Urinary Concentrations of Metals and Metalloids in Malaysian Adults

Effects of prenatal exposure to multiple heavy metals on infant neurodevelopment: A multi-statistical approach

Prenatal exposure to heavy metals poses risks to fetal brain development, yet the joint effects of these metals remain unclear, with inconsistent findings across statistical models. This study investigates the joint effect of prenatal exposure to cadmium (Cd), nickel (Ni), mercury (Hg), and lead (Pb) on infant neurodevelopment using various statistical approaches. The study included 400 mother-infant pairs. Heavy metal levels were measured in maternal urine samples at the 12th week of gestation, and infant neurodevelopment at 40 days was evaluated by the Bayley Scales of Infant and Toddler Development. Generalized Additive Models (GAM), Multivariable Linear Regression (MLR) with restricted cubic spline (RCS), Bayesian Kernel Machine Regression (BKMR), and Weighted Quantile Sum (WQS) regression were applied to explore the associations between heavy metal exposure and neurodevelopmental outcomes. GAM revealed a significant linear relationship for Cd with cognitive scale (p = 0.045) and expressive language (p = 0.043). MLR confirmed that Cd was negatively associated with both cognitive scale (β = -1.47, p = 0.044) and expressive language (β = -0.32, p = 0.019) and RCS presented a non-linear association between Pb and language scale (p = 0.001). BKMR suggested a negative but non-significant association with most outcomes. WQS indicated a significant adverse effect of metal mixture on expressive language (β = -0.26, 95% CI = -0.44, -0.07), identifying Cd and Ni as the primary contributors. Prenatal exposure to heavy metals have detrimental effects on infant neurodevelopment, especially on language development.

Human exposure to chromite mining pollution, the toxicity mechanism and health impact

Significant amounts of toxic metal-containing mining waste are produced by chromium mining activities, along with the production of air pollutants. The presence of toxic metals in various environmental media including air, water, and soil, along with their chemical species such as hexavalent chromium, pose major health hazards for both directly exposed mining workers and the population residing near the mining areas. Highlighting the requirements for enhanced environmental protection and safety measures, this comprehensive review shed light on the global environmental pollution stemming from chromite mining activities. Based on the published literature, the study also investigated into the pollution caused by toxic metals and explored their probable health effects on exposed individuals. The exposure routes and the mechanisms of toxic metal induced carcinogenicity in the exposed groups were assessed. Additionally, the generated reactive species in exposed individuals and the toxicity mechanisms of hexavalent chromium were discussed. Considering these findings, this review proposed the necessity of cross-sectional biomonitoring studies involving occupationally exposed workers from chromite mining operations. The anticipated impact of this review is to influence the global and national chromite mining industry, instigating improvements in occupational settings, real-time pollution monitoring, and healthcare provisions for exposed workers.

Impact of COVID-19 on temporal trends and health risks of urinary metal concentrations among residents of Guangzhou, China

Long-term biomonitoring of urinary metal ions is an essential tool for the epidemiological assessment of chronic exposure levels, enabling us to track changes in metal exposure over time and better understand its health implications. In this study, we evaluated the temporal trends of urinary metal ions among 1962 residents of Guangzhou, China, from 2018 to 2022. The total metal ion concentrations in the urine of the population did not change significantly between 2018 and 2019. With the onset of the COVID-19 pandemic in 2020, urinary total metal ion concentrations began to decline dramatically, reaching their lowest level in 2021. A rebound in concentrations was observed in 2022, which returned to the initial levels observed in 2018. Urine chromium and cadmium concentrations peaked in 2020, while urinary lead levels were the highest in 2021, and urinary nickel concentrations were the highest in 2022. Males consistently displayed higher urinary concentrations of lead and arsenic throughout each year of the study. Furthermore, minors consistently had higher urinary nickel levels than adults, whereas adults consistently had higher urinary cadmium concentrations than minors. Cluster analyses were conducted annually on urinary metal ions to examine the differences in their distribution and to evaluate changes in metal exposure patterns over time. The Monte Carlo simulations indicate that the whole population exhibits a high non-carcinogenic risk from arsenic exposure and significant carcinogenic risks associated with exposure to nickel, arsenic, chromium, and cadmium. The next two years were predicted by a gray prediction model, and the results are tested using mean absolute percentage error which demonstrating high accuracy.

