Association between heavy metals and colon cancer: an ecological study based on geographical information systems in North-Eastern Iran

Source-specific probabilistic health risk assessment of heavy metals in surface water of the Yangtze River Basin

The detrimental effects of heavy metal accumulation on both ecosystems and public health have raised widespread concern. Source-specific risk assessment is crucial for developing effective strategies to prevent and control heavy metal contamination in surface water. This study aims to investigate the contamination characteristics of heavy metals in the Yangtze River Basin, identifying the pollution sources, assessing the risk levels, and further evaluating the health risks to humans. The results indicated that the average concentrations of heavy metals were ranked as follows: zinc (Zn) > arsenic (As) > copper (Cu) > chromium (Cr) > cadmium (Cd) > nickel (Ni) > lead (Pb), with average concentrations of 38.02 μg/L, 4.34 μg/L, 2.53 μg/L, 2.10 μg/L, 1.17 μg/L, 0.84 μg/L, and 0.32 μg/L, respectively, all below the WHO 2017 standards for safe drinking water. The distribution trend indicates higher concentrations in the upper and lower reaches and lower concentrations in the mid-reaches of the river. By integrating the Absolute Principal Component Scores-Multiple Linear Regression (APCS-MLR) receptor model and Positive Matrix Factorization (PMF) model, the main sources of heavy metals were identified as industrial activities (APCS-MLR: 41.3 %; PMF: 42.1 %), agricultural activities (APCS-MLR: 30.1 %; PMF: 27.4 %), and unknown mix sources (APCS-MLR: 29.1 %; PMF: 30.4 %). The calculation of the hazard index (HI) for both children and adults was <1, indicating no non-carcinogenic or carcinogenic risks. Based on the source-specific risk assessment, agricultural activities contribute the most to non-carcinogenic risks, while industrial activities pose the greatest contribution to carcinogenic risks. This study offers a reference for monitoring heavy metals and controlling health risks to residents, and provides crucial evidence for the utilization and protection of surface water in the Yangtze River Basin.

A critical review on the ecotoxicity of heavy metal on multispecies in global context: A bibliometric analysis

Heavy metals (HMs) have become a significant concern in the current era, with deleterious effects on diverse living organisms when exposed beyond threshold concentrations. Both nature and human beings have been constantly casting out HMs into environmental matrices through various activities. Innumerable cases of threatened diseases such as cancer, respiratory ailments, reproductive defects, skin diseases, and several others have been a cause of significant concern for humans as the number of instances has been increasing with each decade. HMs migrates via several pathways to infiltrate biological organisms and amass within them. Even though numerous treatment approaches are available for remediating HM pollution, however, they are expensive, along with other setbacks. Due to such constraints, combating HM contamination requires environmentally conscious strategies like bioremediation, which employs an array of biological systems to remove HMs from the environment. Nonetheless, to address the current global HM pollution situation, it is critical to comprehend not only how these hazardous HMs cause toxicity in various living organisms but also the knowledge gaps that currently exist concerning the subject of HM ecotoxicity. In the present investigation, data was extracted from Google Scholar using software program called Harzing's Publish or Perish. The collected information has been subsequently displayed as a network file using the VOSViewer software tool. Thus, the current review presents a significant insight with the inclusion of a readily accessible bibliometric analysis to comprehend the present status of HMs research, global research trends, existing knowledge discrepancies, and research challenges. Further, it also provides an in-depth review of HMs ecotoxicity, with a focus on arsenic (As), cadmium (Cd), and lead (Pb). Thus, as indicated by the bibliometric study, the present review will assist future investigators studying HMs ecotoxicity by providing baseline data concerning a wide range of living organisms and by addressing research gaps.

Oxidative Stress in Military Missions-Impact and Management Strategies: A Narrative Analysis

This narrative review comprehensively examines the impact of oxidative stress on military personnel, highlighting the crucial role of physical exercise and tailored diets, particularly the ketogenic diet, in minimizing this stress. Through a meticulous analysis of the recent literature, the study emphasizes how regular physical exercise not only enhances cardiovascular, cognitive, and musculoskeletal health but is also essential in neutralizing the effects of oxidative stress, thereby improving endurance and performance during long-term missions. Furthermore, the implementation of the ketogenic diet provides an efficient and consistent energy source through ketone bodies, tailored to the specific energy requirements of military activities, and significantly contributes to the reduction in reactive oxygen species production, thus protecting against cellular deterioration under extreme stress. The study also underlines the importance of integrating advanced technologies, such as wearable devices and smart sensors that allow for the precise and real-time monitoring of oxidative stress and physiological responses, thus facilitating the customization of training and nutritional regimes. Observations from this review emphasize significant variability among individuals in responses to oxidative stress, highlighting the need for a personalized approach in formulating intervention strategies. It is crucial to develop and implement well-monitored, personalized supplementation protocols to ensure that each member of the military personnel receives a regimen tailored to their specific needs, thereby maximizing the effectiveness of measures to combat oxidative stress. This analysis makes a valuable contribution to the specialized literature, proposing a detailed framework for addressing oxidative stress in the armed forces and opening new directions for future research with the aim of optimizing clinical practices and improving the health and performance of military personnel under stress and specific challenges of the military field.

The relationship between serum manganese concentration with all-cause and cause-specific mortality: a retrospective and population-based cross-sectional study

BACKGROUND

The study aimed to explore the association between manganese concentration and all-cause, cardiovascular disease (CVD)-related, and cancer-related mortality in the general population of the United States.

METHODS

We integrated the data from the National Health and Nutrition Examination Survey from 2011 to 2018. A total of 9,207 subjects were selected based on the inclusion and exclusion criteria. The relationship between manganese concentration and all-cause, CVD-related, and cancer-related mortality was analyzed by constructing a Cox proportional hazard regression model and a restricted cubic spline (RCS) plot. Additionally, subgroup analyses stratified by age, sex, race/ethnicity, hypertension, diabetes mellitus (DM), chronic heart disease, chronic heart failure, angina pectoris, heart attack, stroke, and BMI were further performed.

RESULTS

In the full adjusted model, compared with the lowest quartile, the adjusted hazard ratios with 95% confidence intervals (CIs) for all-cause, CVD-related, and cancer-related mortality across manganese quartiles were (1.11 (0.87,1.41), 0.96 (0.74, 1.23), and 1.23 (0.96, 1.59); P-value for trend =0.041), (0.86 (0.54, 1.37), 0.87 (0.55, 1.40), and 1.07 (0.67, 1.72); P-value for trend =0.906), and (1.45 (0.92, 2.29), 1.14 (0.70, 1.88), and 1.26 (0.75, 2.11); P-value for trend =0.526), respectively. The RCS curve shown a U-shaped association between manganese concentration and all-cause mortality and CVD-related mortality (P-value for nonlinear <0.05). However, there was an increase and then a decrease in the link between manganese concentration and cancer-related mortality (P-value for nonlinear <0.05). Manganese exposure was positively correlated with sex (correlation coefficient, r =0.19, P-value <0.001) and negatively correlated with age (correlation coefficient, r =-0.11, P-value <0.001) and serum creatinine (correlation coefficient, r =-0.12, P-value <0.001), respectively.

CONCLUSIONS

Our findings suggest that elevated serum manganese concentrations are associated with all-cause and CVD-related mortality in the U.S. population and that maintenance of serum manganese between 8.67-9.23 µg/L may promote public health.

Association of Metal Exposure with Novel Immunoinflammatory Indicators

Objective: We aimed to investigate the relationship between metal exposure and novel immunoinflammatory indicators. Methods: Data on adults participating in the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2018 were analyzed. Various statistical models were employed to assess the association between metal exposure and novel immune-inflammation-related indicators. Additionally, the impact of metal exposure on inflammation in different gender populations was explored. Results: This study included 4482 participants, of whom 51.1% were male. Significant correlations were observed among various metals. Both elastic net (ENET) and linear regression models revealed robust associations between cadmium (Cd), cobalt (Co), arsenic (As), mercury (Hg), and immunoinflammatory indicators. Weighted quantile sum (WQS) and Quantile g-computation (Q-gcomp) models demonstrated strong associations between barium (Ba), Co, and Hg and immunoinflammatory indicators. Bayesian kernel machine regression (BKMR) analysis indicated an overall positive correlation between in vivo urinary metal levels and systemic inflammation response index (SIRI) and aggregate index of systemic inflammation (AISI). Furthermore, Co, As, and Hg emerged as key metals contributing to changes in novel immunoinflammatory indicators. Conclusions: Metals exhibit associations with emerging immunoinflammatory indicators, and concurrent exposure to mixed metals may exacerbate the inflammatory response. Furthermore, this relationship varies across gender populations.

Genetic prediction of micronutrient levels and the risk of colorectal polyps: A mendelian randomization study

OBJECTIVE

Previous epidemiological and experimental studies have yielded conflicting results regarding the influence of human micronutrient levels on the risk of colorectal polyps (CP). In our study, we conducted a two-sample Mendelian randomization (MR) investigation to probe the link between 13 human micronutrients (calcium, selenium, magnesium, phosphorus, folate, vitamins B-6, B-12, C, D, beta-carotene, iron, zinc, and copper) and the genetic susceptibility to CP.

METHODS

Summary statistics for CP (n = 463,010) were obtained from pan-European genome-wide association studies, and instrumental variables for 13 micronutrients were screened from published genome-wide association studies (GWAS). After selecting suitable instrumental variables, we performed a two-sample MR study, deploying sensitivity analyses to judge heterogeneity and pleiotropy, using inverse variance weighted methods as our primary estimation tool.

RESULTS

Our study identified that a genetic predisposition to elevated toenail and circulating selenium or serum β-carotene concentrations lowers the risk of CP occurrence. However, no statistically significant association was observed between the other 11 micronutrients and the risk of CP.

CONCLUSION

The study findings provide evidence that the micronutrient selenium and β-carotene may confer protective effects against the development of CP.

