Exposure to lead and other toxic metals from informal foundries producing cookware from scrap metal

Associations of Blood and Urinary Heavy Metals with Stress Urinary Incontinence Risk Among Adults in NHANES, 2003-2018

People come into contact with heavy metals in various ways in their daily lives. Accumulating evidence shows that toxic metal exposure is hazardous to human health. However, limited information is available regarding the impact of metal mixtures on stress urinary incontinence (SUI). Therefore, we used data from 10,622 adults from the 2003-2018 National Health and Nutrition Examination Survey (NHANES) to investigate the independent and comprehensive association between heavy metal co-exposure and SUI. Among them, 2455 (23.1%) had been diagnosed with SUI, while the rest had no SUI. We evaluated the independent and combined associations of 3 blood metals and 10 urinary metals with SUI risk, along with subgroup analyses according to age and gender. In the single-exposure model, blood cadmium (Cd), lead (Pb), mercury (Hg), urinary Cd, Pb, and cesium (Cs) were found to be positively connected with SUI risk. Moreover, weighted quantile sum (WQS) regression, quantile-based g-computation (qgcomp), and Bayesian kernel machine regression (BKMR) consistently demonstrated blood and urinary metal-mixed exposure were positively associated with the risk of SUI, and emphasized that blood Pb and Cd and urinary Cd and Cs were the main positive drivers, respectively. This association was more pronounced in the young and middle-aged group (20-59 years old) and the female group. Nevertheless, further research is necessary to validate these significant findings.

The influence of contemporary and emerging factors on blood lead concentrations among young males in conflict with the law: a case study from a middle-income country

Introduction

Scientific evidence shows that contemporary and emerging factors contribute to high blood lead concentrations in different populations. The study aimed to determine blood lead concentrations and risk factors associated with high blood lead concentrations among young males in conflict with the law.

Methods

A cross-sectional analytical study was conducted among 192 conveniently selected participants from two youth secure (correctional) facilities in Gauteng Province, South Africa.

Results

The study's overall blood lead concentration median was 3.30 μg/dl, ranging from 0.85 to 48.11 μg/dl. Young males born outside of South Africa (median = 8.78 μg/dl) and in villages (median = 4.95 μg/dl), working before coming to the facility (median = 5.23 μg/dl) and involvement in illegal mining (median = 9.00 μg/dl) had high blood lead concentrations in this study. Contemporary and emerging risk factors such as being born outside the country (AOR: 3.10, 95%CI: 1.01-1.88), involvement in illegal mining activities (AOR: 1.36, 95%CI: 1.14-1.91) and staying in a house with peeling paint on the outside (AOR: 2.26, 95%CI: 1.12-4.30) were found to influence blood lead concentration.

Discussion

The study findings show that contemporary (co-existing) and emerging factors influence blood lead concentrations. Therefore, there is a need to investigate these factors further in communities that may be affected. Lastly, there is a need for a holistic approach involving multiple sectors to introduce human lead concentration screening and preventive programmes.

Low levels of potentially toxic elements in workers are associated with self-reported health outcomes

