Chromium in drinking water: association with biomarkers of exposure and effect

Human Health Effects of Oral Exposure to Chromium: A Systematic Review of the Epidemiological Evidence

The toxicity and carcinogenicity of hexavalent chromium via the inhalation route is well established. However, a scientific debate has arisen about the potential effects of oral exposure to chromium on human health. Epidemiological studies evaluating the connection between ingested chromium and adverse health effects on the general population are limited. In recent years, a wealth of biomonitoring studies has emerged evaluating the associations between chromium levels in body fluids and tissues and health outcomes. This systematic review brings together epidemiological and biomonitoring evidence published over the past decade on the health effects of the general population related to oral exposure to chromium. In total, 65 studies were reviewed. There appears to be an inverse association between prenatal chromium exposure and normal fetal development. In adults, parameters of oxidative stress and biochemical alterations increase in response to chromium exposure, while effects on normal renal function are conflicting. Risks of urothelial carcinomas cannot be overlooked. However, findings regarding internal chromium concentrations and abnormalities in various tissues and systems are, in most cases, controversial. Environmental monitoring together with large cohort studies and biomonitoring with multiple biomarkers could fill the scientific gap.

Joint and interactive effects of metal mixtures on liver damage: Epidemiological evidence from repeated-measures study

BACKGROUND

The impact of heavy metals on liver function has been examined in numerous epidemiological studies. However, these findings lack consistency and longitudinal validation.

METHODS

In this study, we conducted three follow-up surveys with 426 participants from Northeast China. Blood and urine samples were collected, along with questionnaire information. Urine samples were analyzed for concentrations of four metals (chromium [Cr], cadmium [Cd], lead [Pb], and manganese [Mn]), while blood samples were used to measure five liver function indicators (alanine aminotransferase [ALT], aspartate aminotransferase [AST], albumin [ALB], globulin [GLB], and total protein [TP]). We utilized a linear mixed-effects model (LME) to explore the association between individual heavy metal exposure and liver function. Joint effects of metal mixtures were investigated using quantile g-computation and Bayesian kernel machine regression (BKMR). Furthermore, we employed BKMR and Marginal Effect models to examine the interaction effects between metals on liver function.

RESULTS

The LME results demonstrated a significant association between urinary heavy metals (Cr, Cd, Pb, and Mn) and liver function markers. BKMR results indicated positive associations between heavy metal mixtures and ALT, AST, and GLB, and negative associations with ALB and TP, which were consistent with the g-comp results. Synergistic effects were observed between Cd-Cr on ALT, Mn-Cr and Cr-Pb on ALB, while an antagonistic effect was found between Mn-Pb and Mn-Cd on ALB. Additionally, synergistic effects were observed between Mn-Cr on GLB and Cd-Cr on TP. Furthermore, a three-way antagonistic effect of Mn-Pb-Cr on ALB was identified.

CONCLUSION

Exposure to heavy metals (Cr, Cd, Mn, Pb) is associated with liver function markers, potentially leading to liver damage. Moreover, there are joint and interaction effects among these metals, which warrant further investigation at both the population and mechanistic levels.

Relationship of individual and mixed urinary metals exposure with liver function in the China National Human Biomonitoring (CNHBM) of Zhejiang Province

BACKGROUND

Heavy metals have been reported to affect liver function. However, there is currently little and inconsistent knowledge about the effects of combined and individual urinary metals on specific parameters of liver function in the general population. Therefore, this study aimed to investigate their associations.

METHODS

This study involved 807 general population from the China National Human Biomonitoring of Zhejiang Province 2017-2018. Concentrations of urinary metals, including Chromium (Cr), Cobalt (Co), Nickle (Ni), Arsenic (As), Selenium (Se), Molybdenum (Mo), Cadmium (Cd), Thallium (Tl) and Lead (Pb) were measured. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), total protein (TP), albumin (ALB), direct bilirubin (DBIL), total bilirubin (TBIL) as liver function biomarkers. Multivariable linear regression and weighted quantile sum (WQS) regression were employed to explore the associations of urinary metals with liver function biomarkers. Subgroup analysis stratified by gender and age, excluding smokers and drinkers for sensitivity analysis.

