The relationship between co-exposure to multiple heavy metals and liver damage

Associations of non-essential metal/metalloids and their mixture with liver function in Chinese older adults: the mediating roles of lipid profiles

The liver is vulnerable to damage from environmental pollutants, but evidence on the effects of non-essential metal/metalloid (NEM) mixture on liver function and their mechanisms remains limited. The study aimed to explore the correlations between individual NEMs and their combinations with liver function, and the mediating roles of lipid profiles. The research involved 2642 individuals aged 60 and older in China. Urine concentrations of arsenic (As), cesium (Cs), barium (Ba), thallium (Tl), and cadmium (Cd) were analyzed using ICP-MS. Liver function was assessed based on the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and albumin (ALB). To evaluate the individual and combined effects of these NEMs on liver function, linear regression, restricted cubic splines (RCS), weighted quantile sum (WQS), quantile g-computation (QGC), and Bayesian kernel machine regression (BKMR) models were utilized. Mediation analyses were conducted to explore the potential role of lipid profiles in NEM-liver function relations. Adjusted linear regression revealed positive associations of Tl with ALT (β = 0.044, 95 % CI: 0.022 to 0.066) and AST (β = 0.019, 95 % CI: 0.004 to 0.035), and negative associations of Cs (β = -0.015, 95 % CI: -0.020 to -0.010), Tl (β = -0.010, 95 % CI: -0.015 to -0.005), and Cd (β = -0.019, 95 % CI: -0.024 to -0.014) with ALB. The RCS model confirmed these linear relationships. Mixture models consistently demonstrated a positive association between the NEM mixture and ALT/AST, primarily driven by Tl, and a negative association with ALB, predominantly influenced by Cd. Mediation analyses suggested triglycerides and total cholesterol partially mediated the associations between Tl, the NEM mixture, and liver function. In conclusion, the NEM mixture, mainly driven by Tl and Cd, is linked to liver function impairment, with lipid profiles potentially mediating these effects. More research is needed to confirm these findings and clarify the mechanisms.

Individual and combined contamination of the toxic metals in commercial cat and dog food

As the long-term accumulation of toxic metals in food poses significant health risks to pets, there is a growing concern among people regarding toxic metal contamination in pet food. In order to investigate the toxic metals levels in pet food in China, we collected a total of 93 imported cat and dog food from the Chinese market produced in 2021-2022, comprising 45 cat food and 48 dog food, and determined the concentrations of lead (Pb), cadmium (Cd), chromium (Cr), mercury (Hg) and arsenic (As) in them. The concentrations of Pb, Cd and Cr were determined by flame atomic absorption spectrometry, while Hg and As were quantified by atomic fluorescence spectrometry. The most contaminated of all samples were Cr and As, which were detected in all samples, followed by Hg, which was detected in 91 samples. In cat food, Cr and As were the most prevalent toxic metals, and Cr and Hg were found in all dog food. Pb was not detected in the canned food, while both cat and dog canned foods showed relatively high contamination rates of Cr, As, and Hg. Cr, Hg and As had the highest contamination levels in dry food. Some samples exceed the limits set by Hygienical Standard for Pet Feed of China (Announcement No. 20 of 2018) regarding Pb and Cr, while other toxic metals remained within acceptable limits. Canned food, however, met all regulatory limits for toxic metals. Across all types of pet food, Cr, Hg, and As were consistently the most prevalent combined contaminants. Analysis of the acute hazard index (aHI) values showed that both cats and dogs face potential dietary exposure risks to the toxic metals investigated, with Cr posing the most significant risk, followed by Pb and As. This study underscores the extensive presence of toxic metal contamination in pet foods, posing a significant risk to pet health due to ongoing exposure to multiple toxic metals.

