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Deierlein AL, Teitelbaum SL, Windham GC, Pinney SM, Galvez MP, Caldwell KL, Jarrett JM, Gajek R, Kushi LH, Biro F, Wolff MS. Lead exposure during childhood and subsequent anthropometry through adolescence in girls. Environ Int 2019; 122:310-315. [PMID: 30503317 PMCID: PMC6366327 DOI: 10.1016/j.envint.2018.11.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 10/22/2018] [Accepted: 11/12/2018] [Indexed: 05/18/2023]
Abstract
INTRODUCTION Cross-sectional studies suggest that postnatal blood lead (PbB) concentrations are negatively associated with child growth. Few studies prospectively examined this association in populations with lower PbB concentrations. We investigated longitudinal associations of childhood PbB concentrations and subsequent anthropometric measurements in a multi-ethnic cohort of girls. METHODS Data were from The Breast Cancer and the Environment Research Program at three sites in the United States (U.S.): New York City, Cincinnati, and San Francisco Bay Area. Girls were enrolled at ages 6-8 years in 2004-2007. Girls with PbB concentrations collected at ≤10 years old (mean 7.8 years, standard deviation (SD) 0.82) and anthropometry collected at ≥3 follow-up visits were included (n = 683). The median PbB concentration was 0.99 μg/d (10th percentile = 0.59 μg/dL and 90th percentile = 2.00 μg/dL) and the geometric mean was 1.03 μg/dL (95% Confidence Interval (CI): 0.99, 1.06). For analyses, PbB concentrations were dichotomized as <1 μg/dL (n = 342) and ≥1 μg/dL (n = 341). Anthropometric measurements of height, body mass index (BMI), waist circumference (WC), and percent body fat (%BF) were collected at enrollment and follow-up visits through 2015. Linear mixed effects regression estimated how PbB concentrations related to changes in girls' measurements from ages 7-14 years. RESULTS At 7 years, mean difference in height was -2.0 cm (95% CI: -3.0, -1.0) for girls with ≥1 μg/dL versus <1 μg/dL PbB concentrations; differences persisted, but were attenuated, with age to -1.5 cm (95% CI: -2.5, -0.4) at 14 years. Mean differences for BMI, WC, and BF% at 7 years between girls with ≥1 μg/dL versus <1 μg/dL PbB concentrations were -0.7 kg/m2 (95% CI: -1.2, -0.2), -2.2 cm (95% CI: -3.8, -0.6), and -1.8% (95% CI: -3.2, -0.4), respectively. Overall, these differences generally persisted with advancing age and at 14 years, differences were -0.8 kg/m2 (95% CI: -1.5, -0.02), -2.9 cm (95% CI: -4.8, -0.9), and -1.7% (95% CI: -3.1, -0.4) for BMI, WC, and BF%, respectively. CONCLUSIONS These findings suggest that higher concentrations of PbB during childhood, even though relatively low by screening standards, may be inversely associated with anthropometric measurements in girls.
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Affiliation(s)
- Andrea L Deierlein
- Department of Epidemiology, College of Global Public Health, New York University, NY, NY, USA.
| | - Susan L Teitelbaum
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, NY, NY, USA
| | - Gayle C Windham
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, CA, USA
| | - Susan M Pinney
- University of Cincinnati College of Medicine, Department of Environmental Health, Cincinnati, OH, USA
| | - Maida P Galvez
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, NY, NY, USA
| | - Kathleen L Caldwell
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jeffery M Jarrett
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ryszard Gajek
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, CA, USA
| | | | - Frank Biro
- Division of Adolescent Medicine, Cincinnati Children's Hospital Center, Cincinnati, OH, USA
| | - Mary S Wolff
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, NY, NY, USA
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Affiliation(s)
- Cria G. Perrine
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion
- U.S. Public Health Service Commissioned Corps., Rockland, Maryland
| | - Kirsten A. Herrick
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Priya M. Gupta
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion
| | - Kathleen L. Caldwell
- Division of Laboratory Sciences, National Center for Environmental Health; Centers for Disease Control and Prevention, Atlanta, Georgia
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Goniewicz ML, Smith DM, Edwards KC, Blount BC, Caldwell KL, Feng J, Wang L, Christensen C, Ambrose B, Borek N, van Bemmel D, Konkel K, Erives G, Stanton CA, Lambert E, Kimmel HL, Hatsukami D, Hecht SS, Niaura RS, Travers M, Lawrence C, Hyland AJ. Comparison of Nicotine and Toxicant Exposure in Users of Electronic Cigarettes and Combustible Cigarettes. JAMA Netw Open 2018; 1:e185937. [PMID: 30646298 PMCID: PMC6324349 DOI: 10.1001/jamanetworkopen.2018.5937] [Citation(s) in RCA: 327] [Impact Index Per Article: 54.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
IMPORTANCE Use of electronic cigarettes (e-cigarettes) is increasing. Measures of exposure to known tobacco-related toxicants among e-cigarette users will inform potential health risks to individual product users. OBJECTIVES To estimate concentrations of tobacco-related toxicants among e-cigarette users and compare these biomarker concentrations with those observed in combustible cigarette users, dual users, and never tobacco users. DESIGN, SETTING, AND PARTICIPANTS A population-based, longitudinal cohort study was conducted in the United States in 2013-2014. Cross-sectional analysis was performed between November 4, 2016, and October 5, 2017, of biomarkers of exposure to tobacco-related toxicants collected by the Population Assessment of Tobacco and Health Study. Participants included adults who provided a urine sample and data on tobacco use (N = 5105). EXPOSURES The primary exposure was tobacco use, including current exclusive e-cigarette users (n = 247), current exclusive cigarette smokers (n = 2411), and users of both products (dual users) (n = 792) compared with never tobacco users (n = 1655). MAIN OUTCOMES AND MEASURES Geometric mean concentrations of 50 individual biomarkers from 5 major classes of tobacco product constituents were measured: nicotine, tobacco-specific nitrosamines (TSNAs), metals, polycyclic aromatic hydrocarbons (PAHs), and volatile organic compounds (VOCs). RESULTS Of the 5105 participants, most were aged 35 to 54 years (weighted percentage, 38%; 95% CI, 35%-40%), women (60%; 95% CI, 59%-62%), and non-Hispanic white (61%; 95% CI, 58%-64%). Compared with exclusive e-cigarette users, never users had 19% to 81% significantly lower concentrations of biomarkers of exposure to nicotine, TSNAs, some metals (eg, cadmium and lead), and some VOCs (including acrylonitrile). Exclusive e-cigarette users showed 10% to 98% significantly lower concentrations of biomarkers of exposure, including TSNAs, PAHs, most VOCs, and nicotine, compared with exclusive cigarette smokers; concentrations were comparable for metals and 3 VOCs. Exclusive cigarette users showed 10% to 36% lower concentrations of several biomarkers than dual users. Frequency of cigarette use among dual users was positively correlated with nicotine and toxicant exposure. CONCLUSIONS AND RELEVANCE Exclusive use of e-cigarettes appears to result in measurable exposure to known tobacco-related toxicants, generally at lower levels than cigarette smoking. Toxicant exposure is greatest among dual users, and frequency of combustible cigarette use is positively correlated with tobacco toxicant concentration. These findings provide evidence that using combusted tobacco cigarettes alone or in combination with e-cigarettes is associated with higher concentrations of potentially harmful tobacco constituents in comparison with using e-cigarettes alone.
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Affiliation(s)
- Maciej L. Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Danielle M. Smith
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | | | - Benjamin C. Blount
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kathleen L. Caldwell
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jun Feng
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lanqing Wang
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Carol Christensen
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Bridget Ambrose
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Nicolette Borek
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Dana van Bemmel
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Karen Konkel
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Gladys Erives
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | | | | | | | | | | | - Raymond S. Niaura
- The Schroeder Institute for Tobacco Research and Policy Studies, Truth Initiative, Washington, DC
| | - Mark Travers
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | | | - Andrew J. Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
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Herrick KA, Perrine CG, Aoki Y, Caldwell KL. Iodine Status and Consumption of Key Iodine Sources in the U.S. Population with Special Attention to Reproductive Age Women. Nutrients 2018; 10:E874. [PMID: 29986412 PMCID: PMC6073695 DOI: 10.3390/nu10070874] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 06/28/2018] [Accepted: 07/02/2018] [Indexed: 11/19/2022] Open
Abstract
We estimated iodine status (median urinary iodine concentration (mUIC (µg/L))) for the US population (6 years and over; n = 4613) and women of reproductive age (WRA) (15⁻44 years; n = 901). We estimated mean intake of key iodine sources by race and Hispanic origin. We present the first national estimates of mUIC for non-Hispanic Asian persons and examine the intake of soy products, a potential source of goitrogens. One-third of National Health and Nutrition Examination Survey (NHANES) participants in 2011⁻2014 provided casual urine samples; UIC was measured in these samples. We assessed dietary intake with one 24-h recall and created food groups using the USDA’s food/beverage coding scheme. For WRA, mUIC was 110 µg/L. For both non-Hispanic white (106 µg/L) and non-Hispanic Asian (81 µg/L) WRA mUIC was significantly lower than mUIC among Hispanic WRA (133 µg/L). Non-Hispanic black WRA had a mUIC of 124 µg/L. Dairy consumption was significantly higher among non-Hispanic white (162 g) compared to non-Hispanic black WRA (113 g). Soy consumption was also higher among non-Hispanic Asian WRA (18 g compared to non-Hispanic black WRA (1 g). Differences in the consumption pattern of key sources of iodine and goitrogens may put subgroups of individuals at risk of mild iodine deficiency. Continued monitoring of iodine status and variations in consumption patterns is needed.
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Affiliation(s)
- Kirsten A Herrick
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention (CDC), Hyattsville, MD 20782, USA.
| | - Cria G Perrine
- Division of Nutrition, Physical Activity, and Obesity, CDC, Atlanta, GA 30341, USA.
| | - Yutaka Aoki
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention (CDC), Hyattsville, MD 20782, USA.
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Vance KA, Makhmudov A, Shakirova G, Roenfanz H, Jones RL, Caldwell KL. Determination of Iodine Content in Dairy Products by Inductively Coupled Plasma Mass Spectrometry. At Spectrosc 2018. [PMID: 32336845 DOI: 10.46770/as.2018.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
A probing study to establish a reliable and robust method for determining the iodine concentration using the ELAN® DRC™ II ICP-MS was performed in combination with a sample digestion and filtration step. Dairy products from locally available sources were evaluated to help determine the possibility and need for further evaluations in relation to the U.S. population's iodine intake. Prior to analysis, the samples were aliquoted and digested for 3 hours at 90±3 °C. Dilution and filtration were performed, following the digestion. The sample extract was analyzed, and the results were confirmed with NIST SRM 1549a Whole Milk Powder. Further experimentation will need to be performed to optimize the method for projected sample concentration and throughput.
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Affiliation(s)
- Kathryn A Vance
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences, Inorganic and Radiation Analytical Toxicology Branch 4770 Buford Hwy NE, MS F-18, Atlanta, GA 30341, USA
| | - Amir Makhmudov
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences, Inorganic and Radiation Analytical Toxicology Branch 4770 Buford Hwy NE, MS F-18, Atlanta, GA 30341, USA
| | - Gulchekhra Shakirova
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences, Inorganic and Radiation Analytical Toxicology Branch 4770 Buford Hwy NE, MS F-18, Atlanta, GA 30341, USA
| | - Hanna Roenfanz
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences, Inorganic and Radiation Analytical Toxicology Branch 4770 Buford Hwy NE, MS F-18, Atlanta, GA 30341, USA
| | - Robert L Jones
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences, Inorganic and Radiation Analytical Toxicology Branch 4770 Buford Hwy NE, MS F-18, Atlanta, GA 30341, USA
| | - Kathleen L Caldwell
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences, Inorganic and Radiation Analytical Toxicology Branch 4770 Buford Hwy NE, MS F-18, Atlanta, GA 30341, USA
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Caldwell KL, Cheng PY, Jarrett JM, Makhmudov A, Vance K, Ward CD, Jones RL, Mortensen ME. Measurement Challenges at Low Blood Lead Levels. Pediatrics 2017; 140:peds.2017-0272. [PMID: 28771411 PMCID: PMC5709716 DOI: 10.1542/peds.2017-0272] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/28/2017] [Indexed: 11/24/2022] Open
Abstract
In 2012, the Centers for Disease Control and Prevention (CDC) adopted its Advisory Committee on Childhood Lead Poisoning Prevention recommendation to use a population-based reference value to identify children and environments associated with lead hazards. The current reference value of 5 μg/dL is calculated as the 97.5th percentile of the distribution of blood lead levels (BLLs) in children 1 to 5 years old from 2007 to 2010 NHANES data. We calculated and updated selected percentiles, including the 97.5th percentile, by using NHANES 2011 to 2014 blood lead data and examined demographic characteristics of children whose blood lead was ≥90th percentile value. The 97.5th percentile BLL of 3.48 µg/dL highlighted analytical laboratory and clinical interpretation challenges of blood lead measurements ≤5 μg/dL. Review of 5 years of results for target blood lead values <11 µg/dL for US clinical laboratories participating in the CDC's voluntary Lead and Multi-Element Proficiency quality assurance program showed 40% unable to quantify and reported a nondetectable result at a target blood lead value of 1.48 µg/dL, compared with 5.5% at a target BLL of 4.60 µg/dL. We describe actions taken at the CDC's Environmental Health Laboratory in the National Center for Environmental Health, which measures blood lead for NHANES, to improve analytical accuracy and precision and to reduce external lead contamination during blood collection and analysis.
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Affiliation(s)
- Kathleen L. Caldwell
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Po-Yung Cheng
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jeffery M. Jarrett
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Amir Makhmudov
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kathryn Vance
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cynthia D. Ward
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Robert L. Jones
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mary E. Mortensen
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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Affiliation(s)
- Kathryn Vance
- Centers for Disease Control and Prevention , NCEH/DLS/IRATB, Atlanta, Georgia
| | - Amir Makhmudov
- Centers for Disease Control and Prevention , NCEH/DLS/IRATB, Atlanta, Georgia
| | - Robert L Jones
- Centers for Disease Control and Prevention , NCEH/DLS/IRATB, Atlanta, Georgia
| | - Kathleen L Caldwell
- Centers for Disease Control and Prevention , NCEH/DLS/IRATB, Atlanta, Georgia
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Georgi JC, Sommer YL, Ward CD, Cheng PY, Jones RL, Caldwell KL. Biomonitoring method for the analysis of chromium and cobalt in human whole blood using inductively coupled plasma - kinetic energy discrimination - mass spectrometry (ICP-KED-MS). Anal Methods 2017; 9:3464-3476. [PMID: 29201158 PMCID: PMC5709816 DOI: 10.1039/c7ay00430c] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The Centers for Disease Control and Prevention developed a biomonitoring method to rapidly and accurately quantify chromium and cobalt in human whole blood by ICP-MS. Many metal-on-metal hip implants which contain significant amounts of chromium and cobalt are susceptible to metal degradation. This method is used to gather population data about chromium and cobalt exposure of the U.S. population that does not include people that have metal-on-metal hip implants so that reference value can be established for a baseline level in blood. We evaluated parameters such as; helium gas flow rate, choice and composition of the diluent solution for sample preparation, and sample rinse time to determine the optimal conditions for analysis. The limits of detection for chromium and cobalt in blood were determined to be 0.41 and 0.06 μg/L, respectively. Method precision, accuracy, and recovery for this method were determined using quality control material created in-house and historical proficiency testing samples. We conducted experiments to determine if quantitative changes in the method parameters affect the results obtained by changing four parameters while analyzing human whole blood spiked with National Institute of Standard and Technology traceable materials: the dilution factor used during sample preparation, sample rinse time, diluent composition, and kinetic energy discrimination gas flow rate. The results at the increased and decreased levels for each parameter were statistically compared to the results obtained at the optimized parameters. We assessed the degree of reproducibility obtained under a variety of conditions and evaluated the method's robustness by analyzing the same set of proficiency testing samples by different analysts, on different instruments, with different reagents, and on different days. The short-term stability of chromium and cobalt in human blood samples stored at room temperature was monitored over a time period of 64 hours by diluting and analyzing samples at different time intervals. The stability of chromium and cobalt post-dilution was also evaluated over a period of 48 hours and at two storage temperatures (room temperature and refrigerated at 4°C). The results obtained during the stability studies showed that chromium and cobalt are stable in human blood for a period of 64 hours.