RESULTS

Both statistical models indicated that urinary metals were positively associated with ALT and AST, while negatively with TP, ALB, DBIL and TBIL. In the WQS analysis, each quartile increase in the ln-transformed levels of metal mixtures was associated with 4.11 IU/L (95% CI: 1.07, 7.15) higher ALT and 3.00 IU/L (95% CI: 1.75, 4.25) higher AST, as well as, with 0.67 g/L (95% CI: 1.24, -0.11) lower TP, 0.74 g/L (95% CI: 1.09, -0.39) lower ALB, 0.38 μmol/L (95% CI: 0.67, -0.09) lower DBIL, and 1.56 μmol/L (95% CI: 2.22, -0.90) lower TBIL. The association between urinary metals and ALT was primarily driven by Cd (55.8%), Cr contributed the most to the association with AST (20.2%) and TBIL (45.2%), while the association with TP was primarily driven by Ni (38.2%), the association with ALB was primarily driven by As (32.8%), and the association with DBIL was primarily driven by Pb (30.9%). The associations between urinary metals and liver function might differ by sex and age.

CONCLUSION

Urinary metals were significantly associated with liver function parameters. Further studies are required to clarify the relationship between heavy metals and liver function.

A review on chromium health hazards and molecular mechanism of chromium bioremediation

Living beings have been devastated by environmental pollution, which has reached its peak. The disastrous pollution of the environment is in large part due to industrial wastes containing toxic pollutants. The widespread use of chromium (Cr (III)/Cr (VI)) in industries, especially tanneries, makes it one of the most dangerous environmental pollutants. Chromium pollution is widespread due to ineffective treatment methods. Bioremediation of chromium (Cr) using bacteria is very thoughtful due to its eco-friendly and cost-effective outcome. In order to counter chromium toxicity, bacteria have numerous mechanisms, such as the ability to absorb, reduce, efflux, or accumulate the metal. In this review article, we focused on chromium toxicity on human and environmental health as well as its bioremediation mechanism.

Potential arsenic-chromium-lead Co-contamination in the hilly terrain of Arunachal Pradesh, north-eastern India: Genesis and health perspective

In the recent times, multi-metal co-contamination in the groundwater of various parts of the globe has emerged as a challenging environmental health problems. While arsenic (As) has been reported with high fluoride and at times with uranium; and Cr & Pb are also found in aquifers under high anthropogenic impacts. The present work probably for the first time traces the As-Cr-Pb co-contamination in the pristine aquifers of a hilly terrain that are under relatively less stress from the anthropogenic activities. Based on the analyses of twenty-two (n = 22) groundwater (GW) samples and six (n = 6) sediment samples, it was found that Cr being leached from the natural sources as evident from 100% of samples with dissolve Cr exceeding the prescribed drinking water limit. Generic plots suggests rock-water interaction as the major hydrogeological processes with mixed Ca²⁺-Na⁺-HCO₃^- type water. Wide range of pH suggests localized human interferences, as well as indicative of both calcite and silicate weathering processes. In general water samples were found high only with Cr and Fe, however all sediment samples were found to contain As-Cr-Pb. This implies that the groundwater is under-risk of co-contamination of highly toxic trio of As-Cr-Pb. Multivariate analyses indicate that the changing pH as the causative factor for Cr leaching into the groundwater. This is a new finding for a pristine hilly aquifers, and we suspect such condition may also be present in other parts of globe, and thus precautionary investigations are needed to prevent this catastrophic situation to arise, and to alert the community in advance.

Association between urine metals and liver function biomarkers in Northeast China: A cross-sectional study

BACKGROUND

After heavy metals enter the body, they affect a variety of organs, particularly the main metabolic organ, the liver. Moreover, people are more likely to be exposed to multiple metals than to a single metal. We explored the associations between exposure to a heavy metal mixture and liver function biomarkers.

METHODS

This study involved 1171 residents living in areas with or without heavy metal exposure in northeast China. Urine concentrations of chromium (Cr), cadmium (Cd), lead (Pb), and manganese (Mn) were measured. Total protein (TP), albumin (ALB), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were used as biomarkers of liver function. A generalized linear model (GLM), quantile g-computation, and Bayesian kernel machine regression (BKMR) were used to explore the associations between the four metals and liver function.

RESULTS

GLM analysis revealed that Cr level was negatively associated with TP (β = - 0.57; 95% CI: - 0.89, - 0.26) and ALB (β = - 0.27; 95% CI: - 0.47, - 0.07) levels, and Cd level was positively associated with AST (β = 1.04; 95% CI: 0.43, 1.65) and ALT (β = 0.94; 95% CI: 0.08, 1.79) levels. ALB (β = 0.26; 95% CI: 0.10, 0.41) and ALT (β = 0.52; 95% CI: 0.02, 1.02) levels were positively associated with urine Mn concentration. The quantile g-computation indicated that exposure to a mixture of the four metals was significantly associated with TP (β = - 0.56; 95% CI: - 0.94, - 0.18) and ALT (β = 0.84; 95% CI: 0.04, 1.63) levels. Among the metals, Cr had the strongest effect on TP and Cd had that on AST. The BKMR model indicated that mixed metal exposure was negatively associated with TP and ALB levels and positively associated with ALT and AST levels.

