Impact of natural events on metal bioaccumulation in Anemonia sulcata

Samples of Anemonia sulcata were collected in 2022 from different areas of the Canary Islands affected by different natural contamination sources, such sandstorms, submarine volcanic activity, continuous rainfall, upwelling and dinoflagellate blooms. Significant differences were observed between the zones for the metals and trace elements analyzed (Al, Zn, Cd, Pb, Ni, Co, Fe, B, Cu, Mg and Li). Anemones from volcanic areas showed higher levels of Cd, Pb and Ni. Individuals from sandstorm areas showed elevated levels of Al, Zn and Fe. Samples collected from areas affected by upwelling processes had higher concentrations of Cu, Mg and Li. Finally, the areas affected by dinoflagellates showed lower levels of Zn, Pb, Fe, Mg and Li. The study reveals how natural phenomena dramatically influence metal accumulation in A. sulcata, which is of great value for anticipating and managing potential problems associated with public health.

Comparative analysis of metal pollution in the Atlantic Ocean and Mediterranean Sea: insights from Anemonia sulcata study

In this study, we investigated metal concentrations in Anemonia sulcata specimens from various locations in the Atlantic Ocean and the Mediterranean Sea. A total of 84 individuals were sampled from specific zones, and their tissue samples were processed for metal analysis using Inductively Coupled Plasma Optical Emission Spectrometry (ICP-OES). The results revealed notable differences in metal concentrations among the studied regions. The Atlantic Ocean and the Mediterranean Sea were found to have distinct patterns of marine pollution, influenced by a complex interplay of geographical, demographic, industrial, and environmental policy factors. Conversely, the semi-enclosed Mediterranean Sea has a lower natural dilution capacity, leading to the accumulation and prolonged presence of pollutants. Population density and industrial activities in coastal areas play a significant role in pollution disparities between the Mediterranean Sea and the Atlantic Ocean. The Mediterranean coasts, with higher population densities and intensive industrial operations, experience greater strain on marine ecosystems due to increased pollution sources. Additionally, environmental policies and management approaches differ between the two regions, contributing to variations in pollution response and regulation.

Metal content in Sardina pilchardus during the period 2014-2022 in the Canary Islands (Atlantic EC, Spain)

The contamination present in an organism varies depending on biological and oceanographic conditions, so monitoring the same species is of great importance to understand the state of the ecosystem. Fifteen specimens in Sardina pilchardus between 12 and 15 cm in total length were collected during the second half of January of each of the study years (2014, 2016, 2018, 2020 and 2022). Samples were analyzed with Inductively Coupled Plasma Optical Emission Spectrometry (ICP-OES) to measure metals (Al, Cd, Cu, Fe, Li, Ni, Pb and Zn) in mg/Kg. There was a progressive decrease in Pb content over the period, with the highest concentration being obtained in 2014 (0.086 ± 0.065 mg/kg). Locally important oceanic-atmospheric events may occur in the study period that strongly impact the tissue composition of marine organisms. In this case, discontinuous trends were evident in some of the metal concentrations analyzed in the muscle of European sardine in the Canary Islands.

A Comparative Analysis of Sparisoma cretense in Island Environments: Unraveling Metal Accumulation Differences in the Canary Islands (Spain, NW African Waters)

This study investigates the impact of varying environmental conditions on the metal composition within the tissues of Sparisoma cretense, contributing to the understanding necessary to offer scientifically sound advice regarding the health status of this species. This knowledge extends beyond fishery production, encompassing implications for food security. The data span the years 2022 and 2023, encompassing both cold and warm climatic seasons. The concentrations of various metals, such as Al, Zn, Cd, Pb, Fe, and Cu, exhibited noteworthy variations across the islands, with significant increases recorded in 2023, particularly during the warm season. The intricate interplay between multiple factors shaped the availability of the analyzed elements in S. cretense. Factors such as rising temperatures during the warm season increased biological activity in marine ecosystems, seasonal fluctuations in weather conditions, water quality, and anthropogenic influences, all contributing to the observed variations in metal concentrations. Additionally, the geological composition of each island and the patterns of marine currents and sediment transport play pivotal roles in these differences. Comprehensive scientific research, monitoring, and environmental surveillance are essential for a holistic understanding of this variability and providing valuable insights for the conservation and management of marine ecosystems in the Canary archipelago.

Impact of the lockdown period during the COVID-19 pandemic on the metal content of the anemone Anemonia sulcata in the Canary Islands (CE Atlantic, Spain)

Anemones, specifically the species Anemonia sulcata, are cnidarians that serve as bioindicators in marine ecosystems, indicating the health of the environment and changes in environmental conditions. Monitoring anemone populations and studying their well-being and distribution provide valuable insights into marine ecosystem conditions. This study aimed to investigate the impact of the SARS-CoV-2 pandemic on the metal content of Anemonia sulcata. Over a six-year period (2017-2022), twenty specimens of Anemonia sulcata were collected in Tenerife, Spain. The results showed that in 2020, during the two-month lockdown in Spain from March to May when tourism was halted, A. sulcata exhibited the lowest concentrations of various metals studied (Al, Cd, Cu, Fe, Pb, and Zn). This finding suggests that the reduced anthropogenic pressure on the coast due to the absence of tourism significantly decreased pollution levels. Therefore, the study emphasizes the importance of promoting sustainable tourism worldwide. The research highlights that minimizing human impact on coastal areas through responsible tourism practices can effectively reduce pollution in marine ecosystems.

Monitoring different sources of marine pollution in the Canarian intertidal zone using Anemonia sulcata as a bioindicator

Sea anemones have often been used as bioindicators of contamination because they are semisessile organisms that rarelly leave their niche, which is why they are conducive to affecting the ecosystem at the local level. The objective of this work is to determine whether the concentrations of heavy metals and trace elements in the anemone Anemonia sulcata vary depending on the source of contamination present. In 2021 seventy specimens were collected at five sampling points and fourteen specimens were collected in each point (Control Zone, Thermal Power Plant, Sewage Pipe, Harbour and Tourism) in 2021, on the island of Tenerife. All the areas studied characterized by a pollution condition had higher concentrations of metals and trace elements than the control area. The anemones from Harbour presented a greater number of metals with a higher concentration than the other study areas.

Metal and trace element concentrations in cetaceans worldwide: A review

This bibliographical review is a compilation of different scientific publications that reported data on metal concentrations in the muscle tissue of different species of cetaceans from seas and oceans around the world. Forty-nine scientific articles were selected, published over a fifteen-year period (2006-2021) with data on heavy metals and trace elements. The different groups of cetaceans considered in this study generally presented low concentrations of Cd and Pb. The same cannot be said of Hg. The highest concentrations of Hg were found in the groups of false killer whales. Similarly, the use of these groups of cetaceans as bioindicators of metal contamination shows that the Mediterranean Sea is one of the most metallically contaminated areas in the world. This may be due to the closed nature of the Mediterranean Sea and to the fact that it is also a highly populated and industrialized area.

Trace and macro elements concentrations in the blood and muscle of loggerhead turtles (Caretta caretta) from the Canary Islands, Spain

Sea turtles can bioaccumulate heavy metals and trace elements over the years, therefore they can be used as bioindicators of pollution in the marine environment. The aim of this study was to analyze seventeen elements in blood and muscle of Caretta caretta from the Canary Islands and compare these concentrations in the two tissues. Thirteen blood samples and six muscle samples were collected from loggerhead turtles admitted to the Rescue Center of La Tahonilla. The samples were processed through microwave digestion and incineration. For the study of the data, a descriptive statistical analysis and a PERMANOVA were performed. All individuals in this study were juveniles (size <70 cm). The results of this study differ from previous studies on loggerhead sea turtles. All the elements analyzed were detected, with Na having the highest concentration in blood (75,379 ± 30,066 mg/kg) and muscle (222,626 ± 156,049 mg/kg). Statistically significant differences were found between the concentration of Al, B, Ba, Ca, Fe, K, Na, Sr, V and Zn in each tissue analyzed. Compared to other studies, a higher Cu concentration was found both in blood (252.9 ± 114.4 mg/kg) and in muscle (416 ± 247.8 mg/kg). This study has provided new data on pollutants in loggerhead sea turtles and increased the information available for different geographic areas, although more studies are needed to understand the effects and impact of these pollutants on sea turtles.