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Affiliation(s)
- Joaudimir Castro Georgi
- Inorganic & Radiation Analytical Toxicology Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop F-50, Atlanta, GA 30341-3717
| | - Yuliya L Sommer
- Inorganic & Radiation Analytical Toxicology Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop F-50, Atlanta, GA 30341-3717
| | - Cynthia D Ward
- Inorganic & Radiation Analytical Toxicology Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop F-50, Atlanta, GA 30341-3717
| | - Po-Yung Cheng
- Inorganic & Radiation Analytical Toxicology Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop F-50, Atlanta, GA 30341-3717
| | - Robert L Jones
- Inorganic & Radiation Analytical Toxicology Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop F-50, Atlanta, GA 30341-3717
| | - Kathleen L Caldwell
- Inorganic & Radiation Analytical Toxicology Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop F-50, Atlanta, GA 30341-3717
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Shrivastava A, Kumar A, Thomas JD, Laserson KF, Bhushan G, Carter MD, Chhabra M, Mittal V, Khare S, Sejvar JJ, Dwivedi M, Isenberg SL, Johnson R, Pirkle JL, Sharer JD, Hall PL, Yadav R, Velayudhan A, Papanna M, Singh P, Somashekar D, Pradhan A, Goel K, Pandey R, Kumar M, Kumar S, Chakrabarti A, Sivaperumal P, Kumar AR, Schier JG, Chang A, Graham LA, Mathews TP, Johnson D, Valentin L, Caldwell KL, Jarrett JM, Harden LA, Takeoka GR, Tong S, Queen K, Paden C, Whitney A, Haberling DL, Singh R, Singh RS, Earhart KC, Dhariwal AC, Chauhan LS, Venkatesh S, Srikantiah P. Association of acute toxic encephalopathy with litchi consumption in an outbreak in Muzaffarpur, India, 2014: a case-control study. Lancet Glob Health 2017; 5:e458-e466. [PMID: 28153514 DOI: 10.1016/s2214-109x(17)30035-9] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 11/22/2016] [Accepted: 12/09/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Outbreaks of unexplained illness frequently remain under-investigated. In India, outbreaks of an acute neurological illness with high mortality among children occur annually in Muzaffarpur, the country's largest litchi cultivation region. In 2014, we aimed to investigate the cause and risk factors for this illness. METHODS In this hospital-based surveillance and nested age-matched case-control study, we did laboratory investigations to assess potential infectious and non-infectious causes of this acute neurological illness. Cases were children aged 15 years or younger who were admitted to two hospitals in Muzaffarpur with new-onset seizures or altered sensorium. Age-matched controls were residents of Muzaffarpur who were admitted to the same two hospitals for a non-neurologic illness within seven days of the date of admission of the case. Clinical specimens (blood, cerebrospinal fluid, and urine) and environmental specimens (litchis) were tested for evidence of infectious pathogens, pesticides, toxic metals, and other non-infectious causes, including presence of hypoglycin A or methylenecyclopropylglycine (MCPG), naturally-occurring fruit-based toxins that cause hypoglycaemia and metabolic derangement. Matched and unmatched (controlling for age) bivariate analyses were done and risk factors for illness were expressed as matched odds ratios and odds ratios (unmatched analyses). FINDINGS Between May 26, and July 17, 2014, 390 patients meeting the case definition were admitted to the two referral hospitals in Muzaffarpur, of whom 122 (31%) died. On admission, 204 (62%) of 327 had blood glucose concentration of 70 mg/dL or less. 104 cases were compared with 104 age-matched hospital controls. Litchi consumption (matched odds ratio [mOR] 9·6 [95% CI 3·6 - 24]) and absence of an evening meal (2·2 [1·2-4·3]) in the 24 h preceding illness onset were associated with illness. The absence of an evening meal significantly modified the effect of eating litchis on illness (odds ratio [OR] 7·8 [95% CI 3·3-18·8], without evening meal; OR 3·6 [1·1-11·1] with an evening meal). Tests for infectious agents and pesticides were negative. Metabolites of hypoglycin A, MCPG, or both were detected in 48 [66%] of 73 urine specimens from case-patients and none from 15 controls; 72 (90%) of 80 case-patient specimens had abnormal plasma acylcarnitine profiles, consistent with severe disruption of fatty acid metabolism. In 36 litchi arils tested from Muzaffarpur, hypoglycin A concentrations ranged from 12·4 μg/g to 152·0 μg/g and MCPG ranged from 44·9 μg/g to 220·0 μg/g. INTERPRETATION Our investigation suggests an outbreak of acute encephalopathy in Muzaffarpur associated with both hypoglycin A and MCPG toxicity. To prevent illness and reduce mortality in the region, we recommended minimising litchi consumption, ensuring receipt of an evening meal and implementing rapid glucose correction for suspected illness. A comprehensive investigative approach in Muzaffarpur led to timely public health recommendations, underscoring the importance of using systematic methods in other unexplained illness outbreaks. FUNDING US Centers for Disease Control and Prevention.
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Affiliation(s)
- Aakash Shrivastava
- National Centre for Disease Control, India, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, Delhi, India
| | - Anil Kumar
- National Centre for Disease Control, India, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, Delhi, India
| | - Jerry D Thomas
- National Center for Environmental Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kayla F Laserson
- Global Disease Detection Program, India, US Centers for Disease Control and Prevention, Embassy of the United States, Shanti Path, Chanakyapuri, New Delhi, India; Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Gyan Bhushan
- Muzaffarpur District Health Department, Government of Bihar, Sadar Hospital, Muzaffarpur, Bihar, India
| | - Melissa D Carter
- National Center for Environmental Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mala Chhabra
- National Centre for Disease Control, India, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, Delhi, India
| | - Veena Mittal
- National Centre for Disease Control, India, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, Delhi, India
| | - Shashi Khare
- National Centre for Disease Control, India, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, Delhi, India
| | - James J Sejvar
- National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mayank Dwivedi
- Global Disease Detection Program, India, US Centers for Disease Control and Prevention, Embassy of the United States, Shanti Path, Chanakyapuri, New Delhi, India
| | - Samantha L Isenberg
- Battelle at the Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rudolph Johnson
- National Center for Environmental Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - James L Pirkle
- National Center for Environmental Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jon D Sharer
- Department of Human Genetics, Emory University, Decatur, GA, USA
| | - Patricia L Hall
- Department of Human Genetics, Emory University, Decatur, GA, USA
| | - Rajesh Yadav
- Global Disease Detection Program, India, US Centers for Disease Control and Prevention, Embassy of the United States, Shanti Path, Chanakyapuri, New Delhi, India; India Epidemic Intelligence Service, National Centre for Disease Control, India, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, Delhi, India
| | - Anoop Velayudhan
- Global Disease Detection Program, India, US Centers for Disease Control and Prevention, Embassy of the United States, Shanti Path, Chanakyapuri, New Delhi, India; India Epidemic Intelligence Service, National Centre for Disease Control, India, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, Delhi, India
| | - Mohan Papanna
- Global Disease Detection Program, India, US Centers for Disease Control and Prevention, Embassy of the United States, Shanti Path, Chanakyapuri, New Delhi, India; India Epidemic Intelligence Service, National Centre for Disease Control, India, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, Delhi, India
| | - Pankaj Singh
- India Epidemic Intelligence Service, National Centre for Disease Control, India, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, Delhi, India
| | - D Somashekar
- India Epidemic Intelligence Service, National Centre for Disease Control, India, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, Delhi, India
| | - Arghya Pradhan
- India Epidemic Intelligence Service, National Centre for Disease Control, India, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, Delhi, India
| | - Kapil Goel
- India Epidemic Intelligence Service, National Centre for Disease Control, India, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, Delhi, India
| | - Rajesh Pandey
- India Epidemic Intelligence Service, National Centre for Disease Control, India, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, Delhi, India
| | - Mohan Kumar
- India Epidemic Intelligence Service, National Centre for Disease Control, India, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, Delhi, India
| | - Satish Kumar
- India Epidemic Intelligence Service, National Centre for Disease Control, India, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, Delhi, India
| | - Amit Chakrabarti
- National Institute of Occupational Health, Indian Council of Medical Research, Ministry of Health and Family Welfare, Government of India, Meghani Nagar, Ahmedabad, Gujarat, India
| | - P Sivaperumal
- National Institute of Occupational Health, Indian Council of Medical Research, Ministry of Health and Family Welfare, Government of India, Meghani Nagar, Ahmedabad, Gujarat, India
| | - A Ramesh Kumar
- National Institute of Occupational Health, Indian Council of Medical Research, Ministry of Health and Family Welfare, Government of India, Meghani Nagar, Ahmedabad, Gujarat, India
| | - Joshua G Schier
- National Center for Environmental Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Arthur Chang
- National Center for Environmental Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Leigh Ann Graham
- Battelle at the Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Thomas P Mathews
- Battelle at the Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Darryl Johnson
- Oak Ridge Institute for Science and Education Fellow at the Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Liza Valentin
- National Center for Environmental Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kathleen L Caldwell
- National Center for Environmental Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jeffery M Jarrett
- National Center for Environmental Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Leslie A Harden
- Western Regional Research Center, US Department of Agriculture, Albany, CA, USA
| | - Gary R Takeoka
- Western Regional Research Center, US Department of Agriculture, Albany, CA, USA
| | - Suxiang Tong
- National Center for Immunizations and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Krista Queen
- National Center for Immunizations and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Clinton Paden
- National Center for Immunizations and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Anne Whitney
- National Center for Immunizations and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Dana L Haberling
- National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ram Singh
- National Centre for Disease Control, India, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, Delhi, India
| | - Ravi Shankar Singh
- National Centre for Disease Control, India, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, Delhi, India
| | - Kenneth C Earhart
- Global Disease Detection Program, India, US Centers for Disease Control and Prevention, Embassy of the United States, Shanti Path, Chanakyapuri, New Delhi, India; Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - A C Dhariwal
- National Vector Borne Disease Control Programme, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, Nirman Bhavan, New Delhi, India
| | - L S Chauhan
- National Centre for Disease Control, India, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, Delhi, India
| | - S Venkatesh
- National Centre for Disease Control, India, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, Delhi, India
| | - Padmini Srikantiah
- Global Disease Detection Program, India, US Centers for Disease Control and Prevention, Embassy of the United States, Shanti Path, Chanakyapuri, New Delhi, India; Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
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10
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Jones DR, Jarrett JM, Tevis DS, Franklin M, Mullinix NJ, Wallon KL, Derrick Quarles C, Caldwell KL, Jones RL. Analysis of whole human blood for Pb, Cd, Hg, Se, and Mn by ICP-DRC-MS for biomonitoring and acute exposures. Talanta 2016; 162:114-122. [PMID: 27837806 DOI: 10.1016/j.talanta.2016.09.060] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 09/26/2016] [Accepted: 09/26/2016] [Indexed: 10/20/2022]
Abstract
We improved our inductively coupled plasma mass spectrometry (ICP-MS) whole blood method [1] for determination of lead (Pb), cadmium (Cd), and mercury (Hg) by including manganese (Mn) and selenium (Se), and expanding the calibration range of all analytes. The method is validated on a PerkinElmer (PE) ELAN® DRC II ICP-MS (ICP-DRC-MS) and uses the Dynamic Reaction Cell (DRC) technology to attenuate interfering background ion signals via ion-molecule reactions. Methane gas (CH4) eliminates background signal from 40Ar2+ to permit determination of 80Se+, and oxygen gas (O2) eliminates several polyatomic interferences (e.g. 40Ar15N+, 54Fe1H+) on 55Mn+. Hg sensitivity in DRC mode is a factor of two higher than vented mode when measured under the same DRC conditions as Mn due to collisional focusing of the ion beam. To compensate for the expanded method's longer analysis time (due to DRC mode pause delays), we implemented an SC4-FAST autosampler (ESI Scientific, Omaha, NE), which vacuum loads the sample onto a loop, to keep the sample-to-sample measurement time to less than 5min, allowing for preparation and analysis of 60 samples in an 8-h work shift. The longer analysis time also resulted in faster breakdown of the hydrocarbon oil in the interface roughing pump. The replacement of the standard roughing pump with a pump using a fluorinated lubricant, Fomblin®, extended the time between pump maintenance. We optimized the diluent and rinse solution components to reduce carryover from high concentration samples and prevent the formation of precipitates. We performed a robust calculation to determine the following limits of detection (LOD) in whole blood: 0.07µgdL-1 for Pb, 0.10µgL-1 for Cd, 0.28μgL-1 for Hg, 0.99µgL-1 for Mn, and 24.5µgL-1 for Se.
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Affiliation(s)
- Deanna R Jones
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
| | - Jeffery M Jarrett
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Denise S Tevis
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Melanie Franklin
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; Battelle Memorial Institute, 2987 Clairmont Rd, Suite 450, Atlanta, GA 30329, USA
| | - Neva J Mullinix
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Kristen L Wallon
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - C Derrick Quarles
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; Oak Ridge Institute for Science and Education, P.O. Box 117, Oak Ridge, TN 37831, USA
| | - Kathleen L Caldwell
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Robert L Jones
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
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11
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Abstract
The accurate assessment of population iodine status is necessary to inform public health policies and clinical research on iodine nutrition, particularly the role of iodine adequacy in normal neurodevelopment. Urinary iodine concentration (UIC) directly reflects dietary iodine intake and is the most common indicator used worldwide to assess population iodine status. The CDC established the Ensuring the Quality of Iodine Procedures program in 2001 to provide laboratories that measure urinary iodine with an independent assessment of their analytic performance; this program fosters improvement in the assessment of UIC. Clinical laboratory tests of thyroid function (including serum concentrations of the pituitary hormone thyrotropin and the thyroid hormones thyroxine and triiodothyronine) are sometimes used as indicators of iodine status, although such use is often problematic. Even in severely iodine-deficient regions, there is a great deal of intraindividual variation in the ability of the thyroid to adapt. In most settings and in most population subgroups other than newborns, thyroid function tests are not considered sensitive indicators of population iodine status. However, the thyroid-derived protein thyroglobulin is increasingly being used for this purpose. Thyroglobulin can be measured in either serum or dried blood spot (DBS) samples. The use of DBS samples is advantageous in resource-poor regions. Improved methodologies for ascertaining maternal iodine status are needed to facilitate research on developmental correlates of iodine status. Thyroglobulin may prove to be a useful biomarker for both maternal and neonatal iodine status, but validated assay-specific reference ranges are needed for the determination of iodine sufficiency in both pregnant women and neonates, and trimester-specific ranges are possibly needed for pregnant women. UIC is currently a well-validated population biomarker, but individual biomarkers that could be used for research, patient care, and public health are lacking.
