Exposure to metals and congenital anomalies: a biomonitoring study of pregnant Bedouin-Arab women.
BACKGROUND
The Bedouin-Arab population in Israel comprises a low socio-economic society in transition. Smoking among males and consanguineous marriages are frequent. A previous study showed elevated rates of major malformations within groups from this population residing near an industrial park, where high ambient values of arsenic (As) and nickel (Ni) were detected, compared to groups living in remote localities.


OBJECTIVE
We estimated the extent of exposure to metals in pregnant Bedouin-Arab women in relation to congenital malformations.


METHODS
We collected maternal urine samples from 140 Bedouin women who gave birth in a local hospital. Patient medical history, type of marriage (consanguineous or non-consanguineous), and parental exposure history were collected by interview and medical records.


RESULTS
Aluminum (Al) was detected in 37 women (26.4%), cadmium (Cd) in 2 (1.4%), As in 10 (7.1%), and Ni in 1 woman (0.7%). The detected rate of Cd exposure was low, though more than 92% of the fathers reported smoking. Concentrations of Al were higher for women residing within 10 km of the local industrial park (Prevalence Ratio (PR)=1.12, p-value=0.012) or who reported using a wood burning stove (PR=1.37, p-value=0.011) and cooking over an open fire (PR=1.16, p-value=0.076). Exposure to Al was adversely associated with minor anomalies (OR=3.8, p-value=0.046) after adjusting for history of abortions (OR=6.1, p-value=0.007). Fetuses prenatally exposed to As were born prematurely (p-value=0.001) and at lower weights (pv=0.023).


CONCLUSIONS
The study population of pregnant women is exposed to high levels of metals mainly of household origin. Our findings may be generalized to similar populations in developing countries.
Environmental Epidemiology Department, Ministry of Health, Jerusalem, Israel; Faculty of Health Science, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Department of Public Health, The Ashkelon Academic College, Ashkelon, Israel.
Isabella
I
Karakis
Faculty of Health Science, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Department of Neonatology, Soroka University Medical Center, Beer-Sheva, Israel.
Daniella
D
Landau
Faculty of Health Science, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel.
Maayan
M
Yitshak-Sade
Faculty of Health Science, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Ultrasound Unit, Department of Obstetrics and Gynecology, Soroka University Medical Center, Beer-Sheva, Israel.
Reli
R
Hershkovitz
Laboratory of Clinical Toxicology and Pharmacology, Sheba Medical Center, Tel-Hashomer, Israel.
Michal
M
Rotenberg
Faculty of Health Science, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Batia
B
Sarov
Environmental Epidemiology Department, Ministry of Health, Jerusalem, Israel; Faculty of Health Science, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Public Health Services, Ministry of Health, Jerusalem, Israel.
Itamar
I
Grotto
Faculty of Health Science, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Electronic address: novack@bgu.ac.il.
Lena
L
Novack
D000328:Adult; D000013:Congenital Abnormalities / Q000453:epidemiology*; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D004785:Environmental Pollutants / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008670:Metals / Q000097:blood*; D011247:Pregnancy
D004785:Environmental Pollutants; D008670:Metals
Biomonitoring; Household environment; Malformations; Metals; Prenatal exposure