[Reference values for lead in blood in urban population in southern Brazil]

Determination of 14 trace elements in blood, serum and urine after environmental disaster in the Doce River basin: Relationship between mining waste and metal concentration in the population

BACKGROUND

Exposure to chemical substances after an environmental disaster can cause both toxic effects and changes in the health status of people who live in or have proximity to environments of this nature, so that the concern with populations is growing.

METHODS

In this cross-sectional study, blood, serum and urine samples were collected from 100 volunteers from Santo Antônio do Rio Doce, eight from Ilha das Pimentas and 50 from the control group; and analyzed by inductively coupled plasma mass spectrometry for biomonitoring of Al, As, Ba, Cd, Co, Cu, Cr, Fe, Hg, Mn, Ni, Se, Pb, Zn. In addition, a comprehensive questionnaire was applied to collect demographic and socioeconomic information, as well as lifestyle.

RESULTS

The concentrations of As, Al, Cd, Ni and Mn were above the reference value in some biological matrices, with more pronounced exposure in Ilha das Pimentas. The concentrations of As, Cd, Cu, Co, Pb and Zn showed statistical differences regarding gender in the different biological matrices. The trace elements in the blood, serum and urine showed significant correlations when considering age and habits such as the consumption of cigarettes, alcoholic beverages and fish. The main correlations were observed between Co, Cr, Mn, Ni and Pb in the blood and cigarette consumption.

CONCLUSION

This is the first study in these regions after the environmental disaster and confirmation of the diagnosis and health care of the participants should be promoted for clinical investigation and the eventual need for treatment. Human biomonitoring demonstrated high concentrations of some toxic elements, with more accentuated exposure in Ilha das Pimentas.

Subacute exposure to lead promotes disruption in the thyroid gland function in male and female rats

Exposure to heavy metals, such as lead, is a global public health problem. Lead has a long historic relation to several adverse health conditions and was recently classified as an endocrine disruptor. The aim of this study was to investigate the effects of subacute exposure to lead on the thyroid gland function. Adult male and female Wistar rats received a lead acetate solution containing 10 or 25 mg/kg, by gavage, three times a week, for 14 days. One week later, behavioral testing showed no alterations in anxiety and motor-exploratory parameters, as evaluated by Open-Field and Plus-Maze Tests, but impairment in learning and memory was found in the male 25 mg/kg lead-treated group and in both female lead-treated groups, as evaluated by the Inhibitory Avoidance Test. After one week, serum levels of tT3 were reduced in the 25 mg/kg female group and in the 10 mg∕ kg male group. However, tT4 levels were increased in the 25 mg/kg male group and in both female treated groups. TSH levels did not change and lead serum levels were undetectable. Morphologic alterations were observed in the thyroid gland, including abnormal thyroid parenchyma follicles of different sizes, epithelial stratification and vacuolization of follicular cells, decrease in colloid eosinophilia and vascular congestion, accompanied by morphometric alterations. An increase in collagen deposition was also observed. No differences were observed in TPO activity or protein expression, H₂O₂ generation by NADPH oxidases or hepatic D1 mRNA expression. However, thyroid NIS protein expression was considerably decreased in the male and female lead-treated groups, while TSHr expression was decreased in the 25 mg/kg female lead-treated group. These findings demonstrated that subacute exposure to lead acetate disrupts thyroid gland function in both sexes, leading to morphophysiological impairment and to changes in learning and memory abilities.

