Factors Contributing to Children’s Lead, Cadmium, and Arsenic Exposures using Human Biomonitoring and Environmental Data in Southern Thailand Öffentlichkeit

Kodsup, Pornpimol (Spring 2019)

Permanent URL: https://etd.library.emory.edu/concern/etds/g732db03h?locale=de
Published

Abstract

Lead, cadmium, and arsenic are toxic substances (Heavy metal and metalloid: HMM) with wide- ranging health effects, including neurodevelopmental decrements, behavioral problems, and cancer, respectively. Children who live in a fishing community with high HMM-related activities are considered to be at higher risk for exposure and resulting outcomes than children who live in areas without fishing-related activities. This epidemiological study was conducted in two communities (i.e., commercial fishing communities and a non-fishing city in southern Thailand) to investigate the associated risks of exposure in children. The study’s primary goals were to determine the potential sources of lead, cadmium, and arsenic exposures in both communities and to determine associated exposure risk factors in children using questionnaire and biomonitoring data.

 

Cross-sectional, analytical studies were undertaken among 60 children who attended local children development center or kindergarten. The total of 30 urine samples, 11 drinking water, and 11 of domestic water, were randomly collected from each community for lead, cadmium, and arsenic content analysis. The parental KAP and children’s direct exposure survey and hygiene and sanitation evaluation were administered to obtain information about socio-economic status and risk factors for lead, cadmium, and arsenic exposures.

 

In fishing community, geometric mean urinary lead, cadmium, and arsenic were 1.02 ± 1.42 ng/mL, 1.02 ± 1.45 ng/mL, and 3.93 ± 1.69 ng/mL, when the city was found to have 0.88 ± 1.46 ng/mL, 0.32 ± 1.38 ng/mL, and 4.02 ± 1.60 ng/mL, respectively. The fishing community’s geometric mean creatinine corrected urinary HMM levels were found to be higher than the city. No statistically significant associations were found between log-transformed urinary lead, cadmium, or arsenic levels and drinking water or domestic water. Pearson correlations suggested that, in fishing community, lead and arsenic sources were not the same. However, cadmium sources were the same with lead or arsenic sources; HMM sources were the same for the city.

 

Our study demonstrated the patterns of lead, cadmium, and arsenic exposures in children by integrating biomonitoring, environmental, and questionnaire data. The results revealed that seasonal factors had more impact on the outcome than geological locations. The factors that influenced lead exposure were parental individual income, parental education level, hygiene and sanitation scores, and children’s direct exposure. Factors influencing arsenic exposures were secondhand smoking and seafood consumption before the urine sample collection day. In addition, we found the number of parental cigarettes smoked significantly affected the magnitude of cadmium exposures. For intervention purposes, we suggested that, for children who live in a high risk area, the HMM annual check-up during a medical visit at school and parental survey should be done. In addition, we provided hygiene and sanitation intervention materials and HMM guidelines to the parents of children in both study areas.

 

Table of Contents

Table of Contents

 

 

I.       Background and significance..................................................................................................................... 1

 

Source of exposures to lead, cadmium, and arsenic in children.................................................................... 1

Source of exposures to lead, cadmium, and arsenic in southern Thailand..................................................... 3

Health effects of lead, cadmium, and arsenic in children............................................................................. 6

Human biomonitoring and biomarkers of lead, cadmium, and arsenic exposures.......................................... 8

Hypotheses............................................................................................................................................ 11

 

II.    Methods.................................................................................................................................................. 11

 

Participant recruitment........................................................................................................................ 12

Exposure assessment........................................................................................................................... 12

Outcome assessment........................................................................................................................... 13

Statistical analysis............................................................................................................................... 14

 

III. Results..................................................................................................................................................... 14

 

Basic demographic data....................................................................................................................... 14

Exposure summary.............................................................................................................................. 15

Outcome summary.............................................................................................................................. 17

Potential HMM exposure sources correlation........................................................................................ 19

Associations between urinary HMM and potential exposures................................................................. 20

 

IV. Discussions.............................................................................................................................................. 23

 

Feasibility........................................................................................................................................... 23

Discussion.......................................................................................................................................... 24

HMM pathways.................................................................................................................................. 26

Dominant HMM exposure contributors................................................................................................. 26

Limitations......................................................................................................................................... 31

 

V.    Conclusions and recommendations.......................................................................................................... 33

 

       Conclusions........................................................................................................................................ 33

Recommendations for future research................................................................................................... 35

Policy recommendations...................................................................................................................... 36

Intervention recommendations............................................................................................................. 36

 

References........................................................................................................................................................... 38

 

Tables ................................................................................................................................................................ 45

 

Figures ................................................................................................................................................................ 51       

 

Appendices.......................................................................................................................................................... 56

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