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Affiliation(s)
- Elizabeth N Pearce
- Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, MA, and
| | - Kathleen L Caldwell
- Division of Laboratory Sciences, National Center for Environmental Health, CDC, Atlanta, GA
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12
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Mortensen ME, Birch R, Wong LY, Valentin-Blasini L, Boyle EB, Caldwell KL, Merrill LS, Moye J, Blount BC. Thyroid antagonists and thyroid indicators in U.S. pregnant women in the Vanguard Study of the National Children's Study. Environ Res 2016; 149:179-188. [PMID: 27208469 PMCID: PMC4907850 DOI: 10.1016/j.envres.2016.05.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 05/10/2016] [Accepted: 05/11/2016] [Indexed: 05/28/2023]
Abstract
The sodium iodide-symporter (NIS) mediates uptake of iodide into thyroid follicular cells. This key step in thyroid hormone synthesis is inhibited by perchlorate, thiocyanate (SCN) and nitrate (NO3) anions. When these exposures occur during pregnancy the resulting decreases in thyroid hormones may adversely affect neurodevelopment of the human fetus. Our objectives were to describe and examine the relationship of these anions to the serum thyroid indicators, thyroid stimulating hormone (TSH) and free thyroxine (FT4), in third trimester women from the initial Vanguard Study of the National Children's Study (NCS); and to compare urine perchlorate results with those in pregnant women from the National Health and Nutritional Examination Survey (NHANES). Urinary perchlorate, SCN, NO3, and iodine, serum TSH, FT4, and cotinine were measured and a food frequency questionnaire (FFQ) was administered to pregnant women enrolled in the initial Vanguard Study. We used multiple regression models of FT4 and TSH that included perchlorate equivalent concentration (PEC, which estimates combined inhibitory effects of the anions perchlorate, SCN, and NO3 on the NIS). We used multiple regression to model predictors of each urinary anion, using FFQ results, drinking water source, season of year, smoking status, and demographic characteristics. Descriptive statistics were calculated for pregnant women in NHANES 2001-2012. The geometric mean (GM) for urinary perchlorate was 4.04µg/L, for TSH 1.46mIU/L, and the arithmetic mean for FT4 1.11ng/dL in 359 NCS women. In 330 women with completed FFQs, consumption of leafy greens, winter season, and Hispanic ethnicity were significant predictors of higher urinary perchlorate, which differed significantly by study site and primary drinking water source, and bottled water was associated with higher urinary perchlorate compared to filtered tap water. Leafy greens consumption was associated with higher urinary NO3 and higher urinary SCN. There was no association between urinary perchlorate or PEC and TSH or FT4, even for women with urinary iodine <100µg/L. GM urinary perchlorate concentrations in the full sample (n=494) of third trimester NCS women (4.03µg/L) were similar to pregnant women in NHANES (3.58µg/L).
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Affiliation(s)
- Mary E Mortensen
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, United States.
| | | | - Lee-Yang Wong
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Liza Valentin-Blasini
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | - Kathleen L Caldwell
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | - John Moye
- NCS Program Office, Eunice Kennedy Shriver National Institute for Child Health and Human Development, National Institutes for Health, Bethesda, MD, United States
| | - Benjamin C Blount
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
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13
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Xiao G, Saunders D, Jones RL, Caldwell KL. Determination of 241Am in Urine Using Sector Field Inductively Coupled Plasma Mass Spectrometry (SF-ICP-MS). J Radioanal Nucl Chem 2016; 301:285-291. [PMID: 27375308 DOI: 10.1007/s10967-014-3103-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Quantification of 241Am in urine at low levels is important for assessment of individuals' or populations' accidental, environmental, or terrorism-related internal contamination, but no convenient, precise method has been established to rapidly determine these low levels. Here we report a new analytical method to measure 241Am as developed and validated at the Centers for Disease Control and Prevention (CDC) by means of the selective retention of Am from urine directly on DGA resin, followed by SF-ICP-MS detection. The method provides rapid results with a Limit of Detection (LOD) of 0.22 pg/L (0.028 Bq/L), which is lower than 1/3 of the C/P CDG for 241Am at 5 days post-exposure. The results obtained by this method closely agree with CDC values as measured by Liquid Scintillation Counting, and with National Institute of Standards Technology (NIST) Certified Reference Materials (CRM) target values.
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Affiliation(s)
- Ge Xiao
- Inorganic and Radiation Analytical Toxicology Branch, Centers for Disease Control and Prevention, 4770 Buford HWY, Mail Stop F50, Atlanta, GA 30341, USA
| | - David Saunders
- Inorganic and Radiation Analytical Toxicology Branch, Centers for Disease Control and Prevention, 4770 Buford HWY, Mail Stop F50, Atlanta, GA 30341, USA
| | - Robert L Jones
- Inorganic and Radiation Analytical Toxicology Branch, Centers for Disease Control and Prevention, 4770 Buford HWY, Mail Stop F50, Atlanta, GA 30341, USA
| | - Kathleen L Caldwell
- Inorganic and Radiation Analytical Toxicology Branch, Centers for Disease Control and Prevention, 4770 Buford HWY, Mail Stop F50, Atlanta, GA 30341, USA
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14
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Wells EM, Herbstman JB, Lin YH, Jarrett J, Verdon CP, Ward C, Caldwell KL, Hibbeln JR, Witter FR, Halden RU, Goldman LR. Cord Blood Methylmercury and Fetal Growth Outcomes in Baltimore Newborns: Potential Confounding and Effect Modification by Omega-3 Fatty Acids, Selenium, and Sex. Environ Health Perspect 2016; 124:373-9. [PMID: 26115160 PMCID: PMC4786979 DOI: 10.1289/ehp.1408596] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 06/24/2015] [Indexed: 05/22/2023]
Abstract
BACKGROUND Methylmercury (MeHg) may affect fetal growth; however, prior research often lacked assessment of mercury speciation, confounders, and interactions. OBJECTIVE Our objective was to assess the relationship between MeHg and fetal growth as well as the potential for confounding or interaction of this relationship from speciated mercury, fatty acids, selenium, and sex. METHODS This cross-sectional study includes 271 singletons born in Baltimore, Maryland, 2004-2005. Umbilical cord blood was analyzed for speciated mercury, serum omega-3 highly unsaturated fatty acids (n-3 HUFAs), and selenium. Multivariable linear regression models controlled for gestational age, birth weight, maternal age, parity, prepregnancy body mass index, smoking, hypertension, diabetes, selenium, n-3 HUFAs, and inorganic mercury (IHg). RESULTS Geometric mean cord blood MeHg was 0.94 μg/L (95% CI: 0.84, 1.07). In adjusted models for ponderal index, βln(MeHg) = -0.045 (g/cm(3)) × 100 (95% CI: -0.084, -0.005). There was no evidence of a MeHg × sex interaction with ponderal index. Contrastingly, there was evidence of a MeHg × n-3 HUFAs interaction with birth length [among low n-3 HUFAs, βln(MeHg) = 0.40 cm, 95% CI: -0.02, 0.81; among high n-3 HUFAs, βln(MeHg) = -0.15, 95% CI: -0.54, 0.25; p-interaction = 0.048] and head circumference [among low n-3 HUFAs, βln(MeHg) = 0.01 cm, 95% CI: -0.27, 0.29; among high n-3 HUFAs, βln(MeHg) = -0.37, 95% CI: -0.63, -0.10; p-interaction = 0.042]. The association of MeHg with birth weight and ponderal index was affected by n-3 HUFAs, selenium, and IHg. For birth weight, βln(MeHg) without these variables was -16.8 g (95% CI: -75.0, 41.3) versus -29.7 (95% CI: -93.9, 34.6) with all covariates. Corresponding values for ponderal index were -0.030 (g/cm(3)) × 100 (95% CI: -0.065, 0.005) and -0.045 (95% CI: -0.084, -0005). CONCLUSION We observed an association of increased MeHg with decreased ponderal index. There is evidence for interaction between MeHg and n-3 HUFAs; infants with higher MeHg and n-3 HUFAs had lower birth length and head circumference. These results should be verified with additional studies.
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Affiliation(s)
- Ellen M. Wells
- School of Health Sciences, Purdue University, West Lafayette, Indiana, USA
- Address correspondence to E.M. Wells, Purdue University, School of Health Sciences; Hampton Hall of Civil Engineering 1269; 550 Stadium Mall Dr.; West Lafayette, IN 47907 USA. Telephone: (765) 496-3535. E-mail:
| | - Julie B. Herbstman
- Columbia Center for Children’s Environmental Health, Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Yu Hong Lin
- Laboratory of Membrane Biochemistry and Biophysics, National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, Department of Health and Human Services, Rockville, Maryland, USA
| | - Jeffery Jarrett
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Carl P. Verdon
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Cynthia Ward
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kathleen L. Caldwell
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Joseph R. Hibbeln
- Laboratory of Membrane Biochemistry and Biophysics, National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, Department of Health and Human Services, Rockville, Maryland, USA
| | - Frank R. Witter
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rolf U. Halden
- Center for Environmental Security, Biodesign Institute, Global Security Initiative, Arizona State University, Tempe, Arizona, USA
| | - Lynn R. Goldman
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
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15
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Sommer YL, Ward CD, Pan Y, Caldwell KL, Jones RL. Long-Term Stability of Inorganic, Methyl and Ethyl Mercury in Whole Blood: Effects of Storage Temperature and Time. J Anal Toxicol 2016; 40:222-8. [PMID: 26912563 DOI: 10.1093/jat/bkw007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In this study, we evaluated the effect of temperature on the long-term stability of three mercury species in bovine blood. We used inductively coupled plasma mass spectrometry (ICP-MS) analysis to determine the concentrations of inorganic (iHg), methyl (MeHg) and ethyl (EtHg) mercury species in two blood pools stored at temperatures of -70, -20, 4, 23°C (room temperature) and 37°C. Over the course of a year, we analyzed aliquots of pooled specimens at time intervals of 1, 2, 4 and 6 weeks and 2, 4, 6, 8, 10 and 12 months. We applied a fixed-effects linear model, step-down pairwise comparison and coefficient of variation statistical analysis to examine the temperature and time effects on changes in mercury species concentrations. We observed several instances of statistically significant differences in mercury species concentrations between different temperatures and time points; however, with considerations of experimental factors (such as instrumental drift and sample preparation procedures), not all differences were scientifically important. We concluded that iHg, MeHg and EtHg species in bovine whole blood were stable at -70, -20, 4 and 23°C for 1 year, but blood samples stored at 37°C were stable for no more than 2 weeks.
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Affiliation(s)
- Yuliya L Sommer
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences, Inorganic and Radiation Analytical Toxicology Branch, 4770 Buford Highway NE, MS F-50, Atlanta, GA 30341, USA
| | - Cynthia D Ward
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences, Inorganic and Radiation Analytical Toxicology Branch, 4770 Buford Highway NE, MS F-50, Atlanta, GA 30341, USA
| | - Yi Pan
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences, Inorganic and Radiation Analytical Toxicology Branch, 4770 Buford Highway NE, MS F-50, Atlanta, GA 30341, USA
| | - Kathleen L Caldwell
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences, Inorganic and Radiation Analytical Toxicology Branch, 4770 Buford Highway NE, MS F-50, Atlanta, GA 30341, USA
| | - Robert L Jones
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences, Inorganic and Radiation Analytical Toxicology Branch, 4770 Buford Highway NE, MS F-50, Atlanta, GA 30341, USA
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16
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Smith AE, Lincoln RA, Paulu C, Simones TL, Caldwell KL, Jones RL, Backer LC. Assessing arsenic exposure in households using bottled water or point-of-use treatment systems to mitigate well water contamination. Sci Total Environ 2016; 544:701-10. [PMID: 26674699 PMCID: PMC4747806 DOI: 10.1016/j.scitotenv.2015.11.136] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 11/25/2015] [Accepted: 11/25/2015] [Indexed: 05/18/2023]
Abstract
There is little published literature on the efficacy of strategies to reduce exposure to residential well water arsenic. The objectives of our study were to: 1) determine if water arsenic remained a significant exposure source in households using bottled water or point-of-use treatment systems; and 2) evaluate the major sources and routes of any remaining arsenic exposure. We conducted a cross-sectional study of 167 households in Maine using one of these two strategies to prevent exposure to arsenic. Most households included one adult and at least one child. Untreated well water arsenic concentrations ranged from <10 μg/L to 640 μg/L. Urine samples, water samples, daily diet and bathing diaries, and household dietary and water use habit surveys were collected. Generalized estimating equations were used to model the relationship between urinary arsenic and untreated well water arsenic concentration, while accounting for documented consumption of untreated water and dietary sources. If mitigation strategies were fully effective, there should be no relationship between urinary arsenic and well water arsenic. To the contrary, we found that untreated arsenic water concentration remained a significant (p ≤ 0.001) predictor of urinary arsenic levels. When untreated water arsenic concentrations were <40 μg/L, untreated water arsenic was no longer a significant predictor of urinary arsenic. Time spent bathing (alone or in combination with water arsenic concentration) was not associated with urinary arsenic. A predictive analysis of the average study participant suggested that when untreated water arsenic ranged from 100 to 500 μg/L, elimination of any untreated water use would result in an 8%-32% reduction in urinary arsenic for young children, and a 14%-59% reduction for adults. These results demonstrate the importance of complying with a point-of-use or bottled water exposure reduction strategy. However, there remained unexplained, water-related routes of exposure.
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Affiliation(s)
- Andrew E Smith
- Maine Department of Health and Human Services, Maine Center for Disease Control and Prevention, 286 Water Street, Augusta, ME 04333, USA.
| | - Rebecca A Lincoln
- Maine Department of Health and Human Services, Maine Center for Disease Control and Prevention, 286 Water Street, Augusta, ME 04333, USA
| | - Chris Paulu
- Maine Department of Health and Human Services, Maine Center for Disease Control and Prevention, 286 Water Street, Augusta, ME 04333, USA; University of Southern Maine, Muskie School of Public Service, PO Box 9300, Portland, ME 04104-9300, USA
| | - Thomas L Simones
- Maine Department of Health and Human Services, Maine Center for Disease Control and Prevention, 286 Water Street, Augusta, ME 04333, USA
| | - Kathleen L Caldwell
- Centers for Disease Control and Prevention, National Center for Environmental Health, Inorganic and Radiation Analytical Toxicology Branch, 4770 Buford Highway NE, MS F-18, Chamblee, GA 30341, USA
| | - Robert L Jones
- Centers for Disease Control and Prevention, National Center for Environmental Health, Inorganic and Radiation Analytical Toxicology Branch, 4770 Buford Highway NE, MS F-18, Chamblee, GA 30341, USA
| | - Lorraine C Backer
- Centers for Disease Control and Prevention, National Center for Environmental Health, Health Studies Branch, 4770 Buford Highway NE, MS F-60, Chamblee, GA 30341, USA
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17
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Abstract
The presence of metals in the environment is ubiquitous and humans are constantly being exposed to them. As such, a general concern exists about potential health consequences that result from the exposure to metals. The continued efforts of environmental scientists to measure metals in clinical specimens are important for defining the extent of human exposure to these chemicals. Laboratory methods to measure the concentration of metals in human blood or urine are available, and they can be used to assess the extent of human exposure to these chemicals. However, several considerations should be reviewed when requesting a laboratory measurement of metals because some factors can affect the test result or its interpretation. These considerations are discussed in this article and include pre-analytical, analytical, and post-analytical factors. Clinicians with this knowledge will be able to request these laboratory tests for their patients with enhanced confidence.