Lead and mercury levels in an environmentally exposed population in the Central Brazil

The objective was to assess the level of exposure to lead and mercury in a population in the Pantanal region in Mato Grosso State, Brazil. Blood lead (PbB) (n = 119) and urinary mercury (HgU) (n = 109) in local residents were measured by atomic absorption spectrometry. Comparison of means and correlations between variables used analysis of variance (ANOVA) and linear regression, respectively, with 95% confidence intervals. Mean PbB was 2.82 ± 1.53µg dL-1. The comparison of PbB stratified by collection site (p ≤ 0.01), work activity (p ≤ 0.01), and consumption of locally produced cow's milk (p ≤ 0.05) showed statistically significant differences. There were also positive associations between PbB and collection site (p ≤ 0.01), participants' profession (p ≤ 0.05), local milk (p ≤ 0.01), and source of drinking water (p ≤ 0.01). Mean HgU was 1.41 ± 0.98µg L-1. The levels only showed significant differences for participants' profession (p ≤ 0.01), and positive associations emerged between HgU and work activity (p ≤ 0.01) and body mass index (p ≤ 0.01). The samples showed low lead and mercury levels, similar to those found in other environmentally exposed populations. Despite these low concentrations, current knowledge on the toxicity of these metals shows that health effects can already be felt at levels that were previously considered safe, thus characterizing a health hazard.

Trace element levels in blood and associated factors in adults living in the metropolitan area of São Paulo, Brazil

This study evaluated blood arsenic (As), cadmium (Cd), lead (Pb), mercury (Hg), copper (Cu) and manganese (Mn) levels in a group of residents (n=374) in the metropolitan area of São Paulo (MASP) and investigated the association between trace element levels in blood and sociodemographic and lifestyle factors. Trace elements were measured in specimens by inductively coupled plasma mass spectrometry (ICP-MS). Geometric means were 3.6μg/L, 0.13μg/L, 23.9μg/L, 1.4μg/L, 999μg/L, and 12.5μg/L for As, Cd, Pb, Hg, Cu, and Mn, respectively. As, Pb and Hg levels were associated with education level. Men presented higher blood lead levels (PbB) and lower blood copper levels (CuB) than women. Fish consumption was primarily related to increased blood Hg levels (HgB). Smokers exhibited 1.8 times more blood cadmium levels (CdB) than non-smokers. Only 4% of the study samples exceeded the Pb reference values for the MASP population, and 12% had Hg levels higher than the German HBM-I value (5μg/L for adults).The study group showed slightly higher exposure to As, Hg and Mn and lower Cd than those of European and North American studies.

Medical geology in the framework of the sustainable development goals

Exposure to geogenic contaminants (GCs) such as metal(loid)s, radioactive metals and isotopes as well as transuraniums occurring naturally in geogenic sources (rocks, minerals) can negatively impact on environmental and human health. The GCs are released into the environment by natural biogeochemical processes within the near-surface environments and/or by anthropogenic activities such as mining and hydrocarbon exploitation as well as exploitation of geothermal resources. They can contaminate soil, water, air and biota and subsequently enter the food chain with often serious health impacts which are mostly underestimated and poorly recognized. Global population explosion and economic growth and the associated increase in demand for water, energy, food, and mineral resources result in accelerated release of GCs globally. The emerging science of "medical geology" assesses the complex relationships between geo-environmental factors and their impacts on humans and environments and is related to the majority of the 17 Sustainable Development Goals in the 2030 Agenda of the United Nations for Sustainable Development. In this paper, we identify multiple lines of evidence for the role of GCs in the incidence of diseases with as yet unknown etiology (causation). Integrated medical geology promises a more holistic understanding of the occurrence, mobility, bioavailability, bio-accessibility, exposure and transfer mechanisms of GCs to the food-chain and humans, and the related ecotoxicological impacts and health effects. Scientific evidence based on this approach will support adaptive solutions for prevention, preparedness and response regarding human and environmental health impacts originating from exposure to GCs.

Associated factors for higher lead and cadmium blood levels, and reference values derived from general population of São Paulo, Brazil

