Heavy Metals and Trace Elements in Human Breast Milk from Industrial/Mining and Agricultural Zones of Southeastern Spain

Toxic element (As, Cd, Pb and Hg) biodistribution and blood biomarkers in Barbaresca sheep raised in Sicily: One Health preliminary study

The health of humans, animals and the environment is interconnected. Adopting a One Health approach means intervening promptly to prevent the main diseases that affect animal health to guarantee the safety of livestock production. Exposure to toxic trace elements in sheep can lead to increased accumulation in different biological substrate, developing both acute and chronic diseases in humans and livestock. The aim of this study was to evaluate the bioaccumulation of arsenic (As), cadmium (Cd), lead (Pb) and mercury (Hg) in Sicilian Barbaresca sheep using the following biological substrates: milk, blood and fleece. An inductively coupled plasma mass spectrometer (ICP-MS) was used for As, Cd and Pb, and a direct mercury analyser (DMA-80) was used for Hg determination. In addition, the role of the haematological parameters as possible indicators of different biodistribution was evaluated. A statistically significant value was observed from our analysed metals in the substrates: arsenic (p < 0.001), cadmium (p < 0.01), lead (p < 0.001) and mercury (p < 0.0001). The correlation analysis showed a relationship between milk and blood for arsenic (p < 0.0001) and lead (p < 0.0001), and no correlation for the metals was observed between milk/blood and the haematological parameters analysed for the low concentration observed in the present study comforting the final consumer.

Toxic elements identified in breast milk of mothers residing in water contaminated region of Sindh and their impact on infants' growth patterns: A case-control study

Breast milk is a vital source of nutrition for breastfed infants, providing essential nutrients and elements but, in some cases, toxic ones. This is the first case-control study that investigated the elemental profile of breast milk samples collected from mothers residing in Matiari (Sindh), a region with insufficient industrial waste management, and its potential impact on infants' anthropometrics. Precisely, 62 milk samples, including 42 cases and 20 controls, were analyzed using the ICP-MS technique. Overall, six elements showed significance between the two groups, arsenic (As) was present at 0.68 μg/L in cases and absent in controls, while lead (Pb) exhibited elevated concentrations in the case group at 4.56 μg/L compared to 0.25 μg/L in controls, well-known for their toxicity. Barium (Ba) and manganese (Mn) levels were also higher in cases, associated with reported health effects on child well-being. Essential elements molybdenum (Mo) and selenium (Se) were higher in the controls. Furthermore, the association of these metals with the child growth standards as per WHO guidelines was calculated. Linear regression analysis revealed As negatively associated with WAZ and WHZ scores, while Mo was positively associated with WAZ, WHZ, and HAZ scores. These findings highlight serious health concerns in the region, where toxic elements pervade drinking water and food sources. Immediate actions are imperative to maintain the wellness of future generations.

Evaluating Heavy Metals in Human Breast Milk: a Cross-Sectional Study from Mining and Agricultural Areas in Northwestern Iran

This study aimed to assess the levels of heavy metals in the breast milk of women residing in the mining and agricultural areas of East Azerbaijan province in Iran. This cross-sectional study analyzed 68 lactating mothers from mining (n = 28) and agricultural (n = 40) areas of East Azerbaijan province in Iran between June 2022 and March 2023. The study used an Inductively Coupled Plasma Optical Emission Spectroscopy (ICP-OES) to measure the concentrations of heavy metals, including arsenic (As), chromium (Cr), copper (Cu), and iron (Fe). A semi-quantitative food frequency questionnaire (SQ-FFQ) was used to collect data on the dietary and sociodemographic characteristics of the mothers. Although the concentration of arsenic (As) was below the limit of detection (LOD), the mean concentrations of chromium (Cr), copper (Cu), and iron (Fe) were 1.11, 0.87, and 13.25 mg/L in agricultural areas and 0.83, 0.93, and 11.35 mg/L in mining areas, respectively. The concentrations of Cr (p < 0.001) and Fe (p = 0.019) were significantly higher in the breast milk of women residing in agricultural areas. However, the concentration of Cu was significantly higher (p = 0.085) in the breast milk of women living in mining areas. Additionally, lactation age had a significant effect on Cu levels (p = 0.015), with a negative coefficient of -0.011. The study indicates that the levels of heavy metals in breast milk can be influenced by the exposure to pesticides, fertilizers, volcanic soil, and disparities in access to post-natal care and iron supplements.

Toxic metals and pediatric clinical immune dysfunction: A systematic review of the epidemiological evidence

BACKGROUND

Children are at high risk for exposure to toxic metals and are vulnerable to their effects. Significant research has been conducted evaluating the role of these metals on immune dysfunction, characterized by biologic and clinical outcomes. However, there are inconsistencies in these studies. The objective of the present review is to critically evaluate the existing literature on the association between toxic metals (lead, mercury, arsenic, and cadmium) and pediatric immune dysfunction.

