Evaluation of a Public Health Intervention to Lower Mercury Exposure from Fish Consumption in Bermuda

Objectives

To assess the efficacy of a public health intervention to reduce blood mercury (Hg) concentration levels in pregnant Bermudian women.

Methods

In 2003, we conducted a study entitled “Prenatal exposure of the Bermudian Population to Environmental Contaminants” which provided Bermuda’s first baseline data on prenatal exposure to several environmental contaminants, including Hg. The mean Hg concentration from 42 healthy newborns measured in umbilical cord blood was 41.3 nmol/L, ranging from 5–160 nmol/L. This concentration was much higher than expected, being approximately 8 times the general levels found in Canada and the U.S. Furthermore, we estimated that 85% of total Hg measured was in the form of methylmercury (MeHg), indicating that seafood consumption was the primary source of Hg exposure during pregnancy in Bermuda. Locally sourced seafood was identified as the most significant possible contributory source of Hg exposure. In 2005 the authors began a complementary research programme to study the levels of Hg in local commercial fish species. Coming out of this research were specific local fish consumption guidelines issued by the Department of Health advising pregnant women to avoid those local fish species found to be high in Hg while still encouraging consumption of fish species having lower Hg levels.

Results

In 2010, under another research initiative, we returned to Bermuda to carry out another evaluation of Hg in human blood. Hg was measured in the blood of 49 pregnant women. The arithmetic mean Hg blood concentration was 6.6 nmol/L and the geometric mean 4.2 nmol/L. The maximum concentration found was 24 nmol/L.

Conclusions

Hg exposure of Bermudian pregnant women has dropped significantly by a factor of around 5 since the foetal cord blood study in 2003.     

Cadmium,lead and mercury concentrations and their influence on morphological parameters in blood donors from different age groups from southern Poland

Due to industrial development, environmental contamination with metals increases which leads to higher human exposure via air, water and food. In order to evaluate the level of the present exposition, the concentrations of metals can be measured in such biological materials as human blood. In this study, we assessed the concentrations of cadmium (Cd), mercury (Hg) and lead (Pb) in blood samples from male blood donors from southern Poland (Europe) born in 1994 (n = 30) and between 1947 and 1955 (n = 30). Higher levels of Pb were seen in the group of older men (4.48 vs 2.48 μg/L), whereas the Hg levels were lower (1.78 vs 4.28 μg/L). Cd concentrations did not differ between age groups (0.56 μg/L). The levels of Cd and Pb in older donors were significantly correlated (Spearman R 0.5135). We also observed a positive correlation between the number of red blood cells (RBC) and Hg concentrations in the older group (Spearman R 0.4271). Additionally, we noted numerous correlations among morphological parameters. Based on our results, we can state that metals influence the blood morphology and their concentrations in blood vary among age groups.     

Effect of exogenous spermidine on polyamine metabolism in water hyacinth leaves under mercury stress

The influence of exogenous spermidine (Spd) on arginine decarboxylase (ADC), ornithine decarboxylase (ODC), polyamine oxidase (PAO) activities and polyamines (PAs), proline contents in water hyacinth leaves under Mercury (Hg) stress was investigated after 6 days treatment. The results showed that free putrescine (Put) content increased, the contents of free spermidine (Spd) and spermine (Spm) and the (Spd + Spm)/Put ratio in water hyacinth leaves decreased significantly with the increase of the Hg concentrations. Hg stress also disturbed the activities of ADC, ODC and PAO and caused changes on proline content. Compared to the Hg-treatment only, exogenous Spd (0.1 mM) significantly reduced the accumulation of free Put, increased the contents of free Spd and Spm and the ratio of (Spd + Spm)/Put in water hyacinth leaves. Furthermore, exogenous Spd enhanced the activities of ADC, ODC and PAO and significantly increased proline content. The PS-conjugated PAs and PIS-bound PAs changed in the same trend as free PAs. These results suggest that exogenous Spd can alleviate the metabolic disturbance of polyamines caused by Hg in water hyacinth leaves.     

