Cadmium, lead, and zinc concentrations in human fingernails

Metal Exposures in Residents Living Near an Urban Oil Drilling Site in Los Angeles, California

Urban environmental justice communities are potentially exposed to multiple toxic metals, through contaminated air, soil, water, and food. However, information on metals and their sources is lacking. This study uses non-negative matrix factorization (NMF) in a community-based participatory research study to identify potential sources and to understand how these metals cluster in a population near an urban oil drilling site. We recruited 203 Latinx, Black, and Asian residents who lived within 1 km of an oil drilling site in south Los Angeles and collected toenail clippings to assess exposure to arsenic (As), cadmium (Cd), mercury (Hg), manganese (Mn), nickel (Ni), lead (Pb), and antimony (Sb). Using NMF, we identified three clusters based on concentrations in the participants' toenails. As, Cd, Pb, and Sb grouped together, indicative of an industrial source. A second grouping was composed of Ni and Mn, which may be related to oil drilling. We also identified a third source factor predominantly driven by Hg and As, which may arise from dietary sources. Utilizing NMF, a dimension reduction method, we identified a source factor high in Ni and Mn in residents living in a neighborhood near an active oil drilling site.

Noninvasive Hemoglobin Level Prediction in a Mobile Phone Environment: State of the Art Review and Recommendations

BACKGROUND

There is worldwide demand for an affordable hemoglobin measurement solution, which is a particularly urgent need in developing countries. The smartphone, which is the most penetrated device in both rich and resource-constrained areas, would be a suitable choice to build this solution. Consideration of a smartphone-based hemoglobin measurement tool is compelling because of the possibilities for an affordable, portable, and reliable point-of-care tool by leveraging the camera capacity, computing power, and lighting sources of the smartphone. However, several smartphone-based hemoglobin measurement techniques have encountered significant challenges with respect to data collection methods, sensor selection, signal analysis processes, and machine-learning algorithms. Therefore, a comprehensive analysis of invasive, minimally invasive, and noninvasive methods is required to recommend a hemoglobin measurement process using a smartphone device.

OBJECTIVE

In this study, we analyzed existing invasive, minimally invasive, and noninvasive approaches for blood hemoglobin level measurement with the goal of recommending data collection techniques, signal extraction processes, feature calculation strategies, theoretical foundation, and machine-learning algorithms for developing a noninvasive hemoglobin level estimation point-of-care tool using a smartphone.

METHODS

We explored research papers related to invasive, minimally invasive, and noninvasive hemoglobin level measurement processes. We investigated the challenges and opportunities of each technique. We compared the variation in data collection sites, biosignal processing techniques, theoretical foundations, photoplethysmogram (PPG) signal and features extraction process, machine-learning algorithms, and prediction models to calculate hemoglobin levels. This analysis was then used to recommend realistic approaches to build a smartphone-based point-of-care tool for hemoglobin measurement in a noninvasive manner.

RESULTS

The fingertip area is one of the best data collection sites from the body, followed by the lower eye conjunctival area. Near-infrared (NIR) light-emitting diode (LED) light with wavelengths of 850 nm, 940 nm, and 1070 nm were identified as potential light sources to receive a hemoglobin response from living tissue. PPG signals from fingertip videos, captured under various light sources, can provide critical physiological clues. The features of PPG signals captured under 1070 nm and 850 nm NIR LED are considered to be the best signal combinations following a dual-wavelength theoretical foundation. For error metrics presentation, we recommend the mean absolute percentage error, mean squared error, correlation coefficient, and Bland-Altman plot.

CONCLUSIONS

We addressed the challenges of developing an affordable, portable, and reliable point-of-care tool for hemoglobin measurement using a smartphone. Leveraging the smartphone's camera capacity, computing power, and lighting sources, we define specific recommendations for practical point-of-care solution development. We further provide recommendations to resolve several long-standing research questions, including how to capture a signal using a smartphone camera, select the best body site for signal collection, and overcome noise issues in the smartphone-captured signal. We also describe the process of extracting a signal's features after capturing the signal based on fundamental theory. The list of machine-learning algorithms provided will be useful for processing PPG features. These recommendations should be valuable for future investigators seeking to build a reliable and affordable hemoglobin prediction model using a smartphone.

