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Biometals : An International Journal on... Aug 2019Heavy metals are naturally existing elements that have relatively high atomic weight and a minimum density five times the density of water. Heavy metals have extensive... (Review)
Review
Heavy metals are naturally existing elements that have relatively high atomic weight and a minimum density five times the density of water. Heavy metals have extensive applications in industries, homes, agriculture and medicine, leading to their wide distribution in the environment. Most heavy metals are reported to be highly toxic. They also have numerous exposure routes, including ingestion, inhalation, and dermal absorption, subsequently inducing some health effects resulting from human and heavy metals contact. The implications of heavy metals with regards to children's health have been noted to be more severe compared to adults. The element's harmful consequences on children health include mental retardation, neurocognitive disorders, behavioral disorders, respiratory problems, cancer and cardiovascular diseases. Much attention should be given to heavy metals because of their high toxicity potential, widespread use, and prevalence. This review therefore examines the exposure routes and health effects of mercury (Hg), lead (Pb), chromium (Cr), cadmium (Cd), and barium (Ba) on children. In addition, their toxic mechanisms are elucidated.
Topics: Barium; Cadmium; Chromium; Humans; Lead; Metals, Heavy
PubMed: 30941546
DOI: 10.1007/s10534-019-00193-5 -
Current Environmental Health Reports Sep 2023Biomarkers are commonly used in epidemiological studies to assess metals and metalloid exposure and estimate internal dose, as they integrate multiple sources and routes... (Review)
Review
PURPOSE OF REVIEW
Biomarkers are commonly used in epidemiological studies to assess metals and metalloid exposure and estimate internal dose, as they integrate multiple sources and routes of exposure. Researchers are increasingly using multi-metal panels and innovative statistical methods to understand how exposure to real-world metal mixtures affects human health. Metals have both common and unique sources and routes of exposure, as well as biotransformation and elimination pathways. The development of multi-element analytical technology allows researchers to examine a broad spectrum of metals in their studies; however, their interpretation is complex as they can reflect different windows of exposure and several biomarkers have critical limitations. This review elaborates on more than 500 scientific publications to discuss major sources of exposure, biotransformation and elimination, and biomarkers of exposure and internal dose for 12 metals/metalloids, including 8 non-essential elements (arsenic, barium, cadmium, lead, mercury, nickel, tin, uranium) and 4 essential elements (manganese, molybdenum, selenium, and zinc) commonly used in multi-element analyses.
RECENT FINDINGS
We conclude that not all metal biomarkers are adequate measures of exposure and that understanding the metabolic biotransformation and elimination of metals is key to metal biomarker interpretation. For example, whole blood is a good biomarker of exposure to arsenic, cadmium, lead, mercury, and tin, but it is not a good indicator for barium, nickel, and uranium. For some essential metals, the interpretation of whole blood biomarkers is unclear. Urine is the most commonly used biomarker of exposure across metals but it should not be used to assess lead exposure. Essential metals such as zinc and manganese are tightly regulated by homeostatic processes; thus, elevated levels in urine may reflect body loss and metabolic processes rather than excess exposure. Total urinary arsenic may reflect exposure to both organic and inorganic arsenic, thus, arsenic speciation and adjustment for arsebonetaine are needed in populations with dietary seafood consumption. Hair and nails primarily reflect exposure to organic mercury, except in populations exposed to high levels of inorganic mercury such as in occupational and environmental settings. When selecting biomarkers, it is also critical to consider the exposure window of interest. Most populations are chronically exposed to metals in the low-to-moderate range, yet many biomarkers reflect recent exposures. Toenails are emerging biomarkers in this regard. They are reliable biomarkers of long-term exposure for arsenic, mercury, manganese, and selenium. However, more research is needed to understand the role of nails as a biomarker of exposure to other metals. Similarly, teeth are increasingly used to assess lifelong exposures to several essential and non-essential metals such as lead, including during the prenatal window. As metals epidemiology moves towards embracing a multi-metal/mixtures approach and expanding metal panels to include less commonly studied metals, it is important for researchers to have a strong knowledge base about the metal biomarkers included in their research. This review aims to aid metals researchers in their analysis planning, facilitate sound analytical decision-making, as well as appropriate understanding and interpretation of results.