Occupational exposure to toxic elements can adversely affect health. The current study evaluated blood concentrations of potentially toxic elements (PTE) including As, Cd, Cr, Cu, Hg, Mn, Ni, Pb, Sb, Sn, and Zn in formal and informal workers. Additionally, the study investigated the associations between blood PTE concentrations and reported health outcomes in the study population. The exposed group included women engaged in informal jewelry welding within their homes in Limeira, São Paulo state, Brazil (n = 36) and men who worked at a steel company in Volta Redonda, Rio de Janeiro state, Brazil (n = 22). The control group comprised residents of the same neighborhoods as the workers but without occupational exposure to chemicals (n = 28 in Limeira; n = 27 in Volta Redonda). Triple Quadrupole Inductively Coupled Plasma Mass Spectrometry (TQ ICP-MS) was used to determine PTE concentrations in blood samples. Glycemia, insulin, and lipid profile tests were performed. All participants completed questionnaires on household risk and reported morbidity. The blood concentrations of Cd, As, and Pb, as well as glycemia, were higher in informal workers than in control subjects. No significant differences were observed between formal workers and control subjects. A robust Poisson regression model, adjusted for variables suggested by a Directed Acyclic Graph, disclosed associations of blood lead and arsenic concentrations with the prevalence of neurological manifestations in Limeira. Blood lead levels > 2.6 μg dL-1 were associated with 2.3 times the prevalence of self-reported neurological manifestations (95 % CI: 1.17-4.58; p = 0.02) than lower blood lead concentrations. Furthermore, a positive association between blood cadmium concentrations and glycemia was observed. Informal occupational exposure to these elements may indicate an increased risk of developing diseases. Monitoring exposure and implementing interventions to reduce PTE exposure in the work environment represent significant steps toward prevention.

Cottage industry as a source of high exposure to lead: A biomonitoring study among people involved in manufacturing cookware from scrap metal

In low-income countries, a widespread but poorly studied type of cottage industry consists of melting scrap metal for making cookware. We assessed the exposure to lead (Pb) among artisanal workers, and their families, involved in manufacturing cookware from scrap metal. In a cross-sectional survey, we compared artisanal cookware manufacturing foundries with carpentry workshops (negative controls) and car battery repair workshops (positive controls), all located in residential areas, in Lubumbashi (DR Congo). We collected surface dust in the workspaces, and blood and urine samples among workers, as well as residents living in the cookware workshops. Trace elements were quantified in the samples by Inductively Coupled Plasma Mass Spectrometry (ICP-MS). In surface dust, median Pb concentrations were higher in cookware foundries (347 mg/kg) than in carpentries (234 mg/kg) but lower than in battery repair workshops (22,000 mg/kg). In workers making the cookware (n = 24), geometric mean (GM) Pb blood cencentration was 118 μg/L [interquartile range (IQR) 78.4-204], i.e. nearly twice as high as among carpenters [60.2 μg/L (44.4-84.7), n = 33], and half the concentration of battery repair workers [255 μg/L (197-362), n = 23]. Resident children from the cookware foundries, had higher urinary Pb [6.2 μg/g creatinine (2.3-19.3), n = 6] than adults [2.3 (2.2-2.5), n = 3]. Our investigation confirms the high Pb hazard linked to car battery repair and reveals a high exposure to Pb among artisanal cookware manufacturers and their families, especially children, in residential areas of a city in a low-income country.

Evaluating metal cookware as a source of lead exposure

BACKGROUND

We previously demonstrated that aluminum cookware brought from Afghanistan by resettled families as well as some aluminum cookware available for purchase in the United States represent a previously unrecognized source of lead exposure. However, the extent to which this cookware represents a source of lead exposure to other United States residents is unclear.

OBJECTIVES

To test additional cookware for lead content and its propensity to leach lead and other toxic metals. This will further our understanding of the extent to which this cookware represents a lead poisoning risk in the United States and elsewhere.

METHODS

We screened an additional 28 pieces of aluminum cookware and 5 brass items for lead content using an X-ray fluorescence (XRF) analyzer and used our leachate method to estimate the amount of lead that migrates into food. We also tested 17 additional stainless steel items to determine whether they would be safer alternatives.

RESULTS

Many aluminum cookware products contained in excess of 100 parts per million (ppm) of lead. Many also leached enough lead under simulated cooking and storage conditions to exceed recommended dietary limits. One hindalium appam pan (an Indian frying pan/wok) leached sufficient lead to exceed the childhood limit by 1400-fold. Brass cookpots from India also yielded high lead levels, with one exceeding the childhood limit by over 1200-fold. In contrast, stainless steel cookware leached much lower levels of lead.