Structuring algae as buffers for heavy metals and trace elements in the Canary Islands intertidal habitat

Coastal marine pollution from sewage pipes, waste discharges, can seriously affect intertidal organisms. Therefore, the aim of this study is to know if the structuring algae in the Canary intertidal can act as buffers against pollution. Samples were taken in the island of Tenerife (Canary Islands, Spain) from the intertidal water of Anemonia sulcata (anemone), Palaemon elegans (shrimp), Gongolaria abies-marina and Jania virgata (both structuring algae). Each sample was analyzed by Inductively Coupled Plasma Optical Emission Spectrometry (ICP-OES) obtaining values for metals and trace elements (Al, Cd, Pb, Ca, K, Mg, Na, B, Ba, Ba, Co, Cr, Cu, Fe, Li, Mn, Mo, Ni, Sr, V and Zn). Higher concentrations were obtained in the two structuring algal species, with J. vigata having higher concentrations than G. abies-marina. Specimens of A. sulcata showed higher concentrations of trace elements and heavy metals than P. elegans. P. elegans y A. sulcata showed higher heavy metal concentrations and trace elements when algae were not present in the pool. Algae have a great buffering role in the intertidal of the Canary Islands.

Analysis of metals and metalloid in commercial fish species from the Galapagos Marine Reserve: Toxicological and nutritional assessment

Aquatic pollution derived from metal presence in the Galapagos Islands could affect biodiversity and human health. This research provide a baseline on food safety in commercial fish species of the Galapagos Islands. We sampled muscle tissue of pelagic (Acanthocybium solandri) and demersal (Caulolatilus affinis, Pontinus clemensi, Hyporthodus mystacinus, and Paralabrax albomaculatus) species. Metal and metalloid concentrations per species were analyzed by Inductively Coupled Plasma Optical Spectrometry (ICP-OES). According to the Food and Agriculture Organization (FAO) regulation none of the studied species should be ingested; and according to the European Food Safety Authority (EFSA) regulation, all the studied species were above the Maximum Allowable Concentration (MAC) for Cd. According to EFSA, C. affinis should not be commercialized. Finally, A. solandri, P. clemensi and H. mystacinus do not represent a human health risk since its Margen of Safety (MoS) < 1 for people of up to 100 kg of body weight.

Influence of Seminal Metals on Assisted Reproduction Outcome

Increased levels of metal ions in human seminal fluid have a significant correlation with male fertility. Few publications explain the effect of metals in semen and their influence on assisted reproductive treatments. Semen parameters and the levels of twenty-two metals were measured in the seminal fluid of 102 men attended in a Reproductive Unit. Metals were determined by optical emission spectrophotometry. A statistical relationship was found between spermiogram and iron, which was lower than expected in pathological spermiograms (p = 0.032); zinc (p = 0.066), calcium (p = 0.047), and magnesium (p = 0.048) mean levels were higher in normozoospermics. More days of sexual abstinence correlates with higher seminal zinc (p = 0.001) and magnesium levels (p = 0.002). Lower vanadium values were found to be associated with higher fertilization rates (p = 0.039). Higher values of lead (p = 0.052) and vanadium (p = 0.032) were obtained in patients who did not reach 100% embryo cleavage rate. Aluminium (p = 0.042) and sodium (p = 0.002) were found in lower amounts associated with better blastocyst rates. The implantation rate shows an inverse association with women's age and iron and calcium content, compared to magnesium and sodium which presented a significant direct association with this percentage. A significant direct relationship was found between the positive evolution of pregnancy and the values of zinc (p = 0.004), calcium (p = 0.013), potassium (p = 0.002), and magnesium (p = 0.009). The study confirms that zinc, iron, calcium, sodium, aluminium, magnesium, vanadium, and lead have positive-negative effects on reproduction and support the analysis of metals in semen as a new line of study on male fertility with implications for reproductive outcomes.

Interdecadal variations of the mercury content in Scomber colias in Canary Islands

Mercury is a very dangerous toxic metal that bioaccumulates very easily in organisms, and it migrates through the food web. The specimens studied in this study were Scomber colias. In the results obtained for the years 1973, 1992, and 2021, the concentration of mercury has been decreasing considerably over the decades, starting with 0.23 ± 0.04 mg/kg in 1973, and having less than half in 2021 with 0.11 ± 0.01 mg/kg. This may be due to the laws imposed by the countries against pollution and to a greater extent in the elimination of mercury; thanks to these measures it has been possible to reduce the concentration of mercury by half in S. colias. Otherwise, the conservation and availability of historical collections of living beings should be considered an unvalued source of information which could help to monitor legislation measures launched to ameliorate the human impact on the natural environment.

Essential Metals and Trace Elements in Cereals and Their Derivatives Commercialized and Consumed in Cape Verde

Cereals and their derivatives are basic foods in the human diet and a source of minerals, but the content of elements may vary depending on the type of cereal or its processing. The levels of Na, K, Ca, Mg, Fe, Cu, Zn, Mo, Co, and Mn have been determined in 126 samples of cereals and cereal derivatives (rice, corn gofio, corn flour, wheat flour, corn, and wheat) commercialized and consumed in Cape Verde using an inductively coupled plasma-optical emission spectrometer (ICP-OES) after a wet microwave digestion process. Some elements stand out in products such as corn gofio (K), wheat (Mg), and wheat flour (Fe). Negative correlations were found between Mo-Na and Na-Zn that could suggest interference between these elements. Bearing in mind the dietary intake evaluation and the guideline values provided by EFSA (European Food Safety Authority) or FAO (Food Authority Organization), the consumption of wheat (100 g/day) provides a notable contribution of Mo, Mn, Fe, and Mg. Considering the nutritional value of the analyzed essential and trace elements, the consumption of different cereals and their derivatives should be promoted.

The influence of the degassing phase of the Tagoro submarine volcano (Canary Islands) on the metal content of three species of cephalopods

Underwater volcanic eruptions are a type of natural contamination that affect all marine organisms at a local level. These eruptions usually begin and end a degassing stage of the volcano that, although they do not affect the magnitude of magma emanation, affect organisms to a lesser degree locally, such as cephalopods that due to their metabolism and trophic level, are good bioindicators of contamination. A total of 180 samples of three species of cephalopods were collected for the study: sixty Sepia officinalis, sixty Octopus vulgaris and sixty Loligo vulgaris in the area of the submarine volcano in El Hierro, Tenerife and Lanzarote in the Canary Islands (twenty samples per species in each location), and the metal concentrations (Al, Cd, Cr, Cu, Fe, Li, Ni, Pb and Zn) in each of the samples were analyzed. All species showed significant differences for all metals in El Hierro compared to Tenerife and Lanzarote. All the analyzed species from El Hierro had higher concentrations of the nine studied metals, this is due to the fact that they were caught near the Tagoro submarine volcano, which at the time was in a state of degassing and discharged many metal-rich compounds.

Assessment of Toxic Metals (Al, Cd, Pb) and Trace Elements (B, Ba, Co, Cr, Cu, Fe, Mn, Mo, Li, Zn, Ni, Sr, V) in the Common Kestrel (Falco tinnunculus) from the Canary Islands (Spain)

The monitoring of trace elements and toxic metals in apical predators of the trophic chain provides data on the degree of contamination in ecosystems. The common kestrel is one of the most interesting raptors in this respect in the Canary Islands; therefore, the study of the levels of trace elements and toxic metals in this species is of much scientific value. The content of trace elements and toxic metals (B, Ba, Co, Cr, Cu, Fe, Mn, Mo, Li, Zn, Ni, Sr, V, Al, Cd, Pb) was determined in the liver, muscle, and feathers of 200 specimens of common kestrel carcasses (Falco tinnunculus canariensis) from Tenerife. Cr (0.82 ± 2.62 mg/kg), Cu (11.82 ± 7.77 mg/kg), and Zn (198.47 ± 520.80 mg/kg) are the trace elements that stand out in the feather samples; this may be due to their affinity for the pigments that give them their coloring. Li was noteworthy in the liver samples (8.470 ± 5.702 mg/kg). Pb stood out in the feathers (4.353 ± 20.645 mg/kg) > muscle (0.148 ± 0.095 mg/kg) > liver (0.187 ± 0.133 mg/kg). The presence of metals in feathers correlates with recent exposure and reflects environmental contamination. When using raptor feathers as indicators of metal contamination, it is important to know what the levels of each metal signify. The analysis of the different tissues and organs of raptors, such as the common kestrel, provides valuable information on the degree of environmental contamination of the ecosystem in which it lives. Gender was not an influencing factor in this study.