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Affiliation(s)
- Richard Y Wang
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA, 30341, USA,
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18
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Xiao G, Jones RL, Saunders D, Caldwell KL. Determination of 234U/238U, 235U/238U and 236U/238U isotope ratios in urine using sector field inductively coupled plasma mass spectrometry. Radiat Prot Dosimetry 2014; 162:618-624. [PMID: 24563523 PMCID: PMC4889024 DOI: 10.1093/rpd/ncu023] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Quantification of the isotopic composition of uranium in urine at low levels of concentration is important for assessing both military and civilian populations' exposures to uranium. However, until now there has been no convenient, precise method established for rapid determination of multiple uranium isotope ratios. Here, the authors report a new method to measure (234)U/(238)U, (235)U/(238)U and (236)U/(238)U. It uses solid-phase chelation extraction (via TRU columns) of actinides from the urine matrix, followed by measurement using a magnetic sector field inductively coupled plasma mass spectrometer (SF-ICP-MS-Thermo Element XR) equipped with a high-efficiency nebulizer (Apex PFA microflow) and coupled with a membrane desolvating nebulizer system (Aridus II™). This method provides rapid and reliable results and has been used successfully to analyse Certified Reference Materials.
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Affiliation(s)
- Ge Xiao
- Inorganic and Radiation Analytical Toxicology Branch, Centers for Disease Control and Prevention, 4770 Buford HWY, Mail Stop F50, Atlanta, GA 30341, USA
| | - Robert L Jones
- Inorganic and Radiation Analytical Toxicology Branch, Centers for Disease Control and Prevention, 4770 Buford HWY, Mail Stop F50, Atlanta, GA 30341, USA
| | - David Saunders
- Inorganic and Radiation Analytical Toxicology Branch, Centers for Disease Control and Prevention, 4770 Buford HWY, Mail Stop F50, Atlanta, GA 30341, USA
| | - Kathleen L Caldwell
- Inorganic and Radiation Analytical Toxicology Branch, Centers for Disease Control and Prevention, 4770 Buford HWY, Mail Stop F50, Atlanta, GA 30341, USA
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Pan Y, Caudill SP, Li R, Caldwell KL. Median and quantile tests under complex survey design using SAS and R. Comput Methods Programs Biomed 2014; 117:292-7. [PMID: 25123100 PMCID: PMC5708173 DOI: 10.1016/j.cmpb.2014.07.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 07/01/2014] [Accepted: 07/21/2014] [Indexed: 05/05/2023]
Abstract
Techniques for conducting hypothesis testing on the median and other quantiles of two or more subgroups under complex survey design are limited. In this paper, we introduce programs in both SAS and R to perform such a test. A detailed illustration of the computations, macro variable definitions, input and output for the SAS and R programs are also included in the text. Urinary iodine data from National Health and Nutrition Examination Survey (NHANES) are used as examples for comparing medians between females and males as well as comparing the 75th percentiles among three salt consumption groups.
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Affiliation(s)
- Yi Pan
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, United States.
| | - Samuel P Caudill
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Ruosha Li
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA 15261, United States
| | - Kathleen L Caldwell
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
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Mortensen ME, Caudill SP, Caldwell KL, Ward CD, Jones RL. Total and methyl mercury in whole blood measured for the first time in the U.S. population: NHANES 2011-2012. Environ Res 2014; 134:257-64. [PMID: 25173092 PMCID: PMC5584810 DOI: 10.1016/j.envres.2014.07.019] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 07/22/2014] [Accepted: 07/24/2014] [Indexed: 05/19/2023]
Abstract
BACKGROUND Despite the public health and toxicologic interest in methyl mercury (MeHg) and ethyl mercury (EHg), these mercury species have been technically difficult to measure in large population studies. METHODS Using NHANES 2011-2012 data, we calculated reference ranges and examined demographic factors associated with specific mercury species concentrations and the ratio of MeHg to THg. We conducted several multiple regression analyses to examine factors associated with MeHg concentrations and also with the ratio of MeHg to THg. RESULTS Asians had the highest geometric mean concentrations for MeHg, 1.58 µg/L (95% CI 1.29, 1.93) and THg, 1.86 µg/L (1.58, 2.19), followed by non-Hispanic blacks with MeHg, 0.52 µg/L (0.39, 0.68) and THg, 0.68 µg/L (0.54, 0.85). Greater education attainment in adults and male sex were associated with higher MeHg and THg concentrations. Race/ethnicity, age, and sex were significant predictors of MeHg concentrations, which increased with age and were highest in Asians in all age categories, followed by non-Hispanic blacks. Mexican Americans had the lowest adjusted MeHg concentrations. The ratio of MeHg to THg was highest in Asians, varied by racial/ethnic group, and increased with age in a non-linear fashion. The amount of increase in the MeHg to THg ratio with age depended on the initial ratio, with a greater increase as age increased. Of the overall population, 3.05% (95% CI 1.77, 4.87) had MeHg concentrations >5.8 µg/L (a value that corresponds to the U.S. EPA reference dose). The prevalence was highest in Asians at 15.85% (95% CI 11.85, 20.56), increased with age, reaching a maximum of 9.26% (3.03, 20.42) at ages 60-69 years. Females 16-44 years old had a 1.76% (0.82-3.28) prevalence of MeHg concentrations >5.8 µg/L. CONCLUSIONS Asians, males, older individuals, and adults with greater educational attainment had higher MeHg concentrations. The ratio of MeHg to THg varied with racial/ethnic group, increased with age, and was nonlinear. U.S. population reference values for MeHg and the ratio of MeHg to THg can assist in more precise assessment of public health risk from MeHg consumed in seafood.
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Affiliation(s)
- Mary E Mortensen
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, MS F-20, 4770 Buford Highway, Atlanta, GA 30341, USA.
| | - Samuel P Caudill
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, MS F-20, 4770 Buford Highway, Atlanta, GA 30341, USA
| | - Kathleen L Caldwell
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, MS F-20, 4770 Buford Highway, Atlanta, GA 30341, USA
| | - Cynthia D Ward
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, MS F-20, 4770 Buford Highway, Atlanta, GA 30341, USA
| | - Robert L Jones
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, MS F-20, 4770 Buford Highway, Atlanta, GA 30341, USA
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deCastro BR, Caldwell KL, Jones RL, Blount BC, Pan Y, Ward C, Mortensen ME. Dietary sources of methylated arsenic species in urine of the United States population, NHANES 2003-2010. PLoS One 2014; 9:e108098. [PMID: 25251890 PMCID: PMC4176478 DOI: 10.1371/journal.pone.0108098] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 08/19/2014] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Arsenic is an ubiquitous element linked to carcinogenicity, neurotoxicity, as well as adverse respiratory, gastrointestinal, hepatic, and dermal health effects. OBJECTIVE Identify dietary sources of speciated arsenic: monomethylarsonic acid (MMA), and dimethylarsinic acid (DMA). METHODS Age-stratified, sample-weighted regression of NHANES (National Health and Nutrition Examination Survey) 2003-2010 data (∼8,300 participants ≥6 years old) characterized the association between urinary arsenic species and the additional mass consumed of USDA-standardized food groups (24-hour dietary recall data), controlling for potential confounders. RESULTS For all arsenic species, the rank-order of age strata for median urinary molar concentration was children 6-11 years > adults 20-84 years > adolescents 12-19 years, and for all age strata, the rank-order was DMA > MMA. Median urinary molar concentrations of methylated arsenic species ranged from 0.56 to 3.52 µmol/mol creatinine. Statistically significant increases in urinary arsenic species were associated with increased consumption of: fish (DMA); fruits (DMA, MMA); grain products (DMA, MMA); legumes, nuts, seeds (DMA); meat, poultry (DMA); rice (DMA, MMA); rice cakes/crackers (DMA, MMA); and sugars, sweets, beverages (MMA). And, for adults, rice beverage/milk (DMA, MMA). In addition, based on US (United States) median and 90th percentile consumption rates of each food group, exposure from the following food groups was highlighted: fish; fruits; grain products; legumes, nuts, seeds; meat, poultry; and sugars, sweets, beverages. CONCLUSIONS In a nationally representative sample of the US civilian, noninstitutionalized population, fish (adults), rice (children), and rice cakes/crackers (adolescents) had the largest associations with urinary DMA. For MMA, rice beverage/milk (adults) and rice cakes/crackers (children, adolescents) had the largest associations.
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Affiliation(s)
- B. Rey deCastro
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences, Atlanta, Georgia, United States of America
| | - Kathleen L. Caldwell
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences, Atlanta, Georgia, United States of America
| | - Robert L. Jones
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences, Atlanta, Georgia, United States of America
| | - Benjamin C. Blount
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences, Atlanta, Georgia, United States of America
| | - Yi Pan
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences, Atlanta, Georgia, United States of America
| | - Cynthia Ward
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences, Atlanta, Georgia, United States of America
| | - Mary E. Mortensen
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences, Atlanta, Georgia, United States of America
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Sommer YL, Verdon CP, Fresquez MR, Ward CD, Wood EB, Pan Y, Caldwell KL, Jones RL. Measurement of mercury species in human blood using triple spike isotope dilution with SPME-GC-ICP-DRC-MS. Anal Bioanal Chem 2014; 406:5039-47. [PMID: 24948088 DOI: 10.1007/s00216-014-7907-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 05/01/2014] [Accepted: 05/16/2014] [Indexed: 11/30/2022]
Abstract
The measurement of different mercury compounds in human blood can provide valuable information about the type of mercury exposure. To this end, our laboratory developed a biomonitoring method for the quantification of inorganic (iHg), methyl (MeHg), and ethyl (EtHg) mercury in whole blood using a triple-spike isotope dilution (TSID) quantification method employing capillary gas chromatography (GC) and inductively coupled dynamic reaction cell mass spectrometry (ICP-DRC-MS). We used a robotic CombiPAL(®) sample handling station featuring twin fiber-based solid-phase microextraction (SPME) injector heads. The use of two SPME fibers significantly reduces sample analysis cycle times making this method very suitable for high sample throughput, which is a requirement for large public health biomonitoring studies. Our sample preparation procedure involved solubilization of blood samples with tetramethylammonium hydroxide (TMAH) followed by the derivatization with sodium tetra(n-propyl)borate (NaBPr(4)) to promote volatility of mercury species. We thoroughly investigated mercury species stability in the blood matrix during the course of sample treatment and analysis. The method accuracy for quantifying iHg, MeHg, and EtHg was validated using NIST standard reference materials (SRM 955c level 3) and the Centre de Toxicologie du Québec (CTQ) proficiency testing (PT) samples. The limit of detection (LOD) for iHg, MeHg, and EtHg in human blood was determined to be 0.27, 0.12, and 0.16 μg/L, respectively.
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Affiliation(s)
- Yuliya L Sommer
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Analytical Sciences, Inorganic and Radiation Analytical Toxicology Branch, 4770 Buford Highway, N.E., MS F-50, Atlanta, GA, 30341, USA,
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Perrine CG, Cogswell ME, Swanson CA, Sullivan KM, Chen TC, Carriquiry AL, Dodd KW, Caldwell KL, Wang CY. Comparison of population iodine estimates from 24-hour urine and timed-spot urine samples. Thyroid 2014; 24:748-57. [PMID: 24308769 PMCID: PMC3993064 DOI: 10.1089/thy.2013.0404] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Median urine iodine concentration (UIC; μg/L) in spot urine samples is recommended for monitoring population iodine status. Other common measures are iodine:creatinine ratio (I/Cr; μg/g) and estimated 24-hour urine iodine excretion (UIE; I/Cr × predicted 24-hour Cr; μg/day). Despite different units, these measures are often used interchangeably, and it is unclear how they compare with the reference standard 24-hour UIE. METHODS Volunteers aged 18-39 years collected all their urine samples for 24 hours (n=400). Voids from morning, afternoon, evening, overnight, and a composite 24-hour sample were analyzed for iodine. We calculated median observed 24-hour UIE and 24-hour UIC, and spot UIC, I/Cr, and two measures of estimated UIE calculated using predicted 24-hour Cr from published estimates by Kesteloot and Joosens (varies by age and sex) and published equations by Mage et al. (varies by age, sex, race, and anthropometric measures). We examined mean differences and relative difference across iodine excretion levels using Bland-Altman plots. RESULTS Median 24-hour UIE was 173.6 μg/day and 24-hour UIC was 144.8 μg/L. From timed-spot urine samples, estimates were: UIC 147.3-156.2 μg/L; I/Cr 103.6-114.3 μg/g, estimated 24-hour UIE (Kesteloot and Joosens) 145.7-163.3 μg/day; and estimated 24-hour UIE (Mage) 176.5-187.7 μg/day. Iodine measures did not vary consistently by timing of spot urine collection. Compared with observed 24-hour UIE, on average, estimated (Mage) 24-hour UIE was not significantly different, while estimated 24-hour UIE (Kesteloot and Joosens) was significantly different for some ethnicity/sex groups. Compared with 24-hour UIC, on average, spot UIC did not differ. CONCLUSIONS Estimates of UIC, I/Cr, and estimated 24-hour UIE (I/Cr × predicted 24-hour Cr) from spot urine samples should not be used interchangeably. Estimated 24-hour UIE, where predicted 24-hour Cr varies by age, sex, ethnicity, and anthropometric measures and was calculated with prediction equations using data from the sample, was more comparable to observed 24-hour UIE than when predicted 24-hour Cr was from published estimates from a different population. However, currently no cutoffs exist to interpret population estimated 24-hour UIE values.
