Schümann K
Walther-Straub-Institut für Pharmakologie und Toxikologie der Ludwig-Maximilians-Universität, München, FRG.
Z Ernahrungswiss. 1990 Mar;29(1):54-73. doi: 10.1007/BF02019535.
There are differences between young and adult organisms regarding toxokinetic aspects and clinical manifestations of heavy metal intoxications. Chronically, toxic Cd intake causes a microcytotic hypochromic anemia in young rats at lower exposure levels and after shorter exposure periods than in adult animals. Cd absorption is increased by co-administration of milk and in conjunction with iron deficiency. After long exposure periods toxic Cd concentrations accumulate in the kidney cortex; this process starts very early in life. In 3-year-old children Cd concentrations in the kidney can reach up to one-third of those found in adults. Hg++ and methyl-Hg can cause Hg encephalopathia, and frequently cause mental retardation in adults. Correspondingly, Hg++ accumulation in the brains of suckling rats is approx. 10 times higher than in grown animals. Milk increases the bioavailability of Hg++. In suckling rats Hg is bound to a greater extent to ligands in the erythrocytes. Methyl-Hg concentrations in breast milk reach 5% of those in maternal plasma and that is a severe hazard for breastfed children of exposed mothers. Toxic Pb concentrations can lead to Pb encephalopathia. A high percentage of surviving children have seizures and show signs of mental retardation. Anemia and reduced intelligence scores were recently observed in children after exposure to very low levels of Pb. Pb absorption is increased in children and after co-administration of milk. There are no definite proofs for carcinogenesis or mutagenesis after oral exposure to Cd, Hg, and Pb in man. Heavy metal concentrations were found in the same order of magnitude in commercial infant formulas and in breast milk. When infant formulas are reconstituted with contaminated tap water, however, Pb and Cd concentrations can be much higher. The average heavy metal uptake from such diets exceeds the provisional tolerable weekly intake levels set by the WHO for adults, calculated on the basis of an average food intake and a downscaled body weight. These considerations do not even provide for differences in absorption and distribution or for the increased sensitivity of children to heavy metal exposure. However, dilution effects for essential heavy metals were observed in fast-growing young children; this effect might be extrapolated to toxic metals. These theoretical considerations are compared with epidemiological evidence. A health statistic from Baltimore shows a decline of Pb intoxications in infants. This observation correlates with a simultaneous decline in exposure to Pb which was due, for example, to decreased use of lead dyes in house paints and the abolition of tin cans for infant food.(ABSTRACT TRUNCATED AT 400 WORDS)
在重金属中毒的毒物动力学方面和临床表现上,幼年生物与成年生物存在差异。长期来看,有毒镉摄入在幼年大鼠中比成年动物在更低暴露水平和更短暴露期后就会导致小细胞低色素性贫血。同时摄入牛奶以及缺铁会增加镉的吸收。长期暴露后,有毒镉浓度会在肾皮质中积累;这个过程在生命早期就开始了。在3岁儿童中,肾脏中的镉浓度可达到成年人的三分之一。汞离子(Hg++)和甲基汞会导致汞性脑病,并经常导致成年人智力发育迟缓。相应地,哺乳期大鼠大脑中的汞离子积累量比成年动物高出约10倍。牛奶会增加汞离子的生物利用度。在哺乳期大鼠中,汞在红细胞中与配体的结合程度更高。母乳中的甲基汞浓度达到母体血浆中浓度的5%,这对接触汞的母亲所哺育的儿童构成严重危害。有毒铅浓度会导致铅性脑病。高比例存活儿童会出现癫痫发作并表现出智力发育迟缓的迹象。最近发现,儿童在接触极低水平的铅后会出现贫血和智力得分降低的情况。儿童以及同时摄入牛奶后铅的吸收会增加。目前尚无确凿证据表明人类经口接触镉、汞和铅后会发生致癌或致突变作用。商业婴儿配方奶粉和母乳中的重金属浓度处于相同数量级。然而,当用受污染的自来水冲调婴儿配方奶粉时,铅和镉的浓度可能会高得多。基于平均食物摄入量和按比例缩小的体重计算,此类饮食中的平均重金属摄入量超过了世界卫生组织为成年人设定的暂定每周耐受摄入量水平。这些考量甚至没有考虑吸收和分布的差异,也没有考虑儿童对重金属暴露的更高敏感性。然而,在快速成长的幼儿中观察到了必需重金属的稀释效应;这种效应可能也适用于有毒金属。将这些理论考量与流行病学证据进行了比较。巴尔的摩的一项健康统计显示,婴儿铅中毒情况有所下降。这一观察结果与同时期铅暴露的下降相关,例如,这是由于室内涂料中铅染料使用减少以及婴儿食品罐头锡罐的废除。(摘要截选至400字)