Effect of Cooking on Speciation and In Vitro Bioaccessibility of Hg and As from Rice,Using Ordinary and Pressure Cookers

Rice is the most widely consumed staple food for a large part of the world’s human population, and owing to environmental pollution, it is a major source of human exposure to mercury (Hg) and arsenic (As). We evaluated the impact of cooking on the speciation and bioaccessibility of Hg and As from rice in this study. Results show that the dominant Hg and As species in rice from Guangzhou market in China were their inorganic forms (iHg and iAs), respectively. The cooking process modified the levels of Hg and As. Average Hg and As bioaccessibility in raw rice was 69.74 and 80.32%, respectively. Hg bioaccessibility decreased to 46.22 and 42.37% for pressure- and ordinary-cooked rice, respectively. In contrast, As bioaccessibility remained unchanged except after cooking with a large amount of water. Protein denaturation and the amount of soluble and volatile forms determine the bioaccessibility of Hg and As in cooked rice by being released into the cooking water or into the air. From the bioaccessibility data, the average established daily intake (EDI) values of Hg and As from pressure-cooked rice for children and adults were 0.034 and 0.025 μg kg⁻¹ day⁻¹ (Hg), and 0.735 and 0.559 μg kg⁻¹ day⁻¹ (As), respectively. This study provides novel insights into Hg and As exposure due to rice cooking.

     

Mercury in blood cells—Altered elemental profiles

The study was composed of 27 persons that displayed vague symptoms similar to those of the victims of Minamata and Iraq. Skew distributions of mercury were observed in individual erythrocytes and neutrophil granulocytes when measured by PIXE. Mercury could not be detected in the platelets. The erythrocytes also displayed lowered concentrations of magnesium and zinc, together with increased concentrations of calcium and strontium. The neutrophils displayed decreased concentrations of magnesium and zinc and increased concentrations of calcium, strontium, and iron. The presence of mercury and the altered elemental profiles in the erythrocytes and the neutrophil granulocytes are suggested as early signs of exposure.     

Quality of Life and Health Perceptions Among Fish-Eating Communities of the Brazilian Amazon: An Ecosystem Approach to Well-Being

Mercury (Hg) contamination in the Brazilian Amazon constitutes a serious environmental and public health issue. This study is part of the CARUSO Project, which uses an ecosystem approach to human health to examine the sources, transmission, and effects of Hg in the Brazilian Amazon, with a view to developing preventive intervention strategy. To date, studies have focused on measures of Hg exposure through fish consumption in relation to health effects; little attention has been given to quality of life (QoL). The objective of this study was to examine the relations between QoL and health perceptions, Hg exposure, sociodemographics, living conditions, and lifestyle in communities along the Tapajós River. A total of 456 adults from 13 villages were interviewed and provided hair samples for Hg analysis. Results showed that perceptions of QoL and health are relatively positive, despite elevated Hg exposure. Logistic regression analyses showed that a positive perception of QoL was associated with the absence of chronic illnesses, not smoking, fruit consumption, residing on the banks of the Tapajós, and living in an in-migrants’ community. The positive perception of health was associated with younger age, the absence of reported symptoms of chronic illnesses, and drinking alcoholic beverages. Cluster analysis revealed that the group that reported the highest QoL had a traditional lifestyle, involving daily fishing and high fish consumption. However, this traditional lifestyle is associated with elevated Hg levels and early reported symptoms potentially linked to Hg exposure. These findings underline the importance of understanding the factors underlying QoL to develop adequate strategies to reduce Hg exposure and promote well-being.     