METHODS

Seven databases (PubMed (NLM), Embase (Elsevier), CINAHL (Ebsco), Web of Science (Clarivate Analytics), ProQuest Public Health Database, and ProQuest Environmental Science Collection) were searched following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in February 2024. Rayaan software identified duplicates and screened by title and abstract in a blinded and independent review process. The remaining full texts were reviewed for content and summarized. Exclusions during the title, abstract, and full-text reviews included: 1) not original research, 2) not epidemiology, 3) did not include toxic metals, 4) did not examine an immune health outcome, or 5) not pediatric (>18 years). This systematic review protocol followed the PRISMA guidelines. Rayaan was used to screen records using title and abstract by two blinded and independent reviewers. This process was repeated for full-text article screening selection.

RESULTS

The search criteria produced 7906 search results; 2456 duplicate articles were removed across search engines. In the final review, 79 studies were included which evaluated the association between toxic metals and outcomes indicative of pediatric immune dysregulation.

CONCLUSIONS

The existing literature suggests an association between toxic metals and pediatric immune dysregulation. Given the imminent threat of infectious diseases demonstrated by the recent COVID-19 epidemic in addition to increases in allergic disease, understanding how ubiquitous exposure to these metals in early life can impact immune response, infection risk, and vaccine response is imperative.

Lactational Exposure of Human Infants to Metal (loid)s: A Comparison of Industrial and Urban Inhabitants in North of the Persian Gulf

In this study, postnatal metal (loid)s (MLs) exposure was compared between the petrochemical and gas area of Asaluyeh (PGA) and urban area of Kaki (UA) in Bushehr province, Iran. Two hundred human breast milk (BM) samples from the industrial and urban areas were analyzed for MLs using Inductivity Coupled Plasma-Optical Emission Spectrometry (ICP-OES). Boron (B), copper (Cu), iron (Fe), and nickel (Ni) were found at the highest levels in both study areas. Adjusted multiple linear regression models revealed that the mean concentration of total MLs in BM samples collected from the PGA was statistically significantly greater than that of the UA (655.85 vs. 338.17 µg/L). Also, the mean concentrations of all detected MLs in BM samples collected from the PGA were statistically significantly higher than those collected from the UA. The hazard index (HI) of combined MLs in the PGA and UA illustrated non-cancer risk for infants. Lead (Pb) and chromium (Cr) in the PGA and Cr in the UA showed the risk of cancer. So it can be concluded that nursing infants from an industrial area are most at risk for MLs exposure during entire lactation course than those from an urban area.

Essential and non-essential element concentrations in human milk samples and the assessment of infants' exposure

As the data concerning element concentrations in human milk (HM) samples and their intake by infants are lacking in Poland, the present study aimed to explore this issue. The material consisted of HM samples obtained from 30 exclusively breastfeeding mothers during 4-6 weeks postpartum. Additionally, to identify the factors that may potentially affect HM composition, information regarding maternal data (anthropometry, body composition, and diet) was also collected. Maternal diet was assessed with two methods-a food frequency questionnaire and 3-day dietary records. In total, 18 essential and non-essential elements were determined. For the elements analysis, we used inductively coupled plasma quadrupole mass spectrometry. Most of the elements (n = 11, 61%) were detected in all HM samples. In all HM samples tin concentration was higher (5.67 ± 2.39 μg/L) than the usual range reported by the World Health Organization (~ 1.0 μg/L). HM cadmium content was positively associated with maternal salty snacks intake (r = 0.502, p = 0.005), arsenic with whole-grain products intake (r = 0.37, p = 0.043), and mercury concentration with fruits and seeds/nuts consumption (r = 0.424, p = 0.042 and r = 0.378, p = 0.039, respectively). Higher HM lead concentration was predicted by maternal age (95% CI [0.94-0.97]), intake of fish (95% CI [1.01-1.03]), and vegetables (95% CI [1.02-1.06]). The highest infants' intake was observed for copper (35.24 ± 12.48) and the lowest for arsenic (0.076 ± 0.102). Infants' exposure to lead was associated with maternal frequency consumption of canned fish (p = 0.0045). There is a need to perform further research on this topic to maximize the benefits of breastfeeding by minimizing maternal and infant exposure to potentially toxic elements.

