Exposure to metals and morbidity at eight years follow-up in women of childbearing age.

This exploratory study was aimed to investigate the link between toxic metal content in women's urine and their morbidity 2 years before and 6 years after the test. Concentrations of 25 metals in urine were analyzed for 111 pregnant women collected prior to delivery. All women were of Arab-Bedouin origin. Information on primary care and hospital visits during the study period was obtained. In a Poisson regression model, a health outcome was regressed over metal exposure and other factors. A Weighted Quantile Sum Regression (WQS) approach was used to indicate metals dominating in their possible impact on women's morbidity. Obesity was the most frequently diagnosed condition in this population (27.9%). Diagnoses in a neurological category accounted for 36.0%, asthma or respiratory-25.2%, psychiatric-12.6%, cardiovascular-14.4% and cancer or benign growth-for 13.5%. Based on WQS analysis, cancer and benign growth were mostly attributed to the increased levels of cadmium, cardiovascular outcomes were linked with lead, and obesity was found associated with elevated levels of nickel. Hematological, neurological and respiratory outcomes were attributed to multiple non-essential metals. The health and exposure profile of women in the study warrants a periodic biomonitoring in attempt to identify and reduce exposure to potentially dangerous elements.

Generalised urticaria following ingestion of a nickel-plated coin in a 4-year-old girl.

We report the case of a 4-year-old girl who presented to the emergency department after ingestion of a nickel-plated coin. Abdominal radiographs confirmed the presence of a coin in her stomach but she was otherwise asymptomatic. She was discharged with assurances that the foreign body would pass spontaneously. The patient developed significant generalised urticaria the next day, which became progressively more severe. Her symptoms prompted endoscopic removal of the nickel-plated coin and a postoperative course of corticosteroids and antihistamine therapy. This is the first reported case of generalised urticaria secondary to ingestion of a coin with nickel plating only (2% nickel content overall). A review of similar cases is provided.

Do Dietary Habits Influence Trace Elements Release from Fixed Orthodontic Appliances?

The objective was to investigate the effect of dietary habits on the release of Cr and Ni ions from orthodontic appliances by hair mineral analysis. Patients (N = 47) underwent electronic questionnaire survey to investigate the effect of dietary habits on Cr and Ni levels in hair. The research was carried out on hair sampled at the beginning and in the 4th, 8th, and 12th months of the treatment. The content of Cr and Ni in the collected samples was determined by ICP-OES. The study showed that consumption of acidic dietary products may have the effect on increasing the release of Cr and Ni ions from orthodontic appliances. The release of Cr from orthodontic appliances in patients who consumed fruit juice, coffee, yoghurt, and vinegar was higher. The coefficients enabling comparison of metal ions release pattern at a given sampling points were defined. The comparison of the coefficients yielded the information on the possible magnification of metal ions released as the result of the additional factor consumption of acidic food or drink that intensifies metal ions release. The following magnification pattern was found for chromium: coffee (7.57 times) > yoghurt (2.53) > juice (1.86) > vinegar (1.08), and for nickel: vinegar (2.2) > coffee (1.22) > juice (1.05). Yoghurt did not intensify the release of nickel. Concluding, orthodontic patients should avoid drinking/eating coffee, yoghurt, fruit juices, and vinegar.

Association of soil arsenic and nickel exposure with cancer mortality rates, a town-scale ecological study in Suzhou, China.

Heavy metals and arsenic are well-known carcinogens. However, few studies have examined whether soil heavy metals and arsenic concentrations associate with cancer in the general population. In this ecological study, we aimed to evaluate the association of heavy metals and arsenic in soil with cancer mortality rates during 2005-2010 in Suzhou, China, after controlling for education and smoking prevalence. In 2005, a total of 1683 soil samples with a sampling density of one sample every 4 km(2) were analyzed. Generalized linear model with a quasi-Poisson regression was applied to evaluate the association between town-scale cancer mortality rates and soil heavy metal concentrations. Results showed that soil arsenic exposure had a significant relationship with colon, gastric, kidney, lung, and nasopharyngeal cancer mortality rates and soil nickel exposure was significantly associated with liver and lung cancer. The associations of soil arsenic and nickel exposure with colon, gastric, kidney, and liver cancer in male were higher than those in female. The observed associations of soil arsenic and nickel with cancer mortality rates were less sensitive to alternative exposure metrics. Our findings would contribute to the understanding of the carcinogenic effect of soil arsenic and nickel exposure in general population.

Detoxification of rats subjected to nickel chloride by a biomaterial-based carbonated orthophosphate.

