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

A State-of-the-Science Review on Metal Biomarkers

PURPOSE OF REVIEW

Biomarkers are commonly used in epidemiological studies to assess metals and metalloid exposure and estimate internal dose, as they integrate multiple sources and routes of exposure. Researchers are increasingly using multi-metal panels and innovative statistical methods to understand how exposure to real-world metal mixtures affects human health. Metals have both common and unique sources and routes of exposure, as well as biotransformation and elimination pathways. The development of multi-element analytical technology allows researchers to examine a broad spectrum of metals in their studies; however, their interpretation is complex as they can reflect different windows of exposure and several biomarkers have critical limitations. This review elaborates on more than 500 scientific publications to discuss major sources of exposure, biotransformation and elimination, and biomarkers of exposure and internal dose for 12 metals/metalloids, including 8 non-essential elements (arsenic, barium, cadmium, lead, mercury, nickel, tin, uranium) and 4 essential elements (manganese, molybdenum, selenium, and zinc) commonly used in multi-element analyses.

RECENT FINDINGS

We conclude that not all metal biomarkers are adequate measures of exposure and that understanding the metabolic biotransformation and elimination of metals is key to metal biomarker interpretation. For example, whole blood is a good biomarker of exposure to arsenic, cadmium, lead, mercury, and tin, but it is not a good indicator for barium, nickel, and uranium. For some essential metals, the interpretation of whole blood biomarkers is unclear. Urine is the most commonly used biomarker of exposure across metals but it should not be used to assess lead exposure. Essential metals such as zinc and manganese are tightly regulated by homeostatic processes; thus, elevated levels in urine may reflect body loss and metabolic processes rather than excess exposure. Total urinary arsenic may reflect exposure to both organic and inorganic arsenic, thus, arsenic speciation and adjustment for arsebonetaine are needed in populations with dietary seafood consumption. Hair and nails primarily reflect exposure to organic mercury, except in populations exposed to high levels of inorganic mercury such as in occupational and environmental settings. When selecting biomarkers, it is also critical to consider the exposure window of interest. Most populations are chronically exposed to metals in the low-to-moderate range, yet many biomarkers reflect recent exposures. Toenails are emerging biomarkers in this regard. They are reliable biomarkers of long-term exposure for arsenic, mercury, manganese, and selenium. However, more research is needed to understand the role of nails as a biomarker of exposure to other metals. Similarly, teeth are increasingly used to assess lifelong exposures to several essential and non-essential metals such as lead, including during the prenatal window. As metals epidemiology moves towards embracing a multi-metal/mixtures approach and expanding metal panels to include less commonly studied metals, it is important for researchers to have a strong knowledge base about the metal biomarkers included in their research. This review aims to aid metals researchers in their analysis planning, facilitate sound analytical decision-making, as well as appropriate understanding and interpretation of results.

Toenail arsenic species and metallome profiles associated with breast, cervical, prostate, and skin cancer prevalence in the Atlantic Partnership for Tomorrow's Health cohort

Introduction

Chronic exposure to arsenic through drinking water has been linked to several cancers. The metabolism of arsenic is thought to play a key role in arsenic-related carcinogenesis as metabolites of varying toxicity are produced and either stored in or excreted from the body. Atlantic Canada has the highest age-standardized incidence rates of all cancers in the country. This may be due to its high levels of environmental arsenic and the prevalence of unregulated private wells for water consumption. Here, we aimed to characterize the profiles of arsenic species and metallome in the toenails of four cancer groups, compare them to healthy participants (N = 338), and assess potential associations between the profiles with cancer prevalence.

Methods

This study employed a case-control design. Toenail samples and questionnaire data from cases (breast, cervical, prostate, and skin cancers) and controls were sourced from the Atlantic Partnership for Tomorrow's Health (PATH) cohort study. The levels of arsenic species were measured using Inductively Coupled Plasma-Mass Spectrometry (ICP-MS) paired with High Performance Liquid Chromatography (HPLC) and total concentrations of metallome (23 metals) were determined by ICP-MS separately. Multivariate analyses were conducted to compare cases with controls within each cancer group.