CONCLUSION

Exposure to mixtures of heavy metals may influence liver function. Cr and Cd may be the largest contributors.

Occupational Cement Dust Exposure and Inflammatory Nemesis: Bangladesh Relevance

Background

Prolonged, repeated exposure to cement dust, depending on duration and sensitivity of cement dust-exposed workers, may cause deteriorating effects on the skin, eye, respiratory and hematological system. Toxic cement dust causes inflammatory damage to different body organs. White blood cells (WBCs) are considered cellular markers of ongoing tissue inflammation.

Aim of the Study

Determining the influence of occupational cement dust exposure on WBCs with its differentials (inflammatory markers) in workers from the cement manufacturing plant.

Methodology

Ninety-two seemingly healthy male subjects (46 workers of cement plant and 46 control subjects, who do not contact cement dust, residing in Dhaka) aged between 20 and 50 years participated in this cross-sectional study. This study took place in Dhaka Medical College, Bangladesh, between the years of 2017 and 2018. An automated hematoanalyser was used to assess both the total and differential count of WBC. Data were analyzed with multivariate regression analysis, independent samples t-test, and correlation test.

Results

The total WBC count, differential count of lymphocyte, and eosinophil were significantly (p< 0.05) higher in cement dust-exposed recruits than in the control group. Additionally, multivariate regression analysis revealed that duration of cement dust exposure showed a significant association with total WBC count [odds ratio (OR)=4.42,95%, confidence level (CI) 1.56,12.47, p 0.005]. Furthermore, univariate analysis revealed that the control group (not exposed to cement dust) was less likely to have the total WBC count alteration (OR = 0.122, 95% CI =0.047 to 0.311) than the cement dust-exposed group. The total WBC count showed a significant positive correlation with exposure duration to this toxic dust.

Conclusion

Cement dust exposure causes harmful inflammatory responses, as evidenced by increased total and differential WBC count. The period of contact with this toxic dust has an impact on WBC count.

Exposição potencial a baixas doses de cromo por via oral e mortalidade por câncer de estômago na população do interior do Estado de São Paulo, Brasil

Resumo: Concentrações de cromo total entre 0,45 e 110µg/L têm sido detectadas, no Sistema Aquífero Bauru (SAB) no Estado de São Paulo, Brasil, excedendo, algumas vezes, o padrão de qualidade adotado pela legislação brasileira, que é de 50μg/L. Segundo a Companhia Ambiental do Estado de São Paulo (CETESB), parte do cromo é composta pela forma hexavalente [Cr(VI)], que apresenta controversas evidências quanto à carcinogenicidade por via oral. Este artigo tem como objetivo avaliar o efeito da exposição ao Cr(VI) em baixas doses na mortalidade por câncer gástrico da população entre 15 e 75 anos ou mais, que consumiu água do SAB, no período entre 2004 e 2015. Foi realizado um estudo ecológico em 326 municípios situados no Planalto Ocidental Paulista e que usam água do SAB. As associações foram estimadas pelo modelo de regressão linear, utilizando-se indicadores de exposição ao cromo (proxy) e razão de mortalidade padronizada (RMP) para as neoplasias gástricas como variável resposta. O Índice de Desenvolvimento Humano Municipal (IDHM) foi empregado para controlar possíveis diferenças socioeconômicas da população investigada. A RMP estimada para o câncer gástrico correspondeu a 79% dos óbitos esperados, sendo que o risco foi menor nos municípios que têm água tratada pela Companhia de Saneamento Básico do Estado de São Paulo (SABESP), com especial atenção para a população feminina (β = -0,146; IC95%: -0,270; -0,021; p = 0,022). Embora os dados da pesquisa sejam limitados, em 77 (23,6%) dos municípios avaliados, houve aumento do risco de câncer gástrico. Dentre esses, quase 70% se abastecem de manancial subterrâneo, associado às bacias hidrográficas com anomalias geoquímicas de Cr(VI).

