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Avalabl online a wonsciencediectcom “Enajertcology sorence @oineor: and Environmental scapeate Safety Te esotlagy nd Encomenl ley $605 458 bapwliewescomaceueesm Lessons from case studies of metals: investigating exposure, bioavailability, and risk Deoraj Caussy."* Michael Gochfeld,? Eugen Gurzau," Corneliu Neagu,* and Heinz Ruedel® “Deparment of Evidence & Information fer Plc, World Held Orgaizaton, Regional Offi or Sout-East Ast, Indrapresths Estate, Ring Road, ‘NewDalit 110 2, Indio * Department of Eironmentl ond Community Meine, UMDNI-Reber: Wood Jobman Medea! School Emionmenal aud Occupational Heath ‘Sciences Ista Consort for Risk Eralaton wash Stakeholder Priipatn, 170 Felaghasses Road. Piwatanay. NJ 19884 USA “Emiroamenal Heads Cnsr, Coat 23 A, laf Napoca 340, Ronee “instinte of Public Het Dr Leonte Sx, 1-3, Bucharest 74256, Roma “Fraumbofe-lnsiat fs Urekehente and Okorritlage, Auf dem Aberg 1, Sknalenerg 57392, Germany Accapted £9 March 20 Abstract Since metals are widely distributed in enviconmental matrices, humans are exposed to them by either anthropogenic activities oF inadvertently by necesity, Selected metals: arsenic, mercury, iron, tin, lead and chromium were chosen on the Basis of thei conomic and public heath importance to illustrate the diversity of exposure pathways and alfferences in factors governing bioavailability. Bioavailability is central to the toxicity of meals and this is discussed from the health risk paradigm tandpoint of ‘sk essesmentand risk management and the impacis of including or excluding bioavailability in sucb assesment. The lessons fren the cave stuies of arsenic, mercuy, tin and chromium provide 2 unified concept of methods that can be used in investigating and controlling outbreaks due to metal poisoning in other similar situations (© 2008 Elsevier Inc. ll rghts reserved. Kerwords: Bioavailability of heavy meal; Oatbrea investigation of metal peeonng; Heth risk paradigm; Arsenic; Mercury: Leads Tin 1. Introduction and scope of paper 2, Importance of metals The case study papers illustrate methodologies for Metuls are natural constiruents of the Earth's erust. understanding exposure, estimating risks, and identify The total masses of metals in ore deposits are small ing methods for implementing intervention programs compares! with their Jarge but highly diluted reservoir in for solving specific environmental, community. and common rocks species. While most of the metals are ‘occupational health problems. Therefore, this paper trace elements in the minerals. metals ike iron, summarizes and consolidates the knowledge about the manganese, and chromium are present im higher Four metals that were selected for the case study amounts. Smelting of metals is a major source of As, ‘background papers and provides a unified approach to. Ph, Cd. Sh. and Cu: however, smehing does not the methods used for investigating and controlling contribute much te He and Cr contamination. fy is well fovutbreaks due to metal poisoning that may be applic» known that natural melal contents in environmental ‘able (0 other similar conditions. This exercise is done in media can vary between different rexions, resulting in Tight of the toxicity and bioavailabilties of the particular spatial variabion of hackground concentrations. Thos metals and their various species, ons defined by mineral deficiencies viter belt” of North America "Comeipending autor. Fax: +91-1-357-907, oor caren! bike in lctind ci Bona odes: eas wheesrs (D. Cans). gockt Se eens ott an Chin Ot ‘eoti.rutgers.cdu (M, Gochfeki. ezurzaniche to (E. Gurzat, ive metal levels. such as the ceneaguiiipbto (C. Nea), rods hsde CH. Rode) ener ic Delta regions of southern Ase. sce font mater © 2003 Ehevier Lo. AD sights reserved uevnean al our lack ta kenwuantes. 26 D, Causey ea | Eeotnicology and Enlrnmentl Safety 56 (2003) 45-51 ‘The distribution and fate of metals or elements in the environment are governed by the properties of the clements or metals and by the influences of environ- mental factors, The metals have some common proper- ties in that they occur in nature mostly in inoreanic forms as either ions or salts and sometimes as organic forms in combination with an organic compound. Many metal compounds are stable, which explains their wide use and their pervasiveness in the environment, Envir- onmental exposures of humans and ecosystems include release of the metal by natural processes, such as volcanic activity, erosion, and biowceumulation; inten- tional anthropogenic processes, such as mining, smelt- ing, industrial uses, and cultural practices; and unintentional anthropogenic processes, such as incin- eration and fossil fuel combustion, The physicochemical properties of metals have been exploited in agricultural, industrial, and medical uses. Intentional-uses of metal compounds include biocides containing As, Hg, Cu, and Sn and continue to be important contributors to bioavailable metals. Because metals have been extensively used for centuries in ‘commerce, environmental contamination is widespread, and exposbre to metals and metal compounds continues to be a significant public health problem. Metals exert biological effects that ean be beneficial or harmful. Many metals such as Fe, Cu, Co, Ma, Za, and Cr are essential for humans, and deficiency states with linical abnormalities have been identified, However, essential elements can also cause (oxic effeets at high doses, Other metals such as Hg, Pb, Ca, and As are not Known to be essential for any animals. However, whether a metal im the environment causes an adverse effect depends on exposure and bioavailability, on hnow much of it enters the body