Human activities are associated with emissions of various metals into the environment, among which the heavy metals lead and cadmium stand out, as they pose a risk to human life even at low concentrations. Thus, accurate knowledge of the levels of these metals exhibited by the overall population, including children, is important. The aim of this study was to estimate the concentrations of lead and cadmium in the blood of adults, adolescents and children residing in the city of São Paulo, assess factors associated with higher lead and cadmium blood levels, and to establish reference values for this population. The study sample consisted of 669 adults over 20 years old, 264 adolescents aged 12 to 19 years old and 391 children under 11 years old from both genders. The samples were collected at the end of 2007 and during 2008 in different city zones. Higher blood lead concentration was significantly associated with gender, smoking, offal intake, area of residence and age. The blood cadmium concentration was significantly associated with gender, smoking, consumption of distilled beverages and age. The reference values of lead and cadmium established for adults above 20 years old were 33 μg/L and 0.6 μg/L, respectively, for adolescents (12 to 19 years old) were 31 μg/L and 0.6 μg/L, respectively and for children under 11 years old were 29 μg/L and 0.2 μg/L, respectively. The results of this study indicate that the exposure levels of the investigated population to lead and cadmium are low.

Lead concentration in the blood of the general population living near a lead-zinc mine site, Nigeria: Exposure pathways

Lead (Pb) poisoning in children is a major public health catastrophe worldwide. This report summarises both exposure pathways and blood Pb levels in children below 7 years of age and adults (above 18 years) from the Adudu community living near a lead-zinc mine in Nasawara, Nigeria. The average and median blood Pb levels in children and adults were 2.1 and 1.3 μg/dL, 3.1 and 1.8 μg/dL, respectively. However, Pb in 14% of adults' blood exceeded 5 μg/dL, which is the recommended threshold blood Pb concentration in adults as established by the Centers for Disease Control and Prevention (CDC). Furthermore 68% of adults' blood exceeded blood Pb action level of 2 μg/dL. For children, 11.4% and 31% of the blood samples exceeded 5 μg/dL and 2 μg/dL, respectively, while no safe blood Pb level in children has been recommended. In Nasawara, a significant difference (p<0.05) was observed between the various age groups in children with 2-4 years old having the highest levels and 6 year old children having the lowest Pb levels. Although this study did not detect elevated levels of Pb in children's blood in regions such as Zamfara, Nigeria and Kabwe, Zambia, a high percentage of samples exceeded 2 μg/dL. Soils, floor dusts, water and crops also reveal that Pb contamination in the study area could potentially be the major cause of blood Pb in the community exposed to mining. This study also observed a significant correlation between water Pb levels of adults and blood Pb levels, suggesting that water is the major exposure pathway. This analysis highlights the need to properly manage mining activities so that the health of communities living in the vicinity of a Pb-Zn mine is not compromised.

Risk factors for lead exposure in adult population in southern Brazil

In Brazil there is no systematic evaluation to access blood lead levels (BLL) in the general population and few studies with adults have been published. The aim of this study was to examine the socioeconomic, environmental, and lifestyle determinants of BLL in the adult Brazilian population. In total, 959 adults, aged 40 years or more, were randomly selected in a city in southern Brazil. Information on socioeconomic, dietary, lifestyle, and occupational background was obtained by interviews. A spatial analysis was conducted to discern whether there were any identifiable sources of exposure. BLL were measured by inductively coupled plasma-mass spectrometry. There was an adjustment for gender, age, race, education, income class, smoking status, alcohol consumption, occupation, and red meat or cow milk consumption (Model 1), and for occupation and gender (Model 2). The geometric mean of BLL was 1.97 μg/dl (95% CI: 1.9-2.04 μg/dl). In Model 1, BLL were positively associated with male gender, older age, and drinking and smoking habits, and less frequently with milk consumption. In Model 2, data showed higher BLL in non-white than white participants, in former smokers and individuals with current or former employment in lead (Pb) industries. The participants living in the area with more Pb industries had higher BLL (3.3 μg/dl) compared with those residing in other areas with no or fewer Pb industries (1.95 μg/dl). Despite the low BLL found in adults living in an urban area, Pb industries need to be monitored and regulatory laws implemented to prevent metal contamination in urban settings.

