Determination of lead, cadmium and arsenic in infant formula in the Lebanese market

Occurrence and health risk assessment of selected metals in commercially available infant formulas in Jordan

BACKGROUND

Infant formulas are the primary source of nutrition for infants and babies when breastfeeding is unavailable, as they are enriched with a variety of macro- and micronutrients to improve their nutritional value and satisfy the different needs of babies. Recently, there has been a rising concern about toxic metal levels in infant formulas, as highlighted by various studies. However, there are currently no sufficient studies focusing on toxic metal levels of infant formulas in Jordan. The current study aims to determine the levels of 25 metals, including Na, Mg, K, Ca, Cr, Fe, Mn, Co, Ni, Cu, Zn, Li, Ti, V, Ga, Sr, Ag, Ba, Bi, Th, U, Al, Cd, In, and Pb, in infant formulas (starter infant formula, follow-on formula, and growing-up formula) using inductively coupled plasma mass spectrometry (ICP-MS) and evaluate their safety and quality.

METHODS

The metal compositions of 37 infant formula samples collected from different Jordanian pharmacies were determined using inductively coupled plasma-mass spectrometry (ICP-MS) after digesting the samples with 9 mL of HNO3 (70 %) and 3 mL of H2O2 (30 %) using the microwave-assisted digestion technique. The possible health risks associated with the exposure to Cd, Pb, Al, and Ni in infant formulas were evaluated using estimated daily intake, target hazard quotient, and hazard index calculations. Also, method validation, including accuracy, precision, limit of detection, and limit of quantification, was performed.

RESULTS

The results revealed that follow-on formula (intended for 7-12-month-old babies) had the highest mean concentration of all studied metals, except for zinc, which had the highest mean concentration in starter infant formula (intended for less than 6-month-old babies). Also, 72.97 % and 89.20 % of the tested samples had Pb and Cd levels that exceeded the European permissible limit, respectively. Regarding the estimated daily intake (EDI), babies aged 7-12 months were found to be the most exposed to Cd and Pb toxicity, while babies aged less than 6 months were found to be the most exposed to Ni toxicity. Unfortunately, the overall non-carcinogenic negative adverse effects (hazard index HI) of Cd and Pb for babies aged 7-12 months exceeded the acceptable threshold of 1.

CONCLUSION

Based on the results, the consumption of infant formulas sold in Jordan may pose serious health risks to babies, with Cd and Pb levels in follow-on formulas (posing the highest risk). The source of contamination in infant formulas may be contaminated raw materials, the manufacturing process, packaging, or storage. So, strict regulations ought to be established to safeguard the health of babies.

Probabilistic risk assessment for determining nonessential metals in commercial infant formula products in Taiwan

During the early months of life, infant formula plays a crucial role as a primary source of both food and essential nutrients for infants, serving as a replacement for or supplement to breast milk. However, nonessential metals in infant formulas are a concern because infants are highly vulnerable to chemical exposure. The aim of this study was to investigate infant exposure to nonessential metals in infant formula products in Taiwan and assess the associated health risks. In this study, concentrations of arsenic (As), barium (Ba), cadmium (Cd), manganese (Mn), lead (Pb), and vanadium (V) in 45 formula products for 0-1-year-old infants were determined by inductively coupled plasma mass spectrometry. The mean As, Ba, Cd, Mn, Pb, and V concentrations were 6.42, 280, 3.72, 1425, 20.4, and 21.9 µg/kg, respectively. According to our probabilistic simulation of the estimated daily intake of metals, the proportion of hazard quotients exceeding one was 7.69% for As and 3.29% for Mn, and that of hazard index (HI) values exceeding 1 was >17% for metals. Arsenic had the largest HI contribution (46.9%), followed by Mn (22.3%) and Pb (12.7%). The nonessential metals content in infant formula raises potential noncarcinogenic health concerns for infants in Taiwan. Therefore, regulations for nonessential metals must be imposed on related food products in Taiwan, with a particular focus on As and Mn.

