Epidemiologic assessment of measures used to indicate low-level exposure to mercury vapor (Hg)

Vitamin E and Lactobacillus Provide Protective Effects Against Liver Injury Induced by HgCl2: Role of CHOP, GPR87, and mTOR Proteins

BACKGROUND AND OBJECTIVE

Mercury is one of the most harmful heavy metals and its toxicity causes severe multi-organ dysfunction. This study was designed to explore novel molecular pathways involved in the hepatoprotective effect of vitamin E (Vit-E) and Lactobacillius plantarum (Lac-B) against mercury toxicity.

METHOD

Acute hepatotoxicity was induced by administration of high dose of mercuric chloride (HgCl2) in male rats, Vit-E or/and Lac-B were given along with HgCl2 for 2 weeks. The effects of those antioxidants were studied focusing on their anti-apoptotic, anti-oxidative stress and anti-inflammatory eficacies. Histopathological examinations were also conducted.

RESULTS

The administration of HgCl2 induced liver injury which manifested by elevation in serum ALT and AST. Liver MDA, caspase-3 and TNF-α levels were markedly increased; whereas, GSH level and SOD activity were declined. HgCl2 significantly elevated the expressions of hepatic CHOP, GPR87, NF-κB and mTOR. Histopathological examination revealed massive hepatocyte degeneration following HgCl2 administration. Treatment with Vit-E or/and Lac-B restored the normal levels of the previously mentioned parameters, as well as improved hepatic architecture.

CONCLUSION

Vit-E and Lac-B provided protective effect against HgCl2-induced hepatotoxicity via reduction of oxidative stress and inflammation, and downregulation of CHOP, GPR87, NF-κB and mTOR proteins' expressions.

Unveiling the Features of Mercury-Associated Minimal Change Disease: Comparison with Primary Minimal Change Disease

Introduction

Long-term exposure to mercury can cause minimal change disease. However, the current understanding of mercury-associated minimal change disease (M-MCD) is inadequate. To improve the understanding of M-MCD, this study retrospectively analyzed the clinicopathological, ultrastructural, and prognostic features of M-MCD, in comparison with primary minimal change disease (P-MCD).

Methods

We retrospectively analyzed the clinicopathological data of 21 M-MCD patients and 21 P-MCD patients. Electron micrographs of glomerular capillaries were taken, and the foot process width (FPW) was measured. A receiver operating characteristics (ROC) curve analysis was performed to determine the optimum cutoff value of FPW that can differentiate the M-MCD from P-MCD.

Results

M-MCD patients presented similar clinical and routine pathological characteristics with P-MCD patients but had lower levels of FPW (935.0 [interquartile range (IQR) 853.7-1,176.7] nm vs. 1,403.2 [IQR 1,089.2-1,841.8] nm, p = 0.002). ROC curve analysis showed that FPW value below 1,385 nm might help to differentiate M-MCD from P-MCD (area under the curve of 0.787, sensitivity of 94.7%, and specificity of 52.4%). For patients with M-MCD, 77.8% achieved complete remission after mercury detoxification monotherapy. Patients with M-MCD had a lower relapse rate than patients with P-MCD (0 vs. 47.1%, p = 0.003). In addition, there was no significant difference in remission time between M-MCD patients treated with mercury detoxification monotherapy and those initially treated with immunosuppressive therapy (2.0 [IQR 1.0-6.0] months vs. 2.0 [IQR 1.5-2.5] months, p = 0.606).

Conclusions

M-MCD patients showed similar clinicopathological features with P-MCD patients, but with less severe foot process effacement, suggesting different pathogenesis of these 2 disease entities. The treatment of mercury detoxification was highly effective for patients with M-MCD and can be considered as a primary choice in clinical practice.

Urinary Concentration Correction Methods for Arsenic, Cadmium, and Mercury: a Systematic Review of Practice-Based Evidence

BACKGROUND

Urinary biomonitoring is widely used to assess environmental chemical exposure; however, a critical gap exists in whether and how to correct for the physiological variation in water content of spot urine samples.

OBJECTIVE

The aim of this systematic review is to summarize the available evidence comparing the performance of urinary concentration correction methods used to determine urinary levels of arsenic, cadmium, and mercury.

METHODS

We searched PubMed/MEDLINE, Embase, LILIAC, Web of Science, and TOXNET up to Sept. 5, 2017 for articles evaluating urinary concentration correction methods (e.g., urine creatinine [U-Cre], specific gravity [U-SG], osmolality [U-Osm]) compared to 24-h or timed urine specimens for levels of arsenic, cadmium, and mercury. Data on study design, methods of urine collection, and the performance of selected correction methods were extracted.

