Maria de Fátima Henriques Carvalho

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.

Lead levels in milk and blood from donors to the Breast Milk Bank in Southern Brazil.

Brazilian scientific literature on the adverse effects of lead on the general population is still very limited. Lead, a potentially toxic substance, has become a public health problem due to its effects, mainly those affecting the central nervous system and on the synthesis of heme. The aim of this study is to evaluate the level of lead exposure of donors to the Breast Milk Bank in the city of Londrina, Parana, by estimating the levels of that metal in milk and blood samples. This is a cross-sectional study conducted during the period between January and July 2007. All mothers enrolled as donors in the Breast Milk Bank were included in this study. A total of 92 volunteers presenting the following inclusion criteria were evaluated in the project: volunteers who were healthy, without any chronic disease, full-term pregnancy, breastfeeding between the 15th and 210 th day after giving birth, and living in the city of the study. Lead in milk and blood was quantified using the inductive coupled plasma mass spectroscopy (ICP-MS) technique. All mothers signed a consent form approved by the Research Ethics Committee from Londrina State University. The median lead concentration in milk samples was 3.0 microg/L, varying from 1.0 to 8.0 microg/L. The median of lead in blood was of 2.7 microg/dl, varying from 1.0 to 5.5 microg/dl. In Spearman correlation analysis, significant but modest correlations could be observed between the concentration of lead in blood and in milk (r(s)=0.207, p=0.048), hemoglobin and ALAD activity (r(s)=-0.264, p=0.011), level of lead in blood and mothers age (r(s)=0.227, p=0.029). However, for hematocrit and hemoglobin, the correlation was higher (r(s)=0.837, p<0.001). No statistically significant associations were found between concentrations of lead in milk and blood and demographic variables studied, obtained through interviews and validated questionnaire. The mean of milk/blood lead ratio was equal to 0.11. In general, the values found in the present study are similar to those obtained in populations in other countries, and are within background levels.

Lead, hemoglobin, zinc protoporphyrin and ferritin concentrations in children

OBJECTIVE To assess the relationship of blood lead and hemoglobin, zinc protoporphyrin, and ferritin concentrations in children. METHODS A cross-sectional study was carried out in 136 anemic and non-anemic children from two rural villages near a lead smelter in Adrianópolis, Southern Brazil, from July to September 2001. Hemoglobin electrophoresis was performed to exclude children with hemoglobin variants and thalassemia syndromes associated with anemia. Lead was determined by atomic absorption spectrophotometry; hemoglobin by automated cell counting; zinc protoporphyrin by hematofluorometry; ferritin by chemiluminescence. Students t-test, Mann-Whitney test, and the c(2) test were used to assess the significance of the differences between the variables investigated in anemic and non-anemic children. Stepwise multivariate linear regression analysis was performed using two models for anemic and non-anemic children respectively. RESULTS Lead was negatively associated to hemoglobin (p<0.017) in the first model, and in the second model lead was positively associated to zinc protoporphyrin (p<0.004) after controlling for ferritin, age, sex, and per capita income. There was an inverse association between hemoglobin and blood lead in anemic children. It was not possible to confirm if anemic children had iron deficiency anemia or subclinical infection, considering that the majority (90.4%) had normal ferritin. CONCLUSIONS The study detected a relationship between anemia and elevated blood lead concentrations. Further epidemiological studies are necessary to investigate the impact of iron nutritional interventions as an attempt to decrease blood lead in children.

Total Arsenic, Cadmium, and Lead Determination in Brazilian Rice Samples Using ICP-MS

This study is aimed at investigating a suitable method for rice sample preparation as well as validating and applying the method for monitoring the concentration of total arsenic, cadmium, and lead in rice by using Inductively Coupled Plasma Mass Spectrometry (ICP-MS). Various rice sample preparation procedures were evaluated. The analytical method was validated by measuring several parameters including limit of detection (LOD), limit of quantification (LOQ), linearity, relative bias, and repeatability. Regarding the sample preparation, recoveries of spiked samples were within the acceptable range from 89.3 to 98.2% for muffle furnace, 94.2 to 103.3% for heating block, 81.0 to 115.0% for hot plate, and 92.8 to 108.2% for microwave. Validation parameters showed that the method fits for its purpose, being the total arsenic, cadmium, and lead within the Brazilian Legislation limits. The method was applied for analyzing 37 rice samples (including polished, brown, and parboiled), consumed by the Brazilian population. The total arsenic, cadmium, and lead contents were lower than the established legislative values, except for total arsenic in one brown rice sample. This study indicated the need to establish monitoring programs for emphasizing the study on this type of cereal, aiming at promoting the Public Health.