IMPACT

Aluminum and brass cookware available for purchase in the United States represents a previously unrecognized source of lead exposure.

Possible Sources of Trace Metals in Obese Females Living in Informal Settlements near Industrial Sites around Gauteng, South Africa

Trace metals have been reported in the literature to be associated with obesity. Exposure to some trace metals such as Mn, Cr, Ni, Cd, and Pb may pose a serious health risk to individuals living around a polluted environment. The present study assessed the levels of trace metals in the blood of obese females living around industrial areas in Gauteng, South Africa. The study was carried out using a mixed method approach. Only females with a BMI ≥ 30.0 were considered. A total of 120 obese females participated in the study (site 1: 40-industrial area, site 2: 40-industrial area, and site 3: 40-residential area), aged 18-45 and not in menopause. Blood samples were analysed for trace metals content using inductively coupled plasma mass spectrometry (ICP-MS). The mean concentrations of trace metals were in the order Pb > Mn > Cr > Co > As > Cd (site 1), Pb > Mn > Co > As > Cd (site 2), and Mn > Cr > Co > As > Pb > Cd (site 3). The blood Mn from site 1 ranged from 6.79 µg/L-33.99 µg/L, and the mean differences obtained from the participants from different sites were significant (p < 0.01). The blood levels of Mn, Pb, Cr, Co, As, and Cd were above the recommended limits set by the WHO in some of the participants. The present study noted, among others, closeness to industrial areas, lifestyle decisions such as the use of tobacco products by their partners indoors, and the method used for cooking as factors that might have accounted for the blood levels of Mn, Pb, Cd and Co. The study showed that there is a need for constant monitoring of the levels of trace metals in the blood of those living in these areas.

A Low-Cost Method Shows Potentially Toxic Element Levels in Dust Correlated with Elevated Blood Levels of These Chemicals in Children Exposed to an Informal Home-Based Production Environment

Dust is recognized as a route of exposure to environmental pollutants. The city of Limeira, Sao Paulo state, Brazil, is a production center for jewelry and fashion jewelry, where part of this jewelry production is home-based, informal, and outsourced. The aim of this study was to evaluate exposure to Potentially Toxic Elements (PTE: Cr, Sn, Mn, Sb, Ni, Cu, Zn, Cd, Pb, and As) in dust among children from households of informal workers using electrostatic dust cloths (EDC). Dust samples were collected in 21 exposed and 23 control families using EDC from surfaces where dust deposits had accumulated for approximately 14 days. In exposed families, dust samples were also collected from welders’ workstations. PTE concentrations were then determined using inductively coupled mass spectrometry (ICP-MS). The results raised concerns in relation to Cr, As, and Cd exposure among children within the informal home-based production environment. Blood PTE concentrations in children showed a moderate correlation with levels of Cr (Rho 0.40), Zn (Rho −0.43), and As (Rho 0.40), and a strong correlation with Cd (Rho 0.80) (p < 0.05), detected in dust. In conclusion, analyzing dust collected using EDC proved a potentially low-cost tool for determining PTE in dust. In addition, the results confirmed that informal home-based work poses a risk for children residing in these households. Public policies are needed to assist these families and promote better conditions of occupational health and safety for the whole family.