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Affiliation(s)
- Cria G. Perrine
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mary E. Cogswell
- Division of Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Christine A. Swanson
- Office of Dietary Supplements, National Institutes of Health, Bethesda, Maryland
| | - Kevin M. Sullivan
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia
- Department of Epidemiology, Emory University, Atlanta, Georgia
| | - Te-Ching Chen
- Division of Health and Nutrition Examination Surveys, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Kevin W. Dodd
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Kathleen L. Caldwell
- Division of Laboratory Science, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Chia-Yih Wang
- Division of Health and Nutrition Examination Surveys, Centers for Disease Control and Prevention, Atlanta, Georgia
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Paul RL, Davis WC, Yu L, Murphy KE, Guthrie WF, Leber DD, Bryan CE, Vetter TW, Shakirova G, Mitchell G, Kyle DJ, Jarrett JM, Caldwell KL, Jones RL, Eckdahl S, Wermers M, Maras M, Palmer CD, Verostek M, Geraghty CM, Steuerwald AJ, Parsons PJ. Certification of Total Arsenic in Blood and Urine Standard Reference Materials by Radiochemical Neutron Activation Analysis and Inductively Coupled Plasma - Mass Spectrometry. J Radioanal Nucl Chem 2014; 299:1555-1563. [PMID: 26300575 PMCID: PMC4544667 DOI: 10.1007/s10967-013-2866-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A newly developed procedure for determination of arsenic by radiochemical neutron activation analysis (RNAA) was used to measure arsenic at four levels in SRM 955c Toxic Elements in Caprine Blood and at two levels in SRM 2668 Toxic Elements in Frozen Human Urine for the purpose of providing mass concentration values for certification. Samples were freeze-dried prior to analysis followed by neutron irradiation for 3 h at a fluence rate of 1×1014cm-2s-1. After sample dissolution in perchloric and nitric acids, arsenic was separated from the matrix by extraction into zinc diethyldithiocarbamate in chloroform, and 76As quantified by gamma-ray spectroscopy. Differences in chemical yield and counting geometry between samples and standards were monitored by measuring the count rate of a 77As tracer added before sample dissolution. RNAA results were combined with inductively coupled plasma - mass spectrometry (ICP-MS) values from NIST and collaborating laboratories to provide certified values of (10.81 ± 0.54) μg/kg and (213.1 ± 0.73) μg/kg for SRM 2668 Levels I and II, and certified values of (21.66 ± 0.73) μg/kg, (52.7 ± 1.1) μg/kg, and (78.8 ± 4.9) μg/kg for SRM 955c Levels 2, 3, and 4 respectively. Because of discrepancies between values obtained by different methods for SRM 955c Level 1, an information value of < 5 μg/kg was assigned for this material.
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Affiliation(s)
- Rick L. Paul
- Analytical Chemistry Division, National Institute of Standards and Technology, Gaithersburg, MD 20899
| | - W. Clay Davis
- Analytical Chemistry Division, National Institute of Standards and Technology, Gaithersburg, MD 20899
| | - Lee Yu
- Analytical Chemistry Division, National Institute of Standards and Technology, Gaithersburg, MD 20899
| | - Karen E. Murphy
- Analytical Chemistry Division, National Institute of Standards and Technology, Gaithersburg, MD 20899
| | - William F. Guthrie
- Statistical Engineering Division, National Institute of Standards and Technology, Gaithersburg, MD 20899
| | - Dennis D. Leber
- Statistical Engineering Division, National Institute of Standards and Technology, Gaithersburg, MD 20899
| | - Colleen E. Bryan
- Analytical Chemistry Division, National Institute of Standards and Technology, Gaithersburg, MD 20899
| | - Thomas W. Vetter
- Analytical Chemistry Division, National Institute of Standards and Technology, Gaithersburg, MD 20899
| | - Gulchekhra Shakirova
- Inorganic and Radiation Analytical Toxicology Branch, Centers for Disease Control and Prevention, Atlanta, GA 30341
| | - Graylin Mitchell
- Inorganic and Radiation Analytical Toxicology Branch, Centers for Disease Control and Prevention, Atlanta, GA 30341
| | - David J. Kyle
- Inorganic and Radiation Analytical Toxicology Branch, Centers for Disease Control and Prevention, Atlanta, GA 30341
| | - Jeffery M. Jarrett
- Inorganic and Radiation Analytical Toxicology Branch, Centers for Disease Control and Prevention, Atlanta, GA 30341
| | - Kathleen L. Caldwell
- Inorganic and Radiation Analytical Toxicology Branch, Centers for Disease Control and Prevention, Atlanta, GA 30341
| | - Robert L. Jones
- Inorganic and Radiation Analytical Toxicology Branch, Centers for Disease Control and Prevention, Atlanta, GA 30341
| | | | | | | | - C. D. Palmer
- Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health (NYSDOH), Albany, NY 12201-0509
| | - M.F. Verostek
- Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health (NYSDOH), Albany, NY 12201-0509
| | - C. M. Geraghty
- Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health (NYSDOH), Albany, NY 12201-0509
| | - Amy J. Steuerwald
- Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health (NYSDOH), Albany, NY 12201-0509
| | - Patrick J. Parsons
- Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health (NYSDOH), Albany, NY 12201-0509
- Dept of Environmental Health Sciences, School of Public Health, University at Albany, 12201-0509
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Quarles CD, Jones DR, Jarrett JM, Shakirova G, Pan Y, Caldwell KL, Jones RL. Analytical method for total chromium and nickel in urine using an inductively coupled plasma-universal cell technology-mass spectrometer (ICP-UCT-MS) in kinetic energy discrimination (KED) mode. J Anal At Spectrom 2014; 2014:297-303. [PMID: 26229219 PMCID: PMC4517978 DOI: 10.1039/c3ja50272d] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Biomonitoring and emergency response measurements are an important aspect of the Division of Laboratory Sciences of the National Center for Environmental Health, Centers for Disease Control and Prevention (CDC). The continuing advancement in instrumentation allows for enhancements to existing analytical methods. Prior to this work, chromium and nickel were analyzed on a sector field inductively coupled plasma-mass spectrometer (SF-ICP-MS). This type of instrumentation provides the necessary sensitivity, selectivity, accuracy, and precision but due to the higher complexity of instrumentation and operation, it is not preferred for routine high throughput biomonitoring needs. Instead a quadrupole based method has been developed on a PerkinElmer NexION™ 300D ICP-MS. The instrument is operated using 6.0 mL min-1 helium as the collision cell gas and in kinetic energy discrimination mode, interferences are successfully removed for the analysis of 52Cr (40Ar12C and 35Cl16O1H) and 60Ni (44Ca16O). The limits of detection are 0.162 μg L-1 Cr and 0.248 μg L-1 Ni. Method accuracy using NIST SRM 2668 level 1 (1.08 μg L-1 Cr and 2.31μg L-1 Ni) and level 2 (27.7 μg L-1 Cr and 115 μg L-1 Ni) was within the 95% confidence intervals reported in the NIST certificate. Among-run precision is less than 10% RSDs (N = 20) for in house quality control and NIST SRM urine samples. While the limits of detection (LOD) for the new quadrupole ICP-UCT-MS with KED method are similar to the SF-ICP-MS method, better measurement precision is observed for the quadrupole method. The new method presented provides fast, accurate, and more precise results on a less complex and more robust ICP-MS platform.
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Affiliation(s)
- C Derrick Quarles
- Inorganic & Radiation Analytical Toxicology Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop F-18, Atlanta, GA 30341
| | - Deanna R Jones
- Inorganic & Radiation Analytical Toxicology Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop F-18, Atlanta, GA 30341
| | - Jeffery M Jarrett
- Inorganic & Radiation Analytical Toxicology Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop F-18, Atlanta, GA 30341
| | - Gulchekhra Shakirova
- Inorganic & Radiation Analytical Toxicology Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop F-18, Atlanta, GA 30341
| | - Yi Pan
- Inorganic & Radiation Analytical Toxicology Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop F-18, Atlanta, GA 30341
| | - Kathleen L Caldwell
- Inorganic & Radiation Analytical Toxicology Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop F-18, Atlanta, GA 30341
| | - Robert L Jones
- Inorganic & Radiation Analytical Toxicology Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop F-18, Atlanta, GA 30341
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Cogswell ME, Wang CY, Chen TC, Pfeiffer CM, Elliott P, Gillespie CD, Carriquiry AL, Sempos CT, Liu K, Perrine CG, Swanson CA, Caldwell KL, Loria CM. Validity of predictive equations for 24-h urinary sodium excretion in adults aged 18-39 y. Am J Clin Nutr 2013; 98:1502-13. [PMID: 24047921 PMCID: PMC3831536 DOI: 10.3945/ajcn.113.059436] [Citation(s) in RCA: 128] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Collecting a 24-h urine sample is recommended for monitoring the mean population sodium intake, but implementation can be difficult. OBJECTIVE The objective was to assess the validity of published equations by using spot urinary sodium concentrations to predict 24-h sodium excretion. DESIGN This was a cross-sectional study, conducted from June to August 2011 in metropolitan Washington, DC, of 407 adults aged 18-39 y, 48% black, who collected each urine void in a separate container for 24 h. Four timed voids (morning, afternoon, evening, and overnight) were selected from each 24-h collection. Published equations were used to predict 24-h sodium excretion with spot urine by specimen timing and race-sex subgroups. We examined mean differences with measured 24-h sodium excretion (bias) and individual differences with the use of Bland-Altman plots. RESULTS Across equations and specimens, mean bias in predicting 24-h sodium excretion for all participants ranged from -267 to 1300 mg (Kawasaki equation). Bias was least with International Cooperative Study on Salt, Other Factors, and Blood Pressure (INTERSALT) equations with morning (-165 mg; 95% CI: -295, 36 mg), afternoon (-90 mg; -208, 28 mg), and evening (-120 mg; -230, -11 mg) specimens. With overnight specimens, mean bias was least when the Tanaka (-23 mg; 95% CI: -141, 95 mg) or Mage (-145 mg; -314, 25 mg) equations were used but was statistically significant when using the Tanaka equations among females (216 to 243 mg) and the Mage equations among races other than black (-554 to -372 mg). Significant over- and underprediction occurred across individual sodium excretion concentrations. CONCLUSIONS Using a single spot urine, INTERSALT equations may provide the least biased information about population mean sodium intakes among young US adults. None of the equations evaluated provided unbiased estimates of individual 24-h sodium excretion.
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Affiliation(s)
- Mary E Cogswell
- Division for Heart Disease and Stroke Prevention (MEC and CDG) and the Division of Nutrition, Physical Activity and Obesity (CGP), National Center for Chronic Disease Prevention and Health Promotion, and the Division of Laboratory Sciences, National Center for Environmental Health (CMP and KLC), CDC, Atlanta, GA; the Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC, Hyattsville, MD (C-YW and T-CC); the National Heart, Lung, and Blood Institute (CML) and Office of Dietary Supplements (CAS and CTS), NIH, Bethesda, MD; the Department of Statistics, Iowa State University, Ames, IA (ALC); the Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (KL); and the Department of Epidemiology and Public Health, Imperial College of London and Medical Research Council-Health Protection Agency, Centre for Environment and Health, London, United Kingdom (PE)
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Wang Y, Chen A, Dietrich KN, Radcliffe J, Caldwell KL, Rogan WJ. Postnatal exposure to methyl mercury and neuropsychological development in 7-year-old urban inner-city children exposed to lead in the United States. Child Neuropsychol 2013; 20:527-38. [PMID: 23971942 DOI: 10.1080/09297049.2013.824955] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND The most common route for general population exposure to methyl mercury (MeHg) is fish consumption. Recommendations to pregnant women about consuming fish contaminated with MeHg are also applied to children, but there are few studies available about the effects of low-level postnatal MeHg exposure in them. OBJECTIVES To investigate the association between postnatal methyl mercury exposure and neuropsychological development in a study of children also exposed to lead, both measured at 7 years. METHODS We measured MeHg concentrations in blood samples from the Treatment of Lead-Exposed Children (TLC) trial in which 780 children with elevated concentrations of lead in blood were followed with neuropsychological tests from ages 12-33 months through 7 years. Here we examine blood MeHg concentration and neuropsychological test scores, both measured at age 7 years. We used a maximum likelihood method to estimate geometric mean MeHg concentration and generalized linear regression models to analyze MeHg and neuropsychological test scores. RESULTS Geometric mean MeHg concentration was 0.56 (95% confidence interval: 0.52, 0.59) μ g/L. A 1 μ g/L increase in MeHg was associated with a 2.1 (95% confidence interval: 0.4, 3.8) point increase in Full-Scale IQ and 0.2 (95% confidence interval: 0.02, 0.4) point increase in Learning Slopeindex T-score on a test of verbal memory. CONCLUSIONS Our results suggest that the relatively low MeHg exposure in US school-aged children from this population has no detectable adverse effect on neuropsychological development. The positive associations observed between MeHg and neurodevelopment may indirectly reflect consumption of beneficial polyunsaturated fatty acids from seafood.
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Affiliation(s)
- Yan Wang
- a Epidemiology Branch , National Institute of Environmental Health Sciences , Research Triangle Park , North Carolina , USA
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Cohen JP, Ruha AM, Curry SC, Biswas K, Westenberger B, Ye W, Caldwell KL, Lovecchio F, Burkhart K, Samia N. Plasma and urine dimercaptopropanesulfonate concentrations after dermal application of transdermal DMPS (TD-DMPS). J Med Toxicol 2013; 9:9-15. [PMID: 23143832 DOI: 10.1007/s13181-012-0272-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
2,3-Dimercaptopropane-1-sulfonate (DMPS) is a metal chelator approved in Europe for oral or intravenous use for heavy metal poisoning. Transdermally applied DMPS (TD-DMPS) is used by some alternative practitioners to treat autism, despite the absence of evidence for its efficacy. We found no literature evaluating the pharmacokinetics of the transdermal route of delivery or the ability of TD-DMPS to enhance urinary mercury elimination. We hypothesized that TD-DMPS is not absorbed. Eight adult volunteers underwent application of 1.5-3 drops/kg of TD-DMPS. Subjects provided 12-h urine collections the day before and day of application. Subjects underwent blood draws at 0, 30, 60,90, 120, and 240 min after TD-DMPS application. Plasma and urine were assayed for the presence of DMPS. Urine was assayed for any change in urinary mercury excretion after DMPS. One control subject ingested 250 mg of oral DMPS and underwent the same urine and blood collections and analyses. No subject had detectable urine DMPS or increased urine mercury excretion after TD-DMPS. One subject had detectable levels of DMPS in the 30-min plasma sample, suspected to be contamination. All other samples for that subject and the other seven subjects showed no detectable plasma DMPS. The control subject had detectable urine and plasma DMPS levels and increased urine mercury excretion. These results indicate that TD-DMPS is not absorbed. There was no increase in urine mercury excretion after TD-DMPS. Our results argue that TD-DMPS is an ineffective metal chelator.
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Affiliation(s)
- Jennifer P Cohen
- Department of Medical Toxicology, Banner Good Samaritan Medical Center, Medical Toxicology, Phoenix, AZ 85006, USA
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Cao Y, Chen A, Bottai M, Caldwell KL, Rogan WJ. The impact of succimer chelation on blood cadmium in children with background exposures: a randomized trial. J Pediatr 2013; 163:598-600. [PMID: 23601497 PMCID: PMC3723771 DOI: 10.1016/j.jpeds.2013.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Revised: 02/06/2013] [Accepted: 03/07/2013] [Indexed: 10/27/2022]
Abstract
Succimer lowers blood lead concentrations in children, and the structure of succimer chelates of lead and cadmium are similar. Using blood samples from a randomized trial of succimer for lead poisoning, however, we found that succimer did not lower blood cadmium in children with background exposure.
