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Relationship between hair cadmium levels, indoor ETS exposure and wheezing frequency in children

Razi, C.H.; Akın, K.O.; Harmancı, K.; Özdemir, O.; Abacı, A.; Hızlı, Ş.; Renda, R.; Çelik, A.

Published in Allergol Immunopathol (Madr). 2012;40:51-9. - vol.40 núm 01

English: [ Abstract | Full text | PDF ]

Abstract

Background

Cadmium (Cd) is a toxic heavy metal and the components of tobacco and scalp hair effectively reflect a long-term environmental exposure.

Objective

The aim of this study was to assess the concentration of Cd levels in the hair of children with recurrent wheezing, and to evaluate the predictors of elevated Cd levels with a focus on anthropometric, environmental, and dietary factors.

Methods

In this case-control study, scalp hair was obtained from 65 children with recurrent wheezing (RW) and from 65 healthy children (HC). Hair Cd concentrations were determined by ICP-MS.

Results

Median (IQR) hair Cd levels were 0.22μg/kg (0.10–0.35) in RW group and 0.12μg/kg (0.04–0.23) in HC group (p=0.013). Multivariable logistic regression model results showed that being a child with RW (OR=6.28; p=0.001), ETS exposure at home (OR=22.56; p<0.001), and mother's education level (OR=0.49; p=0.020), are the major predictor variables for elevated hair Cd levels (cut off >0.17μg/kg). In RW group, multivariable logistic regression results showed that hair Cd levels of >0.17μg/kg was significantly predictive of having three or more wheezing episodes in RW group after adjustment for ETS exposure at home (OR=5.48; p=0.012).

Conclusion

We demonstrated that the more children are exposed to ETS at home, the more they are exposed to heavy metals like Cd. Especially children who have had three or more wheezing attacks over the last six months are much more susceptible than the other asthmatic and non-asthmatic children, and Cd exposure aggravates their asthmatic status.

Key words: Asthma. Wheezing. Indoor air pollution. Hair toxic metals. Hair Cd.

Introduction

Introduction Heavy metal pollution has become a serious health concern in recent years. Cadmium (Cd) is a toxic heavy metal and the components of tobacco, together with water and food contamination, represent the main sources of non-occupational exposure in the general population.¹^,² Cd enters the human body mainly after inhalation of environmental tobacco smoke (ETS) and also via gastrointestinal absorption. Inhalation is the major means of cadmium absorption for children.³^,⁴ Continuous exposure to low levels of Cd may result in bioaccumulation and can cause a variety of adverse health effects on human beings, depending on the level and the duration of exposure, among which kidney dysfunction, lung diseases and disturbed calcium metabolism and bone defects are the most prominent.⁵^,⁶ However, trace element and toxic heavy metal concentrations in biological samples are affected by environmental and geographical factors. Therefore, considerable variations can occur between specific subgroups of the populations.⁶ Another difficulty in assessing the effects of toxic heavy metals for past and long-term exposure is to find a reliable biological indicator.⁷ Cd in blood is widely used as indices for current or recent exposure.⁸^,⁹ Compared to other types of clinical specimens, scalp hair has different uses and even advantages over blood or urine,⁸ and each centimetre of scalp hair reflects approximately one month of past exposure.⁹ A considerable number of studies have revealed that head hair better reflects a long-term environmental exposure than does blood and/or urine for toxic metals like Cd (as biomarker), and children's head hair may...

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Razi, C.H.^a; Akın, K.O.^b; Harmancı, K.^c; Özdemir, O.^d; Abacı, A.^d; Hızlı, Ş.^d; Renda, R.^d; Çelik, A.^d