
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Affiliation(s)
- Takehisa Matsukawa
- Department of Epidemiology and Environmental Health, Juntendo University Graduate School of Medicine
| | - Kazuhito Yokoyama
- Department of Epidemiology and Environmental Health, Juntendo University Graduate School of Medicine
| | - Mohsen Vigeh
- Department of Epidemiology and Environmental Health, Juntendo University Graduate School of Medicine.,Maternal, Fetal and Neonatal Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences
| | - Emiko Nishioka
- Department of Epidemiology and Environmental Health, Juntendo University Graduate School of Medicine.,Department of Maternal Nursing, Division of Nursing, National Defense Medical College
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11
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Poropat AE, Laidlaw MAS, Lanphear B, Ball A, Mielke HW. Blood lead and preeclampsia: A meta-analysis and review of implications. ENVIRONMENTAL RESEARCH 2018; 160:12-19. [PMID: 28938191 DOI: 10.1016/j.envres.2017.09.014] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 08/18/2017] [Accepted: 09/08/2017] [Indexed: 05/02/2023]
Abstract
BACKGROUND Multiple cross-sectional studies suggest that there is an association between blood lead and preeclampsia. OBJECTIVES We performed a systematic review and meta-analysis to summarize information on the association between preeclampsia and lead poisoning. METHODS Searches of Medline, Web of Science, Scopus, Pubmed, Science Direct and ProQuest (dissertations and theses) identified 2089 reports, 46 of which were downloaded after reviewing the abstracts, and 11 studies were evaluated as meeting the selection criteria. Evaluation using the ROBINS-I template (Sterne, et al., 2016), indicated moderate risk of bias in all studies. RESULTS We found that blood lead concentrations were significantly and substantially associated with preeclampsia (k = 12; N = 6069; Cohen's d = 1.26; odds ratio = 9.81; odds ratio LCL = 8.01; odds ratio UCL = 12.02; p = 0.005). Eliminating one study produced a homogeneous meta-analysis and stronger estimates, despite the remaining studies coming from eight separate countries and having countervailing risks of bias. CONCLUSIONS Blood lead concentrations in pregnant women are a major risk factor for preeclampsia, with an increase of 1μg/dL associated with a 1.6% increase in likelihood of preeclampsia, which appears to be the strongest risk factor for preeclampsia yet reported. Pregnant women with historical lead exposure should routinely have blood lead concentrations tested, especially after mid-term. Women with concentrations higher than 5μg/dL should be actively monitored for preeclampsia and be advised to take prophylactic calcium supplementation. All pregnant women should be advised to actively avoid lead exposure.
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Affiliation(s)
- Arthur E Poropat
- Griffith University - School of Applied Psychology, Brisbane, Australia
| | - Mark A S Laidlaw
- RMIT University - Centre for Environmental Sustainability and Remediation (EnSuRe), School of Science, Bundoora, Victoria, Australia.
| | - Bruce Lanphear
- Simon Fraser University - Faculty of Health Sciences, Vancouver, British Columbia, Canada
| | - Andrew Ball
- RMIT University - Centre for Environmental Sustainability and Remediation (EnSuRe), School of Science, Bundoora, Victoria, Australia
| | - Howard W Mielke
- Tulane University - Department of Pharmacology, Tulane University School of Medicine, New Orleans, LA, USA
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12
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Bayat F, Akbari SAA, Dabirioskoei A, Nasiri M, Mellati A. The Relationship Between Blood Lead Level and Preeclampsia. Electron Physician 2016; 8:3450-3455. [PMID: 28163864 PMCID: PMC5279982 DOI: 10.19082/3450] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Accepted: 09/18/2016] [Indexed: 01/20/2023] Open
Abstract
Introduction Lead is a heavy metal to which people are commonly exposed. One of the possible mechanisms of tissue damages caused by this toxic metal is oxidative stress, which in turn may cause numerous pregnancy complications such as preeclampsia. The present study was conducted to determine the relationship between maternal Blood Lead Level (BLL) and preeclampsia. Methods The present case-control study was conducted on 158 pregnant women admitted to a hospital in Zanjan, Iran, from August 2015 to March 2016. To measure their BLL, 1.5 cc of blood was drawn from each participant. The demographic and obstetric details of the patients were recorded in a form. The potentiometric method was used to test the samples. The data obtained were analyzed by SPSS version 22, using Mann-Whitney U test, the Chi square, independent-samples t-test, Pearson product-moment correlation, and simple linear regression analysis. Results The mean BLL was 6.24±1.74 μg/dl in the control group and 8.04±3.4 μg/dl in the preeclampsia group. The two groups were matching in terms of the mother’s age and education and the household income. A significant relationship was observed between BLL and preeclampsia (p=0.028), as per every unit of increase (1 μg/dl) in BLL, systolic blood pressure increased by 0.014 mm Hg and diastolic blood pressure by 0.013 mm Hg (p=0.004). Conclusion The results obtained suggest a relationship between BLL and preeclampsia. Global health measures should be taken to remove the exposure to lead so as to reduce its absorption by pregnant women.