Results

Arsenic speciation profiles varied by cancer type and were significantly different between cases and controls in the breast (p = 0.0330), cervical (p = 0.0228), and skin (p = 0.0228) cancer groups. In addition, the profiles of metallome (nine metals) were significantly differentiated in the prostate (p = 0.0244) and skin (p = 0.0321) cancer groups, with higher zinc concentrations among cases compared to controls.

Conclusion

History of cancer diagnosis was associated with specific profiles of arsenic species and metallome. Our results indicate that arsenic methylation and zinc levels, as measured in toenails, may be an important biomarker for cancer prevalence. Further research is needed to use toenails as a prognostic measure of arsenic-and other metal-induced cancer.

A Current Review of Water Pollutants in American Continent: Trends and Perspectives in Detection, Health Risks, and Treatment Technologies

Currently, water pollution represents a serious environmental threat, causing an impact not only to fauna and flora but also to human health. Among these pollutants, inorganic and organic pollutants are predominantly important representing high toxicity and persistence and being difficult to treat using current methodologies. For this reason, several research groups are searching for strategies to detect and remedy contaminated water bodies and effluents. Due to the above, a current review of the state of the situation has been carried out. The results obtained show that in the American continent a high diversity of contaminants is present in the water bodies affecting several aspects, in which in some cases, there exists alternatives to realize the remediation of contaminated water. It is concluded that the actual challenge is to establish sanitation measures at the local level based on the specific needs of the geographical area of interest. Therefore, water treatment plants must be designed according to the contaminants present in the water of the region and tailored to the needs of the population of interest.

The relationship between cadmium and cognition in the elderly: a systematic review

Context: The relationship between cadmium (Cd) and the cognition of the elderly is indistinct.Objective: To summarise the studies on the relationship between the cognition of the elderly and Cd.Methods: Literatures were searched in PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), and Wan fang database on April 25, 2022. The entries in the STROBE statement were used to evaluate the literature quality; all the quantitative studies that met the requirements were systematically summarised.Results: Blood Cd was negatively correlated with the cognitive ability of the elderly, corresponding to different cognitive ability assessment methods, the regression coefficients were: -0.11 (-0.20, -0.03), -0.46 (-0.71, -0.21), -0.54 (-0.90, -0.17), -0.19 (-0.37, -0.01), and -2.29 (-3.41, -1.16). The regression coefficients between urinary Cd level and cognition score were -1.42 (-2.38, -0.46), and 0.76 (-1.28, -0.23). When dietary Cd increased by 1 μg/kg, the composite z-score decreased by 3.64 (p = 0.001). There was no significant correlation between drinking water Cd, fingernail Cd and cognition (p > 0.05).Conclusion: We concluded that blood Cd (including whole blood and plasma), urine Cd and dietary Cd were negatively correlated with the cognition of the elderly, but the relationship between Cd in drinking water and fingernails and cognition was not statistically significant.

Environmental effects on trace elements in the fingernails of centenarians and their offspring

Bio-monitoring is commonly used to investigate trace elements, and the human nail provides an ideal medium for such testing. Toxic and essential trace metals (Cd, Pb, Fe, and Se) in the fingernails of participants from the Hainan Province were investigated. Samples included 136 centenarians and 197 offspring (101 older adult children and 96 middle-aged grandchildren) who were also sampled for comparison. As a hotspot for longevity, participants in the Hainan Province were found to have high essential nutrients of Fe and Se, and lacked the toxic element Pb. A similar trend was found for trace elements in soil and rice in the Hainan Province. The trace elements preserved in nails revealed dietary and environmental influences that varied among different generations. For the grandchildren's generation, the environment played an important role in elements in their nails, and a significant correlation and linear relationships were found, especially for Fe and Se. As the participants increased in age (from the grandchildren to the centenarians), the correlation between various elements decreased. For centenarians, the influence of beneficial or harmful properties of the elements became more important than their environment. The results also pointed to the important role of trace elements in human health, especially Fe and Se as essential elements. This study can provide information on the factors that influence the existence of trace elements in the human body and demonstrate the advantage of using the human fingernail in bio-monitoring.