P-020 Influence of vanadium and lead in seminal fluid on assisted reproductive techniques

Study question

In recent decades there has been an increase in environmental contaminants than can affect assisted reproduction techniques. We analyze the influence of vanadium (V) and lead (Pb) on these results.

Summary answer

Higher seminal fluid V levels affect fertilization rate (FR). Higher Pb and V levels decrease embryo cleavage rate (CR).

What is known already

Some animal studies have shown that V produces toxicity in the male reproductive system through oxidative stress, and this leads to decreases sperm count and motility, as well increased concentration of abnormal sperm.

Pb is one of the main pollutants and, it accumulates in the male reproductive organs, deteriorates the quality of semen, increases the frequency of spontaneous abortion and male infertility. And it has also been seen that it inhibits sperm functions in vitro, although its mechanism of action is still unknown.

Study design, size, duration

A prospective study was conducted in 102 males, with a mean age of 38.0 ± 5.7, attended successively for initial evaluation, in the Human Reproduction Unit of the Hospital Universitario de Canarias, between february and april 2018, who underwent a semen analysis and metal detection and, subsequently, an IVF/ICSI treatment during years 2019 and 2020 (n = 92). The relationship between the presence of metals and the results of ART has been established.

Participants/materials, setting, methods

We included two groups based on semen parameters: 41 patients with pathological spermiograms (40.2%), while the remaining 61 (59.8%) had a normal semen analysis and constituted the control group.The study of seminal parameters was performed according to the WHO guidelines. The metals analysis was carried out in the Toxicology Area of the Universidad de La Laguna, using the digestion for microwave method. Metal measurement was performed using inductively coupled plasma optical emission spectrometry (ICP-OES).

Main results and the role of chance

In our study we have observed 79.4% of patients have V in semen. Significant differences have been found in the concentration of V in semen (t100=1.988, p = 0.05), is higher in patients who drink alcohol (0.51± 0.40 mg/Kg) than in abstinent patients (0.35± 0.30 mg/Kg).

The group with FR above 75% presented lower V values compared to those with rates below 75% (p = 0.039). Within this last group, 33.3% present V values higher than 0.7 mg / kg compared to 15.8% who present it in the group with FR greater than 75% (OR = 2.67 CI95% 1.01, 7.52; p = 0.048).

A statistical relationship was found between CR and Pb and V. Those who did not reach 100% CR presented higher Pb values (p = 0.052). Of them, 63.6% presented Pb compared to 38.5% in the group reaching 100% division. This same relationship was observed for V, with higher values in the group that did not reach 100% (p = 0.032), and V being present in 90.9% of the samples compared to 79.5% in the group reaching 100%.

Limitations, reasons for caution

The limitation of this study was the volume of semen that could be obtained for the metal detection, only 0.5 ml. This was because the semen sample was used at the same time to make a diagnosis of infertility though a spermiogram

Wider implications of the findings

The determination of metals in semen opens a new field in the study of infertility, and many cases of unknown infertility could due to metal presence or absence in seminal fluid, with the option of performing several treatments to correct these possible anomalies.

Trial registration number

not applicable

Fluoride levels in river water from the volcanic regions of Cauca (Colombia)

Fluoride concentrations of 0.5 mg/L in drinking water are considered useful for dental caries prevention. However, fluoride concentrations higher than 1.2 mg/L in water can pose a risk of dental fluorosis due to high exposure to fluoride. The objective is to determine the fluoride concentration in water from aqueducts of different Colombian municipalities of Cauca (Popayán, Coconuco, and Puracé) to assess the fluoride dietary intake from the consumption of this water. A total of 66 water samples have been taken from Popayán, Coconuco, and Puracé. Fluoride content was determined by fluoride ion-selective electrode (ISE) potentiometry. The fluoride concentrations recorded in Coconuco and Puracé water were ≤ 0.002 mg/L. The mean fluoride content recorded in the Popayán water was 0.42 mg/L, with its highest concentration in Cauca River water (0.83 mg/L). Considering the admissible intake values, the water from Popayán confers remarkable fluoride intakes, especially in children with high percentages of contribution to the admissible daily intake (46.7% to 7- to 12-month children and 41.5% to 1- to 3-year children). The fluoride content in the water of Coconuco and Puracé does not reach an optimal value (< 0.5 mg/L) for the protective effect against dental caries, while the water of the main Cauca River basin does reach the optimal value. Likewise, the intake of fluoride from the consumption of the analyzed water does not confer any health risk. However, the implementation of monitoring systems for fluoride levels is recommended in order to safeguard the consumer's health.

Determination of the Fluoride Content in Water of Aqueducts of Cauca (Colombia) by Ion Exchange Chromatography

Water for human consumption is the main source of fluoride exposure. The concentration in water should not exceed 1 mg/L of fluoride since, at higher levels; it increases the risk of dental fluorosis, among other adverse effects. The fluoride content of 149 water samples from different aqueducts in Cauca (Colombia) has been determined by ion exchange chromatography with the aim of fluoride risk assessment. The rural area of the Municipality of Santander de Quilichao registered fluoride concentrations between 0.012 and 0.150 mg/L. The urban area of Santander de Quilichao recorded lower fluoride levels than the rural area (0.027-0.068 mg/L). The urban area of the Municipality of Cajibío registered fluoride levels of 0.082-0.186 mg/L. The highest levels of fluoride were found in Timbío (0.121-0.210 mg/L). The fluoride levels recorded in this study are not considered sufficient to trigger dental fluorosis. Likewise, optimal levels are not considered to protect the child population against dental caries. However, a monitoring plan of fluoride concentrations in water should be implemented to assure the quality and safe of the water.

Metal and metalloids concentration in Galapagos fish liver and gonad tissues

The Galapagos Islands are one of the best-preserved archipelagos in the world. We sampled individuals of six demersal and three pelagic species. The metal concentration of liver and gonad tissues were analyzed by Inductively Coupled Plasma Optical Spectrometry. Findings suggest none of the pelagic species showed metallic concentrations that could pose a risk to their health or reproductive capacity. S. violacea and P. clemensi Zn levels were higher in liver than in gonads, indicating that these species could be in their reproduction period. Zn risk toxicity for the study species is negligible. High concentrations of Cd were found in the liver of C. princeps, C. affinis and P. albomaculatus which could cause morphological and physiological alterations. We hypothesize that the high metal concentrations found in the demersal species could come from the volcanism of the islands, since no major sources of anthropogenic metal contamination can be found in the archipelago.

Metal content in stranded pelagic vs deep-diving cetaceans in the Canary Islands

The Canary Islands are home to many cetacean species, many of which are resident species. The present work aims to analyze, for the first time to the best of the authors' knowledge, the macronutrients, micronutrients and trace elements and toxic heavy metals in muscle and liver tissue of six species of stranded cetaceans in the Canary Islands. The study species were: Tursiops truncatus, Stenella frontalis, Delphinus delphis, Grampus griseus, Globicephala macrorynchus and Physeter macrocephalus. Statistical analysis studied the significant differences between the concentrations in muscle and liver tissues, with the differences in element content depending on the type of diving and length of the species. The results indicate that there are differences between muscle and liver for Ca, Cd, Co, Cu, K, Mg, Mn, Mo, Ni, Pb, Sr, V and Zn. Deep-diving animals differ in their concentrations of Cr, Cu, Mg, Mn, Mo, and Zn with respect to shallow-diving animals in muscle and in liver in Al, B, Cr, K, Mn and Mo. As for the differences between sex, the males present differences in their concentrations of B, Cd, K and Mg in muscle tissue with respect to the females, while differences in the liver were only detected in the Fe content. The study of the correlations shows that as the size of the animal increases, the concentration of Cd increases while the concentrations of Al, Cu and Zn decrease. The specimens foraging in shallower waters had the highest concentration of the macronutrient.