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Affiliation(s)
- Fatemeh Bayat
- M.Sc. of Midwifery, Department of Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sedigheh Amir Ali Akbari
- M.Sc. of Midwifery, Department of Midwifery, Faculty of Midwifery and Nursing School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atousa Dabirioskoei
- M.D., Gynecologist, Associate Professor, Department of Gynecology and Obstetrics, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Malihe Nasiri
- Ph.D. in Biostatics, Associate Professor, Department of Basic Sciences, Faculty of Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Aliosat Mellati
- Ph.D. in Biochemistry, Professor, Metabolic Research Center and Department of Biochemistry, Faculty of Zanjan University of Medical Sciences, Zanjan, Iran
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La-Llave-León O, Salas Pacheco JM, Estrada Martínez S, Esquivel Rodríguez E, Castellanos Juárez FX, Sandoval Carrillo A, Lechuga Quiñones AM, Vázquez Alanís F, García Vargas G, Méndez Hernández EM, Duarte Sustaita J. The relationship between blood lead levels and occupational exposure in a pregnant population. BMC Public Health 2016; 16:1231. [PMID: 27927239 PMCID: PMC5142354 DOI: 10.1186/s12889-016-3902-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 12/02/2016] [Indexed: 11/10/2022] Open
Abstract
Background Pregnant women exposed to lead are at risk of suffering reproductive damages, such as miscarriage, preeclampsia, premature delivery and low birth weight. Despite that the workplace offers the greatest potential for lead exposure, there is relatively little information about occupational exposure to lead during pregnancy. This study aims to assess the association between blood lead levels and occupational exposure in pregnant women from Durango, Mexico. Methods A cross-sectional study was carried out in a population of 299 pregnant women. Blood lead was measured in 31 women who worked in jobs where lead is used (exposed group) and 268 who did not work in those places (control group). Chi-square test was applied to compare exposed and control groups with regard to blood lead levels. Odds ratio (OR) and 95% confidence intervals (CI) were calculated. Multivariable regression analysis was applied to determine significant predictors of blood lead concentrations in the exposed group. Results Exposed women had higher blood lead levels than those in the control group (4.00 ± 4.08 μg/dL vs 2.65 ± 1.75 μg/dL, p = 0.002). Furthermore, women in the exposed group had 3.82 times higher probability of having blood lead levels ≥ 5 μg/dL than those in the control group. Wearing of special workwear, changing clothes after work, living near a painting store, printing office, junkyard or rubbish dump, and washing the workwear together with other clothes resulted as significant predictors of elevated blood lead levels in the exposed group. Conclusions Pregnant working women may be at risk of lead poisoning because of occupational and environmental exposure. The risk increases if they do not improve the use of protective equipment and their personal hygiene. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3902-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Osmel La-Llave-León
- Instituto de Investigación Científica, Universidad Juárez del Estado de Durango, Avenida Universidad esq. con Volantín, Zona Centro, C.P. 34000, Durango, DGO, Mexico.