RESULTS

A total of 10 papers met the inclusion criteria. Two papers evaluated the performance of urinary concentration correction methods for arsenic, four for cadmium, three for mercury, and one for multiple metals. The median sample size for arsenic was 105, for cadmium 107, and for mercury 35. The studies were highly heterogeneous in population selection, urine collection, urine quality control, statistical comparison among selected correction methods, and presentation of the results. The median (range) of correlation coefficients comparing each corrected values with corresponding levels of timed urine specimens are 0.74 (0.17-0.92) for un-correction (n = 13), 0.82 (0.52-0.98) for U-Cre (n = 13), and 0.75 (0.28-0.98) (n = 12) for U-SG.

CONCLUSION

Findings from limited evidence support that urine creatinine and urine-specific gravity corrections remain practical approaches to correct metal concentrations for urine dilution as compared to 24-h or 12-h urine samples. Further studies with larger sample sizes are needed to clarify this fundamental issue of environmental biomonitoring using spot urine samples in both general and priority populations.

Mercury Exposures in Informal Gold Miners and Relatives in Southern Peru

Subjects working in or living near informal gold mining and processing in southern Peru were studied to determine mercury exposures from two tasks: amalgamation and amalgam smelting. The authors collected 17 airborne and 41 urinary mercury levels. The mean urinary levels were 728 (range: 321-1662) and 113 (45-197) microg/L for working in smelters and living near smelters, respectively. A third group working in amalgamation had a mean 18 microg/L (range 8-37). People living in the mining town but with no mining activities had 8 microg/L (5-10), while a control group outside the town had 4 microg/L (2-6). Mean airborne mercury exposure was 2423 microg/m3 (range 530-4430) during smelting, 30.5 microg/m3 (12-55) during amalgamation, and 12 microg/m3 (3-23) in the mining town. Smelters are highly contaminated with mercury, as are the people living around smelters.

What do we know of childhood exposures to metals (arsenic, cadmium, lead, and mercury) in emerging market countries?

Arsenic, cadmium, lead, and mercury present potential health risks to children who are exposed through inhalation or ingestion. Emerging Market countries experience rapid industrial development that may coincide with the increased release of these metals into the environment. A literature review was conducted for English language articles from the 21st century on pediatric exposures to arsenic, cadmium, lead, and mercury in the International Monetary Fund's (IMF) top 10 Emerging Market countries: Brazil, China, India, Indonesia, Mexico, Poland, Russia, South Korea, Taiwan, and Turkey. Seventy-six peer-reviewed, published studies on pediatric exposure to metals met the inclusion criteria. The reported concentrations of metals in blood and urine from these studies were generally higher than US reference values, and many studies identified adverse health effects associated with metals exposure. Evidence of exposure to metals in the pediatric population of these Emerging Market countries demonstrates a need for interventions to reduce exposure and efforts to establish country-specific reference values through surveillance or biomonitoring. The findings from review of these 10 countries also suggest the need for country-specific public health policies and clinician education in Emerging Markets.

Heterogeneous mercury reaction chemistry on activated carbon

Experimental and theory-based investigations have been carried out on the oxidation and adsorption mechanism of mercury (Hg) on brominated activated carbon (AC). Air containing parts per billion concentrations of Hg was passed over a packed-bed reactor with varying sorbent materials at 140 and 30 degrees C. Through X-ray photoelectron spectroscopy surface characterization studies it was found that Hg adsorption is primarily associated with bromine (Br) on the surface, but that it may be possible for surface-bound oxygen (O) to play a role in determining the stability of adsorbed Hg. In addition to surface characterization experiments, the interaction of Hg with brominated AC was studied using plane-wave density functional theory. Various configurations of hydrogen, O, Br, and Hg on the zigzag edge sites of graphene were investigated, and although Hg-Br complexes were found to be stable on the surface, the most stable configurations found were those with Hg adjacent to O. The Hg-carbon (C) bond length ranged from 2.26 to 2.34 A and is approximately 0.1 A shorter when O is a nearest-neighbor atom rather than a next-nearest neighbor, resulting in increased stability of the given configuration and overall tighter Hg-C binding. Through a density of states analysis, Hg was found to gain electron density in the six p-states after adsorption and was found to donate electron density from the five s-states, thereby leading to an oxidized surface-bound Hg complex.

Comparison of calcium, magnesium, sodium, potassium, zinc, and creatinine concentration in 24-h and spot urine samples in women

: The 24-h urine sample is considered as the most reliable material for testing many but not necessarily all constituents in urine. However, its collection is tedious for both patients and research participants. The aim of this study was to compare concentrations of essential elements calcium (Ca), magnesium (Mg), sodium (Na), potassium (K), and zinc (Zn) in 24-h and spot urine samples.

