Comparison of hair with nail as index media for biological monitoring of mercury

Discerning animal-sourced food in diet using isotope analysis of human scalp hair and fingernails

PURPOSE

Diet-related diseases are advancing as the leading cause of death globally. As self-reporting of diet by patients can be associated with errors, stable isotopes of human tissues can be used to diagnose diseases, understand physiology, and detect change in diet. This study investigates the effect of type and amount of food on the nitrogen and carbon concentration (Nconc and Cconc) and isotopic composition (δ15N and δ13C) in human scalp hair and fingernails.

METHODS

A total of 100 residents participated in the study whereas only 74 individuals provided complete diet history. Sixty-six food items majorly available to them were also collected. The Nconc, Cconc, δ15N and δ13C values of human hair, nails and food items were determined.

RESULTS

The Nconc, Cconc, δ15N and δ13C values between plant-sourced and animal-sourced food items, as well as human hair and nail tissue were significantly different (p < 0.05). The δ15N value of human tissues was distinct between lacto-vegetarians and omnivores by 0.9‰. The δ15N and δ13C values of human tissues increased by 0.4-0.5‰ with every 5% increase in the consumption of animal protein.

CONCLUSIONS

The study helps to demarcate lacto-vegetarians from omnivores, and estimate the percentage of animal protein in diet based on the dual isotope values of human tissues. It also acts as a reference to determine isotopic composition of hair tissue provided the isotope value of nail tissue is known and vice versa.

Non-Essential Trace Elements Dietary Exposure in French Polynesia: Intake Assessment, Nail Bio Monitoring and Thyroid Cancer Risk

Background:

In French Polynesia, thyroid cancer mortality and incidence is reported to be the highest in the world. Excessive levels of non-essential trace elements (nETE) in the body are associated with several types of cancer.

Objective:

The present study aims to provide quantitative information on food contamination by mercury (Hg), lead (Pb), arsenic (As) and cadmium (Cd) in French Polynesia and its potential correlation with measurements performed in fingernails of Polynesians, and then to investigate the potential association between these nETE and different thyroid cancer risks.

Methods:

The study population included 229 interviewed cases and 373 interviewed controls We performed a descriptive analysis of Polynesian food and examined the association between thyroid cancer risk and daily intake levels of nETE and with fingernail nETE levels.

Results:

Hg contamination was mainly present in sea products, Pb contamination was present in almost all samples, Cd was detectable in starchy food and As was detectable in all sea products. No patient exceeded dietary contamination WHO limits for Pb, 2 participants exceeded it for Hg and 3 individuals (0.5%) for cadmium. In fingernail clippings, the most detectable pollutant was Pb (553 participants), then Hg (543 participants) then Cd (only in 130 participants). Thyroid cancer risk was increased more than 4 times by Pb daily intake in patients with a history of cancer in first-degree relatives than in ones without (p for interaction =0.01), and 2 times more in women with more than 3 pregnancies than in those with none or less (p for interaction =0.005); it was also increased following As intake by more than 30% in patients with a history of cancer in first-degree relatives than in ones without (p for interaction =0.05).

Conclusion:

Locally produced foods are not a source of nETE exposure in French Polynesia. Dieatry nETE exposure and fingernail nETE concentration are not associated to differentiated thyroid cancer risk. No correlation found between nETE dietary exposure and fingernail nETE concentration.

A method to determine integrated steroid levels in wildlife claws

Glucocorticoids act throughout life to regulate numerous physiological and behavioral processes. Their levels are therefore highly labile, reacting to varying conditions and stressors. Hence, measuring glucocorticoids (and other steroids) in wildlife is challenging, and devising methods that are unaffected by the stress of capture and handling should be explored. Here we use the tip of free-ranging chameleons' claws that were cut to allow individual identification, and report a steroids extraction and quantification method. Claw steroids present an integrated level representing the period of claw growth. We found that we could measure corticosterone in small amounts of chameleon claw matrix using commercial EIA kits. Using this method, we learned that in wild male chameleons, claw corticosterone levels were associated with body size. We suggest that claw-testing can potentially provide an ideal matrix for wildlife biomonitoring.

