Metal exposure in a child population after a mine tailings dam failure. Projeto Bruminha

OBJECTIVE

This study aimed to analyze the urinary concentrations of As, Cd, Pb, Hg, and Mn in children living in areas directly affected by the tailings of the Brumadinho disaster.

METHODS

We performed a cross-sectional descriptive study on a population of 217 children aged 0 to 6 years, living in Córrego do Feijão (CF), Parque da Cachoeira (PC), Aranha (AR), and Tejuco (TJ), enrolled in the Longitudinal Study of Child Health in Brumadinho (Minas Gerais) - Projeto Bruminha. Socioeconomic data and urine samples were collected to determine the concentration of selected metals.

RESULTS

Children living in locations not directly affected by the disaster (AR and TJ) had higher concentrations of As and Mn than those in directly affected areas (CF and PC). Additionally, children living in locations not potentially exposed to dust from tailings mud or mining activity (AR) showed higher urinary As concentrations than those potentially exposed (CF, PC, and TJ).

CONCLUSION

Our results suggest the need to investigate possible sources of As exposure in children living in areas not directly affected by the disaster and not potentially exposed to dust.

Maternal Mercury Exposure and Hypertensive Disorders of Pregnancy: A Systematic Review

OBJECTIVE

 The present review aimed to synthesize the evidence regarding mercury (Hg) exposure and hypertensive disorders of pregnancy (HDP).

DATA SOURCES

 The PubMed, BVS/LILACS, SciELO and UFRJ's Pantheon Digital Library databases were systematically searched through June 2021.

STUDY SELECTION

 Observational analytical articles, written in English, Spanish, or Portuguese, without time restriction.

DATA COLLECTION

 We followed the PICOS strategy, and the methodological quality was assessed using the Downs and Black checklist.

DATA SYNTHESIS

 We retrieved 77 articles, of which 6 met the review criteria. They comprised 4,848 participants, of which 809 (16.7%) had HDP and 4,724 (97.4%) were environmentally exposed to Hg (fish consumption and dental amalgam). Mercury biomarkers evaluated were blood (four studies) and urine (two studies). Two studies found a positive association between Hg and HDP in the group with more exposure, and the other four did not present it. The quality assessment revealed three satisfactory and three good-rated studies (mean: 19.3 ± 1.6 out 28 points). The absence or no proper adjustment for negative confounding factor, such as fish consumption, was observed in five studies.

CONCLUSION

 We retrieved only six studies, although Hg is a widespread toxic metal and pregnancy is a period of heightened susceptibility to environmental threats and cardiovascular risk. Overall, our review showed mixed results, with two studies reporting a positive association in the group with more exposure. However, due to the importance of the subject, additional studies are needed to elucidate the effects of Hg on HDP, with particular attention to adjusting negative confounding.

Protocol of the Longitudinal Study on Child Health in Brumadinho (MG): “Bruminha Project”

ABSTRACT: Objective: To present the research protocol and to describe the preliminary results of the Bruminha Project. Methods: This project is part of the set of health actions proposed under the Brumadinho Health Project. It is a prospective cohort study with periodic follow-ups for four years. The eligible population was all children aged 0 to 6 years living in four rural communities of the affected municipality. Sociodemographic and health data were collected, as well as urinary samples, for assessment of exposure to metals. Results: In the first year of study, we evaluated 62% (217) of the eligible population and collected 172 (79%) valid urine samples. At least one metal was detected in all samples, and in 50.6% (n=87) or them, the metal concentration was higher than the reference value. In 38% (n=82) of the children, neuropsychomotor development was considered at risk. Report of respiratory allergy was four times (4.27) more frequent and of bronchitis 62% higher (1.62) in children living in locations exposed to dust from ore residues, compared to those living more than 10 km away from the site of the dam disaster. Conclusion: The study protocol was proven adequate to evaluate the proposed outcomes. The strategy used for population selection required adjustments regarding the long-term community awareness process, with new participants in the upcoming follow-ups (2022 and 2023).

