Toenail cerium levels and risk of a first acute myocardial infarction: the EURAMIC and heavy metals study

The association between cerium status and risk of first acute myocardial infarction (AMI) was examined in a case-control study in 10 centres from Europe and Israel. Cerium in toenails was assessed by neutron activation analysis in 684 cases and 724 controls aged 70 years or younger. Mean concentrations of cerium were 186 and 173 microg/kg in cases and controls, respectively. Cerium was positively associated with low socio-economic status, smoking, mercury, zinc and scandium (p0.001). Cases had significantly higher levels of cerium than controls after adjustment for age and centre (case-control ratio 1.074; 95% CI 1.002-1.151) and increased in further adjustment for other cardiovascular risk factors 1.085; 95% CI 1.025-1.149. The risk after adjustment for age and centre was higher with increasing cerium levels (p for trend=0.02). After adjustment for BMI, history of hypertension, smoking, alcohol intake, diabetes, family history of CHD, beta-carotene, lycopene, alpha-tocopherol, selenium, mercury and scandium, the OR for the highest quintile was 1.43 (95% CI 0.85-2.41; p-trend 0.08). When we applied this same model in non-smokers the odds ratios in the 4th and 5th quintiles of cerium as compared with the lowest were 2.09 (95% CI 1.05-4.16) and 2.81 (95% CI 1.21-6.52), respectively, p-trend 0.011. Our results suggest that toenail cerium levels may be associated with an increased risk of AMI, but more research is warranted to shed further light and fully understand the plausibility and public health implications of these findings.     

WATER RESOURCES DEVELOPMENT IN THE MULLICA RIVER BASIN1

ABSTRACT: The potential withdrawal of water from the Mullica River-Great Bay Estuary is southern New Jersey prompted a joint study by biologists and engineers to determine the maximum supply of water that could be diverted from the basin without causing undue environmental impacts. The effect of removal of water from the basin over long periods of time was simulated by review of records of a severe drought. Based on analysis of streamflows and salinities during these drought conditions, minimum mean monthly streamflows were determined corresponding to the maximum salinities tolerable by the fish and shellfish communities, important sources of revenue and recreation in the region. A physically optimized, chance constrained linear programming model was developed for the conjunctive use of ground and surface waters. Adjusting water withdrawal from streamflow and groundwater sources according to physical and seasonal criteria would permit maximum use of the basin's resources, with no additional burden on the ecology of the estuary.