Effect of chromium supplementation on hs-CRP, TNF-α and IL-6 as risk factor for cardiovascular diseases: A meta-analysis of randomized-controlled trials

BACKGROUND

The objective of this systematic review is to assess the relationship between chromium supplementation and inflammatory biomarkers levels (hs-CRP, TNF-α, IL-6) as risk factor for cardiovascular diseases. Recent studies raise questions regarding the potential of chromium supplementation to decrease the blood-levels of inflammatory markers, lowering cellular oxidative stress as markers of myocardial infarction; however, the results of the researches are inconclusive.

METHODS

The following databases including PubMed, Scopus, Cochran Library and Embase databases were systematically searched until April 2020. Analysis was performed using random-effect model.

RESULTS

The pooled findings for biomarkers of inflammation showed that chromium supplementation significantly reduced serum high-sensitivity C-reactive protein (hs-CRP) (WMD: -0.87 mg/dL, 95% CI: -1.49, -0.26), and tumor necrosis factor-alpha (TNF-α) (WMD: -0.97 pg/ml; 95% CI: -1.92, -0.01) and chromium insignificantly reduced interleukin -6 (IL-6) (WMD: -0.45 pg/ml, 95% CI: -1.18, 0.29).

CONCLUSION

Overall, the results of this systematic review and meta-analysis imply that chromium supplementation may help to improve biomarkers of inflammation as markers of myocardial infarction.

Polyaniline@magnetic chitosan nanomaterials for highly efficient simultaneous adsorption and in-situ chemical reduction of hexavalent chromium: Removal efficacy and mechanisms

Devising new versatile nano-adsorbents for efficient capturing of heavy metals in water represents one important direction for environmental remediation. Here, the application of a novel polyaniline@magnetic chitosan (PANI@MCTS) composite consisting of numerous nitrogen-containing functional groups and magnetic Fe₃O₄ nanoparticles was reported for the efficient treatment of chromium-containing wastewater. This material exhibited a fast adsorption kinetics (80% removal efficiency within 15 min) and strong adsorption capacity (186.6 mg(Cr(VI))•g^-1(PANI@MCTS)) for removing Cr(VI) in water as well as an excellent magnetic separation ability. The adsorption of Cr(VI) was found to follow the Langmuir isotherm model and comply with the pseudo-second-order kinetics. More importantly, the PANI@MCTS could facilitate the in-situ chemical reduction of Cr(VI) to Cr(III) that enabled the detoxification treatment of Cr(VI) in water. XPS analysis revealed the simultaneous adsorption and in-situ chemical reduction of Cr(VI) on the PANI@MCTS, where the coordination and electrostatic interaction between Cr(VI) and the positively charged nitrogen containing functional groups contributed to the adsorption, and the = N-/-NH- groups served as active redox pair triggered the in-situ chemical reduction reaction. The recycle experiment showed an excellent stability of this material with >90% removal efficiency after five repeats of treatment. This work provides a promising alternative material for the effective treatment of chromium-containing wastewater.

Concurrent adsorption and micro-electrolysis of Cr(VI) by nanoscale zerovalent iron/biochar/Ca-alginate composite

This study introduced a new approach for simultaneously enhancing Cr(VI) removal performance and mitigating release of dissolved Fe during nanoscale zero-valent iron (nZVI)-mediated reactions. After entrapping nZVI-impregnated biochar (BC) in the matrix of calcium-alginate (CA) bead, the physicochemical characterization of nZVI/BC/CA composites revealed that nZVI/BC particles were embedded inside CA having a spherical shape and several cracks on its outer layer. The multi-functionality of nZVI/BC/CA composites consisting of reductant (nZVI), porous adsorbent (BC), and external screening layer (CA) enhanced the removal of Cr(VI) with the maximum adsorption capacity of 86.4 mg/g (based on the Langmuir isotherm) and little release of dissolved Fe. With the XPS analysis and fitting results of kinetics (pseudo second order) and isotherms (Redlich-Peterson model), plausible removal mechanisms of Cr(VI) were simultaneous adsorption and micro-electrolysis reactions by nZVI/BC/CA composites. The practical applicability of nZVI/BC/CA composites was further demonstrated through the fixed-bed column experiments. These results provide new insights into the design of high-performance engineered biochar for wastewater treatment.