Behavior of mercury in a soil–plant system as affected by inoculation with the arbuscular mycorrhizal fungus Glomus mosseae

Effects of inoculation with the arbuscular mycorrhizal (AM) fungus Glomus mosseae on the behavior of Hg in soil–plant system were investigated using an artificially contaminated soil at the concentrations of 0, 1.0, 2.0, and 4.0 mg Hg kg⁻¹. Mercury accumulation was lower in mycorrhizal roots than in nonmycorrhizal roots when Hg was added at the rates of 2.0 and 4.0 mg kg⁻¹, while no obvious difference in shoot Hg concentration was found between mycorrhizal and nonmycorrhizal treatments. Mycorrhizal inoculation significantly decreased the total and extractable Hg concentrations in soil as well as the ratio of extractable to total Hg in soil. Equilibration sorption of Hg by soil was investigated, and the results indicated that mycorrhizal treatment enhanced Hg sorption on soil. The uptake of Hg was lower by mycorrhizal roots than by nonmycorrhizal roots. These experiments provide further evidence for the role of mycorrhizal inoculation in increasing immobilization of Hg in soil and reducing the uptake of Hg by roots. Calculation on mass balance of Hg in soil suggests the presence of Hg loss from soil presumably through evaporation, and AM inoculation enhanced Hg evaporation. This was evidenced by a chamber study to detect the Hg evaporated from soil.     

The relationship between ultrasonographically measured testicular volumes and cord blood inhibin B concentrations in healthy term male neonates

Serum inhibin B (INHB) concentrations are associated with testicular volumes (TV) in all periods of childhood. The aim of the study was to investigate the relationship between TV measured by ultrasonography (US) and cord blood inhibin B and total testosterone (TT) concentrations, stratified by mode of delivery. In total 90 male infants were included. Testes of healthy, term newborns were evaluated by US on the third day after delivery. TV were calculated using two formulae: The ellipsoid formula [length (mm) × width (mm²) × π/6] and Lambert formula [length (mm) x width (mm) x height (mm) x 0.71]. Cord blood was taken for the determination of total testosterone (TT) and INHB. TT and INHB concentrations were evaluated according to TV percentiles (<10th, 10th-90th, >90th). There was a strong positive correlation between mean TV calculated with both formulae by percentile group (r = 0.777, r = 0.804, r = 0.846; p < 0.001). Cord blood INHB, but not TT were significantly lower in newborns with TV < 10th percentile compared to those with TV between 10 and 90th percentile and > 90th percentile (p < 0.05). There was a positive correlation between left and right TV calculated by either formula, and cord blood INHB (r = 0.212, 0.313, 0.320, 0.246, p < 0.05), not TT. There was no significant difference between hormones and TV when grouped by mode of delivery (p > 0.05). The Lambert and ellipsoid formulas are equally reliable in calculating neonatal testicular by ultrasound. INHB concentration is high in cord blood and positively correlated with neonatal TV. Cord blood INHB concentration may be an indicator for early detection of testicular structure and function disorders in neonates.     

汞在SPAC-人体系统中的转递及主要影响因素

汞（Hg）是环境中一种具有高度毒性的重金属元素,且具有较高挥发性,因而作为一种全球性的污染物而备受关注。汞在SPAC系统中的迁移转化,是全球汞循环的重要环节,与人类的建康密切相关。汞通过食物链进入人体并在体内蓄积受多种因素影响,主要包括3个方面：土壤性质（如土壤汞含量、pH、有机质、粘土矿物等）,植物特性（植物类型、种类和生育期等）,大气状况（如光照强度、气温和大气湿度等）。此外,锌、硒和抗氧化剂等的存在也有较大影响。综述了汞在SPAC-人体系统中的迁移积累及其调控机理。     