| | - José Manuel Salas Pacheco
- Instituto de Investigación Científica, Universidad Juárez del Estado de Durango, Avenida Universidad esq. con Volantín, Zona Centro, C.P. 34000, Durango, DGO, Mexico
| | - Sergio Estrada Martínez
- Instituto de Investigación Científica, Universidad Juárez del Estado de Durango, Avenida Universidad esq. con Volantín, Zona Centro, C.P. 34000, Durango, DGO, Mexico
| | - Eloísa Esquivel Rodríguez
- Facultad de Enfermería y Obstetricia, Universidad Juárez del Estado de Durango, Ave. Cuauhtémoc, 223 norte, CP 34 000, Durango, Mexico
| | - Francisco X Castellanos Juárez
- Instituto de Investigación Científica, Universidad Juárez del Estado de Durango, Avenida Universidad esq. con Volantín, Zona Centro, C.P. 34000, Durango, DGO, Mexico
| | - Ada Sandoval Carrillo
- Instituto de Investigación Científica, Universidad Juárez del Estado de Durango, Avenida Universidad esq. con Volantín, Zona Centro, C.P. 34000, Durango, DGO, Mexico
| | - Angélica María Lechuga Quiñones
- Instituto de Investigación Científica, Universidad Juárez del Estado de Durango, Avenida Universidad esq. con Volantín, Zona Centro, C.P. 34000, Durango, DGO, Mexico
| | | | - Gonzalo García Vargas
- Facultad de Medicina de Gómez Palacio, Universidad Juárez del Estado de Durango, La Salle 1 y Sixto Ugalde, S/N. Col. Revolución, CP. 35050, Gómez Palacio, Durango, Mexico
| | - Edna Madai Méndez Hernández
- Instituto de Investigación Científica, Universidad Juárez del Estado de Durango, Avenida Universidad esq. con Volantín, Zona Centro, C.P. 34000, Durango, DGO, Mexico
| | - Jaime Duarte Sustaita
- Facultad de Medicina de Gómez Palacio, Universidad Juárez del Estado de Durango, La Salle 1 y Sixto Ugalde, S/N. Col. Revolución, CP. 35050, Gómez Palacio, Durango, Mexico
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Risk of preeclampsia from exposure to particulate matter (PM₂.₅) speciation chemicals during pregnancy. J Occup Environ Med 2015; 56:1228-34. [PMID: 25479291 DOI: 10.1097/jom.0000000000000317] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To determine whether maternal exposure to particulate matter (PM₂.₅) speciation chemicals during pregnancy is associated with the risk of preeclampsia. METHODS We allocated average daily exposure values for 36 ambient particulate matter speciation chemicals to mothers during their first trimester and their entire pregnancy. The main outcome of interest was preeclampsia occurrence. Adjusted odd ratios and 95% confidence intervals were computed. RESULTS The odds for preeclampsia were increased per interquartile range increase in pollutants for exposure to elemental carbon during the first trimester of pregnancy (odds ratio = 1.08; confidence interval = 1.01 to 1.16) and during the entire pregnancy period (odds ratio = 1.05; confidence interval = 1.01 to 1.11). The most substantial risk for preeclampsia was observed for PM2.5 aluminum exposure during the entire pregnancy, resulting in 10% increased risk (odds ratio = 1.10; confidence interval = 1.03 to 1.18) per interquartile range increase in aluminum. CONCLUSIONS Maternal exposure to PM2.5, aluminum, and elemental carbon during pregnancy increases the risk of preeclampsia.