Recently, the therapeutic approaches of the detoxification against the metals (nickel) in the body are the use of biomaterials such as carbonated hydroxyapatite. The aim of this study is therefore to analyze the physiological and physicochemical parameters of strain white rats "Wistar" receiving nickel chloride and to study the protective associative of apatite against adverse effects of this metal, and this in comparison with control rats. Our results showed that the nickel induced in rats an oxidative stress objectified by elevated levels of thiobarbituric acid-reactive substances and conjugated dienes associated with inhibition of the activity of the antioxidant defense system such as glutathione peroxidase, superoxide dismutase and catalase in the liver, kidney, spleen and erythrocyte. Disorders balances of ferric, phosphocalcic, a renal failure and a liver toxicity were observed in rats exposed to nickel. As well as a significant increase in the rate of nickel in the bones and microcytic anemia was revealed. However, the implantation of carbonated hydroxyapatite in capsule form protects rats intoxicated by the nickel against the toxic effects of this metal by lowering the levels of markers of lipid peroxidation and improving the activities of defense enzymes. Our implantation technique is effective to correct ferric balance and phosphocalcic equilibrium, to protect liver and kidney function, to reduce the rate of bone nickel and to correct anemia. They clearly explain the beneficial and protective of our biomaterial which aims the detoxification of rats receiving nickel by substituting cationic (Ca(2+) by Ni(2+)) and anionic (OH(-) by Cl(-)) confirmed by physicochemical characterization like the IR spectroscopy and X-ray diffraction. These techniques have shown on the one hand a duplication of OH(-) bands (IR) and on the other hand the increase of the volume of the apatite cell after these substitutions (X-ray diffraction).

An unusual presentation of nickel-associated "school chair sign".

Symmetric sources of exposure generally result in symmetric contact dermatitis, but patient habits may distort or modify exposures in ways that may obscure clinical relevance. We present a variant of "school chair sign" consistent with the child's usual habit of sitting obliquely with her right leg crossed over her left leg.

A total diet study of nickel intake in a Spanish population (Canary Islands).

The aim of this study was to analyse nickel content in foods and beverages most commonly consumed by the Canary Island people to determine the dietary intake of this metal throughout the Canary Islands as a whole and in each of the seven islands. A total of 440 samples were analysed by graphite furnace atomic absorption spectrometry. Nickel concentrations ranged between 2.348 ± 1.716 mg/kg in nuts and 0.002 ± 0.002 mg/l in water. Estimated total intake of nickel was 0.093 mg/day for the Canary population, which is far below the tolerable upper intake level (UL) established for adults. Gran Canaria turned out to be the island with the highest nickel intake. Differential analysis of nickel intake by age and sex of the Canary Island community showed that values were below the UL in children as well as in adults. These outcomes were compared with data from other populations at the national and international levels.

Effect of nickel and chromium exposure on buccal cells of electroplaters.

The electroplating industry commonly involves the use of nickel and chromium. An assessment of the genotoxic effects of these metals can be carried out by micronucleus (MN) test in buccal cells. Other nuclear anomalies (NA) observed in buccal cells viz., karyorrhexis, pyknosis and karyolysis are also the indicators of genotoxicity. The current study aims at determining the extent of genotoxic damage in relation to the duration of exposure to nickel and hexavalent chromium via micronuclei induction and other nuclear anomalies. The present investigation included 150 subjects of which 50 individuals with no history of nickel/chromium exposure (Group I) were taken as control, 50 electroplaters exposed to nickel and hexavalent chromium for duration of less than 10 years (Group II) and 50 electroplaters exposed for ≥10 years (Group III) were included. Slides of buccal cells were prepared and the frequency of MN (‰) and NA (‰) were calculated. ANOVA was applied to test significance. Results were considered significant at p < 0.05 and p < 0.001. Group III showed the highest MN frequency (1.08 ± 0.54‰, p < 0.05), karyorrhexis (20.75 ± 6.29, p < 0.05), karyolysis (3.50 ± 1.91, p < 0.001), binucleate (4.75 ± 2.75, p < 0.05) and enucleated cells (5.75 ± 1.70, p < 0.05). Significant increase in frequencies between Group II and III was found as duration of exposure increased. Plasma nickel and chromium levels were also determined which showed a positive correlation with frequency MN and other nuclear abnormalities (p < 0.01).

[A new medical concept: the metallic profile]. / Le profil métallique : un nouveau concept médical.