Body Burden of Hg in Different Bio-Samples of Mothers in Shenyang City,China

Hg is an accumulative and neuro-toxic heavy metal which has a wide range of adverse effects in human health. However, few studies are available on body burden of Hg level in different bio-samples of pregnant women in Chinese population. Therefore, this study evaluated Hg levels in different maternal bio-samples in Shenyang city, China and investigated the correlation of Hg levels in different bio-samples. From October to December 2008, 200 pregnant women about to deliver their babies at ShengJing Hospital (Shenyang city, northeast of China) participated in this study. The geometric mean (GM) of Hg levels in cord blood, maternal venous blood, breast milk, and maternal urine were 2.18 µg/L, 1.17 µg/L, 1.14 µg/L, and 0.73 µg/L, respectively, and the GM of maternal hair Hg level was 404.45 µg/kg. There was a strong correlation between cord blood and maternal blood total Hg level (r = 0.713, P<0.001). Frequency of fish consumption more than or equal to 3 times per week during pregnancy was suggested as a significant risk factor of prenatal Hg exposure (unadjusted OR 3.5, adjusted OR 2.94, P<0.05). This study provides evidence about Hg burden of mothers and the risk factors of prenatal Hg exposure in Shenyang city, China.     

Mercury exposure in an endangered seabird: long-term changes and relationships with trophic ecology and breeding success

Mercury (Hg) is an environmental contaminant which, at high concentrations, can negatively influence avian physiology and demography. Albatrosses (Diomedeidae) have higher Hg burdens than all other avian families. Here, we measure total Hg (THg) concentrations of body feathers from adult grey-headed albatrosses (Thalassarche chrysostoma) at South Georgia. Specifically, we (i) analyse temporal trends at South Georgia (1989–2013) and make comparisons with other breeding populations; (ii) identify factors driving variation in THg concentrations and (iii) examine relationships with breeding success. Mean ± s.d. feather THg concentrations were 13.0 ± 8.0 µg g⁻¹ dw, which represents a threefold increase over the past 25 years at South Georgia and is the highest recorded in the Thalassarche genus. Foraging habitat, inferred from stable isotope ratios of carbon (δ¹³C), significantly influenced THg concentrations—feathers moulted in Antarctic waters had far lower THg concentrations than those moulted in subantarctic or subtropical waters. THg concentrations also increased with trophic level (δ¹⁵N), reflecting the biomagnification process. There was limited support for the influence of sex, age and previous breeding outcome on feather THg concentrations. However, in males, Hg exposure was correlated with breeding outcome—failed birds had significantly higher feather THg concentrations than successful birds. These results provide key insights into the drivers and consequences of Hg exposure in this globally important albatross population.     

A significant relationship between mercury exposure from dental amalgams and urinary porphyrins: a further assessment of the Casa Pia children’s dental amalgam trial

Previous studies noted specific changes in urinary porphyrin excretion patterns associated with exposure to mercury (Hg) in animals and humans. In our study, urinary porphyrin concentrations were examined in normal children 8–18 years-old from a reanalysis of data provided from a randomized, prospective clinical trial that was designed to evaluate the potential health consequences of prolonged exposure to Hg from dental amalgam fillings (the parent study). Our analysis examined dose-dependent correlations between increasing Hg exposure from dental amalgams and urinary porphyrins utilizing statistical models with adjustments for the baseline level (i.e. study year 1) of the following variables: urinary Hg, each urinary porphyrin measure, gender, race, and the level of lead (Pb) in each subject’s blood. Significant dose-dependent correlations between cumulative exposure to Hg from dental amalgams and urinary porphyrins associated with Hg body-burden (pentacarboxyporphyrin, precoproporphyrin, and coproporphyrin) were observed. Overall, 5–10% increases in Hg-associated porphyrins for subjects receiving an average number of dental amalgam fillings in comparison to subjects receiving only composite fillings were observed over the 8-year course of the study. In contrast, no significant correlations were observed between cumulative exposure to Hg from dental amalgams and urinary porphyrins not associated with Hg body-burden (uroporphyrin, heptacarboxyporphyrin, and hexacarboxyporphyrin). In conclusion, our study, in contrast to the no-effect results published from the parent study, further establishes the sensitivity and specificity of specific urinary porphyrins as a biomarker for low-level Hg body-burden, and also reveals that dental amalgams are a significant chronic contributor to Hg body-burden.     

