Exposure to Metals and Congenital Anomalies: a Biomonitoring Pilot Study in Bedouin Women in Southern Israel

Monday, 18 August 2014
Exhibit hall (Dena'ina Center)
Isabella Karakis, PhD , Ministry of Health, Jerusalem, Israel
Daniella Landau, MD , Soroka University Medical Center, Beer-Sheva, Israel
Maayan Yitshak-Sade, MPH , Ben-Gurion University of the Negev, Beer-Sheva, Israel
Doron Dukler, MD , Soroka University Medical Center, Beer-Sheva, Israel
Reli Hershkovitz, MD , Soroka University Medical Center, Beer-Sheva, Israel
Michal Rotenberg, MD , Sheba Medical Center, Tel Hashomer, Israel
Batia Sarov, PhD , Ben-Gurion University of the Negev, Beer-Sheva, Israel
Itamar Grotto, MD , Ministry of Health, Jerusalem, Israel
Lena Novack, PhD , Ben-Gurion University of the Negev, Beer-Sheva, Israel
INTRODUCTION:  Bedouin-Arab population in Israel is of low socio-economic status, characterized by frequent smoking among males and consanguineous marriages. Previous study showed elevated rates of major malformations within Bedouin population residing near an industrial park (IP) compared to remote localities. High ambient values of Arsenic (As) and Nickel (Ni) were detected in the area. Exposure to metals has been related to birth defects. We estimated the extent of exposure to metals in pregnant Bedouin-Arab women in relation to congenital malformations.

METHODS:  We enrolled 140 Bedouin women upon their admission to delivery room of a local hospital. Maternal urine samples were collected and maintained at -20C till tested in Clinical Toxicology lab in Tel-HaShomer. The information on pregnancy, consanguineous marriages, and parental exposures was collected.

RESULTS:  Aluminum (Al) was detected in 34 out of 140 women (24.3%), Cadmium – in 2 women (1.4%), As -  in 10 women (7.1%) and Ni - in 1 (0.7%), amounting to 40 women (30%) positive to any of the 4 metals. Cd exposure rate was low, in spite of above 92% prevalence of smoking among Bedouin males, which might be explained by a low maternal passive-smoking exposure. Mothers exposed to metals frequently complained on transport (pv<0.001), reported cooking on open fire (pv=0.018), usage of stove or open fire for heating (pv=0.020) and had a tendency of living closer to IP (pv=0.082). Exposure to metals was not affected by maternal age or consanguineous marriage. Twelve fetuses had minor anomalies, another 12 were diagnosed with major anomalies and 2 fetuses died in-utero. Ten fetuses to mothers exposed to metals (23.8%) had anomalies or died in-utero compared to 16.3% in the unexposed group. Fetuses to exposed to metals were born at a lower weight (pv=0.023).

CONCLUSIONS:  Our findings urge for further screening for metals in susceptible populations in Israel.

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