Serum trace elements during treatment in pancreatic cancer patients and their associations with cancer prognosis

BACKGROUND & AIMS

In this study, we assessed serum trace element concentrations in patients with pancreatic cancer and compared the results to those of healthy controls and patients with chronic pancreatitis. We evaluated the association between trace element concentrations during cancer treatment and the risk of cancer progression and mortality in pancreatic cancer patients.

METHODS

A retrospective cohort study was conducted at a tertiary center in Korea. Serum trace element concentrations of cobalt (Co), copper (Cu), selenium (Se), and zinc (Zn) were measured at diagnosis using an inductively coupled plasma-mass spectrometry in 124 patients with pancreatic cancer, 50 patients with chronic pancreatitis, and 120 healthy controls. Trace elements were measured after a median of 282.5 (95% confidence interval [CI], 224.0-326.5) days from treatment initiation to assess changes in trace element concentrations during treatment.

RESULTS

Serum Co concentrations were significantly higher in patients with chronic pancreatitis and pancreatic cancer compared to healthy controls, while serum Se concentrations were significantly lower. During treatment, serum concentrations of Cu, Se, and Zn significantly decreased in patients with pancreatic cancer. During the follow-up (median 152.5; 95% CI, 142.8-160.0 months), 85.5% of patients experienced progression or relapse, and 84.7% of patients died. Patients with decreased Se and Zn concentrations during treatment had a higher mortality (hazard ratio [HR], 2.10; 95% CI, 1.31-3.38; P = 0.0020 for Se; HR, 1.72; 95% CI, 1.06-2.79; P = 0.0269 for Zn) compared to those with unchanged or increased trace element concentrations during treatment. Patients with a greater reduction in Zn concentrations during treatment had a higher mortality than those with a smaller reduction (HR, 1.59; 95% CI, 1.01-2.52; P = 0.0483). Patients whose Zn status changed from normal to deficient during treatment had an increased mortality (HR, 1.76; 95% CI, 1.16-2.67, P = 0.0084). Patients with multiple (≥2) trace element deficiencies after treatment had poorer outcomes than those with no or single trace element deficiency.

CONCLUSIONS

This study revealed that decreases in Se and Zn concentrations during cancer treatment were associated with adverse outcomes in terms of cancer progression and mortality in patients with pancreatic cancer. Further prospective investigations are recommended.

Association between exposure to multiple metals and stress urinary incontinence in women: a mixture approach

There is limited evidence linking exposure to heavy metals, especially mixed metals, to stress urinary incontinence (SUI). This study aimed to explore the relationship between multiple metals exposure and SUI in women. The data were derived from the National Health and Nutrition Examination Survey (NHANES), 2007-2020. In the study, a total of 13 metals were analyzed in blood and urine. In addition, 5155 adult women were included, of whom 2123 (41.2%) suffered from SUI. The logistic regression model and restricted cubic spline (RCS) were conducted to assess the association of single metal exposure with SUI risk. The Bayesian kernel machine regression (BKMR) and weighted quantile sum (WQS) were used to estimate the combined effect of multiple metals exposure on SUI. First, we observed that blood Pb, Hg and urinary Pb, Cd were positively related to SUI risk, whereas urinary W was inversely related by multivariate logistic regression (all p-FDR < 0.05). Additionally, a significant non-linear relationship between blood Hg and SUI risk was observed by RCS analysis. In the co-exposure models, WQS model showed that exposure to metal mixtures in blood [OR (95%CI) = 1.18 (1.06, 1.31)] and urine [OR (95%CI) = 1.18 (1.03, 1.34)] was positively associated with SUI risk, which was consistent with the results of BKMR model. A potential interaction was identified between Hg and Cd in urine. Hg and Cd were the main contributors to the combined effects. In summary, our study indicates that exposure to heavy metal mixtures may increase SUI risk in women.

Spatiotemporal variations, health risk assessment, and sources of potentially toxic elements in potamic water of the Anday Stream Basin (Türkiye), Black Sea Region

Monitoring and protecting freshwater habitats are paramount for a sustainable water management perspective. This study investigated potentially toxic elements (PTEs) in the potamic water of the Anday Stream Basin (Türkiye), Black Sea Region, for a hydrological year (from May 2020 to April 2021). Among PTEs, the highest average values were recorded for sodium (Na) at 41.3 mg/L and the lowest for mercury (Hg) at 0.009 μg/L and noted under quality guidelines. The stream was found to be at the level of "Low Heavy Metal Pollution" and "Low Contamination" based on the ecotoxicological risk indices. The highest calculated hazard quotient (HQ) value of 1.21E-02 for Cd was noted in the children via the dermal pathway and the lowest of 6.91E-06 for Fe in adults via the ingestion pathway. Results revealed a higher hazard index (HI) value of 1.50E-02 for Cd to children and the lowest of 1.98E-05 for Fe to adults. As a result of applying agricultural risk indices, the stream showed sodium adsorption ratio values less than 6 and was found to be "Excellent" for agriculture. However, the sodium percentage values were less than 20 and found "Permissible" and the magnesium hazard > 50 and noted as "Unsuitable" for agriculture. Statistical analysis revealed that natural factors mainly attributed to PTE contamination of the Anday Stream Basin.

Diverging likelihood of colon and rectal cancer in Yogyakarta, Indonesia: A cross sectional study

OBJECTIVES

Colon and rectal cancer are associated with different risk factors and prognostic. However, this discrepancy has not been widely explored in the local population. This study aimed to investigate the site-specific likelihood of colorectal cancer (CRC) incidence in the Yogyakarta province, Indonesia.

METHODS

This cross-sectional study analyses 1,295 CRC cases diagnosed in 2008-2019 registered in the Yogyakarta population-based cancer registry (PBCR) database. Cases were grouped into colon and rectal cancer. Log-binomial regression was used to determine the relative risk of either colon or rectal cancer across different gender, age group, and rurality of residence. The age-specific rates were calculated by age group and temporal trend for each group were analyzed using joinpoint regression.

RESULTS

Females displayed higher odds of colon cancer (relative risk/RR = 1.20, 95%CI = 1.02-1.41) and lower odds of rectal cancer (RR = 0.92, 95%CI = 0.85-0.99). Elevated odds of colon cancer were observed in younger age group, especially 30-39 (RR = 1.87, 95%CI = 1.10-3.19), while decreased odds of rectal cancer was apparent in age group 30-39 and 40-49 (RR = 0.75, 95%CI = 0.60-0.93 and RR = 0.82, 95%CI = 0.69-0.98, respectively). Living in urban or rural areas did not significantly influence the odds of either having colon (RR = 0.98, 95%CI = 0.82-1.17) or rectal cancer (RR = 1.01, 95%CI = 0.93-1.10). During 2008-2019, trends of colon cancer in age <50 increased by 8.15% annually while rectal cancer displayed a 9.71% increase annually prior to 2017, followed by a 17.23% decrease until 2019.

CONCLUSIONS

Yogyakarta population shows higher odds of young-onset colon cancer, especially between age 30-39 years old. Overall observation of trend shows increasing incidence in young-onset colon cancer, and non-significant decrease in rectal cancer.

Carcinogenic and non-carcinogenic human health risk assessments of heavy metals contamination in drinking water supplies in Iran: a systematic review

The contamination of water due to heavy metals (HMs) is a big concern for humankind; particularly in developing countries. This research is a systematic review, conducted by searching google scholar, Web of Science, Science Direct, PubMed, Springer, and Scopus databases for related published papers from 2010 to July 2021, resulting in including 40 articles. Among the analyzed HMs in the presented review, the average content of Cr, Pb, Ba, Al, As, Zn, and Cd exceeded the permissible limits suggested by the World Health Organization (WHO) and 1,053 Iranian standards. Also, the rank order of Hazard Quotient (HQ) of HMs was defined as Cd>As>Cr>Pb>Li for children which means Cd has the highest non-carcinogenic risk and Li has the least. This verifies to the current order As>Cr>Pb>Fe=Zn=Cu>Cd for adults. The corresponded values of HQ and Hazard Index (HI) in most cities and villages were investigated and the results indicated a lower than 1 value, which means consumers are not at non-carcinogenic risk (HQ). Carcinogenic risk (CR) of As in the adult and children consumers in most of the samples (58.82% of samples for both groups) were investigated too, and it was more than>1.00E-04 value, which determines that consumers are at significant CR.

Spatial epidemiological analysis of the burden of liver cancer in China

Background

Liver cancer is one of the most common cancers in the world, with unique regional variations in disability-adjusted life years (DALY) rate, nearly 50% of liver cancer cases occur in China. Therefore, understanding the epidemiological characteristics of liver cancer is of utmost importance. In this study, to analyze the spatial distribution characteristics and clustering of the DALY rate of liver cancer in 1990 and 2017 in China based on provincial administrative divisions, and to explore its possible influencing factor.

Methods

The DALY rate data of liver cancer at the provincial level in China were collected, the global autocorrelation of the DALY rate was analyzed by Moran's I, the local autocorrelation of the DALY rate was analyzed by Getis-Ord-Gi*, and the influencing factors related to the DALY rate were analyzed by the least squares regression model.

Results

The DALY rate of liver cancer in China generally showed an increasing trend. The DALY rate increased in 22 provinces and decreased in nine provinces. In 2017, the distribution of DALY rate in all provinces showed heterogeneity, with the highest DALY rate in Guangxi (1,363.37/100,000) and the lowest in Beijing (315.78/100,000). In 2017, the low and low clustering were mainly concentrated in Inner Mongolia, Ningxia, Shanxi, Hebei, and Tianjin. The low and high clustering in Yunnan, Guizhou, and Guangdong, were surrounded by the high clustering in neighboring provinces, high and high concentration is mainly concentrated in Hunan and neighboring provinces. The results of the least square regression model showed that the per capita years of education, hepatitis B incidence and the proportion of population over 65 years old had an impact on the DALY rate of liver cancer (P<0.05).