Predictors of urinary heavy metal concentrations among pregnant women in Jinan, China

BACKGROUND

Toxic heavy metal exposure and insufficiency or excess of essential heavy metals may have negative effects on pregnant women's health and fetal growth. To date, the predictors of pregnant women's heavy metal exposure levels remain unclear and vary with different regions. The study intended to explore potential predictors of exposure to heavy metals individually and high co-exposure to heavy metal mixtures.

METHODS

We recruited 298 pregnant women in first trimester from prenatal clinics in Jinan, Shandong Province, China, and collected spot urine samples and questionnaire data on their demographic characteristics, lifestyle habits, consumption of food and dietary supplement, and residential environment. All urine samples were analyzed for seven heavy metals: cobalt (Co), molybdenum (Mo), strontium (Sr), arsenic (As), cadmium (Cd), lead (Pb) and mercury (Hg).

RESULTS

Factors associated with single heavy metal concentration were as follows: a) urinary As, Sr and Cd increased with women's age respectively; b) pregnant women with higher monthly household income per capita had lower Sr and Mo levels; c) pregnant women with intermittent folic acid supplementation and those not taking tap water as domestic drinking water had lower Sr concentrations; d) Cd was positively linked with consumption frequency of rice; e) Hg was adversely related to consumption frequency of egg and the women who took purified water as domestic drinking water had lower Hg exposure. In addition, pregnant women's age was positively associated with odds of high co-exposure to Co, As, Sr, Mo, Cd and Pb; while those with an educational level of college had lower odds of high exposure to such a metal mixture compared with those whose educational levels were lower than high school.

CONCLUSION

Predictors of single urinary heavy metal concentration included pregnant women's age (As, Sr and Cd), monthly household income per capita (Sr and Mo), folic acid supplementation (Sr), rice consumption frequency (Cd), egg consumption frequency (Hg) and the type of domestic drinking water (Sr and Hg). Pregnant women with older age, lower educational level tended to have high co-exposure to Co, As, Sr, Mo, Cd and Pb.

Distribution of urinary trace element exposure and dietary sources in women over 50 in an agricultural region- A community-based KoGES cohort study

BACKGROUND

There is a noticeable lack of information on the levels of both non-essential and essential trace elements in women aged over 50. The main objective of this study is to investigate trace element concentrations and explore the influence of sociodemographic factors and dietary sources of exposure in this demographic.

METHODS

We analyzed 19 trace elements, including manganese, cobalt, copper, zinc, molybdenum, chromium, nickel, arsenic, strontium, cadmium, tin, antimony, cesium, barium, tungsten, mercury, thallium, lead, and uranium, using ICP-MS and mercury analyzer. Urine samples were obtained from a cohort of 851 women aged over 50 who participated in the 8th KoGES-Ansung study (2017-2018). Multiple linear models were employed to explore associations between urinary trace element concentrations and sociodemographic factors and dietary sources of exposure. We used K-means clustering to discern patterns of exposure to trace elements and identify contributing factors and sources.

RESULTS

Our findings indicate higher concentrations of molybdenum (Mo), arsenic (As), cadmium (Cd), and lead (Pb) in our study population compared to women in previous studies. The study population were clustered into two distinct groups, characterized by lower or higher urinary concentrations. Significant correlations between age and urinary concentrations were observed in Ni. Smoking exhibited positive associations with urinary Cd and As. Associations with dietary sources of trace elements were more distinct in women in the high-exposure group. Urinary antimony (Sb) was positively linked to mushroom and egg intake, As to mushroom and fish, and Hg to egg, dairy products, fish, seaweed, and shellfish.

