Iranian population exposures to heavy metals, PAHs, and pesticides and their intake routes: a study protocol of a national population health survey

Abstract

Cancer is the second leading cause of death in the world and the third leading cause of death in Iran. It has been proven that numerous cancer cases are caused by exposure to environmental pollutants. There is a public health concern regarding an increase in exposure to carcinogens across Iran through different sources (air, food, and water) and a lack of research to address this issue. This study aims to gather data on exposure to heavy metals, polycyclic aromatic hydrocarbons (PAHs), and pesticides and their intake routes during the implementation of a national population health survey. This is a cross-sectional study of environmental pollutants in Iran, with a stratified multi-stage random sampling method, which led to 660 nationally representative samples in 132 clusters in three sequential parts. The first will be questionnaires to obtain demographics, assets, food records, air quality, and food frequency. The second will be physical measurements, including anthropometric and body composition. The third will be lab assessments that measure 26 types of environmental pollutants (7 heavy metals, 16 PAHs, and 3 pesticides) in urine, inhaled air, and consumed food and water of the population under study using ICP-MS and GS-MS devices. The results of this study will inform policymakers and the general population regarding the level of threat and will provide evidence for the development of interventional and observatory plans on the reduction of exposures to these pollutants. It could also be used to develop local standards to control contaminants through the three exposure routes. This study protocol will obtain data needed for policymakers to set surveillance systems for these pollutants at the national and provincial level to address the public concerns regarding the contamination of food, air, and water.

Exposures to pesticides and risk of cancer: Evaluation of recent epidemiological evidence in humans and paths forward

“…Titles and abstracts were screened for all papers produced by the literature search. Studies excluded from the primary analyses during title and abstract screening were reviews, [24][25][26] editorials, 27 animal or in vitro studies, 28 mechanistic studies (even if they used endpoints potentially related to clinical cancer, as epigenetic markers, telomere length, endocrine response), [29][30][31][32] papers on study protocols, 33 biostatistics methods papers, 34,35 epidemiological profiles and cohort descriptions, 36,37 risk/ exposure assessments 38 and other studies where human cancer was not a primary outcome. 39 The following search terms were used in PubMed to identify relevant journal articles assessing the relationship between human exposure to pesticides and cancer, which were published in 2017 or later:…”

Unveiling the lead exposure attributed burden in Iran from 1990 to 2019 through the lens of the Global Burden of Disease study 2019

“…Second, the final results may be skewed due to differences in sample selection and burden measurement in prior surveys. The aforementioned limitations could be alleviated by future relevant national studies 44 . Moreover, all limitations to the GBD study would also apply to ours 12 .…”

Impact of Atmospheric Polycyclic Aromatic Hydrocarbons (PAHs) of Falling Dust in Urban Area Settings: Status, Chemical Composition, Sources and Potential Human Health Risks

“…Figure 2a-c presents the results of the average daily dose ingestion (ADDing). The ADDing was calculated separately for children (>6), teenagers (6)(7)(8)(9)(10)(11)(12), and adults (>12) for all PAHs with each collected sample. The highest and lowest ADDing values for P1 (naphthalene) were 6.3 × 10 −7 mg kg −1 and 4.2 × 10 −7 mg kg −1 , respectively, for children (<6 years old) with an average value of 3.1 × 10 −7 mg kg −1 .…”

“…Local input is considered to be the main source with a minor influx from longer-range transport [10]. Therefore, it is anticipated that a variety of compounds are released during diesel combustion leading to potential environmental pollution that may negatively affect human health, especially in children [11,12]. In another study, the PAHs BaP, cyclopentaphenanthrene, benzoacephenanthrylene, anthracene, chrysene, benz(a)anthracene, naphthalene, phenanthrene, and fluorine were detected in the blood serum of children suffering from asthmatic allergy [13,14].…”