Childhood blood lead levels and environmental risk factors in Madagascar

One-third of children globally have blood lead levels (BLLs) exceeding the (former) US CDC reference value of 5 µg/dL; this value may be as high as one-half for children in low- and middle-income countries (LMICs). Lead exposure occurs through a variety of routes (e.g., water, dust, air), and in LMICs specifically, informal economies (e.g., battery recycling) can drive lead exposures due, in part, to absent regulation. Previous work by our team identified a ubiquitous source of lead (Pb), in the form of Pb-containing components used in manually operated pumps, in Toamasina, Madagascar. Characterization of BLLs of children exposed to this drinking water, and identification of additional exposure routes were needed. BLLs were measured for 362 children (aged 6 months to 6 years) in parallel with surveying to assess 14 risk factors related to demographics/socioeconomics, diet, use of pitcher pumps, and parental occupations. BLL data were also compared against a recent meta-review of BLLs for LMICs. Median childhood BLL (7.1 µg/dL) was consistent with those of other Sub-Saharan African LMICs (6.8 µg/dL) and generally higher than LMICs in other continents. Risk factors significantly associated (p < 0.05, univariate logistic regression) with elevated BLL (at ≥ 5 µg/dL) included male gender, living near a railway or major roadway (owing potentially to legacy lead pollution), having lower-cost flooring, daily consumption of foods (beans, vegetables, rice) commonly cooked in recycled aluminum pots (a previously identified lead source for this community), and a maternal occupation (laundry-person) associated with lower socioeconomic status (SES). Findings were similar at the ≥ 10 µg/dL BLL status. Our methods and findings may be appropriate in identifying and reducing lead exposures for children in other urbanizing cities, particularly in Sub-Saharan Africa, where lead exposure routes are complex and varied owing to informal economics and substantial legacy pollution.

Investigating aluminum cookpots as a source of lead exposure in Afghan refugee children resettled in the United States

BACKGROUND

Afghan refugee children resettled in Washington State have the highest prevalence of elevated blood lead levels (BLLs) of any other refugee or immigrant population. Resettled families brought several lead-containing items with them from Afghanistan, including aluminum cookpots.

OBJECTIVES

To evaluate the potential contribution of lead-containing cookpots to elevated BLLs in Afghan children and determine whether safer alternative cookware is available.

METHODS

We screened 40 aluminum cookpots for lead content using an X-ray fluorescence (XRF) analyzer and used a leachate method to estimate the amount of lead that migrates into food. We also tested five stainless steel cookpots to determine whether they would be safer alternatives.

RESULTS

Many aluminum cookpots contained lead in excess of 100 parts per million (ppm), with a highest detected concentration of 66,374 ppm. Many also leached sufficient lead under simulated cooking and storage conditions to exceed recommended dietary limits. One pressure cooker leached sufficient lead to exceed the childhood limit by 650-fold. In contrast, stainless steel cookpots leached much lower levels of lead.

SIGNIFICANCE

Aluminum cookpots used by refugee families are likely associated with elevated BLLs in local Afghan children. However, this investigation revealed that other U.S. residents, including adults and children, are also at risk of poisoning by lead and other toxic metals from some imported aluminum cookpots.

IMPACT STATEMENT

Some aluminum cookware brought from Afghanistan by resettled families as well as cookpots available for purchase in the United States represent a previously unrecognized source of lead exposure.

Association Between Blood Lead Level With High Blood Pressure in US (NHANES 1999–2018)

Background

Lead is a toxic metal for human health, but the effect on blood pressure (BP) is still controversial. The object of this study was to demonstrate the association between blood lead levels with BP and hypertension (HTN).

Methods

We used the database from the National Health and Nutrition Examination Survey (NHANES, 1999–2018) to perform a cross-sectional study. We performed multivariate regressions to examine the association between blood lead level with HTN and BP, and then a subgroup analysis was performed.

Results

A total of 32,289 participants were included in this study, but no significant difference was found between blood lead levels and HTN. However, the association between blood lead levels with systolic and diastolic pressure became positive. In the subgroup analysis stratified by race, the association between non-Hispanic white and black people still existed.

Conclusion

The association between blood lead levels with HTN was not significant, but it was positively associated with BP. Besides, the association between non-Hispanic white and black people was also significant.

Associations of plasma metal concentrations with the risks of all-cause and cardiovascular disease mortality in Chinese adults

BACKGROUND

Exposure to metals/metalloids from both the natural environment and anthropogenic sources have a complex influence on human health. However, relatively few studies have explored the relations of exposure to multiple metals/metalloids with mortality. Therefore, this prospective study aims to examine the relations of multiple metal/metalloids exposures with all-cause and cardiovascular disease (CVD) mortality.