Protocolo do estudo longitudinal de saúde infantil em Brumadinho (MG): Projeto Bruminha

RESUMO: Objetivo: Apresentar o protocolo da pesquisa e descrever os resultados preliminares da linha de base da população de estudo do Projeto Bruminha. Métodos: Este projeto é parte do conjunto de ações propostas no âmbito do Programa de Ações Saúde Brumadinho. Trata-se de um estudo de coorte prospectiva, com seguimento periódico por quatro anos, cuja população elegível foi constituída de todas as crianças de 0 a 6 anos de idade residentes em quatro localidades situadas na zona rural do município afetado, com coleta de dados sociodemográficos e de saúde e de amostras urinárias para avaliação da exposição a metais. Resultados: No primeiro ano de estudo foi avaliada 62% (217) da população elegível e se coletaram 172 (79%) amostras de urina válidas. Em todas as amostras analisadas foi detectado pelo menos um metal, e em 50,6% (n=87) concentrações urinárias acima do valor de referência. Em 38% (n=82) das crianças a avaliação do desenvolvimento neuropsicomotor foi considerada de risco. O relato de alergia respiratória foi quatro vezes (4,27) mais frequente e de bronquite 61% maior (1,62) nas crianças residentes nas localidades expostas à poeira de resíduos de minério, proporcionalmente àquelas residentes a mais de 10 km do local do desastre. Conclusão: O protocolo do estudo mostrou-se adequado para avaliação dos desfechos propostos. A estratégia de captação da população de estudo necessitou de reajustes quanto ao processo de sensibilização da comunidade a longo prazo com entrada de novos participantes nos próximos seguimentos (2022 e 2023).

Metal exposure and oxidative stress biomarkers in a Brazilian agricultural community

We examined the association between exposure to metals, metalloids, and oxidative stress biomarkers among rural community residents in Brazil. Multiple linear regression was used to evaluate associations between serum metal and metalloid concentrations and blood oxidative stress biomarkers, adjusting for sex, age, education, smoking, and alcohol use. After adjustment for covariates, glutathione peroxidase activity (GPx) was inversely and significantly associated with an increase in serum arsenic (As) levels. Positive and significant associations were seen between elevated glutathione reductase (GR) activity and serum cadmium (Cd), barium (Ba), and lead (Pb) concentrations. In addition, we observed a significant increase in malondialdehyde (MDA) levels in association with an increase in Ba levels. These findings suggest that toxic metals and metalloids such as As, Ba, Cd, and Pb alter antioxidant enzyme activities. In addition, Ba seems to promote lipid peroxidation.

Exposure to pesticides and oxidative stress in Brazilian agricultural communities

BACKGROUND

Oxidative stress may be an important mechanism linking pesticide exposure to several diseases. We evaluated the association between pesticide exposures and oxidative stress biomarkers in Brazilian agricultural workers.

METHODS

A cross-sectional study was conducted in healthy agricultural (N = 52) and non-agricultural workers (N = 68) in a rural community in Rio de Janeiro State, Brazil. Regular pesticide use, sociodemographic, and lifestyle information was obtained by questionnaire. Oxidative stress biomarkers (N = 7) were measured in serum and plasma. We calculated percent differences and 95% confidence intervals (CI) in oxidative stress biomarkers for use of pesticides adjusted for sex, age, education, smoking, and alcohol consumption, using multiple linear regression.

RESULTS

Living close to or in the fields was associated with glutathione peroxidase activity but not with any other markers. We observed significant positive associations between 8-isoprostane levels and activities of glutathione reductase, glutathione peroxidase, and glutathione-S-transferase with reported use of certain insecticides, fungicides, and herbicides. Our results also indicate a significant and negative association between glutathione-S-transferase activity and insecticide use.

CONCLUSIONS

These findings suggest that use of pesticides may be associated with differences in oxidative stress biomarkers.

Serum levels of perfluorooctanoic acid and perfluorooctane sulfonic acid in pregnant women: Maternal predictors and associations with birth outcomes in the PIPA Project

AIM

Perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS) are persistent pollutants associated with adverse birth outcomes. This study aimed to identify predictors of blood PFOA and PFOS concentrations in pregnant women and to estimate their associations with birth outcomes in Brazil.

METHODS

We conducted a cross-sectional study with 139 pregnant women enrolled in the pilot study of the Rio Birth Cohort Study on Environmental Exposure and Childhood Development (PIPA Project). Multiple linear regression was used to estimate associations between PFOA and PFOS with maternal predictors and birth outcomes.

RESULTS

Higher levels of PFOA were observed in women aged 16-19 and 20-39 years, while fish consumption from 0.6 to 2.0 times per week was associated with lower levels of the substance. PFOS levels were higher in women living in houses with up to four rooms but lower in those who reported passive exposure to smoking. Increased newborn length and head circumference were also associated with higher maternal levels of PFOA.

CONCLUSIONS

In our study, age, fish consumption, passive smoking, and the number of rooms in the house were predictors of maternal PFAS levels. However, we did not observe significant associations between maternal plasma PFAS concentrations and birth outcomes.