: Urine samples were collected from 143 generally healthy women, aged 30–79 years. Fasting spot urine was collected immediately after the end of the 24-h collection, therefore being of the same content as the first morning urine which ended the 24-h collection. Elements were analyzed by flame atomic absorption/emission spectrometry and expressed as mg/g and/or mmol/mol of creatinine (Cr). Spearman rank order correlations between 24-h and spot urine were carried out for each element. Ratios of elements in 24-h to spot urine samples were calculated to estimate the element-proportion of spot in the 24-h sample.

: All coefficients of correlation between 24-h and spot urine of measured elements and Cr were significant (p<0.05): Zn (0.637), Mg (0.623), Ca (0.603), Na (0.452), K (0.396), and Cr (0.217). Ratios of 24-h to spot urine samples for each element (except K) were similar and close to 2, indicating uniform proportion of elements from spot urine sample in the 24-h sample. In addition, a high correlation between various pairs of elements was obtained in both 24-h and spot urine; the highest being between Na/Ca (0.435) and (0.578), respectively. This is in accordance with theoretical presumptions and previous findings regarding those relationships.

: Although replacing burdensome 24-h urine collection with spot urine sampling might not provide the solution in all cases, our results show that for the elements analyzed, spot urine could be a reliable alternative.

Clin Chem Lab Med 2009;47:216–21.

The safety of dental amalgam in children

The safety of mercury-containing dental amalgam has been hotly debated for well over a century. Dental exposures from mercury have been suggested as the cause of numerous diseases including multiple sclerosis, autism and many others. Known health effects of mercury exposure include CNS and renal damage. However, these effects have only been shown at occupational or higher levels of exposure, and have not been conclusively shown to be present at levels of mercury exposure consistent with that from dental amalgam fillings. The use of mercury amalgam fillings remains a state-of-the-art treatment for dental caries throughout the world. Although there have been a small number of peer-reviewed reports examining the health effects of dental mercury in children, only very recently have the only randomised, controlled clinical trials (two) of the safety of mercury amalgam been published. The purpose of this review is to discuss the scientific evidence on the safety of the use of mercury-containing dental amalgam as a treatment for dental caries.

Neurocognitive screening of mercury-exposed children of Andean gold miners

Performance on Raven's Coloured Progressive Matrices (RCPM) test of visual-spatial reasoning was used to evaluate the effects of mercury (Hg) exposure on 73 Andean children aged 5 to 11 years (mean: 8.4) living in the Nambija and Portovelo gold mining areas of Ecuador, where Hg is widely used in amalgamation. Mean levels of Hg found in blood (Hg(B)), urine (Hg(U)), and hair (Hg(H)) samples were 5.1 microg/L (SD: 2.4; range: 1-10 microg/L), 13.3 microg/L (SD: 25.9; range: 1-166 microg/L), and 8.5 microg/g (SD: 22.8; range: 1-135 microg/g), respectively. Of the children in the Nambija area 67-84.9% had abnormal RCPM standard scores (i.e., < or = 25%tile), depending on the test norm used in the data analysis. Higher standard scores for Peruvian (t = 4.77; p = < 0.0001) and Puerto Rican (t = 4.51; p = < 0.0001) norms than for U.S. norms suggested a linguistic influence. No difference was found between Peruvian and Puerto Rican norms (t = 0.832; p = < 0.408), which showed a significant positive correlation (r = 0.915, p = < 0.0001). Children with abnormal Hg(B) and Hg(H) levels had significantly lower scores on the RCPM subtest B than did children with nontoxic Hg levels (t = -2.16; p = < 0.034). These results suggest that a substantial number of Hg-exposed children in the Nambija study area have neurocognitive deficits in visual-spatial reasoning.

Mercury levels in urine and hair of children in an Andean gold-mining settlement

This field study investigated mercury (Hg) levels in urine and hair of Andean children of indigenous Saraguro and Metizo gold miners in the Nambija, Ecuador gold mining settlement. Spot samples of urine and hair samples were collected concurrently from 80 children each. Urine samples were used to determine the inorganic Hg burden, while hair samples were used as an index of methylmercury (MeHg) exposure from consumption of Hg contaminated fish. The mean level of Hg in urine (HgU) was 10.9 microg/L, and the mean level in hair (HgH) was 6.0 microg/g. Regression analysis showed a significant association (r = 0.404, p = 0.0007) between matched HgU and HgH samples. Mean HgU and HgU levels tended to be higher for children aged 6-14 years than for a younger group. The wide range of Hg levels in the urine and hair of Andean children of gold miners may place them at risk for neurodevelopmental and learning disorders.