Associations of Semen Quality with Seminal Non-essential Heavy Metals in Males from the Canary Islands

Semen quality and levels of non-essential metals such as strontium (Sr), aluminum (Al), lead (Pb), nickel (Ni), and vanadium (V) were measured. Metals were determined by ICP-OES (inductively coupled plasma - optical emission spectrometry) in semen samples from 102 men who were recruited in a Reproduction Unit in the Canary Islands. The presence of each metal was as follows: Sr: 56.9%, Al: 73.5%, Pb: 45.1%, Ni: 15.7%, and V: 79.4% of the samples. No significant differences were found in the relationship between the spermiogram, the sperm motility, and the concentration of spermatozoa levels of non-essential metals. It is noteworthy that Ni levels tend to be lower in patients with oligozoospermia (t (46.4) = 1.84; p = 0.070). Between lifestyle and non-essential metals, there was a significant relationship between the level of occupational exposure to metals and Ni (χ²(2) = 13.91; p = 0.001). We did not find significant differences in non-essential seminal metal content and smoking status but, there were differences between drinkers and the concentration of V in semen (t (100) = -1.99; p = 0.050). The occupational exposure to metals and place of residence have effects on Al and V levels in semen. Regarding obesity, significant differences were found in Pb levels (t (18.0) = 2.34; p = 0.031). Obese patients have a lower Pb level, and the percentage of progressive sperm motility was lower in obese men (t (98) = 2.14; p = 0.035). The detection of metals in semen opens a new field in the study of male infertility with the possibility of performing treatments aimed at correcting these possible anomalies.

Cost-effectiveness of the CNIC-polypill strategy for the secondary prevention of CV disease in male and female patients with established coronary heart disease based on improved risk factor control

Background

The burden of CV disease is a health and economic challenge to societies that is expected to grow in future years due to an increased prevalence in CV risk factors. Adequate management and appropriate therapy positively modify risk factors and, consequently, improve outcomes and cost-effectiveness of care. The CNIC-polypill has demonstrated in real-life, clinical effectiveness studies, its superiority over monocomponents in improving the lipidic parameters and in reduction of blood pressure in secondary CV prevention patients.

Purpose

To assess the cost-effectiveness of the CNIC-polypill (acetylsalicylic acid 100mg, atorvastatin 20/40mg, ramipril 2.5/5/10mg) compared to usual care with individual monocomponents for the secondary prevention of CV events in patients with a history of coronary heart disease (CHD) based on control of CV risk factors.

Methods

A Markov cost-effectiveness model (1-year cycles; 4 health states: stable disease, subsequent CHD, subsequent stroke, death; payer perspective; direct medical costs; lifetime horizon; 4% discount rate) based on changes in TC (10,1% reduction), HDL-c (7.4% increment) and SBP (2.6% reduction) obtained from the NEPTUNO* – a real-life, clinical effectiveness study conducted in Spain – was set for Portugal (base case). The probability of transition between health states was based on the SMART risk equation (S0, t=10= 0.8107). Cost-effectiveness was calculated for a hypothetical population (n=1,000) that replicated the characteristics of the population in the proACS registry, comprised of Portuguese patients with previous CHD. Systematic reviews identified epidemiological, costs, utility and mortality data. Outcomes were costs (€, 2020), life years (LY) and quality adjusted LY (QALY) gained.

Results

In patients with a history of CHD, the incremental cost of the CNIC-polypill strategy reaches €365,527, while preventing 35 recurrent CHD events and 17 subsequent strokes. In women and men with previous CHD, the incremental cost reaches €392,529 and €354,444 respectively while preventing recurrent 47 and 30 CHD events and 19 and 16 subsequent strokes respectively. The ICER is €5,130/LY gained for the overall population, €5,768/LY gained for women and €4,884/LY gained for men. The ICUR is €5,332/QALY gained in total, €5,817/QALY gained for women and €5,137/QALY gained for men. Assuming a willingness-to-pay (WTP) threshold of €30,000/QALY gained, there is 76.1% chances in total, 75.8% in women and 76.9% in men for the CNIC-polypill to be cost-effective and 27.8% chances overall, 27.7% in women and 25.5% in men of it being cost saving compared to usual care.

Conclusion

The CNIC-polypill seems to be a cost-effective strategy in men and women compared to usual care with monocomponents for the secondary prevention of CV disease based on improved control of risk factors. A larger reduction in the number of recurrent events is seen in women compared to men at a slightly higher cost.

Funding Acknowledgement

Type of funding sources: Private company. Main funding source(s): Ferrer International S.A. Base case resultsProbabilistic sensitivity analysis

Assessments of metallic contents in rare cephalopods from the Canary Islands: relationships with depth habitat and body size

This study investigated 20 elements in the muscle of 11 cephalopod species caught in the Canary Islands inhabiting from coastal to meso-bathypelagic habitats. Among them, trace element contents from large and elusive cephalopods such as Architeuthis dux, Taningia danae, Lepidoteuthis grimaldii, and Haliphron atlanticus were determined. Statistically significant differences in element concentration were found among class sizes and habitat. Large species that are inhabiting in deepest waters such as Loligo forbesii, A. dux, T. danae, H. atlanticus, and L. grimaldii showed a high load and variability in Fe and Al, while coastal species were characterized by a homogeneous element composition, being the Zn loads highest than other elements. Metal contents in large and elusive cephalopod species were dominated by Fe, Ni, Al, Zn, and Sr, with these species being able to carry important amounts of these elements to predators such as deep-diving odontocetes that reside around the Canary waters.

Influence of Biometric and Seasonal Parameters on the Metal Content of Scomber colias in Northwestern African Waters

Studies of the content of heavy metals and trace elements in fish and other marine organisms are of great importance to know the state of the marine ecosystem. This study has been carried out in northwestern African waters, Scomber colias being the target species, sampling a total of 345 specimens over 2 years. For the determination of metals and trace elements (Al, B, Cd, Cr, Cu, Fe, Li, Ni, Pb, V, and Zn) in the muscle, the ICP-OES (inductively coupled plasma optical emission spectrometry) was used. In the statistical study, the factors (oceanographic and maturity in the seasons, size of the specimens) were used. The samples sampled in the cold season that had high concentrations of metals may be due to the influence that African upwelling has on the Canary Islands. The metallic contents of our samples are lower than those found in the studies in Mauritania and Morocco due to the greater influence that upwelling has in these areas.

Determination and risk assessment of toxic metals in lipsticks from Europe and China

BACKGROUND

The presence of toxic toxic metals in lipstick can pose a health risk to many consumers of this type of cosmetics, especially for women. Thus, the aim of this study was to assess consequences attributed to dermal and oral exposure to toxic metals in lipsticks manufactured in China and Europe as determined by non-cancer and cancer risks assessment models from SCCS and USEPA, respectively.

METHOD

The treatment of the samples was carried out by calcination using muffle furnaces and the determination of Al, Cd and Pb were determined by inductively coupled plasma optical emission spectrometry (ICP-OES).

CONCENTRATIONS

The concentration of Cd and Pb in the study samples does not exceed the limits stablished for the FDA (00,228 mg kg^-1·day^-1 for Cd and 000,343 mg kg^-1·day^-1 for Pb, respectively) but they do not comply with the Regulation of the European Parliament, which prohibits the presence of these two metals in cosmetics. Neither European Union nor United States have established maximum levels for Al in cosmetics.

CONCLUSIONS

The cancer risk assessment of Cd and Pb metals resulted in a total cancer risk less than 1. The results of non-cancer oral risk assessment for Pb had a MoS result of 88 for China and 62 for Europe, suggesting that Pb poses a risk for the human health, especially in samples manufactured in Europe.

Differences in macroelements, trace elements and toxic metals between wild and captive-reared greater amberjack (Seriola dumerili) from the Mediterranean Sea

Despite its legislative regulation and control, the quality and safety of aquatic products is somewhat questioned due to the potential bioaccumulation of pollutants. The elements (Al, B, Ba, Ca, Cd, Co, Cr, Cu, Fe, K, Li, Mg, Mn, Mo, Na, Ni, Pb, Sr, V and Zn) were determined in the liver and muscle of wild and captive-reared Seriola dumerili with the aim of studying possible differences between origins, and sex-related variations. Additionally, the dietary intake of these elements derived from its consumption was also evaluated. Most of the elements and metals analyzed were accumulated to a higher extent in the liver of wild specimens whereas lower differences were observed in the muscle. Overall, the elements and metal composition of wild females strongly differed from that of captive-reared specimens probably related to the mobilization of nutrients for the spawning season in wild mature females, which were greater than their captive-reared counterparts.