Health risk assessments of heavy metals and trace elements exposure in the breast milk of lactating mothers in the Northeastern Iran

Mother's breast milk is a natural and complete food for infants but can be a main source of exposure to toxic pollutants. These pollutants can negatively affect the health of the infant. Therefore, conducting biomonitoring surveys is essential to evaluate such health effects in toxicological research. This study aimed to estimate the probable health risks for infants exposed to essential and non-essential trace elements through breast milk ingestion. This descriptive-analytical, cross-sectional study was performed on 90 breastfeeding mothers referred to the health centers in Mashhad, Iran in January 2021. The health risk assessments (carcinogenic and non-carcinogenic risk) were estimated using chronic daily intake (CDI), hazard quotient (HQ), hazard index (HI), and lifetime carcinogenic risk (CR), which were recommended by the US Environmental Protection Agency (US EPA). The results of the HQ values of trace elements through ingestion exposure for arsenic (90%), copper (90%), zinc (40%), and iron (10%) exceeded the threshold of HQ, and arsenic (66.59%), copper (16.91%), and zinc (9.68%) and iron (4.57%) had the highest contribution to increasing the HI index. The average value of CR was 5. 08 × 10-3. Chromium and iron showed significant relationships (P<0.05) with education level and disease background in this study, and the concentration of chromium, iron, and zinc in the breast milk samples significantly changed during lactation stages (P<0.05). Overall, the risk of carcinogenicity through exposure to breast milk for infants was higher than the safety level of US EPA risk. Therefore, there could be a potential health risk of trace elements, particularly arsenic, copper, and zinc for infants in Mashhad, Iran through the consumption of mothers' breast milk. More efforts are required to control and reduce routes of receiving trace elements in breastfeeding mothers by the competent authorities.

Polyphenol exposure of mothers and infants assessed by LC-MS/MS based biomonitoring in breast milk

Exposure to polyphenols is relevant throughout critical windows of infant development, including the breastfeeding phase. However, the quantitative assessment of polyphenols in human breast milk has received limited attention so far, though polyphenols may positively influence infant health. Therefore, a targeted LC-MS/MS assay was developed to investigate 86 analytes representing different polyphenol classes in human breast milk. The sample preparation consisted of liquid extraction, salting out, freeze-out, and a dilution step. Overall, nearly 70% of the chemically diverse polyphenols fulfilled all strict validation criteria for full quantitative assessment. The remaining analytes did not fulfill all criteria at every concentration level, but can still provide useful semi-quantitative insights into nutritional and biomedical research questions. The limits of detection for all analyzed polyphenols were in the range of 0.0041-87 ng*mL-1, with a median of 0.17 ng*mL-1. Moreover, the mean recovery was determined to be 82% and the mean signal suppression and enhancement effect was 117%. The developed assay was applied in a proof-of-principle study to investigate polyphenols in breast milk samples provided by twelve Nigerian mothers at three distinct time points post-delivery. In total, 50 polyphenol analytes were detected with almost half being phenolic acids. Phase II metabolites, including genistein-7-β-D-glucuronide, genistein-7-sulfate, and daidzein-7-β-D-glucuronide, were also detected in several samples. In conclusion, the developed method was demonstrated to be fit-for-purpose to simultaneously (semi-) quantify a wide variety of polyphenols in breast milk. It also demonstrated that various polyphenols including their biotransformation products were present in breast milk and therefore likely transferred to infants where they might impact microbiome development and infant health.

Accumulation characteristics of metals in human breast milk and association with dietary intake in northeastern China

The trace elements present in breast milk play a vital role in the growth and development of infants. Nevertheless, numerous studies have reported the presence of toxic metal contamination in breast milk from various countries and regions, which poses potential risks to breastfed infants. This article aimed to investigate the characteristics of trace elements in breast milk and explore the relationship between breast milk and diet in Dalian, a coastal city in northeastern China. Breast milk samples and representative local food samples were collected from Dalian for research. The results revealed that 57 % of breast milk samples significantly exceeded the WHO safety limit (0.6 μg/L) for arsenic, with a measured mean value of 0.96 μg/L. Moreover, the levels of chromium (mean value: 2.63 μg/L) in 34 % of breast milk samples exceed the WHO recommended safety level (chromium: 1.5 μg/L). Aquatic foods accounted for 60 % to 90 % of the total intake of arsenic, cadmium, vanadium, mercury, and lead. The Spearman correlation analysis demonstrated strong positive correlations among breast milk metal elements, including copper-zinc (r = 0.68) and nickel‑chromium (r = 0.89). Furthermore, the food-to-milk accumulation factors (FMAF) of strontium, nickel, arsenic, vanadium, cadmium, and mercury were relatively low (median values <0.005). While the FMAF values for chromium and lead were higher, with median values of 0.038 and 0.07, respectively. The results indicated potential risks of the toxic metal arsenic in breast milk from Dalian, China for breastfed infants. Therefore, continuous monitoring of breast milk for toxic metals and foodborne contamination is necessary.

Concentrations of Lead and Arsenic in Mother's Milk and Children's Blood in Peruvian Breastfeeding Dyads

BACKGROUND

Toxic trace elements could enter human milk through mothers' food consumption, drinking water, air, or incidental soil ingestion, and are of concern to the nursing infant.

