This document summarizes the results of a study measuring levels of cadmium in urine and mercury in hair of 129 Belgian children ages 6-11 and their mothers. For cadmium, the main determinants of higher levels were age and living in an urban area. For mercury, higher levels correlated with greater fish consumption and more dental fillings. Most participants' cadmium and mercury levels were below health guidelines, though a small percentage exceeded some limits. The study also compared Belgian results to other European countries participating in the same monitoring program.

1. Hair mercury and urinary cadmium
levels in Belgian children and their
mothers within the framework of
the COPHES/DEMOCOPHES projects
C. Pirard1, G. Koppen2, K. De Cremer3, I. Van
Overmeire3, M.C. Dewolf4, E. Van De Mieroop5, D.
Aerts6, P. Biot6, J. Van Loco3, C. Charlier1, the COPHES
coordination team
1 CHU of Liège, Laboratory
of Clinical, Forensic and Environmental Toxicology
2 Flemish Institute of Technological Research, Environmental Risk and Health unit
3 Scientific Institute of Public Health
4 Provincial Institute for Hygiene and Bacteriology (IPHB), Mons
5 Provincial Institute for Hygiene (PIH), Antwerp
6 Federal Public Service Health, Food chain safety and Environment
ISBM, 10/09/2013

2. INTRODUCTION:
The European projects DEMOCOPHES and COPHES
Harmonised protocols for the
collection of comparable HBM
data throughout Europe
Belgium, Cyprus, Czech Republic,
Denmark, Germany, Hungary, Ireland,
Luxembourg, Poland, Portugal, Romania,
Slovakia, Slovenia, Spain, Sweden,
Switzerland, the United Kingdom
17 European countries measured:
‐ Cadmium, Phthalate metabolites,
cotinine and Bisphenol A in urine
‐ Mercury in hair
in children (6‐11 years) and their
mothers (≤ 45 years) N = 3688
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3. INTRODUCTION:
Cadmium and Mercury
URINARY CADMIUM
biomarker of long‐term cadmium exposure
Toxicity: known human carcinogen (IARC 1); accumulation in the
kidneys glomerular and tubular toxicity
Exposure: tobacco smoke and dietary intake
HAIR MERCURY
90‐95% MeHg & 5‐10% inorganic Hg
Toxicity of organic mercury: high neurotoxicity
Exposure to MeHg: dietary intake (fish and sea product)
Exposure to inorganic Hg: inhalation during occupational
activities or from dental amalgam release
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4. DEMOCOPHES in Belgium
Population characteristics
MOTHER
CHILD
N
129
129
Girl
129
63 (49%)
Boy
‐
66 (51%)
Age range (mean) > 45 yr (40yr) 6‐11 yr (8yr)
Smoker status
Present
12 (9%)
0 (0%)
Former
32 (25%)
0 (0%)
Never
85 (66%)
129 (100%)
ETS
‐ at home
Never
106 (91%)
112 (87%)
‐ elsewhere
Never
50 (43%)
68 (53%)
Residence area
Rural
65 (50.4%)
Urban
64 (49.6%)
Brussels
Dutch & French speaking
Sampling (2011‐2012)
‐ 1st morning urine in PP vessels
‐ 3 cm‐length hair from the scalp
Analyses
Urinary cadmium: ICP‐MS
Hair mercury: Flow Injection
Mercury System (FIMS)
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5. RESULTS: CADMIUM
Population
N
LOQ
Positive
GM µg/l
samples (%) (µg/g creat)
Mother
125
0.01
99.2
Child
125
0.01
86.4
0.21
(0.18)
0.04
(0.04)
Range µg/l
(µg/g creat)
N > health
guidance
<LOQ ‐ 1.10
(<LOQ ‐ 0.767)
<LOQ ‐ 0.320
(<LOQ ‐ 0.323)
2>HBM I
0>HBM I
Increased levels with age
Correlation between mother and her child
No correlation with active or passive smoking status (cotinine,
ETS statement) but very low smoker rate
No correlation with consumption of food commonly suspected
to show high cadmium levels, nor with local food consumption
Higher levels in people living in urban areas vs rural
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6. RESULTS: CADMIUM
Comparison with the results from European population
participating to the DEMOCOPHES project
ISBM, 10/09/2013