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Affiliation(s)
- Yang Cao
- Unit of Biostatistics, Division of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 17177, Sweden
| | - Aimin Chen
- Department of Environmental Health, Division of Epidemiology and Biostatistics, University of Cincinnati College of Medicine, Cincinnati, Ohio 45267, United States
| | - Matteo Bottai
- Unit of Biostatistics, Division of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 17177, Sweden
| | - Kathleen L. Caldwell
- Inorganic and Radiation Analytical Toxicology Branch, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, United States
| | - Walter J. Rogan
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina 27709, United States
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Wang CY, Cogswell ME, Loria CM, Chen TC, Pfeiffer CM, Swanson CA, Caldwell KL, Perrine CG, Carriquiry AL, Liu K, Sempos CT, Gillespie CD, Burt VL. Urinary excretion of sodium, potassium, and chloride, but not iodine, varies by timing of collection in a 24-hour calibration study. J Nutr 2013; 143:1276-82. [PMID: 23761643 PMCID: PMC6370020 DOI: 10.3945/jn.113.175927] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Revised: 03/25/2013] [Accepted: 05/13/2013] [Indexed: 11/14/2022] Open
Abstract
Because of the logistic complexity, excessive respondent burden, and high cost of conducting 24-h urine collections in a national survey, alternative strategies to monitor sodium intake at the population level need to be evaluated. We conducted a calibration study to assess the ability to characterize sodium intake from timed-spot urine samples calibrated to a 24-h urine collection. In this report, we described the overall design and basic results of the study. Adults aged 18-39 y were recruited to collect urine for a 24-h period, placing each void in a separate container. Four timed-spot specimens (morning, afternoon, evening, and overnight) and the 24-h collection were analyzed for sodium, potassium, chloride, creatinine, and iodine. Of 481 eligible persons, 407 (54% female, 48% black) completed a 24-h urine collection. A subsample (n = 133) collected a second 24-h urine 4-11 d later. Mean sodium excretion was 3.54 ± 1.51 g/d for males and 3.09 ± 1.26 g/d for females. Sensitivity analysis excluding those who did not meet the expected creatinine excretion criterion showed the same results. Day-to-day variability for sodium, potassium, chloride, and iodine was observed among those collecting two 24-h urine samples (CV = 16-29% for 24-h urine samples and 21-41% for timed-spot specimens). Among all race-gender groups, overnight specimens had larger volumes (P < 0.01) and lower sodium (P < 0.01 to P = 0.26), potassium (P < 0.01), and chloride (P < 0.01) concentrations compared with other timed-spot urine samples, although the differences were not always significant. Urine creatinine and iodine concentrations did not differ by the timing of collection. The observed day-to-day and diurnal variations in sodium excretion illustrate the importance of accounting for these factors when developing calibration equations from this study.
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Affiliation(s)
- Chia-Yih Wang
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA.
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31
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Caldwell KL, Pan Y, Mortensen ME, Makhmudov A, Merrill L, Moye J. Iodine status in pregnant women in the National Children's Study and in U.S. women (15-44 years), National Health and Nutrition Examination Survey 2005-2010. Thyroid 2013; 23:927-37. [PMID: 23488982 PMCID: PMC3752509 DOI: 10.1089/thy.2013.0012] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND This report presents iodine data from National Health and Nutrition Examination Survey (NHANES) and from a sample of pregnant women in the National Children's Study (NCS) Vanguard Study. METHODS Urinary iodine (UI) was measured in a one third subsample of NHANES 2005-2006 and 2009-2010 participants and in all 2007-2008 participants age 6 years and older. These measurements are representative of the general U.S. population. UI was also measured in a convenience sample of 501 pregnant women enrolled in the NCS initial Vanguard Study from seven study sites across the United States. RESULTS NHANES median UI concentration in 2009-2010 (144 μg/L) was significantly lower than in 2007-2008 (164 μg/L). Non-Hispanic blacks had the lowest UI concentrations (131 μg/L) compared with non-Hispanic whites or Hispanics (147 and 148 μg/L, respectively). The median for all pregnant women in NHANES 2005-2010 was less than adequate (129 μg/L), while third trimester women had UI concentrations that were adequate (median UI 172 μg/L). Third trimester women participating in the NCS similarly had an adequate level of iodine intake, with a median UI concentration of 167 μg/L. Furthermore, NCS median UI concentrations varied by geographic location. CONCLUSIONS Dairy, but not salt, seafood, or grain consumption, was significantly positively associated with median UI concentration in women of childbearing age. Pregnant women in their third trimester in the NHANES 2005-2010 had adequate median UI concentrations, but pregnant women in NHANES who were in their first or second trimesters had median UI concentrations that were less than adequate. Non-Hispanic black pregnant women from both the NHANES 2005-20010 and the NCS consistently had lower UI median concentrations than non-Hispanic whites or Hispanics.
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Affiliation(s)
- Kathleen L Caldwell
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
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32
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Perrine CG, Sullivan KM, Flores R, Caldwell KL, Grummer-Strawn LM. Intakes of dairy products and dietary supplements are positively associated with iodine status among U.S. children. J Nutr 2013; 143:1155-60. [PMID: 23700343 PMCID: PMC4532542 DOI: 10.3945/jn.113.176289] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Although pregnant women and some groups of reproductive-age women in the US may be at risk of iodine deficiency, data also suggest that iodine intake among many U.S. children may be above requirements. Our objective was to describe the association of iodine sources with iodine status among children. We analyzed 2007-2010 NHANES data of urine iodine concentration (UIC) spot tests for children aged 6-12 y (n = 1553) and used WHO criteria for iodine status (median UIC: 100-199 μg/L = adequate; 200-299 μg/L = above requirements; ≥300 μg/L = excess). The overall median UIC was above requirements for children aged 6-12 y [211 μg/L (95% CI: 194, 228 μg/L)]. Median UIC increased by quartile of previous day dairy intake, ranging from adequate in the lowest quartile [157 μg/L (95% CI: 141, 170 μg/L)] to above requirements in the highest quartile [278 μg/L (95% CI: 252, 336 μg/L)]. Median UIC was 303 μg/L (95% CI: 238, 345 μg/L) among the 17% of children who had taken a dietary supplement containing iodine the previous day, compared with 198 μg/L (95% CI: 182, 214 μg/L) among those who had not. In adjusted regression analyses, recent dairy intake and recent supplement use were significantly positively associated with UIC levels, whereas recent grain intake was negatively associated. Adding salt to food at the table was not associated with UIC. Iodine-containing supplements are likely not needed by most schoolchildren in the US because dietary iodine intake is adequate in this age group.
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Affiliation(s)
- Cria G. Perrine
- Divisions of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA,U.S. Public Health Service Commissioned Corps, Atlanta, GA,To whom correspondence should be addressed. E-mail:
| | - Kevin M. Sullivan
- Divisions of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA,Rollins School of Public Health, Emory University, Atlanta, GA
| | - Rafael Flores
- Divisions of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA
| | - Kathleen L. Caldwell
- Divisions of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA
| | - Laurence M. Grummer-Strawn
- Divisions of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA,U.S. Public Health Service Commissioned Corps, Atlanta, GA
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Horton DK, Adetona O, Aguilar-Villalobos M, Cassidy BE, Pfeiffer CM, Schleicher RL, Caldwell KL, Needham LL, Rathbun SL, Vena JE, Naeher LP. Changes in the concentrations of biochemical indicators of diet and nutritional status of pregnant women across pregnancy trimesters in Trujillo, Peru, 2004-2005. Nutr J 2013; 12:80. [PMID: 23758715 PMCID: PMC3685542 DOI: 10.1186/1475-2891-12-80] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 05/22/2013] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND In developing countries, deficiencies in essential micronutrients are common, particularly in pregnant women. Although, biochemical indicators of diet and nutrition are useful to assess nutritional status, few studies have examined such indicators throughout pregnancy in women in developing countries. METHODS The primary objective of this study was to assess the nutritional status of 78 Peruvian women throughout pregnancy for 16 different nutritional indicators including fat-soluble vitamins and carotenoids, iron-status indicators, and selenium. Venous blood samples from which serum was prepared were collected during trimesters one (n = 78), two (n = 65), three (n = 62), and at term via the umbilical cord (n = 52). Questionnaires were completed to determine the demographic characteristics of subjects. Linear mixed effects models were used to study the associations between each maternal indicator and the demographic characteristics. RESULTS None of the women were vitamin A and E deficient at any stage of pregnancy and only 1/62 women (1.6%) was selenium deficient during the third trimester. However, 6.4%, 44% and 64% of women had ferritin levels indicative of iron deficiency during the first, second and third trimester, respectively. Statistically significant changes (p ≤ 0.05) throughout pregnancy were noted for 15/16 nutritional indicators for this Peruvian cohort, with little-to-no association with demographic characteristics. Three carotenoids (beta-carotene, beta-cryptoxanthin and trans-lycopene) were significantly associated with education status, while trans-lycopene was associated with age and beta-cryptoxanthin with SES (p < 0.05). Concentrations of retinol, tocopherol, beta-cryptoxanthin, lutein + zeaxanthin and selenium were lower in cord serum compared with maternal serum (p < 0.05). Conversely, levels of iron status indicators (ferritin, transferrin saturation and iron) were higher in cord serum (p < 0.05). CONCLUSION The increasing prevalence of iron deficiency throughout pregnancy in these Peruvian women was expected. It was surprising though not to find deficiencies in other nutrients. The results highlight the importance of continual monitoring of women throughout pregnancy for iron deficiency which could be caused by increasing fetal needs and/or inadequate iron intake as pregnancy progresses.
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Affiliation(s)
- D Kevin Horton
- Agency for Toxic Substances and Disease Registry, Atlanta, GA, USA
| | - Olorunfemi Adetona
- The University of Georgia, College of Public Health, 150 Environmental Health Science Bldg, Athens, Georgia 30602-2102, USA
| | | | - Brandon E Cassidy
- The University of Georgia, College of Public Health, 150 Environmental Health Science Bldg, Athens, Georgia 30602-2102, USA
| | - Christine M Pfeiffer
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, 30341, USA
| | - Rosemary L Schleicher
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, 30341, USA
| | - Kathleen L Caldwell
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, 30341, USA
| | - Larry L Needham
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, 30341, USA
| | - Stephen L Rathbun
- Department of Biostatistics and Epidemiology, The University of Georgia, College of Public Health, Paul D. Coverdell Center for Biomedical and Health Sciences, Athens, Georgia, 30602-7396, USA
| | - John E Vena
- Department of Biostatistics and Epidemiology, The University of Georgia, College of Public Health, Paul D. Coverdell Center for Biomedical and Health Sciences, Athens, Georgia, 30602-7396, USA
| | - Luke P Naeher
- The University of Georgia, College of Public Health, 150 Environmental Health Science Bldg, Athens, Georgia 30602-2102, USA
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34
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Pfeiffer CM, Sternberg MR, Caldwell KL, Pan Y. Race-ethnicity is related to biomarkers of iron and iodine status after adjusting for sociodemographic and lifestyle variables in NHANES 2003-2006. J Nutr 2013; 143:977S-85S. [PMID: 23596169 PMCID: PMC4811330 DOI: 10.3945/jn.112.173039] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The NHANES 2003-2006 has assessed iron and iodine status, 2 trace element nutrients of continued public health interest, in the U.S. population. We investigated associations of sociodemographic (age, sex, race-ethnicity, education, income) and lifestyle (smoking, alcohol consumption, BMI, physical activity, dietary supplement use) variables with the iron status indicators serum ferritin, soluble transferrin receptor (sTfR), and body iron in women aged 20-49 y (n = 2539, 2513, and 2509, respectively) and with urine iodine, a biomarker of iodine intake, in adults aged ≥ 20 y (n = 3066). Significant correlations between the study variables and biomarkers were weak (|r| ≤ 0.24). Urine creatinine (uCr) was moderately significantly correlated with urine iodine (r = 0.52). The individual variables explained ≤ 5% of the variability in biomarker concentrations in bivariate analysis. In multiple regression models, sociodemographic and lifestyle variables together explained 4-13% of the variability in iron indicators and 41% of the variability in urine iodine (uCr in the model). The adjusted estimated body iron was ≈ 1 unit (mg/kg) lower in non-Hispanic black vs. non-Hispanic white women and ≈ 1 unit higher in women who smoked vs. those who did not and in women consuming 1 vs. 0 alcoholic drinks/d. The adjusted estimated urine iodine concentration (uCr in the model) was 34% lower in non-Hispanic blacks vs. non-Hispanic whites, 22% higher in supplement users vs. nonusers, and 11% higher with every 10-y increase in age. In summary, after adjusting for sociodemographic and lifestyle variables (and uCr in the iodine model), race-ethnicity retained a strong association with sTfR, body iron, and urine iodine; smoking and alcohol consumption with iron biomarkers; and supplement use and age with urine iodine.
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Affiliation(s)
- Christine M. Pfeiffer
- To whom correspondence should be addressed: Christine M. Pfeiffer, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, NE, Mail Stop F55, Atlanta, GA 30341, Phone: 770-488-7926, Fax: 770-488-4139,
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35
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Pan Y, Caldwell KL, Li Y, Caudill SP, Mortensen ME, Makhmudov A, Jones RL. Smoothed Urinary Iodine Percentiles for the US Population and Pregnant Women: National Health and Nutrition Examination Survey, 2001-2010. Eur Thyroid J 2013; 2:127-34. [PMID: 24783051 PMCID: PMC3821505 DOI: 10.1159/000348247] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Revised: 01/18/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Iodine intake is essential for normal growth, development and metabolism throughout life, especially for women during gestation and lactation. The present study applies a novel statistical approach, providing smoothed urinary iodine (UI) percentile curves for the total US population as well as the categories of sex, race/ethnicity, women of childbearing age and pregnant women who were participants in the National Health and Nutrition Examination Survey (NHANES) 2001-2010. To our knowledge, this is the first application of this technique to NHANES nutritional biomarker data. METHODS We used UI and urinary creatinine that were measured in participants aged 6 and older in the NHANES survey periods 2001-2002, 2003-2004, 2005-2006, 2007-2008 and 2009-2010. A nonparametric double-kernel method was applied to smooth percentile curves for UI and creatinine-corrected results. RESULTS The UI population estimates showed a U-shaped distribution by age for the total US population. Overall, females had lower UI concentrations and median values compared to males (median UI for females, 141.8 µg/l; median UI for males, 176.1 µg/l; p < 0.0001). Non-Hispanic blacks had the lowest median UI concentrations compared to other racial/ethnic groups (p < 0.0001). Among women of childbearing age (15-44 years), UI concentrations mostly declined with increasing age. Pregnant women aged 35 years and older tended to have higher UI concentrations than younger pregnant women at similar percentiles. CONCLUSIONS The smoothed reference distribution of UI concentrations provides an improved and visual display of the entire distribution of values for the US population and specific demographic categories.