Over the past decade great progress has been made in metals and metalloids analysis. This analysis is a basic stage in toxicity assessment and is indispensable in achieving a realistic evaluation of substance toxicity. A recently introduced technique, inductively coupled plasma mass spectrometry (ICP-MS) is progressively replacing atomic absorption. This analysis permits multi-elementary determinations, approximately 30 elements, with an optimal gain in sensitivity in many biological matrices: i.e. whole blood, plasma, urine, hair, nail, biopsy samples. Moreover, this method allows semiquantitative determination with an additional 30 supplementary elements, which enables the toxicologist to sufficiently estimate the toxic levels and metal exposure. The authors demonstrate that the ICP-MS could be very useful for a wide range of clinical applications. Furthermore, this procedure offers new exploration possibilities in various fields such as clinical toxicology, forensic toxicology as well as work place testing or environmental exposure and permits epidemiologic studies. This analytical method in fact also provides a new scientific approach. To our knowledge we are the first to propose: the metallic profile.

Urinary excretion of an oxidative stress marker, 8-hydroxyguanine (8-OH-Gua), among nickel-cadmium battery workers.

The relationship between oxidative stress and carcinogenic metals including nickel and cadmium is a matter of interest. To assess the oxidative stress status of workers exposed to nickel and cadmium simultaneously, we determined urinary excretion of 8-hydroxyguanine (8-OH-Gua), a urinary oxidative stress marker. Our subjects were 66 (64 males and 2 females) nickel-cadmium battery workers. Spot urine and blood samples were collected. The levels of cadmium in blood (Cd-B) and nickel in urine (Ni-U) were determined by graphite furnace atomic absorption spectrophotometry. 8-OH-Gua in urine was analyzed using a high performance liquid chromatography-electrochemical detector (HPLC-ECD) system. Data on age, sex, duration of present work and smoking status were also obtained from each subject. Creatinine-adjusted 8-OH-Gua was significantly correlated with age, Ni-U and Cd-B in univariate analysis, while multivariate analysis revealed that Ni-U and Cd-B were significant independent variables and that these two biological exposure indices were positively correlated with 8-OH-Gua. The data were also analyzed in the context of mixture toxicity. The subjects were divided into groups based on median level of Ni-U and Cd-B (2.86 mug/g creatinine and 0.23 mug/dl, respectively). Workers with high Ni-U/high Cd-B (Group IV) had the highest levels of 8-OH-Gua levels (GM (GSD), 21.7(2.0)), followed by those with high Ni-U/low Cd-B (11.5(1.6) Group III), those with low Ni-U/high Cd-B (8.9(1.9) Group II), and those with low Ni-U/low Cd-B (8.5(1.5) Group I). The p values of Students' t-tests between Group I and Group II, III and IV were 0.847, 0.050 and <0.001, respectively. The combined effect of Cd and Ni on the urinary excretion of 8-OH-Gua departed from additivity.

Dermatitis de contacto por prótesis ortopédicas / Contact dermatitis for orthopaedic prostheses

Diversas aleaciones son utilizadas en la fabricación de prótesis ortopédicas (ej: titanio, vitalio, etc), dentro de las cuales la más utilizada es la de acero inoxidable. El níquel, parte importante de esta aleación, es capaz de liberarse y provocar sensibilización, desencadenando reacciones cutáneas locales y sistémicas. De los materiales que componen la aleación para formar acero inoxidable, el níquel es el que más frecuentemente se ve implicado en reacciones cutáneas por sensibilidad, en tanto que otros como el cromo y cobalto, la posibilidad de pérdida de material a partir de la prótesis es discutida. Presentamos el caso de una paciente con dermatitis alérgica al níquel con lesiones generalizadas, que aparecieron luego del implante de prótesis ortopédicas de acero inoxidable, dando positivo para níquel sulfato en las pruebas epicutáneas.

Several alloys are used in the manufacture of orthopaedics prostheses (ie: titanium, vitalium). Stainless steel is the most frequently used among them. Nickel is an important component of this alloy and may release and provoke sensitivity. Arising local and systemic cutaneous reactions. Nickel is the material composing stainless steel that ordinary is implicated in cutaneous reactions of sensitivity; the role of chrome or cobalt is still uncertain. Our patient is a woman affected of nickel contact dermatitis, with generalized reactions that appear after an implant of a stainless steel orthopaedic prosthesis. Epicutaneous tests were performed, confirming a strong sensitivity to nickel sulphate.

A quantitative analysis of aerosols inside an armored vehicle perforated by a kinetic energy penetrator containing tungsten, nickel, and cobalt.