Reference values of lead in blood and related factors among blood donors in the Western Amazon, Brazil

The aim of this study was to (1) determine the reference value of blood lead levels (BLL) in a sample of blood donors of Rio Branco, the capital city of Acre, in the Western Brazilian Amazon, and (2) explore factors influencing lead (Pb) exposure levels. Between 2010 and 2011, blood samples were collected from universal blood donors attending the Central Hemotherapic Unit in Rio Branco with a total number of 1196. Information on characteristics of 1183 donors was obtained through questionnaires. Blood Pb concentrations were determined by inductively coupled plasma-mass spectrometry with detection limit of 0.003 μg/L. Association between BLL and participant characteristics was examined by linear regression analysis. Reference values of BLL were calculated as the upper limit of the 95% confidence interval of the 95th percentile. Reference values of BLL were 109.5 μg/L for men, 70.7 μg/L for women, 88.9 μg/L for younger individuals (18-29 yr), 115.3 μg/L for older ones (≥30 yr), 94.2 μg/L for nonsmokers, and 164.5 μg/L for smokers. Levels of BLL were significantly higher in males, subjects older than 29 yr, non-whites, smokers, regular consumers of manioc flour, and donors practicing any activity related to paints, ceramics, pottery, fishing, or firearms. Subjects with higher education, higher income, vitamin intake use, and drinkers of bottled water displayed lower BLL. In general, BLL in men and women from Rio Branco were higher than those described in other adult populations. Prevention of exposure of this population to local sources of Pb needs to be addressed.

Cadmium exposure induces vascular injury due to endothelial oxidative stress: the role of local angiotensin II and COX-2

Cadmium is an environmental pollutant that is closely linked with cardiovascular diseases, such as atherosclerosis and hypertension. Moreover, cadmium can induce an increase in oxidative stress. One of the main sites affected by oxidative stress is the aorta, which consequently develops atherosclerosis. However, there are few reports demonstrating aortic effects induced by small concentrations of cadmium that are similar to those found in the blood resulting from occupational exposure. Furthermore, several studies have reported on chronic cadmium exposure, and the results of these studies may have been influenced by the secondary effects induced by this metal, such as hypertension. Therefore, we investigated the effects of acute cadmium exposure on the vascular reactivity to phenylephrine of aortic rings isolated from male Wistar rats. Cadmium increased phenylephrine reactivity without changing the vasorelaxation induced by acetylcholine and sodium nitroprusside. Endothelial damage or incubation with L-NAME shifted the phenylephrine concentration-response curves leftward in arteries incubated with or without cadmium, but the curves were shifted to a lesser degree after cadmium incubation. Enalapril, losartan, the nonselective COX inhibitor indomethacin, the TXA(2) synthase inhibitor furegrelate, the selective COX-2 inhibitor NS 398, the TP receptor antagonist SQ 29.548, the EP1 receptor antagonist SC 19.220, superoxide dismutase, and the NADPH oxidase inhibitor apocynin partially reverted the cadmium-induced effects on the reactivity to phenylephrine. Cadmium exposure increased vasoconstrictor activity by reducing NO bioavailability owing to the increased production of ROS by NADPH oxidase. The results of the tested cadmium concentration, which is below the reference values, suggest that acute cadmium exposure may induce vascular injury through endothelial oxidative stress. These data contribute to the evidence indicating that cadmium is a high risk to public health.

Reference values for lead, cadmium and mercury in the blood of adults from the metropolitan area of Sao Paulo, Brazil

Human biomonitoring is an important tool for the evaluation of environmental exposure to contaminants. The data that are obtained from these studies might be compared to appropriate reference values (RVs) in a specific population. The RVs were derived from the rounded values of the upper limit of the 95th confidence interval of the 95th percentile for lead (Pb), cadmium (Cd) and mercury (Hg) in blood from adults in the metropolitan area of Sao Paulo (MASP), Brazil to investigate the association between blood metals and sociodemographic and lifestyle factors. Blood samples from 653 nonsmoking blood donors without occupational exposure to the studied metals were collected in 2006. Our evaluations distinguished a younger group (18-39 years) and an older group (40-65 years). RVs in the younger group were 60 μgPb/L and 4 μgHg/L for men and 47 μgPb/L and 4 μgHg/L for women. RVs in the older group were 80 μgPb/L and 5 μgHg/L for men and 63 μgPb/L and 6 μgHg/L for women. The RV for Cd was 0.6 μg/L for adults aged 18-65 years. Pb and Cd levels demonstrated a significant association with sex and age. Male blood contained 50% more Pb, and the older group exhibited 23% more Pb. Fish consumption and amalgam fillings were primarily related to Hg levels. RVs for lead were similar to the Czech Republic and Germany but higher than the US population. The RV for Cd in Brazil was well below the RVs of these countries. The RVs for Hg in Brazil were similar to the US but higher than Germany and the Czech Republic.