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Affiliation(s)
- Yi Pan
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Ga., Md., USA
| | - Kathleen L. Caldwell
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Ga., Md., USA
- *Kathleen L. Caldwell, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, NE, MS-F18, Atlanta, GA 30341 (USA), E-Mail
| | - Yan Li
- Joint Program in Survey Methodology, University of Maryland, College Park, Md., USA
| | - Samuel P. Caudill
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Ga., Md., USA
| | - Mary E. Mortensen
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Ga., Md., USA
| | - Amir Makhmudov
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Ga., Md., USA
| | - Robert L. Jones
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Ga., Md., USA
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Affiliation(s)
- Kevin M. Sullivan
- Division of Nutrition, Physical Activity, and Obesity, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Cria G. Perrine
- Division of Nutrition, Physical Activity, and Obesity, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Elizabeth N. Pearce
- Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, Massachusetts
| | - Kathleen L. Caldwell
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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37
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Swanson CA, Zimmermann MB, Skeaff S, Pearce EN, Dwyer JT, Trumbo PR, Zehaluk C, Andrews KW, Carriquiry A, Caldwell KL, Egan SK, Long SE, Bailey RL, Sullivan KM, Holden JM, Betz JM, Phinney KW, Brooks SPJ, Johnson CL, Haggans CJ. Summary of an NIH workshop to identify research needs to improve the monitoring of iodine status in the United States and to inform the DRI. J Nutr 2012; 142:1175S-85S. [PMID: 22551802 PMCID: PMC3738225 DOI: 10.3945/jn.111.156448] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The Office of Dietary Supplements (ODS) at the NIH sponsored a workshop on May 12-13, 2011, to bring together representatives from various NIH institutes and centers as a first step in developing an NIH iodine research initiative. The workshop also provided an opportunity to identify research needs that would inform the dietary reference intakes for iodine, which were last revised in 2001. Iodine is required throughout the life cycle, but pregnant women and infants are the populations most at risk of deficiency, because iodine is required for normal brain development and growth. The CDC monitors iodine status of the population on a regular basis, but the status of the most vulnerable populations remains uncertain. The NIH funds very little investigator-initiated research relevant to iodine and human nutrition, but the ODS has worked for several years with a number of other U.S. government agencies to develop many of the resources needed to conduct iodine research of high quality (e.g., validated analytical methods and reference materials for multiple types of samples). Iodine experts, scientists from several U.S. government agencies, and NIH representatives met for 2 d to identify iodine research needs appropriate to the NIH mission.
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Affiliation(s)
- Christine A Swanson
- Office of Dietary Supplements, National Institutes of Health, Bethesda, MD, USA.
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Wolkin A, Hunt D, Martin C, Caldwell KL, McGeehin MA. Blood mercury levels among fish consumers residing in areas with high environmental burden. Chemosphere 2012; 86:967-971. [PMID: 22153999 DOI: 10.1016/j.chemosphere.2011.11.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Revised: 11/03/2011] [Accepted: 11/13/2011] [Indexed: 05/31/2023]
Abstract
Mercury is a ubiquitous, persistent toxicant found in the environment. In water, mercury bioaccumulates up the food chain and leads to high concentrations in fish. Consumption of contaminated fish is the major source of exposure to mercury in the US. The objective of this study was to enroll persons living in areas selected by the Environmental Protection Agency (EPA) to have high mercury concentrations and who consume at least 6o z of locally caught fish per week to determine the feasibility of monitoring future trends among a population identified as highly exposed. Blood samples were collected at time of interview and analyzed for mercury. Participants (n=287) were enrolled from North Carolina, Maryland, and South Dakota. Participants reported eating an average of five servings of fish per week. The overall geometric mean for total mercury was 0.75 μg L(-1), with North Carolina having the highest mean level (2.02 μg L(-1)). Overall, 42% of the study population had levels greater than the US geometric mean 0.83 μg L(-1). The number of servings of fish consumed was not found to be associated with blood mercury levels. We were able to identify some persons with elevated mercury concentrations living in areas identified by EPA; however, identifying and monitoring a highly exposed population over time would be challenging.
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Affiliation(s)
- Amy Wolkin
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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Wells EM, Goldman LR, Jarrett JM, Apelberg BJ, Herbstman JB, Caldwell KL, Halden RU, Witter FR. Selenium and maternal blood pressure during childbirth. J Expo Sci Environ Epidemiol 2012; 22:191-7. [PMID: 22108761 PMCID: PMC3661205 DOI: 10.1038/jes.2011.42] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2011] [Accepted: 06/14/2011] [Indexed: 05/25/2023]
Abstract
Evidence suggests selenium concentrations outside the nutritional range may worsen cardiovascular health. This paper examines the relationship between selenium and maternal blood pressure (BP) among 270 deliveries using umbilical cord serum as a proxy for maternal exposure levels. Multivariable models used linear splines for selenium and controlled for gestational age, maternal age, race, median household income, parity, smoking, and prepregnancy body mass index. Non-parametric analysis of this dataset was used to select spline knots for selenium at 70 and 90 μg/l. When selenium was <70 μg/l, increasing selenium levels were related to a non-statistically significant decrease in BP. For selenium 70-90 μg/l, a 1 μg/l increase was related to a 0.37 mm Hg (95% confidence interval (CI): 0.005, 0.73) change in systolic and a 0.35 mm Hg (0.07, 0.64) change in diastolic BP. There were very few selenium values >90 μg/l. Other studies indicate that the maternal/cord selenium ratio is 1.46 (95% CI: 1.28, 1.65). This u-shaped relationship between selenium and BP is consistent with a dual role of selenium as an essential micronutrient that is nonetheless a toxicant at higher concentrations; however, this needs to be studied further.
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Affiliation(s)
- Ellen M. Wells
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health; Baltimore, Maryland, USA
- Department of Environmental Health Sciences, Case Western Reserve University School of Medicine; Cleveland, Ohio, USA
| | - Lynn R. Goldman
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health; Baltimore, Maryland, USA
- George Washington University School of Public Health and Health Services; Washington D.C., USA
| | - Jeffery M. Jarrett
- Inorganic and Radiation Analytical Toxicology Branch, Centers for Disease Control and Prevention; Atlanta, Georgia, USA
| | - Benjamin J. Apelberg
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health; Baltimore, Maryland, USA
| | - Julie B. Herbstman
- The Columbia Center for Children’s Environmental Health, Columbia University Mailman School of Public Health; New York, New York, USA
| | - Kathleen L. Caldwell
- Inorganic and Radiation Analytical Toxicology Branch, Centers for Disease Control and Prevention; Atlanta, Georgia, USA
| | - Rolf U. Halden
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health; Baltimore, Maryland, USA
- Swette 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
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Tellez-Plaza M, Navas-Acien A, Caldwell KL, Menke A, Muntner P, Guallar E. Reduction in cadmium exposure in the United States population, 1988-2008: the contribution of declining smoking rates. Environ Health Perspect 2012; 120:204-9. [PMID: 22062584 PMCID: PMC3279452 DOI: 10.1289/ehp.1104020] [Citation(s) in RCA: 113] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Accepted: 11/07/2011] [Indexed: 05/04/2023]
Abstract
BACKGROUND Public health policies such as tobacco control, air pollution reduction, and hazardous waste remediation may have reduced cadmium exposure among U.S. adults. However, trends in urine cadmium, a marker of cumulative cadmium exposure, have not been evaluated. OBJECTIVES We estimated the trends in urine cadmium concentrations in U.S. adults using data from the National Health and Nutrition Examination Surveys (NHANES) from 1988 to 2008. We also evaluated the impact of changes in the distribution of available cadmium determinants (age, sex, race, education, body mass index, smoking, and occupation) at the population level to explain cadmium trends. METHODS The study population included 19,759 adults ≥ 20 years of age with measures of urine cadmium and cadmium determinants. RESULTS Age-adjusted geometric means of urine cadmium concentrations were 0.36, 0.35, 0.27, 0.27, 0.28, 0.25, and 0.26 µg/g creatinine in 1988-1991, 1991-1994, 1999-2000, 2001-2002, 2003-2004, 2005-2006, and 2007-2008, respectively. The age, sex, and race/ethnicity-adjusted percent reduction in urine cadmium geometric means comparing 1999-2002 and 2003-2008 with 1988-1994 were 27.8% (95% confidence interval: 22.3%, 32.9%) and 34.3% (29.9%, 38.4%), respectively (p-trend < 0.001), with reductions in all participant subgroups investigated. In never smokers, reductions in serum cotinine accounted for 15.6% of the observed reduction. In ever smokers, changes in smoking cessation, and cumulative and recent dose accounted for 17.1% of the observed reduction. CONCLUSIONS Urine cadmium concentrations decreased markedly between 1988 and 2008. Declining smoking rates and changes in exposure to tobacco smoke may have played an important role in the decline of urine cadmium concentrations, benefiting both smokers and nonsmokers. Cadmium has been associated to several health outcomes in NHANES 1999-2008. Consequently, despite the observed decline, further reduction in cadmium exposure is needed.
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Affiliation(s)
- Maria Tellez-Plaza
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Room W7513D, Baltimore, MD 21205 USA.
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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. Environ Health Perspect 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Wells EM, Jarrett JM, Lin YH, Caldwell KL, Hibbeln JR, Apelberg BJ, Herbstman J, Halden RU, Witter FR, Goldman LR. Body burdens of mercury, lead, selenium and copper among Baltimore newborns. Environ Res 2011; 111:411-417. [PMID: 21277575 PMCID: PMC3064741 DOI: 10.1016/j.envres.2010.12.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2010] [Revised: 12/14/2010] [Accepted: 12/28/2010] [Indexed: 05/27/2023]
Abstract
Umbilical cord blood or serum concentrations of mercury, lead, selenium and copper were measured with inductively coupled plasma mass spectrometry in a population of 300 infants born in Baltimore, Maryland. Geometric mean values were 1.37 μg/L (95% confidence interval: 1.27, 1.48) for mercury; 0.66 μg/dL (95% CI: 0.61, 0.71) for lead; and 38.62 μg/dL (95% CI: 36.73, 40.61) for copper. Mean selenium was 70.10 μg/L (95% CI: 68.69, 70.52). Mercury, selenium and copper levels were within exposure ranges reported among similar populations, whereas the distribution of lead levels was lower than prior reports; only one infant had a cord blood lead above 10 μg/dL. Levels of selenium were significantly correlated with concentrations of lead (Spearman's ρ=0.20) and copper (Spearman's ρ=0.51). Multivariable analyses identified a number of factors associated with one of more of these exposures. These included: increase in maternal age (increased lead); Asian mothers (increased mercury and lead, decreased selenium and copper); higher umbilical cord serum n-3 fatty acids (increased mercury, selenium and copper), mothers using Medicaid (increased lead); increasing gestational age (increased copper); increasing birthweight (increased selenium); older neighborhood housing stock (increased lead and selenium); and maternal smoking (increased lead). This work provides additional information about contemporary prenatal element exposures and can help identify groups at risk of atypical exposures.
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Affiliation(s)
- Ellen M. Wells
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health; Baltimore, Maryland 21205, USA
- Department of Environmental Health Sciences, Case Western Reserve University School of Medicine; Cleveland, Ohio 44106, USA
| | - Jeffery M. Jarrett
- Inorganic and Radiation Analytical Toxicology Branch, Centers for Disease Control and Prevention; Atlanta, Georgia 30333, USA
| | - Yu Hong Lin
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland 20892, USA
| | - Kathleen L. Caldwell
- Inorganic and Radiation Analytical Toxicology Branch, Centers for Disease Control and Prevention; Atlanta, Georgia 30333, USA
| | - Joseph R. Hibbeln
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland 20892, USA
| | - Benjamin J. Apelberg
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health; Baltimore, Maryland 21205, USA
| | - Julie Herbstman
- The Columbia Center for Children’s Environmental Health, Columbia University Mailman School of Public Health; New York, New York 10032, USA
| | - Rolf U. Halden
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health; Baltimore, Maryland 21205, USA
- Center for Environmental Biotechnology, Biodesign Institute, Arizona State University; Tempe, Arizona 85287, USA
| | - Frank R. Witter
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine; Baltimore, Maryland 21205, USA
| | - Lynn R. Goldman
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health; Baltimore, Maryland 21205, USA
- George Washington University School of Public Health and Health Services; Washington D.C. 20037, USA
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Abstract
BACKGROUND This report presents urinary iodine (UI) concentrations for the general U.S. population during 2005-2006 and 2007-2008. These findings are the fourth and fifth assessments of the population since National Health and Nutrition Examination Survey (NHANES) III (1988-1994), when the median UI concentration for the population decreased from NHANES I (1971-1974). METHODS During 2005-2006 and 2007-2008, ~ 5000 participants per year were selected to participate in NHANES. The participants were interviewed and examined. UI concentration was measured on a random one third subsample of 2649 participants, aged 6 years and older in 2005-2006, and in all participants in 2007-2008. These urine iodine concentrations are representative of the general U.S. population by age, sex, and race/ethnicity. RESULTS (i) The median UI concentrations for the general U.S. population in 2005-2006 and 2007-2008 were 164 mg/L (95% confidence interval [CI] 154-174) and 164 mg/L (95% CI 154-173), respectively. Also, the proportions of the population with a UI concentration of < 50 mg/L during these survey periods were 9.8% ± 1.3% and 8.8% ± 0.4%, respectively. The median UI concentration and prevalence of ≥ 200 mg/L appeared to be higher in children and persons ≥ 70 years than in other age groups. (ii) In both surveys, children aged 6-11 years had median UI concentrations of ≥ 200 mg/L, and about 5% of them had a UI concentration of < 50 mg/L. (iii) All pregnant women (sample size 184) surveyed during 2005-2008 had a median UI concentration of 125 mg/L (95% CI 86-198), and 56.9% ± 7.9% of this group had a UI concentration of < 150 mg/L. UI concentrations were lower among non-Hispanic black survey participants than non-Hispanic white and Mexican-American participants. CONCLUSIONS These findings affirm the stabilization of UI concentration and adequate iodine nutrition in the general U.S. population since 2000. However, certain groups likely do not achieve a sufficient dietary iodine intake according to the World Health Organization. The needs of these vulnerable groups and the inadequacy of their dietary iodine intake should be addressed in future efforts.
