Concentrations of Arsenic, Chromium, and Nickel in Toenail Samples From Appalachian Kentucky Residents

Johnson, Nancy E.; Shelton, Brent J.; Hopenhayn, Claudia; Tucker, Thomas; Unrine, Jason M.; Huang, Bin; Christian, W. Jay; Zhuo, Zewei; Shi, Xianglin; Li, Li

doi:10.1615/jenvironpatholtoxicoloncol.v30.i3.40

Cited by 35 publications

(29 citation statements)

References 32 publications

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“…Studies done in rural areas of Appalachia showed some of the highest cervical cancer rates in America where a vast majority of study participants were non-Hispanic Whites 33 In the Appalachian region, poverty rates remain high, tobacco smoking and obesity are prevalent, and many jobs in the area, like coal mining, put individuals at higher cancer risk due to carcinogens in the environment. 34,35 Heath insurance is also a factor affecting health outcomes of cancer patients. In 2008, approximately 40% of Hispanics, 26% of Blacks, and 16% of White adults did not have health insurance.…”

Section: Cancermentioning

confidence: 99%

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Review: Increasing Awareness and Education on Health Disparities for Health Care Providers

Nesbitt

Palomarez

2016

Ethn Dis

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The focus of this review is to highlight health care disparities and trends in several common diseases in selected populations while offering evidence-based approaches to mitigating health care disparities. Health care disparities cross many barriers and affect multiple populations and diseases. Ethnic minorities, the elderly, and those of lower socioeconomic status (SES) are more at-risk than others. However, many low SES Whites and higher SES racial minorities have poorer health than their racial or SES peers. Also, recent immigrant groups and Hispanics, in particular, maintain high health ratings. The so-called Hispanic Paradox provides an example of how culture and social background can be used to improve health outcomes. These groups have unique determinants of disparity that are based on a wide range of cultural and societal factors. Providing improved access to care and reducing the social determinants of disparity is crucial to improving public health. At the same time, for providers, increasing an understanding of the social determinants promotes better models of individualized care to encourage more equitable care. These approaches include increasing provider education on disparities encountered by different populations, practicing active listening skills, and utilizing a patient’s cultural background to promote healthy behaviors. Ethn Dis. 2016;26(2):181-190; doi:10.18865/ed.26.2.181

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Section: Cancermentioning

confidence: 99%

“…In 2008, approximately 40% of Hispanics, 26% of Blacks, and 16% of White adults did not have health insurance. 36 Although the Affordable Care Act has helped millions more get access to care, a large number of uninsured patients still exist in the United States.…”

Section: Cancermentioning

confidence: 99%

Review: Increasing Awareness and Education on Health Disparities for Health Care Providers

Nesbitt

Palomarez

2016

Ethn Dis

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“…(29–31) Such studies have measured toenail metal concentrations of methylmercury, (32, 33) Pb, (34, 35) Cd, (36, 37) As, (38–40) Mn, (24, 41) Ni (20) and more. Mn and Ni have been isolated in toenail samples from welders.…”