Based on the Sam50-MICOS-ATAD3-mtDNA axis: Exploring oligomeric proanthocyanidins to alleviate molybdenum and cadmium co-induced liver inflammation in sheep

Molybdenum (Mo) and cadmium (Cd), well-defined hazardous pollutants in the environment, exhibit potential toxic effects on liver tissues by inducing oxidative stress and inflammatory responses. This study aims to investigate the role of the Sam50-MICOS-ATAD3-mtDNA axis in mediating the inflammatory response in liver inflammation induced by co-exposure to Mo and Cd in sheep, as well as the protective effects of oligomeric proanthocyanidins (OPC). The findings indicated that co-exposure to Mo and Cd induced cellular degeneration, rupture of hepatic mitochondrial membranes and mitochondrial dysfunction that was accompanied by the levels of ATP, SDH and GSH-Px reduced in the sheep liver tissue. Furthermore, the co-exposure downregulated the expression levels of mitochondrial membrane proteins (Sam50, MICOS and ATAD3) and degree of co-localization between Sam50 and Mic60. In addition, co-exposure to Mo and Cd elicited an increase in mtDNA content and promoted the upregulation of inflammation-related factor levels, which resulted in an augmentation of TNF-α, CRP, and IL-18 contents. However, OPC alleviated the above changes induced by the combination of Mo and Cd. In conclusion, co-exposure to Mo and Cd decreases mtDNA stability by disrupting the Sam50-MICOS-ATAD3 axis, thereby inducing liver inflammation in sheep. Nevertheless, OPC could alleviate this damage.

Cross-sectional associations between multiple plasma heavy metals and lung function among elderly Chinese

Environmental exposure to heavy metals may adversely affect lung function particularly in the elderly. However, limited data are available directly evaluating the relationship of heavy metal exposures with lung function in Chinese elderly. We aimed to investigate the associations between plasma metals and lung function among Chinese elderly residents. We conducted a cross-sectional study of 308 elderly residents in an industrial area and a non-industrial area in northwest China and estimated the single and combined effects of plasma metals and their interactions with lung functions (forced vital capacity [FVC], forced expiratory volume in 1 s [FEV1], and FEV1/FVC). We analyzed 12 plasma metals and identified 4 metals by lasso regression and BKMR model for further analysis. Bayesian kernel machine regression (BKMR) and quantile-g computation (QG-comp) models estimated four metals that had greater importance in lung function indicators, namely strontium (Sr), chromium (Cr), cobalt (Co) and nickel (Ni). Subgroup analyses were performed based on the resident areas. Both BKMR and QG-comp models showed metal mixtures was positively associated with FEV1/FVC (0.046 [0.017,0.075]) among all participants but of negative association with FVC, and similar results were found among participants in non-industrial area. The subgroup analysis by region showed higher heavy metal levels in industrial areas than non-industrial area. Sr concentrations were lower in non-industrial area, but they had a negative effect on FVC. In conclusion, plasma Sr, Cr, Co, and Ni levels are significant associated with lung function particularly with restrictive ventilatory dysfunction among the Chinese elderly population.

Bladder cancer associated with elevated heavy metals: Investigation of probable carcinogenic pathways through mitochondrial dysfunction, oxidative stress and mitogen-activated protein kinase

OBJECTIVE

Carcinogenic mechanisms of heavy metals/ trace elements (HMTE) in bladder cancer (BC) are exactly unknown. Mitochondrial dysfunction (MD), oxidative stress (OS), and mitogen-activated protein kinases (MAPK) are probable carcinogenic mechanisms. The purpose is to investigate probable carcinogenic pathways of HMTE in BC using six MD genes, seven OS markers, and p38-MAPK.

METHODS

Study included 125 BC/radical cystectomy (RC) patients between October 2020 and October 2022, and 72 controls. Exclusion criteria included previous neoplasm, chemo- or radiotherapy. Two samples (cancer/noncancer) were taken from RC specimens. Tissues/plasma/urine cadmium (Cd), lead (Pb), cobalt (Co), nickel (Ni), strontium (Sr), aluminium (Al), zinc (Zn), boron (B) were measured by ICP-OES. Tissue MD genes (mt-CO3, mt-CYB, mt-ATP 6, mt-ATP8, mt-CO1, mt-ND1), and serum OS markers (8-OHdG, MDA, 3-NT, AGEs, AOPP, ROS, SOD2), p38-MAPK were assessed by RT-PCR, and ELISA, respectively.

