Department of Public Health & Primary Care, Ghent University, Ghent, Belgium; Department of (Tropical) Pediatrics, GZA Hospitals, Antwerp, Belgium.
Department of Public Health, University of Lubumbashi, Lubumbashi, DR Congo; Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
Lancet Planet Health. 2020 Apr;4(4):e158-e167. doi: 10.1016/S2542-5196(20)30059-0.
Widespread environmental contamination caused by mining of copper and cobalt has led to concerns about the possible association between birth defects and exposure to several toxic metals in southern Katanga, Democratic Republic of the Congo (DRC). We therefore aimed to assess the possible contribution of parental and antenatal exposure to trace metals to the occurrence of visible birth defects among neonates.
We did a case-control study between March 1, 2013, and Feb 28, 2015, in Lubumbashi, DRC. We included newborns with visible birth defects (cases) and healthy neonates born in the same maternity ward (controls). Mothers were interviewed about potentially relevant exposures, including their partners' jobs. Various trace metals were measured by inductively coupled plasma mass spectrometry in maternal urine, maternal blood, umbilical cord blood, placental tissue, and surface dust at home. Multivariable logistic regression analyses were done to calculate adjusted odds ratios and their 95% CIs (CI).
Our study included 138 neonates with visible birth defects (about 0·1% of the 133 662 births in Lubumbashi during the study period) and 108 control neonates. Potential confounders were similarly distributed between cases and controls. Vitamin consumption during pregnancy was associated with a lower risk of birth defects (adjusted odds ratio 0·2, 95% CI 0·1-0·5). Mothers having paid jobs outside the home (2·8, 1·2-6·9) and fathers having mining-related jobs (5·5, 1·2-25·0) were associated with a higher risk of birth defects. We found no associations for trace metal concentrations in biological samples, except for a doubling of manganese (Mn; 1·7, 1·1-2·7) and zinc (Zn; 1·6, 0·9-2·8) in cord blood. In a separate model including placentas, a doubling of Mn at the fetal side of the placenta was associated with an increased risk of birth defects (3·3, 1·2-8·0), as was a doubling of cord blood Zn (5·3, 1·6-16·6).
To our knowledge, this is the first study of the effects of mining-related pollution on newborns in sub-Saharan Africa. Paternal occupational mining exposure was the factor most strongly associated with birth defects. Because neither Mn nor Zn are mined in Lubumbashi, the mechanism of the association between their increased prenatal concentrations and birth defects is unclear.
Flemish Interuniversity Council-University Development Cooperation, The Coalition of the North-South movement in Flanders 11.11.11.
铜矿和钴矿开采导致的广泛环境污染，使得人们对在刚果民主共和国（DRC）南部加丹加地区，出生缺陷与接触多种有毒金属之间可能存在的联系感到担忧。因此，我们旨在评估父母和产前接触痕量金属对新生儿可见出生缺陷发生的可能贡献。
我们于 2013 年 3 月 1 日至 2015 年 2 月 28 日在刚果民主共和国卢本巴希进行了病例对照研究。我们纳入了有可见出生缺陷（病例）的新生儿和在同一产科病房出生的健康新生儿（对照）。母亲接受了有关潜在相关暴露的访谈，包括其伴侣的工作。通过电感耦合等离子体质谱法在母亲尿液、母亲血液、脐带血、胎盘组织和家庭表面灰尘中测量各种痕量金属。进行多变量逻辑回归分析以计算调整后的优势比及其 95%置信区间（CI）。
我们的研究包括 138 名有可见出生缺陷的新生儿（约占研究期间卢本巴希 133662 例分娩中的 0.1%）和 108 名对照新生儿。潜在的混杂因素在病例和对照组之间分布相似。妊娠期间维生素的摄入与出生缺陷的风险较低相关（调整后的优势比 0.2，95%CI 0.1-0.5）。母亲在外从事有报酬的工作（2.8，1.2-6.9）和父亲从事与采矿相关的工作（5.5，1.2-25.0）与出生缺陷的风险增加相关。除了脐带血中锰（Mn）和锌（Zn）的浓度分别增加一倍（Mn：1.7，1.1-2.7；Zn：1.6，0.9-2.8）外，我们在生物样本中的浓度没有发现其他关联。在一个包含胎盘的单独模型中，胎盘中 Mn 的浓度增加一倍与出生缺陷的风险增加相关（3.3，1.2-8.0），脐带血 Zn 的浓度增加一倍也与出生缺陷的风险增加相关（5.3，1.6-16.6）。
据我们所知，这是第一项关于采矿相关污染对撒哈拉以南非洲新生儿影响的研究。父亲的职业采矿暴露是与出生缺陷最密切相关的因素。由于在卢本巴希没有开采 Mn 和 Zn，因此其产前浓度增加与出生缺陷之间的关联机制尚不清楚。
佛兰芒大学理事会-大学发展合作，北南运动联盟 11.11.11。
