Risk of laryngeal and nasopharyngeal cancer associated with arsenic and cadmium in the Tunisian population

Chronic exposure to heavy metals has long been recognized as being capable of increasing head and neck cancer (HNC) incidence, such as laryngeal (LC) and nasopharyngeal (NPC), among exposed human populations. The aim of the present study was to evaluate the concentrations of arsenic (As) and cadmium (Cd) in the blood of 145 patients (LC and NPC) and 351 controls in order to establish a potential relationship between these factors and the occurrence of LC and NPC. Mean blood levels of As and Cd in patients (5.67 and 3.51 μg/L, respectively) were significantly higher than those of controls (1.57 and 0.74 μg/L, respectively). The blood levels of As and Cd were mostly significantly higher than those of controls (p?<?0.05) after controlling the other risk factors of HNC including tobacco smoking and chewing, and alcohol drinking. Cd levels in blood increase significantly with the number of occupational exposure years for patients (p?<?0.05). However, seafood was not found to be contributing as an exposure source. Among these risk factors, smoking (>30 pack years) and occupational exposure (>20 years) presented the most significant association with HNC (OR?=?10.22 and 10.38, respectively, p?<?0.001). Cd level in blood sample of cases that are occupationally exposed/tobacco users (smokers and chewers) were higher than that of non-occupationally exposed/nontobacco users (p?<?0.001). The logistic regression model illustrated that HNC (LC?+?NPC) was significantly associated with blood levels of As (OR?=?2.41, p?<?0.001) and Cd (OR?=?4.95, p?<?0.001).     

Blood nickel and chromium levels in association with smoking and occupational exposure among head and neck cancer patients in Tunisia

Chronic exposure to chromium (Cr) and nickel (Ni) has long been recognized as being capable to increase head and neck cancer (HNC) incidence among exposed human populations. This study represents the first biomonitoring of Cr and Ni exposure in Tunisia and focuses on a possible association with HNC risk. The aim of the present study was to evaluate the concentrations of Cr and Ni in the blood of HNC patients and controls. Metals blood levels of 169 HNC patients and 351 controls were determined using a Perkin-Elmer Analyst 800 Atomic Absorption Spectrometer. Mean blood levels of Cr and Ni in HNC cases (52.15 and 111.60 μg/L, respectively) were significantly higher than those of controls (37.04 and 30.50 μg/L, respectively). Cases’ blood levels of Cr and Ni were significantly higher than those of controls after controlling for the other risk factors of HNC, including smoking, shisha consumption, occupational exposure, and nearby environment (P?<?0.05). Among these risk factors, smoking and occupational exposure presented the most significant association with HNC (odds ratio (OR)?=?6.54 and 7.66, respectively, P?<?0.001). Cr and Ni levels in blood sample of cases and controls that are smoker/occupationally exposed were higher than that of non-smoker/non-occupationally exposed (P?<?0.05). Smokers who are occupationally exposed present the most significant association with HNC (OR?=?25.08, P?<?0.0001). High levels of blood Cr (OR?=?2.09) and high levels of blood Ni (OR?=?8.87) were strongly associated with HNC after other potential confounders were controlled (P?=?0.004 and P?<?0.0001, respectively). This study suggested a potential role of Cr and Ni in the mechanism of HNC development.     

Cadmium in blood of Tunisian men and risk of bladder cancer: interactions with arsenic exposure and smoking

Prior investigations identified an association between low-level blood arsenic (As) and bladder cancer risk among Tunisian men but questions remain regarding confounding by cadmium (Cd), a well-established bladder carcinogen. A case–control study of Tunisian men was re-examined to assess the levels of cadmium in blood and reparse the association between the simultaneous exposure to these metals and bladder cancer risk. Levels of blood Cd were significantly twice higher among cases than in controls (P?<?0.05) and were positively correlated with smoking and age. Additionally, analysis of metal levels among non-smokers according to the region of residence showed very high blood Cd and As levels for the coastal regions of Sfax and central Tunisia. After controlling for potential confounders, for low blood As levels (<0.67 μg/L), the OR for blood Cd was 4.10 (95 % CI 1.64–10.81), while for higher levels (>0.67 μg/L), it was reduced to 2.10 (CI, 1.06–4.17). Adjustment for Cd exposure did not alter the risk associated to As exposure. This study is the first to report the relationship between Cd exposure and risk of bladder cancer occurrence in interaction with smoking and As exposure. Smoking is shown to be the main exposure source to Cd in the Tunisian population but also environmental pollution seems to be responsible of Cd exposure among non-smokers. Exposure assessment studies encompassing a wider population are needed.     

