BMC Pregnancy and Childbirth | |
Geophagy practices and the content of chemical elements in the soil eaten by pregnant women in artisanal and small scale gold mining communities in Tanzania | |
Cynthia Mannion1  Deborah SK Thomas3  Shahirose S Premji2  Mary Joseph4  Elias C Nyanza5  | |
[1] Faculty of Nursing, University of Calgary, University of Calgary, 2500 University Drive, NW, Calgary, AB T2N 1 N4, Canada;Department of Community Health Sciences, Faculty of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada;Department of Geography & Environmental Sciences, University of Colorado Denver, PO Box 173364, Denver, CO 80217-3364, USA;Goodneighbours Tanzania, P.O. Box 33104, Dar es salaam, Boko Area, Kinondoni, Tanzania;School of Public Health, Catholic University of Health and Allied Sciences, P.O. Box 1464, Bugando Area, Mwanza, Tanzania | |
关键词: Mercury; Arsenic; Soil pollution; Chemical elements; Pregnancy; Pica; Geophagy; | |
Others : 1127413 DOI : 10.1186/1471-2393-14-144 |
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received in 2013-06-17, accepted in 2014-04-10, 发布年份 2014 | |
【 摘 要 】
Background
Geophagy, a form of pica, is the deliberate consumption of soil and is relatively common across Sub-Saharan Africa. In Tanzania, pregnant women commonly eat soil sticks sold in the market (pemba), soil from walls of houses, termite mounds, and ground soil (kichuguu). The present study examined geophagy practices of pregnant women in a gold mining area of Geita District in northwestern Tanzania, and also examined the potential for exposure to chemical elements by testing soil samples.
Method
We conducted a cross sectional study using a convenience sample of 340 pregnant women, ranging in age from 15–49 years, who attended six government antenatal clinics in the Geita District, Tanzania. Structured interviews were conducted in June-August, 2012, to understand geophagy practices. In addition, soil samples taken from sources identified by pregnant women practicing geophagy were analysed for mineral element content.
Results
Geophagy was reported by 155 (45.6%) pregnant women with 85 (54.8%) initiating the practice in the first trimester. A total of 101 (65%) pregnant women reported eating soil 2 to 3 times per day while 20 (13%) ate soil more than 3 times per day. Of 155 pregnant women 107 (69%) bought pemba from local shops, while 48 (31%) consumed ground soil kichuguu. The estimated mean quantity of soil consumed from pemba was 62.5 grams/day. Arsenic, chromium, copper, iron, manganese, nickel and zinc levels were found in both pemba and kichuguu samples. Cadmium and mercury were found only in the kichuguu samples. Based on daily intake estimates, arsenic, copper and manganese for kichuguu and copper and manganese for pemba samples exceed the oral Minimum Risk Levels designated by the U.S. Agency for Toxic Substance and Disease Registry.
Conclusion
Almost 50% of participants practiced geophagy in Geita District consistent with other reports from Africa. Both pemba and kichuguu contained chemical elements at varying concentration, mostly above MRLs. As such, pregnant women who eat soil in Geita District are exposed to potentially high levels of chemical elements, depending upon frequency of consumption, daily amount consumed and the source location of soil eaten.
【 授权许可】
2014 Nyanza et al.; licensee BioMed Central Ltd.
【 预 览 】
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20150220143007618.pdf | 368KB | download | |
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【 图 表 】
Figure 1.
【 参考文献 】
- [1]Al-Rmalli SW, Jenkins RO, Watts MJ, Haris P: Risk of human exposure to arsenic and other toxic elements from geophagy: trace element analysis of baked clay using inductively coupled plasma mass spectrometry. Environ Health 2010, 9:79. BioMed Central Full Text
- [2]Kutalek R, Wewalka G, Gundacker C, Auer H, Wilson J, Haluza D, Huhulescu S, Hillier S, Sager M, Prinz A: Geophagy and potential health implications: geohelminths, microbes and heavy metals. Trans R Soc Trop MedHyg 2010, 104(12):787-795.