Mercury (Hg) burden in children: the impact of dental amalgam

The risks and benefits of using mercury (Hg) in dental amalgam have long been debated. This study was designed to estimate Hg body burden and its association with dental amalgam fillings in 182 children (ages: 5-15 years) living in Taif City. Hg was measured in urine (UHg), hair (HHg) and toenails (NHg) by the Atomic Absorption Spectrophotometer with Vapor Generator Accessory system. Urinary Hg levels were calculated as both micrograms per gram creatinine (μg/g creatinine) and micrograms per liter (μg/L). We found that children with amalgam fillings (N=106) had significantly higher UHg-C levels than children without (N=76), with means of 3.763 μg/g creatinine versus 3.457 μg/g creatinine, respectively (P=0.019). The results were similar for UHg (P=0.01). A similar pattern was also seen for HHg, with means of 0.614 μg/g (N=97) for children with amalgam versus 0.242 μg/g (N=74) for those without amalgam fillings (P=0). Although the mean NHg was higher in children without amalgam (0.222 μg/g, N=61) versus those with (0.163 μg/g, N=101), the relationship was not significant (P=0.069). After adjusting for many confounders, the multiple logistic regression model revealed that the levels of UHg-C and HHg were 2.047 and 5.396 times higher, respectively, in children with dental amalgam compared to those without (P<0.01). In contrast, a significant inverse relationship was seen between NHg levels and dental amalgam fillings (P=0.003). Despite the controversy surrounding the health impact of dental amalgam, this study showed some evidence that amalgam-associated Hg exposure might be related with symptoms of oral health, such as aphthous ulcer, white patches, and a burning-mouth sensation. Further studies are needed to reproduce these findings. The present study showed that significant numbers of children with or without amalgam had Hg levels exceeding the acceptable reference limits. The detrimental neurobehavioral and/or nephrotoxic effects of such an increased Hg on children should be a cause of concern, and further investigation is warranted. Our results are alarming and indicate an urgent need for biomonitoring and assessment of exposure. Changes in dental practices involving amalgam, especially for children, are highly recommended in order to avoid unnecessary exposure to Hg.

Mercury exposure and risk of cardiovascular disease in two U.S. cohorts

BACKGROUND

Exposure to methylmercury from fish consumption has been linked to a potentially increased risk of cardiovascular disease, but evidence from prior studies is equivocal. Beneficial effects of the ingestion of fish and selenium may also modify such effects.

METHODS

Among subjects from two U.S. cohorts (a total of 51,529 men and 121,700 women) whose toenail clippings had been stored, we prospectively identified incident cases of cardiovascular disease (coronary heart disease and stroke) in 3427 participants and matched them to risk-set-sampled controls according to age, sex, race, and smoking status. Toenail mercury and selenium concentrations were assessed with the use of neutron-activation analysis. Other demographic characteristics, cardiovascular risk factors, fish consumption, and lifestyle habits were assessed by means of validated questionnaires. Associations between mercury exposure and incident cardiovascular disease were evaluated with the use of conditional logistic regression.

RESULTS

Median toenail mercury concentrations were 0.23 μg per gram (interdecile range, 0.06 to 0.94) in the case participants and 0.25 μg per gram (interdecile range, 0.07 to 0.97) in the controls. In multivariate analyses, participants with higher mercury exposures did not have a higher risk of cardiovascular disease. For comparisons of the fifth quintile of mercury exposure with the first quintile, the relative risks were as follows: coronary heart disease, 0.85 (95% confidence interval [CI], 0.69 to 1.04; P=0.10 for trend); stroke, 0.84 (95% CI, 0.62 to 1.14; P=0.27 for trend); and total cardiovascular disease, 0.85 (95% CI, 0.72 to 1.01; P=0.06 for trend). Findings were similar in analyses of participants with low selenium concentrations or low overall fish consumption and in several additional sensitivity analyses.

CONCLUSIONS

We found no evidence of any clinically relevant adverse effects of mercury exposure on coronary heart disease, stroke, or total cardiovascular disease in U.S. adults at the exposure levels seen in this study. (Funded by the National Institutes of Health.).