The applicability of fingernail lead and cadmium levels as subchronic exposure biomarkers for preschool children

Preschool children are exposed daily to metals in their homes and at daycare centers (DCC). Metal exposure and health effects are associated even at low levels, and children comprise a group of public health concern. Nail metals have been studied for exposure biomonitoring and compared to other biological media. The aim of this study was to explore the applicability of preschool fingernail lead and cadmium as subchronic exposure biomarkers. Nail lead and cadmium levels (NLL and NCL) of 602 preschool children (age: 1-4 years) who attended 21 DCC in São Paulo, Brazil, in 2013 were analyzed. Results were compared against blood lead and cadmium levels (BLL and BCL) found in a previous study. Inductively coupled plasma mass spectrometry (ICP-MS) analyses were performed for both samples. DCC and metal contaminated sites (MCS) were georeferencing. Logistic regression tests were applied to verify associations between nail metal levels and risk factors (sex, age, maternal education, secondary smoking, DCC geographic district, vehicle flow density, relative altitude and distance between DCC and nearest MCS) (p < 0.05). BLL was stratified by exposure level (low: <5 μg.dL^-1; high: >13.9 μg.dL^-1; medium: ≥5 μg.dL^-1 and ≤13.9 μg.dL^-1) and also tested the associations in order to verify if nail lead levels are affected by exposure intensity defined by blood metals concentrations. Radius distance and relative altitude of DCC to nearest MCS were associated with high NLL and NCL. Abnormal appearance of nails was associated with high NLL and low NCL. Lead and cadmium exposure magnitude had no significant impact on NLL. NLL should only be used for initial screening, and when financial resources are scarce, especially in areas located near contaminated sites. Preschool children were co-exposed to both lead and cadmium, reinforcing the need for broader studies evaluating exposure to environmental pollutants for more than one chemical element.

Heavy metals in hair and nails as markers of occupational hazard among welders working in United Arab Emirates

Studies have shown that hair and nail samples can be used as a marker to assess occupational exposure to heavy metals. The objective of this study was to estimate the levels of heavy metals: Lead (Pb), Nickel (Ni), Cadmium (Cd), and Manganese (Mn) in hair and nail samples of welders working in United Arab Emirates and to find an association between the heavy metal concentration with the parameters like smoking habits, exposure/day, years of experience and use of protective personal equipment (PPE). Hair and toes nail samples were collected from exposed and non-exposed subjects with respect to, social habits, exposure/day and years of welding experience. The levels of Pb, Cd, Mn, and Ni, in hair and toenails, assayed by atomic absorption spectrophotometer. We observed that the metal concentration was higher in toenail as compared to hair samples in both the groups. Cd was significantly high in both the groups whereas, Mn in the hair was high in the exposed group. The Mn in hair was notably higher among smokers and the Cd in hair and Ni in the nail samples was significantly higher in the subjects with > 8 h/day exposure. The concentration of Cd and Ni in hair increased with increasing years of experience and was maximum in the subjects with welding experience of > 20 years. Our results signify that hair and nail samples can be used as an indicator to heavy metal exposure. Given that the present study shows high level of some metals in the hair and nail of welders, awareness of occupational hazards and annual assessment of welder's health is necessary.

