Exposure to heavy metals and red blood cell parameters in children: A systematic review of observational studies
BackgroundMechanistic studies show that heavy metals interfere with the hematopoietic system by inhibiting key enzymes, which could lead to anemia. However, the link between children's exposure and red blood cell (RBC) parameters has been inconsistent. We aimed to summarize evidence on human st...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2022.921239/full |
| _version_ | 1817981982107238400 |
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| author | Carolina Capitão Carolina Capitão Raquel Martins Raquel Martins Osvaldo Santos Osvaldo Santos Osvaldo Santos Manuel Bicho Manuel Bicho Manuel Bicho Tamás Szigeti Andromachi Katsonouri Beatrice Bocca Flavia Ruggieri Wojciech Wasowicz Hanna Tolonen Ana Virgolino Ana Virgolino |
| author_facet | Carolina Capitão Carolina Capitão Raquel Martins Raquel Martins Osvaldo Santos Osvaldo Santos Osvaldo Santos Manuel Bicho Manuel Bicho Manuel Bicho Tamás Szigeti Andromachi Katsonouri Beatrice Bocca Flavia Ruggieri Wojciech Wasowicz Hanna Tolonen Ana Virgolino Ana Virgolino |
| author_sort | Carolina Capitão |
| collection | DOAJ |
| description | BackgroundMechanistic studies show that heavy metals interfere with the hematopoietic system by inhibiting key enzymes, which could lead to anemia. However, the link between children's exposure and red blood cell (RBC) parameters has been inconsistent. We aimed to summarize evidence on human studies exploring the association between exposure to lead, mercury, cadmium, arsenic, and chromium VI and RBC parameters in children.MethodsFollowing the PRISMA guidelines, we searched PubMed, Scopus, and Web of Science databases for studies published between January 2010 and April 2022. Eligible papers included human observational studies that directly assessed exposure (internal dose) to the heavy metals under study and RBC parameters in participants aged ≤ 18 years. We excluded studies using hospital-based samples. Study quality was assessed using the National Institutes of Health's Quality Assessment Tools for Cohort and Cross-Sectional Studies. We synthesized the evidence using vote counting based on the direction of the relationship.ResultsOut of 6,652 retrieved papers, we included a total of 38 (33 assessing lead, four mercury, two cadmium, and two arsenic; chromium VI was not assessed in any included paper). More than half of the studies were conducted in Asia. We found evidence of a positive relationship between lead concentration and hemoglobin (proportion of studies reporting negative relationships = 0.750; 95% Confidence Interval (CI) 0.583, 0.874) and mean corpuscular hemoglobin (0.875; 95% CI 0.546, 0.986), and a positive relationship with red cell distribution width (0.000; 95%CI 0.000, 0.379). When considering only good-quality studies (24% of the Pb studies), only the relationship with hemoglobin levels remained (0.875; 95% CI: 0.546, 0.986).ConclusionWe found evidence of a negative relationship between lead concentration and hemoglobin and mean corpuscular hemoglobin and of a positive relationship with red cell distribution width in children. We also identified a need to conduct more studies in European countries. Future studies should use standardized practices and make efforts to increase study quality, namely by conducting comprehensive longitudinal studies. Our findings support the need to take further actions to limit heavy metal exposure during childhood. |
| first_indexed | 2024-04-13T23:14:33Z |
| format | Article |
| id | doaj.art-d75bb1415cb9415db4824e3df8b85654 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-04-13T23:14:33Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-d75bb1415cb9415db4824e3df8b856542022-12-22T02:25:28ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602022-10-011010.3389/fped.2022.921239921239Exposure to heavy metals and red blood cell parameters in children: A systematic review of observational studiesCarolina Capitão0Carolina Capitão1Raquel Martins2Raquel Martins3Osvaldo Santos4Osvaldo Santos5Osvaldo Santos6Manuel Bicho7Manuel Bicho8Manuel Bicho9Tamás Szigeti10Andromachi Katsonouri11Beatrice Bocca12Flavia Ruggieri13Wojciech Wasowicz14Hanna Tolonen15Ana Virgolino16Ana Virgolino17Environmental Health Behaviour Lab, Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisbon, PortugalLaboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, Lisbon, PortugalEnvironmental Health Behaviour Lab, Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisbon, PortugalLaboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, Lisbon, PortugalEnvironmental Health Behaviour Lab, Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisbon, PortugalLaboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, Lisbon, PortugalUnbreakable