Mercury contamination in human hair and some marine species from Sfax coasts of Tunisia: levels and risk assessment

The aim of this study was to measure the mercury (Hg) contents of three marine fish and common seafood species (Diplodus annularis, Sarpa salpa and Sepia officinalis) at two sampling sites in the gulf of Gabes, i.e. Sidi Mansour (polluted site) and Kerkennah (control site). These species are frequently consumed by the population living at the Sfax coasts of Tunisia, particularly by the families of fisherman. Additionally, the hair mercury levels of 55 volunteers (28 women, 27 men) were analysed and the daily total mercury intake through the fish and seafood diet was estimated. The key findings were: (1) the mercury contents of the examined fish and seafood species frequently exceeded the regulatory guideline value of 0.5 mg/kg, (2) no site-specific differences in hair mercury contents were found, (3) fish and seafood consumption is probably the major contributor of mercury exposure in this population, (4) the daily mercury intake through frequent consumption of D. annularis exceeds the US EPA reference dose. Further studies are necessary to evaluate the health risks associated with such high mercury exposure levels in order to allow optimal counseling and therapy of the concerned population and to avoid future impairment of human health, particularly children's health.     

Biomonitoring of cadmium, chromium, nickel and arsenic in general population living near mining and active industrial areas in Southern Tunisia

The human health impact of the historic and current mining and industrial activities in Tunisia is not known. This study assessed the exposure to metals in the population of Southern Tunisia, using biomonitoring. The aim of this pilot study was to evaluate metal exposure on 350 participants living near mining and active industrial areas in the South of Tunisia. Blood specimens were analyzed for metals (Cd, Cr, As, and Ni) by Atomic Absorption Spectrometer equipped with Zeeman background correction and AS-800 auto sampler by graphite furnace and graphite tubes with integrated L'vov platform. The sample population was classified according to different age groups, sex, smoking habit, sea food and water drinking consumption, occupational exposure, amalgam fillings and place of residence. The blood As, Cd, Cr and Ni values expressed as mean?±?SD were 1.56?±?2.49, 0.74?±?1.15, 35.04?±?26.02 and 30.56?±?29.96 μg/l, respectively. Blood Cd and Ni levels in smokers were 2 and 1.2 times, respectively, higher than in non-smokers. Blood Cd levels increase significantly with age (p?=?0.002). As, Cd and Ni were significantly correlated with gender and age (p?<?0.05). Cd level in blood samples of subjects occupationally exposed was 1.3 times higher than that of non-exposed. Blood metals were not significantly affected by amalgam fillings, place of living and sea food and drinking water consumption. This first biomonitoring study of metal exposure in the South of Tunisia reveals a substantial exposure to several metals. The pathways of exposure and health significance of these findings need to be further investigated.     

Seasonal ecotoxicological monitoring of freshwater zooplankton in Bir Mcherga dam (Tunisia)

Environmental Science and Pollution Research - Dams represent large semi-closed reservoirs of pesticides and various organic and inorganic pollutants from agricultural and human activities, and...     

Use of metallothioneins as biomarkers for environmental quality assessment in the Gulf of Gabès (Tunisia)

Detection and assessment of the impact of pollution on biological resources imply increasing research on early-warning markers such as metallothioneins (MTs) in metal exposure. In this paper, we have collated published information on the use of metallothioneins and metallothionein-like proteins (MTLPs) as biomarkers for environmental quality assessment in the Gulf of Gabès. In this area, some species of fish and bivalve were used as bioindicators of pollution. In these species, an induction of MTs/MTLPs by the essential metals such as Cu and Zn and the non-essential metals such as Cd was observed by different authors who suggest the potential use of these proteins as biomarkers. However, MT concentrations can be influenced by many biotic (sex, maturity stages, and tissues) and abiotic factors (temperature, salinity, and pH). This is essentially the case in field studies where many parameters can randomly affect MT levels, so the endogeneous regulation of MTs must be considered before using MTs as an indicator of heavy metal exposure. Moreover, the use of biomarker cannot be examined independently of the evaluation of techniques that enable its quantification. Therefore, the approach to the use of MTs/MTLP as biomarkers of exposure for an assessment of the physiological status of aquatic organisms is discussed in this paper.     

Trace metal quantification in bladder biopsies from tumoral lesions of Tunisian cancer and controls subjects

The incidence of bladder tumors has been dramatically increasing since the 1970s, possibly as a consequence of ongoing environmental pollution. Previous studies have provided some evidence of an association between cancer and exposure to carcinogenic metals. In order to examine the association between levels of toxic metals in patients with bladder tumors and controls, the amounts of arsenic, cadmium, chromium, and nickel were measured in tumoral lesions and adjacent normal part of the bladder mucosa excised for carcinoma and compared with those in the bladder mucosa of volunteer subjects operated for non-neoplastic diseases. The quantification of metals in tissue was assessed by atomic absorption spectroscopy. In tumoral tissues of the excised bladder mucosa, content of Cr and Ni was significantly low compared to that of adjacent normal tissues and control tissues while that of As and Cd in normal tissues adjacent to the tumor were significantly elevated compared to controls. Though the sample size was small, the present study shows that concentrations of metals such as Cd, Cr, As, and Ni in bladder tissue may be used as a biomarker of exposure. On the basis of the results obtained in this study, high amounts of As and Cd in adjacent normal parts of the bladders with carcinomas compared to controls would strongly suggest possible, individual or synergistic, effects of these pollutants on enzymatic systems, priming an oncogenic pathway.