RESEARCH AIM

To determine the concentration of toxic trace elements (lead and arsenic) in Peruvian mothers' milk and their association with blood concentrations in their own infants 3-20 months old.

METHOD

This exploratory, cross-sectional study, carried out in Peru, included breastfeeding mother/child dyads (N = 40). Following standardized protocols, biospecimens of human milk and child's blood were collected.

RESULTS

Lead and arsenic concentrations in milk were above the method detection limits in 73% and 100% of samples with median concentrations of 0.26 µg/L (IQR = 0.10, 0.33 µg/L) and 0.73 µg/L (IQR = 0.63, 0.91 µg/L), respectively. Concentrations of lead and arsenic in blood were 2.05 µg/dL (SD = 1.35), and 1.43 µg/dl (geometric mean: SD = 1.39), respectively. Blood lead concentrations in 12.5% (n = 5) of the samples were above the U.S. Center for Disease Control and Prevention reference value (< 3.5 µg/dl), and over half of arsenic concentrations were above the acceptable levels of < 1.3 µg/dl (Mayo Clinic Interpretative Handbook). Our results showed that for every one-month increase in age, lead blood concentrations increased by 0.1 µg/dl (p = 0.023). Additionally, every 1 µg/L increase in the mother's milk arsenic was associated with a 1.40 µg/dl increase in the child's blood arsenic concentration.

CONCLUSIONS

Implementing effective interventions to decrease the toxic exposure of reproductive-aged women is needed in Peru and worldwide.

Aluminum Concentrations in Breast Milk Samples Obtained from Breastfeeding Women from a Resource-Limited Country: A Study of the Predicting Factors

This study assessed aluminum concentrations in breast milk samples obtained from breastfeeding women in resource-limited countries, estimated daily intake of aluminum by breastfed infants, and identified predictors of higher breast milk aluminum concentrations. A descriptive analytical approach was used in this multicenter study. Breastfeeding women were recruited from different maternity health clinics in Palestine. Aluminum concentrations in 246 breast milk samples were determined using an inductively coupled plasma-mass spectrometric method. The mean breast milk aluminum concentration was 2.1 ± 1.5 mg/L. The mean estimated daily intake of aluminum by infants was 0.37 ± 0.26 mg/kg body weight/day. Multiple linear regression showed that breast milk aluminum concentrations were predicted by living in urban areas, closer to industrial areas, waste disposals, frequent use of deodorants, and less frequent use of vitamins. Breast milk aluminum levels among Palestinian breastfeeding women were comparable to those previously determined in occupationally unexposed women.

Alteration of epigenetic methyl and acetyl marks by postnatal chromium(VI) exposure causes apoptotic changes in the ovary of the F1 offspring

Hexavalent chromium, Cr(VI), is a heavy metal endocrine disruptor used widely in various industries worldwide and is considered a reproductive toxicant. Our previous studies demonstrated that lactational exposure to Cr(VI) caused follicular atresia, disrupted steroid hormone biosynthesis and signaling, and delayed puberty. However, the underlying mechanism was unknown. The current study investigated the effects of Cr(VI) exposure (25 ppm) during postnatal days 1-21 via dam's milk on epigenetic alterations in the ovary of F1 offspring. Data indicated that Cr(VI) disrupted follicle development and caused apoptosis by increasing DNMT3a /3b and histone methyl marks (H3K27me3 and H3K9me3) along with decreasing histone acetylation marks (H3K9ac and H3K27ac). Our study demonstrates that exposure to Cr(VI) causes changes in the epigenetic marks, partially contributing to the transcriptional repression of genes regulating ovarian development, cell proliferation (PCNA), cell survival (BCL-XL and BCL-2), and activation of genes regulating apoptosis (AIF and cleaved caspase-3), resulting in follicular atresia. The current study suggests a role for epigenetics in Cr(VI)-induced ovotoxicity and infertility.

Comparison between pollutants found in breast milk and infant formula in the last decade: A review

Since ancient times, breastfeeding has been the fundamental way of nurturing the newborn. The benefits of breast milk are widely known, as it is a source of essential nutrients and provides immunological protection, as well as developmental benefits, among others. However, when breastfeeding is not possible, infant formula is the most appropriate alternative. Its composition meets the nutritional requirements of the infant, and its quality is subject to strict control by the authorities. Nonetheless, the presence of different pollutants has been detected in both matrices. Thus, the aim of the present review is to make a comparison between the findings in both breast milk and infant formula in terms of contaminants in the last decade, in order to choose the most convenient option depending on the environmental conditions. For that, the emerging pollutants including metals, chemical compounds derived from heat treatment, pharmaceutical drugs, mycotoxins, pesticides, packaging materials, and other contaminants were described. While in breast milk the most concerning contaminants found were metals and pesticides, in infant formula pollutants such as metals, mycotoxins, and packaging materials were the most outstanding. In conclusion, the convenience of using a feeding diet based on breast milk or either infant formula depends on the maternal environmental circumstances. However, it is important to take into account the immunological benefits of the breast milk compared to the infant formula, and the possibility of using breast milk in combination with infant formula when the nutritional requirements are not fulfilled only with the intake of breast milk. Therefore, more attention should be paid in terms of analyzing these conditions in each case to be able to make a proper decision, as it will vary depending on the maternal and newborn environment.