Conclusions

The DALY rate of liver cancer in China showed an overall increasing trend. In 2017, the DALY rate of liver cancer in China had a spatial aggregation in the whole country, and the per capita years of education, the incidence of hepatitis B and the proportion of population over 65 years old had an impact on the DALY rate of liver cancer in space.

New approach into human health risk assessment associated with heavy metals in surface water and groundwater using Monte Carlo Method

This study assessed the environmental and health risks associated with heavy metals in the water resources of Egypt's northwestern desert. The current approaches included the Spearman correlation matrix, principal component analysis, and cluster analysis to identify pollution sources and quality-controlling factors. Various indices (HPI, MI, HQ, HI, and CR) were applied to evaluate environmental and human health risks. Additionally, the Monte Carlo method was employed for probabilistic carcinogenic and non-carcinogenic risk assessment via oral and dermal exposure routes in adults and children. Notably, all water resources exhibited high pollution risks with HPI and MI values exceeding permissible limits (HPI > 100 and MI > 6), respectively. Furthermore, HI oral values indicated significant non-carcinogenic risks to both adults and children, while dermal contact posed a high risk to 19.4% of samples for adults and 77.6% of samples for children (HI > 1). Most water samples exhibited CR values exceeding 1 × 10-4 for Cd, Cr, and Pb, suggesting vulnerability to carcinogenic effects in both age groups. Monte Carlo simulations reinforced these findings, indicating a significant carcinogenic impact on children and adults. Consequently, comprehensive water treatment measures are urgently needed to mitigate carcinogenic and non-carcinogenic health risks in Siwa Oasis.

Pollution status and ecological risks of metals in surface water of a coastal estuary and health risk assessment for recreational users

Since the areas close to the Sundarbans mangrove estuary, which is one of the most dynamic and productive ecosystems in the world, are very suitable for urban and industrial activities, the coastal areas of this ecosystem are constantly exposed to metal contamination. In this study, we analyzed the levels, spatial distributions, sources, pollution status, ecological risks, and health risks for recreational users of 16 metals in surface water collected from 18 sampling sites in the Sundarbans estuary. Considering the mean values of metals, Sr (2523 μg/L), Al (1731 μg/L), B (1692 μg/L) and Fe (1321 μg/L) were the most abundant metals in the coastal waters of the estuary, while Cd (0.977 μg/L), Ni (3.11 μg/L), Cu (5.98 μg/L) and Cr (9.77 μg/L) were the less abundant metals. All metals except Zr had the coefficient of variation (CV) values of over 35%, suggesting that other metals showed strong variation between sampling sites due to anthropogenic activities. Al, Fe and Pb levels of all sampling sites were above the limit values set for coastal and marine waters. Similarly, Pb levels of all sites exceeded the USEPA chronic criterion set for saltwater aquatic life. The results of pollution indices indicated that there was a serious metal pollution in almost all sampling sites. Low ecological risk (ER) at four sites, moderate ER at five sites and considerable ER at nine sites were recorded. Dual hierarchical clustering analysis grouped 16 metals into four clusters based on their potential sources and 18 sampling sites into three clusters based on their similar pollution characteristics. Health risk assessment results indicated that total hazard index (THI) values of all sites for recreational children were above the acceptable level of 1, indicating that water of all sites is not safe for health of children. However, THI values of all sites except ST8 (1.1) and ST11 (1.19) for recreational adults were below 1. Among the metals studied, Zr was found to be metal that contributes the most (75.89%) to total health risk in this coastal estuary. This finding reveals the necessity of monitoring of such less-studied metals such as Zr in the surface water of coastal estuaries. Carcinogenic risk values of As were within or below the acceptable range at all sites, indicating that carcinogenic risks would not be expected for recreational users.

The impact of toxic metal bioaccumulation on colorectal cancer: Unravelling the unexplored connection

Colorectal cancer is a major public health concern, with increasing incidence and mortality rates worldwide. Environmental factors, including exposure to toxic metals, such as lead, chromium, cadmium, aluminium, copper, arsenic and mercury, have been suggested to play a significant role in the development and progression of this neoplasia. In particular, the bioaccumulation of toxic metals can play a significant role in colorectal cancer by regulating biological phenomenon associated to both cancer occurrence and progression, such as cell death and proliferation. Also, frequently these metals can induce DNA mutations in well-known oncogenes. This review provides a critical analysis of the current evidence, highlighting the need for further research to fully grasp the complex interplay between toxic metal bioaccumulation and colorectal cancer. Understanding the contribution of toxic metals to colorectal cancer occurrence and progression is essential for the development of targeted preventive strategies and social interventions, with the ultimate goal of reducing the burden of this disease.

Exposure of environmental trace elements in prostate cancer patients: A multiple metal analysis

Prostate cancer (PCa) is the second leading cause of cancer-related deaths among men. To elucidate the connection between trace elements (arsenic: As, cadmium: Cd, lead: Pb, chromium: Cr, and nickel: Ni) and the risk of PCa, we analyzed trace element levels in the serum, urine, and tissues of PCa patients, while also examining their smoking status. We correlated these levels with their smoking habits. Notably, levels of Cd (P ≤ 0.05) and As (P ≤ 0.01) were significantly higher in the tumor tissue than in adjacent tissues. No significant differences were observed in the levels of Pb, Cr and Ni. Additionally, urinary Cd levels in 70% and arsenic levels in 2.3% of the PCa cohort were markedly higher than the CDC-reported cutoff (Cd ≤ 0.185 μg/L & As ≤100 μg/L). None displayed elevated levels of urinary Pb, Cr, and Ni. Conversely, in serum samples, the concentration of arsenic exceeded the CDC-determined limit (As ≤1.0 μg/L) in 31.69% of PCa patients. However, only 7.04% of patients had higher serum Cd levels than the CDC standard values (Cd ≤ 0.315 μg/L), while all PCa patients exceeded the Cr CDC limit (Cr ≤ 0.16 μg/L) and the Ni CDC limit (Ni ≤ 0.2 μg/L). On the contrary, no significant differences were observed in serum Pb (Pb ≤ 35.0 μg/L). Our findings establish a positive link between Cd and arsenic tissue concentrations and the risk of PCa. Subsequent studies are essential to determine whether elevated trace element levels pose a risk for the development of prostate carcinogenesis. Interestingly, among the PCa cohort comprising smokers, notably higher Cd levels were observed only in tumor tissues (P ≤ 0.01) and urine (P ≤ 0.05) compared to other elements or in other specimens.

Prediction of human health risk and disability-adjusted life years induced by heavy metals exposure through drinking water in Fars Province, Iran

Exposure to heavy metals in contaminated drinking water is strongly correlated with various cancers, highlighting the burden of disease. This study aimed to assess the non-carcinogenic and carcinogenic risks associated with exposure to heavy metals (As, Pb, Cd, and Cr) in drinking water of Fars province and evaluate the attributed burden of disease. Non-carcinogenic risk assessment was performed using the hazard quotient (HQ) method, while the carcinogenic risk assessment utilized the excess lifetime cancer risk approach. The burden of disease was evaluated in terms of years of life lost, years lived with disability, and disability-adjusted life years (DALY) for three specific cancers: skin, lung, and kidney cancer. The average drinking water concentrations of arsenic (As), cadmium (Cd), chromium (Cr) and lead (Pb) were determined to be 0.72, 0.4, 1.10 and 0.72 μg/L, respectively. The total average HQ of heavy metals in drinking water in the study area were 0.127, 0.0047, 0.0009 and 0.0069, respectively. The average ILCRs of heavy metal in the entire country were in the following order: 1.15 × 10-5 for As, 2.22 × 10-7 for Cd and 3.41 × 10-7 for Cr. The results also indicated that among the various counties analyzed, Fasa experiences the greatest burden of disease in terms of DALYs, with a value of 87.56, specifically attributed to cancers caused by exposure to arsenic. Generally, it can be said that the burden of disease is a critical aspect of public health that requires comprehensive understanding and effective intervention.

The correlation between small papillary thyroid cancers and gamma radionuclides Cs-137, Th-232, U-238 and K-40 using spatially-explicit, register-based methods

A steep increase of small papillary thyroid cancers (sPTCs) has been observed globally. A major risk factor for developing PTC is ionizing radiation. The aim of this study is to investigate the spatial distribution of sPTC in Sweden and the extent to which prevalence is correlated to gamma radiation levels (Caesium-137 (Cs-137), Thorium-232 (Th-232), Uranium-238 (U-238) and Potassium-40 (K-40)) using multiple geospatial and geostatistical methods. The prevalence of metastatic sPTC was associated with significantly higher levels of Gamma radiation from Th-232, U-238 and K-40. The association is, however, inconsistent and the prevalence is higher in densely populated areas. The results clearly indicate that sPTC has causative factors that are neither evenly distributed among the population, nor geographically, calling for further studies with bigger cohorts. Environmental factors are believed to play a major role in the pathogenesis of the disease.

Human exposure to heavy metals and related cancer development: a bibliometric analysis

As notifications on carcinogenicity of heavy metals increase, more and more attention is paid recently to heavy metals exposure. In our study, the human exposure to heavy metals and cancer knowledge epistemology was investigated using bibliometric analysis. The bibliometric data of the research articles were retrieved using following keywords: "heavy metal," "trace element", "cancer", "carcinogen", and "tumor" in the Scopus database. Specifically, 2118 articles published between 1972 and 2023 were found, covering a total of 1473 authors, 252 sources, and 2797 keywords. Retrospective data obtained from 251 documents and 145 journals were further analyzed by performance analysis and techniques of science mapping. The number of studies conducted in this field increased from one article published in 1972 to 18 articles published in 2022 in the study of Michael P Waalkes. The most impactful author regarding the number of published papers was Masoudreza Sohrabi with 7 publications. In the majority of the published papers, the most popular keywords were "cadmium" and "carcinogenicity". However, in recent 4 years, the emphasis has been placed more on epidemiology studies. Our study provides general knowledge about the trend of publication on the role of heavy metals in causing cancer. The leading researchers in the field of the effects of heavy metals on the development of cancer were identified in our studies. Our results might also create a better understanding of new and emerging issues and can be used as a comprehensive road map for future researchers.