P–059 Association between seminal levels of Fe and semen quality

Study question

The detection of metals in semen offers a new field in the study of male infertility.

Summary answer

Normozoospermia is associated with higher amounts of Fe. In males with pathological spermiogram, the percentage of men with Fe in semen was lower than expected.

What is known already

Increased levels of Fe in human semen appear to have a significant correlation with male fertility, suggesting that Fe in human seminal plasma has an important factor in male reproductive function. Fe acts as an antioxidant being a co-factor of catalasa, which protects sperm. On the other hand, elevated Fe levels are associated with sperm damage and continues to increase the lipid peroxidation that will affect the plasma membrane and the sperm motility. Most authors associate Fe with sperm motility and higher estimated fertility potential, based on standard semen parameters in fertile men, which are associated with lower levels of Fe.

Study design, size, duration

A prospective study was carried out in 102 men in a Reproduction unit in Tenerife, from February to April 2018 as a part on an epidemiologic study of environmental contaminants and male reproduction. The participant were categorized into two groups, according to the results of semen analysis following the World Health Organization guidelines: the pathological and the normal semen group that constituted the control group. The metal was determined in semen samples.

Participants/materials, setting, methods

Semen quality and levels of Fe were measured in seminal plasma on a total of 102 men attended successively, for the initial infertility evaluation, The collected samples were used for both semen analysis following the World Health Organization (WHO) guidelines and metal detection and carried out using a Makler® counting chamber (Irvine Scientific, CA) and for metals, were determined by ICP-OES (Inductively Coupled Plasma-Optical Emission Spectrometry) in semen samples.

Main results and the role of chance

The percentage of males with the presence of Fe was 97.1% and the average level were 0.6283 mg/Kg. When analyzing the relationship between the spermiogram parameters with the levels of Fe in the semen, significant differences were found. All men with a normal sperm analysis presented Fe in semen, but among men diagnosed with altered spermiogram, the percentage of men with Fe in semen (92.7%) was lower than expected (97%) (χ2 128 1 =4.59; p = 0.032). As for the concentration of Fe in spermiogram in the first quartile (25% lower), measuring 0.33 mg/Kg, more pathological samples were found than expected (X2 133 2 =6.921; p = 0.031) having a higher probability of being more pathological (52% vs 31.4%). On the other hand, men with pathological sperm concentration, have higher levels of Fe, in the fourth quartile (0.61 mg/kg), with more frequency than expected (90.6% vs 97%) (χ2 136 1 =6.48; p = 0.011). The association between BMI and the presence of Fe was statistically significant. In obese males (BMI ≥30.0 kg/m2), the percentage of men with Fe in semen (80%) was lower than expected (97%) (χ2 42 2 =11.302; p = 0.001).

Limitations, reasons for caution

The limitation of this study was the volume of semen that could be obtained for metal detection, only 0.8 mL. because the collected samples were used for both semen analysis and metal detection.

Wider implications of the findings: The determination of metals in semen opens a new field in the study of male infertility and many cases of unknown infertility could be due to metal presence or absence in semen, with the option of performing treatments.

Trial registration number

Not applicable

Limpets as bioindicators of element pollution in the coasts of Tenerife (Canary Islands)

Currently, there is an increase in marine pollution around the world; the most affected areas are the coastal ones since on the coast is where anthropogenic pollution first acts. Therefore, it is important to have natural bioindicators as organisms that indicate us in the first instance of this pollution. The main objective of the present research is to determine if Patella aspera and Patella candei crenata show statistical differences in their element content in contaminated areas of the Island of Tenerife and to verify if limpets can be good bioindicators of marine pollution by trace elements and non-essential elements. A total of 160 limpets were taken from 4 slopes of the Island of Tenerife in the Canary Islands. The samples were analyzed using the ICP-OES to obtain results of essential trace elements (Cr, Cu, Fe, Li, Ni, and Zn) and non-essential elements (Al, B, Cd, Pb, and V). P. aspera showed a higher concentration of elements than P. candei crenata, and it was in the Buenavista locality where alarming values of Cd 0.658 ± 0.124 mg/kg were observed for P. aspera. These two limpet species have been found to be useful as bioindicators of marine pollution based on the concentrations of metals especially for Cd and Cu.

Characterization of classes of mollusks in the East Atlantic according to their element content

One hundred and ninety-two samples from six species of mollusks classified into the following taxonomic classes: Gastropoda (Patella aspera, Patella candei crenata), Bivalvia (Mytilus galloprovincialis, Ensis directus), and Cephalopoda (Abraliposis morisii, Pyroteuthis margatifera) were investigated. Samples were collected in the Atlantic Ocean (Canary Islands and Galicia). The concentrations of Al, B, Ba, Ca, Cd, Co, Cr, Cu, Fe, K, Li, Mg, Mn, Mo, Na, Ni, Pb, Sr, V, and Zn were determined by ICP-OES. Statistical analysis verified that the classes of benthic organisms had the highest concentration of elements. However, the Cephalopoda class had the highest Cd (1.685 ± 0.929 mg/kg) and Pb (0.826 ± 1.104 mg/kg) content. On the other hand, the values obtained in this study were compared with studies conducted in other parts of the world to verify the environmental state of the Atlantic Ocean using the organisms studied as bioindicators.

Human Exposure to Potentially Toxic Elements from the Consumption of Soybean Beverages Commercialized in Spain

ABSTRACT

Plant-based beverages have been positioned as an alternative to cow's milk. Some of the most commonly consumed plant-based beverages are those made from soybeans. Soybean beverages can be an important source of essential elements. However, soybean plants can be exposed to high concentrations of contaminants, such as toxic metals, from the soil and the environment. The objective of this study was to determine the concentrations of potentially toxic elements (PTEs; Fe, Cu, Cr, Co, Mn, Mo, Zn, B, Ba, Ni, Li, Sr, V, Al, Cd, and Pb) to evaluate the human exposure and toxic risk from the consumption of these soybean beverages. Forty samples of various brands of soybean beverages were analyzed by inductively coupled plasma-optical emission spectroscopy. The most abundant PTE was Al (3.93 mg/L), followed by Fe (1.91 mg/L) and Ba (0.69 mg/L). Based on a mean consumption of two servings of soybean beverage per day (250 mL per serving), this consumption results in a daily intake of Al and Pb that is significant but still below of the maximum recommended amount. However, higher consumption could exceed the maximum recommended Al and Pb values, with consequent risks to the human health.

HIGHLIGHTS

Human Exposure to Toxic Metals (Al, Cd, Cr, Ni, Pb, Sr) from the Consumption of Cereals in Canary Islands

The Canary Islands is an archipelago that consumes cereals and derivatives imported from other regions of the world. The increase in contamination with toxic metals makes it necessary to assess the content of toxicological metals of interest to ensure quality and safety. The content of toxic metals (Al, Cd, Cr, Pb, Ni, Sr) was determined in 221 samples of cereals and derivatives (corn, wheat, gofio, corn gofio, barley gofio, roasted corn and flour) marketed in the Canary Islands using ICP-OES (inductively coupled plasma optical emission spectrometry) to assess dietary exposure. Al content recorded in barley gofio (29.5 mg/kg fresh weight) stands out. The estimated daily intake (EDI) of Pb is 52 µg/day if 100 g/day of barley gofio is consumed (121% and 240% of the BMDL nephrotoxicity limit set by the EFSA at 0.63 µg/kg body weight/day for adults and children, respectively). The EDI of PB is 16 µg/day if 30 g barley gofio/day is consumed by adults (36.2% of the abovementioned BMDL nephrotoxicity limit). The EDI of Pb is 7.8 µg/day if 15 g barley gofio/day is consumed by children (32.2% of the abovementioned BMDL nephrotoxicity limit). Gofio is a food of high nutritional value. It is necessary to establish monitoring programs for toxic metals in raw materials and processed products to reduce exposure levels.