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Affiliation(s)
- Kathleen L Caldwell
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
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Nelson AE, Shi XA, Schwartz TA, Chen JC, Renner JB, Caldwell KL, Helmick CG, Jordan JM. Whole blood lead levels are associated with radiographic and symptomatic knee osteoarthritis: a cross-sectional analysis in the Johnston County Osteoarthritis Project. Arthritis Res Ther 2011; 13:R37. [PMID: 21362189 PMCID: PMC3132016 DOI: 10.1186/ar3270] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2010] [Revised: 01/11/2011] [Accepted: 03/01/2011] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Lead (Pb) is known to affect bone, and recent evidence suggests that it has effects on cartilage as well. As osteoarthritis (OA) is a highly prevalent disease affecting bone and cartilage, we undertook the present analysis to determine whether whole blood Pb levels are associated with radiographic and symptomatic OA (rOA and sxOA, respectively) of the knee. METHODS The analysis was conducted using cross-sectional data from the Johnston County Osteoarthritis Project, a rural, population-based study, including whole blood Pb levels, bilateral posteroanterior weight-bearing knee radiography and knee symptom data. rOA assessment included joint-based presence (Kellgren-Lawrence (K-L) grade 2 or higher) and severity (none, K-L grade 0 or 1; mild, K-L grade 2; moderate or severe, K-L grade 3 or 4), as well as person-based laterality (unilateral or bilateral). SxOA was deemed present (joint-based) in a knee on the basis of K-L grade 2 or higher with symptoms, with symptoms rated based on severity (0, rOA without symptoms; 1, rOA with mild symptoms; 2, rOA with moderate or severe symptoms) and in person-based analyses was either unilateral or bilateral. Generalized logit or proportional odds regression models were used to examine associations between the knee OA status variables and natural log-transformed blood Pb (ln Pb), continuously and in quartiles, controlling for age, race, sex, body mass index (BMI), smoking and alcohol drinking. RESULTS Those individuals with whole blood Pb data (N = 1,669) had a mean (±SD) age of 65.4 (±11.0) years and a mean BMI of 31.2 (±7.1) kg/m2, including 66.6% women and 35.4% African-Americans, with a median blood Pb level of 1.8 μg/dl (range, 0.3 to 42.0 μg/dl). In joint-based analyses, for every 1-U increase in ln Pb, the odds of prevalent knee rOA were 20% higher (aOR, 1.20; 95% CI, 1.01 to 1.44), while the odds of more severe rOA were 26% higher (aOR, 1.26; 95% CI, 1.05 to 1.50, under proportional odds). In person-based analyses, the odds of bilateral rOA were 32% higher for each 1-U increase in ln Pb (aOR, 1.32; 95% CI, 1.03 to 1.70). Similarly for knee sxOA, for each 1-U increase in ln Pb, the odds of having sxOA were 16% higher, the odds of having more severe symptoms were 17% higher and the odds of having bilateral knee symptoms were 25% higher. Similar findings were obtained with regard to ln Pb in quartiles. CONCLUSIONS Increases in the prevalence and severity measures for both radiographically and symptomatically confirmed knee OA (although statistically significant only for rOA) were observed with increasing levels of blood Pb, suggesting that Pb may be a potentially modifiable environmental risk factor for OA.
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Affiliation(s)
- Amanda E Nelson
- Thurston Arthritis Research Center, University of North Carolina, 3300 Thurston Building, Chapel Hill, NC 27599, USA.
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Cao Y, Chen A, Jones RL, Radcliffe J, Dietrich KN, Caldwell KL, Peddada S, Rogan WJ. Efficacy of succimer chelation of mercury at background exposures in toddlers: a randomized trial. J Pediatr 2011; 158:480-485.e1. [PMID: 20889164 PMCID: PMC3086399 DOI: 10.1016/j.jpeds.2010.08.036] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Revised: 07/19/2010] [Accepted: 08/20/2010] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To examine whether succimer, a mercaptan compound known to reduce blood lead concentration in children, reduces blood mercury concentration. STUDY DESIGN We used samples from a randomized clinical trial of succimer chelation for lead-exposed children. We measured mercury levels in pre-treatment samples from 767 children. We also measured mercury levels in blood samples drawn 1 week after treatment began (n = 768) and in a 20% random sample of the children who received the maximum 3 courses of treatment (n = 67). A bootstrap-based isotonic regression method was used to compare the trend with time in the difference between the adjusted mean mercury concentrations in the succimer group and that in the placebo group. RESULTS The adjusted mean organic mercury concentration in the succimer group relative to the placebo group fell from 99% at baseline to 82% after 3 courses of treatment (P for trend = .048), but this resulted from the prevention of the age-related increase in the succimer group. CONCLUSION Succimer chelation for low level organic mercury exposure in children has limited efficacy.
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Affiliation(s)
- Yang Cao
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
- Department of Health Statistics, Faculty of Health Services, Second Military Medical University, Shanghai, China
| | - Aimin Chen
- Department of Environmental Health, Division of Epidemiology and Biostatistics, University of Cincinnati College of Medicine, Cincinnati, OH USA
| | - Robert L. Jones
- Inorganic and Radiation Analytical Toxicology Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Jerilynn Radcliffe
- The Children’s Hospital of Philadelphia, and University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Kim N. Dietrich
- Department of Environmental Health, Division of Epidemiology and Biostatistics, University of Cincinnati College of Medicine, Cincinnati, OH USA
| | - Kathleen L. Caldwell
- Inorganic and Radiation Analytical Toxicology Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Shyamal Peddada
- Biostatistics Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709, USA
| | - Walter J. Rogan
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
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Cole CR, Grant FK, Swaby-Ellis ED, Smith JL, Jacques A, Northrop-Clewes CA, Caldwell KL, Pfeiffer CM, Ziegler TR. Zinc and iron deficiency and their interrelations in low-income African American and Hispanic children in Atlanta. Am J Clin Nutr 2010; 91:1027-34. [PMID: 20147474 PMCID: PMC2844684 DOI: 10.3945/ajcn.2009.28089] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Information about the zinc status of low-income minority children in the United States is lacking. OBJECTIVE The objective was to determine the prevalence of zinc deficiency and anemia and their interrelation among low-income African American and Hispanic preschool children. DESIGN This was a cross-sectional study in which a prospective 3-d food diary was completed, and hemoglobin, serum ferritin, zinc, copper, and C-reactive protein concentrations were measured. Children with elevated C-reactive protein concentrations were excluded from analysis. RESULTS Of 292 children recruited, 280 (mean +/- SD age: 2.5 +/- 1.2 y) qualified for analysis. One hundred forty-six (52%) children were African American and 134 (48%) were Hispanic; 202 (72%) were enrolled in the Women, Infants, and Children nutrition program. A low serum zinc concentration (<10.7 mumol/L) was present in 34 (12%) children, and 37 (13%) were anemic (hemoglobin < 110 g/L). African American (odds ratio: 3.47; 95% CI: 1.51, 7.96) and anemic (odds ratio: 2.92; 95% CI: 1.24, 6.90) children had an increased risk of zinc deficiency. Serum zinc correlated with hemoglobin (r = 0.24, P < 0.001). Children with a height/length less than the fifth percentile had significantly lower mean serum zinc concentrations than those with a height/length greater than the fifth percentile (12.4 +/- 1.8 compared with 13.0 +/- 2.2 micromol/L; P < 0.001). In a multiple logistic regression model, African American race-ethnicity was associated with zinc deficiency (odds ratio: 0.26; P = 0.02). The main sources of iron and zinc in the diets were meat products and cereals. CONCLUSIONS The prevalence of zinc deficiency and anemia was high in this population of low-income minority children, especially among African Americans. Further investigation of the incidence of zinc deficiency and the ability of anemia to screen for it is warranted.
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Affiliation(s)
- Conrad R Cole
- Department of Pediatrics, Emory University, Atlanta, GA 30322, USA.
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Iqbal S, Blumenthal W, Kennedy C, Yip FY, Pickard S, Flanders WD, Loringer K, Kruger K, Caldwell KL, Jean Brown M. Hunting with lead: association between blood lead levels and wild game consumption. Environ Res 2009; 109:952-9. [PMID: 19747676 DOI: 10.1016/j.envres.2009.08.007] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2009] [Revised: 08/10/2009] [Accepted: 08/13/2009] [Indexed: 05/06/2023]
Abstract
BACKGROUND Wild game hunting is a popular activity in many regions of the United States. Recently, the presence of lead fragments in wild game meat, presumably from the bullets or shot used for hunting, has raised concerns about health risks from meat consumption. OBJECTIVE This study examined the association between blood lead levels (PbB) and wild game consumption. METHODS We recruited 742 participants, aged 2-92 years, from six North Dakota cities. Blood lead samples were collected from 736 persons. Information on socio-demographic background, housing, lead exposure source, and types of wild game consumption (i.e., venison, other game such as moose, birds) was also collected. Generalized estimating equations (GEE) were used to determine the association between PbB and wild game consumption. RESULTS Most participants reported consuming wild game (80.8%) obtained from hunting (98.8%). The geometric mean PbB were 1.27 and 0.84 microg/dl among persons who did and did not consume wild game, respectively. After adjusting for potential confounders, persons who consumed wild game had 0.30 microg/dl (95% confidence interval: 0.16-0.44 microg/dl) higher PbB than persons who did not. For all game types, recent (<1 month) wild game consumption was associated with higher PbB. PbB was also higher among those who consumed a larger serving size (> or = 2 oz vs. <2 oz); however, this association was significant for 'other game' consumption only. CONCLUSIONS Participants who consumed wild game had higher PbB than those who did not consume wild game. Careful review of butchering practices and monitoring of meat-packing processes may decrease lead exposure from wild game consumption.
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Affiliation(s)
- Shahed Iqbal
- Epidemic Intelligence Service, Office of Workforce and Career Development, Centers for Disease Control and Prevention, Chamblee, GA 30341, USA.
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Caldwell KL, Mortensen ME, Jones RL, Caudill SP, Osterloh JD. Total blood mercury concentrations in the U.S. population: 1999-2006. Int J Hyg Environ Health 2009; 212:588-98. [PMID: 19481974 DOI: 10.1016/j.ijheh.2009.04.004] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2009] [Revised: 04/17/2009] [Accepted: 04/26/2009] [Indexed: 10/20/2022]
Abstract
We describe the distribution and demographic characteristics of total blood Hg levels in the U.S. general population among persons ages 1 year and older who participated in the 2003-2006 National Health and Nutrition Examination Survey (NHANES). We also describe trends in the total blood Hg of children ages 1-5 (n=3456) and females ages 16-49 during 1999-2006 (n=7245). In the combined 2003-2006 survey periods, the geometric means for non-Hispanic blacks, 0.853microg/L (95% confidence interval [CI], 0.766-0.950microg/L), and non-Hispanic whites, 0.833microg/L (95% CI, 0.752-0.922microg/L), were higher than the geometric mean for Mexican Americans, 0.580microg/L (95% CI, 0.522-0.645microg/L). Also in 2003-2006, regression analysis of log total blood Hg with age, race/ethnicity and gender showed that total blood Hg levels in the population exhibited a quadratic increase with age (p<0.0001), peaking at ages 50-59 in non-Hispanic blacks and whites, at ages 40-49 in Mexican Americans, and then declining at older ages. Over the four survey periods (1999-2006), regression analysis showed that total blood Hg levels increased slightly for non-Hispanic white children and decreased slightly for non-Hispanic black and Mexican American children. Over the same four survey periods, female children had slightly higher total blood Hg levels than males (0.356 vs. 0.313microg/L, p=0.0050) and total blood Hg levels in non-Hispanic black women aged 16-49 years were significantly higher than in non-Hispanic white women (1.081 vs. 0.850microg/L, p<0.0001) and in Mexican American women (1.081 vs. 0.70microg/L, p<0.0001).
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Affiliation(s)
- Kathleen L Caldwell
- Division of Laboratory Sciences, National Center for Environmental Health, CDC, 4770 Buford Highway, NE, Mailstop F-18, Atlanta, GA 30341, USA.
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Jones RL, Homa DM, Meyer PA, Brody DJ, Caldwell KL, Pirkle JL, Brown MJ. Trends in blood lead levels and blood lead testing among US children aged 1 to 5 years, 1988-2004. Pediatrics 2009; 123:e376-85. [PMID: 19254973 DOI: 10.1542/peds.2007-3608] [Citation(s) in RCA: 241] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To evaluate trends in children's blood lead levels and the extent of blood lead testing of children at risk for lead poisoning from national surveys conducted during a 16-year period in the United States. METHODS Data for children aged 1 to 5 years from the National Health and Nutrition Examination Survey III Phase I, 1988-1991, and Phase II, 1991-1994 were compared to data from the survey period 1999-2004. RESULTS The prevalence of elevated blood lead levels, >/=10 microg/dL, among children decreased from 8.6% in 1988-1991 to 1.4% in 1999-2004, which is an 84% decline. From 1988-1991 and 1999-2004, children's geometric mean blood lead levels declined in non-Hispanic black (5.2-2.8 microg/dL), Mexican American (3.9-1.9 microg/dL), and non-Hispanic white children (3.1 microg/dL to 1.7 microg/dL). However, levels continue to be highest among non-Hispanic black children relative to Mexican American and non-Hispanic white children. Blood lead levels were distributed as follows: 14.0% were <1.0 microg/dL, 55.0% were 1.0 to <2.5 microg/dL, 23.6% were 2.5 to <5 microg/dL, 4.5% were 5 to <7.5 microg/dL, 1.5% were 7.5 to <10 microg/dL, and 1.4% were >/=10 microg/dL. Multivariable analysis indicated that residence in older housing, poverty, age, and being non-Hispanic black are still major risk factors for higher lead levels. Blood lead testing of Medicaid-enrolled children increased to 41.9% from 19.2% in 1988-1991. Only 43.0% of children with elevated blood lead levels had previously been tested. CONCLUSIONS Children's blood lead levels continue to decline in the United States, even in historically high-risk groups for lead poisoning. To maintain progress made and eliminate remaining disparities, efforts must continue to test children at high risk for lead poisoning, and identify and control sources of lead. Coordinated prevention strategies at national, state, and local levels will help achieve the goal of elimination of elevated blood lead levels.
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Affiliation(s)
- Robert L Jones
- Centers for Disease Control and Prevention, National Center for Environmental Health, 4770 Buford Hwy, Atlanta, GA 30341.
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Ruha AM, Curry SC, Gerkin RD, Caldwell KL, Osterloh JD, Wax PM. Urine mercury excretion following meso-dimercaptosuccinic acid challenge in fish eaters. Arch Pathol Lab Med 2009; 133:87-92. [PMID: 19123743 DOI: 10.5858/133.1.87] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2008] [Indexed: 11/06/2022]
Abstract
CONTEXT Public awareness of methylmercury in fish has caused patients to seek testing for mercury poisoning. In some patients, the diagnosis of mercury poisoning has been made based on urine mercury excretions following oral dosing of meso-dimercaptosuccinic acid (DMSA), a metal chelator. However, studies comparing urine mercury excretion following DMSA in healthy non-fish eaters with healthy fish eaters could not be located. OBJECTIVES To describe urinary mercury excretion before and after DMSA in healthy fish eaters and non-fish eaters, and to determine whether urine mercury excretion after DMSA would rise above baseline levels to a greater extent in fish eaters. DESIGN A total of 24 healthy physicians were assigned to 1 of 3 groups based on fish consumption: non-fish eaters; 1 to 2 fish servings per week; and 3 or more servings per week. Blood mercury concentrations and 12-hour urine mercury and creatinine excretions were measured before and after oral ingestion of 30 mg of DMSA per kilogram of body weight. RESULTS A total of 24 subjects completed the study, and 2 subsequently were excluded. No difference in baseline urinary mercury excretion was detected between groups. All groups demonstrated an increase in urinary mercury excretion following DMSA, which was higher in fish eaters (P = .04). Multiple linear regression found that the best predictor of a rise in urine mercury excretion following DMSA challenge was the prechelation blood mercury concentration. CONCLUSIONS In this study of healthy physicians, oral DMSA produced a rise in urine mercury excretion both in non-fish eaters and fish eaters. The increase in chelated mercury excretion was higher in fish eaters. A simple rise in chelated mercury excretion over baseline excretion is not a reliable diagnostic indicator of mercury poisoning.
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Affiliation(s)
- Anne-Michelle Ruha
- Department of Medical Toxicology, Banner Good Samaritan Medical Center, Phoenix, AZ 85006, USA.
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