Urinary biomarkers of exposure to toxic and essential elements: A comparison of infants fed with human milk or formula

Background

Early-life exposure to nonessential (toxic) and essential trace elements can influence child development. Although infant formula powders and the water used to reconstitute them can contain higher concentrations of many elements compared with human milk, the influence of feeding mode on reliable biomarkers of infant exposure has rarely been demonstrated.

Methods

We evaluated associations between urinary biomarkers and feeding mode (exclusively human milk, exclusively formula, or combination-fed) for four toxic (arsenic, cadmium, nickel, and uranium) and three essential elements (cobalt, molybdenum, and selenium) using general linear models.

Results

A total of 462 participants from the rural New Hampshire Birth Cohort Study were on average 6 weeks old between July 2012 and March 2019 and had urine samples, 3-day food diaries, and relevant covariate data available. In adjusted models, urinary arsenic was 5.15 (95% confidence interval = 4.04, 6.58), molybdenum was 19.02 (14.13-25.59), and selenium was 1.51 (1.35-1.68) times higher in infants fed exclusively with formula compared with infants fed exclusively with human milk. By contrast, urinary uranium was 0.59 (0.46-0.75) and cobalt was 0.78 (0.65-0.95) times lower with formula feeding than human milk feeding.

Conclusion

Our findings suggest that infant exposure to several potentially toxic elements varies by feeding mode, as concentrations of reliable urinary biomarkers were higher with formula or human milk, depending on the element. Importantly, exposure to arsenic increased with household tap water arsenic regardless of feeding mode, suggesting that all infants could be at risk in populations with high concentrations of arsenic in drinking water.

Estimated daily intake and health risk assessment of toxic elements in infant formulas

In this study, the heavy metal (Al, Mn, Co, Cu, Zn, As, Se, Cd, Sn, Pb and Hg) concentrations were determined in a total of seventy-two infant formula samples manufactured by sixteen different brands in Türkiye. During the analyses, inductively coupled plasma MS was used in evaluating the nutritional profile and the toxicological risk associated with the consumption of these products. Given the analysis results, the highest Pb content was found in milk-based 'beginner' formulas (0-6 months, three samples) packed in metal containers. The highest concentration of Mn was found in powdered infant formula (Brand 3) that is suitable for 9-12-month-olds. Mn level was found to be above the limit values in nine samples (12·5 %). Cd level exceeded the limit values in two infant formula samples of Brand 3 (0·038 µg/g) and Brand 15 (0·023 µg/g). Therefore, the mean Cd concentration found here reaches the maximum limit set by the European Union commission legislation. Cu was detected in all infant formulas. The highest concentration was determined in Brand 1 (9-12 months, seven samples) and found to be 2·637 (sd 1·928) µg/g. This value is much higher than the reference values set in the national and international standards. Based on the results achieved here, the estimated daily intake (EDI) and target hazard quotient values for all the metals in infant formulas were found lower than < 1. These findings suggest that the baby foods examined would not pose any health risk. The daily intakes exceeding the baby nutrition values recommended by the WHO would pose health risk since they would exceed the EDI levels.

Assessing heavy metal levels in pediatric enteral nutrition formulas available in the Turkish market: Implications for consumer health

In this study, we assessed the levels of lead (Pb), cadmium (Cd), mercury (Hg), and inorganic arsenic (iAs) in 27 pediatric enteral nutrition (EN) formulas from five international brands available in the Turkish market. Analysis was conducted using inductively coupled plasma mass spectrometry (ICP-MS). Non-carcinogenic and carcinogenic risk assessment was performed using hazard quotient (HQ), hazard index (HI), carcinogenic risk (CR), Toxicological contribution % of Provisional Tolerable Weekly Intake (PTWI) models. Our objective was to evaluate heavy metal exposure in EN formulas, specifically focusing on Cd, Pb, iAs, and Hg levels according to recommended amounts for different age groups based on their energy requirements. Average concentrations of iAs in polymeric (PC), oligomeric (OC), and monomeric (MC) EN formulas were as follows: PC: 2.13 ± 0.16 ( Collapse