METHODS

A total of 6155 participants within the Dongfeng-Tongji (DF-TJ) cohort were involved in this analysis, which were followed for mortality until December 31, 2018. We applied inductively coupled plasma mass spectrometry (ICP-MS) to measure baseline plasma concentrations of 23 metals. We utilized Cox regression models to calculate the hazard ratios (HRs) for all-cause and CVD mortality associated with metal concentrations. We proposed plasma metal score to assess the simultaneous exposure to multiple metals through summing each metal concentration weighted by the regression coefficients with all-cause mortality.

RESULTS

During the follow-up (mean duration, 9.8 years), we ascertained 876 deaths, including 416 deaths of CVD (157 deaths of coronary heart disease and 259 deaths of stroke). In the multiple-metals model, after adjusting for potential confounders, plasma copper, molybdenum, and vanadium were positively associated with all-cause mortality, whereas manganese, selenium, and thallium were negatively associated with the risk of all-cause mortality, with adjusted HRs (95% Confidence Interval, CI) of the fourth quartiles were 1.73 (1.42-2.11, P-trend < 0.001) for copper, 1.33 (1.09-1.63, P-trend = 0.005) for molybdenum, 1.43 (1.16-1.77, P-trend < 0.001) for vanadium, 0.74 (0.58-0.94, P-trend = 0.005) for manganese, 0.68 (0.56-0.83, P-trend < 0.001) for selenium, and 0.74 (0.59-0.92, P-trend = 0.002) for thallium, respectively. Positive associations were observed between plasma copper, molybdenum, vanadium concentrations and CVD mortality, whereas negative associations were found for plasma selenium and thallium concentrations with CVD mortality in the multiple-metals model. Compared with the first quartiles, the HRs of fourth quartiles were 1.94 (1.45-2.58, P-trend < 0.001) for copper, 1.72 (1.26-2.35, P-trend < 0.001) for molybdenum, 1.81 (1.32-2.47, P-trend < 0.001) for vanadium, 0.67 (0.50-0.89, P-trend = 0.003) for selenium, and 0.58 (0.41-0.81, P-trend < 0.001) for thallium, respectively. The plasma metal score was significantly associated with higher risks of all-cause and CVD death in dose-response fashions. When compared with the first quartiles of plasma metal score, the HRs of fourth quartiles were 2.16 (1.76-2.64; P-trend < 0.001) for all-cause mortality and 3.00 (2.24-4.02; P-trend < 0.001) for CVD mortality.

CONCLUSIONS

The study indicated that several plasma metals/metalloids were key determinants and predictors of all-cause and CVD death in the Chinese population. Our findings highlighted the importance to comprehensively assess and monitor multiple metals/metalloids exposures.

Lead Poisoning among Male Juveniles Due to Illegal Mining: A Case Series from South Africa

Illegal mining is a major public health and societal concern. Recent scientific evidence indicates elevated blood–lead levels in illegal gold miners and associated communities. Yet, there is little research in this regard from low- to middle-income countries (LMICs), where illegal mining is growing. This case series is extracted from a cross-sectional study of lead exposure in incarcerated juveniles in greater Johannesburg. From survey records (blood–lead levels and questionnaires), three males had elevated blood–lead levels and presented with health conditions and behavioural problems putatively linked with lead poisoning. Based on the record review, all three juveniles were in a secure facility due to illegal mining-related activities. All three cases had high blood–lead levels and demonstrated a tendency toward aggressive or violent behaviour. They also presented with conditions associated with lead poisoning, such as anaemia, respiratory illness, abdominal disorders, and musculoskeletal conditions. Juveniles involved in illegal mining are at risk of exposure to heavy metals such as lead, and there is a need for relevant preventative action and health care programmes in this group.