CONCLUSIONS

Our study underscores the significant gap in understanding urinary concentrations of trace elements in women aged over 50. With higher concentrations of certain elements compared to previous studies and significant correlations between age, smoking, and specific food sources, it is imperative to address this gap through targeted dietary source-specific risk management.

Relationship of individual and mixed urinary metals exposure with liver function in the China National Human Biomonitoring (CNHBM) of Zhejiang Province

BACKGROUND

Heavy metals have been reported to affect liver function. However, there is currently little and inconsistent knowledge about the effects of combined and individual urinary metals on specific parameters of liver function in the general population. Therefore, this study aimed to investigate their associations.

METHODS

This study involved 807 general population from the China National Human Biomonitoring of Zhejiang Province 2017-2018. Concentrations of urinary metals, including Chromium (Cr), Cobalt (Co), Nickle (Ni), Arsenic (As), Selenium (Se), Molybdenum (Mo), Cadmium (Cd), Thallium (Tl) and Lead (Pb) were measured. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), total protein (TP), albumin (ALB), direct bilirubin (DBIL), total bilirubin (TBIL) as liver function biomarkers. Multivariable linear regression and weighted quantile sum (WQS) regression were employed to explore the associations of urinary metals with liver function biomarkers. Subgroup analysis stratified by gender and age, excluding smokers and drinkers for sensitivity analysis.

RESULTS

Both statistical models indicated that urinary metals were positively associated with ALT and AST, while negatively with TP, ALB, DBIL and TBIL. In the WQS analysis, each quartile increase in the ln-transformed levels of metal mixtures was associated with 4.11 IU/L (95% CI: 1.07, 7.15) higher ALT and 3.00 IU/L (95% CI: 1.75, 4.25) higher AST, as well as, with 0.67 g/L (95% CI: 1.24, -0.11) lower TP, 0.74 g/L (95% CI: 1.09, -0.39) lower ALB, 0.38 μmol/L (95% CI: 0.67, -0.09) lower DBIL, and 1.56 μmol/L (95% CI: 2.22, -0.90) lower TBIL. The association between urinary metals and ALT was primarily driven by Cd (55.8%), Cr contributed the most to the association with AST (20.2%) and TBIL (45.2%), while the association with TP was primarily driven by Ni (38.2%), the association with ALB was primarily driven by As (32.8%), and the association with DBIL was primarily driven by Pb (30.9%). The associations between urinary metals and liver function might differ by sex and age.

CONCLUSION

Urinary metals were significantly associated with liver function parameters. Further studies are required to clarify the relationship between heavy metals and liver function.

Urinary concentrations of heavy metals in pregnant women living near a petrochemical area according to the industrial activity

BACKGROUND

The progressive industrialization has resulted in an increase in heavy metal pollution in the environment, which has a dangerous impact on human health. Prenatal exposure to heavy metals, even at very low concentrations, may be especially harmful to pregnant women and their children. Different industrial activities can contribute to heavy metal pollution in a specific area.

OBJECTIVE

1) To explore the concentrations of heavy metals in urine samples of pregnant women, and 2) to evaluate the potential effect of different industrial activities in Tarragona (Spain).

METHODS

Urinary levels of four heavy metals (nickel (Ni), cadmium (Cd), mercury (Hg), and lead (Pb)) from 368 pregnant women recruited in the ECLIPSES study were analyzed. Home addresses and all the industries potentially releasing heavy metals were geo-referenced. Buffer zones were established within a 1.5, 3, and 5 km radius at the center of each industry. Subsequently, the number of participants living in and out of each buffer zone was recorded.

RESULTS

Urinary levels of Ni and Cd, but not those of Hg and Pb, were obviously increased in pregnant women living near most of the industrial sites. After adjustment for potential co-variates, only Cd showed notable differences according to the industrial activity. Compared to women living outside the buffer, Cd levels were increased in those living within 1.5 and 3 km of chemical industries, within 5 km of energy industries, within 1.5, 3, and 5 km of mineral industries, and within 3 and 5 km of metal processing industries.