Topics: Pregnancy; Female; Humans; Cadmium; Arsenic; Manganese; Selenium; Nickel; Barium; Uranium; Tin; Zinc; Mercury; Biomarkers
PubMed: 37337116
DOI: 10.1007/s40572-023-00402-x -
American Journal of Speech-language... Jul 2020Purpose The modified barium swallow study (MBSS) is a widely used videofluoroscopic evaluation of the functional anatomy and physiology of swallowing that permits... (Review)
Review
Purpose The modified barium swallow study (MBSS) is a widely used videofluoroscopic evaluation of the functional anatomy and physiology of swallowing that permits visualization of bolus flow throughout the upper aerodigestive tract in real time. The information gained from the examination is critical for identifying and distinguishing the type and severity of swallowing impairment, determining the safety of oral intake, testing the effect of evidence-based frontline interventions, and formulating oral intake recommendations and treatment planning. The goal of this review article is to provide the state of the science and best practices related to MBSS. Method State of the science and best practices for MBSS are reviewed from the perspectives of speech-language pathologists (SLPs) and radiologists who clinically practice and conduct research in this area. Current quandaries and emerging clinical and research trends are also considered. Results This document provides an overview of the MBSS and standards for conducting, interpreting, and reporting the exam; the SLPs' and radiologist's perspectives on standardization of the exam; radiation exposure; technical parameters for recording and reviewing the exam; the importance of an interdisciplinary approach with engaged radiologists and SLPs; and special considerations for examinations in children. Conclusions The MBSS is the primary swallowing examination that permits visualization of bolus flow and swallowing movement throughout the upper aerodigestive tract in real time. The clinical validity of the study has been established when conducted using reproducible and validated protocols and metrics applied according to best practices to provide accurate and reliable information necessary to direct treatment planning and limit radiation exposure. Standards and quandaries discussed in this review article, as well as references, provide a basis for understanding the current best practices for MBSS.
Topics: Barium; Child; Cineradiography; Deglutition; Deglutition Disorders; Fluoroscopy; Humans; Radiation Exposure
PubMed: 32650657
DOI: 10.1044/2020_AJSLP-19-00189 -
Environment International Apr 2022Exposure to some conventional trace elements has been found to be associated with miscarriage; however, evidence for combined exposure is inconclusive. Therefore, it is...
BACKGROUND
Exposure to some conventional trace elements has been found to be associated with miscarriage; however, evidence for combined exposure is inconclusive. Therefore, it is important to explore the joint associations between toxic and essential trace elements and miscarriage.
METHODS
This cross-sectional study measured a wide range of element levels in the whole blood of pregnant women by using inductively coupled plasma mass spectrometry. The associations between individual elements and miscarriage were appraised using logistic regression model. Multi-exposure models, including Bayesian kernel machine regression (BKMR) and weighted quantile sum regression (WQS), were used to explore the mixed exposure to elements. Furthermore, grouped weighted quantile sum (GWQS) considered multiple elements with different magnitudes and directions of associations.
RESULTS
In logistic regression, the odds ratios (ORs) with a 95% confidence interval (CI) in the highest quartiles were 5.45 (2.00, 15.91) for barium, 0.28 (0.09, 0.76) for copper, and 0.32 (0.12, 0.83) for rubidium. These exposure-outcome associations were confirmed and supplemented by BKMR, which indicated a positive association for barium and negative associations for copper and rubidium. In WQS, a positive association was found between mixed elements and miscarriage (OR: 1.71; 95% CI: 1.07, 2.78), in which barium (75.7%) was the highest weighted element. The results of GWQS showed that the toxic trace element group dominated by barium was significantly associated with increased ORs (OR: 2.71; 95% CI: 1.74, 4.38). Additionally, a negative association was observed between the essential trace element group and miscarriage (OR: 0.32; 95% CI: 0.18, 0.54), with rubidium contributing the most to the result.
CONCLUSIONS
As a toxic trace element, barium was positively associated with miscarriage both by individual and multiple evaluations, while essential trace elements, particularly rubidium and copper, exhibited negative associations. Our findings provide significant evidence for exploring the effects of trace elements on miscarriage.
