In Utero Exposure to Aluminium and Other Neurotoxic Elements in Urban Coastal South African Women at Delivery: An Emerging Concern.

Aluminium (Al) is a non-essential neurotoxicant and there is limited information regarding exposure to Al in utero. This study sought to evaluate the in utero exposure to Al in urban South African women, its effects on birth outcomes and possible synergistic effects between Al, essential and neurotoxic elements such as lead (Pb), mercury (Hg) and arsenic (As), as well as a a potential sex-dependent response to these elements in neonates. This study has found elevated levels of Al in urban women at delivery. The Spearman's rank correlation coefficients (p-value) of the association between maternal serum Al and birth outcomes (gestational age and parity), and between maternal serum Al and Cu, Zn and Se, were statistically significant. However, in the general and the stratified models, no association was found between any of the birth outcomes and maternal serum Al. The association between maternal serum Al and neurotoxic elements at delivery showed a significant positive correlation for Pb only (rho = 0.361; p < 0.001) which was found to be sex-dependent in neonates (males, rho = 0.285; p < 0.004 and females, rho = 0.444, p < 0.001). Our preliminary findings indicate that in utero exposure to Al is an emerging concern requiring further research and directives from public health authorities.

Prenatal Exposure to Aluminum and Status of Selected Essential Trace Elements in Rural South African Women at Delivery.

This study sought to evaluate the in utero exposure to aluminum and status of selected trace elements in South African women at delivery since aluminum is known to be toxic in all developmental stages even at low concentrations. Serum aluminum was negatively correlated with aluminum in urine, both uncorrected and corrected for creatinine, which suggests the retention of aluminum in body stores. Serum copper and zinc levels were found to be high in this study population. Serum copper levels were negatively correlated with aluminum in serum (ß = -0.095; p = 0.05). There was a marginal negative correlation between aluminum levels in serum and manganese levels in whole blood (ß = -0.087; p = 0.08). Copper levels in maternal serum were negatively correlated with birth weight and the length of neonates. There were a number of positive correlations between maternal characteristics and birth outcomes. Mothers who consumed root vegetables frequently appeared to be protected from aluminum retention and increased body burden since their serum aluminum levels were found to be significantly lower. The findings of the current study can be used as a baseline for further research on aluminum exposure and its associated interactions and outcomes in vulnerable populations.

The placenta as a barrier for toxic and essential elements in paired maternal and cord blood samples of South African delivering women.

Environmental toxicants such as metals may be detrimental to foetus and infant development and health because of their physiological immaturity, opportunistic and differential exposures, and a longer lifetime over which disease, initiated during pregnancy and in early life, can develop. The placental mechanisms responsible for regulation of absorption and excretion of elements during pregnancy are not fully understood. The aim of this paper is to assess the correlation for selected toxic and essential elements in paired whole blood samples of delivering women and cord blood, as well as to evaluate the placental permeability for selected elements. Regression analyses used to assess this correlation in 62-paired samples of maternal and cord whole blood of delivering women show that the concentrations of mercury, lead, cobalt, arsenic and selenium in maternal and cord blood differed statistically. Lead, cobalt, arsenic and selenium appear to pass the placental barrier by a diffusion mechanism. It was also found that the mercury levels in cord blood were almost double those of the mother, suggesting that the foetus may act as a filter for the maternal mercury levels during pregnancy. Transplacental transfer for arsenic and cobalt was 80% and 45%, respectively, suggesting that the placenta modulates the rate of transfer for these elements. Cadmium, manganese, copper and zinc levels did not show statistically significant correlations between two compartments (maternal versus cord whole blood). The study confirms that most of the toxic metals measured have an ability to cross the placental barrier.

Addressing the challenges of underdevelopment in environmental and occupational health in southern Africa.

Since 1996, the University of Michigan's Fogarty International Center training and research program in Environmental and Occupational Health (EOH) in Southern Africa has contributed to capacity development in the 14 countries of the Southern African Development Community. Methods include training citizens from the region in master's, doctoral, and short-term focused programs; assisting the development of graduate programs in EOH at institutions, developing resources for distance-based degree programs; direct support ofjunior and mid-level researchers, and organizing regional short courses and regional conferences. Substantial EOH resources now present in South Africa are leveraged to assist capacity development in the rest of the region. The program's successes appear to be due to strong regional leadership and oversight structures, a strategy of developing EOH resource centers in several countries, and close collaboration with other regional and international EOH programs.