Geochemical investigation of soil quality in terms of toxic elements using an AHP-based index

In this study, a new Ecological Soil Pollution Index (ESPI) and the associated classification system for this index have been proposed to determine the pollution potential of soil. ESPI was designed using eight elements, namely arsenic, lead, cadmium, nickel, copper, zinc, chromium and cobalt. ESPI, calculated based on the AHP method, is categorized into four classes inspired by the recommendation of some international organizations such as World Health Organization and the Food and Agriculture Organization. ESPI classes based on performance scores of samples are "No pollution," "Low pollution risk," "Medium pollution risk" and "High pollution risk." According to ESPI calculations, the element with the highest efficiency in the hierarchy is arsenic with a weight ratio of 32%, whereas the lowest values are 3.4% and 2.4% for chromium and cobalt, respectively. 5.5% of the soil samples have a high pollution risk, 5.5% medium pollution and 40.7% low pollution risk, whereas 48.3% do not have a pollution risk. Based on the distribution maps, the areas with high pollution potential are located in the north, northwest and southeast of the study area, which is due to the high arsenic, lead and cadmium weight values in the model hierarchy. The correlation coefficients between ESPI and some other indexes indicate that ESPI can produce similar results to them. As a result, ESPI is a user-friendly method that can produce reliable results by combining large numbers of data under a single score.

Estimating human health risks associated with heavy metal exposure from bottled water using Monte Carlo simulation

Water is the most important non-organic compound for living cells, and the life of all living organisms depends on it. Water is not found purely in nature, but it always contains some solutes, suspended matters and soluble gases. In this study, 11 bottled water brands (500 mL) were sampled across the Kashan city market to determine the concentration of selected heavy metals (Cr, Cd, Pb, Ni and As) and evaluated their potential risks following consumption. The concentration range of Cr, Cd, Pb, Ni and As were 5-34 μg/L, 1.5-7 μg/L, 1-7 μg/L, 2-29 μg/L, Collapse

Key Words

• Bottled water
• Heavy metals
• Human risk assessment
• Kashan

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Affiliation(s)

Nezam Mirzaei Department of Environmental Health Engineering, Social Determinants of Health (SDH) Research Center, Kashan University of Medical Sciences, Kashan, Iran
Safa Kalteh Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Hakime Zamani-Badi Department of Health, Safety and Environment Management, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran
Heshmatallah Moradpour Department of Environmental Health Engineering, Social Determinants of Health (SDH) Research Center, Kashan University of Medical Sciences, Kashan, Iran
Zeinab Parmoozeh Department of Environmental Health Engineering, Social Determinants of Health (SDH) Research Center, Kashan University of Medical Sciences, Kashan, Iran
Mansour Baziar Department of Environmental Health Engineering, Ferdows Faculty of Medical Sciences, Birjand University of Medical Sciences, Birjand, Iran

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Viability of two adaptive fuzzy systems based on fuzzy c means and subtractive clustering methods for modeling Cadmium in groundwater resources

The Adaptive Neuro-Fuzzy Inference System (ANFIS) combines the strengths of both Artificial Neural Networks (ANNs) and Fuzzy Logic (FL) into a single framework. By doing so, it allows for quicker learning and adaptable interpretation capabilities, which are useful for modeling complex patterns and identifying nonlinear relationships. One significant challenge in assessing water quality is the difficulty and time-consuming nature of determining the various factors that impact it. Given this situation, predicting heavy metal levels in groundwater resources, both urban and rural, is essential. This paper investigates two methods, ANFIS-FCM and ANFIS-SUB, to determine their effectiveness in modeling Cadmium (Cd) in groundwater resources. ‏The parameters to be considered are: dissolved solids (TDS), electroconductivity (EC), turbidity (TU), and pH were assumed to be the independent variables. A total of 51 sampling location were used with in the groundwater resource were used to develop the fuzzy models. For evaluating the performance of ANFIS-FCM and ANFIS-SUB models, three different performance criteria including the correlation coefficient, root mean square error, and sum square error were used for comparing the model outputs with actual outputs‏.‏ Based on the obtained results from scatter plots of actual and predicted value by ANFIS-SUB and ANFIS- FCM models, the determination coefficient (R²) value for total data, test and train sets is equal to 0.978, 0.982, 0.993 and to 0.983, 0.999 and 0.998 respectively. This result proved the Cd predictions of the implemented ANFIS-FCM model was significantly close to the measured all experimental data with R² of 0.983. The performance of the implemented ANFIS-FCM model was compared with the ANFIS-SUB model and it is found that the ANFIS-FCM provided slightly higher accuracy than the ANFIS-SUB model. Also, the results obtained from the comparison between the predicted and the actual data indicated that the ANFIS-FCM and ANFIS-SUB have a strong potential in estimating the heavy metals in the groundwater with a high degree of accuracy.

Metabolomics: a promising tool for deciphering metabolic impairment in heavy metal toxicities

Heavy metals are the metal compounds found in earth's crust and have densities higher than that of water. Common heavy metals include the lead, arsenic, mercury, cadmium, copper, manganese, chromium, nickel, and aluminum. Their environmental levels are consistently rising above the permissible limits and they are highly toxic as enter living systems via inhalation, ingestion, or inoculation. Prolonged exposures cause the disruption of metabolism, altered gene and/or protein expression, and dysregulated metabolite profiles. Metabolomics is a state of the art analytical tool widely used for pathomolecular inv22estigations, biomarkers, drug discovery and validation of biotransformation pathways in the fields of biomedicine, nutrition, agriculture, and industry. Here, we overview studies using metabolomics as a dynamic tool to decipher the mechanisms of metabolic impairment related to heavy metal toxicities caused by the environmental or experimental exposures in different living systems. These investigations highlight the key role of metabolomics in identifying perturbations in pathways of lipid and amino acid metabolism, with a critical role of oxidative stress in metabolic impairment. We present the conclusions with future perspectives on metabolomics applications in meeting emerging needs.

Biological and chemical contamination of illegal, uncontrolled refuse storage areas in Poland

This study focused on assessing the microbiological and chemical contamination of air, soil and leachate in uncontrolled refuse storage areas in central Poland. The research included an analysis of the number of microorganisms (culture method), endotoxin concentration (gas chromatography-mass spectrometry), heavy metals level (atomic absorption spectrometry), elemental characteristics (elemental analyser), cytotoxicity assessment against A-549 (human lung) and Caco-2 (human colon adenocarcinoma) cell lines (PrestoBlue™ test) and toxic compound identification (ultra-high-performance liquid chromatography-quadrupole time-of-flight ultrahigh-resolution mass spectrometry). Microbial contamination differed depending on the dump and the group of tested microorganisms. The number of bacteria was: 4.3 × 10² - 1.8 × 10³ CFU m^-3 (air); 1.1 × 10³ - 1.2 × 10⁶ CFU mL^-1 (leachate); 1.0 × 10⁶ - 3.9 × 10⁶ CFU g^-1 (soil). Respectively, for air and soil the number of fungi was: 2.2 × 10² - 4.6 × 10² CFU m^-3; 1.8 × 10² - 3.9 × 10³ CFU g^-1. Metal levels (Fe, Mn, Pb, Zn, Al, Hg, Cd, Cu, Cr) were higher than in the control sample; however, the average concentrations did not exceed the permissible standards. The cytotoxicity of soil and leachate samples depended on the dump, sample and cell line tested. The leachates were more cytotoxic than soil extracts. Compounds belonging to pesticides, surfactants and biocides, chemicals and/or polymer degradation products, medicinal drugs and insect repellents were found. The detection of potential pathogens in the air, soil and leachate, the presence of toxic compounds and the confirmation of the cytotoxic effect of leachate and soil on human cell lines justify the need for further research on the risks posed by illegal dumps. These studies should aim at developing a unified assessment method and a method to minimise the risk of contaminants spreading in the environment, including harmful biological agents.

Assessment of essential and toxic elemental concentrations in tumor and non-tumor tissues with risk of colorectal carcinoma in Pakistan

BACKGROUND

Colorectal tumor is a major cause of cancer morbidity and mortality both in USA and around the globe. Exposure to environmental toxicants such as toxic trace elements has been implicated in colorectal malignancy. However, data linking them to this cancer are generally lacking.

METHODS

Accordingly, the current study was to investigate the distribution, correlation and chemometric evaluation of 20 elements (Ca, Na, Mg, K, Zn, Fe, Ag, Co, Pb, Sn, Ni, Cr, Sr, Mn, Li, Se, Cd, Cu, Hg and As) in the tumor tissues (n = 147) and adjacent non tumor tissues (n = 147) of same colorectal patients which were analyzed by flame atomic absorption spectrophometry employing nitric acid-perchloric acid based wet digestion method.

RESULTS

On the average, Zn (p < 0.05), Ag (p < 0.001), Pb (p < 0.001), Ni (p < 0.01), Cr (p < 0.005) and Cd (p < 0.001) showed significantly higher levels in the tumor tissues compared with the non tumor tissues of patients, whereas mean levels of Ca (p < 0.01), Na (p < 0.05), Mg (p < 0.001), Fe (p < 0.001), Sn (p < 0.05) and Se (p < 0.01), were significantly elevated in the non tumor tissues than the tissues of tumor patients. Most of the elements revealed markedly disparities in their elemental levels based on food (vegetarian/nonvegetarian) habits and smoking (smoker/nonsmoker) habits of donor groups. The correlation study and multivariate statistical analyses demonstrated some significantly divergent associations and apportionment of the elements in the tumor tissues and non tumor tissues of donors. Noticeably, variations in the elemental levels were also noted for colorectal tumor types (lymphoma, carcinoids tumor and adenocarcinoma) and stages (I, II, III, & IV) in patients.

CONCLUSION

Overall, the study revealed that disproportions in essential and toxic elemental concentrations in the tissues are involved in pathogenesis of the malignancy. These findings provide the data base that helps to oncologist for diagnosis and prognosis of colorectal malignant patients.

