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Geographic differences in exposures to metals and essential elements in pregnant women living in Suriname

Journal of Exposure Science & Environmental Epidemiology volume 33, pages 911–920 (2023)Cite this article

Abstract

Background

In Suriname, 20% of pregnancies end in adverse birth outcomes. While prenatal exposure to metals may lead to adverse health outcomes, exposure assessments in Suriname are scant. Environmental contamination from mercury (Hg) used in artisanal goldmining in the Amazonian Interior, and the uncontrolled use of pesticides in suburban regions are of particular concern.

Objective

This study assessed geographic differences in exposures to metals and essential elements in pregnant Surinamese women.

Methods

This study is a subset (n = 400) of the Caribbean Consortium for Research in Environmental and Occupational Health (CCREOH) cohort study. Sector-field inductively-coupled plasma mass spectrometry was used to determine concentrations of lead (Pb), Hg, selenium (Se), cadmium (Cd), manganese (Mn) and tin (Sn) in whole blood of the pregnant women. High vs. low exposures to Pb and Hg were determined and were based respectively on CDC (3.5 ug/dL) and USEPA (3.5 ug/L) action levels. Differences in geographic exposures were tested with the Mann-Whitney U-test, and differences between blood elemental concentrations and action levels for Pb and Hg with the Wilcoxon signed rank test. The association between demographics and high exposures of Pb and Hg was examined with multivariate logistic regression models.

Results

The median concentrations of Pb, Hg and Se (5.08 μg/dL, 7.87 μg/L, and 228.26 μg/L respectively) in Interior women, were higher than the Urban and Suburban regions (p < 0.001), and higher than internationally accepted action levels (p < 0.001). The median concentrations of Mn and Sn found in Suburban women (17.55 and 0.97 ug/L respectively) were higher than Urban and Interior regions (p < 0.02).

Significance

Pregnant women living in Suriname’s Amazonian Interior are exposed to Hg and Pb at levels of public health concern. Urgently needed is a comprehensive source characterization assessment and the development, implementation and monitoring of environmental health policies, specifically addressing the chemicals of concern.

Impact

In a subset of participants enrolled in the CCREOH environmental epidemiology cohort study elevated levels of Hg and Pb were identified. This is the first comprehensive exposure assessment in the Surinamese population. Health concerns include adverse birth- and neurodevelopmental outcomes. Geographic differences require a tailored approach to health intervention and comprehensive source characterization. Future research should ascertain the role of Se as a potential protective factor. Environmental policy development, implementation and monitoring is pivotal to mitigate exposures to these neurotoxicants.

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Fig. 1: Heatmap of elemental blood concentrations and metals indices.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

This study was conducted as part of the Caribbean Consortium for Research in Environmental and Occupational Health (CCREOH) (U01TW010087; U2RTW010104 NIH/FIC). We thank all participants and recruiters of the CCREOH study. We gratefully acknowledge all participating hospitals and midwifery personnel, Regional Health Department clinics, and Medical Mission Primary Health Care Suriname, including Drs. Gaitree Baldewsing, Aloysius Koendjbiharie and Radha Ramjatan. We thank the Wisconsin State Laboratory of Hygiene for conducting the blood elemental analyses. Research reported in this publication was supported by the Fogarty International Center of the National Institutes of Health under Award Numbers R24TW009561, U2RTW010104 and U01TW010087. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. No funds have been received for covering the costs to publish in open access.

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Authors and Affiliations

  1. School of Public Health, Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, PA, USA

    Firoz Z. Abdoel Wahid, Hannah H. Covert & Maureen Lichtveld

  2. School of Public Health and Tropical Medicine, Department of Environmental Health Sciences, Tulane University, New Orleans, LA, USA

    Firoz Z. Abdoel Wahid, Hannah H. Covert & Maureen Lichtveld

  3. Foundation for Perinatal Interventions and Research in Suriname (Perisur), Paramaribo, Suriname

    Ashna D. Hindori-Mohangoo

  4. School of Public Health, Department of Environmental Health Sciences, University of Alabama at Birmingham, Birmingham, AL, USA

    Maryam Karimi & Jeffrey K. Wickliffe

  5. Department of Civil, Construction, and Environmental Engineering, University of Alabama at Birmingham, Birmingham, AL, USA

    Samain Sabrin

  6. Trace Element Research Group, University of Wisconsin-Madison & Wisconsin State Laboratory of Hygiene, Madison, WI, USA

    Martin Shafer

  7. Scientific Research Center Suriname, Academic Hospital Paramaribo, Paramaribo, Suriname

    Anisma R. Gokoel

  8. School of Public Health and Tropical Medicine, Department of Biostatistics and Data Science, Tulane University, New Orleans, LA, USA

    Arti Shankar

  9. Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname

    Wilco Zijlmans

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  1. Firoz Z. Abdoel Wahid
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Contributions

I, Firoz Abdoel Wahid, hereby confirm that I had full access to the data in the study and final responsibility for the decision to submit for publication. The contributing authors met all the criteria set by the Journal of Exposure Science and Environmental Epidemiology: FA and JW: conceived and designed the work that led to submission, acquired data and played an important role in interpreting the results. FA, JW, AH, SS and MK drafted the manuscript. FA, AG, WZ. MS, AH and AS: acquired data. HC, AG, WZ, and ML played an important role in interpreting the results. All contributing authors revised the manuscript, approved the final version, and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Firoz Z. Abdoel Wahid.

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The authors declare no competing interests.

Ethical approval

The CCREOH study was approved by Human Subjects Protection authorities at all participating institutions as well as the Central Committee on Research Involving Human Subjects, Medical Ethical Committee of the Ministry of Health in Suriname (reference number VG 023-14) and the Institutional Review Board of Tulane University, New Orleans, LA, USA (study number 839093).

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Abdoel Wahid, F.Z., Hindori-Mohangoo, A.D., Covert, H.H. et al. Geographic differences in exposures to metals and essential elements in pregnant women living in Suriname. J Expo Sci Environ Epidemiol 33, 911–920 (2023). https://doi.org/10.1038/s41370-023-00526-0

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