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La-Llave-León O, Lugo-Soto R, Aguilar-Durán M, Estrada-Martínez S, Salas-Pacheco JM, Sandoval-Carrillo A, Castellanos-Juárez FX, Barraza-Salas M, Vázquez-Alanís F, García-Vargas G. Relationship Between Blood Lead Levels and Hematological Indices in Pregnant Women. Women Health 2014; 55:90-102. [DOI: 10.1080/03630242.2014.972019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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16
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Zahran S, Magzamen S, Breunig IM, Mielke HW. Maternal exposure to neighborhood soil Pb and eclampsia risk in New Orleans, Louisiana (USA): evidence from a natural experiment in flooding. ENVIRONMENTAL RESEARCH 2014; 133:274-81. [PMID: 24981826 DOI: 10.1016/j.envres.2014.06.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 04/30/2014] [Accepted: 06/02/2014] [Indexed: 05/13/2023]
Abstract
BACKGROUND Previous studies link maternal blood lead (Pb) levels and pregnancy-related hypertensive disorders. OBJECTIVE Assess the relationship between neighborhood soil Pb and maternal eclampsia risk. METHODS Zip code summarized high density soil survey data of New Orleans collected before and after Hurricanes Katrina and Rita (HKR) were merged with pregnancy outcome data on 75,501 mothers from the Louisiana office of public health. Cross-sectional logistic regression analyses are performed testing the association between pre-HKR accumulation of Pb in soils in thirty-two neighborhoods and eclampsia risk. Then we examine whether measured declines in soil Pb following the flooding of the city resulted in corresponding reductions of eclampsia risk. RESULTS Cross-sectional analyses show that a one standard deviation increase in soil Pb increases the odds of eclampsia by a factor of 1.48 (95% CI: 1.31, 1.66). Mothers in zip code areas with soil Pb>333 mg/kg were 4.00 (95% CI: 3.00, 5.35) times more likely to experience eclampsia than mothers residing in neighborhoods with soil Pb<50mg/kg. Difference-in-differences analyses capturing the exogenous reduction in soil Pb following the 2005 flooding of New Orleans indicate that mothers residing in zip codes experiencing decrease in soil Pb (-387.9 to -33.6 mg/kg) experienced a significant decline in eclampsia risk (OR=0.619; 95% CI: 0.397, 0.963). CONCLUSIONS Mothers residing in neighborhoods with high accumulation of Pb in soils are at heightened risk of experiencing eclampsia.
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Affiliation(s)
- Sammy Zahran
- Department of Economics, C-312A Clark Building, Colorado State University, Fort Collins, CO, 80523-1771 USA; Robert Wood Johnson Health and Society Scholar, Columbia University, 722 W 168th St, New York, NY 10032, USA.
| | - Sheryl Magzamen
- Department of Environmental and Radiological and Health Sciences, 147 Environmental Health Building, Colorado State University, Fort Collins, CO, 80523-1681 USA.
| | - Ian M Breunig
- Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, 220 Arch Street, 12th floor, Room 01-209, Baltimore, MD 21201, USA.
| | - Howard W Mielke
- Department of Pharmacology, Tulane University School of Medicine, 1430 Tulane Avenue SL-83, New Orleans, LA, 70112-2699, USA.
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Evidence that birth weight is decreased by maternal lead levels below 5μg/dl in male newborns. Reprod Toxicol 2014; 47:21-6. [DOI: 10.1016/j.reprotox.2014.05.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 05/08/2014] [Accepted: 05/15/2014] [Indexed: 11/23/2022]
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18
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Kennedy DA, Woodland C, Koren G. Lead exposure, gestational hypertension and pre-eclampsia: A systematic review of cause and effect. J OBSTET GYNAECOL 2012; 32:512-7. [DOI: 10.3109/01443615.2012.693987] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Vigeh M, Yunesian M, Shariat M, Niroomanesh S, Ramezanzadeh F. Environmental carbon monoxide related to pregnancy hypertension. Women Health 2012; 51:724-38. [PMID: 22185288 DOI: 10.1080/03630242.2011.633599] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Carbon monoxide pollution frequently occurs due to auto exhaust, industrial emissions, and/or cigarette smoke. Exogenous and endogenous carbon monoxide affects blood pressure; however, the relation of carbon monoxide exposure to pregnancy hypertension has not been systematically examined. For the present study the authors recruited a total of 2,707 apparently healthy, non-obese, non-smoking mothers, aged between 15 and 40 years, who had singleton births, and who lived within two miles of the selected air monitoring stations in Tehran, Iran, to study the relation of ambient carbon monoxide to pregnancy hypertension (>140 mmHg systolic and/or >90 mmHg diastolic after the 20th week of gestation). A relatively small but statistically significant elevation in mean postpartum diastolic blood pressure (mean ± SD, 69.5 ± 9.8 mmHg) was observed in the mothers' who were exposed to relatively high ambient carbon monoxide (mean = 14.1 ppm) compared to mothers exposed to lower carbon monoxide (mean = 1.8 ppm) concentrations (mean ± SD, 68.0 ± 8.3 mmHg, p < 0.01). The authors found twice the rate of pregnancy hypertension in the relatively higher carbon monoxide exposed mothers than the mothers with lower exposure (adjusted odds ratio = 2.02, 95% CI 1.35-3.03). Findings of the present study suggest that high level ambient carbon monoxide exposure is associated with pregnancy hypertension.