Do high soil geochemical backgrounds of selenium and associated heavy metals affect human hepatic and renal health? Evidence from Enshi County, China

It is unclear whether the United States Environmental Protection Agency (US EPA) method can accurately assess heavy metal risks in high-Se areas. Herein, a black shale outcropping in Enshi County, China, was taken as the study area, and a carbonate outcropping in Lichuan County was the control area. Selenium and associated heavy metal concentrations in rock, soil, rice, human blood and urine samples and human sensitive hepatic and renal biomarkers were measured. The results showed that the contents of selenium, cadmium, molybdenum and copper in the study area were 3.68 ± 2.72 μg/g, 2.65 ± 1.42 μg/g, 16.3 ± 15.5 μg/g, and 57.3 ± 17.6 μg/g, respectively, in soil (n = 47) and 1.072 ± 0.924 μg/g, 0.252 ± 0.310 μg/g, 2.800 ± 2.167 μg/g, and 10.91 ± 27.42 μg/g, respectively, in rice (n = 47). The daily adult intake levels of selenium, cadmium and molybdenum from rice consumption in the study area (exposure group) exceed the recommended tolerance values in China. According to the US EPA method, these environmental media pose a significant risk to human health. However, in the exposure group (n = 111), the median levels of the sensitive hepatic biomarkers alanine aminotransferase (18 U/L), aspartate aminotransferase (28 U/L) and total bilirubin (10.9 μmol/L) and the sensitive renal biomarkers serum creatinine (70.1 μmol/L), urinary nitrogen (5.73 mmol/L) and uric acid (303.80 μmol/L) were within reference ranges and had values equivalent to those of the control group (P > 0.05). The elements tended to differentiate during migration from one medium to another. Due to the complex interaction between selenium and heavy metals, a survey of human health indicators is indispensable when the US EPA method is used to assess the heavy metal risks in high-Se areas. The recommended molybdenum tolerable intake in the U.S. (2000 μg/d) is reasonable based on a comparison.

A new method for estimating ore grade based on sample length weighting

Estimation of ore grade is very important for the value evaluation of ore deposits, and it directly affects the development of mineral resources. To improve the accuracy of the inverse distance weighting (IDW) method in ore grade estimation and reduce the smoothing effect of the IDW method in grade estimation, the weight calculation method involved in the IDW method was improved. The length parameter of the ore sample was used to calculate the weight of the IDW method. The length of the ore samples was used as a new factor of the weighting calculation. A new method of IDW integrated with sample length weighting (IDWW) was proposed. The grade estimation of Li, Al, and Fe in porcelain clay ore was used as a case study. A comparative protocol for grade estimation via the IDWW method was designed and implemented. The number of samples involved in the estimation, sample combination, sample grade distribution, and other factors affecting the grade estimation were considered in the experimental scheme. The grade estimation results of the IDWW and the IDW methods were used for comparative analysis of grades of the original and combined samples. The estimated results of the IDWW method were also compared with those of the IDW method. The deviation analysis of the estimated grade mainly included the minimum, maximum, mean, and coefficient of variation of the ore grade. The estimation effect of IDWW method was verified. The minimum deviations of the estimated grade of Li, Al, and Fe were between 9.129% and 59.554%. The maximum deviations were between 4.210 and 22.375%. The mean deviations were between - 1.068 and 7.187%. The deviations in the coefficient of variation were between 3.076 and 36.186%. The deviations in the maximum, minimum, mean, and coefficients of variation of the IDWW were consistent with those of the IDW, demonstrating the accuracy and stability of the IDWW method. The more the samples involved in the estimation, the greater the estimation deviations of IDW and IDWW methods. The estimated deviations of Li, Al, and Fe were affected by the shape of the grade distribution, when the same estimation parameters were used. The grade distribution pattern of the samples significantly influenced the grade estimation results. The IDWW method offers significant theoretical advantages and addresses the adverse effects of uneven sample lengths on the estimates. The IDWW method can effectively reduce the smoothing effect and improves the utilization efficiency of the original samples.

Analysis of the distribution characteristics of prostate cancer and its environmental factors in China

The high incidence and mortality and the increasing trend of prostate cancer has been one of the public health issues in many countries and regions. Meanwhile, the spatio-temporal heterogeneity of prostate cancer implies that lifestyle and ecological changes may be associated with prostate cancer, however, sufficient evidence is still lacking. This paper tried to reveal the spatial and temporal distribution characteristics of prostate cancer in China and explore the potential associations with related socioeconomic and natural condition factors. Data on prostate cancer incidence and mortality in 182 counties (districts) in mainland China from 2014-2016 were collected, and the distribution characteristics of prostate cancer were analyzed using spatiotemporal scan statistic. Spatial regression models and geodetector method were used to analyze the potential associations between meteorological conditions, socioeconomic development, and prostate cancer incidence and mortality. SaTScan, GeoDa, and GeoDetector were used for the above statistical analyses. The high-risk clusters for prostate cancer incidence and mortality were located in southeastern China, and the low-risk clusters were located in north-central China. Spatial regression models showed that the number of industrial enterprises/km² (incidence: β = 0.322, P < 0.001; mortality: β = 0.179, P < 0.001), GDP (incidence:β = 0.553, P < 0.001; mortality: β = 0.324, P < 0.001), number of beds in medical and health institutions/1000 persons (incidence: β = 0.111, P = 0.005; mortality: β = 0.068, P = 0.021), and urbanization rate (incidence: β = 0.156, P < 0.001; mortality: β = 0.100, P < 0.001) were positively associated with the incidence and mortality of prostate cancer. The urbanization rate (incidence: q = 0.185, P < 0.001; mortality: q = 0.182, P < 0.001) has the greatest explanatory power, and the interaction of all factors was bivariate enhanced or nonlinearly enhanced. The distribution of prostate cancer in China has obvious spatial heterogeneity. The incidence and mortality rate of prostate cancer are on the rise, and special plans should be formulated in each region according to local conditions.

Heavy metals in unrecorded Albanian rakia: A pilot study on a potential public health risk

Unrecorded alcohol has been linked to illness above and beyond that caused by ethanol alone because of the presence of toxic contaminants. While it can be found in all countries, consumption is high in Albania, where it is frequently consumed as a fruit brandy known as rakia. Among the contaminants identified previously in such products, metals including lead have been detected at levels posing a risk to health but there is little information on their presence in rakia. To fill this gap, we measured the level of ethanol and 24 elements among them toxic metals in 30 Albanian rakia samples. We found that 63.3% of rakia samples had ethanol concentration above 40% v/v. We also showed that there was a significant difference between the measured [mean: 46.7% v/v, interquartile range (IQR): 43.4-52.1% v/v] and reported (mean: 18.9% v/v, IQR: 17.0-20.0% v/v) concentrations of ethanol in rakia. Among the metals detected, aluminium, copper, iron, manganese, lead, and zinc were present in rakia samples at concentrations ranging between 0.013 and 0.866 mg/l of pure alcohol (pa), 0.025-31.629 mg/l of pa, 0.004-1.173 mg/l of pa, 0.185-45.244 mg/l of pa, 0.044-1.337 mg/l of pa, and 0.004-10.156 mg/l of pa, respectively. Copper and lead were found to be the greatest concern posing a potential public health risk. Although the estimated daily intake of these heavy metals from unrecorded rakia was below their toxicological threshold, the concentrations of lead and copper exceeded their limit value of 0.2 and 2.0 mg/l of pa specified for spirits in 33% and 90% of samples, respectively. Therefore, the possibility of adverse health effects cannot be excluded completely. Our findings highlight the need for action by policymakers against the risks posed by these products in Albania.

Anthropic impact on soil heavy metal contamination in riparian ecosystems of northern Algeria

The aim of this research was to highlight the impact of urbanization and agriculture on soil quality, mainly by focusing on heavy metal accumulation (Cd, Cu, Fe, Mn, Ni, Pb and Zn) in the fragile riparian ecosystems of the Medjerda river (Souk-Ahras, Algeria). This study was performed in three cultivated soils (0-10, 10-20, 20-60 cm depth) along an increasing gradient of anthropogenic pressure in non-urban (NU), peri-urban (PU) and urban areas (U). Geo-accumulation index (Igeo), Enrichment factor (EF), Pollution load index (PLI) and Potential ecological risk index (RI) were calculated, as well as the potential non-carcinogenic risk for humans (HI). Additionally, to corroborate the role of Bufo spinosus D. as biosentinel, a skin biopsy was performed to quantify the concentration of heavy metals in both terrestrial and aquatic ecosystems. The results showed that when compared to NU, U and PU areas were richer in heavy metals. In particular, Igeo-Cd displayed strongly contaminated soil in U (>3), EF showed high enrichment of heavy metals (>2) for all the soils except for Ni, PLI presented no contamination for all (<1) while RI was significantly higher in U (>300), denoting a strong impact of heavy metals on soil quality. However, HI was below 1 for all the studied areas, although the highest values were related to U and PU. The skin biopsy showed the highest values for Cu, Fe and Pb in PU (0.328, 0.713 and 0.524 mg kg^-1, respectively) similarly to trends observed in the soil of that area. This study shed light on the rising pollution of heavy metals due to urbanization and agricultural input in these fragile ecosystems where Bufo spinosus D. plays the role of potential bio-indicator for environmental pollution.