CONCLUSION

Among the analyzed heavy metals, Cd showed an increasing trend in urinary concentrations in women living near chemical, energy, mineral, and metal processing industries. This study highlights the need to develop legislative measures to minimize Cd exposure, especially by sensitive populations. Moreover, additive or synergistic effects of co-exposure to other air pollutants should not be disregarded.

Risk assessment of combined exposure to lead, cadmium, and total mercury among the elderly in Shanghai, China

Lead (Pb), cadmium (Cd) and total mercury (THg) are toxic heavy metals (THMs) that are widely present in the environment and can cause substantial health problems. However, previous risk assessment studies have rarely focused on the elderly population and have usually targeted a single heavy metal, which might underestimate the long-term accumulative and synergistic effects of THMs in humans. Based on the food frequency questionnaire and inductively coupled plasma mass spectrometry, this study assessed external and internal exposures to Pb, Cd and THg in 1747 elderly people in Shanghai. Probabilistic risk assessment with the relative potential factor (RPF) model was used to assess the neurotoxicity and nephrotoxicity risks of combined THMs exposures. The mean external exposures of Pb, Cd and THg in Shanghai elderly were 46.8, 27.2 and 4.9 μg/day, respectively. Plant-based foods are the main source of Pb and THg exposure, while Cd is mainly from animal-based foods. The mean concentrations of Pb, Cd and THg were 23.3, 1.1 and 2.3 μg/L in the whole blood, and 6.2, 1.0 and 2.0 μg/L in the morning urine, respectively. Combined exposure to THMs leading to 10.0 % and 7.1 % of Shanghai elderly at risk of neurotoxicity and nephrotoxicity. The results of this study have important implications for understanding the profiles of Pb, Cd and THg exposure in the elderly living in Shanghai and provide data support for risk assessment and control of nephrotoxicity and neurotoxicity from combined THMs exposure in the elderly.

Correlative study on heavy metal-induced oxidative stress and hypertension among the rural population of Malwa Region of Punjab, India

Heavy metal-induced toxicity contributes to the progression of various metabolic disorders and possible mechanisms involved in disease progression are not well established. In this study, the correlation of  heavy metal exposure and  hypertension have been demonstrated. The results showed that in hypertensive subjects, the lipid profiles (triglycerides, LDL-C, HDL-C, and total cholesterol) and cardiac markers (CK-MB and LDH) were altered abruptly. As a consequence of heavy- induced oxidative stress, the oxidants (TBARS and protein carbonyls) and antioxidants (SOD, GSH, and TAC) were significantly increased and decreased, respectively in hypertension subjects. The concentrations of heavy metals (Pb, Cd, and As) exceeded the permissible limits in hypertensive subjects. The Nrf-2 genotyping indicated that heavy metals may induce mutations at molecular level. The results of correlation analysis revealed that the heavy metals interact with cellular components and interfere with metabolic processes which then results in disturbed lipid profile, enhanced oxidative stress, and reduced antioxidant status. The current study systematically estimated the association of hair and nail heavy metal concentrations with hypertension among the population residing in the Malwa region of Punjab. The proposed study highlighted that heavy metals act as a silent risk factor in the hypertension progression in the population of Malwa region. Future studies are required to confirm current findings and further scrutinize the effect of heavy metals exposure in early adulthood, early, and late mid-life to develop metabolic complications such as hypertension.

Association of Metals and Metalloids With Urinary Albumin/Creatinine Ratio: Evidence From a Cross-Sectional Study Among Elderly in Beijing

Background

Environmental exposure to toxic elements contributes to the pathogenesis of chronic kidney disease (CKD). Few studies focus on the association of urinary metals and metalloids concentrations with the urinary albumin/creatinine ratio (UACR) among elderly, especially in areas and seasons with severe air pollution.

Objective

We aimed to evaluate the associations of urinary metals and metalloids concentration with UACR, which is an early and sensitive indicator of CKD.