Association of lead, cadmium and mercury with paraoxonase 1 activity and malondialdehyde in a general population in Southern Brazil

ABSTRACT Metal exposure is associated with increased oxidative stress (OS), which is considered an underlying mechanism of metal‐induced toxicity. Malondialdehyde (MDA) is a final product of lipid peroxidation, and it has been extensively used to evaluate metal‐induced OS. Pro‐oxidant effects produced by metals can be mitigated by paraoxonase 1 (PON1), an antioxidant enzyme known to prevent cardiovascular disease and atherosclerosis. Among other factors, the Q192R polymorphism and the exposure to heavy metals have been known to alter PON1 activity. Here, we evaluated the association of blood lead (Pb), cadmium (Cd) and mercury (Hg) levels with PON1 activity, and with MDA concentrations in a randomly selected sample of Brazilian adults aged 40 years or older, living in an urban area in Southern Brazil. A total of 889 subjects were evaluated for blood Pb and Cd levels, and 832 were tested for Hg. Geometric mean of blood Pb, Cd and Hg was 1.93 &mgr;g/dL, 0.06 &mgr;g/L and 1.40 &mgr;g/L, respectively. PON1 activity was significantly different among various genotypes: QQ (PON1=121.4 U/mL), QR (PON1=87.5 U/mL), and RR (PON1=55.2 U/mL), p<0.001. PON1 genotypes were associated only with Cd blood levels. Those with QR genotype had Cd concentrations higher (0.07 &mgr;g/L) than those with the RR genotype (0.04 &mgr;g/L) with p=0.034. However, PON1 activity was not significantly associated with metal concentrations. Cluster analysis showed that men who reported to be current smokers and drinkers with higher blood Pb and Cd levels, had significantly lower PON1 activity than non‐smokers or ‐drinkers, and women with lower Pb and Cd levels. RR genotype carriers had lower PON1 activity than those with the QR genotype, and had higher levels of Pb and Cd compared with other genotype carriers. For blood Hg, no association with PON1 activity or genotype was noted. We found low levels of Pb, Cd and Hg in environmentally exposed Brazilian adults. Cd concentrations were increased in subjects with QR genotype. Those with RR genotype had lower PON1 activity and higher levels of Pb and Cd than other genotype carriers. The results of cluster analysis suggested that smoking status exerts a significant influence on PON1 activity. Other studies with environmentally exposed populations are required to further clarify whether low blood levels of metals influence OS biomarkers. HighlightsLow levels of lead, cadmium and mercury were found in a sample of Brazilian adults.PON1 activity and MDA was not significantly associated with metals concentrations.Blood cadmium was significantly different according with PON1 genotypes, and RR genotype carriers had lower PON1 activity and higher Pb and Cd levels.Men, smokers, drinkers, with higher blood Pb and Cd levels had lower PON1 activity.There was not a trend of an association with PON1 activity or genotype with blood mercury.

Blood manganese levels and associated factors in a population-based study in Southern Brazil

ABSTRACT Manganese (Mn) is an essential dietary nutrient for human health serving as a cofactor for many enzymes; however, exposure to excessive quantities of Mn may lead to toxicity with symptoms analogous to Parkinson’s disease (PD). Population-based biomonitoring is an effective tool for characterizing the body burden of environmental or occupational pollutants, including Mn. The objective of this cross-sectional study was to (1) estimate reference values (RV) for blood Mn in an adult population and (2) assess the variables that were associated with higher blood metal levels. A total of 947 adults, aged 40 years or older, were randomly selected in a city in Southern Brazil. Information on socioeconomic, dietary, lifestyle, and occupational background was collected by trained interviewers. Blood Mn levels (μg/L) were analyzed by inductively coupled plasma-mass spectrometer (ICP-MS). The RV for blood Mn concentrations were obtained from the upper limits of the 95% confidence intervals (CI) of the 95th percentile distributions. Cluster analysis was performed to identify variables associated with high or low blood Mn concentrations. The RV for blood Mn levels in this study were 18.54 and 20.15 μg/L for men and women, respectively. Mn blood concentrations decreased with age and were higher in females compared to males. No marked association was noted between blood Mn and smoking or drinking habits, education levels and socioeconomic status. Diastolic blood pressure was higher in a group of women approximately 54 years of age associated with elevated blood Mn levels. Important reference data stratified by demographic and lifestyle factors that may prove useful for future surveillance of environmental exposure to Mn and health risks associated with this metal are presented.