Atmospheric wet deposition of trace elements in Bangladesh: A new insight into spatiotemporal variability and source apportionment

The interaction between water vapor and natural/anthropogenic airborne particles deposits a massive amount of trace elements in the ecosystem. As the principal source region of the Indian monsoon originated from the Bay of Bengal, atmospheric trace elements in Bangladesh have impacted atmospheric wet deposition along the pathway, even reaching the headwaters in the Asian water tower. However, no study reports the atmospheric wet deposition of trace elements at the spatiotemporal scale. Thus, this study investigated the concentration, sources, and deposition of eighteen trace elements (Al, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Rb, Sr, Mo, Cd, Sn, Sb, Ba, and Pb) from 232 precipitation samples at four sites in Bangladesh. Results showed that the VWM concentrations of the eighteen measured trace elements ranged from 0.03 to 535.6 μg L^-1. Zn, Fe, and Al were the principal elements of the atmosphere at four sites with mean values of 207.9 ± 227.8, 18.2 ± 9.3, and 16.3 ± 6.8 μg L^-1, respectively. Besides, the eighteen trace elements showed significant variation in spatial scale with distinct seasonality. Enrichment factors of Zn, Sb, and Cd indicated serious anthropogenic influences. The major sources of trace elements were fossil fuel combustion, brick kilns, crustal dust, fugitive Pb, metal smelters, and battery recycling. Both the concentration and precipitation amount played a pivotal role in the deposition. Most of the air masses during the monsoon season came from marine sources passing over southern India and Sri Lanka. Meanwhile, the air masses during the non-monsoon season were from West Asia and the northwestern Indian subcontinent. The air masses are transported over a long range and deposit massive amounts of particulate matter in the Third Pole Himalayan region. This first-hand work on spatiotemporal variation provides a reference dataset for future targeting of the scientific community and policymakers for the development of strategies and action plans.

Toxic mechanisms of cadmium and exposure as a risk factor for oral and gastrointestinal carcinomas

Incidence and mortality rates of gastrointestinal (GI) and oral cancers are among the highest in the world, compared to other cancers. GI cancers include esophageal, gastric, colon, rectal, liver, and pancreatic cancers, with colorectal cancer being the most common. Oral cancer, which is included in the head and neck cancers category, is one of the most important causes of death in India. Cadmium (Cd) is a toxic element affecting humans and the environment, which has both natural and anthropogenic sources. Generally, water, soil, air, and food supplies are reported as some sources of Cd. It accumulates in organs, particularly in the kidneys and liver. Exposure to cadmium is associated with different types of health risks such as kidney dysfunction, cardiovascular disease, reproductive dysfunction, diabetes, cerebral infarction, and neurotoxic effects (Parkinson's disease (PD) and Alzheimer's disease (AD)). Exposure to Cd is also associated with various cancers, including lung, kidney, liver, stomach, hematopoietic system, gynecologic and breast cancer. In the present study, we have provided and summarized the association of Cd exposure with oral and GI cancers.

Analysis of the concentration of heavy metals in soil, vegetables and water around the bole Lemi industry park, Ethiopia

Irrigation water contaminated with industrial waste could pollute the soil and vegetables with heavy metals. The objective of this study was to analyze the concentration of heavy metals in soil and vegetables after irrigation practices with wastewater emanating from industrial parks. 24 samples were collected from 8 sampling stations for vegetable, soil and water samples separately, following APHA procedures. Samples were collected using a composite sampling method in May and June 2021. Water samples were collected using clean polyethylene plastic bottles while soil and vegetables were sampled using clean plastic bags. Analysis was done for heavy metal concentrations such as Pb, Cr, Cd, and Zn for each sample using descriptive statistics of changes in concentrations, one-way analysis of variance (ANOVA), Principal Component Analysis and Pearson Correlation Coefficient. The mean concentration of heavy metals in soil, vegetables, and water samples was analyzed. Unlike the rest of the heavy metal concentrations, the result showed the highest levels for Zn, i.e., 7.82 mg/kg and 5.12 mg/kg for vegetables and soil samples, respectively. The maximum value of the bioconcentration factor (BCF), the highest value of Estimated Daily Intake (EDI), and the maximum Target Cancer Risk (TCR) value recorded were 19.39, 0.001, and 8.09 × 10^-5 for Cd, Zn, and Cr, respectively. But, Hazard Index (HI) indicated no potential health effects. On the other hand, the concentration of heavy metals in the soil sample showed that Cr and Cd were strongly positively correlated with the concentration of Pb in vegetables during May. Cd concentration in the water sample was also strongly positively correlated with the concentration of Pb during May. The application of proper management for the reduction of contaminants, and suitable irrigation methods with treated wastewater is essential. The study can provide a basis for the City Administration of Addis Ababa to properly protect the water quality of rivers and provide a reference for river management around the industry parks across the country.

Ecological study of ambient air pollution exposure and mortality of cardiovascular diseases in elderly

As an independent risk factor, ambient air pollution can assume a considerable part in mortality and worsening of cardiovascular disease. We sought to investigate the association between long-term exposure to ambient air pollution and cardiovascular disease mortality and their risk factors in Iranian's elderly population. This inquiry was conducted ecologically utilizing recorded data on cardiovascular disease mortality from 1990 to 2019 for males and females aged 50 years or more from the Global Burden of Disease dataset. Data was interned into Joinpoint software 4.9.0.0 to present Annual Percent Change (APC), Average Annual Percent Change (AAPC), and its confidence intervals. The relationship between recorded data on ambient air pollution and cardiovascular disease' mortality, the prevalence of high systolic blood pressure, high LDL cholesterol levels, high body mass index, and diabetes mellitus type2 was investigated using the Spearman correlation test in R 3.5.0 software. Our finding demonstrated that cardiovascular diseases in elderly males and females in Iran had a general decreasing trend (AAPC = -0.77% and -0.65%, respectively). The results showed a positive correlation between exposure to ambient ozone pollution (p ≤ 0.001, r = 0.94) ambient particulate and air pollution (p < 0.001, r = 0.99) and mortality of cardiovascular disease. Also, ambient air pollution was positively correlated with high systolic blood pressure (p < 0.001, r = 0.98), high LDL cholesterol levels (p < 0.001, r = 0.97), high body mass index (p < 0.001, r = 0.91), diabetes mellitus type2 (p < 0.001, r = 0.77). Evidence from this study indicated that ambient air pollution, directly and indirectly, affects cardiovascular disease mortality in two ways by increasing the prevalence of some traditional cardiovascular disease risk factors. Evidence-based clinical and public health methodologies are necessary to decrease the burden of death and disability associated with cardiovascular disease.

Micronutrients and heavy metals in rice farms: the case of Ahvaz and Bawie Counties, Khuzestan Province, Iran

This study addressed micronutrients (Fe, Zn, Cu, Mn, Co) and heavy metals (As, Pb) in the soil and rice crop in Khuzestan Province, Iran. Twenty-eight composite soil and grain samples from the intended rice farms were garnered during harvest time. Concentrations of the elements in the samples and in the grains were, respectively, determined by inductively coupled plasma optical emission spectrometry and inductively coupled plasma mass spectrometry device. The average concentration of As, Fe, Co, Cu, Mn, Pb, and Zn in soil of crop were 2.71, 20,065.8, 10.43, 22.28, 422.28, 5.85, and 47.07 mg/kg, respectively. The physicochemical properties of soil, bioconcentration factor, daily intakes, and health risk assessment of the elements were calculated. The results revealed that the area covered by alkaline saline soils is poor in micronutrients. Bioconcentration factor values of all elements were less than 1. Low levels of bioconcentration factor may be for low levels of nutrients in the soil and physicochemical conditions of the soil. Furthermore, the daily intake of Co (adults' group) and Fe and Zn (children group) was very low. Health risk assessment showed only adults are threatened by non-cancerous diseases due to excessive value of all the elements (HI = 2.53) and cancerous diseases caused by excessive As and Pb (2.86E-04 and 2.01E-05, respectively). Considering that Khuzestan Province is the fourth largest producer of rice in Iran, the lack of micronutrients and the presence of heavy metals in rice produced in the study area can adversely affect consumers. Further investigation is therefore a must in the region.

Investigation of health risk assessment and the effect of various irrigation water on the accumulation of toxic metals in the most widely consumed vegetables in Iran

The quality of irrigation water sources can significantly affect the concentrations of heavy metals (HMs) in cultivated vegetables. This study aimed to investigate the effect of various water resources, including treated wastewater effluent (TWE), river water (RW), and well water with chemical fertilizer (WW+F), on the accumulation of heavy metals (HMs) in the three most widely consumed edible vegetables (Coriander, Radish, and Basil) in Iran. A total of 90 samples of edible vegetables, 13 samples of irrigation water, and 10 soil samples were collected to determine HMs concentrations. Iron (Fe), Zinc (Zn), Copper (Cu), Manganese (Mn), Lead (Pb), Cadmium (Cd), Chromium (Cr), Nickel (Ni,) and Arsenic (As) were analyzed by inductively coupled plasma optical emission spectrometry (ICP-OES). Eventually, the Total Target Hazard Quotient (TTHQ) for the toxic metals of As, Pb, and Cd was determined. The results revealed that the TTHQ of toxic metals in vegetables was less than the allowable limits (TTHQ = 1). Also, TWE was the best irrigation water type since the HMs content of vegetables was low. By comparing the results with national and international standards, it can be concluded that the Gharasou RW for irrigation of edible vegetables was inappropriate.

Combined exposure to multiple metals on cardiovascular disease in NHANES under five statistical models

BACKGROUND

It is well-documented that heavy metals are associated with cardiovascular disease (CVD). However, there is few studies exploring effect of metal mixture on CVD. Therefore, the primary objective of present study was to investigate the joint effect of heavy metals on CVD and to identify the most influential metals in the mixture.

METHODS

Original data for study subjects were obtained from the National Health and Nutrition Examination Survey. In this study, adults with complete data on 12 kinds of urinary metals (antimony, arsenic, barium, cadmium, cobalt, cesium, molybdenum, mercury, lead, thallium, tungsten, and uranium), cardiovascular disease, and core covariates were enrolled. We applied five different statistical strategies to examine the CVD risk with metal exposure, including multivariate logistic regression, adaptive elastic net combined with Environmental Risk Score, Quantile g-computation, Weighted Quantile Sum regression, and Bayesian kernel machine regression.

