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. 2021 Dec:157:106800.
doi: 10.1016/j.envint.2021.106800. Epub 2021 Aug 3.

Parental metal exposures as potential risk factors for spina bifida in Bangladesh

Gwen Tindula  1 , Sudipta Kumer Mukherjee  2 , Sheikh Muhammad Ekramullah  2 , D M Arman  2 , Subrata Kumar Biswas  3 , Joynul Islam  4 , John F Obrycki  1 , David C Christiani  5 , Liming Liang  6 , Benjamin C Warf  7 , Maitreyi Mazumdar  8
Affiliations

Parental metal exposures as potential risk factors for spina bifida in Bangladesh

Gwen Tindula et al. Environ Int. 2021 Dec.

Abstract

Background: Neural tube defects are a pressing public health concern despite advances in prevention from folic acid-based strategies. Numerous chemicals, in particular arsenic, have been associated with neural tube defects in animal models and could influence risk in humans.

Objectives: We investigated the relationship between parental exposure to arsenic and 17 metals and risk of neural tube defects (myelomeningocele and meningocele) in a case control study in Bangladesh.

Methods: Exposure assessment included analysis of maternal and paternal toenail samples using inductively coupled plasma mass spectrometry (ICP-MS). A total of 278 participants (155 cases and 123 controls) with data collected from 2016 to 2020 were included in the analysis.

Results: In the paternal models, a one-unit increase in the natural logarithm of paternal toenail arsenic was associated with a 74% (odds ratio: 1.74, 95% confidence interval: 1.26-2.42) greater odds of having a child with spina bifida, after adjusting for relevant covariates. Additionally, paternal exposure to aluminum, cobalt, chromium, iron, selenium, and vanadium was associated with increased odds of having a child with spina bifida in the adjusted models. In the maternal models, a one-unit increase in the natural logarithm of maternal toenail selenium and zinc levels was related to a 382% greater (odds ratio: 4.82, 95% confidence interval: 1.32-17.60) and 89% lower (odds ratio: 0.11, 95% confidence interval: 0.03-0.42) odds of having a child with spina bifida in the adjusted models, respectively. Results did not suggest an interaction between parental toenail metals and maternal serum folate.

Discussion: Parental toenail levels of numerous metals were associated with increased risk of spina bifida in Bangladeshi infants. Paternal arsenic exposure was positively associated with neural tube defects in children and is of particular concern given the widespread arsenic poisoning of groundwater resources in Bangladesh and the lack of nutritional interventions aimed to mitigate paternal arsenic exposure. The findings add to the growing body of literature of the impact of metals, especially paternal environmental factors, on child health.

Keywords: Arsenic; Bangladesh; Folate; Heavy metals; Neural tube defects.

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Conflict of interest statement

Conflict of Interest Statement

GT received a Student/New Investigator Travel Award of $750.00 to attend and present at the 2019 Environmental Mutagenesis and Genomics Society annual meeting in Washington DC from September 19–23, 2019. The other authors declare they have no actual or potential competing financial interests.

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