Portable X-ray fluorescence of zinc applied to human toenail clippings

Zinc is an essential trace element in humans. Zinc deficiency can result in a range of serious medical conditions which include effects on growth and development, the immune system, the central nervous system, and the gastrointestinal system. Diagnosis of zinc deficiency is often precluded by the lack of a noninvasive and reliable biomarker. Zinc concentration in nail is considered an emerging biomarker of zinc status in humans. Whether zinc in nail accurately reflects zinc status is beyond the scope of the current study, but is an important research question. The development of a portable method to quickly assess zinc concentration from a single nail clipping could be a useful advance. In this study, single toenail clippings from 60 individuals living in Atlantic Canada were measured for zinc using a portable X-ray fluorescence (XRF) technique. These samples were obtained from the Atlantic PATH cohort, part of the largest chronic disease study ever performed in Canada. Each toenail clipping was measured using three 300 s trials with a mono-energetic portable XRF system. Results were then assessed using two different approaches to the XRF analysis: (1) factory-calibrated zinc concentrations were output from each trial, and (2) energy spectra were analyzed for the characteristic X-rays resulting from zinc. Following the measurement of zinc using the non-destructive portable XRF method, the same clippings were measured for zinc concentration using the "gold standard" technique of inductively coupled plasma-mass spectrometry (ICP-MS). A linear equation of best fit was determined for the relationship between average XRF output zinc concentration and ICP-MS zinc concentration, with a correlation coefficient r = 0.60. Similarly, a linear equation of best fit was found for the relationship between a normalized XRF energy spectrum zinc signal and ICP-MS zinc concentration, with a correlation coefficient r = 0.68. Individual ICP-MS zinc concentrations ranged from 32 μg/g to 140 μg/g, with a population average of 85 μg/g. The results of this study indicate that portable XRF is a sensitive method for the measurement of zinc in a single nail clipping, and provides a reasonable estimation of zinc concentration. Further method development is required before portable XRF be considered a routine alternative to ICP-MS for the assessment of zinc in nail clippings.

A comparison of blood and toenails as biomarkers of children's exposure to lead and their correlation with cognitive function

This study sought to compare lead (Pb) concentrations in toenails and blood and to investigate the association of each biomarker with children's cognitive function. Toenails and whole blood samples were collected from 224 twelve-year-old children, and their full-scale intelligence quotient (FSIQ) was assessed using the Wechsler Intelligence Scale for Children-4th edition. Inductively coupled plasma-mass spectrometry was used to determine blood (BPb) and toenail (TPb) Pb concentrations. Log BPb and Log TPb were significantly correlated (r² = 0.49, p < 0.001). In unadjusted analyses, both log-transformed BPb and TPb were significantly associated with decreased FSIQ, but BPb accounted for approximately quadruple the FSIQ scores' variability than log-transformed TPb (model R² = 0.12 and R² = 0.03, respectively). After adjusting for neighborhood deprivation, caregiver intelligence (assessed with the Wechsler Abbreviated Scale of Intelligence-2nd edition), and child BMI, BPb remained significantly associated with decreased FSIQ, while TPb did not (p = 0.16). These results suggest that while concentrations of Pb in blood and toenails are correlated, TPb does not predict cognitive outcomes at these exposure levels. With caution and in conjunction with BPb, TPb may be used as a population-based biomarker of Pb exposure.

ATSDR evaluation of the health effects of zinc and relevance to public health

As part of its mandate, the Agency for Toxic Substances and Disease Registry (ATSDR) prepares toxicological profiles on hazardous chemicals found at Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) National Priorities List (NPL) sites, which have the greatest public health impact. These profiles comprehensively summarise toxicological and environmental information. This article constitutes the release of portions of the Toxicological Profile for Zinc. The primary purpose of this article is to provide public health officials, physicians, toxicologists, and other interested individuals and groups with an overall perspective on the toxicology of zinc. It contains descriptions and evaluations of toxicological studies and epidemiological investigations, and provides conclusions, where possible, on the relevance of toxicity and toxicokinetic data to public health. Toxicology and Industrial Health 2006; 22: 423-493.

Human nail usage as a Bio-indicator in contamination monitoring of heavy metals in Dizajabaad, Zanjan province-Iran

BACKGROUND

Due to pedogeochemical background and anthropogenic sources, heavy metal contamination of soil is a widespread problem in some parts of Zanjan province located in North West Iran. In this study an affected area located near National Iranian Lead and Zinc Company (NILZ) was selected for detailed study.

METHODOLOGY

Thirty soil samples and eighteen leaf samples were collected and analyzed for heavy metal contamination by Inductively Coupled Plasma-Optical Emission Spectroscopy (ICP-OES). Both soil and plant samples were found to be basically polluted by Pb (72.60 and 97.11), Zn (546.47 and 166.61), and Cd (1.80 and 1.55) mg. kg(-1) respectively. High concentrations of these elements in soil and plant species signifies possible health risks to humans. The distribution maps drawn using Arc GIS (10) show high concentrations of these toxic metals around Dizajabaad village. To assess vulnerability and health risks of metal concentrations in human bodies' twenty nine fingernail samples were also collected from people living in this village.