Metals in commercial fish in the Galapagos Marine Reserve: Contribution to food security and toxic risk assessment

Metal pollution in the marine environment can damage places with exceptional biodiversity such as the Galapagos Islands. For this reason, it is important to evaluate the toxic risk from metals derived from fish consumption and to perform a nutritional assessment. We sampled 20 individuals of demersal (Caulolatilus princeps and Mycteroperca olfax) and pelagic (Thunnus albacares and Seriolella violacea) species. The levels of the toxic elements (Al, B, Ba, Cd, Ni, Pb and Sr), and the macroelements, microelements and trace elements (Ca, Cr, Fe, K, Li, Mn, Mo, Mg, Na, V and Zn) of species muscle tissue were analyzed by Inductively Coupled Plasma Optical Spectrometry (ICP-OES). Demersal species have higher concentrations of Cr, K, Mg and Mo; while pelagic species have higher levels of Zn. M. olfax could potentially cause Cd toxicity so it is recommended not to ingest more than 86 and 73 g of this species (i.e. roughly, one serving) per week for men and women, respectively. None of the species could be marketed in Europe and the USA due to Cd level exceed the allowed limits by EFSA and FAO. Furthermore, the dietary intake of C. princeps is recommended due to its high concentration of Ca, Na, K, Mg and Cr, while T. albacares is recommended for people with Zn deficiency. However, due to the Cd level in C. princeps it is not recommended to ingest more than five servings per week. We attribute the source of metals in the studied fish from the volcanic origin of the islands rather than from human pollution. This is the first study that thoroughly estimate concentration of metals in commercial fish species and its contribution to food security in the Galapagos.

Cost-effectiveness of a cardiovascular polypill strategy (aspirin, atorvastatin, ramipril) for the secondary prevention of cardiovascular disease based on real life improvement in risk factor control

Funding Acknowledgements

Type of funding sources: Private company. Main funding source(s): Ferrer Internacional

Background

The cardiovascular (CV) polypill has consistently demonstrated cost-effectives in decreasing the risk of CV disease in patients in secondary prevention. Previous pharmacoeconomic studies addressed improvements in adherence as a driver of health gains. This economic assessment focuses on the implications of improved control of risk factors with the polypill as observed in clinical practice.

Purpose

To assess the cost-effectiveness of a fixed-dose combination polypill (ASA 100mg, atorvastatin 20/40mg, ramipril 2.5/5/10mg) strategy for the secondary prevention of CV and cerebrovascular events in adults with a history of coronary heart disease (CHD) or stroke compared to usual care with monocomponents.

Methods

A Markov cost-effectiveness model (1-year cycles; 4 health states: stable disease, subsequent CHD, subsequent stroke, death; payer perspective; direct medical costs; lifetime horizon; 4% discount rate) based on changes in CV risk factors (total cholesterol, 18.3% reduction; high density lipoprotein cholesterol, 2.1% increment; systolic blood pressure, 11.46% reduction) obtained from a real-life effectiveness study was set for Portugal. The probability of transition between health states was based on the SMART risk equation. Cost-effectiveness was calculated for two cohorts (n = 1,000) of secondary prevention patients with previous CHD or stroke. Systematic reviews, Portuguese registries, mortality tables and official reports were searched to identify effectiveness, epidemiological, costs and utility data. Outcomes were costs (€, 2020) per life year (LY) and Quality Adjusted LY (QALY) gained. One-way (OWA) and probabilistic (PSA) sensitivity analyses tested consistency. Assumptions were validated by experts.

Results

In the CHD cohort, the incremental cost-effectiveness ratio for the polypill strategy (ICER) is 2,402 €/LY and the incremental cost-utility ratio (ICUR) is 2,328 €/QALY. Incremental cost reaches 278,927 € (polypill, 13,198,506 €; monocomponents: 12,919,579 €) with less subsequent CV events (552.31 vs 641.88) and CV deaths (102.4 vs 118.68). Assuming a willingness-to-pay (WTP) threshold of 30.000 €/QALY gained, the PSA shows a 81.4% probability for the polypill to be cost-effective and 39.1% chances to be costs saving compared to usual care. In the stroke cohort, the ICER is 386 €/LY and the ICUR is 553 €/QALY. Incremental costs are 34,178 € (polypill, 10,138,807 €; monocomponents: 10,104,629 €) with less subsequent CV events (481.99 vs 564.50) and CV deaths (101.00 vs. 117.23) with the polypill. There is a 75.9% probability for the polypill to be cost-effective and 49.5% chances to be costs saving.

Conclusion

The CV polypill is a cost-effective secondary prevention strategy compared to usual care with monocomponents. Its ICER is well below acceptable thresholds in both CV and cerebrovascular disease patients. It reduces the number of recurrent events at a moderately higher cost compared to monocomponents.

How consistent are cost-effectiveness estimates of a cardiovascular polypill strategy for the secondary prevention of cardiovascular disease across different cardiovascular risk equations?

Funding Acknowledgements

Type of funding sources: Private company. Main funding source(s): Ferre Internacional

Background

Risk equations (RE) are crucial to individualise estimates and properly adjust preventive treatments in patients with previous cardiovascular (CV) disease. RE are also routinely incorporated into health economic assessments but it is unknown if the cost-effectiveness results vary according to the RE applied.

Purpose

To determine the cost-effectiveness of a CV polypill (ASA 100mg, atorvastatin 20/40mg and ramipril 2.5/5/10mg) strategy compared to usual practice of combining monocomponents in the prevention of recurrent events in patients with previous coronary heart disease (CHD) or stroke applying two different CV RE: SMART and FRAMINGHAM, respectively.

Methods

A Markov cost-effectiveness model (1-year cycles; 4 health states: stable disease, subsequent CHD, subsequent stroke; death; payer perspective; direct medical costs; lifetime horizon; 4% discount rate) was developed for Portugal. Transition probability between health states was based on the SMART RE and an adaptation for secondary CV prevention of the FRAMINGHAM RE, respectively. Cost-effectiveness was calculated for a mixed cohort of secondary prevention patients (weighed post-CHD: 57.9%; post-stroke: 42.1%). Systematic literature reviews, Portuguese registries, mortality tables and official reports ware used to identify effectiveness, epidemiological, costs and utility data. Outcomes were costs (€, 2020) per life year (LY) and Quality Adjusted Life Year (QALY) gained. One-way (OWA) and probabilistic (PSA) sensitivity analyses tested the consistency of results. Assumptions were validated by experts.

Results

Applying the SMART RE, the incremental cost-effectiveness ratio (ICER) is 1,555€/LY gained and the incremental cost-utility ratio (ICUR) is 1,785€/QALY gained for the polypill strategy. The incremental costs of adopting the polypill strategy are 171,378€. Recurrent CV events (550.68 vs 642.13) and CV deaths (106.05 vs 122.81) are also less frequent with the polypill strategy compared with monocomponents. Assuming a willingness-to-pay (WTP) threshold of 30.000 €/QALY gained, there is a 77.80% probability for the polypill strategy to be cost-effective and 43.00% chances to be costs saving when used in a mixed cardiovascular and cerebrovascular disease population. Applying the FRAMINGHAM RE, the ICER is 998€/LY gained and the ICUR is 1,242€/QALY. The incremental costs amount 175,122€. Recurrent CV events (452.66 vs 563.48) and CV deaths (104.77 vs 127.32) are less frequent with the polypill strategy. The PSA shows a 99.5% probability for the polypill strategy to be cost-effective and 46.8% chances to be costs saving.

Conclusion

Both risk equations result in comparable results on the cost-effectiveness of interventions for the secondary prevention of CV disease. The polypill strategy remains cost-effective compared to the common practice of using individual monocomponents concomitantly, reducing recurrent CV events at a moderately higher cost.