Section: Introductionmentioning

confidence: 99%

Toenail Metal Concentration as a Biomarker of Occupational Welding Fume Exposure

Grashow¹,

Jinming²,

Fang

et al. 2014

Journal of Occupational and Environmental Hygiene

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In populations exposed to heavy metals, there are few biomarkers that capture intermediate exposure windows. We sought to determine the correlation between toenail metal concentrations and prior 12 month work activity in welders with variable, metal-rich, welding fume exposures. Forty-eight participants, recruited through a local union, provided 69 sets of toenail clippings. Union-supplied and worker verified personal work histories were used to quantify hours welded and respirator use. Toenail samples were digested and analyzed for lead (Pb), manganese (Mn), cadmium (Cd), nickel (Ni) and arsenic (As) using ICP-MS. Spearman correlation coefficients were used to examine the correlation between toenail metal concentrations. Using mixed models to account for multiple participation times, we divided hours welded into three-month intervals and examined how weld hours correlated with log-transformed toenail Pb, Mn, Cd, Ni and As concentrations. Highest concentrations were found for Ni, followed by Mn, Pb and As, and Cd. All of the metals were significantly correlated with one another (rho range=0.28-0.51), with the exception of Ni and As (rho=0.20, p=0.17). Using mixed models adjusted for age, respirator use, smoking status and BMI, we found that Mn was associated with weld hours 7-9 months prior to clipping (p = 0.003), Pb was associated with weld hours 10-12 months prior to clipping (p=0.03) and over the entire year (p=0.04). Cd was associated with weld hours 10-12 months prior to clipping (p=0.05), and also with the previous year's total hours welded (p=0.02). The association between Ni and weld hours 7-9 months prior to clipping approached significance (p=0.06). Toenail metal concentrations were not associated with the long-term exposure metric, years as a welder. Results suggest Mn, Pb, and Cd may have particular windows of relevant exposure that reflect work activity. In a population with variable exposure, toenails may serve as useful COMPETING INTERESTSThe authors declare they have no competing financial interests. HHS Public Access

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“…Both hair and nails have been used in environmental monitoring of human exposure to arsenic and other toxic elements. [28][29][30][31][32][33][34] Compared to hair, fingernails and, in particular, toenails have slower growth rates, which makes them convenient as a biomarker of long-term exposure. [35] A large number of papers are devoted to validation of arsenic concentration in nail clippings as a tool to assess chronic effects of exposure to arsenic in drinking water.…”

Section: Introductionmentioning

confidence: 99%

Synchrotron X-ray absorption spectroscopy analysis of arsenic chemical speciation in human nail clippings

et al. 2014

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Environmental context. Chronic ingestion of arsenic leads to its accumulation in keratinous tissues, which can represent a risk factor for developing cancer. We use synchrotron X-ray absorption spectroscopy to investigate chemical bonding of arsenic in the keratins from nail clippings of volunteers from areas in Atlantic Canada with low-to-moderate arsenic contamination of drinking water. The study helps our understanding of arsenic metabolism and its role in cancer development.Abstract. Drinking water aquifers in many areas of the world have naturally elevated levels of inorganic arsenic exceeding the World Health Organization limit. Arsenic concentrations in human nail clippings are commonly used as a biomarker of exposure to this toxic element. However, the chemical form of arsenic accumulated in nail tissues is not well determined. We employed synchrotron microprobe and bulk X-ray absorption spectroscopy techniques to analyse the concentration and chemical speciation of arsenic in the finger-and toenail clippings of volunteers living in the vicinity of Sackville, New Brunswick, Canada. This area is known to have low-to-moderately elevated levels of arsenic in ground water. Arsenic species in clippings were represented by three main groups, distinguished by the As-K near-edge X-ray absorption fine structure spectra: (1) As III type, which can be fitted as a mixture of As bound to thiols, and also to oxygen or methyl groups, with a small contribution from As V species, (2) As V type, best represented by fitting arsenate in aqueous solution and (3) The As III þ As V mixture type. The high proportion (%) of sulfur-bound arsenic species most likely corresponds to binding between arsenic (in its trivalent and, to a lesser extent, pentavalent forms) and cysteine residues in the sulfur-rich fraction of keratin and keratin-associated proteins. Further work is needed to explore whether these chemical species could be used as toxicity biomarkers of human exposure to elevated levels of As in drinking water.

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Concentrations of Arsenic, Chromium, and Nickel in Toenail Samples From Appalachian Kentucky Residents

Cited by 35 publications

References 32 publications

Review: Increasing Awareness and Education on Health Disparities for Health Care Providers

Review: Increasing Awareness and Education on Health Disparities for Health Care Providers

Toenail Metal Concentration as a Biomarker of Occupational Welding Fume Exposure

Synchrotron X-ray absorption spectroscopy analysis of arsenic chemical speciation in human nail clippings

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