Key Words

• Carcinogenic risk
• Enteral nutrition formula
• Hazard quotient
• Health risk assessment
• Heavy metal

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MESH Headings

• Female
• Child
• Humans
• Male
• Cadmium/analysis
• Enteral Nutrition
• Lead
• Metals, Heavy/analysis
• Mercury/analysis
• Risk Assessment

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Affiliation(s)

Gursel Isci Department of Nutrition and Dietetics, Faculty of Health Sciences, Agri Ibrahim Cecen University, 04100, Agri, Turkey.
Betul Orucoglu Department of Nutrition and Dietetics, Faculty of Health Sciences, Afyonkarahisar Health Sciences University, 03100, Afyonkarahisar, Turkey.
Merve Ekici Department of Nutrition and Dietetics, Faculty of Health Sciences, Agri Ibrahim Cecen University, 04100, Agri, Turkey; Department of Nutrition and Dietetics, Institute of Health Sciences, Acıbadem Mehmet Ali Aydınlar University, 34758, Istanbul, Turkey.

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Occurrence and dietary exposure assessment of heavy metals in baby foods in the Kingdom of Saudi Arabia

Early childhood exposure to heavy metals like arsenic (As), cadmium (Cd), and lead (Pb) through baby foods unfolds many concerns about their toxic effects on growth and health. In this study, occurrence and dietary intake of As, Cd, and Pb in stage 1 infant formula (0-6 months), stage 2 infant formula (7-12 months), cereal-based meals, and biscuits were estimated. First, the levels of As, Cd, and Pb were determined with ICP-MS, followed by the calculation of estimated daily intake (EDI), target hazard quotient (THQ), and hazard index (HI) for As and Cd, and margin of exposure (MoE) for Pb. Mean levels of As, Cd, and Pb were the highest in cereal-based meals and biscuits as 15.5-11.1, 5.18-8.76, and 35.2-53.8 μg/kg, respectively. Newborns to 6 months old infants were estimated to be the highest exposed population to Cd and Pb (0.08 and 0.36 μg/kg bw/day), while infants aged 7-12 months old were exposed the highest to As. Based on the THQ, HI, and MoE findings, the current exposure levels from the selected baby foods to As, Cd, and Pb pose low potential chronic risks to both infant age groups. This research provides a roadmap for future investigations in chemical contaminants often detected in baby foods consumed regularly by Saudi infants.

Comparison between pollutants found in breast milk and infant formula in the last decade: A review

Since ancient times, breastfeeding has been the fundamental way of nurturing the newborn. The benefits of breast milk are widely known, as it is a source of essential nutrients and provides immunological protection, as well as developmental benefits, among others. However, when breastfeeding is not possible, infant formula is the most appropriate alternative. Its composition meets the nutritional requirements of the infant, and its quality is subject to strict control by the authorities. Nonetheless, the presence of different pollutants has been detected in both matrices. Thus, the aim of the present review is to make a comparison between the findings in both breast milk and infant formula in terms of contaminants in the last decade, in order to choose the most convenient option depending on the environmental conditions. For that, the emerging pollutants including metals, chemical compounds derived from heat treatment, pharmaceutical drugs, mycotoxins, pesticides, packaging materials, and other contaminants were described. While in breast milk the most concerning contaminants found were metals and pesticides, in infant formula pollutants such as metals, mycotoxins, and packaging materials were the most outstanding. In conclusion, the convenience of using a feeding diet based on breast milk or either infant formula depends on the maternal environmental circumstances. However, it is important to take into account the immunological benefits of the breast milk compared to the infant formula, and the possibility of using breast milk in combination with infant formula when the nutritional requirements are not fulfilled only with the intake of breast milk. Therefore, more attention should be paid in terms of analyzing these conditions in each case to be able to make a proper decision, as it will vary depending on the maternal and newborn environment.

