The relation between blood lead and mercury levels and chronic neurological diseases in children

Abstract

Aim: The aim of our study was to investigate the relation between lead and mercury exposure and some chronic neurodevelopmental diseases in children Material and Method: In the Departments of Pediatric Neurology and Pediatric Psychiatry clinics children diagnosed with motor mental retardation epilepsy attention deficit hyperactivity disorder and autism were included in the study as the study group 39 boys and 20 girls Age and sex matched healthy children were used as controls Blood lead and mercury levels were measured using the atomic absorption spectrophotometry method The possible effect of environmental factors that could cause exposure to heavy metals such as vaccination fish consumption and the number of dental fillings the mother had were also considered Results: The average age was 7 66 years and 7 68 years in the study and the control groups respectively The average lead level in the blood was 1 91 micro;g dl in the study group 2 19 micro;g dl in the control grocup The average mercury level in the blood was 0 84 micro;g L in the study group and 0 99 micro;g L in the control group No significant difference was found between the study and control groups in terms of blood mercury and lead levels When the relation of vaccination the frequency of fish consumption and the number of dental fillings in the mother with blood lead and mercury levels was evaluated no significant difference was found between the study and control groups Conclusions: Our study shows that the heavy metal levels of children with chronic neurodevelopmental diseases are not different from those of healthy children Yet this conclusion does not lower the significance of enviromental heavy metal hazard on human health Turk Arch Ped 2013; 48: 221 225

Keywords

• Blood lead level, blood mercury level, chronic neurodevelopmental disease, environmental exposure

Çocukluk çağı kronik nörogelişimsel hastalıklar ile kan kurşun ve cıva düzeyleri arasındaki ilişki

Abstract

Amaç: Ağır metal maruziyetinin çocukluklarda kronik nörogelişimsel ve nöropsikiyatrik hastalıklara yol açabildiği öne sürülmektedir Çalışmanın amacı kurşun ve civa maruziyetinin bazı çocukluk çağı kronik nörogelişimsel hastalıkları ile ilişkisini incelemektir.

Gereç ve Yöntem: İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Çocuk Nörolojisi ve Çocuk Psikiyatrisi Poliklinikleri rsquo;nde ortak olarak izlenen motor zeka geriliği epilepsi dikkat eksikliği hiperaktivite bozukluğu ve otizm tanılı çocuklar hasta grubu 39 erkek 20 kız ; yaş ve cinse göre eşleştirilmiş aynı sayılarda sağlıklı çocuklar da kontrol grubu olarak çalışmaya alındı Çocuklardan alınan venöz kan örneklerinde kurşun ve civa düzeyleri atomik absorpsiyon spektrofotometri yöntemi ile ölçüldü Ağır metal maruziyetine yol açabilecek bazı çevresel etmenlerin aşılanma durumu balık tüketimi annelerin diş dolgusu sayısı olası etkileri değerlendirildi İstatistiksel analizler için Mann Whitney U Kruskal Wallis ve ki kare testleri uygulandı.

Bulgular: Olgu grubunun yaş ortalaması 7 66 kontrol grubunun 7 68 yıldı Ortalama kan kurşun düzeyi hasta grubunda 1 91 micro;g dL kontrol grubunda 2 19 micro;g dL ortalama kan civa düzeyi hasta grubunda 0 84 micro;g L kontrol grubunda 0 99 micro;g L saptandı Hasta ve kontrol gruplarında kan ve civa düzeyleri arasında anlamlı farklılık görülmedi Aşılanma durumu balık tüketim sıklığı ve annelerin diş dolgusu sayısının kan kurşun ve civa düzeyleri ile ilişkisi değerlendirildiğinde olgu ve kontrol grupları arasında anlamlı farklılık saptanmadı.

Çıkarımlar: Bu çalışma kronik nörogelişimsel hastalığı olan çocuklarda kan kurşun ve civa düzeylerinin sağlam çocuklardan farklı olmadığını göstermektedir Ancak bu sonuç çevresel ağır metal maruziyetinin insan sağlığı üzerindeki önemini azaltmamaktadır.