Dental Fluorosis: the Risk of Misdiagnosis-a Review

Fluoride has been considered as the single factor most frequently responsible for causing enamel mottling. However, in humans, either endogenous and/or exogenous factors not related to fluoride exposure may also cause enamel mottling. In this sense, various studies in the international literature have reported severe mottling of the teeth that could not be attributed to fluoride exposure. Thus, misdiagnosis of non-fluoride-induced enamel defects may occur frequently. Reports of unexpectedly high population prevalence and individual cases of fluorosis, where such diagnoses are irreconcilable with the identified fluoride history, highlight the necessity for a more precise definition and diagnosis of dental fluorosis. Also, a more discriminating diagnostic procedure is suggested. Particularly, positive identification of environmental fluoride levels to which the communities and individuals are exposed shall be developed before the confirmation of a diagnosis of fluorosis. It is considered that a more critical methodology for the diagnosis of fluorosis will be helpful in the rational use and control of fluorides for dental health, and in the identification of factors that may induce enamel defects.

Dietary exposure to trace elements (B, Ba, Li, Ni, Sr, and V) and toxic metals (Al, Cd, and Pb) from the consumption of commercial preparations of Spirulina platensis

Spirulina is a multicellular cyanobacterium that is consumed as a dietary supplement. The content of trace elements (B, Ba, Li, Ni, Sr, V) and toxic metals (Al, Cd, Pb) was determined in 24 spirulina samples marketed in two different formulations (tablets and powder) by ICP-OES (inductively coupled plasma optical emission spectrometry). The highest element concentration was found in the powder presentation, except for Li. The powder presentation element levels (mg/kg dry weight) were Al (28.1), Sr (10.3), B (1.73), Li (1.47), Ba (1.25), Ni (0.63), Pb (88.1 μg/kg dw), Cd (37.2 μg/kg dw), and V (22.9 μg/kg dw). Considering an adult with a body weight of 68.48 kg and the posology guidelines (14 tablespoons per week), the consumption of powdered spirulina contributes greatly to the Al intake by 2.04% of its TWI (tolerable weekly intake) set at 1 mg/kg body weight/week, followed by Cd with 1.05% of its TWI set at 2.5 μg/kg bw/week. Pb intake represents 1.05% of the BMDL (benchmark dose) level associated with nephrotoxicity and 0.44% of the BMDL associated with cardiovascular effects. This assessment suggests that spirulina consumption does not pose risks to the consumer as far as exposure to toxic metals (Al, Cd, Pb) is concerned. However, the presence of trace elements and toxic metals in spirulina preparations should be monitored to ensure its quality and safety.

Toxic Metals in Cereals in Cape Verde: Risk Assessment Evaluation

Consumption of cereals and cereal-based products represents 47% of the total food energy intake in Cape Verde. However, cereals also contribute to dietary exposure to metals that may pose a risk. Strengthening food security and providing nutritional information is a high-priority challenge for the Cape Verde government. In this study, toxic metal content (Cr, Ni, Sr, Al, Cd, and Pb) is determined in 126 samples of cereals and derivatives (rice, corn, wheat, corn flour, wheat flour, corn gofio) consumed in Cape Verde. Wheat flour samples stand out, with the highest Sr (1.60 mg/kg), Ni (0.25 mg/kg) and Cr (0.13 mg/kg) levels. While the consumption of 100 g/day of wheat would contribute to 13.2% of the tolerable daily intake (TDI) of Ni, a consumption of 100 g/day of wheat flour would contribute to 8.18% of the tolerable weekly intake (TWI) of Cd. Results show relevant Al levels (1.17-13.4 mg/kg), with the highest level observed in corn gofio. The mean Pb average content in cereals is 0.03-0.08 mg/kg, with the highest level observed in corn gofio. Al and Pb levels are lower in cereals without husks. Without being a health risk, the consumption of 100 g/day of wheat contributes to 17.5% of the European benchmark doses lower confidence limit (BMDL) of Pb for nephrotoxic effects; the consumption of 100 g/day of corn gofio provides an intake of 1.34 mg Al/day (13.7% of the TWI) and 8 µg Pb/day (20% of the BMDL for nephrotoxic effects). A strategy to minimize the dietary exposure of the Cape Verdean population to toxic metals from cereals should consider the continuous monitoring of imported cereals on arrival in Cape Verde, the assessment of the population's total diet exposure to toxic metals and educational campaigns.

Human exposure assessment to potentially toxic elements (PTEs) from tofu consumption

Potentially toxic elements (PTEs) (V, B, Ba, Li, Sr, Cr, Ni, Al, Pb, Cd) were determined in 130 samples of different tofu types (natural, flavored, smoked, and fresh made) by ICP-OES (inductively coupled plasma optical emission spectrometry). Al was the most notable element found with the highest concentration (6.71 mg/kg ww) found in flavored tofu. Ni level (0.38 mg/kg) stands out in smoked tofu. European tofu has higher PTE levels than Chinese tofu. Organic-produced tofu has higher PTE concentrations than conventional produced tofu. A total of 200 g/day of smoked tofu confers a contribution percentage of 39.6% of its TDI (tolerable daily intake). In addition, 200 g/day of flavored tofu would mean a high Pb contribution with a 23.2% of the BMDL (benchmark dose level) set in 0.63 μg/kg bw/day to the development of nephrotoxicity. Mean consumption would not pose a risk to adults' health. Considering the obtained results, it would be advisable to establish limits for certain metals such as Pb, Al, and Ni in this type of product. Furthermore, it is recommendable to set consumer guidelines to some tofu types in order to avoid excessive intake of PTEs.

Dietary Intake of Essential Elements (Na, K, Mg, Ca, Mn, Zn, Fe, Cu, Mo, Co) from Tofu Consumption

Tofu is one of the most consumed soybean products. Currently, tofu is consumed in vegan and vegetarian diets to avoid meat. However, it is necessary to determine the content of essential elements to assess the dietary intake. Essential elements (Na, K, Mg, Ca, Mn, Zn, Fe, Cu, Mo, Co) were determined in 130 samples of tofu by ICP-OES (inductively coupled plasma optical emission spectroscopy). The highest element content was found in flavoured tofu; the most notable were Na (2519 mg/kg wet weight) and Fe (19.5 mg/kg ww). Consumption of 200 g/day of flavoured tofu by adults would mean a high contribution of Cu (46.9% women, 38.1% men), Fe (55.7% women, 65.0% men) and Na (25.2% adults) to its AI (adequate intakes) sets by the EFSA (European Food Safety Authority). Natural tofu would mean a remarkably Mn contribution (50% adults) to the AI. Tofu could be an important source of essential elements such as Mg, Mn, Na, Cu and Fe.

Risk assessment of iodine intake from the consumption of red seaweeds (Palmaria palmata and Chondrus crispus)

Seaweeds are a basic food in the Asian diet. The search for functional and healthy foods has increased the seaweed consumption in Europe and the USA. Seaweeds are a source of essential elements such as iodine. However, high intake levels of iodine can cause damages to human health. Red seaweeds like dulse (Palmaria palmata) and Irish moss (Chondrus crispus) are common in shops and large stores. The iodine level in 30 samples of red seaweeds (dulse and Irish moss) has been determined by redox volumetry with sodium thiosulfate to determine the iodine content of both species and to assess the iodine dietary exposure from dulse and Irish moss consumption. Irish moss (3.86 ± 1.49 mg/kg dry weight) has the highest average iodine content. Four grams per day of dehydrated Irish moss seaweeds contributes greatly to the iodine recommended daily intake (DRI) for children (25.7%). The consumption of analyzed seaweeds (4 g/day) does not pose a health risk. However, the consumption of 286 g/day of Irish moss would lead to exceeding the UL for the adult population set at 1100 μg/day. It is necessary that the consumer respects the consumption guidelines of the seaweed packers.

Human exposure to fluoride from tea (Camellia sinensis) in a volcanic region-Canary Islands, Spain

Fluoride is highly present in the environment, especially in water and its derivatives. Excessive fluoride contribution to diet poses a health risk. Tea leaves accumulate fluoride and the consumption of tea (Camellia sinensis) could pose a risk to human by the excessive fluoride intake. Ninety tea samples were analyzed by potentiometry using a selective fluoride ion electrode. Mixed tea samples (2.82 ± 1.11 mg/L) and black tea samples (2.28 ± 0.79 mg/L) recorded the highest fluoride levels. The contribution of drinking water is important for increasing fluoride levels in teas. The daily consumption of two cups (250 mL per cup) of mixed and black teas prepared with La Laguna tap water does pose a health risk for children (4-8 years old) because of the high contribution percentages (74.4% and 63.6%, respectively) of the Tolerable Upper Intake Level set in 2.5 mg/day by the EFSA (European Food Safety Authority). A minor consumption in children (4-8 years old) and adults during pregnancy is advisable.