Dietary intake of cadmium, chromium, copper, manganese, selenium and zinc in a Northern Italy community

This study provides the dietary intakes of six trace elements (cadmium, chromium, copper, manganese, selenium and zinc), generally characterized by both nutritional and toxicological features depending on their exposure. Being diet the most relevant source of exposure to trace elements in non-professionally exposed subjects, we measured content of these trace elements in foods composing the typical Italian diet using inductively coupled plasma-mass spectrometry, and assessing dietary habits using a validated semi-quantitative food frequency questionnaire we eventually estimated dietary daily intake of trace elements in a Northern Italian community. In the 890 analyzed food samples, the main contributors to cadmium intake are cereals, vegetables and sweets, while cereals, beverages and vegetable are to primary source of manganese. The primary contributors for copper are cereals, fresh fruits and vegetables, while for chromium are beverages, cereals and meat. The main source of selenium intake are cereals and meat, followed by fish, seafood and milk and dairy products, while of zinc intake are meat, cereals, milk and dairy products. In our Italian population sample, the estimated median (interquartile range) dietary daily intakes are 5.00 (3.17-7.65), 56.70 (36.08-86.70) and 66.53 (40.04-101.32) μg/day for cadmium, chromium and selenium, and corresponding figures are 0.98 (0.61-1.49), 2.34 (1.46-3.52) and 8.50 (5.21-12.48) mg/day for copper, manganese and zinc. The estimated intakes are generally within the average intake reported in other European populations, and in such cases well above the daily dietary intakes recommended by national international agencies, avoiding the risk of excess or deficiency. The present estimated intake data can be used to examine a specific trace element of interest and would afford enhanced health protection from those trace elements characterized by both nutritional and toxicological effects.

Concurrent reduction-adsorption of chromium using m-phenylenediamine-modified magnetic chitosan: kinetics, isotherm, and mechanism

Magnetic chitosan particles (MCS) were chemically grafted by m-phenylenediamine (mPD) forming a distinctive shell layer with abundant nitrogenous functional groups and used as an adsorbent for the effective removal of Cr(VI) from aqueous solution. By interaction among functional groups in the facile oxidative polymerization process, the grafting of mPD and its polymers on MCS surface was innovatively realized. Through Fourier-transformed infrared spectroscopy, energy dispersive spectrometer, X-ray photoelectron spectroscopy, etc., the chemical properties of MCS before and after modification were characterized and the concurrent reduction-adsorption mechanism in Cr(VI) adsorption by mPD-MCS was carefully analyzed. The maximal Cr(VI) removal performance of mPD-MCS reached 227.27 mg/g, which was significantly better than that of the original MCS. The analysis indicated that Cr(VI) could be efficiently reduced to Cr(III) and the removal of Cr(VI) and Cr(III) was through adsorption and chelation simultaneously by mPD-MCS. Results also indicated that the concurrent reduction-adsorption was enhanced by protonation of nitrogenous functional groups under low pH. The obtained results suggest that mPD-MCS has a good potential in removal and detoxication of Cr(VI) from aqueous solutions.

Study on Cr(VI) Leaching from Cement and Cement Composites

This paper reports an experimental study on hexavalent chromium leaching from cement samples and cement composites containing silica fume and zeolite additions that were subjected to various leaching agents. The water-soluble Cr(VI) concentrations in cements ranged from 0.2 to 3.2 mg/kg and represented only 1.8% of the total chromium content. The presence of chromium compounds with both chromium oxidation states of III and VI was detected in the cement samples by X-ray photoelectron spectroscopy (XPS). Leaching tests were performed in a Britton-Robinson buffer to simulate natural conditions and showed increased dissolution of Cr(VI) up to 6 mg/kg. The highest amount of leached hexavalent chromium was detected after leaching in HCl. The findings revealed that the leaching of chromium from cements was higher by 55⁻80% than that from the cement composites. A minimum concentration was observed for all cement samples when studying the relationship between the soluble Cr(VI) and the cement storage time.

Hair biomonitoring and health status of a general population exposed to Nickel

An epidemiological cross-sectional study was conducted in a Greek population, being orally exposed to Ni via food consumption, in order to investigate possible health effects and to evaluate hair Ni concentration as a biomarker of exposure. The study population consisted of 139 men and 155 women, aged 25-69. Socio-demographics, lifestyle, dietary habits, occupational and medical history data were recorded through a personal interview. Hematological and biochemical examinations were conducted in blood specimens. Metals - Ni, Cr, Cd, Pb, Hg, Cu and Zn - were determined in hair samples. Women were characterized by higher Ni and Cu hair concentrations, while men by higher Cr and Hg. Factors affecting hair metal concentrations were identified to be dietary habits, consumption of local crops, occupation and smoking. Hair element content in the study population was comparable to the "reference ranges" reported in Europe, except for Ni, found higher in a fraction of our population. Men in the upper quartile of hair Ni distribution are at higher risk for abnormal high cholesterol, LDL, albumin and calcium, with odds ratios (OR) varying between 3.5 and 6.2. Accordingly, high hair Ni content in women is associated with abnormal glucose (OR=3.9), triglycerides (OR=3.1) and low abnormal sodium (OR=4.3). The study provides evidence of the suitability of hair analysis in assessing environmental exposure to Ni and supports the use of hair Ni content as a valuable and relatively inexpensive tool of biomonitoring, to identify people at risk for certain biochemical alterations.