RESULTS

BC and adjacent tissue showed higher (Al, Co, Pb, Ni, Zn, Cd,Sr), lower B concentrations, compared to controls. High tissue concentrations (Cd, Co, Pb, Ni, Sr) were associated with higher MD genes, OS, MAPK and lower SOD2 levels. The same differences were greater in 41 patients with concomitant elevation of two or more HMTE. Noninclusion of BC-related oncogenes (e.g. RAS) is a limitation.

CONCLUSIONS

Evidence suggests that high BC tissue (Cd, Co, Pb, Ni, Si) concentrations are associated with over-expressed MD genes, OS, p38-MAPK and low SOD2. These findings provide important understanding keys of probable carcinogenic pathways in BC associated with HMTE. So, efforts should be performed to minimize and counteract exposure to toxic HMTE.

Association between the levels of toxic heavy metals and schizophrenia in the population of Guangxi, China: A case-control study

The relationship between body levels of heavy metals and the risk of schizophrenia remains unclear. This study investigates the relationship between plasma levels of toxic heavy metals and the risk of schizophrenia among adults in Guangxi, China. Plasma concentrations of lead (Pb), cadmium (Cd), arsenic (As), and chromium (Cr) were measured using inductively coupled plasma mass spectrometry (ICP-MS). To evaluate both the single and combined effects of metal exposure on the risk of schizophrenia, we employed multivariate logistic regression, Bayesian Kernel Machine Regression (BKMR), and generalized Weighted Quantile Sum (gWQS) models. Additionally, we employed the Comparative Toxicogenomics Database (CTD) to analyze the mechanistic pathways through which metal mixtures may induce schizophrenia. Relative mRNA expression levels were measured using Real-Time Quantitative Reverse Transcription Polymerase Chain Reaction (RT-qPCR). Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were conducted to predict potential biological functions. In logistic regression models, compared to the lowest exposure group (Q1), the odds ratios (ORs) for Pb in groups Q2, Q3, and Q4 were 2.18 (95% CI: 1.20-3.94), 4.74 (95% CI: 2.52-8.95), and 3.62 (95% CI: 1.80-7.28), respectively. Both BKMR and gWQS models indicated a positive correlation between the combined effects of toxic heavy metal mixtures and the risk of schizophrenia, with Pb demonstrating the most substantial impact, particularly in older adults and females. Elevated levels of tumor necrosis factor (TNF) and interleukin-1 beta (IL-1β) were observed in patients with schizophrenia, while the expression of tumor protein p53 (TP53) was significantly reduced. These findings underscore the critical need to avoid exposure to toxic heavy metals to prevent schizophrenia, highlighting significant public health implications.

Interactive association of metals and Life's Essential 8 with mortality in U.S. adults: a prospective cohort study from the NHANES dataset

BACKGROUND

Life's Essential 8 (LE8) is a novel assessment of cardiovascular health (CVH) by evaluating lifestyle, and reports of the associations between LE8 and urinary metals on mortality have been very limited. This study aimed to conduct a prospective cohort study and investigate the combined effects of metals and LE8 on mortality in U.S. adults.

METHODS

This study enrolled participants with complete information on urinary metals, LE8, mortality status, and confounders from the National Health and Nutrition Examination Survey (2005-2018). The Cox regression model, adaptive lasso penalized regression, and restricted cubic spline were used to analyze the individual effects of metals and LE8 on all-cause mortality. The additive and multiplicative interaction scales and quantile g-computation were used to evaluate the interaction and combined effects. Stratified analyses were performed to clarify whether metals and LE8 interacted with other variables to influence all-cause mortality.

