Urinary cadmium clearance, its relationship to glomerular filtration rate and implications for cadmium epidemiology

Decreasing renal glomerular filtration rate (GFR) in association with increasing blood cadmium levels was reported in epidemiological studies of general populations. Dependence of cadmium clearance on GFR has implications for interpreting causation in these studies. Associations between cadmium clearance and creatinine clearance, a metric of GFR, were evaluated in a sample of the U.S. population. Blood to urine cadmium clearance and serum creatinine clearance were estimated in approximately 6000 individuals included in the National Health and Nutrition Examination Survey (NHANES 2009-2016). Linear regression models explained approximately 45% of variance in cadmium clearance in adults, with 74% of the explained variance attributed to creatinine clearance and 25% explained by age. In adolescents (12-<20 years), linear regression models explained 55% of variance in cadmium clearance with >99% of the explained variance attributed to creatinine clearance. The models predicted that halving creatinine clearance would result in a 40% decrease in cadmium clearance and a 20% rise in blood cadmium. Dependence of cadmium clearance on GFR has implications for assigning causation to studies in which increasing blood cadmium levels have been associated with increasing risk of low GFR. Statistical associations between blood cadmium and low GFR, such as elevated odds ratios in upper percentile strata of populations, may be partially a consequence of lower cadmium clearance in association with low GFR that is reverse causation.

Estimates of urinary blood lead clearance and its relationship to glomerular filtration rate based on a large population survey

Blood lead (Pb) clearance (CbPb) and serum creatinine clearance (CsCr), a metric of glomerular filtration rate (GFR), were estimated in approximately 7,600 subjects from the NHANES (2009-2016). Median CbPb in adults was 0.04 L/day (5th-95th percentile range: 0.01-0.12). Linear regression models explained approximately 68% of variance in CbPb in adults, with >98% of explained variance attributed to CsCr. These results provide an improved quantitative understanding of the possible effects of reverse causality in the interpretation of studies of associations between blood Pb and decrements in GFR.

In vivo and in vitro methods for evaluating soil arsenic bioavailability: relevant to human health risk assessment

Arsenic (As) is the most frequently occurring contaminant on the priority list of hazardous substances, which lists substances of greatest public health concern to people living at or near U.S. National Priorities List site. Accurate assessment of human health risks from exposure to As-contaminated soils depends on estimating its bioavailability, defined as the fraction of ingested As absorbed across the gastrointestinal barrier and available for systemic distribution and metabolism. Arsenic bioavailability varies among soils and is influenced by site-specific soil physical and chemical characteristics and internal biological factors. This review describes the state-of-the science that supports our understanding of oral bioavailability of soil As, the methods that are currently being explored for estimating soil As relative bioavailability (RBA), and future research areas that could improve our prediction of the oral RBA of soil As in humans. The following topics are addressed: (1) As soil geochemistry; (2) As toxicology; (3) in vivo models for estimating As RBA; (4) in vitro bioaccessibility methods; and (5) conclusions and research needs.

Predicting oral relative bioavailability of arsenic in soil from in vitro bioaccessibility

Several investigations have been conducted to develop in vitro bioaccessibility (IVBA) assays that reliably predict in vivo oral relative bioavailability (RBA) of arsenic (As). This study describes a meta-regression model relating soil As RBA and IVBA that is based upon data combined from previous investigations that examined the relationship between As IVBA and RBA when IVBA was determined using an extraction of soil in 0.4 M glycine at pH 1.5. Data used to develop the model included paired IVBA and RBA estimates for 83 soils from various types of sites such as mining, smelting, and pesticide or herbicide application. The following linear regression model accounted for 87% of the observed variance in RBA (R(2) = .87): RBA(%) = 0.79 × IVBA(%) + 3. This regression model is more robust than previously reported models because it includes a larger number of soil samples, and also accounts for variability in RBA and IVBA measurements made on samples collected from sites contaminated with different As sources and conducted in different labs that have utilized different experimental models for estimating RBA.

