Contributions of risk factors to high lead and cadmium levels in deciduous teeth

Background: Epidemiologic evidence supports lead and cadmium as CVD risk factors. In the Trial to Assess Chelation Therapy (TACT), edetate disodium infusions lowered CVD risk in patients with a prior myocardial infarction. The impact of repeated chelation on established biomarkers of metal body burden, post-chelation lead and pre-chelation urine cadmium, is unknown. Objective: To assess metals in urine samples collected at the first and at 10 or more infusions with edetate disodium. We hypothesized that post-chelation urine lead and pre-chelation urine cadmium would be lower after 10 infusions compared to the first infusion. Other metals were exploratory. Methods: 13 patients with coronary artery disease (CAD) received a median of 3 g of edetate disodium over 3h per infusion and a median of 51 infusions (range 22-61). We collected pre and post-chelation urine samples at infusions 1 and ≥10. Metals were analyzed with ICPMS and controlled for urine dilution. Pre and post-chelation geometric means (GM) of urine metals at the ≥10 vs. first infusion were compared using paired T-tests. Results: Mean (SD) age was 75 (11) years, 77% participants were men, 46% were past smokers, 92% had diabetes, and 92% had peripheral artery disease. Comparing infusions ≥10 to 1 (Table), the GM (μg/g creatinine) dropped from 0.45 to 0.03 (94% reduction; p=0.005) for pre-chelation lead and from 14.80 to 2.91 (80% reduction; p=0.04) for post-chelation lead. For pre and post-chelation cadmium, the corresponding figures were 0.34 to 0.12 (64% reduction; p=0.17) and 2.81 to 2.35 (16% reduction; p=0.48), respectively. Conclusions: TACT treatment may decrease total body burden of lead, further supporting lead is a modifiable CVD risk factor. Data are insufficient to inform on changes in the burden of cadmium or other metals. Ongoing, larger studies will assess the effect of repeated chelation on toxic metal burden and incident cardiovascular disease.

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Abstract P060: Reduction of Cardiovascular Mortality in the United States Population, 1988-2004: A Larger Contribution of Declining Exposures to Cadmium and Lead Compared to Traditional Cardiovascular Risk Factors

Circulation ◽

10.1161/circ.133.suppl_1.p060 ◽

2016 ◽

Vol 133 (suppl_1) ◽

Author(s):

Adrian Ruiz-Hernandez ◽

Ana Navas-Acien ◽

Roberto Pastor-Barriuso ◽

Josep Redon ◽

Eliseo Guallar ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Cardiovascular Mortality ◽

Blood Lead ◽

Mortality Rates ◽

Lead And Cadmium ◽

The Us ◽

Urine Cadmium ◽

Cadmium And Lead ◽

Cvd Mortality

Introduction: Lead and cadmium exposures have markedly declined in the US following the banning of lead in gasoline and the implementation of tobacco control, air pollution reduction, and hazardous waste remediation policies since the mid 1970s. While lead and cadmium have been proposed as cardiovascular disease risk factors, little is known about their potential contribution to the decline in cardiovascular mortality in US adults. Hypothesis: We assessed the hypothesis that lead and cadmium exposure reductions partly explain the decreasing trend in cardiovascular mortality that occurred in the US from 1988-1994 to 1999-2004, after controlling for traditional cardiovascular risk factors including smoking, obesity, physical inactivity, hypertension, diabetes, chronic kidney disease, and dyslipidemia. Methods: Cohort study of 15,421 men and women ≥40 years old participating in the National Health and Nutrition Examination Survey (NHANES) 1988-1994 and 1999-2004. We implemented a mediation approach with additive hazard models to estimate the reductions in cardiovascular disease (CVD) mortality rates over time explained through changes in urine cadmium and blood lead concentrations. Results: After adjusting for age, sex, race and smoking, urine cadmium and blood lead concentrations decreased by 20.4 and 38.2%, respectively, between 1988-1934 and 1999-2004. Age-adjusted CVD mortality rates in the US decreased from 712.0 to 356.8 /100.000 person-years comparing 1988-1994 to 1999-2004. Changes in traditional CVD risk factors explained 16% of this decline. The observed reductions in urine cadmium and blood lead levels explained an additional 27.6% of this decline. Conclusions: The net impact of declining cadmium and lead exposures on mortality changes in the US was larger compared to traditional risk factors. These findings support that reducing cadmium and lead exposures resulted in a major public health achievement. The general population, however, remains exposed to cadmium and lead at concentrations that have been associated to CVD in the US population. Preventive strategies to enable additional reductions in exposure to cadmium and lead are needed.