- [3]Njiru H, Elchalai U, Paltiel O: Geophagy during pregnancy in Africa: a literature review. Obstet Gynecol Surv 2011, 66(7):452-459.
- [4]Corbett RW, Ryan C, Weinrich SP: Pica in pregnancy: does it affect pregnancy outcomes? MCN Am J Matern Child Nurs 2003, 28:183-189.
- [5]Ngozi PO: Pica practices of pregnant women in Nairobi, Kenya. East Afr Med J 2008, 85(2):72-79.
- [6]Kawai K, Saathoff E, Antelman G, Msamanga G, Fawzi WW: Geophagy (soil-eating) in relation to anemia infection among HIV-infected pregnant women in Tanzania. Am J Trop Med Hyg 2009, 80(1):36-43.
- [7]Antelman G, Msamanga GI, Spiegelman D, Urassa EJ, Narh R, Hunter DJ, Fawzi WW: Nutritional factors and infectious disease contribute to anemia among pregnant women with human immunodeficiency virus in Tanzania. J Nutr 2000, 130:1950-1957.
- [8]Yanai J, Noguchi J, Yamada H, Sugihara S, Kilasara M, Kosaki T: Functions of geophagy as supplementation of micronutrients in Tanzania. Soil Sci Plant Nutr 2009, 55(1):215-223. doi:10.1111/j.1747-0765.2008.00346.x
- [9]Knudsen JW: Akula udongo (earth eating habit): a soil and cultural practice among Chagga women on the slopes of the Mount Kilimanjaro. Afr J Ind Know Systems 2001, 1:19-26.
- [10]Young SL: Pica in pregnancy: new ideas about old condition. Annu Rev Nutr 2010, 30:403-422.
- [11]Hergüner S, Ozyildirim I, Tanidir C: Is pica an eating disorder or an obsessive-compulsive spectrum disorder? Prog Neuropsychopharmacol Biol Psychiatry 2008, 32:2010-2011.
- [12]Khan Y, Tisman G: Pica in iron deficiency: a case series. J Med Case Rep 2010, 4:86. doi:10.1186/1752-1947-4-86 BioMed Central Full Text
- [13]Crawford L, Bodkin K: Health and social impacts of geophagy in Panama. MSURJ 2011, 6(1):31-37. http://msurj.mcgill.ca/vol6/iss1/crawford2011.pdf webcite
- [14]Vermeer DE, Ferrell RE: Nigerian geophagical clay: a traditional antidiarrheal pharmaceutical. Science 1985, 227:634-636.
- [15]Habold C, Reichardt F, Le Maho Y, Angel F, Liewig N, Lignot JH, Oudart H: Clay ingestion enhances intestinal triacylglycerol hydrolysis and non-esterified fatty acid absorption. Br J Nutr 2009, 102:249-257. doi:10.1017/S0007114508190274
- [16]Szajewska H, Dziechciarz P, Mrukowicz J: Meta-analysis: smectite in the treatment of acute infectious diarrhoea in children. Aliment Pharmacol Ther 2006, 23:217-227.
- [17]Baidoo SE, Tay SCK, Obiri-Danso K, Abruquah HH: Intestinal helminth infection and anaemic during pregnancy: a community based study in Ghana. J Bacteriol Res 2010, 2(2):9-13.
- [18]Young SL, Goodman D, Farag TH, Ali SM, Khatib MR, Khalfan SS, Tielsch JM, Stoltzfus RJ: Geophagia is not associated with Trichuris or hookworm transmission in Zanzibar, Tanzania. Trans R Soc Trop Med Hyg 2007, 101:766-772.
- [19]Food and Drug Administration (FDA): Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Nickel, Silicon, Vanadium, and Zinc. Washington DC: Report of the Panel on Micronutrients, Food and Drug Administration. Dietary Supplements. Center for Food Safety and Applied Nutrition, National Academy Press; 2001.