Keywords

• Çevresel maruziyet
• kronik nörogelişimsel hastalık
• kan kurşun düzeyi
• kan civa düzeyi

References

1. Odding E, Roebroeck ME, Stam HJ. The epidemiology of cerebral palsy: incidence, impairments and risk factors. Disabil Rehabil 2006; 28(4): 183-91.
2. Theoharides TC, Kempuraj D, Redwood L. Autism: an emerging ‘neuroimmune disorder’ in search of therapy. Expert Opin Pharmacother 2009; 10(13): 2127-43.
3. Davidson PW, Myers GJ, Weiss B. Mercury exposure and child development outcomes. Pediatrics 2004; 113(Suppl 4); 1023-9.
4. C Canfield RL, Henderson CR Jr, Cory-Slechta DA, Cox C, Jusko TA, Lanphear BP. Intellectual impairment in children with blood lead concentrations below 10 microg per deciliter. N Engl J Med 2003; 348(16): 1517-26.
5. Cheuk DK, Wong V. Attention-deficit hyperactivity disorder and blood mercury level: a case-control study in Chinese children. Neuropediatrics 2006; 37(4): 234-40.
6. Nigg JT, Nikolas M, Mark Knottnerus G, Cavanagh K, Friderici K. Confirmation and extension of association of blood lead with attention-deficit/hyperactivity disorder (ADHD) and ADHD symptom domains at population-typical exposure levels. J Child Psychol Psychiatry 2010; 51(1): 58-65.
7. Bradstreet J, Geier DA, Kartzinel JJ, Adams JB, Geier MR. A Case-control study of mercury burden in children with autistic spectrum disorders. J Am Phys Surg 2003; 8(3): 76-9.
8. Bernard SL, Enayati A, Binstock T, Roger H, Redwood L, McGinnis W. Autism: A unique type of mercury poisoning. Cranford, NJ: ARC Research, 2000. https://legacy.autism.com/triggers/vaccine/ mercurylong.htm. Erişim tarihi: 09.02.2013.