Integrating Experimental (In Vitro and In Vivo) Neurotoxicity Studies of Low-dose Thimerosal Relevant to Vaccines

There is a need to interpret neurotoxic studies to help deal with uncertainties surrounding pregnant mothers, newborns and young children who must receive repeated doses of Thimerosal-containing vaccines (TCVs). This review integrates information derived from emerging experimental studies (in vitro and in vivo) of low-dose Thimerosal (sodium ethyl mercury thiosalicylate). Major databases (PubMed and Web-of-science) were searched for in vitro and in vivo experimental studies that addressed the effects of low-dose Thimerosal (or ethylmercury) on neural tissues and animal behaviour. Information extracted from studies indicates that: (a) activity of low doses of Thimerosal against isolated human and animal brain cells was found in all studies and is consistent with Hg neurotoxicity; (b) the neurotoxic effect of ethylmercury has not been studied with co-occurring adjuvant-Al in TCVs; (c) animal studies have shown that exposure to Thimerosal-Hg can lead to accumulation of inorganic Hg in brain, and that (d) doses relevant to TCV exposure possess the potential to affect human neuro-development. Thimerosal at concentrations relevant for infants’ exposure (in vaccines) is toxic to cultured human-brain cells and to laboratory animals. The persisting use of TCV (in developing countries) is counterintuitive to global efforts to lower Hg exposure and to ban Hg in medical products; its continued use in TCV requires evaluation of a sufficiently nontoxic level of ethylmercury compatible with repeated exposure (co-occurring with adjuvant-Al) during early life.     

Cadmium,Lead, and Selenium in Cord Blood and Thyroid Hormone Status of Newborns

Cadmium (Cd), lead (Pb), and selenium (Se) concentrations in cord whole blood, sampled from 24 women at the time of delivery in a hospital in Tokyo in 2005, were determined by inductively coupled plasma mass spectrometry with a reaction cell. Signal enhancement caused by nonspectroscopic interference for Se was evident and the standard addition technique was essential for correcting the interference. Median concentration in cord bloods was 0.20 ng/g, 6.7 ng/g (0.67 μg/dL), and 191 ng/g for Cd, Pb and Se, respectively. Lead concentration was lower, whereas Se concentration was higher, than those reported in other countries. The trace element concentration was related to the levels of thyroid stimulating hormone (TSH) and free thyroxin (fT4) in the neonatal blood sampled at 4–6 days postpartum. A significantly negative correlation was observed between Cd concentrations in cord blood and TSH concentration in neonatal blood. The result indicated the possible effect of in utero Cd exposure on thyroid hormone status of newborns and that Cd exposure level should be assessed as a covariate in the survey on the relationship between in utero chemicals (e.g., PCBs) exposure and thyroid hormone status.     

Concentration of Zinc,Copper, Iron,Calcium, and Magnesium in the Serum,Tissues, and Urine of Streptozotocin-Induced Mild Diabetic Rat Model

A survey carried out in Lake Tana in 2015 found that Hg levels in some fish species exceeded internationally accepted safe levels for fish consumption. The current study assesses human exposure to Hg through fish consumption around the Lake Tana. Of particular interest was that a dietary intake of fishes is currently a health risk for Bihar Dar residents and anglers. Hair samples were collected from three different groups: anglers, college students and teachers, and daily laborers. A questionary includes gender, age, weight, activity. Frequency of fish consumption and origin of the eaten fish were completed by each participant. Mercury concentrations in hair were significantly higher (P value <0.05) for anglers (mean?±?standard deviation 0.120?±?0.199 μg/g) than college students (mean?±?standard deviation 0.018?±?0.039 μg/g) or daily workers (mean?±?standard deviation 16?±?9.5 ng/g). Anglers consumed fish more often than daily workers and college group. Moreover, there was also a strong correlation (P value <0.05) between the logarithms of total mercury and age associated with mercury concentration in scalp hair. Mercury concentrations in the hair of men were on average twice the value of the women. Also, users of skin lightening soap on a daily basis had 2.5 times greater mercury in scalp hair than non-users. Despite the different sources of mercury exposure mentioned above, the mercury concentrations of the scalp hair of participants of this study were below levels deemed to pose a threat to health.     