- [20]Korfali SI, Hawi T, Mroueh M: Evaluation of heavy metals content in dietary supplements in Lebanon. Chem Cent J 2013, 7:10. doi:10.1186/1752-153X-7-10 BioMed Central Full Text
- [21]Agency of Toxic Substances and Disease Registry (ATSDR): Toxicological profile of copper. Atlanta, GA: US Department of Public Health and Human Services, Public Health Services; 2004.
- [22]Agency for Toxic Substances and Disease Registry (ATSDR): Toxicological profile for manganese. Atlanta, GA: U.S. Department of Public Health and Human Services, Public Health Service; 2012.
- [23]Agency of Toxic Substances and Disease Registry (ATSDR): Toxicological profile of zinc (update). Atlanta, GA: US Department of Public Health and Human Services, Public Health Services; 2005.
- [24]Food and Nutrition Board (FNB): Dietary reference intakes: Vitamin A, vitamin K, arsenic, boron, chromium, copper, iodide, iron, manganese, molybdenum, nickel, silicon, vanadium and zinc. Washington D.C: Institute of Medicine, National Academy Press; 2001.
- [25]Otten JJ, Pitzi Hellwig J, Meyers LD: Dietary DRI Reference Intakes: the essential guide to nutrient requirements; Institute of Medicine of the National Academies. Washington, DC: The National Academies Press; 2006.
- [26]Chou CHSJ, Holler J, De Rosa C: Minimal Risk Levels (MRLs) for hazardous substances. J of Clean Technology, Environmental Toxicology, and Occupational Medicine 1998, 7(1):1-24.
- [27]Anderson JJB: Minerals. In Krause’s Food, Nutrition, & Diet Therapy. 11th edition. Edited by Mahan LK, Escott-Stump S. USA: Saunders; 2004:120-163.
- [28]Agency of Toxic Substances and Disease Registry (ATSDR): Toxicological Profile of Nickel (Update). Atlanta, GA: US Department of Public Health and Human Services, Public Health Services; 2005.
- [29]Agency of Toxic Substances and Disease Registry (ATSDR): Toxicological profile of lead (update). Atlanta, GA: US Department of Public Health and Human Services, Public Health Services; 2007.
- [30]Agency of Toxic Substances and Disease Registry (ATSDR): Toxicological profile for arsenic. Atlanta, GA: US Department of Public Health and Human Services, Public Health Services; 2007.
- [31]Agency of Toxic Substances and Disease Registry (ATSDR): Toxicological Profile for Mercury. Atlanta: US Department of Public Health and Human Services, Public Health Services; 1999.
- [32]Wasserman GA, Liu X, Parvez F, Ahsan H, Factor-Litvak P, Van Geen A, Slavkovich V, LoIacono NJ, Cheng Z, Hussain I, Momotaj H, Graziano JH: Water arsenic exposure and children’s intellectual function in Araihazar, Bangladesh. Environ Health Perspect 2004, 112(17):1329-1333.
- [33]Clifton JC 2nd: Mercury exposure and public health. Pediatr Clin North Am 2007, 54(2):237-269.
- [34]Wigle DT, Arbuckle TE, Turner MC, Bérubé A, Yang Q, Liu S, Krewski D: Epidemiologic evidence of relationships between reproductive and child health outcomes and environmental chemical contaminants. J Toxicol Environ Health B Crit Rev 2008, 11(5–6):373-517. doi:10.1080/10937400801921320
- [35]Wigle DT, Arbuckle TE, Walker M, Wade MG, Liu S, Krewski D: Environmental hazards: evidence for effects on child health. J Toxicol Environ Health B Crit Rev 2007, 10(1–2):3-39.
- [36]Huyck KL, Kile ML, Mahiuddin G, Quamruzzaman Q, Rahman M, Breton CV, Dobson CB, Frelich J, Hoffman E, Yousuf J, Afroz S, Islam S, Christiani DC: Maternal exposure associated with low birth weight in Bangladesh. J Occup Environ Med 2007, 49(10):1097-1104.
- [37]Rosado JL, Ronquillo D, Kordas K, Rojas O, Alatorre J, Lopez P, Garcia-Vargas G, Del Carmen Caamaño M, Cebrián ME, Stoltzfus RJ: Arsenic exposure and cognitive performance in Mexican schoolchildren. Environ Health Perspect 2007, 115(9):1371-1375.