Assessment of Opuntia ficus-indica (L.) Mill. extracts for the removal of lead from soil: the role of CAM plant harvest phase and soil properties

Extensive research to date has focused on the coagulation-flocculation and biosorption properties of the invasive Opuntia ficus-indica (L.) Mill. to remove metals from water. However, no studies have reported on the use of O. ficus-indica extract as a leaching agent to remove metals from contaminated soil. In the present work, a new environmentally friendly method for lead-contaminated soil remediation is evaluated. The method involves the use of cladode extract from O. ficus-indica as a soil washing agent. This new technique can serve to mitigate against the potential deterioration of soil quality and other secondary environmental impacts that result from the use of inorganic acids and/or chelating agents. Extractions from cladodes harvested during both day and night crassulacean acidic metabolism (CAM) phases were evaluated for treatment of lead contamination in three different soils including kaolinite, montmorillonite and a field-natural soil sample. Lead removal rates, which ranged from 44 to 100%, were significantly impacted by the intrinsic properties of the soils, the leachate dosage, the plant harvest phase, and the soil washing duration. Fourier-transform infrared spectroscopy (FTIR) characterization of the leachates indicated that functional groups present in the O. ficus-indica extracts played an essential role in the removal process. Results suggest that this species possesses promising potential to be used as a sustainable basis for the abatement of lead contaminated soil.

Perfluorooctanoic Acid and Perfluorooctane Sulfonate in Human Milk: First Survey from Lebanon

Human milk is the primary source of nutrition for infants in their first year of life. Its potential contamination with perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), a group of toxic man-made chemicals, is a health concern that may threatens infants' health. Our study aims to assess the levels of PFOA and PFOS in the breast milk of Lebanese lactating mothers and the maternal factors associated with their presence. High-performance liquid chromatography (HPLC) coupled with a Micromass Quattro micro API triple quadrupole mass spectrometer was used to detect the level of contamination in 57 collected human milk samples. PFOA and PFOS were present in 82.5% and 85.7% of the samples, respectively, while PFOA levels ranged between 120 and 247 pg/mL with a median of 147 pg/mL, and those of PFOS ranged between 12 and 86 pg/mL with a median of 27.5 pg/mL. The median contamination for PFOA exceeded the threshold set by the European Food Safety Authority (EFSA) (60 pg/mL); however, that of PFOS was below the threshold (73 pg/mL). The consumption of bread, pasta, meat, and chicken more than twice per week and that of white tubers and roots at least once per week was significantly associated with higher levels of PFOA (p < 0.05). No significant association was found between maternal age, BMI, parity, level of education, place of residence, source of water used, and smoking with the levels of PFOA and PFOS in the human milk. Additionally, the consumption of cereals at least twice per week was significantly associated with higher levels of PFOS. These findings call for actions to improve the local environmental and agricultural practices, and the regulations and standards for inspecting imported food. It is important to highlight that the benefits of breastfeeding outweigh the reported contamination with PFOS and PFOA in our study.

Field evaluation of metal bioaccumulation in the gastropod Helix aspersa at agricultural and industrial sites in Lebanon

Juvenile Helix aspersa Müller exposed in field microcosms were used to assess the spatial and temporal bioaccumulation of Cd, Cr, Cu, Fe, Mn, Ni, Pb, and Zn at two agricultural and two industrial sites in Lebanon. The study was performed over a 12-week period where caged snails were sampled once every 3 weeks and assessed for metal bioaccumulation and partitioning between soft tissue and shells. Results showed that metal bioaccumulation by snails was site dependent, with Fe and Cd being the greatest and least accumulated metals, respectively. Significant differences between bioaccumulation in each of the matrices (soft tissue and shells) were also observed. Time-dependent bioaccumulation results showed an increasing accumulation trend at both agricultural sites, while a slight decline was observed at the end of the sampling campaign for the industrial sites. The study of the bioaccumulation factors (BAF) revealed that tested H. aspersa were macroconcentrators for Zn and Cd (BAF > 2) and deconcentrators for all other analyzed elements (BAF < 1). The high partitioning factor values obtained for Cu and Zn indicate an affinity of these two elements for the soft tissues of the snails. The results of this field study indicate that H. aspersa are well suited for active biomonitoring and could provide reliable information on metal pollution and bioavailability.