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Affiliation(s)
- Mohsen Vigeh
- Department of Hazard Assessment, National Institute of Occupational Safety and Health, Kawasaki, Japan.
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20
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Wells EM, Navas-Acien A, Herbstman JB, Apelberg BJ, Silbergeld EK, Caldwell KL, Jones RL, Halden RU, Witter FR, Goldman LR. Low-level lead exposure and elevations in blood pressure during pregnancy. ENVIRONMENTAL HEALTH PERSPECTIVES 2011; 119:664-9. [PMID: 21292600 PMCID: PMC3094418 DOI: 10.1289/ehp.1002666] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Accepted: 12/17/2010] [Indexed: 05/07/2023]
Abstract
BACKGROUND Lead exposure is associated with elevated blood pressure during pregnancy; however, the magnitude of this relationship at low exposure levels is unclear. OBJECTIVES Our goal was to determine the association between low-level lead exposure and blood pressure during late pregnancy. METHODS We collected admission and maximum (based on systolic) blood pressures during labor and delivery among 285 women in Baltimore, Maryland. We measured umbilical cord blood lead using inductively coupled plasma mass spectrometry. Multivariable models were adjusted for age, race, median household income, parity, smoking during pregnancy, prepregnancy body mass index, and anemia. These models were used to calculate benchmark dose values. RESULTS Geometric mean cord blood lead was 0.66 μg/dL (95% confidence interval, 0.61-0.70). Comparing blood pressure measurements between those in the highest and those in the lowest quartile of lead exposure, we observed a 6.87-mmHg (1.51-12.21 mmHg) increase in admission systolic blood pressure and a 4.40-mmHg (0.21-8.59 mmHg) increase in admission diastolic blood pressure after adjustment for confounders. Corresponding values for maximum blood pressure increase were 7.72 (1.83-13.60) and 8.33 (1.14-15.53) mmHg. Benchmark dose lower limit values for a 1-SD increase in blood pressure were < 2 μg/dL blood lead for all blood pressure end points. CONCLUSIONS A significant association between low-level lead exposures and elevations in maternal blood pressure during labor and delivery can be observed at umbilical blood lead levels < 2 μg/dL.
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Affiliation(s)
- Ellen M. Wells
- Department of Environmental Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Julie B. Herbstman
- Columbia Center for Children’s Environmental Health, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Benjamin J. Apelberg
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ellen K. Silbergeld
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kathleen L. Caldwell
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Robert L. Jones
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Rolf U. Halden
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center for Environmental Biotechnology, Biodesign Institute, Arizona State University, Tempe, Arizona, USA
| | - Frank R. Witter
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Lynn R. Goldman
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- George Washington University School of Public Health and Health Services, Washington, DC, USA
- Address correspondence to L.R. Goldman, George Washington University School of Public Health and Health Services, 2300 Eye St. NW, Suite 106, Washington, DC 20037 USA. Telephone: (202) 994-7270. Fax: (202) 994-3773. E-mail:
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Vigeh M, Yokoyama K, Kitamura F, Afshinrokh M, Beygi A, Niroomanesh S. Early pregnancy blood lead and spontaneous abortion. Women Health 2011; 50:756-66. [PMID: 21170817 DOI: 10.1080/03630242.2010.532760] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Although evidence tends to suggest that high levels of lead exposure increase the risk of spontaneous abortion, we do not yet know whether moderate- to low-level exposure elevates risk. Among 351 women (aged 16 to 35 years, with single pregnancies) who were registered for a longitudinal study, 15 (4.3%) women experienced spontaneous abortion after the 12th week of gestation and before the 20th week. We collected participants' blood samples during the first trimester of pregnancy (8-12 weeks) for lead measurement by inductively coupled plasma-mass spectrometry. Mean ± standard deviation of blood lead was 3.8 ± 2.0 μg/dl (range 1.0-20.5 μg/dl) with a geometric mean of 3.5 μg/dl. Mean blood lead concentrations did not differ significantly between spontaneous abortion cases and ongoing pregnancies (3.51 ± 1.42 and 3.83 ± 1.99 μg/dl, respectively). The findings suggest that in apparently healthy women, low blood lead levels (mean < 5 μg/dl) measured in early pregnancy may not be a risk factor for spontaneous abortion.