RESULTS

A total of 8017 participants were included in this study. The concentrations of cadmium, cobalt, lead, antimony, and thorium were greater in the low CVH group than in the high CVH group [median (µg/L): 0.29 vs. 0.19, 0.36 vs. 0.35, 0.48 vs. 0.39, 0.05 vs. 0.04, and 0.07 vs. 0.06]. The interaction between cadmium and LE8 was statistically significant, with a synergy index of 1.169 (95% CI: 1.004, 1.361). The stratified analyses showed that the interaction between age and LE8 had an impact on all-cause mortality (P for interaction = 0.004).

CONCLUSIONS

In this representative sample of the U.S. population, we found that the combined effect of cadmium, lead, thallium, and LE8 was positively associated with all-cause mortality. Furthermore, the interaction between cadmium and LE8 influenced all-cause mortality. So people should adopt healthy behaviors and reduce heavy metal exposure to minimize the risk of adverse health outcomes.

Biosorption and Bioprotective Potential of Levilactobacillus brevis in Mice Challenged by Lead-Induced Oxidative Stress

Lead (Pb) poisoning is a widespread issue in both developed and developing countries that poses a significant public health challenge. Our study aimed to explore the impact of Levilactobacillus brevis strains on inflammatory and antioxidant gene expression in the liver and brain of mice exposed to oxidative stress caused by Pb. We began by evaluating Pb absorption by Levilactobacillus brevis strains (ARKA-CH-1 (A1) and ARKA-CH-6 (A6)) using the inductively coupled plasma mass spectrometry (ICP-MS) in vitro to identify the most effective strain. We then divided four groups of BALB/c mice into control and experimental groups and treated them for 30 days. The control group received a normal diet, while the experimental groups consumed lead-containing water (0.6 g/L) with or without Levilactobacillus brevis strains. Following the experiments, we collected blood samples to test liver markers, antioxidant enzymes, and immunoglobulins. We also used real-time PCR to examine the expression of superoxide dismutase (SOD) and inducible nitric oxide synthase (iNOS) genes. The results showed that the A1 strain was the most effective in absorbing Pb. The Pb exposure led to an increase in liver enzyme values and a decrease in antioxidant enzyme activity and immunoglobulin factors. However, the combination of A1 and A6 strains had a greater effect in reducing inflammatory enzymes and increasing antioxidant enzymes. Furthermore, we observed a significant increase in iNOS gene expression and a notable decrease in SOD gene expression with Pb consumption. However, the combination of A1 and A6 strains had a synergistic effect in reducing iNOS and increasing SOD gene expression. In conclusion, Levilactobacillus brevis A1 strain alone or in combination with the A6 strain could be a promising strategy to mitigate the oxidative stress symptoms in mice challenged by lead-induced toxicity.

Association between heavy metal exposure and biomarkers for non-alcoholic fatty liver disease in Korean adolescents

Objectives

The global prevalence of non-alcoholic fatty liver disease (NAFLD) in adolescents has increased. In addition to childhood obesity, environmental risk factors, such as heavy metals that are known to be involved in hepatotoxicity, play role in NAFLD occurrence. However, their association with NAFLD remains unclear. This study aimed to investigate the association between heavy metal exposure and NAFLD biomarkers in adolescents.

Methods

In this cross-sectional study, we used the data of a total of 1505 adolescents aged 12-17 years who participated in the Korean National Environmental Health Survey III (2015-2017) and IV (2018-2020). The presence of blood lead (BPb), blood mercury (BHg), urinary mercury (UHg), and urinary cadmium (UCd) were measured. Liver enzymes including serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyl transferase (GGT) were evaluated. For NAFLD biomarkers, the hepatic steatosis index (HSI) was calculated. Multivariate linear regression models, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) model were used to investigate the association between heavy metals and NAFLD biomarkers.