Idea Research, Cadaval, PortugalLaboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, Lisbon, PortugalLaboratório de Genética, Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisbon, PortugalInstituto Rocha Cabral, Lisbon, PortugalNational Public Health Center, Budapest, HungaryState General Laboratory, Ministry of Health, Nicosia, CyprusDepartment of Environment and Health, Istituto Superiore di Sanità, Rome, ItalyDepartment of Environment and Health, Istituto Superiore di Sanità, Rome, ItalyNofer Institute of Occupational Medicine, Lodz, Poland0Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, FinlandEnvironmental Health Behaviour Lab, Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisbon, PortugalLaboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, Lisbon, PortugalBackgroundMechanistic studies show that heavy metals interfere with the hematopoietic system by inhibiting key enzymes, which could lead to anemia. However, the link between children's exposure and red blood cell (RBC) parameters has been inconsistent. We aimed to summarize evidence on human studies exploring the association between exposure to lead, mercury, cadmium, arsenic, and chromium VI and RBC parameters in children.MethodsFollowing the PRISMA guidelines, we searched PubMed, Scopus, and Web of Science databases for studies published between January 2010 and April 2022. Eligible papers included human observational studies that directly assessed exposure (internal dose) to the heavy metals under study and RBC parameters in participants aged ≤ 18 years. We excluded studies using hospital-based samples. Study quality was assessed using the National Institutes of Health's Quality Assessment Tools for Cohort and Cross-Sectional Studies. We synthesized the evidence using vote counting based on the direction of the relationship.ResultsOut of 6,652 retrieved papers, we included a total of 38 (33 assessing lead, four mercury, two cadmium, and two arsenic; chromium VI was not assessed in any included paper). More than half of the studies were conducted in Asia. We found evidence of a positive relationship between lead concentration and hemoglobin (proportion of studies reporting negative relationships = 0.750; 95% Confidence Interval (CI) 0.583, 0.874) and mean corpuscular hemoglobin (0.875; 95% CI 0.546, 0.986), and a positive relationship with red cell distribution width (0.000; 95%CI 0.000, 0.379). When considering only good-quality studies (24% of the Pb studies), only the relationship with hemoglobin levels remained (0.875; 95% CI: 0.546, 0.986).ConclusionWe found evidence of a negative relationship between lead concentration and hemoglobin and mean corpuscular hemoglobin and of a positive relationship with red cell distribution width in children. We also identified a need to conduct more studies in European countries. Future studies should use standardized practices and make efforts to increase study quality, namely by conducting comprehensive longitudinal studies. Our findings support the need to take further actions to limit heavy metal exposure during childhood.https://www.frontiersin.org/articles/10.3389/fped.2022.921239/fullHBM4EUbiomonitoringhematologyerythrocyte indiceschild |
| spellingShingle | Carolina Capitão Carolina Capitão Raquel Martins Raquel Martins Osvaldo Santos Osvaldo Santos Osvaldo Santos Manuel Bicho Manuel Bicho Manuel Bicho Tamás Szigeti Andromachi Katsonouri Beatrice Bocca Flavia Ruggieri Wojciech Wasowicz Hanna Tolonen Ana Virgolino Ana Virgolino Exposure to heavy metals and red blood cell parameters in children: A systematic review of observational studies Frontiers in Pediatrics HBM4EU biomonitoring hematology erythrocyte indices child |
| title | Exposure to heavy metals and red blood cell parameters in children: A systematic review of observational studies |
| title_full | Exposure to heavy metals and red blood cell parameters in children: A systematic review of observational studies |
| title_fullStr | Exposure to heavy metals and red blood cell parameters in children: A systematic review of observational studies |
| title_full_unstemmed | Exposure to heavy metals and red blood cell parameters in children: A systematic review of observational studies |
| title_short | Exposure to heavy metals and red blood cell parameters in children: A systematic review of observational studies |
| title_sort | exposure to heavy metals and red blood cell parameters in children a systematic review of observational studies |
| topic | HBM4EU biomonitoring hematology erythrocyte indices child |
| url | https://www.frontiersin.org/articles/10.3389/fped.2022.921239/full |
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