School of Public Health, Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, PA, USA.
School of Public Health and Tropical Medicine, Department of Environmental Health Sciences, Tulane University, New Orleans, LA, USA.
J Expo Sci Environ Epidemiol. 2023 Nov;33(6):911-920. doi: 10.1038/s41370-023-00526-0. Epub 2023 Feb 10.
In Suriname, 20% of pregnancies end in adverse birth outcomes. While prenatal exposure to metals may lead to adverse health outcomes, exposure assessments in Suriname are scant. Environmental contamination from mercury (Hg) used in artisanal goldmining in the Amazonian Interior, and the uncontrolled use of pesticides in suburban regions are of particular concern.
This study assessed geographic differences in exposures to metals and essential elements in pregnant Surinamese women.
This study is a subset (n = 400) of the Caribbean Consortium for Research in Environmental and Occupational Health (CCREOH) cohort study. Sector-field inductively-coupled plasma mass spectrometry was used to determine concentrations of lead (Pb), Hg, selenium (Se), cadmium (Cd), manganese (Mn) and tin (Sn) in whole blood of the pregnant women. High vs. low exposures to Pb and Hg were determined and were based respectively on CDC (3.5 ug/dL) and USEPA (3.5 ug/L) action levels. Differences in geographic exposures were tested with the Mann-Whitney U-test, and differences between blood elemental concentrations and action levels for Pb and Hg with the Wilcoxon signed rank test. The association between demographics and high exposures of Pb and Hg was examined with multivariate logistic regression models.
The median concentrations of Pb, Hg and Se (5.08 μg/dL, 7.87 μg/L, and 228.26 μg/L respectively) in Interior women, were higher than the Urban and Suburban regions (p < 0.001), and higher than internationally accepted action levels (p < 0.001). The median concentrations of Mn and Sn found in Suburban women (17.55 and 0.97 ug/L respectively) were higher than Urban and Interior regions (p < 0.02).
Pregnant women living in Suriname's Amazonian Interior are exposed to Hg and Pb at levels of public health concern. Urgently needed is a comprehensive source characterization assessment and the development, implementation and monitoring of environmental health policies, specifically addressing the chemicals of concern.
In a subset of participants enrolled in the CCREOH environmental epidemiology cohort study elevated levels of Hg and Pb were identified. This is the first comprehensive exposure assessment in the Surinamese population. Health concerns include adverse birth- and neurodevelopmental outcomes. Geographic differences require a tailored approach to health intervention and comprehensive source characterization. Future research should ascertain the role of Se as a potential protective factor. Environmental policy development, implementation and monitoring is pivotal to mitigate exposures to these neurotoxicants.
在苏里南，20%的妊娠以不良生育结局告终。虽然产前暴露于金属可能导致不良健康后果，但苏里南的暴露评估却很少。亚马逊内陆地区手工采金产生的汞（Hg）以及郊区地区不受控制地使用农药造成的环境污染尤其令人担忧。
本研究旨在评估苏里南孕妇体内金属和必需元素的地理差异暴露情况。
本研究是加勒比环境与职业健康研究联合会（CCREOH）队列研究的一个子集（n=400）。采用电感耦合等离子体质谱法（sector-field inductively-coupled plasma mass spectrometry）测定孕妇全血中铅（Pb）、汞（Hg）、硒（Se）、镉（Cd）、锰（Mn）和锡（Sn）的浓度。根据美国疾病控制与预防中心（CDC）（3.5μg/dL）和美国环保署（USEPA）（3.5μg/L）的行动水平，确定了 Pb 和 Hg 的高暴露与低暴露。采用 Mann-Whitney U 检验检测地理暴露差异，采用 Wilcoxon 符号秩检验检测全血元素浓度与 Pb 和 Hg 行动水平之间的差异。采用多元逻辑回归模型检验人口统计学因素与 Pb 和 Hg 高暴露的关系。
内陆地区女性的 Pb、Hg 和 Se 中位数浓度（分别为 5.08μg/dL、7.87μg/L 和 228.26μg/L）高于城市和郊区地区（p<0.001），也高于国际公认的行动水平（p<0.001）。郊区地区女性的 Mn 和 Sn 中位数浓度（分别为 17.55μg/L 和 0.97μg/L）高于城市和内陆地区（p<0.02）。
生活在苏里南亚马逊内陆地区的孕妇暴露于 Hg 和 Pb 的水平引起了公共卫生关注。迫切需要进行全面的源特征评估，并制定、实施和监测环境健康政策，特别是针对关注的化学物质。
在 CCREOH 环境流行病学队列研究的参与者子集中，发现了 Hg 和 Pb 水平升高。这是对苏里南人群的首次全面暴露评估。健康问题包括不良的生育和神经发育结果。地理差异需要采取有针对性的方法进行健康干预和全面的源特征评估。未来的研究应确定 Se 作为潜在保护因素的作用。环境政策的制定、实施和监测对于减轻这些神经毒性物质的暴露至关重要。