Hair mercury levels in pregnant women in Mahshahr, Iran: fish consumption as a determinant of exposure

MeHg is a well-documented neurotoxicant even at low levels of exposure. Developing brain, in particular, is vulnerable to that. Through bioaccumulating to differing degrees in various fish species, it can have serious adverse effects on the development and functioning of the human central nervous system, especially during prenatal exposure. Therefore, the purpose of this study was to investigate mercury concentration in hair samples of pregnant women living in Mahshahr located in Khuzestan province, Iran. It assessed the association between fish consumption and specific characteristics that can influence exposure. From April to June 2008, 149 pregnant women were invited to participate in this study. An interview administered questionnaire was used to collect information about age, body weight, height, fish (fresh, canned and shrimp) consumption, pregnancy stage, residence duration, education level, family income and number of dental amalgam fillings. The obtained results showed that the geometric mean and range for hair total Hg concentration was 3.52 microg/g (0.44-53.56 microg/g). About 5.4% of mothers had hair total Hg levels in excess of 10 microg/g. Maternal hair mercury level was less than threshold level of WHO (5 microg/g). As expected, there was a clear increase in hair Hg with reported fresh marine fish consumption (p=0.04). The highest mean for hair mercury level in a group who consumed fish several times per week, was 4.93 microg/g. Moreover, a significant effect of age and residential time on Hg concentration in the hair of the women was found. Pregnant women in Mahshahr consumed large amounts of fish; consequently, most of their offspring were prenatally exposed to moderately high levels of mercury. The results found suggest that pregnant women should decrease their fish consumption.

Mercury exposure assessment in Iranian women's hair of a port town with respect to fish consumption and amalgam fillings

In this study we aimed to estimate the level of mercury in women's hair and its association with fish consumption and amalgam fillings in an Iranian southern port town (named Mahshahr). A total number of 195 hair samples were collected randomly from women aged 25-45 years free from occupational exposures to mercury. Additional information about these women's age, weight, height, number of pregnancies, level of education, number of amalgam fillings and fish consumption were also gathered. The determination of Hg level in hair samples was carried out by the LECO, AMA 254, Advanced Mercury Analyzer, according to ASTM standard No. D-6722. The average mercury level in these women's hair was 2.95+/-2.33microg/g (ranged from 0.07 to 24.46microg/g). In the next stage, the study participants were divided into four groups with respect to their fish consumption and number of amalgam fillings; A) <3 amalgam fillings, <3 times fish consumption per month, B) <3 amalgam fillings, >7 times fish consumption per month, C) >6 amalgam fillings, <3 times fish consumption per month, and D) >6 amalgam fillings, >7 times fish consumption per month. Statistical analysis showed that the Hg level was significantly different in these four groups (P<0.001). Mercury levels in this sample exceeded the USEPA-recommended 1microg/g in 76.4% of the studied population. Finally, the multiple linear regression results revealed that frequency of fish consumption and amalgam restorations are the most important routes of Hg exposure. However, the main determinant of Hg exposure was the intake of Hg through fish consumption.

Comparison of hair, nails and urine for biological monitoring of low level inorganic mercury exposure in dental workers

Creatinine-corrected urine mercury measurements in spot urine samples are routinely used in monitoring workers exposed to inorganic mercury. However, mercury measurement in other non-invasive biological material has been used in some epidemiological studies. Dentists and dental nurses remain a group of workers with potential exposure to inorganic mercury through their handling of mercury-containing amalgam, although changes in work practices have reduced the current, likely exposure to mercury. Therefore, dental workers remain an occupational cohort in whom the value of using different biological media to identify exposure to low level inorganic mercury can be investigated. Samples of head hair, pubic hair, fingernails, toenails and urine were analysed for mercury content from a cohort of UK dentists (n=167) and a socioeconomically similar reference population (n=68) in whom any mercury exposure was primarily through diet. The mercury content in all biological material was significantly higher in the dental workers than in the control population (p<0.0001). The geometric mean and 90th percentile mercury concentrations in the urine samples from dentists were 1.7 and 7.3 micromol mol(-1) creatinine, respectively, with only one sample having a value at around the UK's Health and Safety Executive biological monitoring health guidance level of 20 micromol mol(-1) creatinine. Receiver operator characteristic analyses suggested that the ability of the biological material to discriminate between dentists and referents were fingernails>urine approximately equal to toenails>pubic hair approximately equal to head hair. Further investigation is warranted as to why fingernails appear to be such a good discriminator, possibly reflecting some contribution of direct finger contact with amalgam or contaminated surfaces rather than systemic incorporation of mercury into growing nails. Good correlation between head hair and pubic hair mercury levels in all subjects was obtained (r=0.832), which was significantly improved when hair samples weighing <10 mg were excluded (r=0.868). Therefore, under these exposure conditions and using the described pre-analytical washing steps, there is little influence from atmospheric contamination on the level of mercury content of head hair. The choice of non-invasive biological materials for mercury analysis depends on a number of considerations. These include the toxicokinetics of urinary mercury excretion, the growth rates of hair and nail, the nature and time-frame of exposure, and the fact that urine mercury may not reflect the body burden level from dietary methyl mercury. However, the data from this study suggests that urine mercury remains the most practical and sensitive means of monitoring low level occupational exposure to inorganic mercury.