Results

Among heavy metals, mercury presence showed a significant association with NAFLD biomarkers. Two-fold increases in BHg and UHg were associated with 0.21 points (95 % confidence interval [CI]: 0.08-0.35) and 0.19 points (95 % CI: 0.09-0.30) higher HSI, respectively. In the WQS model, heavy metal mixture was significantly associated with increased HSI (β = 0.06, 95 % CI: 0.01-0.11). Similarly, in the BKMR model, heavy metal mixture was positively associated with NAFLD biomarkers, and BHg was the most important contributor in the association.

Conclusions

BHg and UHg were significantly associated with NAFLD biomarkers in adolescents, indicating that organic and inorganic mercury exposure could potentially be a risk factor for NAFLD. To mitigate and address the risk of NAFLD associated with heavy metal exposure, it is imperative to take measure to reduce avoidable mercury exposure is necessary.

Inflammation as a pathway for heavy metal-induced liver damage-Insights from a repeated-measures study in residents exposed to metals and bioinformatics analysis

BACKGROUND

Epidemiological studies on heavy metal exposure and liver injury are predominantly cross-sectional, lacking longitudinal data and exploration of potential mechanisms.

METHOD

We conducted a repeated-measures study in Northeast China from 2016 to 2019, involving 322 participants. Linear mixed models (LMM) and Bayesian kernel machine regression (BKMR) were employed to explore the associations between individual and mixed blood metal concentrations [chromium (Cr), cadmium (Cd), vanadium (V), manganese (Mn), lead (Pb)] and liver function biomarkers [alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (ALB), globulin (GLB), total protein (TP)]. Mediation and enrichment analyses were used to determine whether the inflammatory response is a critical pathway for heavy metal-induced liver damage.

RESULT

We obtained a total of 958 observations. The results from LMM and BKMR indicated significant associations between individual and mixed heavy metals and liver function biomarkers. Longitudinal analysis revealed associations between Cd and the annual increase rate of ALT (β = 2.61; 95% CI: 0.97, 4.26), the annual decrease rate of ALB (β = -0.21; 95% CI: -0.39, -0.03), Mn and the annual increase rate of GLB (β = 0.38; 95% CI: 0.05, 0.72), and V and the annual decrease rate of ALB/GLB (β = -1.15; 95% CI: -2.00, -0.31). Mediation analysis showed that high-sensitivity C-reactive protein (hsCRP) mediated the associations between Cd and AST, TP, with mediation effects of 27.7% and 13.4%, respectively. Additionally, results from Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses supported the role of inflammatory response pathways.

CONCLUSION

Our findings indicate that heavy metal exposure leads to liver damage, with the inflammatory response potentially serving as a crucial pathway in this process. This study offers a novel perspective on understanding heavy metal-induced liver injury and provides insights for preventive measures against the health damage caused by heavy metals.

Internal Flames: Metal(loid) Exposure Linked to Alteration of the Lipid Profile in Czech Male Firefighters (CELSPAC-FIREexpo Study)

Increased wildfire activity increases the demands on fire rescue services and firefighters' contact with harmful chemicals. This study aimed to determine firefighters' exposure to toxic metal(loid)s and its association with the lipid profile. CELSPAC-FIREexpo study participants (including 110 firefighters) provided urine and blood samples to quantify urinary levels of metal(loid)s (arsenic, cadmium (Cd), mercury, and lead (Pb)), and serum lipid biomarkers (cholesterol (CHOL), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), and triglycerides (TG)). The associations were investigated by using multiple linear regression and Bayesian weighted quantile sum (BWQS) regression. Higher levels of Pb were observed in firefighters. Pb was positively associated with CHOL and TG. Cd was negatively associated with HDL. In the BWQS model, the mixture of metal(loid)s was associated positively with CHOL (β = 14.75, 95% CrI = 2.45-29.08), LDL (β = 15.14, 95% CrI = 3.39-29.35), and TG (β = 14.79, 95% CrI = 0.73-30.42), while negatively with HDL (β = -14.96, 95% CrI = -25.78 to -1.8). Pb emerged as a key component in a metal(loid) mixture. The results suggest that higher exposure to lead and the mixture of metal(loid)s is associated with the alteration of the lipid profile, which can result in an unfavorable cardiometabolic profile, especially in occupationally exposed firefighters.