Elevados teores de sódio em alimentos industrializados consumidos pela população brasileira

Sodium is an essential compound for regulating the intracellular and extracellular mineral fluids, and for maintaining the blood pressure. An inadequate diet with ingestion of large quantities of salt may cause the chronic non-communicable diseases (NCDs) such as hypertension, cardiovascular diseases, cerebrovascular accidents, among others; thus, decreasing the intake of this mineral can reduce the risk factors of such diseases. The present study aimed at determining the sodium contents in some processed foods consumed by the Brazilian population: corn-based snacks, biscuit, hamburger, sausage and noodles, by means of inductively coupled plasma atomic emission spectrometry technique (ICP OES). The high sodium contents detected in these products revealed the importance of implementation and maintenance of food monitoring programs in the country. These strategies will provide tools to assist the food producers for controlling the sodium addition in processed products. Also, these actions will yield data which will be useful for the competent authorities to establish a legal provision which limits the amount of sodium added into the processed food, to ensure the offering of healthy foods to the population, in order to promote satisfactory public health.

Comparação de diferentes métodos estatísticos utilizados para avaliar o desempenho de participantes em um programa de ensaio de proficiência

Five statistical approaches were applied for assessing the performance of participants in 19 rounds (2007-2011) of the Proficiency Testing Program for lead in blood determination (PEP-Pbs), conducted by Instituto Adolfo Lutz. The performance evaluation was provided by using the z-score. The following statistical approaches were tested: 1 – mean and standard deviation, after rejecting outliers; 2 – median and normalized inter-quartile range; 3 – robust mean and robust standard deviation; 4 – robust mean and standard deviation for proficiency assessment of 3 μg/100 mL (for concentrations up to 40 μg/100 mL and a standard deviation for proficiency assessment of 7.5 % of the assigned value (for concentrations above 40 μg/100 mL); 5 – robust mean and standard deviation for proficiency assessment of 2 μg/100 mL (for concentration up to 40 μg/100 mL) or 5 % of the assigned value (for concentrations above 40 μg/100 mL). The approach 4 showed to be the most adequate statistical methodology to assess the performance of participating laboratories in the PEP-Pbs.Five statistical approaches were applied for assessing the performance of participants in 19 rounds (2007-2011) of the Proficiency Testing Program for lead in blood determination (PEP-Pbs), conducted by Instituto Adolfo Lutz. The performance evaluation was provided by using the z-score. The following statistical approaches were tested: 1 – mean and standard deviation, after rejecting outliers; 2 – median and normalized inter-quartile range; 3 – robust mean and robust standard deviation; 4 – robust mean and standard deviation for proficiency assessment of 3 μg/100 mL (for concentrations up to 40 μg/100 mL and a standard deviation for proficiency assessment of 7.5 % of the assigned value (for concentrations above 40 μg/100 mL); 5 – robust mean and standard deviation for proficiency assessment of 2 μg/100 mL (for concentration up to 40 μg/100 mL) or 5 % of the assigned value (for concentrations above 40 μg/100 mL). The approach 4 showed to be the most adequate statistical methodology to assess the performance of participating laboratories in the PEP-Pbs.

Validation of methodology for determining As, Pb and Cd in fish by using ICP-MS: Preliminary studies

The progress of industry has led to the increased emission of pollutants into ecosystems, and fish consumption has been a remarkable source of human exposure to toxic metals. Arsenic, cadmium and lead constitute a potentially significant threat to human health because they are associated with several adverse health effects. Therefore, fish biomonitoring has been a crucial tool for assessing the environmental exposure to contaminants. This study aimed at determining arsenic, cadmium and lead contents in fish samples from a Proficiency Testing for Metals conducted by the Nuclear and Energy Research Institute (IPEN), in order to develop a routine analytical methodology using ICP-MS. The methodology was evaluated by using the certified reference oyster tissue material, which indicated good agreement between the certified and the determined concentrations for As, Cd and Pb. The report on the Proficiency Test performance evaluation, based on the z-score index, evidenced satisfactory results in both samples of the analyzed elements.