Validation of an Analytical Method for the Determination of Manganese and Lead in Human Hair and Nails Using Graphite Furnace Atomic Absorption Spectrometry

This article describes the validation of analytical methods for the determination of Manganese (Mn) and lead (Pb) by graphite furnace atomic absorption spectrometry (GFAAS) in human hair and nail samples. Method validation parameters such as linearity, repeatability, reproducibility, and precision were determined. In addition, the limit of detection (LOD), the limit of quantification (LOQ), and measurement uncertainty were calculated. The developed method was linear in the concentration ranges of 0.001–0.015 and 0.002–0.020 µg·L−1 of Mn and Pb, respectively. The determination coefficients obtained were greater than 0.995. The recoveries obtained after the addition of the standard concentration for the metals ranged from 84.80–107.98%, with a precision not exceeding 12.97% relative standard deviation. The calculated LOD and LOQ for Mn and Pb are within the ranges established by Commission Regulation (EU) No. 836/2011. The expanded uncertainty was estimated to be less than 9.93–6.59% for Mn and Pb. Matrix effects were also studied, finding a smooth effect in both matrices. The analysis of 30 samples of each type revealed the presence of Mn in 30 and Pb in 13 samples. Overall, the proposed validation method was considered optimal for the determination of Mn and Pb.

Childhood exposure to metal(loid)s in industrial and urban areas along the Persian Gulf using toenail tissue as a biomarker

Metal(loid)s (MLs) with natural or anthropogenic sources may cause adverse health effects in children. This study aimed to compare the childhood exposure to ΣMLs (essential, non-essential and toxic) in an industrial and an urban area in Southwest Iran using toenail tissue as a biomarker. The present study was carried out with school children in the age range of 7-12 years, who were living in an industrial area in the petrochemical and gas area (PGA) of the Central District of Asaluyeh County and in an urban area (UA) located in the Kaki District. A total of 270 boys and girls were recruited in January to April 2019. The ICP-MS was used for determination of the studied MLs. A multi-linear regression model was constructed to assess the effect of residence area on toenail ML levels. A significantly higher level of ΣMLs in toenail from the PGA was observed compared to the level in the UA (8.839 vs. 7.081 μg/g, β = -0.169 and p < 0.05). However, all of the 15 MLs studied were detected in the toenail samples from both study sites. Significant differences for the mean Cr (β = -0.563), Fe (β = -0.968), Mn (β = -0.501), Ni (β = -0.306), and Pb (β = -0.377) levels were found between toenail samples from the study areas (p < 0.05), with higher levels in the PGA. The results of this study suggest that children in industrial area are prone to a greater risk for ML exposures compared with those living in a non-industrial urban area.

Determination of trace cadmium in saliva samples using spray assisted droplet formation-liquid phase microextraction prior to the measurement by slotted quartz tube-flame atomic absorption spectrophotometry

BACKGROUND

An effective, green and rapid analytical strategy namely the simultaneous spray assisted droplet formation-liquid phase microextraction (S-SADF-LPME) method was developed for the determination of trace quantity of cadmium in saliva samples by using the slotted quartz tube-flame atomic absorption spectrophotometry (SQT-FAAS). By the developed method, external dispersive solvent usage for droplet formation was reduced to obtain a more environmental-friendly method.

METHODS

Method consists of a simultaneous complexing and extraction step, which was based on spraying an extraction solvent containing a solid ligand into the aqueous sample solution, forming fine droplets without the use of dispersive solvent. The procedure was implemented using a customized, cost effective and portable spray apparatus to minimize the consumption of reagent, analysis time and operation steps. Thus, this methodology ensures better repeatability and accuracy while minimizing the relative errors caused by the experimental steps. Parameters including the buffer amount, extractant/ligand concentration, extraction solvent type, extraction/ligand solution volume, spraying number and vortex period were systemically optimized to lower the detection limit.

RESULTS

Under the optimal extraction conditions, 96.9-folds enhancement in the detection power of the traditional FAAS was achieved. The limit of detection and limit of quantification values of presented method were calculated to be 0.65 and 2.17 ng mL^-1, respectively. Accuracy and applicability of the optimized method was investigated by collecting saliva samples from smokers. Satisfactory percent recovery values wereachieved for cadmium with a low standard deviation in the acceptable range of 84.9-109.6 %.

CONCLUSION

The developed dispersive solvent-free S-SADF-LPME technique presents a fast, simple, cost-effective and eco-friendly microextraction method based on the use of an easily accessible and functional spray apparatus.