Effects of multiple metals exposure on abnormal liver function: The mediating role of low-density lipoprotein cholesterol

Equilibration of metal metabolism is critical for normal liver function. Most epidemiological studies have only concentrated on the influence of limited metals. However, the single and synergistic impact of multiple-metal exposures on abnormal liver function (ALF) are still unknown. A cross-sectional study involving 1493 Chinese adults residing in Shenzhen was conducted. Plasma concentrations of 13 metals, including essential metals (calcium, copper, cobalt, iron, magnesium, manganese, molybdenum, zinc, and selenium) and toxic metals (aluminum, cadmium, arsenic, and thallium) were detected by the inductively coupled plasma spectrometry (ICP-MS). ALF was ascertained as any observed abnormality from albumin, alanine transaminase, aspartate transaminase, γ-glutamyl transpeptidase, and direct bilirubin. Diverse statistical methods were used to evaluate the single and mixture effect of metals, as well as the dose-response relationships with ALF risk, respectively. Mediation analysis was conducted to evaluate the role of blood lipids in the relation of metal exposure with ALF. The average age of subjects was 59.7 years, and 56.7 % were females. Logistic regression and the least absolute shrinkage and selection operator (LASSO) penalized regression model consistently suggested that increased levels of arsenic, aluminum, manganese, and cadmium were related to elevated risk of ALF; while magnesium and zinc showed protective effects on ALF (all p-trend < 0.05). The grouped weighted quantile sum (GWQS) regression revealed that the WQS index of essential metals and toxic metals showed significantly negative or positive relationship with ALF, respectively. Aluminum, arsenic, cadmium, and manganese showed linear whilst magnesium and zinc showed non-linear dose-response relationships with ALF risk. Mediation analysis showed that LDL-c mediated 4.41 % and 14.74 % of the relationship of plasma cadmium and manganese with ALF, respectively. In summary, plasma aluminum, arsenic, manganese, cadmium, magnesium, and zinc related with ALF, and LDL-c might underlie the pathogenesis of ALF associated with cadmium and manganese exposure. This study may provide critical public health significances in liver injury prevention and scientific evidence for the establishment of environmental standard.

Association of Combined PFOA, PFOS, Metals and Allostatic Load on Hepatic Disease Risk

This study utilizes the National Health and Nutrition Examination Survey (NHANES) 2017-2018 data to explore the relationship between exposure to perfluoroalkyl substances (specifically perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS), metals lead (Pb), mercury (Hg), and cadmium (Cd), allostatic load, and hepatic disease markers, including the fatty liver index a measure of the likelihood of non-alcoholic fatty liver disease, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and total bilirubin. The paper identified significant associations and interaction effects by employing descriptive statistics, Spearman's correlation analysis, linear regression, and Bayesian kernel machine regression (BKMR). Descriptive statistics highlight sex-specific differences in contaminant levels. Spearman's analysis underscores strong correlations among metals and per- and polyfluoroalkyl substances (PFAS). Linear regression reveals significant impacts of specific contaminants on AST, ALT, ALP, and bilirubin levels, adjusting for age and alcohol consumption. BKMR results further elucidate the complex, potentially synergistic relationships between these environmental exposures and the likelihood of non-alcoholic fatty liver disease, offering nuanced insights into their combined effects on liver health. The findings emphasize the intricate dynamics of environmental exposures on hepatic function, advocating for targeted public health interventions.