Human health risk assessment of potentially toxic elements in the breast milk consumed by infants in Western Iran

This study aimed to assess the human health risk of some toxic metals/metalloids [lead (Pb), mercury (Hg), cadmium (Cd), nickel (Ni), chromium (Cr), and arsenic (As)] on infants via consumption of the breast milk of women living in urban areas of Kermanshah city, west of Iran. After collecting milk samples, the carcinogenic and non-carcinogenic risk assessment as well as uncertainty analysis of toxic metal levels were carried out. The order of concentration of heavy metals/metalloids in the breast milk samples was Cr (41.07 ± 23.19) > Ni (19.25 ± 11.81) > Pb (11.5 ± 4.48) > As (1.96 ± 2.04) > Cd (.72 ± 0.42) > Hg (0.31 ± 0.26). The results revealed that the levels of Cr and Pb in the breast milk samples were exceeded the World Health Organization (WHO) tolerable daily intake. In the breast milk samples a high levels of one of the trace elements As, Cd, Cr, Pb, and Ni were observed (over 73%) and in 40% of them the levels of Cr, Pb, Cd, As, and Ni were all above WHO tolerable daily intake. Moreover, the As-related point assessment of target risk factor (THQ) was higher than the allowable limit only for 1-month-old male neonates and 2-month-old female neonates (THQ > 1). In addition, Cr-related THQ scores were higher at all age and gender groups (THQ > 1). In conclusion, our findings suggest a potential risk of some metals for infants via the consumption of mothers' breast milk.

Detection of Cadmium and Lead in Kidney Stones. Associations with Patient Demographics, Stone Composition, and Smoking

BACKGROUND

Kidney stones are a highly prevalent disease worldwide. Additionally, both environmental and occupational exposure to Pb and Cd continue to be prevalent globally and can result in renal toxicity. The objective of this study was to examine the potential presence of Pb and Cd in kidney stones, and to assess for correlation with demographic factors including smoking, gender, age, and kidney stone matrix composition.

METHODS

Patient kidney stones (n = 96) were analyzed using Fourier transform infrared spectroscopy to identify the stone constituents. Cd and Pb concentrations (µg/g) were determined by inductively coupled plasma mass spectrometry. Cd and Pb concentrations were correlated using bivariable and multivariable statistical analysis with demographic factors (age, gender, smoking status), and kidney stone composition.

RESULTS

Kidney stone Cd (median 0.092 µg/g, range 0.014 to 2.46) and Pb concentrations (median 0.95 µg/g, range 0.060 to 15.4) were moderately correlated (r = 0.56, P < 0.0001). Cd concentrations were positively associated with patient history of smoking, patient age, and calcium oxalate monohydrate levels while negatively associated with struvite and uric acid/uric acid dihydrate. Pb concentrations were positively associated with females and apatite levels while negatively associated with uric acid/uric acid dihydrate. After holding constant other stone type composition levels, smoking status, and age, both Pb and Cd were positively associated with apatite and negatively associated with uric acid/uric acid dihydrate, struvite, and calcium carbonate.

CONCLUSIONS

Cd and Pb kidney stone concentrations are associated with specific kidney stone types. Cd and Pb kidney stone concentrations are both associated with smoking.

The impact of the 2019/2020 Australian landscape fires on infant feeding and contaminants in breast milk in women with asthma

BACKGROUND

The 2019/2020 Australian landscape fires (bushfires) resulted in prolonged extreme air pollution; little is known about the effects on breastfeeding women and their infants. This study aimed to examine the impact of prolonged landscape fires on infant feeding methods and assess the concentration of polycyclic aromatic hydrocarbons (PAHs) and elements in breast milk samples.

METHODS

From May - December 2020, women with asthma, who were feeding their infants during the fires, were recruited from an existing cohort. Data on infant feeding and maternal concern during the fires were retrospectively collected. Breast milk samples were collected from a sample of women during the fire period and compared with samples collected outside of the fire period for levels of 16 PAHs (gas chromatography coupled with mass spectrometry), and 20 elements (inductively coupled plasma-mass spectrometry).