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Advantages of the Use of Deciduous Teeth, Hair, and Blood Analysis for Lead and Cadmium Bio-Monitoring in Children. A Study of 6-Year-Old Children from Krakow (Poland)

Biological Trace Element Research ◽

10.1007/s12011-010-8896-6 ◽

2010 ◽

Vol 143 (2) ◽

pp. 637-658 ◽

Cited By ~ 26

Author(s):

Henryk J. Barton

Keyword(s):

Blood Analysis ◽

Deciduous Teeth ◽

Lead And Cadmium ◽

Bio Monitoring

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Evaluation of Lead and Cadmium Levels in Deciduous Teeth of Children Additionally Exposed to Particles from Tobacco Smoke in Indoor Environment. Preliminary Results

Toxicology Letters ◽

10.1016/03784-2749(59)47464- ◽

1995 ◽

Vol 78 ◽

pp. 36

Author(s):

R Górny

Keyword(s):

Tobacco Smoke ◽

Indoor Environment ◽

Deciduous Teeth ◽

Preliminary Results ◽

Lead And Cadmium

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Blood lead and cadmium levels in preschool children and associated risk factors in São Paulo, Brazil

Environmental Pollution ◽

10.1016/j.envpol.2018.04.124 ◽

2018 ◽

Vol 240 ◽

pp. 831-838 ◽

Cited By ~ 16

Author(s):

Kelly Polido Kaneshiro Olympio ◽

Júlia Prestes da Rocha Silva ◽

Agnes Soares da Silva ◽

Vanessa Cristina de Oliveira Souza ◽

Marília Afonso Rabelo Buzalaf ◽

...

Keyword(s):

Risk Factors ◽

Preschool Children ◽

Blood Lead ◽

Sao Paulo ◽

São Paulo ◽

Lead And Cadmium ◽

Associated Risk Factors

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CARDIOVASCULAR TOXICITY IN COPPER PRODUCTION WORKERS EXPOSED TO HEAVY METALS

Hygiene and Sanitation ◽

10.33029/0016-9900-2020-99-1-37-44 ◽

2020 ◽

Vol 99 (1) ◽

pp. 37-44

Author(s):

L. N. Budkar ◽

V. B. Gurvich ◽

Elena A. Karpova ◽

K. S. Kudrina ◽

T. Yu. Obukhova ◽

...

Keyword(s):

Risk Factors ◽

Heavy Metals ◽

Cardiovascular Diseases ◽

Aminolevulinic Acid ◽

Ferrous Metal ◽

Copper Production ◽

Copper Smelting ◽

Stepwise Logistic Regression ◽

Exposure Limits ◽

Lead And Cadmium

Introduction. Cardiovascular diseases (CVD) are a leading cause of morbidity and mortality. The role of occupational hazards in the CVD prevalence remains to be clarified. Material and methods. Here we report the results of the study of risk factors and CVD prevalence in 590 workers at the largest copper production plants in the Sverdlovsk region, exposed to heavy metals in the workplace. The workers` health information was obtained during a regular medical examination in 2018. The lead concentration increase to 1.3-1.8 occupational exposure limits was registered in the working areas of the concentrating mill (for bunkerman) and copper smelting workshops (transporter, smelter, converter, non-ferrous metal spreader, repairman, electrician). Results. We studied the exposure indices (Pb level in blood), the response markers (reticulocyte count, erythrocytes basophilic stippling, coproporphyrin, and aminolevulinic acid in the urine), and their correlation to a working tenure. Based on this analysis, we attributed CVD risk factors and cardiovascular diseases to the occupation, in order to potentially modify some of those risk factors and ultimately inform the risk management. Hypertension occurred in 57% of the examined workers, which is higher than in the general population. We calculated relative risk, confidence intervals and attributable fraction. We developed a predictive mathematical model (stepwise logistic regression) to predict high-stage hypertension and identified the risk factors associated with its development. Conclusions. Correlation analysis revealed direct correlations between stages 2 and 3 hypertension and a working tenure over 20 years. We think it’s reasonable to consider the documented CVDs as related to the toxic effects of heavy metals (lead and cadmium).

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