Topics: Abortion, Spontaneous; Barium; Bayes Theorem; Copper; Cross-Sectional Studies; Female; Humans; Pregnancy; Rubidium; Trace Elements
PubMed: 35219936
DOI: 10.1016/j.envint.2022.107161 -
Frontiers in Public Health 2022Epidemiological evidence on Urine metals and cognitive impairment in older individuals is sparse and limited. The goal of this study was to analyze if there was a link...
BACKGROUND
Epidemiological evidence on Urine metals and cognitive impairment in older individuals is sparse and limited. The goal of this study was to analyze if there was a link between urinary metal levels and cognitive performance in U.S. people aged 60 and up.
METHODS
The National Health and Nutrition Examination Survey (NHANES) data from 2011 to 2014 were utilized in this cross-sectional analysis. Memory function was quantified using the following methods: Established Consortium for Word Learning in Alzheimer's Disease (CERAD-WL) (immediate learning and recall and delayed recall), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST). An inductively coupled plasma mass spectrometry (ICP-MS) was used to estimate urine metal concentrations. The connection of Urine metals level with cognitive function was investigated employing binary logistic regression and restricted cubic spline models.
RESULTS
A total of 840 participants aged 60 years and over were enrolled in this study. After controlling for confounders, the association between cadmium, barium, cobalt, cesium, manganese, and thallium and poor cognitive performance showed significance in multiple logistic regression compared to the lowest quartile of metals. In the DSST test, the weighted multivariate adjusted ORs (95% CI) for cadmium in the highest quartile, barium and cesium in the third quartile were 2.444 (1.310-4.560), 0.412 (0.180-0.942) and 0.440 (0.198-0.979), respectively. There were L-shaped associations between urine cesium, barium, or manganese and low cognitive performance in DSST. Urine lead, molybdenum and uranium did not show any significant relationships with cognitive impairment, respectively, compared to the respective lowest quartile concentrations.
CONCLUSION
The levels of barium (Ba), cobalt (Co), cesium (Cs), manganese (Mn), and thallium (Tl) in urine were found to be negatively related to the prevalence of impaired cognitive performance in our cross-sectional investigation. Higher cadmium (Cd) levels were associated with cognitive impairment.
Topics: Barium; Cadmium; Cesium; Cobalt; Cognition; Cross-Sectional Studies; Humans; Manganese; Molybdenum; Nutrition Surveys; Thallium; Uranium
PubMed: 36148349
DOI: 10.3389/fpubh.2022.985127 -
Environmental Research Dec 2022It is well-documented that heavy metals are associated with cardiovascular disease (CVD). However, there is few studies exploring effect of metal mixture on CVD....
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.
Topics: Adult; Antimony; Arsenic; Barium; Bayes Theorem; Cadmium; Cardiovascular Diseases; Cesium; Cobalt; Environmental Exposure; Environmental Pollutants; Humans; Mercury; Models, Statistical; Molybdenum; Nutrition Surveys; Thallium; Tungsten; Uranium
PubMed: 36174761
DOI: 10.1016/j.envres.2022.114435 -
Clinical Case Reports Jul 2021We have presented a case of barium appendicitis, which is a rare complication of barium enema studies. Barium sulfate is used widely for gastrointestinal radiographic...
We have presented a case of barium appendicitis, which is a rare complication of barium enema studies. Barium sulfate is used widely for gastrointestinal radiographic studies and is associated with few complications. Clinicians need to be fully aware of this complication.
PubMed: 34322273
DOI: 10.1002/ccr3.4583 -
The Science of the Total Environment Aug 2023Accumulating evidence showed that environmental exposure to toxic metals was harmful to human health. However, information about the effects of exposure to metal...