9. American Psychiatric Association. Task Force on DSM-IV. Diagnostic and Statistical Manual of Mental Disorders: DSM-IVTR. 4th ed. Washington: American Psychiatric Association, 2000: 1-9
10. Cornelis R, Nordberg M. General chemistry, sampling, analytical methods, and speciation, atomic absorption spectrometry. In: Nordberg GF, Fowler BA, Nordberg M, Friberg L,(eds). Handbook on the Toxicology of Metals 3rd ed. Academic Pres, 2005; 2: 44-7.
11. US Centers for Disease Control. Preventing lead poisoning in young children. Atlanta, GA, 1991. http://www.cdc.gov/nceh/lead/ Publications/books/plpyc/contents.htm. Erişim tarihi: 12.01.2013.
12. Centers for Disease Control and Prevention (CDC). Blood mercury levels in young children and childbearing-aged women-United States, 1999-2002. MMWR Morb Mortal Wkly Rep 2004; 53(43): 1018-20.
13. Ball LK, Ball R, Pratt RD. An assessment of thimerosal use in childhood vaccines. Pediatrics 2001; 107: 1147-54.
14. Vural N, Güvendik G. Ankara’da yaşayan çocuklarda kurşun absorpsiyonunun çevre kirliliği ile ilgisinin araştırılması. Ulusal Çevre Sempozyumu. Adana, 1994.
15. Kısmet E, Karataş M, Demirkaya E, ve ark. Ankara’da farklı bölgelerde yaşayan değişik yaş grubu çocuklarda kan kurşun düzeyleri. Gülhane Tıp Dergisi 2004; 46: 3337.
16. Göker Ş, Aydın A. İstanbul’un çeşitli semtlerinde oturan çocuklarda kan kurşun düzeyleri ve bu düzeylere etki eden risk faktörleri. Türk Pediatri Arşivi 2000; 35(1): 15-23.
17. Böttjer NK, Kaypmaz A. İlkokul çocuklarında kan kurşun düzeyi ve risk faktörleri ve subjektif okul başarı durumu ilişkisi. İÜ CTF Uzmanlık tezi. İstanbul, 2008.
18. Centers for Disease Control and Prevention (CDC Blood lead levels in young children--United States and selected states, 199619 MMWR Morb Mortal Wkly Rep 2000 ;49(50): 1133-7.
19. Doğan-Sağlamtimur N, Kumbur H. Metals (Hg, Pb, Cu, and Zn) bioaccumulation in sediment, fish, and human scalp hair: a case study from the city of mersin along the southern coast of Turkey. Biol Trace Elem Res 2010; 136(1): 55-70.
20. Ulukapi I, Cengiz S, Sandalli N. Effect of mercury from dental amalgams on mercury concentration in urine. J Nihon Univ Sch Dent 1994; 36(4): 266-8.
21. Wong SL, Lye EJ. Lead, mercury and cadmium levels in Canadians. Health Rep 2008; 19(4): 31-6.
22. Ip P, Wong V, Ho M, Lee J, Wong W. Environmental mercury exposure in children: South China’s experience. Pediatr Int 2004; 46(6): 715-21.
23. Geier DA, Geier MR. A comparative evaluation of the effects of MMR immunization and mercury doses from thimerosalcontaining childhood vaccines on the population prevalence of autism. Med Sci Monit 2004; 10(3): 33-9.
24. Stehr-Green P, Tull P, Stellfeld M, Mortenson PB, Simpson D. Autism and thimerosal-containing vaccines: lack of consistent evidence for an association. Am J Prev Med 2003; 25(2): 101-6. Madsen KM, Lauritsen MB, Pedersen CB, et al. Thimerosal and the occurrence of autism: negative ecological evidence from Danish population-based data. Pediatrics 2003; 112(3): 604-6.
25. Heron J, Golding J; ALSPAC Study Team. Thimerosal exposure in infants and developmental disorders: a prospective cohort study in the United kingdom does not support a causal association. Pediatrics 2004; 114(3): 577-83.
26. Clark B, Vandermeer B, Simonetti A, Buka I. Is lead a concern in Canadian autistic children? Paediatr Child Health 2010; 15(1): 17Majewska MD, Urbanowicz E, Rok-Bujko P, Namyslowska I, Mierzejewski P. Age-dependent lower or higher levels of hair mercury in autistic children than in healthy controls. Acta Neurobiol Exp (Wars) 2010; 70(2); 196-208.
27. Yorbık Ö, Dilaver B, Cansever A, Akay C, Sayal A, Söhmen T. Otistik çocuklarda saç kurşun düzeylerinin araştırılması. Klinik Psikiyatri Dergisi 2003; 6(4): 213-6.
28. Needleman HL, Riess JA, Tobin MJ, Biesecker GE, Greenhouse JB. Bone lead levels and delinquent behavior. JAMA 1996; 275(5): 363Roy A, Bellinger D, Hu H, et al. Lead exposure and behavior among young children in Chennai, India. Environ Health Perspect 2009; 117(10): 1607-11.
29. Wang HL, Chen XT, Yang B, et al. Case-control study of blood lead levels and attention deficit hyperactivity disorder in Chinese children. Environ Health Perspect 2008; 116(10): 1401-6.
30. Nicolescu R, Petcu C, Cordeanu A, et al. Environmental exposure to lead, but not other neurotoxic metals, relates to core elements of ADHD in Romanian children: performance and questionnaire data. Environ Res 2010; 110(5): 476-83.
31. Ha M, Kwon HJ, Lim MH, et al. Low blood levels of lead and mercury and symptoms of attention deficit hyperactivity in children: a report of the children’s health and environment research (CHEER). Neurotoxicol 2009; 30(1): 31-6.
32. Mazumdar M, Bellinger DC, Gregas M, Abanilla K, Bacic J, Needleman HL. Low-level environmental lead exposure in childhood and adult intellectual function: a follow-up study. Environ Health 2011; 10: 24.
33. Ragothaman M, Kulkarni G, Ashraf VV, et al. Elemental mercury poisoning probably causes cortical myoclonus. Mov Disord 2007; 22(13): 1964-8.
34. Lockitch G, Berry B, Roland E, Wadsworth L, Kaikov Y, Mirhady F. Seizures in a 10-week-old infant: lead poisoning from an unexpected source. CMAJ 1991; 145(11): 1465-8.