Mouse assay for determination of arsenic bioavailability in contaminated soils

A mouse assay for measuring the relative bioavailability (RBA) of arsenic (As) in soil was developed. In this study, results are presented of RBA assays of 16 soils, including multiple assays of the same soils, which provide a quantitative assessment of reproducibility of mouse assay results, as well as a comparison of results from the mouse assay with results from a swine and monkey assay applied to the same test soils. The mouse assay is highly reproducible; three repeated assays on the same soils yielded RBA estimates that ranged from 1 to 3% of the group mean. The mouse, monkey, and swine models yielded similar results for some, but not all, test materials. RBA estimates for identical soils (nine test soils and three standard reference materials [SRM]) assayed in mice and swine were significantly correlated (r = 0.70). Swine RBA estimates for 6 of the 12 test materials were higher than those from the mouse assay. RBA estimates for three standard reference materials (SRM) were not statistically different (mouse/swine ratio ranged from 0.86-1). When four test soils from the same orchard were assessed in the mouse, monkey, and swine assays, the mean soil As RBA were not statistically different. Mouse and swine models predicted similar steady state urinary excretion fractions (UEF) for As of 62 and 74%, respectively, during repeated ingestion doses of sodium arsenate, the water-soluble As form used as the reference in the calculation of RBA. In the mouse assay, the UEF for water soluble As(V) (sodium arsenate) and As(III) (sodium [meta] arsenite) were 62% and 66%, respectively, suggesting similar absolute bioavailabilities for the two As species. The mouse assay can serve as a highly cost-effective alternative or supplement to monkey and swine assays for improving As risk assessments by providing site-specific assessments of RBA of As in soils.

Amending soils with phosphate as means to mitigate soil lead hazard: a critical review of the state of the science

Ingested soil and surface dust may be important contributors to elevated blood lead (Pb) levels in children exposed to Pb contaminated environments. Mitigation strategies have typically focused on excavation and removal of the contaminated soil. However, this is not always feasible for addressing widely disseminated contamination in populated areas often encountered in urban environments. The rationale for amending soils with phosphate is that phosphate will promote formation of highly insoluble Pb species (e.g., pyromorphite minerals) in soil, which will remain insoluble after ingestion and, therefore, inaccessible to absorption mechanisms in the gastrointestinal tract (GIT). Amending soil with phosphate might potentially be used in combination with other methods that reduce contact with or migration of contaminated soils, such as covering the soil with a green cap such as sod, clean soil with mulch, raised garden beds, or gravel. These remediation strategies may be less expensive and far less disruptive than excavation and removal of soil. This review evaluates evidence for efficacy of phosphate amendments for decreasing soil Pb bioavailability. Evidence is reviewed for (1) physical and chemical interactions of Pb and phosphate that would be expected to influence bioavailability, (2) effects of phosphate amendments on soil Pb bioaccessibility (i.e., predicted solubility of Pb in the GIT), and (3) results of bioavailability bioassays of amended soils conducted in humans and animal models. Practical implementation issues, such as criteria and methods for evaluating efficacy, and potential effects of phosphate on mobility and bioavailability of co-contaminants in soil are also discussed.

Issues related to time averaging of exposure in modeling risks associated with intermittent exposures to lead

Typical exposures to lead often involve a mix of long-term exposures to relatively constant exposure levels (e.g., residential yard soil and indoor dust) and highly intermittent exposures at other locations (e.g., seasonal recreational visits to a park). These types of exposures can be expected to result in blood lead concentrations that vary on a temporal scale with the intermittent exposure pattern. Prediction of short-term (or seasonal) blood lead concentrations arising from highly variable intermittent exposures requires a model that can reliably simulate lead exposures and biokinetics on a temporal scale that matches that of the exposure events of interest. If exposure model averaging times (EMATs) of the model exceed the shortest exposure duration that characterizes the intermittent exposure, uncertainties will be introduced into risk estimates because the exposure concentration used as input to the model must be time averaged to account for the intermittent nature of the exposure. We have used simulation as a means of determining the potential magnitude of these uncertainties. Simulations using models having various EMATs have allowed exploration of the strengths and weaknesses of various approaches to time averaging of exposures and impact on risk estimates associated with intermittent exposures to lead in soil. The International Commission of Radiological Protection (ICRP) model of lead pharmacokinetics in humans simulates lead intakes that can vary in intensity over time spans as small as one day, allowing for the simulation of intermittent exposures to lead as a series of discrete daily exposure events. The ICRP model was used to compare the outcomes (blood lead concentration) of various time-averaging adjustments for approximating the time-averaged intake of lead associated with various intermittent exposure patterns. Results of these analyses suggest that standard approaches to time averaging (e.g., U.S. EPA) that estimate the long-term daily exposure concentration can, in some cases, result in substantial underprediction of short-term variations in blood lead concentrations when used in models that operate with EMATs exceeding the shortest exposure duration that characterizes the intermittent exposure. Alternative time-averaging approaches recommended for use in lead risk assessment more reliably predict short-term periodic (e.g., seasonal) elevations in blood lead concentration that might result from intermittent exposures. In general, risk estimates will be improved by simulation on shorter time scales that more closely approximate the actual temporal dynamics of the exposure.