RESULTS AND DISCUSSION

Analysis for different heavy metal contents of nail samples reveals very high levels of the same toxic elements (Pb = 15.15, Cd = 1.18, As = 15.47, Zn = 68.46 and Ni = 18.22 mg. kg(-1)) compared with samples collected from an unaffected area and available values indicated in the literature. Further, high concentration of heavy metals in the nail samples suggests long term exposure of inhabitants to these toxic metals.

Monitoring exposure to heavy metals among children in Lake Victoria, Kenya: environmental and fish matrix

This study used hair and nails to biomonitor heavy metals (Pb, Cd, Cr and Cu) from geological source and exposure through regular fish consumption among children in Lake Victoria, Kenya. Concentration of Pb and Cu in water reflected anthropogenic pathways, while Cd and Cr reflected accumulation from the catchment basin. Higher concentration of heavy metals in the nails samples than the hair samples suggested longer term exposure. The estimated intake of Cd and Cr from fish in one site associated with high concentration of the metals from geological source was appreciably above the respective recommended daily allowance, signifying possible health risks to humans. Significant correlations between Pb, Cd and Cu in hair, nails and heavy metals from fish consumed suggested fish consumption as possible pathway of heavy metals in humans. Possible health risks from heavy metals were likely due to consumption of higher quantities of fish and from geological basins.

Evaluation of environmental and occupational exposure to mercury among Iranian dentists

The purpose of the study was to evaluate the environmental and occupational exposure to mercury (Hg), and to examine the various parameters, which contribute to high levels of mercury of Iranian dentists in Tehran. One-hundred hair and nail samples were collected from dentists. In addition, fifty samples from a control group and twenty-five additional samples from dental nurses were taken for comparison. The survey included a structured questionnaire designed to provide information about the parameters that influenced their occupational and environmental exposure to Hg. Overall mean concentrations in the hair and nails of the dentists was 2.84+/-0.47 and 3.56+/-0.53 mg/kg dry wt respectively. The equivalent values were 0.61+/-0.07 mg/kg in hair and 0.39+/-0.06 mg/kg in nails for the control group. In addition, mean concentrations in the dental nurses were 0.92+/-0.23 and 1.77+/-0.51 mg/kg in hair and nails respectively. The study showed that use of masks had a significant effect on Hg levels (p=0.02 for hair and p=0.03 for nails) and use of gloves only had significant effect on nails Hg (p=0.05). Hg concentrations in nails were significantly lower among the dentists who always used gloves and masks. Also, fish consumption and number of patients visited per day had a significant effect on hair (p=0.02 and p=0.02 respectively) and nails (p=0.03 and p=0.02 respectively) Hg. On the other hand, there was a significant effect of age in relation to Hg concentration in the hair and nails of the dentists (p=0.006 for hair and p=0.01 for nails). Multiple regressions were computed between hair Hg and the various assessed variables. The only positive results were between Hg concentration and masks for the dentists (p=0.03), and Hg concentration and the number of fish meals for the control group (p=0.009).

Case-control study of toenail cadmium and prostate cancer risk in Italy

A role of cadmium exposure in prostate cancer etiology has been suggested by epidemiologic and laboratory studies, but conclusive evidence on this topic is still lacking. We investigated the relation between cadmium exposure, estimated by determining toenails cadmium levels, and prostate cancer risk in forty patients newly diagnosed with prostate cancer and fifty-eight hospital controls recruited in two provinces from southern and northern Italy. We found an excess cancer risk in subjects in the third and fourth (highest) quartiles of toenail cadmium concentration (odds ratio 1.3 and 4.7, respectively) compared with subjects in the bottom quartile. Results were basically unchanged when limiting the analysis to each province or entering toenail cadmium concentrations as continuous values in the regression model (P=0.004). Despite the limited statistical stability of the point estimates, these findings appear to support the hypothesis that cadmium exposure increases prostate cancer risk.

Fingernails as biological indices of metal exposure

Metal determination in human tissues is the most common application of biological monitoring for screening, diagnosis and assessment of metal exposures and their risks. Various biopsy-materials may be used. This paper deals with the quantitative determination of Cd, Pb, Cr, Mn, Fe, Ni, Cu, and Zn concentrations in nails of male subjects exposed to these metals along with their respective controls, while working in locomotive, carriage and road ways workshops, and lead battery factories. The levels of Cd, Pb, Cr, Mn, Fe, Ni, Cu and Zn in fingernails, assayed by atomic absorption spectrophotometry, were compared with their respective controls by student 't' test. All the obtained values were correlated to the personal and medical history of the subjects under study. Significantly high levels of Cd, Pb, Cr, Fe, Ni, Cu and Zn were present in smokers, compared to nonsmokers. The concentrations of Cd, Pb, Cr, Mn and Fe were not significantly high in vegetarian subjects. It was also observed that there is no contribution of liquor towards nail-metal concentration. Significant correlations were observed between skin disease and Cr, Mn, Fe, Cu; hypertension and Cd, Mn, Cu; mental stress and Cd, Pb, Mn, Ni, Cu, Zn; diabetes and Cr, Mn, Ni; chest pain and Pb; respiratory trouble and Cr, Mn, Fe, Ni, Zn; tuberculosis and Zn; acidity and Cd; and ophthalmic problems and Mn, Fe, Ni, and Zn.

Arsenic and other elements in hair, nails, and skin-scales of arsenic victims in West Bengal, India

For the first time, biological tissues (hair, nails, and skin-scales) of arsenic victims from an arsenic affected area of West Bengal (WB), India were analyzed for trace elements. Analysis was carried out by inductively coupled plasma-mass spectrometry (ICP-MS) for 10 elements (As, Se, Hg, Zn, Pb, Ni, Cd, Mn, Cu, and Fe). A microwave digester was used for digestion of the tissue samples. To validate the method, certified reference materials--human hair (GBW 07601) and bovine muscle (CRM 8414)--were analyzed for all elements. The W test was used to study the normal/log normal distribution for each element in the tissue samples. For hair (n=44) and nails (n=33), all elements show log-normal distribution. For skin-scale samples (n=11), data are not sufficient to provide the information about the trend. Geometric mean, standard error, and range for each element were presented and compared with literature values for other populations. This study reveals the higher levels of toxic elements As, Mn, Pb, and Ni in the tissue samples compared with available values in the literature. The elevated levels of these toxic metals in the tissues may be due to exposure of these elements through drinking water and food. The correlations of Mn and Ni with other essential elements, e.g. Fe, Cu, Zn, suggest that Mn and Ni may substitute for those elements in hair, nails, and skin-scales. However, correlation represents the relation between two elements only and does not take into consideration of the presence of other elements. Principle component analysis was applied to explain the behavior among the elements present in hair and nails. This study reveals that in the arsenic-affected areas of WB, the concentrations of other toxic elements in drinking water and foodstuff should be monitored to evaluate the arsenic poisoning.

Environmental exposure to trace elements and risk of amyotrophic lateral sclerosis: a population-based case-control study

We analyzed the association between the environmental exposure to trace elements and the risk of sporadic amyotrophic lateral sclerosis (ALS) in a population-based case-control study in the Emilia-Romagna region in northern Italy. We evaluated exposure to selected trace elements by measuring toenail concentrations of the same by means of inductively coupled plasma optical spectrometry and instrumental neutron activation analysis. The final number enrolled in the study was 22 patients and 40 controls. Disease progression, assessed through a clinical score, was generally unassociated with toenail trace element levels, with the exception of an inverse relation with zinc and selenium content and a direct correlation with copper concentration. In logistic regression analysis, we found no evidence of an association between ALS risk and toenail content of cadmium, lead, copper, zinc, manganese, selenium, chromium, cobalt, iron, and aluminum. This investigation does not suggest a major role in sporadic ALS etiology of environmental exposure to these trace elements, though results for zinc, selenium, and copper should be evaluated with caution due to the potential limitations of toenails as biomarkers of chronic exposure in patients.