Persistent, bioaccumulative and toxic substances in fish: human health considerations

Fish are important dietary items that provide essential nutrients. Fish however, bioaccumulate monomethyl mercury (MMHg) and organo-halogenated pollutants (OHP) that are persistent bioaccumulative and toxic substances (PBTS). Unlike man-made OHP, MMHg is mainly of natural origin but background concentrations of aquatic systems are determined by the environmental Hg-methylating potential. Industrial activities can modulate environmental discharges and fish bioaccumulation of PBTS. Fish and seafood consumption are associated with human body load of PBTS, but farming practices that utilize fishmeal increase the terrestrial food chain resulting in farm-animal accumulation of PBTS. These substances are neurotoxic and endocrine active that can impact humans and wild life, but chemical characteristics of MMHg and OHP modulate interactions with animal tissues. MMHg is protein reactive with a faster metabolism (months) than OHP that are stored and slowly (years) metabolized in fat tissues. Except for brain-Hg, neither Hg nor OHP in tissues are markers of toxic effects; however, deficits in neurobehavioral test-scores of children have been shown in some fish-eating populations. These deficits are transient and within normal range, and are not prodromes of neurological diseases. Although population studies show that consumption of fish at current levels of contamination do not explain neurological disorders, endocrine activity remains controversial. Understanding risk of hazard caused by fish-PBTS consumption requires a wide range of expertise. We discuss chemical, toxic, metabolic, and ecological characteristics associated with PBTS in fish. There are proven health outcome derived from fish consumption, while risk of exposure to avoidable PBTS is a chance that can be minimized by societal actions.

Toenail mercury and dietary fish consumption

New England is one of three areas in the United States with the highest annual deposition of mercury, an established environmental pollutant with a variety of health effects. We measured the mercury content in toenails of 27 individuals in New Hampshire who participated as controls in a health study in 1994-95. The mean total toenail mercury concentration was 0.27 mcg/g (median 0.16; SD 0.27; range 0.04-1.15 mcg/g). The best predictor of toenail mercury levels was the mean combined fish and shellfish consumption measured using four simple questions from a validated food frequency questionnaire. Toenail total mercury content was significantly correlated with the mean average weekly consumption of finfish and shellfish (Spearman correlation coefficient 0.48, P=0.012). Multivariate models confirmed that toenail total mercury concentration was best predicted by total finfish and shellfish consumption.

[Levels of lead and mercury in the hair of children living in Cubatão, in the southeast region of Brazil]

A study was carried out in 6 districts of Cubatão county, S. Paulo State, Brazil on a sample of 251 children aged between 1 and 10. The concentration of heavy metals (lead and mercury) in hair was tested. The lead concentration in the hair of 229 children was tested, and in 189 (82.5%) levels varying from 2.5 to 71.4 micrograms/g were detected. The average concentration of the lead found in hair was of 7.25 +/- 8.51 micrograms/g. The concentration of mercury in the hair of 217 children was checked and all of them were found to have levels varying from 0.2 to 3.0 micrograms/g. The average concentration of mercury was of 0.82 +/- 0.48 microgram/g. No statistical difference (p > 0.05) was observed between the averages found for lead and mercury in the hair of those who consumed and those who did not consume aquatic organisms.