Small-scale Gold Mining in the Puyango River Basin,Southern Ecuador: A Study of Environmental Impacts andHuman Exposures

This study addresses the impact of small-scale gold mining on the environment and communities of the Puyango River basin in the southwest of Ecuador between 1999 and 2001. Our primary objectives were to measure mercury, manganese, and lead in the river, to identify pathways of population exposure, and biological indicators of human exposure. A multi-method design at the catchment scale was applied to the analysis of water, sediments, and particulate matter for mercury, lead, and manganese over two different seasons. A household survey was undertaken, and individuals were assessed for lead (blood samples), and for mercury (urine and hair samples). River water samples had high concentrations of particulate matter (700 mg/L). Mercury and lead levels in water at the gold processing plants were very high in both seasons (250 ng Hg/L and 160 μg Pb/L). Mercury and lead, there was a downstream gradient with the areas adjacent to the gold processing plants having the highest levels. In Portovelo, the Upper Basin city, 14% of the population reported occupational exposure to inorganic mercury. Although no one in Portovelo consumes water from the river, 10% of the population consume local fish. This contrasts the Lower Basin where 98% of the population consume fish, and 100% use river water for drinking and cooking. Lead blood levels over 20 μg/dl were found in 39.4% of the study population and blood mercury over 10 μg/L only in 10.0%. Urinary mercury over 4 μg/L was found in 66.5% of the examined persons. Hair methylmercury did not exceed the safe limit of 2 μg/g, the mean concentration was 1.2 μg/g. Mining activity and erosion contributes to heavy-metal contamination (mercury, lead, and manganese) throughout the Puyango Basin. The relation between environmental contamination is complex and further research is being conducted to understand these relations.     

Trace element contamination in feather and tissue samples from Anna’s hummingbirds

Trace element contamination (17 elements; Be, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Se, Mo, Cd, Ba, Hg, Tl, and Pb) of live (feather samples only) and deceased (feather and tissue samples) Anna's hummingbirds (Calypte anna) was evaluated. Samples were analyzed using inductively coupled plasma-mass spectrometry (ICP-MS; 17 elements) and atomic absorption spectrophotometry (Hg only). Mean plus one standard deviation (SD) was considered the benchmark, and concentrations above the mean + 1 SD were considered elevated above normal. Contour feathers were sampled from live birds of varying age, sex, and California locations. In order to reduce thermal impacts, minimal feathers were taken from live birds, therefore a novel method was developed for preparation of low mass feather samples for ICP-MS analysis. The study found that the novel feather preparation method enabled small mass feather samples to be analyzed for trace elements using ICP-MS. For feather samples from live birds, all trace elements, with the exception of beryllium, had concentrations above the mean + 1 SD. Important risk factors for elevated trace element concentrations in feathers of live birds were age for iron, zinc, and arsenic, and location for iron, manganese, zinc, and selenium. For samples from deceased birds, ICP-MS results from body and tail feathers were correlated for Fe, Zn, and Pb, and feather concentrations were correlated with renal (Fe, Zn, Pb) or hepatic (Hg) tissue concentrations. Results for AA spectrophotometry analyzed samples from deceased birds further supported the ICP-MS findings where a strong correlation between mercury concentrations in feather and tissue (pectoral muscle) samples was found. These study results support that sampling feathers from live free-ranging hummingbirds might be a useful, non-lethal sampling method for evaluating trace element exposure and provides a sampling alternative since their small body size limits traditional sampling of blood and tissues. The results from this study provide a benchmark for the distribution of trace element concentrations in feather and tissue samples from hummingbirds and suggests a reference mark for exceeding normal. Lastly, pollinating avian species are minimally represented in the literature as bioindicators for environmental trace element contamination. Given that trace elements can move through food chains by a variety of routes, our study indicates that hummingbirds are possible bioindicators of environmental trace element contamination.     