These tests were conducted to develop a database that could be used to assess risks to soldiers from exposure to aerosolized metallic particulates when the crew compartment of an Abrams tank is perforated by a kinetic energy penetrator. Quantitative data are reported for aerosols produced by kinetic energy penetrators containing tungsten, nickel, and cobalt. The following are addressed: (1) concentrations and rates of particle settling inside the vehicle, (2) particle size distribution, (3) inhalable and respirable particulates, (4) distribution of aerosol particles by mass, and (5) particle shapes. The scenario described in this report simulates a rare occurrence. The lessons learned, however, highlight a requirement for developing protocols for analyses of metals in body fluids and urine as soon as practical, and also for implementing targeted postdeployment medical surveillance programs that monitor both body burden for respired metals and pulmonary function.

Small-for-gestational-age newborns of female refinery workers exposed to nickel.

OBJECTIVES: It has not yet been established whether exposure to nickel (Ni) compounds may cause reproductive toxicity. The objective of this study was to investigate whether women employed under conditions of nickel exposure in early pregnancy were at elevated risk of delivering a newborn small-for-gestational-age (SGA). MATERIALS AND METHODS: A register-based study of a well defined population. Data on pregnancy outcome and maternal occupation were obtained from the Kola Birth Registry. Each birth record was assigned a Ni exposure rating category according to maternal occupation at the time of becoming pregnant. Nickel exposure assessment was based on determining the water-soluble Ni subfraction of respirable aerosol fraction obtained by personal monitoring, and/or on measurements of urine Ni concentration. The reference population were the delivering women with background exposure level. The study population consisted of 22 836 births (>27 weeks of gestation) and the SGA infants were defined as below the 10th percentile birth weight for gestational age in the source population. Multiple logistic regression was used to analyze the association of the outcome with the assigned exposure rating category. RESULTS: The adjusted odds ratio for Ni-exposed women for giving birth to an SGA newborn was 0.84 (95% CI: 0.75-0.93). CONCLUSIONS: We found no adverse effect of maternal occupational exposure to water-soluble Ni in the first part of pregnancy on the risk of delivering an SGA newborn without trisomy. The finding does not exclude a possibility that exposure throughout pregnancy might produce such an effect.

First epileptic seizure induced by occupational nickel poisoning.

Toxic causes of seizures are numerous: alcohol and other substances of abuse, drugs, and industrial and household products. However, in the absence of a clearly suggestive history and/or associated symptoms and signs, identification of the toxic origin of new-onset seizures may be extremely difficult. We report here the case of a patient admitted in our hospital after a single generalized tonic-clonic seizure. The remarkable coincidence that a colleague of his, with whom he was working to clean the same workshop, had been admitted 1 week earlier for respiratory distress, coma, and de novo nonconvulsive focal status epilepticus, led us to consider a possible toxicologic etiology. Urine analysis revealed a high nickel concentration, suggestive of acute nickel poisoning.

Effects of nickel poisoning on expression pattern of the 72/73 and 94 kDa stress proteins in rat organs and in the COS-7, HepG2, and A549 cell lines.

The present study deals with the effects of Ni on the expression level of three stress proteins, namely, the cytosolic HSP72 and HSP73, and the reticulum-associated GRP94. Experiments were carried out on "Wistar'' female rats daily injected with 4 mg NiCl2 per kg body weight for 1, 3, 5, and 10 days. Another set of experiments were carried out using cell lines, derived from the monkey kidney (COS-7), and from human tumors of the lung (A549) and liver (HepG2). Cells were cultured for 4 days in the permanent presence of 100, 200, or 400 microM NiCl2. In control rats, stress proteins pattern was found to be tissue specific: two protein bands of 96 and 94 kDa were immunodetected with the anti-GRP94 antibody in kidney and liver extracts, whereas only the 96 kDa band was present in ovary extracts. HSP73 was present in kidney, liver, and ovary whereas HSP72 was only found in kidney. In kidney of nickel-treated animals, HSP73 and the 96 kDa proteins were overexpressed whereas HSP72 was strongly down regulated. No such effect was observed in liver or ovary. Similarly, in nickel-treated cell lines, HSP72 was downregulated and GRP94 (96 kDa protein) was overexpressed. HSP73 expression appeared moderately increased in A549 cells but decreased in COS-7 cells. Because long-term caloric restriction was reported to reduce free radical generation in cells, the effect of 1 month food restriction (50%) was tested in rats as a possible way to lower oxidative damages induced by Ni. No significant effect on HSP expression was observed.