Relationship of lead and cadmium to essential elements in hair, teeth, and nails of environmentally exposed people

The aim of this investigation was to evaluate the environmental exposure to Pb and Cd during 1990-1997 of inhabitants of Katowice District, which is an area of high environmental exposure to lead and cadmium, as well as exposure to Fe, Zn, Cu, Mn, Ni, Cr, Ca, Na, and K, on the basis of concentrations in hair, teeth, and nails. This investigation was to explain if accumulation of Pb and Cd can affect the concentration of such essential metals as Fe, Zn, Cu, and Ca. Inhabitants of the Beskid area constituted a control group. Analysis of the aforementioned elements was carried out on 624 hair samples, 785-tooth- samples, and 338 nail samples taking into consideration sex, age (<15, 16-30, >30 years), and type of teeth (incisor, canine, molar, premolar). Concentrations of elements in the media investigated were determined using atomic absorption spectroscopy. The results were calculated using the Statistica program. The major statistical analysis focuses on determining analysis of variance by MANOVA/ANOVA, Rao R (P<0.05), Spjotvolla-Stoline'a test, and cluster analysis (1-Pearson r). The investigation revealed that among the media investigated, Pb concentration in hair is an environmental marker of exposure to this metal in the human organism and depends on sex and age. It was also observed that an increase in Pb concentration in hair causes a decrease in Fe and Ca concentrations and changes the ratios of essential metals: Fe/Cu, Fe/Zn, and Ca/Zn. It is concluded that not only in blood but also in the hair, lead significantly influences Ca and Fe. Analysis of nail samples of people living in Katowice District indicated that an increasing concentration of Pb decreases concentrations of copper and zinc. Increased accumulation of such metals as Ni, Cr, and Mn in teeth was observed for samples taken from inhabitants of Katowice District.

Application of double focusing sector field ICP-MS for multielemental characterization of human hair and nails. Part I. Analytical methodology

The capabilities of double focusing sector field inductively coupled plasma mass spectrometry (ICP-SMS) for the determination of 71 elements in hair and nails were studied. A microwave-assisted digestion procedure with nitric acid and hydrogen peroxide as well as direct sampling of the nails by laser ablation (LA) have been tested. Examples of spectral interferences are given and different correction procedures are discussed. Method detection limits below ng g(-1) were obtained for 39 elements investigated by using high-purity reagents and by taking special care to prevent contamination during preparation. However, these detection limits were insufficient for detection of some platinum group elements in the majority of the samples. The accuracy of the analytical procedure was estimated by analysis of the GBW07601 certified reference material as well as by participation in an interlaboratory comparison program. The reproducibility was assessed from replicate analysis (including sample preparation) and was found to be, as average values for all elements, 9-10% R.S.D. and 18-19% R.S.D. for hair and nails, respectively. Contribution from exogenous deposition was evaluated by analyzing samples before and after washing, as well as by studying spatial element distribution along hair and nails. It was found that even after sample washing, many elements are enriched in the surface of the nail.

Occurrence of heavy metals, sodium, calcium, and potassium in human hair, teeth, and nails

Heavy metals in biological samples: nails, teeth, and hair were examined during 1991-1993. Investigations of biological samples (hair n = 249 samples, teeth n = 145, nails n = 80 samples) were provided for inhabitants of selected towns in Beskid Slaski. The towns are small mountain towns in southern Poland: Wista, Szczyrk, Istebna, Koniakow, and Jaworzynka. The analysis of ANOVA and MANOVA variances were used for biological samples in the context of age, sex, and type of samples for 12 elements (Pb, Cd, Cr, Zn, Fe, Cu, Mn, Ni, Co, Ca, Na, and K). The matrix correlation and cluster analysis were applied to explain the behavior of metals in human hair, teeth, and nails.

Lead in drinking water from water coolers and in fingernails from subjects in Kuwait City, Kuwait

In response to concerns raised by the Kuwait Ministry of Public Health (KMPH) about the high lead levels in some commercial water coolers, samples of drinking water and fingernails were collected from 129 healthy donors (77 males and 52 females) during the period December 1994-February 1995. The mean nail lead levels for females and males were 5.50 +/- 7.76 and 5.08 +/- 14.65 microg/g, respectively, and the difference between these means was not significant (P = 0.025). A positive correlation was found between lead levels in drinking water and lead in fingernails from both males and females. However, the effect of water lead levels on lead levels in fingernails of females was more significant (P = 0.002) than that on levels in fingernails of males (P = 0.21). Contrasted with all other coolers, water from one brand of coolers, Al-Hassawi, appears to contribute significantly to lead exposures among households with lead levels ranging between 15.89 and 70.30 microg/l and mean of 32.09 +/- 13.23 microg/l.