and reaches the eritical target organ(s). Therefore, in investigating an outbreak attributable to a metal it is important to gather information on its fate, transport, and distribution the environment, 3, ‘The diversity of pathways for exposure fe metal poisoning Humans and other biota are exposed to different environmental media in different ways. Table I gives an overview of the media of concem for six important metals, four of which are discussed in detail in. the background papers. The combination of medium and route of exposure defines a pathway (Gochfeid, 1998), For each of the metals there exist several exposure pathways that depend on the particular contaminated media of air, soil, water, or food and on the target population. Some pathways prevail for occupational exposure, ¢g., airborne arsenic from smelters, while others are important mainly for very young children, eg. ingestion of lead contaminated soil. Food is an importast pathway for several metals, particularly in populations consuming regionsl foods, perhaps reflec- tive of local contamination in an ecoregion. This would be true for people consuming grain grown on exdmium- enriched soil, from either phosphate fertilizer ot sewaxe sludge. for people consuming fish from mercury- enriched lakes, or for people consuming vegetables from « lead-smelting contaminated area. Tablet Relevance of diferent madlato metal exposures! aie Soo War Bioiafiood ‘Asses + + + Occupation Mining Snel Smeione Mercury + tee bees Cocupatonal ‘ionisation Met in ish uaal Iron + +e ++ + Occupational Mine tangs Rustin pes Mining Te + 0 + + Organon pestis, TBT in fh? Occupations Snelers Lead = $e + bee scupitions| Todi: ingestion Led pipes and solder Leaded sles and Glass Smlers Paprika Todd yale Wheat (Csiro) Caroma - + + | Occupation STEFF Ainiy wiewim Medi, metynerr, TB, eibutyin $7 mediums leans ++ mlevant = Tes or ineguetly vant 0 not sewane. D. Cou esa | Bevortoigy and Eneenmen! Safety $6 (2008) 45-51 ” 4. Rationale for choice of the metals ‘The metals considered herein were chosen hecsuse they represent different chemical properties and exert different toxicities based oa valenee states and chemical species. Some of the metals, such as Sn. Cr, Cu, and Fe, are essential elements, while others, stich &s Hg, Pb, Cd and As, are not essential, Althoush most risk assessments have been based on anthropogenie sources of metals from smelters, incinerators, and hazardous ‘waste sites, arsenic represents an unusual ease where some of the largest outbreaks of poisoning have been due to naturally occurring arsenic in water supplies 5. Factors affecting bioavailability and toxicities of the selected metals Metals vary greatly in their bioavailability or ability to enter organisms and cause toxicity, However, the ‘erm bioavailability has not been consistently used for all metals in the literature. Some scientists differentiate between extersal availability or “bioaecessibility” and interac! bioavailebility. External bioavailability is lar ely determined by the ability of the metals to be solubilized aud released from environmental media such as soil, food, and feed. this term is also synonymously used with biowccessibifity. Internal bioavailability deo {ermines the ability of the metais to be absorbed and reach the target organ, where it exerts js toxic effects For the purpose of this review. and in keeping with the convention of this symposium, bioaveiability 1 sed in its broad sense to include bath external bioaecessibility and internal bioavailability Once 4 metst or mets) compound has been released into the Jung oF gastrointestinal (GI) waci, @ certain fraction is absosbed and the remainder is exhaled or is eliminated by the GI tract, This absorbed fraction denends partly on the inurinsic absorptive capacity of the organ as well as on hast factors (see paper by Burget et al., in this issue), Absorption varies among metals species of metals, and anionic components, For exam: ple. absorption of Na and K is greater than 901%, white absorption of Cr is less than 1% in the Gl wract of humans, G1 absorption of elemental Hg is fess than 1s methyl mercury absorption approaches 100%. and fead oxide is much more bioavailable thas lead sulfide (Merion, 19973), The main toxicity targets include skin (As), nervous system (Pb, Hg, AS), blood (Pb, Asp, kidney (Pb Ca), long (Ca), and cancer (As, Ca, Cr, But each metal has additional pathophysiologic effects, partly depen- dent on the species. As an example, chromiuin( 1) and nicked ate sensitizers, and mercury and somatic and nervous system development ‘The presence of other cations in the immediate dict us well as the underlying avcritional state likewise infla- ences absorption. Thus adequate stores of dietary Fe: Ca, and Zn inhibit the absorption of Cd whereas dietary Ca. Zn, and other cations are reported to inhibit. the absorption of Fe. in many cases cations compete tor the same transporters. Frem combined applications of the PKKM models and other studies it has been established that soluble inorganic arsenic is readily absorbed from the gastrointestinal tract of the human volunteer subject. For instance between 80% and 909% of a single dose of arsenite As(IM) or arsenate (As(V)) has been found to be absorbed frorn the gastrointestinal tracts of humans (Pomroy et al, 1980). Another factor that plays a major role in the bioavailability of metals is the species as indicated im the Group I report. For example, tin exists in the oxidation state 0 as pure metal and in alloys. in the oxidation states +I and +1V in inorganic tin compounds (stannic and stannous salts), and as organotin compounds of tetravatent tin (e.g, tributyl- tin). Each of these species has