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Affiliation(s)
- Mohsen Vigeh
- Department of Hazard Assessment, National Institute of Occupational Safety and Health, Kawasaki, Japan.
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Vigeh M, Saito H, Sawada SI. Lead exposure in female workers who are pregnant or of childbearing age. INDUSTRIAL HEALTH 2010; 49:255-261. [PMID: 21173522 DOI: 10.2486/indhealth.ms1192] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
In adults, high-level lead exposure often occurs in the lead-related industries. Acute lead poisoning has become rare, but chronic exposure to low-level lead remains a public health issue. With recent advances in our understanding of lead toxicity at low-levels, researchers have shifted their focus to studying lead at concentrations below those currently recommended as 'acceptable' in worker protection. As gender plays an important role in the storage, biokinetics, and toxicity of lead, it seems inappropriate to extrapolate findings of lead exposure in men to women. Women's bones release lead more slowly to the bloodstream, so blood levels remain increased for a long time after cessation of high exposure, reflecting the endogenous source of the lead. Particularly in pregnant women, bone lead release could influence health in pregnancy and be extremely harmful to the rapidly growing and developing fetus. Accordingly, female workers of childbearing age should avoid excessive lead exposure. However, because studies of pregnant workers encounter many difficulties and inconveniences, sufficient research has not been conducted in this area. As an alternative, a group of non-occupationally exposed women, matched as well as possible for anthropometric and reproductive variables and with almost the same levels of blood lead, could be recruited for survey.
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Affiliation(s)
- Mohsen Vigeh
- National Institute of Occupational Safety and Health, 6-21-1 Nagao, Tama-ku, Kawasaki 214-8585, Japan.
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Sheppard SJ, Khalil RA. Risk factors and mediators of the vascular dysfunction associated with hypertension in pregnancy. Cardiovasc Hematol Disord Drug Targets 2010; 10:33-52. [PMID: 20041838 DOI: 10.2174/187152910790780096] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2009] [Accepted: 12/24/2009] [Indexed: 01/24/2023]
Abstract
Normal pregnancy is associated with significant hemodynamic changes and vasodilation in the uterine and systemic circulation in order to meet the metabolic demands of the mother and developing fetus. Hypertension in pregnancy (HTN-Preg) and preeclampsia (PE) are major complications and life-threatening conditions to both the mother and fetus. PE is precipitated by various genetic, dietary and environmental factors. Although the initiating events of PE are unclear, inadequate invasion of cytotrophoblasts into the uterine artery is thought to reduce uteroplacental perfusion pressure and lead to placental ischemia/hypoxia. Placental hypoxia induces the release of biologically active factors such as growth factor inhibitors, anti-angiogenic proteins, inflammatory cytokines, reactive oxygen species, hypoxia-inducible factors, and antibodies to vascular angiotensin II receptor. These bioactive factors affect the production/activity of various vascular mediators in the endothelium, smooth muscle and extracellular matrix, leading to severe vasoconstriction and HTN. As an endothelial cell disorder, PE is associated with decreased vasodilator mediators such as nitric oxide, prostacyclin and hyperpolarizing factor and increased vasoconstrictor mediators such as endothelin, angiotensin II and thromboxane A(2). PE also involves enhanced mechanisms of vascular smooth muscle contraction including intracellular free Ca(2+) concentration ([Ca(2+)](i)), and [Ca(2+)](i) sensitization pathways such as protein kinase C, Rho-kinase and mitogen-activated protein kinase. Changes in extracellular matrix composition and matrix metalloproteases activity also promote vascular remodeling and further vasoconstriction in the uterine and systemic circulation. Characterization of the predisposing risk factors, the biologically active factors, and the vascular mediators associated with PE holds the promise for early detection, and should help design specific genetic and pharmacological tools for the management of the vascular dysfunction associated with HTN-Preg.