RESULTS

One-hundred-and-two women who were feeding infants completed the survey, and 77 provided 92 breast milk samples. Two women reported concern about the impact of fire events on their infant feeding method, while four reported the events influenced their decision. PAHs were detected in 34% of samples collected during, versus no samples collected outside, the fire period (cross-sectional analysis); specifically, fluoranthene (median concentration 0.015 mg/kg) and pyrene (median concentration 0.008 mg/kg) were detected. Women whose samples contained fluoranthene and pyrene were exposed to higher levels of fire-related fine particulate matter and more fire days, versus women whose samples had no detectable fluoranthene and pyrene. Calcium, potassium, magnesium, sodium, sulphur, and copper were detected in all samples. No samples contained chromium, lead, nickel, barium, or aluminium. No statistically significant difference was observed in the concentration of elements between samples collected during the fire period versus outside the fire period.

CONCLUSIONS

Few women had concerns about the impact of fire events on infant feeding. Detection of fluoranthene and pyrene in breast milk samples was more likely during the 2019/2020 Australian fire period; however, levels detected were much lower than levels expected to be related to adverse health outcomes.

Concentrations and predictors of aluminum, antimony, and lithium in breast milk: A repeated-measures study of donors

Aluminum (Al), antimony (Sb), and lithium (Li) are relatively common toxic metal(oid)s that can be transferred into breast milk and potentially to the nursing infant. This study assessed concentrations of Al, Sb, and Li in breast milk samples collected from donor mothers and explored the predictors of these concentrations. Two hundred forty-two pooled breast milk samples were collected at different times post-partum from 83 donors in Spain (2015-2018) and analyzed for Al, Sb, and Li concentrations. Mixed-effect linear regression was used to investigate the association of breast milk concentrations of these elements with the sociodemographic profile of the women, their dietary habits and utilization of personal care products (PCPs), the post-partum interval, and the nutritional characteristics of milk samples, among other factors. Al was detected in 94% of samples, with a median concentration of 57.63 μg/L. Sb and Li were detected in 72% and 79% of samples at median concentrations of 0.08 μg/L and 0.58 μg/L, respectively. Concentrations of Al, Sb, and Li were not associated with post-partum time. Al was positively associated with total lipid content of samples, weight change since before pregnancy, and coffee and butter intakes and inversely with meat intake. Li was positively associated with intake of chocolate and use of face cream and eyeliner and inversely with year of sample collection, egg, bread, and pasta intakes, and use of hand cream. Sb was positively associated with fatty fish, yoghurt, rice, and deep-fried food intakes and use of eyeliner and inversely with egg and cereal intakes and use of eyeshadow. This study shows that Al, Sb, and Li, especially Al, are widely present in donor breast milk samples. Their concentrations in the milk samples were most frequently associated with dietary habits but also with the lipid content of samples and the use of certain PCPs.

Passive exposure to electronic cigarette aerosol in pregnancy: A case study of a family

BACKGROUND

Passive exposure to the aerosols of electronic cigarettes (e-cigarettes) has been little studied. We assessed this exposure in late pregnancy in a woman and her 3-year-old child, exposed through e-cigarette use by another household member.

METHODS

This prospective longitudinal case study involved a family unit consisting of an e-cigarette user, a pregnant woman who delivered an infant during the study, and the couple's older 3-year-old son. At 31, 36, and 40 weeks of the pregnancy, we measured biomarkers (nicotine metabolites, tobacco-specific nitrosamines, propanediols, glycerol, and metals) in the urine and hair of all three participants and in the saliva of the adults, in cord blood at delivery, and in the breast milk at the postpartum period.

RESULTS

Samples from the e-cigarette user showed quantifiable concentrations of all analytes assessed (maximum urinary cotinine concentration, 4.9 ng/mL). Among samples taken from the mother, nicotine and its metabolites were found mainly in urine and also in saliva and hair, but not in cord blood. During the postpartum period, we found cotinine concentrations of 2.2 ng/mL in the mother's urine and 0.22 ng/mL in breast milk; 1,2-propanediol was generally detected in urine and saliva, but not in cord blood or breast milk. The maximum urinary cotinine concentration in the 3-year-old child was 2.6 ng/mL and propanediols also were detected in his urine. Nitrosamines were not detected in samples taken from the mother or the 3-year-old. Metals found in the refill liquid were detected at low levels in both the mother and the 3-year-old.

CONCLUSIONS

We detected low but not negligible concentrations of e-cigarette-related analytes (including cord blood and breast milk) in an exposed pregnant non-user and in a 3-year-old child also living in the home. Passive exposure to e-cigarette aerosols cannot be disregarded and should be assessed in larger observational studies.

Toxic metal and trace element status in the breast milk of Turkish new-born mothers

BACKGROUND AND AIM

This study aims to evaluate the toxic metal and trace element concentrations in breast milk obtained from new-born nursing mothers in rural Giresun province, located on the coast of the Black Sea.