Occupational and environmental human lead exposure in Brazil

The purpose of this paper is to present a review of data on assessment of exposure and adverse effects due to environmental and occupational lead exposure in Brazil. Epidemiological investigations on children lead exposure around industrial and mining areas have shown that lead contamination is an actual source of concern. Lead in gasoline has been phasing out since the 1980s, and it is now completely discontinued. The last lead mining and lead refining plant was closed in 1995, leaving residual environmental lead contamination which has recently been investigated using a multidisciplinary approach. Moreover, there are hundreds of small battery recycling plants and secondary smelting facilities all over the country, which produce focal urban areas of lead contamination. Current regulatory limits for workplace lead exposure have shown to be inadequate as safety limits according to a few studies carried out lately.

Environmental contamination and human exposure to lead in Brazil

Adverse effects caused by environmental lead pollution are well recognized. Being a widespread agent in the environment and a major harmful element to organic systems, mostly to children, lead has been investigated all over the world, aiming to improve measures regarding its control. The purpose of this chapter is to present a review of the situation of production, uses, assessment of exposure, and adverse effects from environmental lead contamination in Brazil. It also presents aspects of Brazilian legislation setting up maximum permissible levels of lead in several environmental compartments such as surface and drinking water, soils, sediment, urban air, and also in commercially sold food, vegetables, fish, and meat, in an effort to control industrial emissions. Epidemiological investigations on children's lead exposure around industrial and mining areas are revised, showing that many situations where lead contamination is potentially present still need to be addressed by governmental agencies. In Brazil, lead was withdrawn from gasoline by the end of the 1980s, and the last lead mining and primary smelting plant was closed in 1995, leaving residual environmental lead contamination, which has recently been investigated using a multidisciplinary approach. Nevertheless, there are hundreds of small secondary battery recycling plants all over the country, running smelting facilities that produce local urban areas of lead contamination.

[Lead level, enamel defects and dental caries in deciduous teeth]

OBJECTIVE

To verify the relationship between lead concentration in the enamel of deciduous teeth and the presence of enamel defects and, consequently, with dental caries among preschool children.

METHODS

The sample consisted of 329 preschool children in Piracicaba, State of São Paulo: 132 attending municipal kindergartens close to industrial plants and 197 attending kindergartens in non-industrial areas. This sample belonged to an initial study made between 2000 and 2001, in which the lead concentration was obtained by means of enamel biopsy. Oral clinical examination of the children from both regions was performed to verify the prevalence of enamel defects, using the Developmental Defects of Enamel (DDE) Index of the World Dental Federation (FDI), and of dental caries, using the decayed, missing and filled surfaces (dmfs) index of the World Health Organization. The chi-squared test and relative risk calculation were utilized in relation to a significance level of 5%, considering each region separately.

RESULTS

Among the children from the non-industrial area, there was a higher proportion with dental caries among those with higher lead concentrations in deciduous teeth (p=0.02). This was not, however, observed among the children from the industrial area (p=0.89). There was an increased relative risk (RR) of caries among the children from the non-industrial area, but this was not seen among the children from the industrial area. No relationship was observed between the presence of lead and enamel defects.

CONCLUSIONS

No data was found that would give evidence of a relationship between lead concentration and enamel defects in either of the areas studied. No relationship was found between lead and dental caries in the industrial area, thus emphasizing that more studies of such relationships are needed.