Method

We conducted a cross-sectional study among 275 elderly people in Beijing from November to December 2016, which has experienced the most severe air pollution in China. We measured 15 urinary metals and metalloids concentration and estimated their association with UACR using a generalized linear model (GLM). Bayesian kernel machine regression (BKMR) and quantile g-computation (qgcomp) models were also conducted to evaluate the combined effect of metal and metalloid mixtures concentration.

Results

Of the 275 elderly people included in the analysis, we found that higher urinary Cu concentration was positively associated with UACR using GLM (β = 0.36, 95% CI: 0.25, 0.46). Using the BKMR model, we found that the change in UACR was positively associated with a change in urinary Cu concentration from its 25th to 75th percentile value with all other metals and metalloids concentration fixed at their 25th, 50th, or 75th percentile levels. Urinary Cu concentration had the most significant positive contribution (59.15%) in the qgcomp model. Our finding was largely robust in three mixture modeling approaches: GLM, qgcomp, and BKMR.

Conclusion

This finding suggests that urinary Cu concentration was strongly positively associated with UACR. Further analyses in cohort studies are required to corroborate this finding.

GIS based interpolation method to urinary metal concentrations in Malaysia

Recently, there has been an increasing ecological and global public health concern associated with environmental contamination by arsenic (As), cadmium (Cd), nickel (Ni) and lead (Pb). This study aims to visualize distribution of these heavy metals concentration in urine of 817 Malaysian adults in Malaysia. This cross-sectional study compiled urine samples from October 2017 to March 2018. Spatial inverse distance weighted (IDW) interpolation method was used to derive a map which illustrate the distribution of these metals from urine samples. Moran's I Index was used to assess the spatial autocorrelation of these metals between the study area. The mean concentration for Ni and Cd was highest in Perak while for As and Pb, they were predominantly in East Coast region (Terengganu and Kelantan). Moran's I index showed significant spatial autocorrelation exist in the study area for all metals except for Pb (p-value<0.05). According to IDW, people in North East and Western regions had the highest concentrations for As and Cd. Individuals in Central region were less exposed than those in North region. These techniques can assist health authorities a better prediction in assessing exposure to heavy metals in population of an area to prioritize their control and preventive measure.

Association between urine metals and liver function biomarkers in Northeast China: A cross-sectional study

BACKGROUND

After heavy metals enter the body, they affect a variety of organs, particularly the main metabolic organ, the liver. Moreover, people are more likely to be exposed to multiple metals than to a single metal. We explored the associations between exposure to a heavy metal mixture and liver function biomarkers.

METHODS

This study involved 1171 residents living in areas with or without heavy metal exposure in northeast China. Urine concentrations of chromium (Cr), cadmium (Cd), lead (Pb), and manganese (Mn) were measured. Total protein (TP), albumin (ALB), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were used as biomarkers of liver function. A generalized linear model (GLM), quantile g-computation, and Bayesian kernel machine regression (BKMR) were used to explore the associations between the four metals and liver function.

RESULTS

GLM analysis revealed that Cr level was negatively associated with TP (β = - 0.57; 95% CI: - 0.89, - 0.26) and ALB (β = - 0.27; 95% CI: - 0.47, - 0.07) levels, and Cd level was positively associated with AST (β = 1.04; 95% CI: 0.43, 1.65) and ALT (β = 0.94; 95% CI: 0.08, 1.79) levels. ALB (β = 0.26; 95% CI: 0.10, 0.41) and ALT (β = 0.52; 95% CI: 0.02, 1.02) levels were positively associated with urine Mn concentration. The quantile g-computation indicated that exposure to a mixture of the four metals was significantly associated with TP (β = - 0.56; 95% CI: - 0.94, - 0.18) and ALT (β = 0.84; 95% CI: 0.04, 1.63) levels. Among the metals, Cr had the strongest effect on TP and Cd had that on AST. The BKMR model indicated that mixed metal exposure was negatively associated with TP and ALB levels and positively associated with ALT and AST levels.

CONCLUSION

Exposure to mixtures of heavy metals may influence liver function. Cr and Cd may be the largest contributors.