METHODS

Milk samples were randomly collected once from early lactation of 50 nursing mothers. Inductively coupled plasma mass spectrometry was used to analyse the concentrations of iron (Fe), nickel (Ni), manganese (Mn), cobalt (Co), chromium (Cr), copper (Cu), zinc (Zn), arsenic (As), molybdenum (Mo), cadmium (Cd) and lead (Pb) in the breast milk. Shapiro-Wilk test was used to evaluate the distribution of data. The Pearson-J correlation was used for normally distributed elements, and Spearman correlation analysis was used for others.

RESULTS

The mean amounts of elements were 3.36 µg kg^-1 of Cr, 9.26 µg kg^-1 of Mn, 797 µg kg^-1 of Fe, 1.99 µg kg^-1 of Ni, 5.92 µg kg^-1 of Cu, 379 µg kg^-1 of Zn and 2.23 µg kg^-1 of Pb. Co, As, Mo and Cd concentrations were below the detection limit. A highly significant correlation was found between iron and Nickel in breast milk.

CONCLUSION

Our findings were evaluated in comparison with the WHO data, and whether they were in accordance with the recommended Dietary Reference Intake (DRI) values for 0-6-months-old infants was calculated. Pb levels were similar to those of WHO, while As and Cd were below the measurable limit. Fe, Mn, and Cr concentrations were higher than WHO data, while Co, Ni, Cu and Zn were lower. This research is the first study conducted in this region.

Mineral Content (Essential and Toxic Elements) of Squid Flesh Is Affected by Maceration with Sodium Salts and Vacuum-Cooking

Maceration with sodium salts is applied to irmprove water holding capacity in squid-based products. The aim of this work was to determine how the mineral content of squid flesh is affected by maceration and further vacuum-cooking. Atlantic squids (Loligo vulgaris) from two fisheries (FAO areas No. 47 and 34) were sampled. Macrominerals (g/100 g) present in raw flesh were Na, Mg, P, S, K and Ca, while microminerals accounting for >1 mg/kg were Zn, Si, Sr, Fe, Cu, Al and Mn. As a result of maceration (3 + 1.5% w: w NaCl+ Na citrate) and vacuum-cooking (at 65 °C for 20 min), some squid minerals was removed. The levels of Cd and As were reduced by half, while Na content increased from 0.28 to 0.49 g/100 g. Maceration with sodium salts generally led to minerals leaching (except for Na) with the medium. Further cooking produced additional losses of most of the minerals present in macerated squid (except Pb and Cd). Squid microminerals were hardly removed with the cooking juice. The consumption of macerated-cooked squid covered > 10% of the recommended dietary intake for Na, P, Zn, Mg and Mn, while health risks were almost negligible and mainly concerned Cd (up to 14% of the probable tolerable weekly intake). The combination of both treatments involves certain loss of most of the essential minerals but also contributes to reducing toxicological risks related to mineral intake through squid products.

Association of Zn and Cu Levels in Cord Blood and Maternal Milk with Pregnancy Outcomes among the Slovenian Population

Trace elements, including zinc (Zn) and copper (Cu), are known to play important roles in human health. The present study aimed to assess the levels of Zn and Cu in cord blood and maternal milk and to analyze their association with maternal and infant characteristics and pregnancy outcomes in a Slovenian study population of mothers and their neonates recruited within the PHIME prospective cohort study. The study included 324 mothers, but the data on Zn and Cu levels in both cord blood and maternal milk was available for 243 mothers. Questionnaires were used to assess the socio-demographic and health status of the mothers, their lifestyle habits (including detailed nutritional habits), and their residential and occupational histories. Inductively Coupled Plasma Mass Spectrometry (ICP-MS) was used to measure Zn and Cu levels in cord blood and maternal milk. Low Zn levels in cord blood were associated with lower gestational age and birth weight and were correlated with an increased probability of the birth of small for gestational age (SGA) infants. Maternal smoking influenced the Cu levels in both cord blood and maternal milk. Cord blood Cu levels were higher and Cu levels in maternal milk were lower in smoking compared to non-smoking mothers. Most importantly, a decreased Zn/Cu ratio in cord blood was associated with lower gestational age and lower birth weight. This indicates the overall positive effects of Zn and negative effects of Cu on pregnancy outcomes.

Toxic metal exposures from infant diets: Risk prevention strategies for caregivers and health care professionals

Concerns are growing regarding the presence of toxic elements such as arsenic (As), cadmium (Cd), mercury (Hg), and lead (Pb) in the ingredients and prepared foods for infants and young children. There are few clear, evidence-based, guidelines on the maximum tolerable limits of toxicants in foods and little understanding of toxicant exposure or adverse health effects attributable to dietary exposure. Caregivers are faced with the burden of making decisions about which foods to select, how often to feed them to their children, and what foods to limit. This article reviews the current literature and existing recommendations on dietary exposure to toxic elements in children under 2 years of age, and their health effects in early childhood-focusing on growth, neurodevelopment, and immune function. The article also outlines best practices for healthcare providers to address the concerns of toxic element exposure through the diet in young children. Several foods consistently appear in the literature as potential sources of toxic element exposure. Contaminated drinking and cooking water, including water used to prepare infant formula, could also be a major exposure source. In the absence of stronger evidence on effects of dietary modification, exclusive breastfeeding until six months of age, followed by a diverse diet are some strategies to reduce dietary toxic element exposure while ensuring an adequate and balanced nutrient intake. Healthcare providers can support families by sharing information and encouraging blood Pb testing, the only element for which such testing is currently recommended.

