Exposição a metais em população adulta residente em áreas industriais: revisão sistemática da literatura

Abstract

Resumo Este artigo objetivou revisar os estudos de biomonitoramento humano (BMH) que avaliaram a exposição a chumbo (Pb), cádmio (Cd), mercúrio (Hg), níquel (Ni), arsênio (As) e manganês (Mn) em adultos residentes próximo a áreas industriais. Realizou-se uma revisão sistemática, sem limite de data inicial até dezembro de 2017, utilizando a base de dados da MEDLINE e a BVS. Foram incluídos estudos originais em inglês, português ou espanhol, com uso de sangue e/ou urina como biomarcador. Os artigos foram avaliados pelos critérios metodológicos, incluindo-se estudos com grupo de comparação e/ou amostragem probabilística. Dos 28 estudos incluídos, 54% foram realizados na Europa, 36% na Ásia, 7% na América do Norte e 4% na África. Fundições, metalúrgicas e siderúrgicas foram as indústrias mais estudadas. Urina e sangue foram usados em 82% e 50% dos estudos, respectivamente. Os elementos mais investigados foram Cd, Pb e As. Embora com metodologias heterogêneas, em geral, os estudos observaram maiores concentrações de metais em expostos, especialmente As e Hg, do que nos grupos de comparação. Esta revisão evidencia a necessidade de estudos de BMH com maior rigor metodológico, reforçando a importância da vigilância em saúde de populações expostas a metais tóxicos, sobretudo nos países em desenvolvimento.

Biomonitoring of Exposure to Metals in a Population Residing in an Industrial Area in Brazil: A Feasibility Study

“…However, international data on blood Cu concentrations are lacking [10,14,54,55]. References: [3,10,[12][13][14][15][16][17][19][20][21][22][23][24][25]54,55].…”

“…For essential metals, subjects residing near areas with different industries in Italy showed lower blood concentrations of Mn (12 µg/L) and higher concentrations of Cu (971 µg/L) [ 60 ] than ours. However, these comparisons should be interpreted with caution, given that these studies present significant methodological limitations such as nonprobability sampling and the absence of a comparison group [ 3 ]. As the three micro areas under study are zone I (exposed population), differences in metal levels and clinical parameters may be related to differences in the characteristics of residents between micro areas, such as smoking habits or living near roads or highways, which will be explored in this HBM project.…”

“…HBM studies in populations near industrial areas are scarce in developing countries [ 3 ], probably due to the lack of financial and technical resources and infrastructures required to conduct this type of survey. Therefore, this valuable study provides an approach to research in partnership with municipal health services to feasibly and efficiently develop extensive surveys in developing countries.…”

“…Steel plants are among the most polluting industries, as their residues may contain complex organic compounds and metals, such as iron (Fe), chrome (Cr), copper (Cu), nickel (Ni), and zinc (Zn) [ 2 ]. A recent systematic review of human biomonitoring (HBM) studies in populations residing near industrial sites, carried out by our research group [ 3 ], showed higher levels of exposure to toxic metals in populations residing in the vicinity of industrial sites than in those in more distant areas. Exposure to industrial emissions may contribute to preclinical hormonal, hematological, hepatic, and renal alterations [ 4 , 5 , 6 ], and in the long term, it can increase the risk of respiratory diseases cutaneous, neurological, renal and liver conditions [ 7 ], and cancer [ 8 ].…”

“…In our review of HBM studies on exposure to metals in industrial areas, we observed a lack of HBM studies in Latin American countries, with most studies being conducted in Europe, North America, and Asia [ 3 ]. In addition, several methodological flaws were identified, such as the absence of a comparison group and the use of non-probabilistic sampling methods [ 3 ]. These weaknesses limit the internal validity of studies as well as the generalization of results.…”