7. RESULTS: CADMIUM
Country
Population
Belgium present study Women
Girls and boys
Belgium
Women
Bangladesh
Girls and boys
Women
Canada
Girls and boys (Inuit)
Women and men (Inuit)
France
Women (non‐smoker)
(ENNS)
Women (non‐smoker)
Germany (GerES IV)
Girls and boys
Germany (GerES III)
Women and men
Women and men (non‐smoker)
Japan
Women (unpolluted area)
Japan
Women
Sweden
Women (non‐smoker)
Thailand
Girls
Boys
Girls and boys
United States
Girls and boys
(NHANES)
Women and men
United States
Girls and boys
(NHANES)
Women and men
N
125
125
541
320
444
16
24
157
319
1734
4740
3128
2332
3512
57
422
427
600
3053
3251
776
918
Age (yr) GM or med
µg/l
mean
40 [18‐45]
0.21
8 [6‐12]
0.04
40.1 [18‐80] 0.22
5
0.31
27 [18‐43]
0.55
[9‐14]
2.29
[20‐39]
0.80
[18‐39]
0.29
[40‐49]
0.33
[3‐14]
0.08
0.22
[18‐69]
[18‐69]
0.20
48.1 [30‐60] 1.19
[41‐50]
1.01
38 [20‐50]
0.18*
[9‐15]
0.13*
[9‐15]
0.12*
[ 9‐12]
0.12*
[6‐11]
0.10
[30‐39]
0.28
0.08
[6‐12]
[35‐50]
0.28
References
Present study
Hoet et al., 2013
Kippler et al., 2010
Benedetti et al., 1992
Fréry et al., 2011
Schulz et al., 2009
Wilhem et al., 2004
Fukui et al., 2004
Moriguchi et al., 2005
Julin et al., 2011
Chaiwong et al., 2009
* µg/g creat
Paschal et al., 2000
Richter et al., 2009
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8. RESULTS: MERCURY
Population
N
LOQ
Mother
129
0.08
Positive
samples (%)
95.3
Child
127
0.08
80.3
GM
Range N > health guidance
µg/g
µg/g
0.38
<LOQ ‐ 1.969
2 > 1.9 µg/g
12 > 1 µg/g
0.20
(<LOQ ‐ 1.995)
1 > 1.9 µg/g
6 > 1 µg/g
No increase with age but mother > child
Correlation between mother and her child
No correlation with active or passive smoking status (cotinine, ETS
statement), gender, hair treatment
Higher levels in children living in urban areas vs rural
Importance of the frequency of fish (sea or freshwater fish),
shellfish and other seafood products
Increase with the number of dental amalgam fillings
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9. RESULTS: MERCURY
Comparison with the results from European population
participating to the DEMOCOPHES project
µg Hg/g hair
Present study: 0.28 µg/g
ISBM, 10/09/2013

