Toxic metals in toenails as biomarkers of exposure: A review

Salcedo‐Bellido, Inmaculada; Gutiérrez‐González, Enrique; García‐Esquinas, Esther; Larrea-Baz, Nerea Fernández de; Navas‐Acien, Ana; Téllez-Plaza, María; Pastor-Barriuso, Roberto; Lope, Virginia; Gómez‐Ariza, José Luis; García-Barrera, Tamara; Pollán, Marina; Moleón, José Juan Jiménez; Pérez‐Gómez, Beatriz

doi:10.1016/j.envres.2021.111028

Cited by 51 publications

(16 citation statements)

References 79 publications

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“…In our study participants the toenail concentrations of aluminium, selenium, zinc and the other elements were similar to concentrations in the homogenized published literature in the same matrix (Amaral et al 2012 ; Gutiérrez-González et al 2019 ; Salcedo-Bellido et al 2021 ; Signes-Pastor et al 2020 ).…”

Section: Discussionsupporting

confidence: 88%

“…One type of such conditions are the disease-induced pathophysiological processes that we already mentioned in the Introduction and in previous papers (Porta et al 2007 , 2008 , 2009 , 2014 , 2005 , 2021 ; Porta 2001 ; Gasull et al 2019 ). Related but different are the metabolic requirements of the tumor (He 2011 ; Gutiérrez-González et al 2019 ; Salcedo-Bellido et al 2021 ; Signes-Pastor et al 2020 ; Longnecker et al 1993 ; Garland et al 1993 ; Hunter et al 1990 ; Hopps 1977 ; Sukumar 2006 ). A third mechanism can operate as follows: symptoms (such as tiredness, loss of appetite, weight loss, abdominal pain, nausea) caused by the still subclinical disease can cause changes in the diet of the subject that change the intake of some nutrients and subsequently their body concentrations.…”

Section: Discussionmentioning

confidence: 99%

“…Problems in using toenails as a matrix for measurement of biomarkers include variability in growth rate, external contamination, and inconsistent protocols for collection and analysis (He 2011 ; Gutiérrez-González et al 2019 ; Salcedo-Bellido et al 2021 ; Signes-Pastor et al 2020 ; Orloff et al 2009 ). Because in the present study sample collection was conducted in-hospital, collection of toenails was similar for all study patients, and the external contamination of nails was minimized by having toenails collected immediately after bathing and scraping, and by sonicating nails in the laboratory prior to analysis (Nichols et al 1998 ).…”

Section: Discussionmentioning

confidence: 99%

“…Information on concentrations of trace elements in nails has long been used in humans to cost-effectively measure exposure and internal dose. In healthy and physically stable individuals, and compared to blood, urine, or hair samples, levels in toenails of mercury, manganese, and arsenic appear to reflect better the corresponding concentrations in the organism for a time frame from a few months to a year preceding sample collection (Amaral et al 2012 ; He 2011 ; Gutiérrez-González et al 2019 ; Salcedo-Bellido et al 2021 ; Signes-Pastor et al 2020 ; Longnecker et al 1993 ; Garland et al 1993 ; Hunter et al 1990 ; Hopps 1977 ; Sukumar 2006 ; Ntihabose et al 2018 ; Marchiset-Ferlay et al 2012 ).…”

Section: Introductionmentioning

confidence: 99%

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Timing of Toenail Collection and Concentrations of Metals in Pancreatic Cancer. Evidence Against Disease Progression Bias

et al. 2021

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Trace elements such as cadmium, arsenic, zinc or selenium increase or decrease risk of a wide range of human diseases. Their levels in toenails may provide a measure of mid-term intake of trace elements for studies in humans. However, in biologically and clinically aggressive diseases as pancreatic cancer, the progression of the disease could modify such concentrations and produce reverse causation bias. The aim was to analyze the influence of specific time intervals between several clinical events and the collection of toenails upon concentrations of trace elements in patients with pancreatic cancer. Subjects were 118 incident cases of pancreatic adenocarcinoma prospectively recruited in eastern Spain. Toenails were collected at cancer diagnosis, and soon thereafter interviews were conducted. Information on cancer signs and symptoms was obtained from medical records and patient interviews. Levels of 12 trace elements were determined in toenail samples by inductively coupled plasma mass spectrometry. General linear models adjusting for potential confounders were applied to analyze relations between log concentrations of trace elements and the time intervals, including the interval from first symptom of cancer to toenail collection (iST). Toenail concentrations of the 12 trace elements were weakly or not influenced by the progression of the disease or the diagnostic procedures. Concentrations of aluminum were slightly higher in subjects with a longer iST (age, sex and stage adjusted geometric means: 11.44 vs. 7.75 µg/g for iST > 120 days vs. ≤ 40 days). There was a weak inverse relation of iST with concentrations of zinc and selenium (maximum differences of about 20 and 0.08 µg/g, respectively). Conclusions: concentrations of the trace elements were weakly or not influenced by the development of the disease before toenail collection. Only concentrations of aluminum increased slightly with increasing iST, whereas levels of zinc and selenium decreased weakly. Even in an aggressive disease as pancreatic cancer, toenail concentrations of trace elements may provide a valid measure of mid-term intake of trace elements, unaffected by clinical events and disease progression. Supplementary Information The online version contains supplementary material available at 10.1007/s12403-021-00436-2.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Timing of Toenail Collection and Concentrations of Metals in Pancreatic Cancer. Evidence Against Disease Progression Bias

et al. 2021

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“…Urinary metal concentrations reflect recent exposure (within several days), whereas toenail metal concentrations reflect cumulative exposure (within 6–12 months) [ 23 , 24 , 25 , 26 ]. Cd and Pb are ubiquitous pollutants that can cause acute and chronic toxicity: Cd is associated with kidney and bone dysfunction [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Associations between Biomarkers of Metal Exposure and Dry Eye Metrics in Shipyard Welders: A Cross-Sectional Study

Liou

Chen

et al. 2022

IJERPH

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Shipyard welders are often exposed to welding metal fumes. Ocular surfaces are continually exposed to environmental hazards. However, limited information on the associations between metal exposure and dry eye metrics in occupational settings is available. This study employed a cross-sectional design that involved the participation of 59 welders and 25 administrative staff in a shipyard in northern Taiwan from September 2020 to October 2020. The participants’ individual information, laboratory data, exposure to particulate matter < 2.5 μm, urinary, and toenail metal concentrations were collected. Dry eye metrics were evaluated using standardized questionnaires and a noninvasive ocular surface analyzer. Urinary V and Cr and toenail V, Cr, Mn, Fe, Ni, Zn, As, and Cd and Pb were significantly higher in the exposed group than in the control group. After adjustment for confounding factors, dry eye metrics were associated with urinary Cd (β = 0.407; p = 0.007) and toenail Pb (β = 0.482; p = 0.002). The participants with higher urinary Cd exhibited higher odds ratios for elevated dry eye metrics. Our study revealed that exposure to welding procedures increases several metal biomarkers. In addition, urinary Cd, and toenail Pb might be related to dry eye disease in shipyard welders.

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