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Affiliation(s)
- Stephanie J Sheppard
- Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts 02115, USA
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Tanbe AF, Khalil RA. Circulating and Vascular Bioactive Factors during Hypertension in Pregnancy. ACTA ACUST UNITED AC 2010; 6:60-75. [PMID: 20419111 DOI: 10.2174/157340710790711737] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Normal pregnancy is associated with significant vascular remodeling in the uterine and systemic circulation in order to meet the metabolic demands of the mother and developing fetus. The pregnancy-associated vascular changes are largely due to alterations in the amount/activity of vascular mediators released from the endothelium, vascular smooth muscle and extracellular matrix. The endothelium releases vasodilator substances such as nitric oxide, prostacyclin and hyperpolarizing factor as well as vasoconstrictor factors such as endothelin, angiotensin II and thromboxane A(2). Vascular smooth muscle contraction is mediated by intracellular free Ca(2+) concentration ([Ca(2+)](i)), and [Ca(2+)](i) sensitization pathways such as protein kinase C, Rho-kinase and mitogen-activated protein kinase. Extracellular matrix and vascular remodeling are regulated by matrix metalloproteases. Hypertension in pregnancy and preeclampsia are major complications and life threatening conditions to both the mother and fetus, precipitated by various genetic, dietary and environmental factors. The initiating mechanism of preeclampsia and hypertension in pregnancy is unclear; however, most studies have implicated inadequate invasion of cytotrophoblasts into the uterine artery, leading to reduction in the uteroplacental perfusion pressure and placental ischemia/hypoxia. This placental hypoxic state is thought to induce the release of several circulating bioactive factors such as growth factor inhibitors, anti-angiogenic proteins, inflammatory cytokines, reactive oxygen species, hypoxia-inducible factors, and vascular receptor antibodies. Increases in the plasma levels and vascular content of these factors during pregnancy could cause an imbalance in the vascular mediators released from the endothelium, smooth muscle and extracellular matrix, and lead to severe vasoconstriction and hypertension. This review will discuss the interactions between the various circulating bioactive factors and the vascular mediators released during hypertension in pregnancy, and provide an insight into the current and future approaches in the management of preeclampsia.
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Affiliation(s)
- Alain F Tanbe
- Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115
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Yazbeck C, Thiebaugeorges O, Moreau T, Goua V, Debotte G, Sahuquillo J, Forhan A, Foliguet B, Magnin G, Slama R, Charles MA, Huel G. Maternal blood lead levels and the risk of pregnancy-induced hypertension: the EDEN cohort study. ENVIRONMENTAL HEALTH PERSPECTIVES 2009; 117:1526-30. [PMID: 20019901 PMCID: PMC2790505 DOI: 10.1289/ehp.0800488] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2008] [Accepted: 06/26/2009] [Indexed: 05/03/2023]
Abstract
BACKGROUND Prior studies revealed associations of environmental lead exposure with risks of hypertension and elevated blood pressure. OBJECTIVE We examined the effect of blood lead levels on blood pressure and the incidence of pregnancy-induced hypertension (PIH) in the second and third trimesters of pregnancy. METHODS One thousand seventeen pregnant women were enrolled in two French municipalities between 2003 and 2005 for the EDEN (Etude des Déterminants pré et post natals du développement et de la santé de l' Enfant) cohort study. Blood lead concentrations were measured by atomic absorption spectrometry in mothers between 24 and 28 weeks of gestation. RESULTS PIH was diagnosed in 106 subjects (10.9%). Age, parity, weight gain, alcohol, smoking habits, and calcium supplementation were comparable between hypertensive and nonhypertensive women. Lead levels were significantly higher in PIH cases (mean +/- SD, 2.2 +/- 1.4 microg/dL) than in normotensive patients (1.9 +/- 1.2 microg/dL; p = 0.02). Adjustment for potential confounder effects slightly attenuated but did not eliminate the significant association between blood lead levels and the risk of PIH (adjusted odds ratio of PIH = 3.3; 95% confidence interval, 1.1-9.7). We also observed geographic differences in lead exposure and in the incidence of PIH and found significant correlations between blood lead levels and unadjusted as well as adjusted systolic and diastolic blood pressures after 24 weeks of gestation. CONCLUSIONS These findings confirm the relationship between blood lead levels at mid-pregnancy and blood pressure and suggest that environmental lead exposure may play an etiologic role in PIH.