Mercury in bald eagle nestlings from South Carolina,USA

Bald eagles (Haliaeetus leucocephalus) may be at risk from contaminants in their diet and young birds may be particularly sensitive to contaminant exposure. To evaluate potential risks from dietary mercury exposure to eagle nestlings in South Carolina (USA), we surveyed mercury concentrations in 34 nestlings over two breeding seasons (1998 and 1999). Samples were also obtained from several post-fledging eagles in the region. Nestling feather mercury ranged from 0.61-6.67 micrograms Hg/g dry weight, nestling down mercury from 0.50-5.05 micrograms Hg/g dry weight, and nestling blood mercury from 0.02-0.25 microgram Hg/g wet weight. We did not detect significant differences in tissue mercury between nestlings from coastal and inland regions in contrast to some other studies of piscivorous birds. Mercury concentrations were much higher in the post fledging birds we sampled. Our data show that nestling eagles in South Carolina are accumulating mercury, and that concentrations in older birds may exceed regulatory guidelines.     

Monitoring Metals in Blood and Hair of the Population Living Near a Hazardous Waste Incinerator: Temporal Trend

The concentrations of As, Be, Cd, Cr, Hg, Mn, Ni, Pb, Sn, Tl, and V were determined in hair of 96 school children and in blood of 144 adults living in the vicinity of a hazardous waste incinerator (HWI) (Constantí, Tarragona County, Catalonia, NE Spain). The results were compared with those obtained in previous (1998 and 2002) surveys performed in the same area. Data were analyzed in terms of age, sex, and specific place of residence. Current mean concentrations in hair ranged between not detected (ND) (As, Be, and Tl) and 1.31 μg/g for Cr. In blood, Be, Hg, Mn, Sn, and Tl levels were under the respective detection limits. The mean blood concentrations of the remaining elements ranged from 0.34 μg/dL for Cd, to 2.40 μg/dL for Pb. Significant differences in hair and blood in relation to gender were only noted for Pb in blood. In general terms, metal concentrations in hair and blood from subjects living in Tarragona County are lower than most levels reported for other countries in recent years.     

Systemic inflammation associated with mechanical ventilation among extremely preterm infants

Little evidence is available to document that mechanical ventilation is an antecedent of systemic inflammation in preterm humans. We obtained blood on postnatal day 14 from 726 infants born before the 28th week of gestation and measured the concentrations of 25 inflammation-related proteins. We created multivariable models to assess the relationship between duration of ventilation and protein concentrations in the top quartile. Compared to newborns ventilated for fewer than 7 days (N = 247), those ventilated for 14 days (N = 330) were more likely to have elevated blood concentrations of pro-inflammatory cytokines (IL-1β, TNF-α), chemokines (IL-8, MCP-1), an adhesion molecule (ICAM-1), and a matrix metalloprotease (MMP-9), and less likely to have elevated blood concentrations of two chemokines (RANTES, MIP-1β), a matrix metalloproteinase (MMP-1), and a growth factor (VEGF). Newborns ventilated for 7–13 days (N = 149) had systemic inflammation that approximated the pattern of newborns ventilated for 14 days. These relationships were not confounded by chorioamnionitis or antenatal corticosteroid exposure, and were not altered appreciably among infants with and without bacteremia. These findings suggest that 2 weeks of ventilation are more likely than shorter durations of ventilation to be accompanied by high blood concentrations of pro-inflammatory proteins indicative of systemic inflammation, and by low concentrations of proteins that might protect from inflammation-mediated organ injury.