RESULTS

Higher levels of cadmium, tungsten, cobalt, and antimony were significantly associated with Increased risk of CVD when covariates were adjusted for multivariate logistic regression. The results from multi-pollutant strategies all indicated that metal mixture was positively associated with the risk of CVD. Based on the results of multiple statistical strategies, it was determined that cadmium, tungsten, cobalt, and antimony exhibited the strongest positive correlations, whereas barium, lead, molybdenum, and thallium were most associated with negative correlations.

CONCLUSION

Overall, our study demonstrates that exposure to heavy metal mixture is linked to a higher risk of CVD. Meanwhile, this association may be driven primarily by cadmium, tungsten, cobalt, and antimony. Further prospective studies are warranted to validate or refute our primary findings as well as to identify other important heavy metals linked with CVD.

Spatial distribution of heavy metals in rice grains and human health risk assessment in Hunan Province, China

Rice is the main food in China, and its pollution by heavy metals has attracted widespread attention. In this study, rice grain samples were collected from 14 prefecture-level cities in Hunan Province, China. The contents of 9 heavy metals (i.e., As, Cr, Co, Ni, Cu, Zn, Cd, Pb, and Sb) were measured using graphite digestion-inductively coupled plasma mass spectrometry (ICP-MS). Pearson correlation analysis and principal component analysis were performed to evaluate the correlation among these heavy metals. In addition, ordinary kriging interpolation were applied to investigate the spatial distribution pattern of the heavy metals. Results showed that the average concentrations of these heavy metals were 0.48 (As), 1.28 (Cr), 0.03 (Co), 0.84 (Ni), 2.39 (Cu), 15.73 (Zn), 0.28 (Cd), 0.66 (Pb), and 0.0043 (Sb) mg/kg, respectively. The single-factor pollution index (SFPI) contamination assessment showed that As, Pb, Cr, Ni, and Cd accumulated significantly in the rice grain, with over-standard rates of 100%, 100%, 64.70%, 47.05%, and 44.12%, respectively. The Sb concentrations at the sampling sites were low, and there was no obvious pollution. Health risk assessment showed that the target hazard quotient followed the order of As> Cr> Cd> Pb> 1.0> Co> Cu> Zn> Ni> Sb, and the carcinogenic risk value was in the order of Cd> Ni> As> Cr> 1.0×10^-4> Pb. In particular, quick actions should be taken to regulate As, Cr, and Cd contents in rice because they posed greater non-carcinogenic and carcinogenic health risks than the others to the local residents.

Heavy metal contamination of soil, sediment and water due to galena mining in Ebonyi State Nigeria: Economic costs of pollution based on exposure health risks

In this study, the effect of galena mining with respect to heavy metal pollution of groundwater, surface water, soil and sediments in Enyimagalagu and Mkpuma-Akpatakpa Communities in Ebonyi State, Nigeria, was investigated to estimate the health and economic burden. The heavy metals were measured using atomic absorption spectrometry (AAS). The water quality of the groundwater and surface water was determined using the water quality index (WQI). The potential health burden was estimated by determining carcinogenic and non-carcinogenic health risks via risk index (RI) and hazard index (HI), respectively. The potential economic burden was estimated using the value of statistical life (VSL) and cost of illness (COI). Obtained results revealed that the WQI of the groundwater and surface water ranged from 197 to 327 indicating very poor to unsuitable water for drinking. No non-carcinogenic risks were associated with exposure to the soil and sediment components of the environment. However, there were non-carcinogenic risks associated with the surface and groundwater, with the HIs ranging from 1.8 to 5.4. Based on the carcinogenic risk threshold of 10^-6, there were carcinogenic risks across all the environmental media ranging from 8.4*10^-5 - 2.1*10^-3. The economic cost of heavy metal pollution ranged from 20.7 million USD (10.35 billion) to 543.3 million USD (271.6 billion) for the VSL, whereas it ranged from 0.141 million USD (70.8 million) to 3.72 million USD (1.86 billion) for the COI. These costs are quite huge and can be avoided via pollution abatement measures.

Assessing levels of selected heavy metals with other pollutants in soil and water resources in Nandom District in the semi-arid northwestern Ghana

This study assessed heavy metal contaminations of soils in cultivated fields (or farms) and water samples from rivers, boreholes, and dug-out wells in Nandom District in semi-arid northwestern Ghana. Other parameters of water from the three sources were also measured and then compared to the permissible limits in the literature. The results showed that soils in farms across the study communities significantly (P ≤ 0.05) had higher levels of chromium (Cr = 0.456 ± 0.132 mgkg^-1), iron (Fe = 214.8 ± 1.52 mgkg^-1), lead (Pb = 0.854 ± 0.03 mgkg^-1), nickel (Ni = 2.813 ± 0.4 mgkg^-1), and arsenic (As = 1.753 ± 0.42 mgkg^-1) when compared to permissible limits set by World Health Organization (WHO) and Food and Agricultural Organization (FAO) for food crops. Water from the study sites significantly (P ≤ 0.0001) had lower levels of heavy metals than the permissible limits set by FAO for irrigation of growing crops. Thus, the water sources appear to be safe for irrigation in the study area. Nonetheless, these sources of water in Nandom District had significantly higher levels of total suspended solids, turbidity, and coliforms that were above the maximum limits indicated in the guidelines of WHO and the Government of Ghana for drinking water. Therefore, treatments of water for drinking are required to minimize any potential threats to public health.

One-pot solution combustion synthesis of porous spherical-shaped magnesium zinc binary oxide for efficient fluoride removal and photocatalytic degradation of methylene blue and Congo red dye

A novel porous spherical-shaped magnesium zinc binary oxide (MZO) was successfully prepared for the first time using a chemical process for fluoride removal and photocatalytic methylene blue (MB) and Congo red (CR) dye degradation. XRD, FESEM, and TEM were studied for phase formation, topographic, crystallographic, and detailed structural information. The surface charge and optical properties of the adsorbent were studied by zeta potential and photoluminescence spectra. The synthesized nano-adsorbents showed high fluoride removal capacity (43.10 mg/g) and photocatalytic activity with a degradation efficiency of 97.83% and 78.40% for MB and CR, respectively. The adsorption was strongly pH-dependent and worked well in the range 6-9. The kinetic studies were performed for both fluoride removal and dye degradation and were found to follow pseudo-second-order and first-order rate law, respectively. The samples were found to be extremely reusable and selective for fluoride removal in presence of co-ions such as NO₃^-, SO₄^2-, and Cl^-. The basic fluoride adsorption process of the samples can be related to ion exchange and electrostatic interactions, according to XPS and FTIR data. The detailed mechanistic study of photocatalytic dye degradation showed that the reaction occurred via OH radicals. Thus, MZO could be considered an effective and quick adsorbent for water purification in fluoride-containing groundwater and industrial dye wastewater.

Determination of macro-, micro-element and heavy metal contents localized in different parts of three different colored onions

The element found at the highest amount in onion samples was sulfur, and followed by K, Ca, P, Na, and Mg in decreasing order. While K contents of white onion parts are determined between 1406.31 (outer most edible) and 1758.72 mg/kg (inner most edible), K contents of the parts of brown onions were measured between 1779.79 (head) and 2495.89 mg/kg (inner most edible). Also, K amounts of purple onions were detected between 2248.73 (shell) and 3064.64 mg/kg (middle edible). In addition, in general, the highest P, S, and K were detected in the middle edible and inner most edible parts of the edible onion samples. While the highest Ca content was localized in brown and purple onion roots, it was most localized in the shell part of white onions. In edible white and brown onions, the highest Na content was found in the inner most edible part. Fe amounts of white and brown onion samples were identified between 7.94 (head) and 20.41 mg/kg (root) to 9.56 (middle edible) and 23.67 mg/kg (head), respectively. Also, Fe contents of the parts of purple onions varied between 13.04 (shell) and 20.61 mg/kg (inner most edible). While the highest Fe and Zn are determined in the middle edible part in edible white onions, the highest Fe and Zn were determined in the outer most edible part in brown onions. In general, the most heavy metals were localized in the bark, head, and root parts of the onions. This had a positive effect on the safe edibility of onions. The heavy metal detected in the highest amount in onion samples was arsenic, followed by Cr, Al, Ni, Se, Ba, Pb, Mo, Co, and Cd in descending order. Generally, purple onion type showed maximum values. Therefore, results of the present study seen to be beneficial in the way that it allowed us to selected some varieties with nutrition value that could be interesting to introduce in gastronomy.

Geospatial analysis of cesarean section in Iran (2016-2020): exploring clustered patterns and measuring spatial interactions of available health services

BACKGROUND

The lives of babies and mothers are at risk due to the uneven distribution of healthcare facilities required for emergency cesarean sections (CS). However, CS without medical indications might cause complications for mothers and babies, which is a global health problem. Identifying spatiotemporal variations of CS rates in each geographical area could provide helpful information to understand the status of using CS services.

METHODS

This cross-sectional study explored spatiotemporal patterns of CS in northeast Iran from 2016 to 2020. Space-time scan statistics and spatial interaction analysis were conducted using geographical information systems to visualize and explore patterns of CS services.

RESULTS

The temporal analysis identified 2017 and 2018 as the statistically significant high clustered times in terms of CS rate. Five purely spatial clusters were identified that were distributed heterogeneously in the study region and included 14 counties. The spatiotemporal analysis identified four clusters that included 13 counties as high-rate areas in different periods. According to spatial interaction analysis, there was a solid spatial concentration of hospital facilities in the political center of the study area. Moreover, a high degree of inequity was observed in spatial accessibility to CS hospitals in the study area.

CONCLUSIONS

CS Spatiotemporal clusters in the study area reveal that CS use in different counties among women of childbearing age is significantly different in terms of location and time. This difference might be studied in future research to identify any overutilization of CS or lack of appropriate CS in clustered counties, as both put women at risk. Hospital capacity and distance from population centers to hospitals might play an essential role in CS rate variations and spatial interactions among people and CS facilities. As a result, some healthcare strategies, e.g., building new hospitals and empowering the existing local hospitals to perform CS in areas out of service, might be developed to decline spatial inequity.