Hypercupremia in female munitions workers using taking oral contraceptives: a case series

Copper is an essential trace element for homeostasis and is mostly obtained through the diet. Copper can also enter the body through occupational and accidental exposure, resulting in the elevation of serum copper levels (hypercupremia). Other factors associated with hypercupremia include smoking, use of oral contraceptives, and several clinical conditions. This case series describes the presence of hypercupremia in workers exposed to copper while also taking oral contraceptives. Serum copper levels of the sample remained high, even after participants spent time away from work, normalizing only after a change in contraceptive methods. The present results underscore the importance of considering oral contraceptives as a possible cause of hypercupremia in women with occupational exposure to copper, regardless of symptomatic status.

Lifetime Pesticide Use and Antinuclear Antibodies in Male Farmers From the Agricultural Health Study

Farming and pesticide use have been associated with systemic autoimmune diseases, and while certain organochlorine insecticides and other pesticides are suspected to influence risk, the role of specific pesticides in the development of systemic autoimmunity is not known. We measured serum antinuclear autoantibodies (ANA) by immunofluorescence on Hep-2 cells in 668 male farmers in the study of Biomarkers of Exposure and Effect in Agriculture (BEEA; 2010-2013), an Agricultural Health Study (AHS) subcohort. We examined ANA in relation to lifetime use of 46 pesticides first reported at AHS enrollment (1993-1997) and updated at intervals through BEEA enrollment. Odds ratios (OR) and 95% confidence intervals (CI) were estimated after adjusting for age, state, education, season of blood draw, current pesticide use, and correlated pesticides. Having ANA antibodies (3 or 4+ intensity at a 1:80 dilution, 21% of study participants) was associated with a reported history of seeking medical care due to exposure to pesticides (OR 2.15; 95%CI 1.17, 3.95), use of the fumigant methyl bromide (OR 3.16; 95%CI 1.05, 9.5), and use of petroleum oil/distillates (OR 1.50; 95%CI 1.00, 2.25). Using a higher threshold (3 or 4+ at a 1:160 dilution, 9%) ANA positivity was associated with the carbamate insecticide aldicarb (OR 4.82; 95%CI 1.33, 17.5) and greater combined use of four cyclodiene organochlorine insecticides (top tertile of intensity-weighted lifetime days vs. no use; OR T3 3.20; 95%CI 1.10, 9.27). By contrast, greater use of non-cyclodiene organochlorine insecticides was inversely associated with ANA (1:80 dilution 3 or 4+, OR T3 0.24; 95%CI 0.08, 0.72). Specific autoantibodies (to extractable nuclear antigens and anti-dsDNA), measured on those with ANA detected at the 1:80 dilution 3 or 4+, were seen in 15 individuals (2%), and were associated with use of two or more cyclodiene organochlorine insecticides and several other pesticides (e.g., carbofuran, ethylene dibromide). These findings suggest that specific pesticide exposures may have long-term effects on ANA prevalence and support the hypothesis that certain organochlorine insecticides may increase the risk of developing systemic autoimmunity.

Understanding the role of environmental factors in the development of systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is a multisystem disease with a complex etiology. Its risk is higher among women, racial and ethnic minorities, and individuals with a family history of SLE or related autoimmune diseases. It is believed that genetic factors interact with environmental exposures throughout the lifespan to influence susceptibility to developing SLE. The strongest epidemiologic evidence exists for increased risk of SLE associated with exposure to crystalline silica, current cigarette smoking, use of oral contraceptives, and postmenopausal hormone replacement therapy, while there is an inverse association with alcohol use. Emerging research results suggest possible associations of SLE risk with exposure to solvents, residential and agricultural pesticides, heavy metals, and air pollution. Ultraviolet light, certain infections, and vaccinations have also been hypothesized to be related to SLE risk. Mechanisms linking environmental exposures and SLE include epigenetic modifications resulting from exposures, increased oxidative stress, systemic inflammation and inflammatory cytokine upregulation, and hormonal effects. Research needs to include new studies of environmental risk factors for SLE in general, with a focus on lifetime exposure assessment. In addition, studies in susceptible subgroups, such as family members, studies based on genetic risk profiles, and studies in individuals with evidence of pre-clinical autoimmunity based on the detection of specific auto-antibodies are also required. Understanding the role of environmental exposures in the development of SLE may help identify modifiable risk factors and potential etiological mechanisms.