Infant exposure to trace elements in breast milk, infant formulas and complementary foods from southern China

Excessive intake of essential trace elements or exposure to potentially toxic elements above certain thresholds may cause adverse health effects in humans. To date, there is scarce evidence concerning Chinese infant exposure to trace elements and the associated risks. In this study, we collected 61 breast milk, 54 infant formula and 90 complementary food samples from southern China to investigate the levels of cobalt (Co), chromium (Cr), copper (Cu), selenium (Se), zinc (Zn), arsenic (As), cadmium (Cd), nickel (Ni) and lead (Pb). The concentrations of these elements in the breast milk samples ranged from under the limit of detection (<LOD)-0.65, <LOD-65.5, 107-1040, 6.17-27.9, 820-10,160, <LOD-2.96, <LOD-0.52, <LOD-230, and <LOD-19.1 μg/L, respectively. In infant formula samples, the concentrations of these elements ranged from 2.77 to 7.56, 27.5-205, 188-4321, 69.7-322, 40,793-84,405, 2.47-12.2, 0.15-3.57, <LOD-505 and 2.19-26.5 μg/kg, respectively, while the concentrations detected in complementary food samples ranged from <LOD-23.7, <LOD-224, <LOD-3705, <LOD-219, 15,335-100,905, <LOD-159, <LOD-66.6, <LOD-502 and <LOD-25.6 μg/kg, respectively. The results showed that the levels of Cr, Cu and Se in 14.8-55.6 % of the infant formula and complementary food samples were lower than the reference values set by Codex Alimentarius or Chinese National Standards, while the levels of Zn in commercial food samples exceeded the corresponding reference values in 9.3-27.8 % of cases; these results suggest a potential risk via the consumption of commercial infant foods. To the best of our knowledge, this is the first study that has comprehensively assessed whether exposure to trace elements via food intake poses potential health risks to Chinese infants.

Contamination of breast milk with lead, mercury, arsenic, and cadmium in Iran: a systematic review and meta-analysis

Breast milk is a complete food for the development of the newborn, but it can also be an important route for environmental pollutants transmission to the infants. This study was aimed to evaluate the status of heavy metals including lead (Pb), mercury (Hg), cadmium (Cd) and arsenic (As) in the breast milk of Iranian mothers. The international databases including Scopus, PubMed, Web of Science and the Persian electronic databases including Scientific Information Database, IranMedex and Magiran were examined to find relevant articles published until July 2021. A total of 23 studies examined the levels of toxic metals in Iranian breast milk samples. According to the findings, the pooled average concentrations (µg/L) of Pb, Cd, Hg and As were 25.61, 2.40, 1.29 and 1.16, respectively. The concentration of Hg and Pb in colostrum milk was more than twice of mature milk. The Hg mean concentration in the breast milk of mothers with at least one amalgam-filled tooth was approximately three times that of mothers without amalgam-filled teeth. Risk assessment analysis indicated that the intake of Pb and Hg by infants through breastfeeding can be considered a health concern in Iran. It seems necessary to reduce the Pb exposure of pregnant and lactating women in Iran. However, more extensive studies are needed to clarify the toxic metals' exposure status of infants through breast milk in other parts of the country.

Intra- and Inter-Day Element Variability in Human Breast Milk: Pilot Study

For infants in the first months of life, breast milk is a complete source of nutrition; however, it can also contain elements that are harmful to the infant. It is therefore critical for infant health to characterize breast milk. The aim of this study was to determine the intra- and inter-day variation of elements in breast milk, for which there is currently limited information, as a pilot study for a larger study. Firstly, we developed a simple and robust analytical method for the determination of multiple elements in breast milk. It was accurate (accuracy ranged from 98% to 107%) for measurement of 26 elements in breast milk by quadrupole inductively coupled plasma-mass spectrometry. Intra- and inter-day variation of elements, protein, and fat in breast milk was determined by analyzing breast milk collected from 11 women at 12 sampling points over three days and calculating intraclass correlation coefficients. Intraclass correlation coefficients showed that while some elements were consistent across time points (e.g., Sr, Ca, and Cu), others showed very high variability (e.g., As, Cd, and Ni). Correlation analyses between elements in breast milk showed strong relationships between those including Fe and Mo, Ca and Sr, and Cd and Fe.