Accumulating evidence showed that environmental exposure to toxic metals was harmful to human health. However, information about the effects of exposure to metal mixtures on psoriasis was scarce. To investigate the independent and comprehensive associations between heavy metal co-exposure and psoriasis in adults, data of 6534 adults aged 20-80 years from the National Health and Nutrition Examination Survey (NHANES) were used. Among them, 187 (2.86 %) were diagnosed with psoriasis and the rest were participants without psoriasis. We examined the independent and combined associations of 3 blood metals and 11 urinary metals with psoriasis risk. In the single-metal analyses, urinary barium (Ba), cesium (Cs), antimony (Sb), uranium (Ur), and cadmium (Cd) were positively correlated with psoriasis risk, while urinary molybdenum (Mo) was identified as a protective factor for psoriasis. Moreover, weighted quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR) models consistently revealed the positive effect of urinary metal co-exposure on psoriasis risk. The associations were more evident in the young and middle-aged group than the elderly group. In the urinary mixtures, Ba was the highest weighted metal in the whole population and the young and middle-aged people, whereas Sb was the top weighted metal in the elderly group. Additionally, BKMR analysis revealed the potential interaction between certain components of urinary metal mixtures in psoriasis. The results of quantile-based g computation (qgcomp) model further proved the toxic effect of urinary metal mixtures on psoriasis, and the positive linear relationship between urinary Ba and psoriasis risk was identified by restricted cubic splines (RCS) regression. We concluded that co-exposure to multiple heavy metals was associated with psoriasis risk. Given the limitations of the NHANES study, further prospective designed studies are warranted.
Topics: Aged; Middle Aged; Adult; Humans; Cross-Sectional Studies; Nutrition Surveys; Bayes Theorem; Metals, Heavy; Barium; Uranium; Psoriasis
PubMed: 37172860
DOI: 10.1016/j.scitotenv.2023.164133 -
Frontiers in Public Health 2023The hepatotoxicity of exposure to a single heavy metal has been examined in previous studies. However, there is limited evidence on the association between heavy metals...
OBJECTIVE
The hepatotoxicity of exposure to a single heavy metal has been examined in previous studies. However, there is limited evidence on the association between heavy metals mixture and non-alcoholic fatty liver disease (NAFLD) and metabolic-associated fatty liver disease (MAFLD). This study aims to investigate the associations of 13 urinary metals, individually and jointly, with NAFLD, MAFLD, and MAFLD components.
METHODS
This study included 5,548 adults from the National Health and Nutrition Examination Survey (NHANES) 2003-2018. Binary logistic regression was used to explore the associations between individual metal exposures and MAFLD, NAFLD, and MAFLD components. Bayesian kernel machine regression (BKMR) and Quantile-based g-computation (QGC) were used to investigate the association of metal mixture exposure with these outcomes.
RESULTS
In single metal analysis, increased levels of arsenic [OR 1.09 (95%CI 1.03-1.16)], dimethylarsinic acid [1.17 (95%CI 1.07-1.27)], barium [1.22 (95%CI 1.14-1.30)], cobalt [1.22 (95%CI 1.11-1.34)], cesium [1.35 (95%CI 1.18-1.54)], molybdenum [1.45 (95%CI 1.30-1.62)], antimony [1.18 (95%CI 1.08-1.29)], thallium [1.49 (95%CI 1.33-1.67)], and tungsten [1.23 (95%CI 1.15-1.32)] were significantly associated with MAFLD risk after adjusting for potential covariates. The results for NAFLD were similar to those for MAFLD, except for arsenic, which was insignificantly associated with NAFLD. In mixture analysis, the overall metal mixture was positively associated with MAFLD, NAFLD, and MAFLD components, including obesity/overweight, diabetes, and metabolic dysfunction. In both BKMR and QGC models, thallium, molybdenum, tungsten, and barium mainly contributed to the positive association with MAFLD.
CONCLUSION
Our study indicated that exposure to heavy metals, individually or cumulatively, was positively associated with NAFLD, MAFLD, and MAFLD components, including obesity/overweight, diabetes, and metabolic dysfunction. Additional research is needed to validate these findings in longitudinal settings.
Topics: Adult; Humans; Non-alcoholic Fatty Liver Disease; Molybdenum; Nutrition Surveys; Thallium; Barium; Arsenic; Bayes Theorem; Overweight; Tungsten; Obesity
PubMed: 36950101
DOI: 10.3389/fpubh.2023.1133194