different properties that influence bioavailability and Tead co a different fate Chromium and arsenic provide another example where valence state 1s critical. The mobility and toxicity of chromium(V1) ip water and soit are high compared to those of chromium(lll). Iy the environment, these species may be imtereonverted depending on redex potential. Inorganic mercury may be methylated by microorganisms. and the resulting methy! mercury is much more bioavailable than its morganic precursors. Arsenic also exists in different oxidation states, and the sanic form can bivaccumulate in marine organism and become inierconverted fo the organic arsenobetaine form, In contrast to Hg znd Sn, itis the inorganic form of arsenic that is more toxic than the organic form, As(V) adsorbs more strongly 10 mineral surfaces than does s(t) and is generally less mobile ancl potentially Jess biowvailable (Korte and Femando, 1991), The ‘anulytical challenge is to determine the exact concentra~ tions of the different species without changing their concentrations. Speciation methods are no avilable for most elemental species (reler to Analytical meth ‘dologies section of this issue) Because metals exist in both organic and ino) forms or species. it is important to oblain element specific data For risk assessment and management, in part due to the varying bioavailability and toxiety of the ditferent species, Although the importance of undes standing which meta? species ave present in the environ- ‘ment has been recognized lor decades, itis only recently that laboratory techniques and protocols have existed te allow speciation on a large scale (see Speciation and Analysis section). As more js feared ahout the metal species. our ability to predict ow abi en status) and hardness. pH, temperature, and oxy 7 D. Cos ct al | Ssptoiolngy and Ensbonmantl Safety $6 (2003) 48-81, biotic factors (bacterial methylation, food chain bio- magnification) can influence interconversions snd. up= take among different species of metals is enhanced, Analytic speciation is particularly important in estab- ishing bioavailabilities of arsenic from the foed chai, Tn any outbreak investigation it is important to determine how the metal species may interact itl each other or with other substances, depending on. environmental factors. Generally. the parameters that significantly influence the availability or potential Ddiowvailability of metalsim natural waters and sediments are hardness, alkalinity, pH, temperature, oxidation) reduction potential, composition and concentration of other ions, particulate matter, and organic carbon content. Cation-exchange capacity also can influence bioavailability in soils and sediments. For metal ions and polar organometallic compounds, the pH is the ‘most important factor controlling partitioning.” The ‘most important phases for interactions with metal ions are the organic carbon (i., in humic acids) and the metal oxides of the sediment or soil. For organometallic eompounds the most desisive parameter seems to be the organic matter content in the respective compartment, Thus. in ascribing a health outcome to the bicavail- ability of a metal, one should ensure that burnic acié is, rot responsible for the observed phenomenon. as has been suznested in the example of arsenite poisoning from tube well water in Taiwan (Lu, 1990}. 6. Examples of bioavailability measures Each metal discussed poses unigue challenges related to its physical and chemical properties that influence biotransformations among chemical species in the environment. Direct measurements of bioavailability can be made in the Iahoratory, but in the eld it is customary to estimate bis tiom factors (CFs), the ratio of the concentration in an ‘organism 10 the concentration in its food oF aguatic environment, Fora number of metals systematic studies are avaitable on the influences of abiotic Factors on the availability in Exumples include metals im 2001), acsenic. copper (Erickson lability from concentra juzous media, soil, and sediments senerah (Gi Toro et al a. 1996), Gn (Fent 1996), sind mereury (Sjohlom et a. 2000) A review of the literature indicates that bioavailability of arsenic is largely a function of the environmental trices in which arsenic accurs, This varies from 100% for ingested soluble salts in ¥ rine tailings. Thus the bioavailabitity of a soil is considerably fo impacted by such factors as water sohbility of arsenic compounds found in soil (Grissom et al. 1999), There is some evidence from literature studies that the totaal aqueous copper concentration is not correlated er to less than 10% in than that from water and is with the bioavailability to biote. A number of studies showed that the toxicity of copper in water is related fo the concentration of the aqueous copper ion. For example in a series of experiments Erickson etal. (1996) showed that increased hardness, dissohved organic earbon concentration, and pH significantly decreased the toxicity of copper to larval futhead minnows (Pimephales promelas) by reducing the free ionic copper concentration, A study on tributyltin (TBT, an organotin compound) Found that the Voaccumulation in mussels (Mytilos edulis) after exposare via water was higher than uptake via food (Laughlin et a, 1986). For the uptake directly from water, a bioconceatration of 5000 was observed with TBT. However, 2 concentration factor of below 2 was calculated after feeding with contaminated algae. |A further aspect is that bioaccumulation depends on the chemical species. Oehlmana et al. (1998) found in the marine mollusk Hinia incrassata biocencenteation factors of 122,000 for TBT, but only 47,700. for

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