Serum trace metals across environmental-pressure strata in Campania, Italy (SPES): a population-based cross-sectional biomonitoring study.
This study highlights significant geographic variation in serum trace metals in Campania, Italy, with medium-impact areas showing notably higher levels of mercury and antimony.
Where it sits
this study against the rest of the thymulin (facteur thymique serique) corpusSummary and findings
This study measured serum trace metals in residents aged 20-49 years across Campania, Italy, using a population-based cross-sectional design. The analysis revealed significant geographic variation in metal concentrations, particularly in medium-impact areas. Notably, higher levels of mercury and antimony were observed compared to the cohort average.
Abstract
<h4>Background and objectives</h4>We characterized fine-scale geographic variation in serum trace metals across Campania (southern Italy).<h4>Materials and methods</h4>In 2016-2017, the SPES programme sampled residents aged 20-49 years from municipal registries across Campania. Municipalities were stratified using an environmental-pressure index into three broad impact strata: high-impact, medium-impact and low-impact. For higher spatial resolution, municipalities were also grouped into 21 predefined municipal clusters. We measured 20 serum trace metals by ICP-MS and estimated age- and sex-adjusted geometric mean ratios (GMRs) comparing each stratum or cluster with the study-wide geometric mean.<h4>Results</h4>Of 4205 enrolled participants, 4188 were included. Medium-impact areas showed higher mercury (GMR 1.87, 95% CI 1.73-2.02) and antimony (1.95, 1.71-2.23) relative to the cohort average. At the municipal-cluster scale, the Irno Valley clusters around the Fonderie Pisano foundry (Baronissi-Pellezzano and Salerno) had about six-fold higher mercury (GMR 5.71 and 6.10) and about three-fold higher antimony (3.45 and 2.93), whereas the Valle del Sabato cluster showed about ten-fold higher antimony (GMR 10.5) and about seven-fold higher nickel (7.16) and cadmium (7.67).<h4>Conclusions</h4>Overall serum metal concentrations were broadly comparable with European general-population ranges, but pronounced small-area heterogeneity indicates localized hotspots that provincial or regional averages can obscure.
Background
This paper addresses the geographic variation in serum trace metals in Campania, Italy, a region with varying environmental pressures. Prior studies have indicated the presence of trace metals in populations, but this study aims to provide a more detailed analysis at a local level. Understanding the distribution of these metals is crucial for public health assessments and environmental monitoring.
Methods
The study employed a cross-sectional design, sampling 4205 residents aged 20-49 years from municipal registries across Campania between 2016-2017. Participants were stratified into high-impact, medium-impact, and low-impact areas based on an environmental-pressure index. Serum trace metals were measured using ICP-MS, and age- and sex-adjusted geometric mean ratios (GMRs) were calculated to compare strata with the overall cohort.
Results
Of the 4205 enrolled participants, 4188 were included in the analysis. The primary endpoint showed that medium-impact areas had a GMR of 1.87 for mercury (95% CI 1.73-2.02) and 1.95 for antimony (95% CI 1.71-2.23) compared to the cohort average. Specific clusters, such as those in the Irno Valley, exhibited GMRs of 5.71 and 6.10 for mercury, and 3.45 and 2.93 for antimony. The Valle del Sabato cluster showed a GMR of 10.5 for antimony, 7.16 for nickel, and 7.67 for cadmium.
Interpretation
The findings indicate significant geographic disparities in serum trace metals, with some areas showing concentrations markedly higher than the cohort average. While the statistical significance of these findings is clear, the clinical implications remain uncertain without established health outcomes linked to these metal levels. The study's cross-sectional nature and potential selection bias limit the ability to draw causal conclusions.
Key findings
- GMR 1.87 for mercury in medium-impact areas, 95% CI 1.73-2.02.
- GMR 1.95 for antimony in medium-impact areas, 95% CI 1.71-2.23.
- GMR 5.71 and 6.10 for mercury in the Irno Valley clusters.
- GMR 3.45 and 2.93 for antimony in the Irno Valley clusters.
- GMR 10.5 for antimony in the Valle del Sabato cluster.
- GMR 7.16 for nickel and 7.67 for cadmium in the Valle del Sabato cluster.
Limitations
- cross-sectional design limits causal inference
- potential selection bias from municipal registries
- not reported in abstract