Complexing activity of 2,3-dimercapto-1-propanesulfonate and its disulfide auto-oxidation product in rat kidney

The complexing activity of 2,3-dimercapto-1-propanesulfonate (DMPS) was examined in vivo and in the isolated perfused rat kidney. Intravenous infusions of the sulfhydryl form of DMPS into rats pretreated with HgCl2 resulted in a dose-dependent increase in the urinary excretion of mercury and a decrease in the retention of mercury in kidney. A 120-min infusion of 2 mg sulfhydryl DMPS.min-1.kg body wt-1 resulted in excretion of 76% of the mercury body burden of which greater than 90% was removed from kidney. The disulfide auto-oxidation product of DMPS significantly increased the urinary excretion of mercury in the rat, but its effect was less than that of an equivalent dose of sulfhydryl DMPS. The presence of disulfide DMPS or 3:1 mixtures of sulfhydryl DMPS and disulfide DMPS in the perfusate increased the excretion of mercury and induced a loss of mercury from the cortex and outer medulla in the isolated perfused rat kidney. Thus both the disulfide and sulfhydryl forms of DMPS can act directly on the kidney to accelerate the excretion of mercury. This is consistent with previous observations of the ability of the kidney to reduce disulfide DMPS to sulfhydryl DMPS.

Complexing activity and excretion of 2,3-dimercapto-1-propane sulfonate in rat kidney

The renal handling of the heavy metal complexing agent, 2,3-dimercapto-1-propane sulfonate (DMPS), was examined in the isolated perfused rat kidney (IPRK). Net tubular secretion of DMPS was saturable and blocked by p-aminohippuric acid (PAH) and probenecid (PRB), indicating involvement of carrier-mediated transport in the excretion of DMPS. DMPS was oxidized to a disulfide form (DMPSS) in perfusate and reduced to a sulfhydryl form (DMPSH) in kidney. In kidneys isolated from rats pretreated with HgCl2, DMPS produced a dose-dependent decrease in retention of inorganic mercury, an increase in urinary excretion of mercury, and an increase in the amount of mercury transferred from kidney into venous perfusate. At a maximally effective dose, 40% of the renal mercury content was excreted in urine during 30 min of perfusion. Urinary excretion of mercury induced by DMPS was completely blocked by concentrations of PRB that blocked tubular secretion of DMPS and decreased uptake of DMPS in kidney. Thus tubular secretion of DMPS and reduction of DMPSS to DMPSH are important in the renal handling of DMPS and may contribute to the activity of DMPS as a complexing agent for renal mercury.

Enhanced accumulation of injected inorganic mercury in renal outer medulla after unilateral nephrectomy

The effects of unilateral nephrectomy on renal accumulation and intrarenal distribution of mercury following a single injection of mercuric chloride (HgCl2, 0.5 mumol Hg/kg body wt, ip) were evaluated in the rat. In rats injected with HgCl2 immediately after nephrectomy or 10, 28, or 43 days after nephrectomy, the accumulation of mercury in the renal outer medulla was significantly greater than in respective sham-operated control rats. The increased accumulation of mercury in renal outer medulla was evident at 24 hr after injection of HgCl2 and persisted for at least 72 hr. The effect appeared to be a phenomenon associated specifically with the renal outer medulla in that elevated concentrations of mercury in the outer medulla were observed in the absence of similar elevations in the renal cortex, inner medulla, liver, and blood or in the whole body mercury content. Urinary excretion of mercury was unaffected by nephrectomy. Thus, associated with unilateral nephrectomy are changes in the renal accumulation and intrarenal distribution of systemically administered inorganic mercury that persist long after the rapid phase of compensatory renal growth (0-7 days) is completed.