Serum trace element levels of gastrointestinal cancer patients in an endemic upper gastrointestinal cancer region

Gastrointestinal (GI) cancers are an important cause of the death rate in Turkey and in the world. Especially upper (esophageal and gastric) GI cancers are the leading types of cancer by 20-27% in Eastern Turkey. Trace elements are involved in many physiological and metabolic processes in the human body. Recent studies suggest that the increase or decrease of trace elements in the body may be related to the formation and development of many diseases such as cancers, diabetes mellitus and cardiovascular diseases etc. METHOD AND MATERIALS: In this study some trace elements; cadmium (Cd), cobalt (Co), Copper (Cu), iron (Fe), magnesium (Mg), manganese (Mn), nickel (Ni), lead (Pb), zinc (Zn) concentrations were investigated in the blood serums of esophageal, gastric and colon cancer patients and healthy controls in Van city area, an endemic upper (esophageal and gastric) GI region of Eastern Turkey. The analysis of the elements was realized with a flame atomic absorption spectrophotometer (FAAS). RESULTS: Mean serum levels of Cd and Ni in esophageal and gastric cancer patients were very significantly lower compared to controls (p < 0.001 and < 0.005). In addition, the mean serum Co level of esophageal cancer patients was very significantly lower than in controls and gastric cancer patients (p < 0.002). Also, the mean serum levels of Fe and Mn in all (esophageal, gastric and colon) cancer groups were very significantly lower than in controls (p < 0.001 and 0.002). Mean serum levels of Cu, Mg, Pb and Zn were not significantly different in all cancer patients compared to controls. CONCLUSION: We have detected the deficiency of five trace elements (Fe, Mn, Cd, Ni, Co) in esophageal, gastric and colon cancer patients. The deficiencies of trace elements may be due to malign over consumption of the nutrients and to the malnutrition of the advanced cancer patients. Nutritional therapy rich in trace elements should be considered as one of the strategies to fight against cancers.

Role of environmental lead in the occurrence of anemia in Indian children: a systematic review and meta-analysis

Exposure to lead among children, as well as adults, is a major global health issue. With diverse routes of exposure (e.g., food, air, and water) either environmentally or occupationally, lead among children can cause mild, moderate, to severe health complications in the later stages of life. The average blood lead level reported by CDC in 2021 is 3.5 µg/dL, and the level of blood lead toxicity is ≥ 10 μg/dL. In this study, we planned to systematically analyze the association between blood lead levels (BLLs) (≥ 10 μg/dL and < 10 μg/dL) and the risk of anemia (hemoglobin level < 11 g/dL) among Indian children aged between ≥ 1 and ≤ 18 years. An online literature search of 5 databases, PubMed, Ovid, EMBASE, Web of Science, and Google Scholar was accomplished with a search updated until 8^th March 2021. Study designs included cohort, cross-sectional, and case-control studies that have evaluated the association of lead toxicity or exposure with anemia (Hb < 11 g/dL) reported in urban and/or rural Indian children. Meta-analysis was performed among a total of 864 children from 4 cross-sectional studies. The association between lead toxicity (BLLs ≥ 10 μg/dL) and the risk of being anemic was not statistically significant (RR = 1.15 (95% CI: 0.86-1.55, I² = 77%). The risks of bias in all included studies were low according to the Newcastle Ottawa Scale. Increased blood lead levels did not appear to be the major contributor to anemia in Indian Children. We need to focus primarily on improving the nutritional quality, fortified food supplements, and a balanced diet for children to reduce the anemia burden in India. Lead toxicity should be sought as an etiological factor only in areas of high environmental risk factors which were leaded paints, leaded batteries, a house near major road/traffic areas, and pesticide exposure.

Effect of extracts from eggs of Helix aspersa maxima and Helix aspersa aspersa snails on Caco-2 colon cancer cells

Background

Colorectal cancer is the third most commonly diagnosed cancer. Natural compounds, administered together with conventional chemotherapeutic agent(s) and/or radiotherapy, may be a novel element in the combination therapy of this cancer. Considering the anticancer properties of compounds derived from different tissues of various snail species confirmed earlier, the purpose of the present research was to evaluate the effect of extracts from eggs of Helix aspera maxima and Helix aspersa aspersa snails, and fractions of extracts containing particles of different molecular weights on Caco-2 human epithelial colorectal adenocarcinoma cells.

Methods

The extracts and fractions were analyzed for antioxidant activity, phenols and total carbohydrates using colorimetric methods. Lipid peroxidation products and glutathione in eggs were also examined using these methods. Crude protein and fat in eggs were determined. Molecular weights of egg proteins and glycoproteins were analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Astaxanthin, selected vitamins and amino acids in eggs were measured using liquid chromatography methods, and minerals by emission spectroscopy, mass spectrometry or X-ray fluorescence. The action of extracts on the cell viability was determined by the MTT (methylthiazolyldiphenyl-tetrazolium bromide) test, based on the mitochondrial oxidative activity, after 24 and 72 h of treatment. The influence of fractions on the cell viability was assayed after 24 h. The effect of extracts on the percentage of live and dead cells was evaluated by the trypan blue assay, in which live cells exclude trypan blue, while dead cells take up this dye, after 12, 24, 48 and 72 h of treatment. Their influence on the integrity of cell membranes was determined based on the activity of LDH (lactate dehydrogenase), released from damaged cells, after 24 and 72 h of treatment. Then, the effect of extracts on the content of lipid peroxidation products in cells was examined using colorimetric method, after 24 h of treatment. Their influence on types of cell death was determined by flow cytometry, after this time.

Results

The extracts and their fractions containing molecules <3 kDa decreased the cell viability, after 24 h of treatment. The extracts reduced the percentage of live cells (also after 48 h), increased the degree of cell membrane damage and the amount of lipid peroxidation products, induced apoptosis and reduced necrosis.

Conclusions

Antioxidants, phenols, lipid peroxidation products, anticancer peptides, restriction of methionine, appropriate ratio of essential amino acids to non-essential amino acids, vitamin D₃, Ca, Mg, S, Cu, Mn, Zn, Se and other bioactive compounds comprised in the extracts and their additive and synergistic effects may have influenced Caco-2 cells. Natural extracts or the chemical compounds contained in them might be used in the combination therapy of colorectal cancer, which requires further research.

Colorectal Cancer in North-Eastern Iran: a retrospective, comparative study of early-onset and late-onset cases based on data from the Iranian hereditary colorectal cancer registry

BACKGROUND

The incidence rate of colorectal cancer (CRC) is increasing among patients below 50 years of age. The reason for this is unclear, but could have to do with the fact that indicative variables, such as tumour location, gender preference and genetic preponderance have not been followed up in a consistent mann er. The current study was primarily conducted to improve the hereditary CRC screening programme by assessing the demographic and clinicopathological characteristics of early-onset CRC compared to late-onset CRC in northeast Iran.

METHODS

This retrospective study, carried out over a three-year follow-up period (2014-2017), included 562 consecutive CRCs diagnosed in three Mashhad city hospital laboratories in north-eastern Iran. We applied comparative analysis of pathological and hereditary features together with information on the presence of mismatch repair (MMR) gene deficiency with respect to recovery versus mortality. Patients with mutations resulting in absence of the MMR gene MLH1 protein product and normal BRAF status were considered to be at high risk of Lynch syndrome (LS). Analyses using R studio software were performed on early-onset CRC (n = 222) and late-onset CRC (n = 340), corresponding to patients ≤50 years of age and patients > 50 years.

RESULTS

From an age-of-onset point of view, the distribution between the genders differed with females showing a higher proportion of early-onset CRC than men (56% vs. 44%), while the late-onset CRC disparity was less pronounced (48% vs. 52%). The mean age of all participants was 55.6 ± 14.8 years, with 40.3 ± 7.3 years for early-onset CRC and 65.1 ± 9.3 years for late-onset CRC. With respect to anatomical tumour location (distal, rectal and proximal), the frequencies were 61, 28 and 11%, respectively, but the variation did not reach statistical significance. However, there was a dramatic difference with regard to the history of CRC in second-degree relatives between two age categories, with much higher numbers of family-related CRCs in the early-onset group. Expression of the MLH1 and PMS2 genes were significantly different between recovered and deceased, while this finding was not observed with regard to the MSH6 and the MSH2 genes. Mortality was significantly higher in those at high risk of LS.

CONCLUSION

The variation of demographic, pathological and genetic characteristics between early-onset and late-onset CRC emphasizes the need for a well-defined algorithm to identify high-risk patients.

The Utility of Serum Vasorin Levels as a Novel Potential Biomarker for Early Detection of Colon Cancer

Objective

The objective of this study was to investigate the utility of vasorin, a newly discovered transmembrane protein, as a novel biomarker in the early detection of colon cancer.

Methods

A total of 80 patients aged 55-70 years, diagnosed with colon cancer and followed up in our clinics, and 50 healthy volunteer blood donors were included in the study. Participants' demographics such as age, gender, and vasorin levels were recorded and compared between the patient and control groups. In addition, primary tumor status (pT) values N and T stages of the tumors were studied in the patient group. All patients included in the study were pathologically confirmed by colonoscopy plus biopsy and postoperative histopathologic examination.

Results

The mean age was found as 64.59±3.70 (min-max: 55-70) years old in the patient group and 63.56±3.07 (min-max: 57-70) years. There was no statistically significant difference between both groups regarding demographics (p>0.05). Serum Vasorin levels were higher in patients with colon cancer than in the control group (p<0.001). Serum Vasorin levels were higher among patients with advanced disease and related to the clinical stage of the locally advanced tumor. 

Conclusion

Our findings revealed that serum vasorin levels are upregulated in patients with colon cancer. Raised vasorin levels may be a non-invasive biomarker beneficial for early detection and prediction of colon cancer prognosis. In addition, vasorin levels further rose as the disease advanced to higher TNM (tumor (T), nodes (N), and metastases (M)) stages. Further comprehensive studies are needed to draw more evident conclusions and generalize our results.