An evaluation of the protective role of vitamin C in reactive oxygen species-induced hepatotoxicity due to hexavalent chromium in vitro and in vivo

Backgroud

Drinking water contamination with hexavalent chromium [Cr (VI)] has become one of the most serious public health problems, thus the investigation of Cr (VI)-induced hepatotoxicity has attracted much attention in recent years.

Methods

In the present study, by determining the indices of hepatotoxicity induced by Cr (VI), the source of accumulated reactive oxygen species (ROS), and the protective effect of the antioxidant Vitamin C (Vit C), we explored the mechanisms involved in Cr (VI)-induced hepatotoxicity in vitro and in vivo.

Results

We found Cr (VI) caused hepatotoxicity characterized by the alterations of several enzymatic and cytokine markers including aspartate aminotransferase (AST), alanine aminotransferase (ALT), interleukine-1β (IL-1β), and tumor necrosis factor-α (TNF-α), etc. ROS production after Cr (VI) exposure was origins from the inhibition of electron transfer chain (ETC) and antioxidant system. Vit C inhibited ROS accumulation thus protected against Cr (VI)-induced hepatotoxicity in L-02 hepatocytes and in the rat model.

Conclusions

We concluded that ROS played a role in Cr (VI)-induced hepatotoxicity and Vit C exhibited protective effect. Our current data provides important clues for studying the mechanisms involved in Cr (VI)-induced liver injury, and may be of great help to develop therapeutic strategies for prevention and treatment of liver diseases involving ROS accumulation for occupational exposure population.

Biomarkers for nutrient intake with focus on alternative sampling techniques

Biomarkers of nutrient intake or nutrient status are important objective measures of foods/nutrients as one of the most important environmental factors people are exposed to. It is very difficult to obtain accurate data on individual food intake, and there is a large variation of nutrient composition of foods consumed in a population. Thus, it is difficult to obtain precise measures of exposure to different nutrients and thereby be able to understand the relationship between diet, health, and disease. This is the background for investing considerable resources in studying biomarkers of nutrients believed to be important in our foods. Modern technology with high sensitivity and specificity concerning many nutrient biomarkers has allowed an interesting development with analyses of very small amounts of blood or tissue material. In combination with non-professional collection of blood by finger-pricking and collection on filters or sticks, this may make collection of samples and analyses of biomarkers much more available for scientists as well as health professionals and even lay people in particular in relation to the marked trend of self-monitoring of body functions linked to mobile phone technology. Assuming standard operating procedures are used for collection, drying, transport, extraction, and analysis of samples, it turns out that many analytes of nutritional interest can be measured like metabolites, drugs, lipids, vitamins, minerals, and many types of peptides and proteins. The advantage of this alternative sampling technology is that non-professionals can collect, dry, and mail the samples; the samples can often be stored under room temperature in a dry atmosphere, requiring small amounts of blood. Another promising area is the potential relation between the microbiome and biomarkers that may be measured in feces as well as in blood.

Oral Chromium Exposure and Toxicity

Hexavalent chromium [Cr(VI)] is a known carcinogen when inhaled. However, inhalational exposure to Cr(VI) affects only a small portion of the population, mainly by occupational exposures. In contrast, oral exposure to Cr(VI) is widespread and affects many people throughout the globe. In 2008, the National Toxicology Program (NTP) released a 2-year study demonstrating that ingested Cr(VI) was carcinogenic in rats and mice. The effects of Cr(VI) oral exposure are mitigated by reduction in the gut; however, a portion evades the reductive detoxification and reaches target tissues. Once Cr(VI) enters the cell, it ultimately gets reduced to Cr(III), which mediates its toxicity via induction of oxidative stress during the reduction while Cr intermediates react with protein and DNA. Cr(III) can form adducts with DNA that may lead to mutations. This review will discuss the potential adverse effects of oral exposure to Cr(VI) by presenting up-to-date human and animal studies, examining the underlying mechanisms that mediate Cr(VI) toxicity, as well as highlighting opportunities for future research.