Human Health Effects of Oral Exposure to Chromium: A Systematic Review of the Epidemiological Evidence

The toxicity and carcinogenicity of hexavalent chromium via the inhalation route is well established. However, a scientific debate has arisen about the potential effects of oral exposure to chromium on human health. Epidemiological studies evaluating the connection between ingested chromium and adverse health effects on the general population are limited. In recent years, a wealth of biomonitoring studies has emerged evaluating the associations between chromium levels in body fluids and tissues and health outcomes. This systematic review brings together epidemiological and biomonitoring evidence published over the past decade on the health effects of the general population related to oral exposure to chromium. In total, 65 studies were reviewed. There appears to be an inverse association between prenatal chromium exposure and normal fetal development. In adults, parameters of oxidative stress and biochemical alterations increase in response to chromium exposure, while effects on normal renal function are conflicting. Risks of urothelial carcinomas cannot be overlooked. However, findings regarding internal chromium concentrations and abnormalities in various tissues and systems are, in most cases, controversial. Environmental monitoring together with large cohort studies and biomonitoring with multiple biomarkers could fill the scientific gap.

The Correlation between Metal Mixed Exposure and Lung Function in Different Ages of the Population

Herein, we explored the overall association between metal mixtures and lung functions in populations of varying ages and the relationship among the associated components. The 2007-2012 National Health and Nutrition Examination Survey data of 4382 American participants was analyzed, and generalized linear, elastic net, quantile g-computation, and Bayesian kernel machine regression models were used to evaluate the relationship between exposure to the metal mixture and lung function at various ages. The results of barium exposure at distinct stages revealed that children and adolescents exhibited greater lung function changes than those in adults and the elderly. Additionally, compared with children and adolescents, cadmium- and arsenic-containing metabolites contributed to nonconductive lung function changes in adults and the elderly exposed to metal mixtures. The results showed that the effects of exposure to metal mixtures on lung function in children and adolescents were predominantly caused by lead and barium. Altogether, children and adolescents were found to be more susceptible to metal-exposure-mediated lung function changes than adults and the elderly.

A review on the potential risks and mechanisms of heavy metal exposure to Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease (COPD) is a chronic disease that affects patients as well as the health and economic stability of society as a whole. At the same time, heavy metal pollution is widely recognized as having a possible impact on the environment and human health. Therefore, these diseases have become important global public health issues. In recent years, researchers have shown great interest in the potential association between heavy metal exposure and the development of COPD, and there has been a substantial increase in the number of related studies. However, we still face the challenge of developing a comprehensive and integrated understanding of this complex association. Therefore, this review aimed to evaluate the existing epidemiological studies to clarify the association between heavy metal exposure and COPD. In addition, we will discuss the biological mechanisms between the two to better understand the multiple molecular pathways and possible mechanisms of action involved, and provide additional insights for the subsequent identification of potential strategies to prevent and control the effects of heavy metal exposure on the development of COPD in individuals and populations.

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.

Association of heavy metal complex exposure and neurobehavioral function of children

Background

Exposure to heavy metals is a public health concern worldwide. Previous studies on the association between heavy metal exposure and neurobehavioral functions in children have focused on single exposures and clinical manifestations. However, the present study evaluated the effects of heavy metal complex exposure on subclinical neurobehavioral function using a Korean Computerized Neurobehavior Test (KCNT).

Methods

Urinary mercury, lead, cadmium analyses as well as symbol digit substitution (SDS) and choice reaction time (CRT) tests of the KCNT were conducted in children aged between 10 and 12 years. Reaction time and urinary heavy metal levels were analyzed using partial correlation, linear regression, Bayesian kernel machine regression (BKMR), the weighted quantile sum (WQS) regression and quantile G-computation analysis.

Results

Participants of 203 SDS tests and 198 CRT tests were analyzed, excluding poor cooperation and inappropriate urine sample. Partial correlation analysis revealed no association between neurobehavioral function and exposure to individual heavy metals. The result of multiple linear regression shows significant positive association between urinary lead, mercury, and CRT. BMKR, WQS regression and quantile G-computation analysis showed a statistically significant positive association between complex urinary heavy metal concentrations, especially lead and mercury, and reaction time.

Conclusions

Assuming complex exposures, urinary heavy metal concentrations showed a statistically significant positive association with CRT. These results suggest that heavy metal complex exposure during childhood should be evaluated and managed strictly.