Development stage and season influence in the metal content of small pelagic fish in the North-West Africa

Marine organisms are exposed to great changes caused by man due to discharges into the oceans, so the study of marine pollution is of great value for each ecosystem. For this study, 963 specimens of pelagic fish have been collected, of which 345 are Scomber colias, 294 are Trachurus picturatus and 324 are Sardina pilchardus, it was wanted to study the development and ontogeny in the three species observing if there were variations in their metallic content. The study covered a total of 2 years, from June 2016 to May 2018.16 samples of each species were studied each month, during the 2 years of sampling, from the samplings carried out by the Canary Islands Oceanographic Center of the Spanish Institute Oceanography (COC-IEO) in the markets of the Island of Tenerife. The concentration of 11 anthropic metals was determined in each sample using the Inductively Coupled Plasma Optical Emission Spectrometry (ICP-OES) technique. Statistical studies were carried out with factors such as the oceanographic season, and the level of maturity of the gonads. S. colias was the species that presented the highest concentration in a greater number of metals. S. pilchardus presents higher concentration in Cu, Li and Zn, in the warm season. These are metals of a very anthropic character on coasts; This species tends to get closer to the coasts compared to the other two and is the cause of its higher concentration in these metals due to the influence of pollution linked to the coast. The immature specimens of the three species had a higher concentration in more metals than the mature specimens.

Seasonal and ontogenic variations of metal content in the European pilchard (Sardina pilchardus) in northwestern African waters

Marine fishes are exposed to great human-induced alterations due to the indiscriminate discharges into the sea, increasing marine pollution. For this study, 324 specimens of Sardina pilchardus from the Canary Islands were analized during a period of 2 years (June 2016 to May 2018). The concentration of 11 metals and trace elements (Al, B, Cd, Cr, Cu, Fe, Li, Ni, Pb, V and Zn) was determined in each individual using the Inductively Coupled Plasma Optical Emission Spectrometry (ICP-OES) technique. Statistical analyses were carried out considering the following factors: oceanographic season, maturity of the gonads in the seasons, size of the specimens. Sardina pilchardus specimens captured in the hot season presented higher Ni, Li and Pb levels than the specimens caught in the cold season. Immature specimens had higher concentration in more metals than the mature specimens. This fact may be due to the fact that these specimens require a much higher metabolic rate due to their growth and do not detoxify like mature specimens. Significant differences were found in the concentration of metals in all the analyzes performed.

Toxic Metals (Al, Cd, Pb) and Trace Element (B, Ba, Co, Cu, Cr, Fe, Li, Mn, Mo, Ni, Sr, V, Zn) Levels in Sarpa Salpa from the North-Eastern Atlantic Ocean Region

Sarpa salpa is a fish belonging to the Sparidae family and is usually found in local markets. Toxic metals such as aluminum (Al), cadmium (Cd), lead (Pb) and trace elements such as boron (B), barium (Ba), cobalt (Co), copper (Cu), chromium (Cr), iron (Fe), lithium (Li), manganese (Mn), molybdenum (Mo), nickel (Ni), strontium (Sr), vanadium (V) and zinc (Zn) are incorporated into fish tissues and remain there. The liver has the highest concentrations of all the analyzed toxic metals and almost all the analyzed trace elements. The consumption of 100 g/day of S. salpa muscle tissue does not pose a health risk. However, 100 g/day of liver consumption may pose a serious health risk due to the intake of Cd (572% of the tolerable weekly intake for adults with a body weight of 68.48 kg) and Pb (117% of the tolerable daily intake for adults weighing 68.48 kg). The consumption of liver of this species is not recommended due to its possible harmful effects on health.

Human Exposure to Iodine from the Consumption of Edible Seaweeds

The increasing consumption of wakame algae (Undaria pinnatifida) and kombu (Laminaria ochroleuca) because of their culinary appeal and beneficial properties means there is a need to study the composition of these new foods. Algae stand out for their high iodine content, this being an essential element whenever it is ingested at recommended levels but which, ingested in high quantities, can cause harmful effects to health such as hyperthyroidism and even goiter. The iodine content in 30 samples of algae from different geographical origins (Asia and Europe) has been determined by oxidation-reduction titration with sodium thiosulfate. European kombu algae (27.7 ± 5.4 mg/kg dry weight) have the highest mean average iodine concentrations. European algae have higher iodine content than Asian algae. Significant differences (p < 0.05) have been recorded among wakame algae according to geographical origin. The consumption of 4 g/day of European kombu algae means an intake of 111 μg/day of iodine, which is a value close to the RDI (recommended daily intake) set at 150 μg/day. It is necessary to monitor iodine levels in algae to avoid excessive intakes and harmful effects on health.

Impacts of climate change on Public Health of the Mediterranean population

The Mediterranean Basin is undergoing a warming trend with longer and warmer summers, an increase in the frequency and the severity of heat waves, changes in precipitation patterns and a reduction in rainfall amounts. This populated region is characterized by significant gaps in the socio-economic levels, parallel with population growth and migration, increased water demand and forest fires risk. Consequently, the vulnerability of the Mediterranean population to human health risks as result of climate change increases significantly.

Climatic changes impact the health of the Mediterranean population directly through extreme heat, drought or storms, or indirectly by changes in water availability, food provision and quality, air pollution and other stressors. The main health effects are related to extreme weather events, changes in the distribution of climate-sensitive diseases and changes in environmental and social conditions. The poorer countries, particularly in North Africa and the Levant, are at highest risk. Climate change affects the vulnerable sectors of the region, including an increasingly older population, with a larger percentage of those with chronic diseases, as well as poor people, which are therefore more susceptible to the effects of extreme temperatures. For those populations, a better surveillance and control systems are especially needed parallel with adaptation planning that become ever more imperative. In order to achieve these goals, it is essential to define indicators of vulnerability and exposure based on health impact assessment, as well as indicators that will promote adaptation planning and resilience for health risk management. In view of the climatic projections and the vulnerability of Mediterranean countries, such indicators will contribute to correct preparedness at the regional and national levels.

Developing urban resilience in Haifa: preparedness to climate change in health and welfare agencies

Background

Extreme climate events (wildfires, floods, heatwaves, cold spells) are becoming more frequent in the Mediterranean, but adaptation levels in the health and welfare sectors remain low. The city of Haifa in northern Israel is prone to both war and extreme climate events. Focusing on Haifa, we aim to 1) examine local officials' risk perceptions of different extreme events, 2) compare preparedness to war vs. climate events, and 3) conduct a spatial analysis of climate and health vulnerabilities.

Methods

Mixed-Methods: a qualitative component including 30 in-depth interviews with local government health and welfare officials, and a qualitative component that includes mapping vulnerability indicators such as socio-economic status, recipients of welfare allowances, and temperature, focusing on urban heat islands.

Results

The city of Haifa developed a comprehensive resilience policy for war and wildfire. However, there is no awareness or preparedness for other climate events that have not yet been experienced. Similarly, hospitals are prepared for emergencies, but not for extreme climate events. There are no national budget or guidelines for climate adaptation at the city level or in hospitals. Correspondingly, risk perceptions of climate change among health and welfare officials remain low. At the city level, social and climatic vulnerabilities are correlated, so that downtown neighborhoods are characterized by poorer socio-economic, health and welfare conditions, and higher summer temperatures.

Conclusions

Haifa has good preparedness for events that had been experienced in the past. While emergency preparedness provides a good infrastructure for climate change preparedness, awareness and adaptation to the unique aspects of climate change preparations are needed, including reference to related spatial dimensions. Identifying the gaps between preparedness to various emergency events, can contribute to better climate change preparedness at the local level.

Key messages

In the city of Haifa, emergency preparedness exists but is not extended to extreme climate events, and awareness to health risks of climate change remains low in the health and welfare agencies. Learning from emergency preparedness to wars, wildfires and earthquakes may contribute to enhancing preparedness to extreme climate events at the local level.