- [38]Spiegel S: Analysis of formalization approaches in the artisanal and small-scale gold mining sector based on experiences in Ecuador, Mongolia, Peru, Tanzania, and Uganda: Tanzania Case Study.. Nairobi, Kenya: United Nations Environmental Programme (UNEP); 2012. http://www.unep.org/chemicalsandwaste/Portals/9/Mercury/Documents/ASGM/Formalization_ARM/Formalization%20Document%20Final%20June%202012.pdf webcite
- [39]Tanzania National Bureau of Statistics: 2012 Population and Housing Census: Population Distribution by Administrative Areas. Dar es salaam: United Republic of Tanzania; 2013.
- [40]Charles E, Thomas DSK, Dewey D, Davey M, Ngallaba SE, Konje E: Perception of Health risks associated with Arsenic and Mercury contamination from Artisanal Gold Mining in Tanzania. BMC Public Health 2013, 13:74. doi:10.1186/1471-2458-13-74 BioMed Central Full Text
- [41]Tanzania Ministry of Health and Social Welfare: Mwanza Region Reproductive and Child Healthcare Report. Geita District: Annual Report; 2011.
- [42]U.S. Environmental Protection Agency: Test methods for evaluating solid waste; physical/chemical methods. 3rd edition. Washington D.C: Final Update IIIA. EPASW-846.3-3a; 1999. http://www.epa.gov/osw/hazard/testmethods/sw846/index.htm webcite
- [43]Eaton AD, Clesceri LS, Rice EW, Greenberg AE (Eds): Standard Methods for the Examination of Water and Wastewater. 21st edition. Washington, D.C.: American Public Health Association: Method 3111B, D, 3112B & 3114B.3:19–34. American Public Health Association (APHA), American Water Works Association (AWWA), Water Environmental Federation (WEF); 2005.
- [44]Nobbins WB: Arsenic determination. USA: Hydride Generation Application Note, Atomic Absorption. Agilent Technologies, Inc; 2010. http://www.chem.agilent.com/Library/applications/AA022.pdf webcite
- [45]Agency of Toxic Substances and Disease Registry (ATSDR): Minimal risk levels for Hazardous Substances (MRLs). 2013. http://www.atsdr.cdc.gov/mrls/mrllist.asp webcite
- [46]U.S. EPA. Exposure Factors Handbook 2011 Edition (Final). . Washington, DC: U.S. Environmental Protection Agency; 2011. EPA/600/R-09/052F
- [47]U.S. Environmental Protection Agency: Test methods for evaluating liquid waste (manual cold-vapor techniques). Volume 1. Washington D.C: Method 7470A; 1994. http://www.epa.gov/epawaste/hazard/testmethods/sw846/pdfs/7470a.pdf webcite
- [48]Yassi A, KjellstrÖm T, Kok T, Guidotti TL: Basic Environmental Health. New York: Oxford University Press; 2001.
- [49]Nwafor AO: Reasons pregnant women who attend antenatal care in Mecklenburg Hospital eat soil. University of Limpopo (Medunsa Campus),: PhD dissertation; 2008.
- [50]Taylor H, Appleton JD, Lister R, Smith B, Chitamweba D, Mkumbo O, Machiwa JF, Tesha AL, Beinhoff C: Environmental assessment of mercury contamination from the Rwamagasa artisanal gold mining centre, Geita District Tanzania. Sci Total Environ 2005, 343(1–3):111-133.
- [51]Dooyema CA, Neri A, Lo Y, Durant J, Dargan PI, Swarthout T, Biya O, Gidado SO, Haladu S, Sani-Gwarzo N, Nguku PM, Akpan H, Idris S, Bashir AM, Brown MJ: Outbreak of fatal childhood lead poisoning related to artisanal gold mining in Northwestern Nigeria. Environ Health Perspect 2012, 120(4):601-607. doi:10.1289/ehp.1103965