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Bravo Y, Quiroz Y, Ferrebuz A, Vaziri ND, Rodríguez-Iturbe B. Mycophenolate mofetil administration reduces renal inflammation, oxidative stress, and arterial pressure in rats with lead-induced hypertension. Am J Physiol Renal Physiol 2007; 293:F616-23. [PMID: 17567935 DOI: 10.1152/ajprenal.00507.2006] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Hypertension is a likely consequence of chronic lead exposure in humans, especially in association with reduced renal function and in high risk populations. Numerous studies have demonstrated that oxidative stress plays an important role in the pathogenesis of experimental lead-induced hypertension and we have shown recently that tubulointerstitial immune cell infiltration is a feature of chronic low-dose lead exposure. Since oxidative stress, renal inflammation, and angiotensin activity are closely linked characteristics in experimental models of hypertension, we decided to investigate whether lead-induced hypertension would be ameliorated by suppressing renal inflammation with the immunosuppressive drug mycophenolate mofetil (MMF). We studied rats exposed for 14 wk to lead acetate (100 ppm in the drinking water) that, in addition, received either MMF, 20 mg.kg(-1).day(-1) by gastric gavage (Pb.MMF group, n = 12) or vehicle (Pb group, n = 12). Control rats received MMF alone (n = 5) or neither lead nor MMF (n = 6). All rats were killed at the end of the experiment. Low-dose lead exposure resulted in mild to moderate tubular cell damage and a progressive increment in blood pressure, oxidative stress, interstitial accumulation of lymphocytes and macrophages, NF-kappaB activation, and increased renal angiotensin II level. The administration of MMF suppressed the tubulointerstitial accumulation of lymphocytes and macrophages and prevented the hypertension, oxidative stress, and NF-kappaB activation and reduced the heightened renal angiotensin content associated with chronic lead exposure. We conclude that interstitial inflammation plays an important role in lead-induced hypertension.
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Affiliation(s)
- Yanauri Bravo
- Instituto Venezolano de Investigaciones Científicas-Zulia, Maracaibo, Venezuela
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Vigeh M, Yokoyama K, Ramezanzadeh F, Dahaghin M, Sakai T, Morita Y, Kitamura F, Sato H, Kobayashi Y. Lead and other trace metals in preeclampsia: a case-control study in Tehran, Iran. ENVIRONMENTAL RESEARCH 2006; 100:268-75. [PMID: 16029873 DOI: 10.1016/j.envres.2005.05.005] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2004] [Revised: 05/23/2005] [Accepted: 05/26/2005] [Indexed: 05/03/2023]
Abstract
To assess the effects of environmental exposures to trace metals on the incidence of preeclampsia, concentrations of lead (Pb), antimony (Sb), manganese (Mn), mercury, cadmium, cobalt and zinc in umbilical cord blood (UCB) and mother whole blood (MWB) were measured in 396 postpartum women without occupational exposure to metals in Tehran, Iran, using inductively coupled plasma mass spectrometry. Mother's ages ranged from 15 to 49 (mean 27) years. Preeclampsia was diagnosed in 31 subjects (7.8%). Levels of Pb, Sb and Mn in UCB were significantly higher in preeclampsia cases [mean+/-SD of 4.30+/-2.49 microg/dl, 4.16+/-2.73 and 46.87+/-15.03 microg/l, respectively] than in controls [3.52+/-2.09 microg/dl, 3.17+/-2.68 and 40.32+/-15.19 microg/l, respectively] (P<0.05). The logistic regression analysis revealed that one unit increase in the common logarithms of UCB concentration of Pb, Sb or Mn led to increase in the risk of preeclampsia several-fold; unit risks (95% CI) were 12.96 (1.57-107.03), 6.11 (1.11-33.53) and 34.2 (1.81-648.04) for Pb, Sb and Mn, respectively (P<0.05). These findings suggest that environmental exposure to Pb, Sb and Mn may increase the risk of preeclampsia in women without occupational exposure; levels of metals in UCB to be sensitive indicators of female reproductive toxicity as compared with those in mother MWB. Further studies are necessary to confirm these findings, especially on Sb and Mn.
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Affiliation(s)
- Mohsen Vigeh
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Hongo Bunkyo-ku, Tokyo, Japan
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