10. RESULTS: MERCURY
FREQUENCY OF FISH
CONSUMPTION
GM: 5.41 µg/g
> 4/week
GM: 1.47 µg/g
3 ‐ 4/week
GM: 0.61 µg/g
1 ‐ 2/week
GM: 0.34 µg/g
0 ‐ 1/week
Present study: 0.28 µg/g
GM: 0.25 µg/g
< 1/month
0
1
2
3
4
5
10
HAIR MERCURY LEVEL
20
30
40 µg/g
Abdelouahab et al., 2008; Barbosa et al., 1997 and 2001; Batista et al., 1996; Bjornberg et al., 2003; Chien et al., 2010;
Cordier et al., 1998; De Wolf et al., 2009; Dickman et al., 1999; Diez et al., 2008 and 2011; Dolbec et al., 2001; Dorea et al.,
2003; Dunn et al., 2008; Elhamri et al., 2007; Foo et al., 1988; Fréry et al., 2011; Gaggi et al., 1996; Gerstenberger et al.,
1997; Hajeb et al., 2008; Harada et al., 1998; Holsbeek et al., 1996; Ip et al., 2004; Johnsson et al., 2004; Karouna‐Renier et
al., 2008; Kim et al., 2008; Kruzikova et al., 2008; Kyle et al., 1982; Leino and Lodenius, 1995; McDowell et al., 2004;
Monrroy et al., 2008; Montuori et al., 2006 Myers et al., 2000 and 2003; Okati et al., 2012; Oskarsson et al., 1990 and 1994;
Pinheiro et al., 2005; Reis et al., 2009; Shao et al., 2013; Stern et al., 2001;Wranova et al., 2008.
ISBM, 10/09/2013

11. CONCLUSIONS:
The Belgian urinary Cd and hair Hg results from the DEMOCOPHES
project: 129 children (6‐11yr) and their mothers (≤ 45 years)
The main determinants for levels of children and mothers were:
for urinary cadmium: the age and the urban or rural character
of the residence place
for hair mercury: fish consumption and the number of dental
amalgam fillings
Compared to health‐based guideline values:
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12. CONCLUSIONS:
The Belgian urinary Cd and hair Hg results from the DEMOCOPHES
project: 129 children (6‐11yr) and their mothers (≤ 45 years)
Compared to health‐based guideline values:
Urinary cadmium levels
Source
WHO
JECFA
CSTEE
German HBM for adults
German HBM for children
BE
Others BMDL
Exposure guidance values
Related health effects
5 µg/g creat
Renal dysfunctions in workers
2.5 µg/g creat
Tubular dysfunctions
2 µg/g creat
Renal dysfunctions
HBM‐I: 1 µg/l Renal dysfunctions in adults
HBM‐II: 4 µg/l
HBM‐I: 0.5 µg/l Renal dysfunctions in children
HBM‐II: 2 µg/l
1.7 ‐ 2 µg/g creat
0.6‐1.1 µg/g creat
Kidney toxicity
Glomerular and tubular dysfunctions
Urinary cadmium levels: less than 1% > HBM‐I
ISBM, 10/09/2013

13. CONCLUSIONS:
The Belgian urinary Cd and hair Hg results from the DEMOCOPHES
project: 129 children (6‐11yr) and their mothers (≤ 45 years)
Compared to health‐based guideline values:
Hair mercury levels
Hg level (µg/g)
5
4.6
4.2
3.8
3.4
3
JECFA
2.6
1.8
1.4
1
0.6
US EPA
2.2
90
80
70
60
50
40
30
20
10
0
0.2
Number of participants
Source Exposure guidance values Related health effects
References
WHO
7 µg/g hair
‐
WHO, 2008
Neurodevelopmental effects associated JECFA, 2012
JECFA
1.3 µg/kg/week
with in utero exposure
Neurodevelopmental effects associated US EPA, 2001
US EPA
0.1 µg/kg/day
with in utero exposure
Cognitive deficit in 7‐year‐old children with Grandjean et al., 1997
Others
<10 µg/g hair
prenatal exposure
Mothers: 9% > 1 µg/g hair
Children: 5% > 1 µg/g hair
Mothers & children:
1% > 1.9 µg/g hair
ISBM, 10/09/2013

14. ACKNOWLEGDMENTS
o The COPHES project was funded by the 7th Framework
Programme (DG Research – No. 244237)
o The DEMOCOPHES project was co‐funded by the LIFE+
programme (DG Environment‐LIFE09 ENV/BE000410) and by the
Belgian Joint Interministerial Conference on Environment and
Health
o Thanks to all of the project partners for their support
especially the Belgian team
o Thank you all for your attention
ISBM, 10/09/2013