Arbets- och Miljömedicin

Medicinska fakulteten | Lunds universitet

PHIME: Public Health Impact of long-term, low-level Mixed Element Exposure in susceptible population strata

PHIME final report

Staffan Skerfving of the Department of Occupational and Environmental Medicine has coordinated this research project during the period 2006-2011 (5 1/2 years). PHIME received 13.4 MEUR from the EU to finance the work.

PHIME had 39 partners in 22 countries, mainly in Europe, but also in Morocco, Ecuador, China, the Seychelles and Bangladesh.

The background was a renewed interest in toxic metals, due to a growing awareness that the exposure in the general population in Europe and elsewhere is at levels with potential to cause toxic effects in susceptible individuals. Such exposures may have a role in the etiology of common clinical diseases, as well as sub-clinical effects, which may be serious for the society.

A wealth of important, novel information was produced. For example, the exposure to lead and cadmium seems to be fairly similar in many European countries, with the exception of particularly polluted areas. The exposure to mercury differs, according to varying fish intake and dental practice. The exposure to lead and mercury is decreasing, while cadmium does not show such a favourable time trend. The tissue concentrations of "catalytic converter elements" platinum, palladium and rhodium are much lower than previously thought.

The toxic effects of methylmercury in fish on the central nervous system of fetuses and on the myocardium of adults are markedly modified by nutrition, notably intake of long-chain n-3 polyunsaturated fatty acids, which also occurs mainly through fish. Arsenic and manganese, ingested mainly through drinking water and food, affect development and health of fetuses, infants and children. Lead exposure is toxic to children’s central nervous system at very low exposures.

Data cast doubt on the urinary excretion of low-molecular weight proteins as a biomarker of cadmium risk to the kidney at low exposure, but, at the same time, there is now evidence of low-level cadmium exposure causing toxic bone effects, with decrease of bone mineral density, increase of osteoporosis and fractures. Preventive actions against cadmium urgently are needed, in light of the continuous exposure world-wide.

PHIME has also profoundly increased the understanding of molecular mechanisms for the uptake of metals in plants, which will enable breeding of cereals with increased levels of essential elements, and - hopefully - decreased levels of toxic ones.

Gene-environment interaction is important in metal toxicity. Thus, the metabolism (toxicokinetics) of mercury, arsenic, lead and cadmium was shown to be modified by genetics, as is toxicodynamics of arsenic, lead, cadmium and manganese. This should be considered in risk assessment, as the risk may vary between individuals, and between populations with different gene frequencies.

Taken together, the scientific results contributed by PHIME have brought new, important insights to the health impact from metals, as a basis for risk assessment and prevention.

A list of peer-reviewed published papers can be found below:

Here, you can also find a short summary of our seminar at the European Environment Agency on 10 February 2011: