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Lead, copper and zinc in deciduous teeth and the diet of schoolchildren in Kamloops and Trail, B.C. Onishi, Geraldine Mineko 1980

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LEAD, COPPER AND ZINC IN DECIDUOUS TEETH AND THE DIET OF SCHOOLCHILDREN IN KAHLOGPS AND TS A IL , B.C. . B. A. ft. fiyerson P o l y - t e c h n i c a l I n s t i t u t e , 1977 A THESIS SUBMITTED IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE i n THE FACULTY OF GRADUATE STUDIES D i v i s i o n of Human N u t r i t i o n by GERALD!NE MINEKO ONISHI S c h o o l o f Home Economics We a c c e p t t h i s t h e s i s as con f o r m i n g t o the r e q u i r e d s t a n d a r d THE UNIVERSITY OF BRITISH COLUMBIA June 1980 © G e r a l d i n e Mineko O n i s h i , 1980 I n p r e s e n t i n g t h i s t h e s i s i n p a r t i a l f u l f i l m e n t o f t h e r e q u i r e m e n t s f o r an a d v a n c e d d e g r e e a t t h e U n i v e r s i t y o f B r i t i s h C o l u m b i a , I a g r e e t h a t t h e L i b r a r y s h a l l make i t f r e e l y a v a i l a b l e f o r r e f e r e n c e a n d s t u d y . I f u r t h e r a g r e e t h a t p e r m i s s i o n f o r e x t e n s i v e c o p y i n g o f t h i s t h e s i s f o r s c h o l a r l y p u r p o s e s may be g r a n t e d by t h e Head o f my D e p a r t m e n t o r by h i s r e p r e s e n t a t i v e s . I t i s u n d e r s t o o d t h a t c o p y i n g o r p u b l i c a t i o n o f t h i s t h e s i s f o r f i n a n c i a l g a i n s h a l l n o t be a l l o w e d w i t h o u t my w r i t t e n p e r m i s s i o n . D e p a r t m e n t o f The U n i v e r s i t y o f B r i t i s h C o l u m b i a 2075 W e s b r o o k P l a c e V a n c o u v e r , C a n a d a V6T 1W5 7 ABSTRACT The a c c u m u l a t i o n of m e t a l c o n t a m i n a n t s i n the human environment has r e c e i v e d a g r e a t d e a l of a t t e n t i o n d u r i n g the l a s t s e v e r a l y e a r s as i t has become apparent t h a t t h e i r p r e s e n c e , i n e x c e s s , r e p r e s e n t s a t h r e a t t o human h e a l t h . B i o c h e m i c a l a s s a y s t o det e r m i n e c o n c e n t r a t i o n s of m e t a l s i n t h e human body have used such t i s s u e s as b l o o d , bone, h a i r , n a i l s and, more r e c e n t l y , t e e t h . The p r e s e n t s t u d y a t t e m p t s t o p r o v i d e f u r t h e r e v i d e n c e f o r t h e use of decid u o u s t e e t h as i n d i c a t o r s of human exposure t o c o n c e n t r a t i o n s of l e a d , copper and z i n c as a r e s u l t of ore s m e l t i n g o p e r a t i o n s i n Kamloops and T r a i l , B r i t i s h Columbia. Kamloops r e p r e s e n t s an a r e a of minimum exposure t o s m e l t e r o p e r a t i o n s i n c o n t r a s t t o T r a i l where a l e a d / z i n c s m e l t e r has been o p e r a t i n g f o r many y e a r s . C o n c e n t r a t i o n s of l e a d , copper and z i n c i n deci d u o u s t e e t h from g e o g r a p h i c a l l y - s t a b l e Kamloops c h i l d r e n , aged 5 y e a r s t o 12 y e a r s , were compared t o c o n c e n t r a t i o n s found i n a s i m i l a r p o p u l a t i o n of g e o g r a p h i c a l l y - s t a b l e T r a i l c h i l d r e n . Whole t e e t h were d i g e s t e d i n n i t r i c and p e r c h l o r i c a c i d s and t r a c e element c o n c e n t r a t i o n s were determined u s i n g i n d u c t i v e l y c o u p l e d plasma e m i s s i o n s p e c t r o s c o p y . Mean l e a d and z i n c c o n c e n t r a t i o n s f o r Kamloops and T r a i l t e e t h , r e s p e c t i v e l y , were: 31.6 ± 7.33 ppm and 48.2. ± 11.5 ppm f o r l e a d (p < 0.05) and 103.4 ± 23.6 ppm and 111.9 ± 15.4 ppm f o r z i n c . Copper was u n d e t e c t a b l e a t < 1 ppm i n a l l t e e t h . L o c a l l y - g r o w n f o ods from each area and foods grown e l s e w h e r e were a l s o a n a l y z e d f o r l e a d , copper and z i n c i n an e f f o r t t o e s t a b l i s h the p o s s i b l e c o n t r i b u t i o n of t h e s e e l e m e n t s i i from l o c a l food r e s o u r c e s i n Kamlccps and T r a i l . Twenty-four hour d i e t c o m p o s i t e s were c o l l e c t e d and a n a l y z e d f o r copper and z i n c by atomic a b s o r p t i o n s p e c t r o s c o p y . Mean copper and z i n c c o n c e n t r a t i o n s f o r foods grown i n Kamloops and T r a i l , r e s p e c t i v e l y , were: 1.5 ± 0.4 ppm and 1.6 ± 0.9 ppm f o r copper and 3. 2 ± 1.3 ppm and 3.1 ± 0.9 ppm f o r z i n c . Mean copper and z i n c c o n c e n t r a t i o n s f o r n o n - l o c a l l y grown foods c o l l e c t e d from Kamloops and T r a i l , r e s p e c t i v e l y , were: 1.1 ± 0.2 ppm and 1.6 ± 0.8 ppm f o r copper and 5.8 ± 1.9 ppm and 6.5 ± 0.3 ppm f o r z i n c . Lead was determined by plasma e m i s s i o n s p e c t r o s c o p y , and was found t o be u n d e t e c t a b l e a t < 1 ppm i n a l l f o o d samples. To a s s e s s t h e e x t e n t of maximal consumption o f l o c a l l y -grown f o o d s , s e l e c t e d home g a r d e n e r s i n t h e B r o c k l e h u r s t d i s t r i c t o f Kamloops and the G e n e l l e d i s t r i c t of T r a i l were i n t e r v i e w e d . S e a s o n a l consumption and home f o o d p r e s e r v a t i o n p r a c t i c e s were d e t e r m i n e d . I n a d d i t i o n , 24-hour d i e t r e c a l l s were o b t a i n e d from 177 E r o c k l e h u r s t d i s t r i c t c h i l d r e n i n September and A p r i l , 1977-78 t o determine " t y p i c a l " e a t i n g p a t t e r n s of the s e c h i l d r e n . . The amount of l o c a l l y - g r o w n f o o d s consumed was dependent mainly on season of the y e a r ; however, c h o i c e of food by t h e c h i l d r e n cn the whole d i d not d i f f e r from f a l l t o s p r i n g . The r e c a l l s a l s o i n d i c a t e d t h a t males consumed more food than f e m a l e s , p a r t i c u l a r l y p r o t e i n . M e a l s , e s p e c i a l l y b r e a k f a s t , were f r e g u e n t l y m issed, and non-n u t r i t i o u s snacks were common t c t h e d i e t s o f many o f the c h i l d r e n . R e s u l t s from t h i s s t u d y i n d i c a t e d t h a t , a l t h o u g h d e c i d u o u s t o o t h l e a d c o n c e n t r a t i o n s were s i g n i f i c a n t l y (p<0.05) h i g h e r i n i i i T r a i l than i n Kamloops, samples of l o c a l l y - g r o w n foods o b t a i n e d i n 1978 f rom t h e s e two communit ies were not e x c e s s i v e l y h igh i n l e a d , z i n c or c o p p e r . In f a c t , t h e s e e lements i n f o o d s compared w e l l t o c o n c e n t r a t i o n s r e p o r t e d i n o ther a r e a s o f North A m e r i c a . I t would a p p e a r , t h e n , t h a t the h i g h e r c o n c e n t r a t i o n s of l e a d i n T r a i l t e e t h are a r e s u l t of i n c r e a s e d i n t a k e from other e n v i r o n m e n t a l s o u r c e s . A n a l y s e s . of food consumpt ion p a t t e r n s of g a r d e n i n g f a m i l i e s r e v e a l e d tha t l o c a l foods compr ised an impor tan t p a r t o f the d i e t . Measures shou ld be taken to ensure the c o n t i n u e d s a f e t y of f o o d s i n a reas where m i n e r a l min ing and s m e l t i n g o c c u r . TABLE OP CONTENTS Ab s t r a c t • 1 L i s t of Tables v i i L i s t of F i g u r e s i x Acknowledgements x I I n t r o d u c t i o n 1 D e f i n i t i o n of Terms 3 I I Review of the L i t e r a t u r e 5 A. O r g a n i z a t i o n of the Chapter 5 B. Copper 6 1. N u t r i t i o n a l S i g n i f i c a n c e 6 2. Environmental Sources f o r Human Intake 10 3. Role of Copper l n the.Body and P o t e n t i a l T o x i c i t y 12 C. Zinc 16 1. N u t r i t i o n a l S i g n i f i c a n c e 16 2. Environmental Sources f o r Human Intake 20 3. Role of Zinc i n the Body and P o t e n t i a l T o x i c i t y 22 D. Lead 26 1. N u t r i t i o n a l S i g n i f i c a n c e 26 2. Environmental Sources f o r Human Intake 29 3. The T o x i c i t y of Lead 31 E. Health and the Environment 35 F. Deciduous Teeth as I n d i c a t o r s of Lead, Zinc and Copper i n the Body 38 G. N u t r i t i o n of Schoolage C h i l d r e n **4 I I I P o p u l a t i o n and Sample 48 A. D e s c r i p t i o n of P o p u l a t i o n 48 1. Kamloops 48 2. T r a i l 53 V B. S e l e c t i o n Procedures 5^ C. Consent to P a r t i c i p a t e 55 IV Lead, Copper and Zinc i n Deciduous Teeth 60 A. Tooth and Data C o l l e c t i o n 60 B. Method of A n a l y s i s 6 l 1. P r e l i m i n a r y Analyses 62 2. M i n e r a l s i n Teeth from Kamloops and T r a i l , B.c 63 C. Data A n a l y s i s , 63 D. Results and D i s c u s s i o n 65 V Food Consumption P a t t e r n s and D i e t a r y Lead, Copper and Zinc 73 A. The I n t e r v i e w 73 1. Purpose 73 2. Data. A n a l y s i s 77 3. R e s u l t s and D i s c u s s i o n 78 B. 2*+-Hour R e c a l l s 89 1. Purpose 89 2. Data A n a l y s i s 91 3. R e s u l t s and D i s c u s s i o n 93 C. Food Composites 106 1. C o l l e c t i o n Procedures 106 2. Method of A n a l y s i s 109 A. Copper and Zinc l n Foods 110 (1) Sample P r e p a r a t i o n 110 (2) Sample D i g e s t i o n and A n a l y s i s 113 B. Lead i n Foods 113 (1) Sample P r e p a r a t i o n 113 (2) Sample D i g e s t i o n and A n a l y s i s 11^ 3. Data A n a l y s i s I l * * k. Results and D i s c u s s i o n 119 VI General D i s c u s s i o n 121 B i b l i o g r a p h y 128 Appendices 1^6 A. L e t t e r of I n t r o d u c t i o n to Interviewees from Dr. J . Garry, Medical Health O f f i c e r , Kamloops 1^6 v i B. Le t t e r of Introduction to Interviewees from Mrs. Bonham on Behalf of Dr. N. Schmitt. Medical Health O f f i c e r , T r a i l 1^7 C. "Coupon" and Questionnaire Distributed to the Schoolchildren i n Kamloops Requesting "a baby tooth f o r science" 148 D. Poster Sent to Schools i n Kamloops 14-9 E. Table 23. Description of Foods Collected from Families l n Brocklehurst and Genelle 150 F. Interview Schedule 15^ G. Brocklehurst Subject Consent to P a r t i c i p a t e i n the Interview l 6 l H. Genelle Subject Consent to P a r t i c i p a t e i n the Interview 162 I. 24-Hour Recall Forms Completed by Third-Graders i n Brocklehurst Schools 163 J . Food Record L i s t s f o r Families l n Brocklehurst and Genelle 164 K. Recommended Daily Nutrient Intake, Revised 19?5» Showing Zinc Intakes Recommended f o r the Various Age Groups 165 L. Recommended Dietary Allowances, Revised 1980, Showing Recommendations f o r Copper and Zinc Allowances 166 M. Other Elements Determined by ICP/AES i n Teeth from Kamloops 167 N. Other Elements Determined by ICP/AES i n Teeth from T r a i l 168 v i i LIST OP TABLES 1. Kamloops P o p u l a t i o n Growth, by Area, 1971 to 1976 49 2. Kamloops P o p u l a t i o n by Sex and Age Groups 50 3. Annual M i g r a t i o n Values, 1971 to 1976, i n Kamloops .... 51 4. T r a i l P o p u l a t i o n by Sex and Age Groups 53 5. Lead, Zinc and Copper i n Deciduous Teeth from Kamloops and T r a i l 65 6. S i g n i f i c a n t C o r r e l a t i o n s Between P a i r s of V a r i a b l e s Related to Tooth Lead Concentrations* 69 7. Mean Zinc and Lead l n Deciduous Teeth by Sex of C h i l d r e n i n Kamloops and T r a i l 71 8. D i s t r i b u t i o n of Sample Interview P o p u l a t i o n Whose C h i l d r e n Attend B r o c k l e h u r s t and Gen e l l e Schools 80 9. Frequency D i s t r i b u t i o n of Interv i e w V a r i a b l e s by Town 81 10. Wllcoxon Matched-Pairs Slgned-Ranks Test f o r D i f f e r e n c e s i n Amount of Locally-Grown Foods Served Fresh and Preserved 88 11. Mean D a i l y N u t r i e n t Intake/ChiId/Group 94 12. Mean N u t r i e n t Intakes of S c h o o l c h i l d r e n by Sex Compared to Recommended D i e t a r y Intakes 95 13. Snacks Eaten by C h i l d r e n 98 14. Snacking P a t t e r n s of C h i l d r e n 98 15. Mean Number of Servings/Child/Day From Each Food Group 99 16. Mean N u t r i e n t Intake and Mean Number of S e r v i n g s / Child/Day From Each Food Group 100 17. Mean N u t r i e n t Intake of C h i l d r e n Who Met Recommended .Dietary Intakes 103 18. Adequacy of D i e t s of Students 104 19. Estimated Mean D a l l y Intakes of Lead, Copper and Zinc by B r o c k l e h u r s t C h i l d r e n 104 20. Sources of Trace Elements l n the D a i l y D i e t of Canadian Adults (Average of 4 Quarters) 105 v i i i 21. Estimated Mean D a i l y I n t a k e / C h i l d of Lead, Copper & Zinc by Survey Group 107 22. Estimated T o t a l D a i l y Intake of Trace Metals from Foods (Average of 4 Quarters) 107 24. Contents of Locally-Grown Food Composites 112 25. Copper, Lead & Z i n c i n Food Samples from B r o c k l e h u r s t and G e n e l l e 115 26. Other Elements Determined by ICP/AES i n L o c a l and Non-Local Food Composites 116 27# D i f f e r e n c e s l n Mean Concentrations of Food Copper & Zinc Found wi t h AAS and ICP/AES 117 28. C a l c u l a t e d Mean Lead, Copper & Zinc Levels i n 24-Hour Die t R e c a l l s Compared w i t h Analyzed Concentrations i n Food Composites 118 29. Most Frequently-Mentioned Foods i n Interviews and D u p l i c a t e Composites 118 1 i x LIST OF FIGURES 1. Map Showing L o c a t i o n of B r o c k l e h u r s t i n R e l a t i o n to Kamloops and the Af ton Copper Mine and Smelter 56 2. Map Showing L o c a t i o n of Genelle i n R e l a t i o n to T r a i l and the Cominco Lead Smelter 57 3. Lead i n Deciduous Teeth from Kamloops and T r a i l 67 4-. Zinc i n Deciduous Teeth from Kamloops and T r a i l 68 5. Mean Family Servings/Week of Locally-Grown Foods by Season . 84 6. D i s t r i b u t i o n of Meals Containing Locally-Grown Foods per Week per Season 85 7. Consumption of Fresh and Preserved Locally-Grown Foods by Season 87 X ACKNOWLEDGEMENTS To those people who have c o n t r i b u t e d t h e i r time, energy, knowledge and support to make completion of t h i s t h e s i s p o s s i b l e , I express my s i n c e r e thanks: To Dr. H a r r i e t Kuhnlein, my s e n i o r a d v i s o r , who formulated the idea f o r t h i s p r o j e c t and provided support when most needed; To Dr. M e l v i n Lee whose knowledge and experience made him a v a l u a b l e c o n s u l t a n t throughout t h i s p r o j e c t ; To Dr. Leon K r a i n t z , a s p e c i a l thanks f o r being such a constant supporter and source of encouragement and who so w i l l i n g l y advised me on a l l aspects of tooth c o l l e c t i o n and a n a l y s i s ; To Dr. N e i l McQuaker f o r a l l o w i n g us to use the f a c i l i t i e s a t the Environmental L a b o r a t o r i e s of the B.C. M i n i s t r y of the Environment', To Mr. David Brown and Mr. Paul Kluckner f o r t h e i r i n v a l u a b l e a s s i s t a n c e w i t h the chemical a n a l y s i s of the t e e t h and f o r v a l i d a t i n g the r e s u l t s of the chemical a n a l y s i s of the food; To Mr. Lewis James and Mrs. V i r g i n i a Greene, both of whom have been i n d i s p e n s a b l e w i t h respect to the growth and development of t h i s t h e s i s ; To Dr. John Garry who provided v a l u a b l e contacts i n B r o c k l e h u r s t and Kamloops and who allowed us to become a f f i l i a t e d w i t h the ongoing Kamloops Trace Metal Survey; To Dr. Nick Schmitt who acted as our contact i n T r a i l ; To Ms P a t r i c i a McKay and Mrs. D a n i e l l e Cantin Bergstrom f o r t h e i r help w i t h the c o l l e c t i o n of the 24- hour r e c a l l s i n the classrooms; To Ms Anna Decelles and Mrs. Kathy McKenzie who opened t h e i r homes to me i n Kamloops; To the Douwes f a m i l y l n T r a i l who were so warmly h o s p i t a b l e to a complete s t r a n g e r ; To Ms Cherie L i n n e l l and Ms I n g e l l s e Orr who a s s i s t e d w i t h the i n t e r v i e w s and who guided me around B r o c k l e h u r s t ; To Ms Penny Nagel who provided the same a s s i s t a n c e i n T r a i l ; To Ms Srba K r u n i c whose a r t i s t i c t a l e n t s were put to use to produce the graphics i n t h i s t h e s i s ; x i To Ms Susan Crowther who probably knows my t h e s i s as w e l l as I as a r e s u l t of many hours spent d i s c u s s i n g i t ; F i n a l l y , I wish to acknowledge a l l the people i n the Brockl e h u r s t and G e n e l l e areas who, i n the i n t e r e s t of the h e a l t h of t h e i r c h i l d r e n , agreed to p a r t i c i p a t e i n t h i s study. T h e i r c h e e r f u l cooperation made t h i s study p o s s i b l e and p l e a s u r a b l e . 1 CHAPTER I INTRODUCTION F o l i a t i o n "•Do n o t h i n g i n e x c e s s , ' the wise Greeks s a i d , • C o l l e c t i v e l y o r i n d i v i d u a l l y ; ' In e v e r y c a s e , 'the p i p e r must be p a i d . ' -But man i g n o r e s h i s a n c i e n t h i s t o r y . . . " "...And so i t ' s come t o pass upon t h i s e a r t h : Mankind has wrought e x c e s s of p o v e r t y . N o i s e , p o i s o n s . . . " "...Excess o f e v e r y t h i n g but C h a r i t y . Thus p l a n e t s through t h e i r cwn p o l l u t i o n d i e , And f l o a t as l i t t e r e d c o f f i n s i n t h e s k y . H (Schroeder, 1976) Ominous though t h i s poem may sound, i t does r e f l e c t t h e f e a r s o f many who a r e concerned about man's r e d i s t r i b u t i o n o f t r a c e elements and t h e i r subseguent e l e v a t e d and widespread presence i n the human environment. Fear i s s a i d t o be borne out of i g n o r a n c e . . The f e a r i n t h i s c a s e , t h e n , i s borne out o f i g n o r a n c e of t h e way i n which c o n t i n u o u s exposure t o mod e r a t e l y e l e v a t e d c o n c e n t r a t i o n s of m e t a l s a r e m e t a b o l i z e d by the body. U n l i k e o v e r t i n t o x i c a t i o n o f metals w i t h i t s c l e a r l y d e f i n e d c l i n i c a l s e g u e l a e , t h e e f f e c t s o f c h r o n i c lew dose exposure are not g r e a t encugh t o be c l i n i c a l l y m a n i f e s t e d . Although t h i s i s a grey a r e a , enough i s knewn about s u b c l i n i c a l c o n c e n t r a t i o n s o f metals i n t h e body t o suggest t h a t t h e y may be hazardous. F o r t u n a t e l y , t h e m e d i c a l p r o f e s s i o n , s c i e n t i s t s , i n d u s t r y and the g e n e r a l p u b l i c have r e c o g n i z e d t h e need t o i n v e s t i g a t e t h i s problem. I n d u s t r y , a major s o u r c e of e n v i r o n m e n t a l c o n t a m i n a t i o n , has been encouraged t o decrease p o l l u t a n t s a r i s i n g f rcm i t s o p e r a t i o n s , and a l s o t o monitor i t s d i s t r i b u t i o n of e l e v a t e d c o n c e n t r a t i o n s of the s e elements i n t o the e nvironment. I n v e s t i g a t i o n s have not been c o n f i n e d t o 2 those m e t a l s , such as l e a d ( P b ) , which have no known f u n c t i o n i n t h e body. I t i s f e l t t h a t even t h o s e which p a r t i c i p a t e i n e s s e n t i a l b i o l o g i c a l s ystems, such as copper (Cu) and z i n c ( Z n ) , can produce d e l e t e r i o u s e f f e c t s i f i m b a l a n c e s and/or ex c e s s e s develop i n t h e body. The most common pathway f o r the e n t r a n c e o f these t h r e e elements t o the body i s through t h e i n g e s t i o n c f food and water. R e s p i r a t i o n can a l s o p r o v i d e an e n t r a n c e . The m e t a b o l i c f a t e o f t h e s e metals has been e x t e n s i v e l y r e s e a r c h e d w i t h as y e t no c o n c r e t e e v i d e n c e f o r c a r e f u l l y d e f i n e d b i o c h e m i c a l mechanisms. However, r e s u l t s emphasize the need t o monitor c o n c e n t r a t i o n s o f exposure. Many t i s s u e s have been used i n b i o c h e m i c a l a s s a y s d e s i g n e d t o measure body burden of t r a c e elements. . T r a d i t i o n a l l y , b l o o d has been the t i s s u e c f c h o i c e . Although b l o o d c o n c e n t r a t i o n s are an e x c e l l e n t r e f l e c t i o n o f t r a n s i e n t exposure t o most m i n e r a l s , the l e v e l s d e c l i n e once i n g e s t i o n i s reduced, and i t i s i m p o s s i b l e t o a s s e s s p r e v i o u s exposure (Needleman and S h a p i r o 1973). Bones and t e e t h , on the o t h e r hand, accumulate s e v e r a l m i n e r a l s and thus would p r o v i d e u s e f u l i n f o r m a t i o n about l i f e t i m e exposure which would be of more v a l u e when a t t e m p t i n g t o a s c e r t a i n t o t a l body burden (Chatman and W i l s o n 1975; Mackie e t a l . , 1977). Bones, of c o u r s e , p r e s e n t p r a c t i c a l problems wi t h sample c o l l e c t i o n and a l s o are s u b j e c t t o a c o n t i n u a l r e m o d e l l i n g p r o c e s s ( S t e w a r t , 1974; S h a p i r o e t a l . , 1975). Teeth, however, a r e e a s i l y o b t a i n e d . I n a d d i t i o n , they a r e p h y s i c a l l y s t a b l e and have f i x e d t i m e s of f o r m a t i o n and e x f o l i a t i o n . T h e r e f o r e , the use of t e e t h , e s p e c i a l l y 3 deci d u o u s t e e t h , has become i n c r e a s i n g l y p o p u l a r i n the assessment c f t o t a l body burden of t r a c e elements ( A l t s h u l l e r e t a l . , 1962; S h a p i r o e t a l . , 1972; E l o c h e t a l . , 1976; A t t r a m a d a l and Jensen 1976; Mackie e t a l . , 1977).. The p r e s e n t s t u d y attempted t o f u r t h e r v a l i d a t e t h e use o f deciduous t e e t h as i n d i c a t o r s of human exposure t o c o n c e n t r a t i o n s of l e a d , copper and z i n c i n Kamloops and T r a i l , two towns i n B r i t i s h Columbia. Attempts were a l s o made t o determine hew much of th e s e elements may be c o n t r i b u t e d by foods grown i n t h e two a r e a s . . S i n c e s u s c e p t i b i l i t y t o t r a c e element t o x i c i t y i s dependent on t o t a l d i e t and n u t r i t i o n a l s t a t u s , an assessment o f the " t y p i c a l " e a t i n g p a t t e r n s o f s c h o o l c h i l d r e n i n t h e Kamlocps area was a l s o c o n d u c t e d . T h i s p r o j e c t i s p a r t of a l o n g - t e r m study t o a s s e s s t h e i n c r e a s e d exposure t o t r a c e elements i n the Kamloops p o p u l a t i o n from a r e c e n t l y - i n s t a l l e d copper s m e l t e r ( G a r r y , 1978). DEFINITION OF TEEMS The f o l l o w i n g d e f i n i t i o n s (except f o r t h e f i r s t one) have been developed e s p e c i a l l y f o r use i n t h i s p r o j e c t . Body Burden: Measurable g u a n t i t i e s of t r a c e elements i n body t i s s u e s of persons w i t h o u t symptoms o f t o x i c i t y (Goyer and Rhyne 1 973). C h r o n i c low dose/ C h r o n i c s l i g h t l y e l e v a t e d : Used 4 i n t e r c h a n g e a b l y and s i g n i f y i n g c o n s t a n t exposure t o c o n c e n t r a t i o n s which exceed t h o s e n o r m a l l y found but not i n s u f f i c i e n t q u a n t i t i e s t o produce f r a n k c l i n i c a l s i g n s and symptoms. G e o g r a p h i c a l l y - S t a b l e : Those c h i l d r e n who were born i n and spent a l i f e t i m e i n the area i n which t h e y p r e s e n t l y r e s i d e . T y p i c a l d i e t a r y p a t t e r n s : R e f e r s t o the n u t r i e n t i n t a k e s and the way i n which food was consumed t h r o u g h o u t the day as determined t y mean v a l u e s c a l c u l a t e d from 24-hour r e c a l l f o rms. 24-Hour r e c a l l : A form on which i s r e c o r d e d a l l food i t e m s i n g e s t e d over the 24-hcur p e r i o d d i r e c t l y p r e c e d i n g the date of c o l l e c t i o n of the r e c a l l . L o c a l l y - G r o w n : Any foods which are known t o be grown i n the f a m i l y garden or i n t h e garden of anyone r e s i d i n g i n the same a r e a . N o n - l o c a l : Any f o o d s not grown i n l o c a l gardens or those purchased from the supermarket or th o s e o f q u e s t i o n a b l e g e o g r a p h i c o r i g i n . 5 CHAPTER I I REVIEW OF THE LITERATURE A-.- ORG ANIZ ATICN OF THE CHAETER A major c o n t r i b u t o r o f e l e v a t e d c o n c e n t r a t i o n s of t r a c e elements i n the environment i s the mining and s m e l t i n g of o r e s . T h e r e f o r e , the sample p o p u l a t i o n f o r t h i s s t u d y was d e r i v e d from two c i t i e s , Kamloops and T r a i l , B.C., both o f which have m i n i n g / s m e l t i n g i n d u s t r i e s . . T r a i l has had a l e a d / z i n c s m e l t e r f o r many y e a r s w h i l e Kamloops has j u s t r e c e n t l y i n s t a l l e d a copper s m e l t e r . The t r a c e elements c f concern i n the p r e s e n t s t u d y , t h e r e f o r e , are l e a d , copper and z i n c . Of these t h r e e e l e m e n t s , copper and z i n c are known t o be e s s e n t i a l t r a c e elements w i t h s p e c i f i c m e t a b o l i c f u n c t i o n s , p a r t i c u l a r l y w i t h r e s p e c t t c enzyme systems. Lead, on t h e oth e r hand, has no known m e t a b o l i c f u n c t i o n and i s r e g a r d e d as e x e r t i n g o n l y t o x i c e f f e c t s i n b i o l o g i c a l systems. A l l t h r e e pose p o t e n t i a l h a z a r d s t o human h e a l t h as a r e s u l t of c o n t i n u o u s l o n g - t e r m exposure a r i s i n g from growing i n d u s t r i a l i z a t i o n and u r b a n i z a t i o n . T h i s c h a p t e r i s a s u r v e y o f the l i t e r a t u r e on p o s s i b l e a d v e r s e e f f e c t s of e l e v a t e d e n v i r o n m e n t a l c o n c e n t r a t i o n s o f th e s e e l e m e n t s . A d i s c u s s i o n of s o u r c e s , r o l e and/or p o s s i b l e t o x i c i t y and n u t r i t i o n a l s i g n i f i c a n c e o f l e a d , copper and z i n c and p o s s i b l e c o m p l i c a t i o n s c f m i n e r a l i n t e r r e l a t i o n s h i p s i s f o l l o w e d by a d e s c r i p t i o n c f t h e e f f e c t s o f i n d u s t r i a l i z a t i o n and changes i n s o c i o - c u l t u r a l s t r u c t u r e . The n e c e s s i t y f o r 6 d e v i s i n g e f f e c t i v e m c n i t o r i n g or s c r e e n i n g d e v i c e s w i l l be n o t e d , i n p a r t i c u l a r , the use of deciduous t e e t h as i n d i c a t o r s of m i n e r a l exposure and subsequent a c c u m u l a t i o n i n t h e body. The l i t e r a t u r e r e v i e w c o n c l u d e s w i t h a d i s c u s s i o n of t h e d i e t a r y h a b i t s c f s c h o o l c h i l d r e n s i n c e t h i s i s a group a t p a r t i c u l a r l y h i g h r i s k f o r exposure t o e l e v a t e d c o n c e n t r a t i o n s of t r a c e e l e m e n t s . As f o o d i s a major source o f c o n t a m i n a t i o n and d i e t and n u t r i t i o n a l s t a t u s appear t o i n f l u e n c e the degree of t o x i c i t y , t h i s f i n a l s e c t i o n w i l l be devoted t o a d i s c u s s i o n of t h e s e f a c t o r s p a r t i c u l a r l y as they r e l a t e t o c h i l d r e n . B.. COPPER JL NUTRITION AL SIGNIFICANCE Copper has been r e c o g n i z e d as a d i e t a r y e s s e n t i a l f o r over 40 y e a r s (Evans, 1973). An a d u l t human body c o n t a i n s 80-120 mg of copper which i s d i s t r i b u t e d throughout t h e body, the h i g h e s t c o n c e n t r a t i o n s i n d e c r e a s i n g o r d e r b e i n g found i n the l i v e r , b r a i n , h e a r t and k i d n e y s . However, i n terms of t o t a l body copper, muscle and bone c o n t a i n a p p r o x i m a t e l y 50% and the l i v e r a c c o u n t s f o r about 10% o f the t c t a l ( Burns, 1973; Burch e t a l . , 1975) . The major s i t e s f c r copper a b s o r p t i o n are i n t h e stomach and upper s m a l l i n t e s t i n e . Normal copper i n t a k e of humans i s e s t i m a t e d to be 2.5-5 mg/day, of which between 0.6 and 1.6 mg i s a bsorbed (Oster and Salgo 1977). The c h e m i c a l form f o r a b s o r p t i o n and the mechanism of t r a n s p o r t a t i o n by the i n t e s t i n e 7 are not c o m p l e t e l y u n d e r s t o o d . . However, r e p o r t s of t h e many r e s e a r c h e r s c f copper metabolism t e n d t o support the f o l l o w i n g mechanism f o r copper a b s o r p t i o n h y p o t h e s i z e d by Evans (1973): copper i n food p a s s i n g through the g a s t r o i n t e s t i n a l t r a c t d i s s o c i a t e s from macrcmolecular s p e c i e s and i s r e l e a s e d as e i t h e r i o n i c copper or as a copper-amino a c i d complex. A f r a c t i o n of the i o n i c copper combines w i t h a v a i l a b l e amino a c i d s i n the i n t e s t i n a l lumen. The complexed copper i s then a c t i v e l y t r a n s p o r t e d a c r o s s t h e i n t e s t i n a l mucosa. Copper which t r a v e r s e s the mucosal membrane as t h e uncomplexed i o n combines w i t h m e t a l l o t h i o n e i n . As copper d i s s o c i a t e s from i n t e s t i n a l m e t a l l o t h i o n e i n , t h e m e t a l e i t h e r d i f f u s e s d i r e c t l y i n t o t h e plasma o r becomes complexed f o r subsequent t r a n s p o r t t o the s e r o s a l s i d e . The copper t h a t remains bound t o m e t a l l o t h i o n e i n i s e x c r e t e d i n t h e f e c e s or s t o r e d t e m p o r a r i l y and e v e n t u a l l y l o s t when t h e mucosa i s shed. Burch e t a l . (1975) propose t h a t copper i s absorbed by both an energy-dependent p r o c e s s r e p r e s e n t i n g a b s o r p t i o n of copper complexes of amino a c i d s and a b s o r p t i o n as copper bound t o two p r o t e i n f r a c t i o n s i n the i n t e s t i n a l mucosa. One of t h e s e p r o t e i n s i s thought t o be s u p e r o x i d e d i s m u t a s e and the o t h e r i s c h a r a c t e r i s t i c of m e t a l l o t h i o n e i n . Many a n t a g o n i s t s t o copper a b s o r p t i o n have been i d e n t i f i e d . . T r a n s i t i o n e l e m e n t s , such as cadmium, mercury and z i n c , because of t h e i r c h e m i c a l s i m i l a r i t y , a c t i n c o m p e t i t i o n w i t h copper f o r b i n d i n g s i t e s w i t h i n s p e c i f i c m e t a b o l i c systems. H a l l e t a l . (1979) r e p o r t r e s u l t s which c o n f i r m t h a t the a n t a g o n i s t i c e f f e c t o f z i n c cn copper metabolism o c c u r s 8 p r i n c i p a l l y at the a b s o r p t i o n l e v e l . The mode of a c t i o n o f z i n c on copper metabolism i s s i m i l a r t c t h a t of cadmium on copper metabolism e x c e p t t h a t cadmium i s a more p o t e n t i n h i b i t o r of copper a b s o r p t i o n . A s c o r b i c a c i d has been shown t o depress i n t e s t i n a l a b s o r p t i o n of copper presumably by competing f o r s u l f h y d r y l b i n d i n g s i t e s on m e t a l l o t h i o n e i n (Evans e t a l . , 1970). D i e t a r y f i b r e , p h y t a t e s i n f o o d , and s u l f i d e a n i o n s a l s o i n t e r f e r e w i t h copper m e t a b c l i s m (Burch et a l . , 1975; Drews e t a l . , 1979; E e i l l y , 1979). A f t e r a b s o r p t i o n from the i n t e s t i n e , copper i s t r a n s p o r t e d t h r ough t h e p c r t a l b l e e d bound t o alb u m i n or complexed w i t h c e r u l o p l a s m i n and amino a c i d s . Normal human plasma c o n t a i n s c l o s e t o 1 ug copper/ml. A p p r o x i m a t e l y 93% i s bound t o c e r u l o p l a s m i n . About 1% i s bound t o albumin which i s s a i d t o be i n r a p i d e g u i l i b r i u m w i t h t i s s u e copper and has been d e s c r i b e d as t h e immediate t r a n s p o r t form of copper i n plasma (Neuman and S a s s - K o r t s a k 1967). R a d i o i s o t o p i c copper i s f i r s t bound by a l b u m i n , then appears i n t h e l i v e r and f i n a l l y appears i n c e r u l o p l a s m i n . C e r u l o p l a s m i n i s s y n t h e s i z e d i n the l i v e r and, w h i l e i t does not a c t as a t r a n s p o r t f a c t o r i n c a r r y i n g copper t o t h e l i v e r from the g u t , i t does s e r v e as a means o f d i s t r i b u t i n g copper t o o t h e r t i s s u e s (Burch et a l . 1975). The s m a l l f r a c t i o n of copper i n human plasma bound to amino a c i d s i s a p p a r e n t l y i n e q u i l i b r i u m w i t h the albumin-bound f r a c t i o n and both are i n e q u i l i b r i u m w i t h i c n i c cepper (Neumann and S a s s - K o r t s a k 1967).. H i s t i d i n e appears t o be the major copper I I b i n d i n g amino a c i d i n plasma, a l t h o u g h o t h e r amino a c i d s 9 have a l s o been shown t o p l a y a r o l e (Lau and S a r k e r 1971).. The amino a c i d - c o p p e r complex appears t o be an i m p o r t a n t mode o f t r a n s p o r t i n t o c e l l s and c e l l u l a r components (Burch e t a l . , 1975) . . I n g e s t e d copper d i s a p p e a r s r a p i d l y from plasma and c o n c e n t r a t e s i n the l i v e r . I n t h e l i v e r , copper h o m e o s t a s i s i s m a i n t a i n e d by t h r e e p r o c e s s e s : 1) p r e p a r a t i o n of copper f o r e x c r e t i o n i n b i l e ; 2) temporary s t o r a g e o f copper; and, 3) i n c o r p o r a t i o n c f copper i n t o c e r u l o p l a s m i n . In t h e e x t r a h e p a t i c t i s s u e s , the metabolism of copper i s c o n f i n e d m a i n l y t o t h e normal s y n t h e s i s and d e g r a d a t i o n of copper dependent enzymes. The major pathway f o r copper e x c r e t i o n i s the b i l e . R e s u l t s f r c m s t u d i e s suggest t h a t t h e major f r a c t i o n of b i l i a r y c opper i s a s s o c i a t e d w i t h amino a c i d s and s m a l l p e p t i d e s . S i n c e copper i s e x c r e t e d bound t o p r o t e i n s , h o m e o s t a s i s depends p a r t l y on adeguate p r o t e i n s y n t h e s i s . T h e r e f o r e , i n h i b i t o r s o f p r o t e i n s y n t h e s i s a l s o r e t a r d the removal of copper. F a c t o r s r e g u l a t i n g b i l e f l o w such as a d r e n a l s t e r o i d s would a l s o d e c r e ase b i l i a r y copper e x c r e t i o n . There i s m i n i m a l e n t e r o h e p a t i c c i r c u l a t i o n of copper and r e a b s o r p t i o n i s n e g l i g i b l e . O r i n a r y copper e x c r e t i o n i s a l s o n e g l i g i b l e under normal c o n d i t i o n s (Evans, 1971; Evans, 1973; Burch et a l . , 1975) . Serum copper and c e r u l o p l a s m i n c o n c e n t r a t i o n s i n c r e a s e d u r i n g pregnancy, w i t h e s t r o g e n t h e r a p y and w i t h o r a l c o n t r a c e p t i v e use (Burch e t a l . , 1975; O s t e r and Salgo 1977). I t has been shown t h a t copper as t h e f r e e metal moves a c r o s s 10 the p l a c e n t a by p a s s i v e t r a n s f e r and t h a t f e t a l l i v e r c opper s t o r e s i n c r e a s e d u r i n g g e s t a t i o n . The newborn i n f a n t a p p a r e n t l y has s u f f i c i e n t copper accumulated t o l a s t t h r o u g h t o weaning, supplemented by s m a l l amounts i n mother's m i l k (Schroeder e t a l . , 1965; Henkin e t a l . , 1971; Casey and Robinson 1S78). Cow's m i l k has a s i g n i f i c a n t l y l o w e r c o n c e n t r a t i o n of copper t h a n human m i l k ( P r a s a d , 1974). . Hypocupremia has been found to accompany h y p o p r o t e i n e m i c d i s o r d e r s and m a l n u t r i t i o n (Schroeder e t a l . , 1965; Evans, 1973). I n a d d i t i o n , c e r t a i n c h r o n i c d i s e a s e s t a t e s w i l l a l s o produce i n c r e a s e s i n blo o d copper and c e r u l o p l a s m i n c o n c e n t r a t i o n s . I t has been shown t h a t i n f e c t i o n s , m y o c a r d i a l i n f a r c t i o n , h e p a t i c d i s e a s e s , m a l i g n a n t d i s e a s e s , anemias and perhaps s c h i z o p h r e n i a are a l l c o i n c i d e n t w i t h h y p e r c u p r e m i a . Zs.- ENVIRONMENTAL SOURCES FOR HUMAN INTAKE Copper, atomic number 29, belongs t o subgroup 1B on t h e p e r i o d i c t a b l e . I t o c c u r s e i t h e r i n t h e +1 or + 2 v a l e n c e s t a t e . As + 2 , i t i s isomorphous w i t h z i n c + 2 , manganese*-2 and i r o n * 2 . Copper commcnly forms o r g a n i c complexes and has a g r e a t a f f i n i t y f o r S- and N- c o n t a i n i n g l i g a n d s (NAS, 1977).. Copper i s a v e r s a t i l e metal and has been u t i l i z e d s i n c e p r e h i s t o r i c t i m e s . I t has always been a p o p u l a r m a t e r i a l f o r use i n cookware as i t i s an e x c e l l e n t c o n d u c t o r of h e a t . Copper i s an e s s e n t i a l t r a c e element f o r most p l a n t s and a n i m a l s and thus i s u b i g u i t o u s i n n a t u r e and promise s t o become even more widespread as removal o f t h i s metal from s i t e s of i t s 11 n a t u r a l s o u r c e s and r e l e a s e i n t o t h e environment s t e a d i l y i n c r e a s e (Schroeder e t a l . , 1966; NAS, 1977; P r a s a d , 1979).. E n v i r o n m e n t a l s o u r c e s are numerous and i n c l u d e a t m o s p h e r i c c o n c e n t r a t i o n s r e s u l t i n g from i n d u s t r i a l e f f l u e n t d i s c h a r g e . I t s p r esence i n domestic water s u p p l i e s i s a r e s u l t , i n p a r t , of waste from mining and a g r i c u l t u r a l o p e r a t i o n s and i s a l s o due t o c o r r o s i o n o f and l e a c h i n g from copper p i p e s , p a r t i c u l a r l y i n s o f t water a r e a s . C o n t a m i n a t i o n of s p e c i f i c e n vironments as a r e s u l t of i n d u s t r y v a r i e s w i t h d i s t a n c e from the o p e r a t i o n a l s i t e and d i r e c t i o n of wind (Andelman and S h a p i r o 1973; S c h r o e d e r , 1975). Copper k e t t l e s and hot water g e y s e r s have a l s o been known t o i n t r o d u c e e x c e s s i v e c o n c e n t r a t i o n s of the i o n i n t o d r i n k i n g water ( N i c h o l a s e t a l . , 1968) . . P l a n t s may accumulate e x c e s s copper through uptake from s o i l depending cn s o i l pH, type c f s c i l , s p e c i e s o f p l a n t , as a r e s u l t of a t m o s p h e r i c f a l l o u t and t h r o u g h a g r i c u l t u r a l s p r a y i n g o p e r a t i o n s ( S c h r o e d e r , 1975; B e a v i n g t o n , 1975; NAS, 1977; B a r r y and C l a r k 1978; McDonald and Duncan 1978). D i e t a r y s o u r c e s c f copper are s i m i l a r t o t h o s e of i r o n and i n c l u d e meat, h e a r t , l i v e r , s h e l l f i s h , s p i n a c h , whole g r a i n bread and c e r e a l s and d r i e d f r u i t s . I t i s d i f f i c u l t t o consume a d i e t which does not s u p p l y adeguate copper because of i t s presence i n v i r t u a l l y a l l forms of p l a n t and animal l i f e . C h o i c e of f o o d and water, l o c a l i t y from which the f o o d and water a r e d e r i v e d and p r o c e s s i n g , s t o r a g e and t r e a t m e n t w i t h f u n g i c i d e s and p e s t i c i d e s determine t h e amount of d i e t a r y copper i n g e s t e d d a i l y (Underwood, 1S71). D e f i c i e n c y i n humans 12 consuming a u s u a l v a r i e d d i e t and h a v i n g normal a b s o r p t i o n i s u n l i k e l y (Burch e t a l . , 1975). A l t h o u g h no recommendations f o r d a i l y i n t a k e of copper have been e s t a b l i s h e d f o r Canada, the Food and N u t r i t i o n Board of t h e U.S. N a t i o n a l Academy o f S c i e n c e s s u g g e s t s t h a t 2 mg of copper d a i l y appears t o m a i n t a i n b a l a n c e i n a d u l t s (Klevay e t a l . , 1979). In a d d i t i o n , t h e 1980 Re v i s e d Recommended D i e t a r y A l l o w a n c e s f o r the U.S. i n c l u d e s a recommendation f o r copper o f 2.0-3.0 mg/ day f o r a d u l t s and a d o l e s c e n t s ( J . Am. D i e t e t . Assoc. Commentary, 1979). . i * - ROLE OF COPPER IN THE BODY AND POTENTIAL TOXICITY Copper i s an e x c e l l e n t c a t a l y s t f o r redox systems and i s i n v o l v e d i n a c t i v i t i e s as d i v e r s e as i r o n u t i l i z a t i o n , energy p r o d u c t i o n , c o n n e c t i v e t i s s u e f o r m a t i o n and p i g m e n t a t i o n , and i s c l o s e l y a s s o c i a t e d w i t h at l e a s t 20 copper p r o t e i n s i n c l u d i n g : 1) C e r u l o p l a s m i n , a l s o known as f e r r o x i d a s e , c o n t a i n s 8 atoms of copper per m o l e c u l e and i s n e c e s s a r y f o r o x i d a t i o n of f e r r o u s to f e r r i c i r c n so i t can b i n d w i t h t r a n s f e r r i n and be t r a n s p o r t e d t c the bone marrow f o r b l o o d f o r m a t i o n ; 2) Monoamine o x i d a s e c o n t a i n s 4 copper atoms per mol e c u l e and c a t a l y z e s the o x i d a t i v e d e a m i n a t i o n of monoamines and i s i n v o l v e d i n t h e s t r u c t u r a l i n t e g r i t y o f v a s c u l a r and bone t i s s u e ; 3) T y r o s i n a s e c a t a l y z e s t h e f i r s t 2 s t e p s i n the s y n t h e s i s of melanin pigment from t y r o s i n e ; 4) L y s l y o x i d a s e r e q u i r e s copper as an e s s e n t i a l c o f a c t o r and i s i n v o l v e d i n the c r o s s - l i n k a g e of t h e p o l y p e p t i d e c h a i n s of e l a s t i n and c o l l a g e n ; 5) Su p e r o x i d e dismutase found i n e r y t h r o c y t e s , b r a i n 13 and l i v e r c o n v e r t s u p e r o x i d e f r e e r a d i c a l a n i o n s i n t o oxygen and hydrogen p e r o x i d e , and thus p r e v e n t s the a c c u m u l a t i o n of a p o t e n t i a l l y t o x i c r a d i c a l (Evans, 1973; E e i n h o l d , 1975; NAS, 1977; P r a s a d , 1979).. While e s s e n t i a l i t y of copper t o human h e a l t h i s i n d i s p u t a b l e , copper d e f i c i e n c y i s , f o r t u n a t e l y , r a r e i n t h e a d u l t human. However, i n f a n t s ( u s u a l l y v e r y s m a l l premature i n f a n t s ) w i t h i nadequate s t o r e s c f copper and/or who are r e c e i v i n g cow's m i l k as t h e i r s o l e s o u r c e of n u t r i e n t s may be at r i s k f o r lew copper s t a t u s . A copper d e f i c i e n c y syndrome has been d e s c r i b e d f o r human i n f a n t s but not f o r a d u l t s . In most i n f a n t copper d e f i c i e n c i e s , an anemia t h a t i s r e s i s t a n t t o i r o n t h e r a p y i s u s u a l l y p r e s e n t , accompanied by n e u t r o p e n i a , bone changes s i m i l a r t o t h o s e of v i t a m i n C d e f i c i e n c y , n e u r o l o g i c a l symptoms and h a i r changes (Oster and S a l g c 1977; P r a s a d , 1979). The mechanism by which copper d e f i c i e n c y causes t h e s e m e t a b o l i c d i s o r d e r s i s thought t c be a r e d u c t i o n i n one or more of the copper enzymes. A d m i n i s t r a t i o n of copper by the o r a l or p a r e n t e r a l r o u t e u s u a l l y r e v e r s e s the symptoms (Evans, 1973; E e i n h o l d , 1975; P r a s a d , 1S79). In a d d i t i o n , p r o l o n g e d a d m i n i s t r a t i o n of c e r t a i n m e d i c a t i o n s can cause p h a r m a c o l o g i c r e d u c t i o n of copper and r e s u l t i n a d e f i c i e n c y ( C a s s e l , 1978; P r a s a d , 1978). C o e x i s t i n g d i s e a s e ( i . e . C o e l i a c , t r o p i c a l and n o n t r o p i c a l s p r u e , Menke's syndrome), and d i e t a r y a n t a g o n i s t s ( i . e . o t h e r t r a n s i t i o n a l m e t a l s , f i b r e , p h y t a t e , v i t a m i n C, i n a d e q u a t e p r o t e i n e t c . ) may a l s o r e s u l t i n low copper s t a t u s w i t h 14 consequent d e f i c i e n c y symptoms ( R e i n h o l d , 1975; Pr a s a d e t a l . , 1978) . A l t h o u g h copper i s e s s e n t i a l t o m a i n t a i n l i f e , an e x c e s s can be f a t a l l y t o x i c . Copper t o x i c i t y i n humans i s a r e l a t i v e l y r a r e o c c u r r e n c e . Copper b a l a n c e appears t o be v e r y r e f i n e d and t h e t o x i c e f f e c t s of e x c e s s e s are u s u a l l y o b v i a t e d by i n c r e a s e d e x c r e t i o n o r i n c o m p l e t e a b s o r p t i o n (Salmon and Wright 1971; S c h e i n l e r g and S t e r n l i e b 1974; NAS, 1977). There are a number o f o t h e r f a c t o r s .which c o n t r i b u t e t o t h e low i n c i d e n c e of copper t o x i c o s i s i n humans. For example, i n g e s t i o n of excess ccpper s a l t s i m m e d i a t e l y i n d u c e s v o m i t i n g t h e r e b y r e l i e v i n g the system of any t o x i c e f f e c t s ( i . e . h e m o l y s i s , h e p a t i c n e c r o s i s , g a s t r o i n t e s t i n a l b l e e d i n g , o l i g u r i a , azotemia) (Chisholm, 1970; Evans, 1973; H i l l , 1977; NAS, 1977). However, i f q u a n t i t i e s e x c e e d i n g grams i n weight are i n g e s t e d , such as i s common i n s u i c i d a l a t t e m p t s , g a s t r o i n t e s t i n a l mucosal u l c e r a t i o n s , h e m o l y s i s , h e p a t i c n e c r o s i s and r e n a l damage from d e p o s i t i o n o f hemoglobin and/or copper can r e s u l t (Evans, 1973; NAS, 1977).. In a d d i t i o n , h i g h l y r e a c t i v e i o n s cf copper r e s u l t i n complex f o r m a t i o n s i n n a t u r e so t h a t t h e f r e e i o n i s seldcm e n c o u n t e r e d ( H i l l , 1977). Copper i s not as v o l a t i l e as l e a d , cadmium and z i n c and t h e r e f o r e does not g i v e o f f m e t a l fumes as r e a d i l y . The o b j e c t i o n a b l e t a s t e o f dust and fumes which are l a d e n w i t h copper and i t s compounds causes people t o l i m i t t h e i r exposure b e f o r e s e r i o u s t c x i c i n t a k e s can o c c u r (NAS, 1977) . C o n t i n u o u s exposure t o m i l d l y e l e v a t e d c o n c e n t r a t i o n s o f co p p e r , as seen i n copper and b r a s s w o r k e r s , l e a d s t o symptoms 15 of l a r y n g i t i s , b r o n c h i t i s , i n t e s t i n a l c o l i c w i t h c a t a r r h and d i a r r h e a , g e n e r a l e m a c i a t i o n and anemia (Mason* 1979). C h e l a t i o n t h e r a p y , most o f t e n u s i n g P e n i c i l l a m i n e , i s t h e p r o p h y l a c t i c t r e a t m e n t o f c h o i c e ( C h i s h o l m , 1970). Copper e x e r t s i t s t o x i c e f f e c t s fcy i n h i b i t i n g t he c a t a l y t i c a c t i v i t y of many enzymes, e s p e c i a l l y microsomal membrane ATPase as w e l l as a v a r i e t y of g l y c o l y t i c enzymes (Evans, 1973).. The b i o c h e m i c a l bases of copper t o x i c i t y have been s t u d i e d u s i n g a n i m a l s and i n v i t r o systems. Although s t u d i e s o f t h i s n a t u r e have l i m i t e d a p p l i c a b i l i t y t o t h e human s i t u a t i o n , t h e y do o f f e r c l a r i f i c a t i o n of seme b i o c h e m i c a l , p h y s i o l o g i c a l and p a t h o l o g i c a l a s p e c t s o f copper metabolism of t h e l i v e r , b r a i n and k i d n e y . C h r o n i c copper p o i s o n i n g , o r t h e c o n t i n u e d i n g e s t i o n of copper i n excess of r e g u i r e m e n t s , does r e s u l t i n a c c u m u l a t i o n of copper i n t i s s u e s , e s p e c i a l l y i n t h e l i v e r . The e x t e n t of a c c u m u l a t i o n and e f f e c t s of e l e v a t e d c o n c e n t r a t i o n s of copper i n the body i s very much governed by m e d i a t i n g f a c t o r s s i m i l a r t o those which i n t e r f e r e w i t h cepper metabolism t o cause i t s d e f i c i e n c y (Underwood, 1971). I n a d d i t i o n , two i n h e r i t e d syndromes which upset copper h o m e o s t a s i s have been d e s c r i b e d . One causes a copper d e f i c i e n c y , Menkes k i n k y h a i r syndrome, due to a d e f e c t i n t h e i n t e s t i n a l a b s o r p t i o n of co p p e r . The second syndrome l e a d s t o e x c e s s i v e a c c u m u l a t i o n o f copper i n t h e l i v e r , b r a i n , k i d n e y s and c o r n e a and i s known as W i l s o n ' s d i s e a s e o r h e p a t o l e n t i c u l a r d e g e n e r a t i o n . T h i s syndrome i s thought t c be caused by t h e e x i s t e n c e o f an abnormal s t o r a g e p r o t e i n w i t h an unusual a f f i n i t y f o r copper r e s u l t i n g i n an 16 i n a b i l i t y t o d i s c h a r g e copper from the l i v e r (Evans, 1973).. Bremner (1974) d e s c r i b e s c h r o n i c copper p o i s o n i n g as a two- phase p r o c e s s . F i r s t , t h e r e i s a p a s s i v e and p r o l o n g e d a c c u m u l a t i o n of copper i n l i v e r which has been known t o exceed 1000 ug/g dry m a t t e r . In t h e second phase, th e s t o r e d copper i s s u d d e n l y r e l e a s e d and i s known as the h a e m o l y t i c c r i s i s . Accompanying t h e h a e m o l y t i c c r i s i s i s j a u n d i c e , a n o r e x i a , e x c e s s i v e t h i r s t and h a e m o g l o b i n u r i a w i t h a r a p i d decrease of b l o o d haemoglobin and g l u t a t h i o n e (GSH) t o very low c o n c e n t r a t i o n s . B l o o d copper c o n c e n t r a t i o n s a l s o e s c a l a t e w i t h a t r a n s i e n t but concommitant i n c r e a s e o f b l o o d methaemoglobin (Bremner, 1974). £ i ZINC J - NUTRITIONAL SIGNIFICANCE The i m p o r t a n c e of z i n c t o human h e a l t h has o n l y r e c e n t l y been e s t a b l i s h e d , a l t h o u g h d i s c o v e r i e s of i t s b i o l o g i c a l r o l e s i n p l a n t s and a n i m a l s have c o n t i n u e d f o r over 100 y e a r s (Committee on N u t r i t i o n , 1978). I t i s t h e most p r e v a l e n t t r a c e metal i n t i s s u e s . I r o n e x i s t s i n h i g h e r c o n c e n t r a t i o n s but i s found p r i m a r i l y i n b l o o d . In comparison w i t h the metals which have a g r e a t e r d i s t r i b u t i o n t h r o u g h o u t th e body, however, z i n c r a nks the h i g h e s t . For an a d u l t human weighing a p p r o x i m a t e l y 70 kg, the t o t a l c o n c e n t r a t i o n of t r a c e m e t a l s have been e s t i m a t e d t o be: i r o n , 4.0 g; z i n c , 2.3 g; manganese, 0.2 g; copper, 0.1 g; and a l l o t h e r s combined, l e s s t h a n 0.1 g (NAS, 17 1979) . A p p r o x i m a t e l y 9C5E cf t o t a l body z i n c i s found i n muscle and bone, but the h i g h e s t c o n c e n t r a t i o n of z i n c i s found i n e n d o c r i n e g l a n d s , n o t a b l y t h e g o n a d a l system and i n s e n s o r y r e c e p t o r s , e s p e c i a l l y the r e t i n a of t h e eye (Committee on N u t r i t i o n , 1978; NAS, 1979). Food and d r i n k are the most common c o n t r i b u t o r s of z i n c t o the human body. The average a d u l t human i n g e s t s 10-15 mg z i n c / d a y and a b s orbs a p p r o x i m a t e l y 5 mg, p r i m a r i l y from t h e s m a l l i n t e s t i n e (NAS, 1979). The mechanism by which z i n c i s absorbed and t r a n s p o r t e d t hroughout the body has been the s u b j e c t o f much i n v e s t i g a t i o n . While these s t u d i e s have been p r o d u c t i v e , more work i s s t i l l r e q u i r e d f o r a complete u n d e r s t a n d i n g of z i n c metabolism i n t h e human body. To d a t e , a l t h o u g h the e v i d e n c e of e a r l i e s t a b s o r p t i o n appears i n t h e stomach, i t has been determined t h a t the major s i t e o f a b s o r p t i o n appears t o be i n t h e second p o r t i o n of t h e duodenum. A b s o r p t i o n a l s o appears t o t a k e p l a c e a t o t h e r p o r t i o n s o f t h e l a r g e and s m a l l i n t e s t i n e (underwood, 1971; NAS, 1979). There are s e v e r a l f a c t o r s which may i n t e r f e r e w i t h z i n c a b s o r p t i o n . These i n c l u d e an i n h e r i t e d d e f e c t i n z i n c a b s o r p t i o n which r e s u l t s i n a c r o d e r m a t i t i s e n t e r o p a t h i c a , l a r g e q u a n t i t i e s o f p h y t a t e and f i b r e i n the d i e t of some p o p u l a t i o n s , p r o l o n g e d a d m i n i s t r a t i o n of t o t a l p a r e n t e r a l n u t r i t i o n , and any m a l a b s o r p t i o n syndrome (Committee on N u t r i t i o n , 1978). . Other d i e t a r y f a c t o r s have a l s o been shown t o d e c rease z i n c a b s o r p t i o n . Soy p r o t e i n s and o t h e r p l a n t p r o t e i n s , c a l c i u m , phosphates and o t h e r m e t a l s , p a r t i c u l a r l y cadmium and l e a d , and 18 a l c o h o l have a l l r e s u l t e d i n d e c r e a s e d a b s o r p t i o n o f z i n c ( P r asad, 1979; NAS, 1979). As w i t h c opper, the mechanism by which z i n c i s t r a n s p o r t e d from the gut lumen a c r o s s the gut mucosa or from the mucosa a c r o s s the gut s e r o s a i s not known. Work by Evans e t a l . (1976) s u g g e s t t h a t a low m o l e c u l a r weight z i n c - b i n d i n g l i g a n d emanating frcm the pancreas may f a c i l i t a t e z i n c uptake i n t o i n t e s t i n a l c e l l s . C o u s i n s (1979) a l s o d i s c u s s e s the r o l e o f i n t r a c e l l u l a r l i g a n d s i n the r e g u l a t i o n of z i n c a b s o r p t i o n . Both i n v e s t i g a t o r s have proposed mechanisms by which z i n c may be t r a n s p o r t e d from the i n t e s t i n a l lumen t o plasma. Evans (1976) proposed t h a t , i n the duodenum, i n g e s t e d z i n c complexes w i t h a z i n c - b i n d i n g l i g a n d which i s s e c r e t e d from t h e p a n c r e a s . The z i n c i s t h u s t r a n s p o r t e d t h rough t h e m i c r o v i l l u s and i n t o the e p i t h e l i a l c e l l where the metal i s t r a n s f e r r e d t o b i n d i n g s i t e s on t h e b a s o l a t e r a l plasma membrane. The z i n c i s t h e n removed frcm r e c e p t o r s i t e s on the membrane by albumin and i s c i r c u l a t e d t h r o u g h the plasma and i n t o the t i s s u e s . C o u s i n s (1979) proposes t h a t t h e z i n c - b i n d i n g l i g a n d i s a c t u a l l y a low m o l e c u l a r weight l i g a n d which r e s u l t s from t h e d e g r a d a t i o n c f l a r g e r m o l e c u l a r weight z i n c - b i n d i n g components. The h y p o t h e s i z e d mechanism of a b s o r p t i o n i s s i m i l a r to t h a t s u g g e sted by Evans (1S76). However, C o u s i n s (1979) p r e s e n t s a more e l a b o r a t e d e s c r i p t i o n . A f t e r a c t i v e t r a n s p o r t , a c r o s s the mucosal brush b o r d e r , the newly a c q u i r e d c y t o p l a s m i c z i n c e q u i l i b r a t e s w i t h a " z i n c p o o l " and i s shunted i n t o h i g h m o l e c u l a r weight p r o t e i n s and m e t a l l o t h i o n e i n o r i s t r a n s f e r r e d t o the plasma where i t c i r c u l a t e s complexed w i t h a l b umin. The 19 remainder of the i n g e s t e d z i n c forms an i n s o l u b l e , non-d i f f u s i b l e complex which i s e x c r e t e d i n the f e c e s (NAS, 1979). I t appears t h a t z i n c m e t a l l o t h i o n e i n s y n t h e s i s and s t o r a g e i s the r e g u l a t o r y mechanism which responds t o v a r i a b l e c o n c e n t r a t i o n s of d i e t a r y z i n c and t h e r e f o r e m a i n t a i n s z i n c h o meostasis i n the body (Evans and Grace 1973; Evans e t a l . , 1979) . I n t h e plasma, a p p r o x i m a t e l y 43% of the z i n c i s bound t o a l b u m i n , the major macromolecular z i n c l i g a n d . I t has been suggested t h a t t h e r e may be two b i n d i n g s i t e s f o r z i n c on a l b u m i n , one h a v i n g a g r e a t e r a f f i n i t y f o r z i n c (Suso and Edwards 1971). The f r e e l y exchangeable or more r e a d i l y removable z i n c from albumin r e p r e s e n t s th e d i f f u s i b l e f r a c t i o n of z i n c i n serum which i s i n e g u i l i b r i u m w i t h amino a c i d z i n c complexes. These complexes a r e m i c r c m o l e c u l a r z i n c l i g a n d s and are a l m o s t e x c l u s i v e l y some form o f h i s t i d i n e and c y s t e i n e (Burch e t a l . , 1975; NAS, 1979). A p p r o x i m a t e l y o n e - t h i r d o f t h e z i n c i n b l o o d serum i s bound t o an a l p h a two m a c r o g l o b u l i n which i s not i n e g u i l i b r i u m w i t h e i t h e r the a l b u m i n - z i n c complex or the amino a c i d z i n c complexes. A p p a r e n t l y , z i n c i s i n c o r p o r a t e d i n t o t h i s m a c r c g l o b u l i n o n l y i n t h e l i v e r which i s the o n l y s i t e where the complex i s m e t a b o l i z e d (NAS,.1979). The major r o u t e of z i n c e x c r e t i o n i s v i a t h e f e c e s . The amount of z i n c i n f e c e s depends on the amount i n g e s t e d (of which 70-80?? i s e x c r e t e d i n the s t o o l ) , and the amount r e a b s o r b e d through the b i l e . Rat s t u d i e s suggest t h a t about o n e - t h i r d of the z i n c s e c r e t e d i n t o t h e gut lumen i s n o r m a l l y r e a b s o r b e d . A s n a i l amount of z i n c i s l o s t d a i l y i n the u r i n e . 20 and l o s s e s t h rough sweat and sebum of s k i n a l s o o c c u r (Underwood, 1971; Burch et a l . , 1975; NAS, 1979). D a v i e s and W i l l i a m s (1976) have shown t h a t , i n r a t s , an i n c r e a s e d demand f o r z i n c by t h e pregnant and l a c t a t i n g a n i m a l and her young may be met by an i n c r e a s e d r a t e o f a b s o r p t i o n by the m a t e r n a l gut. I n human pregnancy, plasma z i n c c o n c e n t r a t i o n s a re u s u a l l y o n l y about t w o - t h i r d s t h a t found i n t h e non-pregnant s t a t e (Jchnson, 1961). I t appears t h a t o r a l c o n t r a c e p t i v e s a l s o decrease plasma z i n c c o n c e n t r a t i o n s and t h a t t h e e s t r o g e n component i s r e s p o n s i b l e f o r t h i s e f f e c t ( H a l s t e a d et a l . , 1974). Mean f e t a l serum z i n c c o n c e n t r a t i o n s a r e n o t s i g n i f i c a n t l y d i f f e r e n t frcm the a d u l t non-pregnant c o n c e n t r a t i o n s as i s found w i t h copper. I t i s suggested t h a t p l a c e n t a l t r a n s f e r o f both copper and z i n c i s e f f e c t e d by a p a s s i v e mechanism (Henkin et a l . , 1971; Chez e t a l . , 1978). Z i n c c o n c e n t r a t i o n i n human m i l k v a r i e s w i t h time a f t e r d e l i v e r y and has been shown t o be h i g h e r than any o t h e r t r a c e element (Underwood, 1971; NAS, 1979). P r o l a c t i n has been i m p l i c a t e d as an i m p o r t a n t f a c t o r i n the c o n t r o l of z i n c c o n c e n t r a t i o n s i n m a t e r n a l m i l k (NAS, 1979). ENVIRONMENTAL SOURCES FOB HUMAN INTAKE Z i n c , atomic number 30, b e l o n g s t c subgroup 11B on the p e r i o d i c t a b l e and i s d i v a l e n t i n a l l i t s compounds (NAS, 1979). Z i n c i s a m p h o t e r i c , h i g h l y r e a c t i v e w i t h o t h e r e l e m e n t s and ;thus forms a wide v a r i e t y of compounds i n c l u d i n g water 21 s o l u b l e z i n c s u l f a t e s and c h l o r i d e s and i n s o l u b l e o x i d e s , c a r b o n a t e s , phosphates, s i l i c a t e s and o r g a n i c complexes (NAS, 1979). M e t a l l i c z i n c i s a good r e d u c i n g agent and d i s s o l v e s i n m i n e r a l a c i d s and s t r o n g bases ( H a l s t e a d , 1974; NAS, 1979). As the f o u r t h most w i d e l y used i n d u s t r i a l m e t a l , z i n c s e r v e s t h e consumer i n a form not e a s i l y r e c o g n i z e d i n t h e end p r o d u c t . . I t i s a c o r r o s i o n p r o t e c t i o n f o r s t e e l ( g a l v a n i z i n g ) , an a l l o y i n g metal w i t h aluminum, magnesium and t i t a n i u m i n mass-produced p r e c i s i o n p a r t s ( d i e - c a s t i n g ) , an a l l o y w i t h copper f o r b r a s s e s , a c h e m i c a l f o r w h i t e p a i n t pigment and an i m p o r t a n t i n g r e d i e n t i n compounding ru b b e r p r o d u c t s . The use o f z i n c i n p h a r m a c e u t i c a l p r o d u c t s has a l o n g h i s t o r y (NAS, 1979). R e c e n t l y , the use of z i n c as a t h e r a p e u t i c agent f o r a wide v a r i e t y c f m e d i c a l and s u r g i c a l problems has become even more p o p u l a r ( C a s s e l , 1978).. Z i n c i n the environment i s as widespread as i s copper and s o u r c e s from which copper i s d e r i v e d a l s o a r e r i c h i n z i n c . Thus, z i n c from i n d u s t r i a l o p e r a t i o n s , motor v e h i c l e s , s o i l e r o s i o n , f u e l o i l and c o a l combustion e n t e r s t h e atmosphere and, more p r e d o m i n a n t l y , the water s o u r c e s . I t t h e n e n t e r s t h e s o i l s which c o n t r i b u t e t o p l a n t and a n i m a l c o n c e n t r a t i o n s of t h e element (Underwood, 1971; H a l s t e a d , 1974; NAS, 1979). As mentioned p r e v i o u s l y , z i n c e n t e r s t h e body p r i m a r i l y through t h e i n g e s t i o n of f o o d . . Foods r i c h e s t i n z i n c a r e meat, eggs, m i l k p r o d u c t s and s h e l l f i s h ( p a r t i c u l a r l y o y s t e r s ) . Human mil k c o n t a i n s l e s s t h a n o r t h e same amount of z i n c as cow's m i l k , but z i n c i n human m i l k i s p r o b a b l y b e t t e r u t i l i z e d t h an t h a t from cow's m i l k ( H e a l t h and Welfare Canada, 1975). 22 F r u i t s and v e g e t a b l e s are not u s u a l l y good s o u r c e s o f z i n c . I t would appear t h a t t h e z i n c c o n t e n t of t h e d i e t might be v e r y dependent on the amount of p r o t e i n i n g e s t e d (WHO E x p e r t Committee, 1973; H a l s t e a d , 1974; Spencer e t a l . , 1976; NAS, 1979).. Energy i n t a k e and c h o i c e c f f o o d s a r e a l s o i m p o r t a n t d e t e r m i n a n t s of the amount c f z i n c i n t h e d i e t (White, 1976). Some r e s e a r c h e r s have e x p r e s s e d a c o n c e r n about t h e d i f f i c u l t y of meeting recommended q u a n t i t i e s of z i n c t h r o u g h t h e d i e t ( G u t h r i e , 1975; White, 1976; K l e v a y e t a l . , 1979; Holden e t a l . , 1979). Other i n v e s t i g a t o r s have found t h a t c h i l d r e n and a d u l t s on a b a l a n c e d mixed d i e t are p r o v i d e d w i t h adequate z i n c (Murphy e t a l . , 1971; Schlaqe and Wortberq 1972; K i r k p a t r i c k and C o f f i n 1972; Meranger and Smith 1972). Z i n c r e g u i r e m e n t s f o r humans have been i n c l u d e d i n the Eecommended D i e t a r y I n t a k e s (RDI) s i n c e the 1975 r e v i s i o n and were d e v i s e d u s i n g the f a c t o r i a l approach (Health and W e l f a r e Canada, 1975). The recommended z i n c i n t a k e s are shown i n Appendix K. Recommended i n t a k e s f o r a d u l t males (10 mg/day) are h i g h e r t h a n f o r females (9 mg/day) e x c e p t d u r i n g the l a t t e r h a l f of pregnancy (12 mg/day) and d u r i n g l a c t a t i o n (16 mg/day). The average Canadian d i e t p r o v i d e s 5-6 mg o f zinc/1000 k c a l ( H e a l t h and W e l f a r e Canada, 1975). 3-. ROLE OF ZINC IN TEE EODY AND POTENTIAL TOXICITY Z i n c i s known t o be a s s o c i a t e d w i t h a t l e a s t 59 enzymes ( R e i n h o l d , 1975) which p a r t i c i p a t e i n a wide v a r i e t y o f m e t a b o l i c p r o c e s s e s i n c l u d i n g c a r b o h y d r a t e , l i p i d , p r o t e i n and 23 n u c l e i c a c i d s y n t h e s i s or d e g r a d a t i o n ( E i o r d a n and V a l l e e 1976). S p e c i f i c z i n c enzymes i n c l u d e : 1) DNA and EN A polymerase; 2) C a r b o x y p e p t i d a s e s which h y d r o l y z e the t e r m i n a l COOH o f p e p t i d e s and p r o t e i n s i n t h e mammalian g u t ; 3) C a r b o n i c anhydrase h e l p s t o a c h i e v e and m a i n t a i n e q u i l i b r i u m between carbon d i o x i d e and the b i c a r b o n a t e a n i o n which i s v i t a l t o many c e l l f u n c t i o n s i n the mammal; 4) A l k a l i n e phosphatase i s e s s e n t i a l f o r t h e n c n - s p e c i f i c h y d r o l y s i s of phosphate monoesters and, of c o u r s e , c a l c i f i c a t i o n of bone; 5) A l c o h o l dehydrogenase i s r e g u i r e d i n t h e metabolism of e t h a n o l ; 6) S u p e r o x i d e dismutase i s a z i n c - c o p p e r p r o t e i n , t h u s z i n c i s a l s o i m p l i c a t e d i n the c o n v e r s i o n of s u p e r o x i d e f r e e r a d i c a l a n i o n s i n t o oxygen and hydrogen p e r o x i d e as was d e s c r i b e d f o r copper ( E i o r d a n and V a l l e e 1976; NAS, 1979).. Z i n c d e f i c i e n c y syndromes p r o b a b l y a r i s e from a decrease i n t h e a c t i v i t y o f t h e s e e s s e n t i a l z i n c - c o n t a i n i n g enzymes (Burch e t a l . , 1975; P r a s a d , 1979). Z i n c d e f i c i e n c y syndromes a r e w e l l documented i n t h e l i t e r a t u r e . P rasad d e s c r i b e d the f i r s t m a n i f e s t a t i o n of z i n c d e f i c i e n c y i n humans i n 1961.. The group s t u d i e d p r e s e n t e d w i t h i r o n d e f i c i e n c y anemia, h e p a t o s p l e n o m e g a l y , g e o p h a g i a , hypogonadism and dwarfism (Burch et a l . , 1975; P r a s a d , 1976). S k i n changes, poor a p p e t i t e , mental l e t h a r g y and d e l a y e d wound h e a l i n g have a l s o been observed i n s u b j e c t s w i t h c h r o n i c z i n c d e f i c i e n c y ( E e i n h o l d , 1975; P r a s a d , 1979). Z i n c d e f i c i e n c y may r e s u l t frcm c h r o n i c a l c o h o l i s m , m a l a b s o r p t i o n , c i r r h o s i s o f the l i v e r and c h r o n i c r e n a l d i s e a s e . P a t i e n t s with a c r o d e r m a t i t i s 24 e n t e r o p a t h i c a , a r a r e autosomal r e c e s s i v e d i s o r d e r , e x h i b i t low serum z i n c and can be , t r e a t e d s u c c e s s f u l l y w i t h the a d m i n i s t r a t i o n of the metal as z i n c s u l f a t e (Burch e t a l . , 1975; P r a s a d , 1979; NAS, 1979). V a r i o u s drugs and p r o l o n g e d p a r e n t e r a l n u t r i t i o n can a l s o a l t e r z i n c s t a t u s of an i n d i v i d u a l (NAS, 1979).. T e r a t o g e n i c i t y has been seen i n z i n c -d e f i c i e n t a n i m a l s but no e v i d e n c e has e s t a b l i s h e d t h i s e f f e c t i n humans (NAS, 1979) . C e r t a i n l y the ; apparent r i s k s i n h e r e n t i n z i n c d e f i c i e n c y a r e cause f o r c o n c e r n . However, t h e c o n t i n u e d p r o d u c t i o n o f z i n c and i t s i n c r e a s i n g use i n i n d u s t r y and i n the t r e a t m e n t o f m e d i c a l and s u r g i c a l problems have encouraged r e s e a r c h e r s t o become more c o g n i z a n t of t h e t c x i c e f f e c t s of z i n c , p a r t i c u l a r l y r e s u l t i n g from p r o l o n g e d exposure o f s l i g h t l y t o mo d e r a t e l y e l e v a t e d c o n c e n t r a t i o n s . The e v i d e n c e t o date s u g g e s t s t h a t l i t t l e i s known about the c h r o n i c t o x i c i t y o f z i n c . Acute e f f e c t s a r i s i n g from i n h a l i n g z i n c fumes i n an i n d u s t r i a l s e t t i n g or from the i n g e s t i o n of l a r g e doses of z i n c s u l f a t e (12 grams) or a c c i d e n t a l exposure o f humans t c foo d or d r i n k c o n t a m i n a t e d w i t h h i g h c o n c e n t r a t i o n s of z i n c have been documented (Eurch e t a l . , 1975; P r a s a d , 1976; NAS, 1979). The r e l a t i v e n o n - t o x i c i t y c f z i n c i s p r o b a b l y a t t r i b u t a b l e t o many of the same h o m e o s t a t i c f e a t u r e s of. copper metabolism. For example, v o m i t i n g a c t s as a p r o t e c t i v e mechanism when as much as 2 grams of z i n c s u l f a t e i s i n g e s t e d (Merck Index, 1960). I t i s a l s o thought t h a t z i n c i s n o n c u m u l a t i v e and t h a t t h e p r o p o r t i o n absorbed i s i n v e r s e l y r e l a t e d t o the amount i n g e s t e d ( P r a s a d , 1976). However, z i n c and cadmium c o n c e n t r a t i o n s i n 25 the k i d n e y have been found t o i n c r e a s e w i t h age (NAS, 1979). The s t u d y c f z i n c t o x i c i t y i s c o m p l i c a t e d by t h e f a c t t h a t i t o f t e n e x i s t s i n c l o s e a s s o c i a t i o n w i t h cadmium, l e a d and o t h e r m e t a l s . T h e r e f o r e , i t i s d i f f i c u l t t o a s c r i b e adverse e f f e c t s of p r o l o n g e d exposure t o i n d u s t r i a l c o n t a m i n a n t s t o z i n c a l o n e ( B a t c h e l o r e t a l . , 1926; NAS, 1979). The t h e r a p e u t i c use of z i n c and imbalances i n d i e t a r y i n t a k e and food c h o i c e have been known to r e s u l t i n a h i g h z i n c r c o p p e r r a t i o which, i n t u r n , produces a copper d e f i c i e n c y (Bremner, 1974; Pra s a d e t a l . , 1978; Bremner, 1979; H a l l e t a l . , 1979). E x p e r i m e n t a l a n i m a l s t u d i e s have c o n f i r m e d t h e s e f i n d i n g s and a l s o have demonstrated a p o s s i b l e p a n c r e a t i c i n v o l v e m e n t r e s u l t i n g i n a c c u m u l a t i o n of z i n c i n the pancreas ( C a s s e l , 1978). K l e v a y ( 1975) d i s c u s s e s i n d e t a i l the h y p o t h e s i z e d a s s o c i a t i o n of a h i g h z i n c : c o p p e r r a t i o and i n c r e a s e d r i s k of c o r o n a r y h e a r t d i s e a s e . The imbalance o f z i n c and copper a p p a r e n t l y l e a d s t o h y p e r c h o l e s t e r o l e m i a and i n c r e a s e d m o r t a l i t y from c o r o n a r y h e a r t d i s e a s e . He d e s c r i b e s the manner i n which t h i s i m b alance can occur through t h e amounts o f z i n c and copper i n human f o o d , the l a c k o f p r o t e c t i v e s u b s t a n c e s i n food o r d r i n k i n g water and t h e a l t e r a t i o n s i n p h y s i o l o g i c a l s t a t u s t h a t produce a d v e r s e changes i n t h e d i s t r i b u t i o n of z i n c and copper i n i m p o r t a n t organs. D i e t a r y f a c t o r s a re f u r t h e r e x p l o r e d by Kl e v a y (1975) and T r o w e l l (1975). There i s a l a c k c f adequate r e s e a r c h c f t h e e f f e c t s of c h r o n i c z i n c t o x i c i t y but t h i s does not mean t h a t t h e r e a r e no adverse e f f e c t s . T h i s l a c k of knowledge of s i d e e f f e c t s s h o u l d 26 encourage r e s e a r c h e r s t o be more i n v e s t i g a t i v e and p h y s i c i a n s to e x e r c i s e c a u t i o n i n p r e s c r i b i n g z i n c c o n t a i n i n g m e d i c a t i o n and the g e n e r a l p u b l i c t o be more d i s c r i m i n a t i n g i n t h e i r c h o i c e of f o o d s ( C a s s e l , 1978; F e l l , 1979). D. LEAD JU NUTRITIONAL SIGNIFICANCE The importance of l e a d a r i s e s from i t s h i g h t o x i c i t y t o b i o l o g i c a l systems. A t t e n t i o n i s f u r t h e r aroused due t o i t s wide d i s s e m i n a t i o n i n t o the environment and l a c k o f knowledge as t o the l e v e l a t which m i n i m a l t o x i c e f f e c t s o c c u r and how t o measure t h a t l e v e l . . A l t h o u g h l e a d s e r v e s no a p p a r e n t f u n c t i o n i n the human body, i t i s s t i l l p r e s e n t i n v a r y i n g c o n c e n t r a t i o n s . N i n e t y per c e n t c f body l e a d i s found i n the s k e l e t o n ; l o w e r c o n c e n t r a t i o n s are found i n l i v e r , k i d n e y and a o r t a ; and muscle and b r a i n c o n t a i n the l e a s t amount (NAS, 1972; B a r r y , 1975). Red b l o o d c e l l s c o n t a i n most o f the l e a d i n b l o o d (NRC, 1973). A p p a r e n t l y , t o t a l body burden of l e a d i n c r e a s e s w i t h age from l e s s than 2 mg f o r c h i l d r e n under 10 y e a r s of age t o over 200 mg f o r p ersons i n t h e i r 8th and 9th decades. E s t i m a t e s o f t o t a l body burden of l e a d i n a d u l t s who are not o c c u p a t i o n a l l y exposed range from a p p r o x i m a t e l y 100-400 mg (Schroeder and T i p t o n 1968; Goyer and Rhyne 1973). S p e c i f i c mechanisms of l e a d a b s o r p t i o n from the g a s t r o i n t e s t i n a l t r a c t have not been d e l i n e a t e d , a l t h o u g h i t 27 appears t o be r e g u l a t e d by some of the same p h y s i o l o g i c a l mechanisms which c o n t r o l the a b s o r p t i o n of c a l c i u m and phosphorous. An i n c r e a s e i n d i e t a r y c a l c i u m and phosphorous w i l l d e c r e a s e l e a d a b s o r p t i o n (NAS, 1S72).. B l a i r e t a l . (1978) c o n c l u d e d t h a t the t r a n s p c r t of l e a d a c r o s s the i n t e s t i n a l w a l l appears t c depend cn the a f f i n i t y of l e a d f o r b i n d i n g s i t e s on t h e t i s s u e , t h e number and a v a i l a b i l i t y o f p a r t i c u l a r b i n d i n g s i t e s and t h e n a t u r e o f t h e i n t e r a c t i o n between t h e l e a d c a t i o n and the i n t e s t i n a l t i s s u e . They found t h a t , i n the r a t , l e a d i s t r a n s p o r t e d i n t o the s e r o s a l space by a p r o c e s s of p a s s i v e d i f f u s i o n l i n k e d to water t r a n s p o r t . M e d i a t i n g f a c t o r s t o t h i s t r a n s p o r t were i n t e r a c t i o n of a p a r t i c u l a r l y t e n a c i o u s n a t u r e between l e a d i o n s and the i n t e s t i n a l t i s s u e and i n t e r a c t i o n s between the l e a d c a t i o n w i t h t i s s u e phosphate i o n s which remove l e a d i o n s from th e t r a n s p o r t p o o l . Conrad and B a r t o n (1978) d e s c r i b e f a c t o r s a f f e c t i n g t h e a b s o r p t i o n and e x c r e t i o n o f l e a d i n the r a t . The primary s i t e of a b s o r p t i o n o c c u r r e d i n t h e duodenum. Substances were i d e n t i f i e d which b i n d l e a d and i n c r e a s e i t s s o l u b i l i t y , t h u s enhancing i t s a b s o r p t i o n . I r o n , z i n c and c a l c i u m d e c r e a s e d t h e a b s o r p t i o n o f l e a d w i t h o u t a f f e c t i n g i t s s o l u b i l i t y , p r o b a b l y by competing f o r shared a b s o r p t i v e r e c e p t o r s i n t h e i n t e s t i n a l mucosa. The t o t a l body burden of l e a d d i d not a f f e c t i t s a b s o r p t i o n , i n d i c a t i n g the absence of a feedback mechanism which l i m i t s a b s o r p t i o n . Lead a b s o r p t i o n was found to i n c r e a s e d u r i n g r a p i d p e r i o d s c f growth and i n i r o n - d e f i c i e n t a n i m a l s . I t was d i m i n i s h e d w i t h s t a r v a t i o n and i n i r o n - o v e r l o a d e d 28 a n i m a l s . E r y t h r o c y t e s were i m p o r t a n t i n l e a d t r a n s p o r t . E x c r e t i o n o c c u r r e d m a i n l y through t i l e , but a l s o through u r i n e and f e c e s . L i m i t e d e x c r e t i o n p e r m i t t e d l e a d a c c u m u l a t i o n , p r i m a r i l y i n t o n e . Other components i n the d i e t i n c l u d i n g p r o t e i n , v i t a m i n D, o t h e r m i n e r a l s , v i t a m i n E and v i t a m i n C have a l s o been found t o modify l e a d a b s o r p t i o n (Mahaffey, 1974; Smith, 1976; Underwood, 1977; S o r r e l l e t a l . , 1977; M y l r o i e e t a l . , 1977; Quarterman e t a l . , 1978; Eosen and S o r e l l 1978; Levander, 1979; Moore, 1979). Form and s o u r c e of l e a d , c o e x i s t i n g d i s e a s e s , age and i n t r a c e l l u l a r c c m p l e x i n g c f l e a d a r e a d d i t i o n a l f a c t o r s which determine s u s c e p t i b i l i t y t o undue a c c u m u l a t i o n o f l e a d i n the body (Goyer and Mahaffey 1972; Forbes and Beina 1972; H u i s i n g h and H u i s i n g h 1974; Moore and Goyer 1974; Jugo, 1977; Z i e g l e r e t a l . , 1978; Quarterman and M o r r i s o n 1978; K o s t i a l e t a l . , 1979). P l a c e n t a l t r a n s f e r of l e a d and i t s p o t e n t i a l e m b r y o t o x i c i t y has been r e c o g n i z e d f o r over a c e n t u r y ( C a r p e n t e r , 1974; C a v a l l e r i e t a l . , 1978). In f a c t , l e a d compounds were o f t e n used i n a t t e m p t s at c r i m i n a l a b o r t i o n ( C a r p e n t e r , 1974). S t u d i e s i n a n i m a l s show t h a t t h e r e can be r a p i d p l a c e n t a l t r a n s f e r of s i g n i f i c a n t amounts of i n o r g a n i c l e a d even at low m a t e r n a l b l o o d l e a d c o n c e n t r a t i o n s . , I n humans, t h i s t r a n s f e r b e g i n s as e a r l y as the 12th week o f g e s t a t i o n and t o t a l l e a d c o n t e n t i n f e t a l t i s s u e s i n c r e a s e s t h roughout pregnancy ( C a r p e n t e r , 1974; C a v a l l e r i e t a l . , 1978). The d i s t r i b u t i o n of l e a d i n f e t a l t i s s u e s i s g e n e r a l , e x p o s i n g a l l major organ systems a t a v e r y c r i t i c a l d e v e l o p m e n t a l p e r i o d ( C a r p e n t e r , 1S74). Data g a t h e r e d from human s t u d i e s s u ggest 29 t h a t m a t e r n a l n u t r i t i o n d u r i n g t h e e a r l i e r p a r t o f pregnancy, p a r t i c u l a r l y the f i r s t t h r e e months when the unborn c h i l d i s most v u l n e r a b l e t o many k i n d s of e n v i r o n m e n t a l i n s u l t s and d i s r u p t i o n s , a f f e c t s f e t a l m o r t a l i t y and development ( A n n i s , 1978; H u r l e y , 1980).. S t u d i e s of m a t e r n a l and newborn b l o o d l e a d i n d i c a t e t h a t c o n c e n t r a t i o n s i n mothers and t h e i r newborns are not s i g n i f i c a n t l y d i f f e r e n t ( C a v a l l e r i e t a l . , 1978). I t has been suggested t h a t l e a d i s t r a n s f e r r e d from mother t o f e t u s by a p a s s i v e p r o c e s s . Lead does e n t e r the o f f s p r i n g through mother's m i l k but t h e mechanism of l e a d t r a n s p o r t i n t o m i l k i s s t i l l unknown. T h e . l a s t few months of l a c t a t i o n appear t o be t h e p e r i o d o f h i g h e s t a b s o r p t i o n o f l e a d from t h e g a s t r o i n t e s t i n a l t r a c t of l a c t a t i n g females ( K o s t i a l and M o m c i l o v i c 1974). The degree o f m a t e r n a l l e a d exposure i s d i r e c t l y r e f l e c t e d i n t h e . f e t a l l e a d e x p o s ure., Kuhnert e t a l . (1977) found t h a t even c o n c e n t r a t i o n s of l e a d n o r m a l l y found i n urban a r e a s i n h i b i t e d e r y t h r o c y t e a m i n o l e v u l i n i c a c i d d e h y d r a t a s e (ALAD) i n pregnant mothers and t h e i r f e t u s e s . 2-- ENVIRONMENTAL SOURCES FOR HUMAN INTAKE Lead, atomic number 82, b e l o n g s t o c l a s s 1VB on t h e p e r i o d i c t a b l e . I t i s r e a d i l y s o l u b l e i n hot n i t r i c a c i d and r e a c t s very s l o w l y w i t h water and a i r t o form l e a d h y d r o x i d e which i s a poi s o n o u s compound. Lead i s one of the seven m e t a l s of a n t i q u i t y and i t s d i s c o v e r y d a t e s back t o a t l e a s t 3500 B.C. The p r i n c i p a l s ource o f l e a d today i s t e t r a - e t h y l l e a d , an 30 a n t i - k n o c k c h e m i c a l added t o g a s o l i n e ( S c h r o e d e r , 1976). . Some ot h e r p r e s e n t day l e a d e m i s s i o n p r o d u c t s i n c l u d e l e a d b r o m o c h l o r i d e from e x h a u s t , l e a d s u l p h a t e from o r e s and l e a d o x i d e , a b y - p r o d u c t o f l e a d r e f i n i n g . Lead from d u s t , p l a s t e r , l e a d - c o n t a i n i n g g l a z e s cn p c t t e r y , p a i n t , paper and n e w s p r i n t can a l s o c o n t r i b u t e t o t o t a l body burden, e s p e c i a l l y i n c h i l d r e n who p r a c t i c e p i c a (Goyer and Rhyne 1973; Smith, 1976; Underwood, 1977; G r a n d j e a n , 1978; Gordon e t a l , , 1979). I n a d d i t i o n , d o m e s t i c water s u p p l i e d by s o f t water s t o r e d i n l e a d -l i n e d t a n k s and water p i p e s and a c i d i c f o o d s , e s p e c i a l l y canned baby f o o d s , p r e s e r v e d i n cans w i t h l e a d s o l d e r i n g have been shown t o make an e x c e s s i v e c o n t r i b u t i o n of t h e m e t a l t o humans (Go l d b e r g , 1974; Lead i n f o o d , 1976; Underwood, 1977; Moore e t a l . , 1979; Morse e t a l . , 1979), Movement of l e a d from i t s o r e s (galena) t o t h e atmosphere by i n d u s t r i a l and m a n u f a c t u r i n g p r o c e s s e s c o n t i n u e s through t o d e p o s i t i o n i n s o i l and r i v e r s , l a k e s and oceans. Lead e n t e r s the f o o d c h a i n and e v e n t u a l l y r e a c h e s humans i n v a r y i n g c o n c e n t r a t i o n s . T h i s depends on pH of s o i l and w a ter, a r a b i l i t y c f l a n d , s p e c i e s of p l a n t c r marine body, s e a s o n , and d i s t a n c e from e n v i r o n m e n t a l s o u r c e (Goyer, 1971; Goyer and Bhyne 1973; B e a v i n g t o n , 1975; Underwood, 1977; McDonald and Duncan 1978; Zimdahl e t a l . , 1978; B a r r y and C l a r k 1978). Lead does not appear t o be l o s t i n the m i l l i n g of f l o u r as w i t h o t h e r m i n e r a l s (Underwood, 1977). F r u i t s and v e g e t a b l e s c o n s t i t u t e the most i m p o r t a n t d i e t a r y s o u r c e o f l e a d (Mahaffey et a l . , 1975). I t i s apparent frcm t h e . f o r e g o i n g t h a t t h e r e i s a wide 31 d i s s e m i n a t i o n of l e a d i n t h e environment and i t s consequent s t o r a g e i n the human body p r e s e n t s a problem wi t h broad i m p l i c a t i o n s . i i THE TOXICITY OF LEAD A s u r v e y of t h e l i t e r a t u r e r e v e a l s t h a t the i n c i d e n c e o f l e a d p o i s o n i n g i s by no means a r e c e n t phenomenon. Lead i s one of the o l d e s t p o i s o n s known to humans. . S c a t t e r e d r e f e r e n c e s t o l e a d p o i s o n i n g have been found i n a n c i e n t m e d i c a l r e c o r d s , but i t was not u n t i l the development of the r a t h e r i m p r e s s i v e Roman l e a d t e c h n o l o g y t h a t l e a d assumed a pre-eminent p o s i t i o n . The Romans appear t o have had u n l i m i t e d use f o r t h i s metal. In a d d i t i o n t o the t o n s c f l e a d which were c o n t i n u a l l y mined, l e a d water systems were i n t r o d u c e d and b r o nze or copper c o o k i n g p o t s were c o a t e d w i t h l e a d or l e a d a l l o y s " . . . t o p r e v e n t l e a c h i n g of copper and s p o i l i n g the t a s t e of f o o d and a l s o t o p r e pare wine and grape sy r u p which was used almost e x c l u s i v e l y as a sweetening agent and p r e s e r v a t i v e . " (Waldron, 1973). The Romans were p r o b a b l y among the f i r s t people t o d e s c r i b e symptoms o f l e a d t o x i c i t y and t o suggest a n t i d o t e s and p r o t e c t i v e d e v i c e s a g a i n s t the " . . . n c x i o u s and d e a d l y vapour of the l e a d f u r n a c e . . . " , the water t h a t " . . . s h o u l d not be brought i n l e a d p i p e s i f (we) d e s i r e t o have i t wholesome...", and t h e " . . . e x c e s s i v e uses of (such) w i n e s . . . " from which " . . . a r i s e d a n g l i n g . . . p a r a l y t i c hands..." (Waldron, 1973). I n f a c t , G i l f i l l a n (1965) has i m p l i e d t h a t l e a d p o i s o n i n g was i n s t r u m e n t a l i n the f a l l c f Rome. 32 A l t h o u g h p a t h o l o g i c a l e f f e c t s of l e a d have been r e c o g n i z e d f o r more than 2000 y e a r s , i n c r e a s e d knowledge and awareness o f a c u t e l e a d i n t o x i c a t i o n have r e s u l t e d i n improved p r o t e c t i o n and s u r v e i l l a n c e o f i n d u s t r i a l workers and p u b l i c c oncern has encouraged i n d u s t r y t o improve methods of waste r e m o v a l . T h e r e f o r e , t o d a y , s p o r a d i c , o v e r t i n t o x i c a t i o n i s l a r g e l y a c c i d e n t a l o r r e s u l t s from i g n o r a n c e of t h e danger of l e a d . Q u e s t i o n s r e l a t e d to the c o n t i n u o u s s l i g h t l y e l e v a t e d d i s t r i b u t i o n o f t h i s metal i n the environment and p o t e n t i a l adverse h e a l t h e f f e c t s of s u b - c l i n i c a l body s t o r e s a r e a p r e s e n t - d a y concern (Goyer and Ehyne 1973). The c l i n i c a l s i g n s and symptoms of l e a d i n t o x i c a t i o n are p r i m a r i l y m a n i f e s t e d i n t h r e e organ systems: t h e c e n t r a l nervous s y s t e m , the h e m a t o p o i e t i c system and t h e k i d n e y (Goyer, 1971; Underwood, 1977; Mahaffey, 1977). The o n s e t o f l e a d p o i s o n i n g i s s l o w l y p r o g r e s s i v e and i s accompanied by many and v a r i e d b i o c h e m i c a l and c l i n i c a l m a n i f e s t a t i o n s (Goyer and Mahaffey 1972). The anemia o f l e a d p o i s o n i n g i s m i c r o c y t i c hypochromic and r e s u l t s from i m p a i r e d heme s y n t h e s i s and i n c r e a s e d f r a g i l i t y and s h o r t e n e d r e d b l o o d c e l l l i f e span (Goyer and Rhyne 1973; Underwood, 1977; Mahaffey, 1977; G r a n d j e a n , 1978; Gordon et a l . , 1979). Heme s y n t h e s i s i s a f f e c t e d p r i m a r i l y by t h e i n h i b i t i o n c f ALAD and f e r r o c h e l a t a s e , the enzyme c o n t r o l l i n g the i n c o r p o r a t i o n o f i r o n i n t o the heme m o l e c u l e . S i n c e t h e enzyme ALAD i s p a r t i c u l a r l y s e n s i t i v e t o l e a d , u r i n a r y and b l o o d c o n c e n t r a t i o n s c f the enzyme and i t s m e t a b o l i t e , d e l t a -a m i n o l e v u l i n i c a c i d have proven very u s e f u l f o r s c r e e n i n g 3 3 purposes. U r i n a r y and b l o o d f r e e e r y t h r o c y t e p r o t o p o r p h y r i n , a nother m e t a b o l i t e i n t h e heme s y n t h e s i s pathway which r e s u l t s from enzyme i n h i b i t i o n has a l s o been used t o i n d i c a t e l e a d t o x i c i t y ( Grandjean, 1S78) , However, i t i s known t h a t n e a r l y a l l the enzymes l e a d i n g t o heme s y n t h e s i s are i n h i b i t e d by l e a d i n t o x i c a t i o n (Smith, 1S76). Tephly e t a l . (1978) and K l a u d e r and P e t e r i n g (1977) suggest how l e a d may a l s o be a f f e c t i n g copper metabolism and t h e r e b y enhancing i r o n d e f i c i e n c y anemia. C h r o n i c l e a d t o x i c i t y can a l s o produce r e n a l t u b u l a r d y s f u n c t i o n w i t h a m i n o a c i d u r i a and g l y c o s u r i a . I t has been p o s t u l a t e d t h a t an impairment o f energy may be r e s p o n s i b l e f o r the reduced t r a n s p o r t f u n c t i o n of t h e k i d n e y and thus t h e a m i n o a c i d u r i a and g l y c o s u r i a i n l e a d t o x i c i t y , and t h a t energy impairment i n r e n a l m i t o c h o n d r i a may r e s u l t from t h e i r r e d u c e d cytochrome c o n t e n t (Underwocd, 1977) . Damage t o the c e n t r a l nervous system r e s u l t i n g i n l e a d e n c e p h a l o p a t h y and neuropathy i s t h e most prominent f e a t u r e i n c h i l d r e n p r o b a b l y due to the f a c t o r s i n f l u e n c i n g t h e i r low l e a d t o l e r a n c e . I n c h i l d r e n , c h r o n i c l e a d p o i s o n i n g i n v o l v e s p h y s i c a l b r a i n damage, accompanied by b e h a v i o u r a l p roblems, i n t e l l e c t u a l impairment and h y p e r a c t i v i t y . The mechanism by which l e a d a f f e c t s the nervous system i s l a r g e l y o b s c u r e , a l t h o u g h i t i s known to b l o c k i m p u l s e t r a n s m i s s i o n by r e d u c i n g a c e t y l c h o l i n e r e l e a s e . R e t a r d a t i o n o f b r a i n growth and a r e d u c t i o n i n t h e DNA c o n t e n t of the c e r e b e l l u m have a l s o been demonstrated i n l e a d - i n t o x i c a t e d s u c k l i n g r a t s (Chisholm, 1970; Underwood, 1977; Gr a n d j e a n , 1978; Gordon e t a l . , 1979; McCauley et a l . , 1979; B u l l e t a l . , 1979). 34 D e p o s i t i o n of l e a d i n the g i n g i v a and e p i p h y s i s of growing bone r e s u l t i n t h e f o r m a t i o n of c h a r a c t e r i s t i c " l e a d l i n e s " (Goyer, 1971; Gordon e t a l . , 1979). Lead i s a c u m u l a t i v e p o i s o n and i t t a k e s a p p r o x i m a t e l y t h r e e t i m e s l o n g e r to e x c r e t e than t o accumulate the same amount of l e a d ( M c m c i l o v i c , 1978) . Because t o l e r a n c e t o l e a d i s i n f l u e n c e d by so many f a c t o r s , i t i s e x t r e m e l y d i f f i c u l t t o d e f i n e a t h r e s h o l d o r " s a f e " l e v e l . . The J o i n t FAO/WHO E x p e r t Committee on Food A d d i t i o n s g i v e s a p r o v i s i o n a l t o l e r a b l e weekly i n t a k e of l e a d by a d u l t s as 3 mg per person o r 0.05 mg/kg body weight ( H u i s i n g h and H u i s i n g h 1974; M i n i s t r y o f H e a l t h , 1974; Underwood, 1977).. At p r e s e n t , no such t o l e r a n c e c o n c e n t r a t i o n s e x i s t f o r c h i l d r e n . Attempts have been made t o c a l c u l a t e p e r m i s s i b l e d i e t a r y i n t a k e of l e a d f o r young c h i l d r e n based on the J o i n t FAO/WHO E x p e r t Committee on Food A d d i t i o n s t o l e r a b l e d a i l y i n t a k e and a d u l t t o x i c i t y d a t a w i t h a d j u s t m e n t s f o r body s i z e and c a l o r i c r e q u i r e m e n t of c h i l d r e n . However, s i m p l y a d j u s t i n g t o l e r a b l e d a i l y e xposure t o r e f l e c t d i f f e r e n c e s i n body weight i s very l i k e l y not adequate as c h i l d r e n a r e known t o absorb a h i q h e r percentage of l e a d t h a n do a d u l t s , and t h e i r exposure through p l a y and e a t i n g o f non-food items i s much g r e a t e r ( K i n g , 1971; A l e x a n d e r , 1974; R i c e et a l . , 1978; Rosen and S o r e l l 1978; David et a l . , 1979; Rummo e t a l . , 1979). I n f a n t s may absorb even h i g h e r p e r c e n t a g e s o f i n g e s t e d l e a d t han do 2- t o 3 - y e a r - o l d c h i l d r e n (Forbes and Rei n a 1972; Jugo e t a l . , 1975; Jugo, 1977; Quarterman and M o r r i s o n 1978; Z i e g l e r et a l . , 1978; K o s t i a l e t a l . , 1579). I t has been s u g g e s t e d . 35 t h e r e f o r e , t h a t the t o l e r a b l e or maximal d a i l y i n t a k e of l e a d from a l l s o u r c e s f o r i n f a n t s between b i r t h and age 6 months s h o u l d be as low as p o s s i b l e and l e s s than 100 ug/day, and t h e i n t a k e s h o u l d be no more than 150 ug of lead/day f o r c h i l d r e n between 6 months and 2 y e a r s (Mahaffey, 1977). The 0.S P u b l i c H e a l t h S e r v i c e has a l s o s e t a d r i n k i n g water s t a n d a r d a t 50 u g / l i t e r of water (Mahaffey, 1977).. Ms. HEALTH AND THE ENVIRONMENT H e a l t h i s a matter of concern t o i n d i v i d u a l s , the p o p u l a t i o n as a whole, and r e s p o n s i b l e governmental a g e n c i e s . . H e a l t h i s a d i f f i c u l t matter t o d e f i n e . One approach i s t o c o n s i d e r h e a l t h as r e p r e s e n t a t i v e c f t h e degree t o which an organism i s i n harmony w i t h i t s environment.. Harmony must e x i s t between a l l a s p e c t s o f t h e ecosystem and humans. One can w e l l i m a g i n e t h a t harmony t o t h i s e x t e n t i s not e a s i l y a t t a i n e d or m a i n t a i n e d . A majcr source of d i s t u r b a n c e i n t h i s d e l i c a t e web of i n t e r r e l a t i o n s h i p s i s t h e i n c r e a s i n g c o n c e n t r a t i o n s of t r a c e e l e m e n t s i n the environment. M e t a l s are n o r m a l l y found i n the environment but i t i s t h e i r r e d i s t r i b u t i o n by human a c t i v i t i e s t h a t has caused problems (Dimer, 1973). Numerous l i n k s between h e a l t h and m i n e r a l c o n t a m i n a n t s have been proposed. I n a d d i t i o n , much a t t e n t i o n has r e c e n t l y been f o c u s e d upcn c h r o n i c l o w - l e v e l exposure w h i c h , by i t s e l f i n s u f f i c i e n t t o cause r e c o g n i z a b l e c l i n i c a l p o i s o n i n g , may n e v e r t h e l e s s be a s s o c i a t e d w i t h d e l e t e r i o u s e f f e c t s . A l l p l a n t s and a n i m a l s , i n c l u d i n g mammals and humans, 36 depend u l t i m a t e l y upon th e s o i l f o r t h e i r s u p p l y of m i n e r a l n u t r i e n t s (Underwood, 1971). The s o i l , i n t u r n , i s a f f e c t e d by elements i n the atmosphere, r a i n f a l l , l o c a t i o n i n terms o f wind and r a i n and a l s o by t h e p l a n t l i f e e x i s t i n g on the s o i l s . N u t r i t i o n a l m a l a d i e s may a r i s e from the i n a b i l i t y of the s o i l s t o s u p p l y , through t h e p l a n t s t h a t grow on them, the m i n e r a l r e q u i r e m e n t s of human and domestic a n i m a l s i n adequate, s a f e or n o n t o x i c amounts and i n proper p r o p o r t i o n s . P l a n t s a r e a f f e c t e d more by i n t e r f e r e n c e o f heavy m e t a l s w i t h normal p r o c e s s e s of d e c o m p o s i t i o n of a n i m a l and v e g e t a b l e m a t t e r r a t h e r t h a n by d i r e c t a c t i o n on p l a n t s t h e m s e l v e s . For example, moderate amounts of p o l l u t a n t s are s u f f i c i e n t t o reduce t h e s u p p l y c f n i t r o g e n a v a i l a b l e t o the p l a n t by i n t e r f e r i n g w i t h normal c o n v e r s i o n p r o c e s s e s i n d e c a y i n g o r g a n i c matter (Cook, 1976). Simple g r o s s d e f i c i e n c i e s o r e x c e s s e s of a s i n g l e element may o c c u r , but d e f i c i e n c i e s o r i e x c e s s e s of a s i n g l e element a r e very o f t e n i n f l u e n c e d by the e x t e n t t o which e t h e r m i n e r a l s , n u t r i e n t s or o r g a n i c f a c t o r s a r e p r e s e n t i n the environment and t h e i r c a p a b i l i t y t o modify u t i l i z a t i o n of t h a t element (Underwood, 1971). Thus, i t i s o b v i o u s t h a t t h e - i n t e r r e l a t i o n s h i p s of a l l components of t h e ecosystem w i t h each o t h e r and w i t h humans i s e x t r e m e l y complex. Changes i n s o c i o - c u l t u r a l s t r u c t u r e , r e s u l t i n g from i n c r e a s e d i n d u s t r i a l i z a t i o n or through a d o p t i o n of new l i f e s t y l e s t o accommodate change brought about by moving from one a r e a t c a n o t h e r w i t h d i f f e r e n t c h a r a c t e r i s t i c s have a l s o been shown t c a f f e c t exposure t o heavy metal c o n t a m i n a t i o n . S t u d i e s i n A u s t r a l i a have shown t h a t c o n c e n t r a t i o n s of m i n e r a l s 37 i n s o i l , herbage, v e g e t a b l e s and r a i n w a t e r c o r r e l a t e s i g n i f i c a n t l y w i t h d i s t a n c e from a copper s m e l t e r and s t e e l w o r k s ( B e a v i n g t o n , 1975; B e a v i n g t o n , 1975; B e a v i n g t o n , 1977).. S i m i l a r l y , c r o p s growing b e s i d e a motorway were shown t o c o n t a i n more l e a d than a s i m i l a r c r o p growing near a l e s s busy r o a d . the l e a d c o n t e n t of c r o p s growing w i t h i n a s h o r t d i s t a n c e from the motorway i n c r e a s e d with t ime (McLean and S h i e l d s 1977) . The e f f e c t of d i s t a n c e from i n d u s t r i a l o p e r a t i o n s on m e t a l c o n t a m i n a t i o n t o humans has a l s o been w i d e l y i n v e s t i g a t e d , p a r t i c u l a r l y w i t h r e s p e c t t o l e a d . L i l i s e t a l . (1977) d i s c o v e r e d t h a t employees o f two secondary l e a d s m e l t e r s e x h i b i t e d a h i g h p r e v a l e n c e of l e a d d i s e a s e o c c u r r i n g even a f t e r one y e a r or l e s s o f l e a d e x p o s u r e . Needleman and S h a p i r o (1974) found s u b s t a n t i a l l y h i g h e r d e n t i n l e a d c o n c e n t r a t i o n s i n t e e t h from urban c h i l d r e n l i v i n g i n d e t e r i o r a t e d h o u s i n g or a t t e n d i n g s c h o o l i n p r o x i m i t y t o a major manufacturer of p a i n t and l e a d p r o d u c t s t h a n i n t e e t h from c h i l d r e n c o n s i d e r e d t o be a low r i s k f o r e x c l u s i v e l e a d e x posure. Other i n v e s t i g a t o r s have proceeded w i t h s i n i l a r s t u d i e s which have produced t h e same t r e n d ( C a p r i o e t a l . , 1974; Habercam e t a l . , 1974; L o c k e r e t z , 1975; Mackie et a l . , 1977; S t e w a r t , 1979). Comparison of l e a d c o n t e n t of t e e t h from a contemporary p o p u l a t i o n of n o n - i n d u s t r i a l i z e d I n d i a n s of the Lacandon F o r e s t i n Mexico w i t h a modern urban i n d u s t r i a l p o p u l a t i o n shows a 45-f o l d d i f f e r e n c e i n median t o o t h l e a d l e v e l ( S h a p i r o e t a l . , 1975) . K u h n l e i n and C a l l o w a y (1977) a l s o demonstrated t h a t change 38 i n d i e t and c o c k i n g h a b i t s are r e f l e c t e d i n t o o t h l e a d c o n c e n t r a t i o n s . , Teeth from 17th c e n t u r y and contemporary Hopi I n d i a n s were c o l l e c t e d and a n a l y z e d i n c o n j u n c t i o n w i t h a n a l y s i s of d i e t a r y h a b i t s and food c o m p o s i t i o n . I n c r e a s e d l e a d consumption i n the contemporary d i e t and i n c r e a s e d e n v i r o n m e n t a l exposure t o t h e metal c o r r e s p o n d e d w i t h i n c r e a s e d l e a d c o n c e n t r a t i o n s of d e n t i n . C o n v e r s e l y , a decrease i n the consumption c f s t r o n t i u m was r e f l e c t e d i n t h e contemporary t e e t h compared to a n c i e n t Hopi t e e t h . C u l t u r a l i n f l u e n c e s on t r a c e element a c c u m u l a t i o n have a l s o been i n v e s t i g a t e d by Steadman e t a l . (1959), A t t r a m a d a l and Jonsen (1978), and Hecker et a l . , (1974). E n v i r o n m e n t a l and d i e t a r y d i f f e r e n c e s were found t o i n f l u e n c e body burden of l e a d i n i n h a b i t a n t s of f o u r d i f f e r e n t g e o g r a p h i c a l a r e a s i n Japan (Kaneko e t a l . , 1974). These and o t h e r s t u d i e s r e v e a l t h a t i n c r e a s e d i n d u s t r i a l i z a t i o n and u r b a n i z a t i o n has c o n t r i b u t e d t o a widespread i n c r e a s e i n t r a c e element exposure and a l s o h i g h l i g h t the e f f e c t s of change i n s o c i o - c u l t u r a l s t r u c t u r e and d i e t . . f i - DECIDUOUS TEETH AS INDICATORS OF LEAD X ZINC AND COPPER IN THE BODY L i t e r a t u r e cn t r a c e e l e m e n t s has become c o n s i d e r a b l y more predominant i n the l a t t e r h a l f o f t h e 20th c e n t u r y . A l t h o u g h t e c h n i c a l and i n d u s t r i a l uses o f met a l s were r e c o g n i z e d f o r c e n t u r i e s , t h e i r i m p o r t a n c e i n t h e maintenance o f human h e a l t h 39 remained r e l a t i v e l y u n e x p l o r e d u n t i l t h e p r e s e n t c e n t u r y when th e y q u i c k l y became the s u b j e c t of f r e q u e n t i n v e s t i g a t i o n . M e t a b o l i c r o l e s f o r some o f the t r a c e e lements have been d e l i n e a t e d and much work has been done t o r e f i n e methods o f a n a l y s i s i n o r d e r t o c o n t r i b u t e t o the d e a r t h o f knowledge i n t h i s very i m p o r t a n t area of human n u t r i t i o n . Trace elements are a l s c v i t a l t o the w e l l - b e i n g of p l a n t s and a n i m a l s . I ndeed, t h e e s t a b l i s h m e n t o f t h e im p o r t a n c e of t r a c e elements t o humans has e v c l v e d from e x p e r i m e n t a t i o n w i t h p l a n t s and a n i m a l s . . For t h e purposes of t h i s r e v i e w , a t t e n t i o n w i l l f o c u s on t h e i r r e l e v a n c e t o humans. U n t i l r e c e n t l y , most of t h e r e s e a r c h on t r a c e elements has been devoted t o d e t e r m i n i n g i f they are e s s e n t i a l , how they f u n c t i o n and a t what l e v e l they s h o u l d e x i s t f o r " o p t i m a l " b i o l o g i c a l f u n c t i o n i n g . Mertz (1975) d e s c r i b e s some of the f a c t o r s t o be c o n s i d e r e d when a t t e m p t i n g t o i n v e s t i g a t e the r e l a t i o n s h i p between t r a c e e lements and h e a l t h and the environment. F i r s t c f a l l , t o d e t e c t a b n o r m a l i t y , one must d e f i n e what i s " n ormal". N o r m a l i t y i s a t h e o r e t i c a l concept based on the g o a l o f o p t i m a l f u n c t i o n and o f p e r f e c t h e a l t h ( M e r t z , 1975). S e l e c t i o n of a m e a n i n g f u l t i s s u e which r e f l e c t s d e f i c i e n t o r e x c e s s i v e e n v i r o n m e n t a l exposure i s paramount t o t h e a c q u i s i t i o n c f u s e f u l i n f o r m a t i o n frcm t r a c e element a n a l y s e s (Fosse and J u s t e s e n 1978). To d e t e c t e x c e s s i v e e x p o s u r e s , one chooses t i s s u e s which s e q u e s t e r and r e t a i n e l e m e n t s . The l u n g , k i d n e y , n a i l s and h a i r a re some examples of such t i s s u e s . T i s s u e s i n v o l v e d i n t r a n s p o r t or s t o r a g e , such as body f l u i d s 40 and bone marrow and c o r t e x a r e a l s o u s e f u l . The e l e v a t e d c o n c e n t r a t i o n s of t r a c e elements i n most t i s s u e s caused by i n g e s t i o n of t h e m e t a l s v a r y a c c o r d i n g t o t h e l e n g t h and i n t e n s i t y of e x posure. B l o o d serum o r plasma a r e t h e most f r e q u e n t l y a n a l y z e d samples, p a r t i c u l a r l y when d i a q n o s i n g a c u t e o r c h r o n i c l e a d p o i s o n i n g . . These measurements a r e good i n d i c a t i o n s i n a c u t e c a s e s b u t , because b l o o d c o n c e n t r a t i o n s are t r a n s i t o r y r t h e y a r e of l i t t l e v a l u e i n " e s t i m a t i n g p a s t e x p o s u r e , body burden o r c h r o n i c low-dose a c c u m u l a t i o n (Needleman and S h a p i r o 1973).. I n a d d i t i o n , t h e r e are o t h e r m e d i a t i n g f a c t o r s which make plasma or serum v a l u e s d i f f i c u l t t o i n t e r p r e t (Sinha and G a b r i e l i 1970; V i t a l e e t a l . , 1975; Solomons, 1979). H a i r a n a l y s e s do not always r e f l e c t t o t a l body s t o r e s . . The a n a l y s i s of z i n c i n h a i r has demonstrated t h a t the c o n c e n t r a t i o n s are much more r e f l e c t i v e of d i e t a r y i n t a k e t h a n t i s s u e s t o r e s and depend not o n l y on d e l i v e r y o f z i n c t o t h e r o o t , but a l s o on t h e r a t e of h a i r growth (Solomons, 1979). I n a d d i t i o n , h a i r a n a l y s e s r e q u i r e l a r g e samples and p a r t i c u l a r a t t e n t i o n must be p a i d t o t h e l e n g t h of h a i r t a k e n , d i s t a n c e away from s c a l p of the sample, beauty t r e a t m e n t a p p l i e d t o t h e h a i r , sample p r e p a r a t i o n and o t h e r i n f l u e n c i n g f a c t o r s (McKenzie, 1978; Deeming and Weber 1978; Jacob et a l . , 1978). I t has been shown t h a t l e a d can exchange w i t h c a l c i u m i n c a l c i f i e d t i s s u e ( S h a p i r o e t a l . , 1975; Moore e t a l . , 1978). More than 90% of the body t u r d e n o f l e a d i s s e q u e s t e r e d i n t h e s k e l e t o n and t e e t h ( C a r r o l l et a l . , 1971; Grandjean and Holma 1973). Z i n c a l s o r e a d i l y a c c u m u l a t e s i n the s k e l e t o n and i n 41 t e e t h and competes w i t h c a l c i u m i n t h e f o r m a t i o n of a p a t i t e ( B r u d e v o l d et a l . , 1960; Steadman e t a l . , 1963).. Copper i s found i n s i g n i f i c a n t amounts i n c a l c i f i e d t i s s u e . I t i s b e l i e v e d t h a t i t s presence i n bone and t e e t h may s i g n i f y t h a t copper has an i m p o r t a n t r o l e i n t h e i r f o r m a t i o n ( B r u d e v o l d and Steadman 1955). I n a d d i t i o n , one of the f u n c t i o n s o f the m i n e r a l phase of bone i s t o remove t o x i c or h a r m f u l i o n s such as l e a d and r a d i o s t r o n t i u m from the f l u i d s ( V o g e l , 1968).. Hence, bone and t e e t h may p r o v i d e v a l u a b l e i n f o r m a t i o n w i t h r e s p e c t to the a c c u m u l a t i o n of l e a d , copper and z i n c i n t h e human body (Chatman and W i l s o n 1975; Mackie e t a l . , 1977). The use c f bene as an i n d i c a t o r poses two problems. F i r s t , bone i s s u b j e c t to a c o n t i n u a l r e m o d e l l i n g p r o c e s s . S e c o n d l y , t h e r e are p r a c t i c a l d i f f i c u l t i e s w i t h o b t a i n i n g bone samples from human s u b j e c t s ( S t e w a r t , 1974; S h a p i r o e t a l . , 1975). T e e t h , e s p e c i a l l y deciduous t e e t h , u n l i k e bone, are more r e a d i l y a v a i l a b l e ; t hey are more p h y s i c a l l y s t a b l e and cause the m e t a l s t c be more e x t e n s i v e l y r e t a i n e d . They a l s o have f i x e d t i m e s cf f o r m a t i o n and e x f o l i a t i o n and a r e r e p l a c e a b l e ( A l t s h u l l e r e t a l . , 1962; S h a p i r o e t a l . , 1972; B l o c h e t a l . , 1976; A t t r a m a d a l and Jonsen 1976; Mackie e t a l . , 1977). Steadman e t a l . (1959) s t u d i e d t r a c e elements i n a n c i e n t I n d i a n t e e t h . . They found t h a t c o p p e r , l e a d and z i n c o ccur i n g r e a t e r c o n c e n t r a t i o n s i n the o u t e r than i n t h e i n n e r p o r t i o n of enamel. F l u o r i d e was found i n g r e a t e s t c o n c e n t r a t i o n i n the e x t e r n a l enamel, f o l l o w e d by z i n c , s i l i c o n , manganese, l e a d , s i l v e r , copper and t i n . The same p a t t e r n of d i s t r i b u t i o n was observed i n the r o o t s (except f o r manganese). There were 42 g e n e r a l l y g r e a t e r c o n c e n t r a t i o n s i n d e n t i n than i n enamel.. The a c q u i s i t i o n of most elements i s c o n f i n e d t o the o u t e r p o r t i o n of the t o o t h and p e n e t r a t i o n i n t o t h e t o o t h i s an e x c e e d i n g l y slow p r o c e s s (Steadman e t a l . , 1959). D e r i s e and E i t c h e y (1974) a n a l y z e d m i c r o m i n e r a l s i n c l u d i n g l e a d , copper and z i n c i n permanent sound t e e t h from 175 p a t i e n t s of v a r y i n g ages. They found c o p p e r , z i n c and l e a d t o be p r e s e n t i n l a r g e r c o n c e n t r a t i o n s i n the enamel p o r t i o n than i n t h e d e n t i n . I t was a l s o noted t h a t l e a d i n c r e a s e d i n enamel w i t h age but d ecreased i n d e n t i n . W e a t h e r e l l and Eobinson (1973) have composed a r e f e r e n c e d t a b l e o f c o n c e n t r a t i o n s c f t r a c e elements n o r m a l l y found i n enamel and d e n t i n c f human t e e t h . A c c o r d i n g t o t h i s t a b l e , copper i n enamel has been found i n t h e range of 0.3 ppm t o 162 ppm and i n d e n t i n , r a n g i n g from 0.2-100 ppm.. Z i n c i n enamel ranges from 190-2100 ppm and from l e s s than 10-1400 ppm i n d e n t i n . Lead e x i s t s i n enamel frcm l e s s than 10-550 ppm and from 1-10 ppm i n d e n t i n . Z i n c was found i n t e e t h i n c o n c e n t r a t i o n s second o n l y t o f l u o r i d e ( B r u d e v o l d e t a l . , 1960). Z i n c and l e a d appear t c accumulate i n s u r f a c e s t r u c t u r e s of t e e t h and o c c u r i n lower c o n c e n t r a t i o n s i n sub-s u r f a c e m a t e r i a l . Copper does not vary g r e a t l y i n i t s d i s t r i b u t i o n i n t e e t h (Erudevold et a l . , 1960). Uptake of t r a c e elements i n t o t e e t h i s g r e a t e s t d u r i n g t i s s u e f o r m a t i o n when they are i n c o r p o r a t e d by a c c r e t i o n and i o n i c exchange r e a c t i o n s . When c r y s t a l growth has c e a s e d , i o n i c exchange between i o n s i n t h e e x t r a c r y s t a l l i n e water and t h o s e i o n s i n the c r y s t a l l i t e s u r f a c e c o n t i n u e s ( W e a t h e r e l l and 43 Robinson 1S73). Thus, the c o n t e n t of some t r a c e elements i n t e e t h may g i v e a u s e f u l i n d i c a t i o n of t h e t o t a l amount accumulated i n t h e body over a l i f e t i m e . The d i s t r i b u t i o n between enamel and d e n t i n can a l s o p r o v i d e i n f o r m a t i o n which would determine whether the main c o n t e n t was e s t a b l i s h e d e a r l y or l a t e r i n l i f e . M a l i k and F r e m l i n (1974) d e s c r i b e a t e c h n i g u e by which the d i s t r i b u t i o n of l e a d and the l e a d c o n t e n t i n human t e e t h i s measured by means of 3 H e + a c t i v a t i o n a n a l y s i s . The t e e t h are l o n g i t u d i n a l l y s e c t i o n e d and p o l i s h e d and i r r a d i a t e d f o r about 6 hours. An a u t o r a d i o g r a p h i s t a k e n of the i r r a d i a t e d t o o t h samples. The a u t o r a d i o g r a p h i s then scanned by an o p t i c a l m i c r o s c o p e . The r e s u l t s pf the scan produce th e p a t t e r n of l e a d d i s t r i b u t i o n i n the t o o t h sample. S h a p i r o e t a l . (1973) d e s c r i b e a s i m i l a r t e c h n i q u e which makes i t p o s s i b l e t c determine th e l o c a t i o n o f l e a d i n the t o o t h . Use of both deciduous and permanent t e e t h t o r e f l e c t e xposure to and a c c u m u l a t i o n of c e r t a i n t r a c e elements i n humans i s an i n c r e a s i n g l y p o p u l a r i d e a . Tooth l e a d , copper and z i n c c o n c e n t r a t i o n s have shewn s i g n i f i c a n t c o r r e l a t i o n s w i t h g e o g r a p h i c l o c a t i o n , d i e t , u r b a n i z a t i o n and i n d u s t r i a l i z a t i o n . (Needleman and S h a p i r o 1973; Kaneko e t a l . , 1974; C a p r i o e t a l . , 1974; de l a Burde and S h a p i r o 1975; Lakomaa and Kytomaa 1977; K u h n l e i n and C a l l o w a y 1977; Fosse and J u s t e s e n 1978; Moore e t a l . , 1978; S h a p i r o e t a l . , 1978). The use of t e e t h as i n d i c a t o r s s h o u l d n o t , however, be e x p e c t ed t c p r o v i d e a complete p i c t u r e . Confounding f a c t o r s such as d i f f e r e n t a n a l y t i c a l and t o o t h c o l l e c t i o n methods, c o n t a m i n a t i o n problems i n h e r e n t i n t h e d e t e r m i n a t i o n of t r a c e 44 e l ements, age and n u t r i t i o n a l s t a t u s of the t o o t h donor and p o s s i b l e c o - e x i s t i n g d i s e a s e may a c t i n d e p e n d e n t l y or t o g e t h e r t o i n f l u e n c e net o n l y t o o t h c o n c e n t r a t i o n s but c l i n i c a l and m e t a b o l i c changes as w e l l . T h e r e f o r e , i t would seem p r a c t i c a l t o compare t o o t h c o n c e n t r a t i o n s w i t h o t h e r e s t a b l i s h e d c l i n i c a l and b i o c h e m i c a l c r i t e r i a t o e s t i m a t e t o t a l tody burden of t r a c e elements. For example, the use of t o o t h c o n c e n t r a t i o n s t o i n d i c a t e e n v i r o n m e n t a l exposure would n e c e s s i t a t e comparison of d a t a w i t h c o n c e n t r a t i o n s found i n a i r , water and f o o d . E s t i m a t i o n o f i n d i v i d u a l body burden i s dependent not o n l y on t o o t h c o n c e n t r a t i o n s but on e x t e n s i v e p e r s o n a l h i s t o r i e s and t e s t s u s i n g b l o o d , u r i n e and p o s s i b l e b e h a v i o u r a l p r e d i c t o r s . As noted above, s t u d i e s ccmparing a l l t h e s e parameters w i t h t r a c e element c o n c e n t r a t i o n s i n t e e t h c o n f i r m t h a t t e e t h do p r o v i d e v a l u a b l e i n f o r m a t i o n w i t h r e g a r d to i n d i v i d u a l body burden and degree c f e n v i r o n m e n t a l exposure . o f s e l e c t e d p o p u l a t i o n s . <2A NUTRITION OF SCHOCLAGE CHILDREN As mentioned p r e v i o u s l y , f o o d and d r i n k c o n s t i t u t e t h e main sou r c e from which t r a c e elements are i n t r o d u c e d t o t h e body. C h i l d r e n , p a r t i c u l a r l y t h o s e who l i v e i n o l d houses and/or near busy roadways or i n d u s t r y , through i n v e s t i g a t i v e p l a y , a r e prcne to t h e a d d i t i o n a l i n g e s t i o n of non-food i t e m s which a r e metal c o n t a m i n a t e d ( C a p r i o e t a l . , .1974; L o c k e r e t z , 1975). T h i s problem does not u s u a l l y a p p l y t o copper and z i n c but i t i s v e r y p e r t i n e n t w i t h r e s p e c t t o l e a d . I n a d d i t i o n t o 45 the i n c r e a s e d exposure o f c h i l d r e n t o metal c o n t a m i n a t i o n , t h e metabolism and d i s t r i b u t i o n o f metals appears t o be d i f f e r e n t i n c h i l d r e n ( K o s t i a l e t a l . , 1979). H i g h l y e f f i c i e n t a b s o r p t i o n and r e t e n t i o n of l e a d by young c h i l d r e n i s th o u g h t t o be p a r t l y r e s p o n s i b l e f o r the h i g h p r e v a l e n c e of l e a d i n t o x i c a t i o n i n c h i l d r e n ( Z i e g l e r e t a l . , 1978). Indeed, i n f a n t s and c h i l d r e n appear t o be much more s e n s i t i v e t o t h e e f f e c t s o f e l e v a t e d l e a d c o n c e n t r a t i o n s , p a r t i c u l a r l y w i t h r e f e r e n c e t o the c e n t r a l nervous system (Needleman and S h a p i r o 1974; Rosen and S o r e l l 1978; Needleman e t a l . , 1979). I t has been demonstrated t h a t c h e l a t i n g agents are l e s s e f f e c t i v e i n c h i l d r e n than i n a d u l t s ; t h u s , not o n l y are c h i l d r e n more l i k e l y t o become i n t o x i c a t e d , t hey a r e a l s o more r e s i s t a n t t o t h e r a p y {Jugo e t a l . , 1975). While the problem with l e a d c c n c e r n s i t s t o x i c i t y , i t i s the d e f i c i e n c y of the o t h e r two elements of c o n c e r n i n t h i s s t u d y , c o p p e r and z i n c , which i s more l i k e l y t o produce d e l e t e r i o u s e f f e c t s on h e a l t h . Z i n c and copper both p e r f o r m e s s e n t i a l f u n c t i o n s and have even more s i g n i f i c a n c e f o r i n f a n t s and c h i l d r e n who e x p e r i e n c e p e r i o d s of r a p i d growth and are c o n s t a n t l y i n t h e p r o c e s s of development. I t s h o u l d be p o i n t e d out t h a t , a l t h o u g h z i n c and copper must be p r e s e n t i n t h e d i e t i n adeguate amounts, an e x c e s s can a l s o be p o t e n t i a l l y dangerous. I t has been demonstrated, f o r example, t h a t a h i g h z i n c : c o p p e r r a t i o can produce h y p e r c h o l e s t e r o l e m i a i n r a t s ( K l e v a y , 1975). A h i g h z i n c : c o p p e r r a t i o can a l s o r e s u l t i n decreased a b s o r p t i o n and u t i l i z a t i o n of copper ( H a l l , 1979). I n t e r a c t i o n s between z i n c and l e a d , l e a d and copper, and 46 between o t h e r d i e t a r y c o n s t i t u e n t s and t h e m i n e r a l s have been o u t l i n e d i n t h e p r e v i o u s s e c t i o n s o f t h i s r e v i e w . Good d i e t a r y h a b i t s and sound n u t r i t i o n a l s t a t u s appear t o be e x t r e m e l y i m p o r t a n t f a c t o r s which i n f l u e n c e t h e s u s c e p t i b i l i t y of an i n d i v i d u a l t o the e f f e c t s of m i n e r a l t o x i c i t y o r d e f i c i e n c y . I t i s o f i n t e r e s t , t h e n , t o e x p l o r e t h e l i t e r a t u r e d e a l i n g w i t h e a t i n g h a b i t s and n u t r i t i o n a l s t a t u s of i n f a n t s and c h i l d r e n . Sex, age, we i g h t , e n v i r o n m e n t , g e o g r a p h i c l o c a t i o n and s o c i o - economic f a c t o r s have a l l been found t o i n f l u e n c e l i f e t i m e e a t i n g h a b i t s (Samuelson e t a l . , 1971; Schlage and Wortberg 1972; Cook e t a l . , 1973; Jacoby e t a l . , 1973; N u t r i t i o n Canada, 1976).. The mean d i e t a r y i n t a k e r e p o r t e d f o r Canadian c h i l d r e n aged 5-11 ye a r s exceeded the recommended i n t a k e s o f a l l n u t r i e n t s e x c e p t f r e e f o l a t e . D a i r y p r o d u c t s appeared t o make the h i g h e s t n u t r i e n t c o n t r i b u t i o n s . C a l o r i c i n t a k e s were g r e a t e s t at meal t i m e s w i t h 155? d u r i n g the morning meal p e r i o d , 30% at neon and 33% d u r i n g the e v e n i n g meal p e r i o d ( N u t r i t i o n Canada, 1976). These r e s u l t s de not r e f l e c t what i s g e n e r a l l y r e p o r t e d i n the l i t e r a t u r e . C h i l d r e n i n t h i s age group t e n d t o be below t h e recommended c a l o r i c i n t a k e and have more t h a n adeguate t o very h i g h c o n c e n t r a t i o n s of p r o t e i n i n t h e i r d i e t s . Ecys tend t o consume more p r o t e i n than g i r l s , f r u i t s and v e g e t a b l e s are not v e r y p o p u l a r i t e m s , and t h e r e appears t o be an i n c r e a s e d r e l i a n c e on snacks as n u t r i e n t s o u r c e s (Robson, 1971; Peckcs and Ross 1973; Wai t , 1973; Beyer and M o r r i s 1974; Smith and J u s t i c e 1979). T h i s p a t t e r n o f consumption appears to be t h e r e s u l t of cha n g i n g l i f e s t y l e s w i t h i n c r e a s i n g dependence on f a s t food o u t l e t s , g r e a t e r 47 numbers of women e n t e r i n g t h e work f o r c e , g r e a t e r freedom o f food c h o i c e f c r c h i l d r e n b e g i n n i n g a t an e a r l i e r age, and an i n c r e a s i n g f r e g u e n c y of meals e a t e n away from home (Eobson, 1971; Shaw, 1979).. These f a c t o r s a r e i m p o r t a n t c o n s i d e r a t i o n s s i n c e the f a m i l y i s a g u i d i n g f o r c e i n the l i f e o f a c h i l d and f a m i l y s t r u c t u r e and i n t e r a c t i o n c o n t r i b u t e s i g n i f i c a n t l y t o the f o r m a t i o n o f l i f e l o n g h a b i t s i n c l u d i n g t h o s e t h a t a f f e c t f o o d c h o i c e and n u t r i t i o n (Eobson, 1971; Beyer and M o r r i s 1974; Bu r t and H e r t z l e r 1979; H e r t z l e r and Vaughan 1979; Yperman and Vermeersh 1979).. L i f e t i m e e a t i n g h a b i t s i n t u r n have pro f o u n d e f f e c t s on t h e h e a l t h and p h y s i c a l w e l l - b e i n g of an i n d i v i d u a l . 48 CHAPTEE I I I POPULATION AND SAMPLE i i DESCRIPTION OF POPULATION JL KAMLOOPS I n c o r p o r a t e d i n 1893, Kamloops has an a r e a o f 76,953.6 a c r e s (31,141.6 h a ) . . Ey highway, th e c i t y i s 264 m i l e s (425 km) n o r t h e a s t c f Vancouver, 392 m i l e s (631 km) west of C a l g a r y and 506 m i l e s (814 km) southwest of Edmonton. ( B r i t i s h Columbia R e g i o n a l I n d e x , 1978). . I n 1976, t h e p o p u l a t i o n o f t h e c i t y of Kamlccps t o t a l l e d 58,311. T a b l e 1 shows Kamloops p o p u l a t i o n by area i n 1976 and a l s o i n d i c a t e s the r a t e o f growth from 1971 to 1976 (Kamplan, 1979). Between 1971 and 1976, t h e r e was a 19.8% i n c r e a s e i n p o p u l a t i o n . On the s o u t h s h o r e , t h e m a j o r i t y of t h e growth o c c u r r e d i n t h e s o u t h w e s t , and i n t h e D a l l a s and B a r n h a r t v a l e a r e a s . On the n o r t h s h o r e , growth o c c u r r e d m a i n l y i n the B r o c k l e h u r s t and Westsyde a r e a s . D i s t r i b u t i o n o f the Kamloops p o p u l a t i o n by age and sex i s shown i n Table 2. ( B r i t i s h Columbia R e g i o n a l I n d e x , 1978). I n 1976, t h e r e were 14,575 f a m i l i e s w i t h an average of 3.5 p e r s o n s / f a a i l y . Table 3 shows Annual M i g r a t i o n V a l u e s , 1971 t o 1976 (Kamplan, May 1979). As can be s e e n , t h e r e i s a very h i g h i n -m i g r a t i o n t o Kamloops i n the young f a m i l y and l a t e - a d o l e s c e n t y e a r s of the l i f e c y c l e . I n a d d i t i o n , t h e r e i s a s m a l l o u t -m i g r a t i o n cf c o u p l e s a t the p r e - r e t i r e m e n t s t a g e o f the f a m i l y Table 1 Kamloops P o p u l a t i o n Growth, by Area, 1971 t o 1976 Area 1971 1973 1976 Kamloops South 11, 869 11,530 11,505 Southwest 372 360 2,50 2 J u n i p e r - B o s e H i l l — 150 • 149 V a l l e y v i e w 3, 786 3, 676 3,547 D a l l a s 1, 228 1,888 1,99 1 B a r n h a r t v a l e 806 1 ;800 2, 548 South Shore 18, 061 19,404 22,242 Kamloops North 13, 959 14,443 12,784 B r o c k l e h u r s t 7, 943 10,542 12,059 T r a n q u i l l e 1, 696 787 488 Westmount—Batchelor H i l l s 665 1,614 1,765 Westsyde 2, 851 5,428 6,761 Noble Creek Area — 309 473 North Shore 27, 114 33,123 34,330 E a y l e i g h 713 882 1, 189 H e f f l e y Creek 888 525 550 North Thompson 1, 776 1,407 1,739 TOTAL 46, 776 53,934 58,311 from Kamplan, 1979 50 Table 2 Kamloops P o p u l a t i o n by Sex and Age Groups Age Group T o t a l Male Female T o t a l 67,255 33,980 33, 290 0- 4 5,605 2,870 2,655 5-14 13,655 7,005 6,650 15-24 13,225 6,440 6,740 25-3 4 11,575 5,710 5,875 35-44 8,520 4,450 4, 115 45-54 6,870 3,560 3, 320 55-6 4 4,235 2, 180 2,075 65 and over 3,610 1 ,775 1,810 from B.C. R e g i o n a l Index, 1978. Table 3 Annual M i g r a t i o n V a l u e s , 1971 t o 1976 i n Kamloops Annual Net M i g r a t i o n V a l u e s Age Group Female Male 0- 4 50 57 5- 9 150 150 10-14 95 75 15-19 80 58 20-2 4 101 49 25-29 141 121 30-3 4 94 63 35-3 9 51 56 40-4 4 34 34 45-4 9 16 9 50-5 4 28 0 55-59 -14 -3 60-6 4 11 -10 65 + 37 24 Annual Gross M i g r a t i o n V a l u e s 874 689 from Kamplan, 1979 - v a l u e s i n d i c a t e c u t - m i g r a t i o n a l l o t h e r v a l u e s i n d i c a t e i n - m i g r a t i o n 52 c y c l e , and an i n - m i g r a t i c n o f the e l d e r l y s e e k i n g r e t i r e m e n t g u a r t e r s . T r a d i t i o n a l l y , the economy was based on a g r i c u l t u r e and the r a i l w a y s . S i n c e the r a p i d growth of the f o r e s t i n d u s t r i e s and mining ever the p a s t 2 decades, however, primary and secondary m a n u f a c t u r i n g a c t i v i t i e s now predominate. The l e a d i n g employer i s Weyerhaeuser Canada L i m i t e d w i t h a l a r g e p u l p m i l l and s a w m i l l . I n a d d i t i o n , t h e r e are 2 plywood p l a n t s and a number o f s a w m i l l s . I n 1976, t h e r e were 269 census farms {those o f one a c r e or more, w i t h s a l e s c f $1,200 or more i n 1975) c o v e r i n g 420,840 a c r e s . A l t h o u g h f r u i t and v e g e t a b l e p r o d u c t i o n was once an i m p o r t a n t s o u r c e o f revenue, beef p r o d u c t i o n remains t h e p r i m a r y a g r i c u l t u r a l a c t i v i t y . F i s h , p a r t i c u l a r l y t r o u t , are a l s o i n good s u p p l y i n t h e hundreds o f l a k e s i n the Kamloops a r e a . . H u n t i n g i s a l s o p o p u l a r . Many n o n - f o r e s t r y m a n u f a c t u r e r s i n c l u d e a r e f i n e r y ( G u lf O i l Canada L i m i t e d ) , a cement p l a n t (Canada Cement L a f a r g e L i m i t e d ) and a copper s m e l t e r ( A f t o n M i l l s L i m i t e d ) . The Kamloops area has one of the warmest and d r i e s t c l i m a t e s i n the p r o v i n c e and i s o f t e n r e f e r r e d to as b e i n g p a r t of the I n t e r i o r " d r y b e l t " . I t averages 10 i n c h e s of p r e c i p i t a t i o n and over 2,000 hours of b r i g h t s u n s h i n e a n n u a l l y . There are 7 s e p a r a t e water systems i n Kamloops w i t h t h e North Thompson, South Thompson and Thompson R i v e r s as s o u r c e s . ( B r i t i s h Columbia R e g i o n a l Index, 1S78). 53 Is. TEA IL I n c o r p o r a t e d i n 1901, T r a i l has an area of 3,105.2 a c r e s (1, 256. 6 h a ) . By highway the c i t y i s 395 miles (636 km) e a s t of Vancouver, 78 m i l e s (125 km) west of C r e s t o n and 21 m i l e s (34 km) s o u t h of C a s t l e g a r ( E r i t i s h Columbia E e g i o n a l I n d e x , 1978). The p o p u l a t i o n i n 1976 was 9,975 ( B r i t i s h Columbia E e g i o n a l I n d e x , 1978). Table 4 g i v e s the d i s t r i b u t i o n o f t h e T r a i l p o p u l a t i o n by age and sex ( E r i t i s h Columbia E e g i o n a l Index, 1978).. I n 1976, t h e r e were 2,665 f a m i l i e s w i t h an average o f 3.2 p e r s o n s / f a m i l y . T a b l e 4 T r a i l P o p u l a t i o n by Sex and Age Groups Age Group T o t a l Male Female Under 15 1,895 9 50 950 15-64 6,790 3,4 30 3,365 65+ 1,290 6 10 675 T o t a l 9,975 4,990 4,990 from B.C. R e g i o n a l Index, 1978 U n l i k e Kamloops, the p o p u l a t i o n i n T r a i l has remained r e l a t i v e l y unchanged i n t o t a l d u r i n g the past two decades. The huge s m e l t e r - r e f i n e r y - f e r t i l i z e r complex ( o r i g i n a l l y c o p per; l a t e r l e a d - z i n c ) owned by Cominco L i m i t e d i s t h e o n l y major i n d u s t r y i n the ar e a and dominates the m a n u f a c t u r i n g s e c t o r . 54 Since i t began o p e r a t i o n at the t u r n of the c e n t u r y , i t has undergone s u b s t a n t i a l m o d i f i c a t i o n s t o improve p r o d u c t i v i t y and to d i m i n i s h environmental contaminants. F o r e s t r y a c t i v i t y i s not l i k e l y t o show any s i g n i f i c a n t expansion, and topography l i m i t s a g r i c u l t u r a l production t c a few farms l o c a t e d on t e r r a c e s along the Columbia River and ranches around Rossland, The main a c t i v i t i e s are cen t e r e d around beef and d a i r y c a t t l e ; p o u l t r y , vegetables and nursery crops provide a d d i t i o n a l revenue. The T r a i l area i s not a major t o u r i s t c e n t r e . L o c a l a t t r a c t i o n s i n c l u d e i n d u s t r i a l and mine t o u r s , good hunting (Blue grouse, Deer and Mountain goat) and good f i s h i n g (for Rainbow and Eastern Brook t r o u t , Kokanee and D o l l y Varden). Red Mountain s k i r e s o r t at Rossland i s a l s o very popular i n winter. T r a i l has a semi-dry c l i m a t e (average annual p r e c i p i t a t i o n 630 mm) and i s surrounded by high mountains. Water i s s u p p l i e d v i a a municipally-owned d i s t r i b u t i o n system. Three w e l l s supply east T r a i l and there i s a lake source and g r a v i t y d i s t r i b u t i o n f o r the r e s t of the c i t y ( B r i t i s h Columbia Regional Index, 1 9 7 8 ) . . JL& SELECTION PROCEDURES The Kamloops p o p u l a t i o n sample was d e r i v e d from an on-going Trace Metal Survey i n Kamloops (Garry, 1978). T h i s l a r g e r survey was designed to t e s t c h i l d r e n i n k i n d e r g a r t e n , grade 3 and grade 6 i n e i g h t elementary s c h o o l s throughout Kamloops, as well as two-year-old c h i l d r e n i n the d i s t r i c t s 55 served by these s c h o o l s . In a l l , a t o t a l of 1,150 c h i l d r e n were t e s t e d by the Survey i n 1977. Blood and h a i r samples were taken, a h e a l t h q u e s t i o n n a i r e completed, and other measurements i n c l u d i n g r e s p i r a t o r y and psychcmetric t e s t i n g were done. For the present study, deciduous t e e t h were s o l i c i t e d from the c h i l d r e n i n grades 3 and 6. . Teeth from T r a i l c h i l d r e n i n the same age group were provided by T r a i l d e n t i s t s and Dr. Leon K r a i n t z of the Department of Or a l B i o l o g y at the U n i v e r s i t y of B r i t i s h Columbia. The c o l l e c t i o n of food and i n f o r m a t i o n p e r t a i n i n g t o food consumption p a t t e r n s r e q u i r e d s e l e c t i n g a sample from each of the two towns that had a s u b s t a n t i a l number of home gardeners. The p o p u l a t i o n i n Kamloops which met t h i s requirement r e s i d e d i n the B r o c k l e h u r s t area. (See map f o r geographic l o c a t i o n ) . In T r a i l , the Ge n e l l e d i s t r i c t was chosen, not only because of hypothesized s i m i l a r i t y to B r o c k l e h u r s t i n home gardening p r a c t i c e s , but a l s o because of s i m i l a r geographic p r o x i m i t y to the smelter. (See map f o r geographic l o c a t i o n ) . This i s an important c o n s i d e r a t i o n s i n c e d i s t a n c e and wind d i r e c t i o n from s m e l t i n g o p e r a t i o n s has a marked e f f e c t on the degree to which contamination can occur (Beavington, 1975; McDonald and Duncan 1979) . £i . CONSENT TO PARTICIPATE A l e t t e r of i n t r o d u c t i o n , together with a b r i e f d e s c r i p t i o n of the proposed study were submitted to the FIGURE 1 MAP SHOWING LOCATION OF BROCKLEHURST IN RELATION TO KAMLOOPS AND THE AFTON COPPER MINE AND SMELTER SOUTH CENTRAL HEALTH U N I T , KAMLOOPS AUGUST 2 2 , 1 9 7 8 FIGURE 2 SHOWING LOCATION OF GENELLE IN RELATION TO T R A I L AND THE COMINCO LEAD SMELTER SMELTER Km 0 16.1 B . C . REGIONAL INDEX, 1978 58 B e h a v i o r a l S c i e n c e s S c r e e n i n g Committee f o r Research I n v o l v i n g Human S u b j e c t s a t U.B.C. p r i o r t o commencement of the p r o j e c t . The a p p r o v a l was o b t a i n e d on May 19, 1978. . Dr. John G a r r y , M e d i c a l H e a l t h O f f i c e r , South C e n t r a l H e a l t h U n i t i n Kamloops, was c o n t a c t e d and he g r a n t e d p e r m i s s i o n t o proceed w i t h t o o t h s o l i c i t a t i o n i n Kamloops and i s s u e d l e t t e r s of i n t r o d u c t i o n t o the i n t e r v i e w e e s . Dr. G a r r y a l s o c o n t a c t e d the p r i n c i p a l s of the B r o c k l e h u r s t s c h o o l s . The p r i n c i p a l s were p r o v i d e d w i t h a d e s c r i p t i o n of t h e s t u d y and c o p i e s o f the i n t e r v i e w and 24-hour r e c a l l forms f o r t h e i r a p p r o v a l . P e r m i s s i o n to s e l e c t the g u e s t i o n n a i r e sample p o p u l a t i o n from the s c h o o l s was g r a n t e d and c o p i e s of t h e grade 3 c l a s s l i s t s from each of 4 s c h o o l s (Kay Bingham, P a r k c r e s t , George H i l l i a r d and A.E. P e r r y ) were o b t a i n e d , from which a random sample of 20 f a m i l i e s was s e l e c t e d f o r i n t e r v i e w . The f a m i l i e s were then c o n t a c t e d by t e l e p h o n e and both v e r b a l and s i g n e d c o n s e n t t o p a r t i c i p a t e preceded the a c t u a l i n t e r v i e w . S e l e c t i o n c f T r a i l p a r t i c i p a n t s was not a random one. Dr. Nick S c h m i t t , M e d i c a l H e a l t h O f f i c e r i n t h e West Kootenay H e a l t h U n i t , g r a n t e d p e r m i s s i o n t o conduct the survey and p r o v i d e d l e t t e r s o f i n t r o d u c t i o n to t h e i n t e r v i e w e e s . Dr. S c h m i t t and h i s a s s i s t a n t , Mike Harnadeck, a l s o a s s i s t e d i n s e l e c t i n g the sample area which would most c l o s e l y resemble the a r e a o f s t u d y i n Kamloops i n terms of g a r d e n i n g p r a c t i c e s and p r o x i m i t y t c the s m e l t e r . The a r e a which f u l f i l l e d t h e s e r e q u i r e m e n t s , however, was q u i t e s m a l l and had o n l y one e l e m e n t a r y s c h o o l w i t h one grade 3 c l a s s r o o m . T h e r e f o r e , o n l y one random l i s t c o u l d be made. I n a d d i t i o n , t h e i n t e r v i e w s 59 were taken on labour Day weekend when many people were on holiday. It was therefore necessary to canvass the area and interview these families with children in any elementary grade. Again, both verbal and written consent were obtained from those interviewed. A description of the study and purpose of the interview were given to each participant in both Brocklehurst and Genelle. 60 CHAPTER IV LEAD, COPEEE AND ZINC IN DECIDUOUS TEETH T h i s c h a p t e r d e s c r i b e s t o o t h and d a t a c o l l e c t i o n p r o c e d u r e s and methods of a n a l y s i s , i n c l u d i n g a p r e l i m i n a r y s t u d y , used t o determine l e a d , copper and z i n c i n d e c i d u o u s t e e t h from s c h o o l c h i l d r e n i n Kamloops and T r a i l . R e s u l t s are p r e s e n t e d and d i s c u s s e d . A i - TOOTH AND DATA COLLECTION Enve l o p e s w i t h a r e g u e s t f o r c h i l d r e n t o " g i v e a t o o t h f o r s c i e n c e " , a l o n g w i t h a s h o r t g u e s t i o n n a i r e (Appendix C ) , were se n t t o Kamloops and d i s t r i b u t e d t o the s c h o o l s by Mrs. Kathy McKenzie, P r o j e c t S u p e r v i s o r , Trace M e t a l Survey. The q u e s t i o n n a i r e was d e s i g n e d t o e l i c i t a b r i e f g e o g r a p h i c h i s t o r y o f each t o o t h donor to ensure t h a t o n l y those t e e t h formed i n the environment i n g u e s t i o n would be a n a l y z e d . Teeth were o r i g i n a l l y r e g u e s t e d frcm a p p r o x i m a t e l y 300 t h i r d - q r a d e c h i l d r e n i n 6 el e m e n t a r y s c h o o l s i n Kamloops. Due t o the t r a n s i e n t n a t u r e of t h e Kamloops p o p u l a t i o n , however, i t was e x t r e m e l y d i f f i c u l t t c o b t a i n a l a r g e number o f t e e t h from c h i l d r e n born i n t h e a r e a . T h e r e f o r e , i t was n e c e s s a r y t o extend the p o p u l a t i o n to i n c l u d e t h o s e c h i l d r e n i n grades 3 t o 6.. P o s t e r s were s e n t a f t e r t h e i n i t i a l r e q u e s t s were made to remind the c h i l d r e n t c donate t h e i r baby t e e t h , and b u t t o n s were o f f e r e d as t o k e n s i n r e t u r n f o r the d o n a t i o n s . The t o o t h c o l l e c t i o n was conducted between August, 1978 and J a n u a r y , 1979. Cf the t e e t h c o l l e c t e d , o n l y 40 were 61 r e s t o r a t i o n f r e e and from g e o g r a p h i c a l l y - s t a b l e c h i l d r e n . N i n e t e e n t e e t h were u t i l i z e d i n the p r e s e n t s t u d y . The r e m a i n i n g t e e t h were r e s e r v e d f o r a n a l y s i s a t t h e end of t h e lo n g - t e r m s t u d y . Dr. S c h m i t t and d e n t i s t s from T r a i l a s s i s t e d i n t h e c o l l e c t i o n c f t e e t h from g e o g r a p h i c a l l y - s t a b l e T r a i l c h i l d r e n . Teeth from T r a i l c h i l d r e n were a l s o o b t a i n e d from Dr. Leon K r a i n t z , Department c f O r a l B i o l o g y , U.B.C. T h i r t y - f o u r u n r e s t o r e d t e e t h from g e o g r a p h i c a l l y - s t a b l e c h i l d r e n frcm Kamloops (15) and T r a i l ( 1 9 ) , B.C. were a n a l y z e d . B;.. METHOD OF ANALYSIS S e v e r a l methods o f a n a l y s i s f o r t r a c e elements i n t e e t h have been r e p o r t e d . The method used f o r t h i s p r o j e c t was deve l o p e d by Dr. N e i l R. McQuaker, Programme Manager, D a v i d F. Brown, Head, T e c h n i c a l S e r v i c e s , and P a u l D.. K l u c k n e r , S r . P r o j e c t C o o r d i n a t o r (McQuaker e t a l . , 1979). The i n s t r u m e n t i n v o l v e d was the I n d u c t i v e l y Coupled Plasma-Atomic E m i s s i o n S p e c t r o m e t e r (ICP/AES). (An A p p l i e d Research L a b o r a t o r i e s QA-137 d i r e c t r e a d i n g s p e c t r o m e t e r w i t h an i n d u c t i v e l y - c o u p l e d argon plasma e x c i t a t i o n s o u r c e ) . The a n a l y s e s were done a t the E n v i r o n m e n t a l l a b o r a t o r y , B.C. M i n i s t r y of the Environment, 3650 Wesbrook C r e s c e n t , Vancouver, B.C., V6S 2L2. 62 Is. PEELIMINflEY ANALYSES P r e l i m i n a r y t e s t s were run u s i n g C a l i f o r n i a t e e t h o b t a i n e d by Dr.. H. K u h n l e i n , 1974-1975, from d e n t i s t s i n the Bay Area of C a l i f o r n i a . The o b j e c t i v e of t h e p r e l i m i n a r y t e s t s was t o determine the b e s t p r e p a r a t i o n of t o o t h sample f o r use w i t h the method of McQuaker, Brown and K l u c k n e r (1979).. Sample p r e p a r a t i o n which would a l l o w f o r q u i c k e s t and most complete d i g e s t i o n w i t h a minimum c f c o n t a m i n a t i o n was d e s i r e d . D i q e s t i o n and a n a l y s i s were t h u s c a r r i e d out u s i n g d e n t i n removed by a low-speed b u r r , powdered whole t o o t h and i n t a c t whole t o o t h samples. The ground d e n t i n samples were found t o be too s m a l l i n mass and d i d not p e r m i t d e t e c t i o n of most elements. The powdered t o o t h and whole t o o t h samples gave t h e same r e s u l t s , and these were above the minimum d e t e c t i o n c o n c e n t r a t i o n s . Since freedom from c o n t a m i n a t i o n i s v i t a l i n the a n a l y s i s of t r a c e elements, i t was d e c i d e d t o use whole t o o t h samples r a t h e r than t h e powder as t h i s would e l i m i n a t e one s t e p where c o n t a m i n a t i o n c o u l d c c c u r . The whole t o o t h was a l s o found t o d i s s o l v e more q u i c k l y i n the a c i d s o l u t i o n used f o r d i g e s t i o n o f the sample m a t e r i a l . T h e r e f o r e , f u r t h e r p r e l i m i n a r y t e s t s were run u s i n g whcle t o o t h samples. The t o o t h samples were c l e a n e d u s i n g two d i f f e r e n t r e a g e n t s (1% papain s o l u t i o n or 10% h y d r o c h l o r i c a c i d s o l u t i o n ) and the r e s u l t s compared. Q u a l i t y c o n t r o l c h e c k s were run u s i n g 5 r e a g e n t b l a n k s , and a s t a n d a r d r e f e r e n c e bone sample of known m i n e r a l c o m p o s i t i o n was a n a l y z e d w i t h each run t o check a c c u r a c y c f method and i n s t r u m e n t a t i o n . 63 2 i MINERALS IN TEETH FRO M KAMLOOPS AND TRAILj. E^C^ Whole sound t e e t h were weighed and then washed by c o v e r i n g i n 1% p a p a i n s o l u t i o n ( a p p r o x i m a t e l y 5 ml/g t o o t h ) o v e r n i g h t . A f t e r r i n s i n g w i t h c o p i o u s q u a n t i t i e s o f d e i o n i z e d water, t h e c l e a n t e e t h were d r i e d a t 105 ° C (10-15 mins.).. A f t e r c o o l i n g t o room temp e r a t u r e ( a p p r o x i m a t e l y 1/2 h o u r ) , t h e samples were a g a i n weighed and p l a c e d i n d i g e s t i o n t u b e s t o which was added an amount of c o n c e n t r a t e d n i t r i c a c i d a p p r o p r i a t e t o the weight o f the t o o t h (10 ml/g t o o t h ) . The sample was taken t o near dryn e s s i n t h e d i g e s t e r by r e f l u x i n g c o n s t a n t l y 1/2 hour a t low t e m p e r a t u r e ( a p p r o x i m a t e l y 130°C) and then at h i g h t e m p e r a t u r e ( a p p r o x i m a t e l y 200 0 C) f o r 1 hour. Next, 5.5 ml 70% p e r c h l o r i c a c i d was added and t h e sample d i g e s t e d u n t i l dense white fumes of p e r c h l o r i c a c i d appeared. The p e r c h l o r i c a c i d s o l u t i o n was then f u n n e l e d i n t o volummetric f l a s k s and b u l k e d t o a p p r o p r i a t e volumes (100 ml/g s a m p l e ) . The samples were then f i l t e r e d t h r ough Whatman #42 paper i n t o acid-washed p o l y b o t t l e s . A n a l y s i s was c a r r i e d out by ICP/AES, and a 20-element scan was r u n . 5a. DATA ANALYSIS Using S t a t i s t i c a l Package f o r the S o c i a l S c i e n c e s (SPSS) and M i c h i g a n I n t e r a c t i v e Data A n a l y s i s System (MIDAS) ( S t a t i s t i c a l Research L a b o r a t o r y , U n i v e r s i t y o f Michigan) , s e v e r a l s t a t i s t i c a l t e s t s were g i v e n the data t o determine i f t h e r e were d i f f e r e n c e s i n the c o n c e n t r a t i o n s of t h e elements i n 64 t e e t h from t h e two a r e a s , and t o t r y t o e x p l a i n how the c o n c e n t r a t i o n s d i f f e r e d and t o e x p l a i n t h o s e d i f f e r e n c e s . S t u d e n t ' s t - t e s t was used t o t e s t the s i g n i f i c a n c e o f the d i f f e r e n c e i n the means o f the c o n c e n t r a t i o n s of elements i n t e e t h from the two areas (dependent v a r i a b l e ) . T h i s t e s t was a l s o used t o determine i f the mean t r a c e element c o n c e n t r a t i o n s d i f f e r e d a c c o r d i n g t o age o f t h e c h i l d , l e n g t h of r e s i d e n c e , t o o t h w e i g h t and town. B i v a r i a t e A n a l y s i s o f V a r i a n c e (ANOVA) was used t o t e s t f o r t h e e f f e c t on the l e v e l of each element of the independent v a r i a b l e s as a group. ( i . e . age of c h i l d , l e n g t h of r e s i d e n c e , t o o t h w e i g h t and town). R e g r e s s i o n A n a l y s i s u s i n g ANOVA pr o c e d u r e s t e s t e d f o r d i f f e r e n c e s i n t h e e f f e c t of t h e independent v a r i a b l e (age o f c h i l d , l e n g t h of r e s i d e n c e t o o t h w e i g h t ) cn l e a d c o n c e n t r a t i o n s a c c o r d i n g t o tcwn. A n a l y s i s of C o v a r i a n c e u s i n g ANCVA procedures t e s t e d which of t h e t h r e e c o v a r i a t e s (age o f c h i l d , l e n g t h o f r e s i d e n c e and t o o t h w e i g h t ) had a s i g n i f i c a n t e f f e c t on l e a d c o n c e n t r a t i o n s . R e g r e s s i o n A n a l y s i s was used t c determine what p r o p o r t i o n of the v a r i a t i o n i n l e a d c o n c e n t r a t i o n s c o u l d be e x p l a i n e d by the c o v a r i a t e s (age of c h i l d , l e n g t h of r e s i d e n c e and t o o t h w e i g h t ) as a group i n each town. ANOVA t e s t e d t h e s i g n i f i c a n c e of the r e l a t i o n s h i p between each o f the c o v a r i a t e s (age of c h i l d , l e n g t h of r e s i d e n c e and t o o t h w e i g h t ) s e p a r a t e l y and l e a d c o n c e n t r a t i o n s i n the two towns t o g e t h e r and then R e g r e s s i o n A n a l y s i s t e s t e d t h e s i g n i f i c a n c e of the r e l a t i o n s h i p between t o o t h w e i g h t and l e a d 65 c o n c e n t r a t i o n s i n each town s e p a r a t e l y . The same t e s t s were a p p l i e d u s i n g z i n c c o n c e n t r a t i o n s . P e a r s o n ' s C o r r e l a t i o n t e s t e d f o r l i n e a r r e l a t i o n s h i p s between each p a i r o f v a r i a b l e s i n t h e a n a l y s i s . To determine i f sex o f c h i l d had an e f f e c t on the m i n e r a l c o n c e n t r a t i o n s , mean z i n c and l e a d c o n c e n t r a t i o n s were e s t i m a t e d f o r males and females s e p a r a t e l y . T h i s was done u s i n g t h e t o t a l sample and l o o k i n g a t Kamloops and T r a i l s e p a r a t e l y . D x. RESULTS AND CISCOSSIGN Table 5 shows t h e mean c o n c e n t r a t i o n s e x p r e s s e d as ug/g (± S.D.) o f l e a d , z i n c and copper i n t e e t h from t h e two c i t i e s . . Table 5 Lead, Z i n c and Copper i n Deciduous Teeth from Kamloops and T r a i l Pb* Zn* Cu* Kamloops 31.60 ± 7.33 103.40 ± 23.65 <1 T r a i l 48.21 ± 11.50** 111.89 ± 15.42 <1 * * S i g n i f i c a n t p<0.05 *ug/g (x±S.D.) Mean l e a d c o n c e n t r a t i o n i n Kamloops was 31 ± 7 ug/g which 66 i s s i g n i f i c a n t l y lower a t p < 0.05 than t h e mean l e a d c o n c e n t r a t i o n i n t e e t h from T r a i l which was 48 ± 11 ug/g.. The mean z i n c c o n c e n t r a t i o n i n Kamloops was 103 ± 123. The mean z i n c c o n c e n t r a t i o n i n T r a i l was 111 ± 15 ug/g which i s h i g h e r t h a n Kamloops v a l u e s but not s i g n i f i c a n t l y d i f f e r e n t . Copper c o n c e n t r a t i o n s were u n d e t e c t a b l e i n a l l t e e t h a t < 1 ug/g. T r a i l l e a d v a l u e s are s i m i l a r t o those found by Needleman and S h a p i r o (1974) when they examined t e e t h c o l l e c t e d from urban P h i l a d e l p h i a c h i l d r e n . However, t h e mean l e a d c o n c e n t r a t i o n s i n t e e t h from the l e s s exposed suburban c h i l d r e n were somewhat lower than those found i n Kamloops. Soremark and Samsahl (1961) a n a l y z e d Swedish t e e t h by a c t i v a t i o n a n a l y s i s and found copper c o n c e n t r a t i o n s comparable t o t h o s e found i n the pr e s e n t s t u d y . F i g u r e 3 i l l u s t r a t e s t he d i f f e r e n c e between t h e d i s t r i b u t i o n of l e a d i n t e e t h from the two c i t i e s . The number of t e e t h a re i n d i c a t e d on the Y a x i s and v a l u e s f o r l e a d c o n c e n t r a t i o n a r e exp r e s s e d i n ug/g on the X a x i s . The g r e a t e s t p e r c e n t a g e of t h e t e e t h frcm both Kamloops and T r a i l f a l l w i t h i n the 30-40 ug/g range. Teeth from T r a i l , however, ar e p r e d o m i n a n t l y d i s t r i b u t e d between 30-70 ug/g, whereas t e e t h from Kamloops have c o n c e n t r a t i o n s i n t h e range of 10-50 ug/g. F i g u r e 4 compares t h e d i s t r i b u t i o n o f z i n c c o n c e n t r a t i o n i n t e e t h from both c i t i e s . A g a i n , the number of t e e t h a re i n d i c a t e d on t h e Y a x i s and t h e v a l u e s f o r z i n c c o n c e n t r a t i o n are e x p r e s s e d i n ug/g on t h e X a x i s . Kamloops v a l u e s a re f a i r l y e v e n l y d i s t r i b u t e d between 60-150 ug/g,. whereas T r a i l 67 FIGURE 3 LEAD IN DECIDUOUS TEETH FROM KAMLOOPS AND TRAIL KAMLOOPS 8-7-6 S 1 2-1 0 8-7-6-x 5-i -U J =»fc 3 2 1 0 10 T R A I L 20 30 40 50 UG/G 60 70 10 20 30 40 50 UG/G 60 70 68 FIGURE 4 ZINC IN DECIDUOUS TEETH FROM KAMLOOPS AND TRAIL KAMLOOPS 60 70 80 90 100 110 120 130 140 150 UG/G TRAIL 'A 6(5 70 8 0 9 0 100 110 120 130 140 150 UG/G 69 v a l u e s are c o n c e n t r a t e d i n the range of 90-150 ug/g. S i g n i f i c a n t c o r r e l a t i o n s a t p < 0.05 e x i s t between s e v e r a l p a i r s o f v a r i a b l e s i n the a n a l y s i s . (Table 6) . Table 6 S i g n i f i c a n t C o r r e l a t i o n s Between P a i r s o f V a r i a b l e s R e l a t e d t o Tooth l e a d C o n c e n t r a t i o n s * V a r i a b l e s r * * Age:Length of Residence 0.86 Age:Toothweight 0.56 Age:{Pb} -0.53 Toothweight: {Pb} -0.74 *p<0.05 **Pearson C o r r e l a t i o n C o e f f i c i e n t s A s t r o n g p o s i t i v e r e l a t i o n s h i p e x i s t s between age and l e n g t h o f r e s i d e n c e , c o n f i r m i n g the g e o g r a p h i c s t a b i l i t y o f the t o o t h donors. As might be e x p e c t e d , t h e r e i s a p o s i t i v e c o r r e l a t i o n between age and t o o t h w e i g h t . Age and l e a d c o n c e n t r a t i o n are n e g a t i v e l y r e l a t e d , and t h e r e i s a l s c a n e g a t i v e r e l a t i o n s h i p between t o o t h w e i g h t and l e a d c o n c e n t r a t i o n . T h e r e f o r e , the l e a d c o n c e n t r a t i o n i n the t e e t h f r c m T r a i l may be h i g h e r because the c h i l d r e n were younger and had s m a l l e r and l i g h t e r t e e t h . The f a c t t h a t t h e l e a d c o n c e n t r a t i o n i s h i g h e r i n the younger c h i l d r e n w i t h s m a l l e r t e e t h i s not s u r p r i s i n g s i n c e i t i s well-known t h a t young c h i l d r e n are s u b j e c t t o much more exposure t o l e a d from 70 d i r t and s o i l when p l a y i n g . In a d d i t i o n , e s p e c i a l l y common among many yeung c h i l d r e n i s t h e p r a c t i c e of p i c a or e a t i n g o f non-food i t e m s t h a t may c o n t a i n l e a d . Not o n l y a re young c h i l d r e n more exposed t o s o u r c e s o f l e a d , l e a d a b s o r p t i o n i s much g r e a t e r i n the younger c h i l d t han i n the o l d e r c h i l d and a d u l t ( Z i e g l e r e t a l , 1978; Jugo e t a l . , 1975; K o s t i a l et a l . , 1979). S c h m i t t et a l . , found a s i m i l a r t r e n d i n b l o o d l e a d c o n c e n t r a t i o n s ( P e r s o n a l Communication, 1977). I n t h e i r T r a i l / N e l s o n s t u d y , which compared l e a d c o n t e n t o f s o i l samples and o f b l o o d samples c o l l e c t e d a t i n c r e a s i n g d i s t a n c e s from the l e a d - z i n c s m e l t e r i n T r a i l , they found a p o s i t i v e c o r r e l a t i o n between t h e mean s o i l l e a d c o n c e n t r a t i o n s f o r each d i s t a n c e and the c o r r e s p o n d i n g b l o o d l e a d v a l u e s i n t h e 1-3 y e a r - o l d c h i l d r e n and grade 1 c h i l d r e n . However, t h e r e was no s i m i l a r r e l a t i o n s h i p between s o i l l e a d c o n c e n t r a t i o n s and b l o o d l e a d c o n c e n t r a t i o n s i n grade 9 s t u d e n t s who were found t o have r e l a t i v e l y lew and uni f o r m b l o o d l e a d c o n c e n t r a t i o n s t h r o u g h o u t the c i t y . The f i n d i n g s c f t h e i r s t u d y support the view t h a t l e a d i n s u r f a c e s o i l and dust was p r o b a b l y l a r g e l y r e s p o n s i b l e f o r t h e h i g h e r l e a d a b s o r p t i o n by t h e younger c h i l d r e n most l i k e l y t h r o u g h o r a l i n t a k e . Table 7 l i s t s l e a d and z i n c i n deciduous t e e t h by sex o f c h i l d from Kamloops and T r a i l . 71 T a b l e 7 Mean Zn and Pb i n Deciduous Teeth by Sex o f C h i l d r e n i n Kamlocps and T r a i l Kamloops n=4 n=11 T r a i l n=5 n=5 T o t a l Mean M i n e r a l Male Female Male Female Male Female ug Zn/g Tooth 92 108 103 125 98 129 ug Pb/g Tooth 26 34 43 41 35 41 Copper was not d e t e c t a b l e i n any of t h e t e e t h . D e t e r m i n a t i o n of d i f f e r e n c e s between m i n e r a l c o n c e n t r a t i o n s i n t e e t h from males and females was not p o s s i b l e i n e i t h e r p o p u l a t i o n . In Kamloops, the t e e t h were not s e l e c t e d a c c o r d i n g t o sex and t h u s t h e r e i s not an even d i s t r i b u t i o n i n the c o l l e c t i o n from males and f e m a l e s . However, when averages are compared, i n the Kamloops p o p u l a t i o n , i t appears t h a t t h e r e i s no s i g n i f i c a n t d i f f e r e n c e i n the z i n c and l e a d c o n c e n t r a t i o n s i n t e e t h from females t h a n i n t h o s e frcm males. There were s e v e r a l t o o t h donors i n T r a i l whose sex was not known which p r e s e n t e d d i f f i c u l t i e s when t r y i n g t o compare m i n e r a l c o n c e n t r a t i o n s between male and female t o o t h donors. Where the sex of donors was known, averages were c a l c u l a t e d , and, i n t h i s c a s e , i n d i c a t e d a g a i n t h a t none of t h e d i f f e r e n c e s i n z i n c c o n c e n t r a t i o n s were s t a t i s t i c a l l y s i g n i f i c a n t . There dees not appear t o be any e v i d e n c e i n the l i t e r a t u r e t o i n d i c a t e t h a t t h e c o n c e n t r a t i o n s i n t e e t h s h o u l d v a r y a c c o r d i n g t o sex. 72 Some researchers have reported tooth lead concentration by age of the tooth frcm eruption to e x f o l i a t i o n (i.e..ug/g/yr..of age). This permits comparison of lead l e v e l s of various pairs of teeth (Altshuller et a l . , 1962; Shapiro et a l . , 1978). I t was not possible to compute the data in t h i s way i n the present study because we did not know the ages at which the teeth erupted in the subjects. 73 CHAPTER V FOOD CONSUMPTION PATTERNS AND DIETARY LEAD, COPPER AND ZINC I n t h i s s e c t i o n o f the s t u d y , an e s t i m a t i o n was made o f t h e c o n t r i b u t i o n of l e a d , copper and z i n c by l o c a l l y - g r o w n f o o d s t o t h e t o t a l d i e t . D e s c r i b e d here i s an assessment o f th e e x t e n t of s e a s o n a l consumption and heme p r e s e r v a t i o n of l o c a l l y - g r o w n f oods by 30 r a n d o m l y - s e l e c t e d f a m i l i e s of g r a d e -s c h o o l c h i l d r e n i n B r o c k l e h u r s t and G e n e l l e , t o g e t h e r w i t h 24-hour f o o d r e c a l l s from 20 of th o s e i n t e r v i e w e d . Twenty d u p l i c a t e f o c d c o m p o s i t e s were a l s o c o l l e c t e d f o r c h e m i c a l a n a l y s i s . In a d d i t i o n , 177 d i e t a r y r e c a l l s were o b t a i n e d from grade 4 s c h o o l c h i l d r e n from 4 B r o c k l e h u r s t s c h o o l s . JU Iiii INTERVIEW JU PURPOSE The purpose of the i n t e r v i e w was t o e s t a b l i s h the fre g u e n c y of consumption and home p r e s e r v a t i o n of l o c a l l y - g r o w n foods of f a m i l i e s i n B r o c k l e h u r s t and G e n e l l e , B.C. I t was des i g n e d a l s c t c p r o v i d e d e s c r i p t i v e d a t a and i n f o r m a t i o n p e r t a i n i n g t o the m o b i l i t y o f the f a m i l i e s i n the sample p o p u l a t i o n f o r comparison w i t h t h e data r e c e i v e d from the t o o t h donors. T h i s comparison c o u l d n o t be made i n the f i n a l a n a l y s i s s i n c e i t was not p o s s i b l e t o ga t h e r d i e t a r y d a t a from the same p o p u l a t i o n t h a t donated t h e t e e t h . A d r a f t i n t e r v i e w was p r e t e s t e d f o r i t s ease o f 74 a d m i n i s t r a t i o n , c l a r i t y of q u e s t i o n and e f f i c a c y w i t h which the q u e s t i o n s e l i c i t e d the d e s i r e d i n f o r m a t i o n . P r e t e s t i n t e r v i e w e e s were s e l e c t e d from t h e qr a d u a t e s t u d e n t body, f r i e n d s , and f a c u l t y members of t h e D i v i s i o n of Human N u t r i t i o n , U.B.C., a l l o f whom were home g a r d e n e r s . An a p p r o p r i a t e l y - m o d i f i e d i n t e r v i e w was a d m i n i s t e r e d t o r a n d o m l y - s e l e c t e d f a m i l i e s of t h i r d - g r a d e r s i n B r o c k l e h u r s t , B.C. . Random s e l e c t i o n was made by c o m p i l i n g a l i s t of s u b j e c t s from grade 3 l i s t s o b t a i n e d from t h e 4 s c h o o l s i n B r o c k l e h u r s t . Next, numbers were a s s i g n e d t o each s t u d e n t and the sample p o p u l a t i o n was d e r i v e d by c h o o s i n g 6 s t u d e n t s from each s c h o o l w i t h t h e use of a random t a b l e . Two l i s t s of s u b j e c t s were composed i n t h i s manner, a master l i s t and an a l t e r n a t e l i s t . F a m i l i e s from both t h e master and a l t e r n a t e l i s t s were c o n t a c t e d by t e l e p h o n e f o r t h e i r p e r m i s s i o n t o be i n t e r v i e w e d . S u b j e c t s from the master l i s t were c o n t a c t e d f i r s t and o t h e r s from the a l t e r n a t e l i s t were chosen t o make up the r e q u i r e d 20 f a m i l i e s . . Seven out o f 20 f a m i l i e s from t h e master l i s t and 13 out of 40 f a m i l i e s from the a l t e r n a t e l i s t c onsented t o be i n t e r v i e w e d . S i n c e G e n e l l e has o n l y one s c h o o l w i t h one s m a l l c l a s s o f t h i r d - g r a d e r s , i t was n e c e s s a r y t o extend the sample p o p u l a t i o n t o i n c l u d e f a m i l i e s o f g r a d e - s c h o o l c h i l d r e n not chosen a t random. I n t h i s c a s e , c h i l d r e n f r c m the s c h o o l l i s t were c a l l e d and p a r t i c i p a n t s were a l s o s o l i c i t e d by e n g u i r i n g i n person a t the hemes i n G e n e l l e . I n t o t a l , 20 f a m i l i e s i n B r o c k l e h u r s t and 10 f a m i l i e s i n G e n e l l e were i n t e r v i e w e d i n 75 September, 1978. In B r o c k l e h u r s t , i n t e r v i e w s were conducted by t h e r e s e a r c h e r and two a s s i s t a n t s (Ms C h e r i e L i n n e l l , and Ms I n g e l i s e O r r ) . The a s s i s t a n t s were g i v e n a d e t a i l e d d e s c r i p t i o n c f the purpose o f t h e s t u d y and t h e i n t e r v i e w . A f t e r t h o r o u g h d e s c r i p t i o n of the i n t e r v i e w , each a s s i s t a n t was r e q u e s t e d t o conduct an i n t e r v i e w w i t h t h e r e s e a r c h e r who was then a b l e t o q i v e f u r t h e r guidance as t o more e f f i c i e n t methods of i n t e r v i e w i n g . The r e s e a r c h e r a l s c s u p e r v i s e d the f i r s t i n t e r v i e w s c f each a s s i s t a n t i n the homes. Si n c e each a s s i s t a n t had seme p r e v i o u s e x p e r i e n c e i n t a l k i n g t o the p u b l i c , i n t e r v i e w i n g t e c h n i q u e s s u f f i c i e n t f o r the purposes of t h i s s t u d y were e a s i l y mastered. The a s s i s t a n t s conducted 15 i n t e r v i e w s and the r e s e a r c h e r , 5. The same procedure was f o l l o w e d i n G e n e l l e where one a s s i s t a n t (Ms Penny Nagel) conducted 2 out of the 10 i n t e r v i e w s . When the f a m i l i e s were v i s i t e d , a f u l l d e s c r i p t i o n o f the stu d y and t h e q u e s t i o n n a i r e was g i v e n by t h e i n t e r v i e w e r . I t was s t r e s s e d t h a t a l l i n f o r m a t i o n g i v e n would remain c o n f i d e n t i a l . S i n c e t h e q u e s t i o n n a i r e ' s main f o c u s was on l o c a l l y - g r o w n f o o d s , a c l e a r d e f i n i t i o n of t h e term was p r o v i d e d . Any foods grown i n the f a m i l y garden o r i n t h e garden of anyone e l s e i n E r o c k l e h u r s t ( G e n e l l e ) were i d e n t i f i e d as l o c a l l y - g r o w n . Any f o o d s o b t a i n e d from the supermarket o r thos e of q u e s t i o n a b l e o r i g i n were c a t e g o r i z e d as n o n - l o c a l l y grown f o o d s . The i n t e r v i e w f o r m a t i s g i v e n i n Appendix F. Freguency of consumption of l o c a l l y - g r o w n foods was d e t e r m i n e d i n two g u e s t i o n s : 7 6 # 1 2 . C o u l d you p l e a s e i n d i c a t e how many meals/week d u r i n g each of t h e f o l l o w i n g seasons c o n t a i n l o c a l l y - g r o w n f o o d s . Summer F a l l Winter S p r i n g (Jun-Sept) JOct-Dec}_ [Jan-Mar) (Apr-May) 0 - 2 meals/week 3 - 5 meals/week 6 - 1 2 meals/week 13+ meals/week # 1 3 . C o u l d you p l e a s e t e l l me which foods from any of t h e s e s o u r c e s your f a m i l y consumes. W e ' l l s t a r t w i t h v e g e t a b l e s . Which v e g e t a b l e s come from your garden or are grown e l s e w h e r e i n B r o c k l e h u r s t (Genelle) and a r e s e r v e d i n your home? How much i s s e r v e d of each o f the s e v e g e t a b l e s per week d u r i n g each season and do you p r e s e r v e any o f them. I f s o , what method do you use? (Question i s a p p l i e d t o f r u i t s , meat, f i s h , p o u l t r y , eggs, cheese cr e t h e r d a i r y p r o d u c t s , beverages, nuts and legumes). Q u e s t i o n # 1 3 a l s o e l i c i t e d i n f o r m a t i o n about fo o d p r e s e r v a t i o n p r a c t i c e s . T r a n s i e n c e or m o b i l i t y of t h e f a m i l i e s i n t h e sample was e s t a b l i s h e d by a s k i n g f o r c h i l d ' s b i r t h p l a c e , l e n g t h o f r e s i d e n c e a t p r e s e n t a d d r e s s , p r e v i o u s address and l e n g t h o f r e s i d e n c e at t h e p r e v i o u s address i n g u e s t i o n s :1 t o 5 . Q u e s t i o n s r e g a r d i n g water s u p p l y and type o f p i p e s a l s o p r o v i d e d i n f o r m a t i o n as t o p o s s i b l e c o n t r i b u t i o n s of t r a c e elements from t h i s s o u r c e . 77 Is. D i l i ANALYSIS The i n t e r v i e w s were coded a f t e r they were completed s i n c e i t was f e l t t h a t a precoded format would be t o o r e s t r i c t i n g g i v e n the type of i n f o r m a t i o n t o be s o l i c i t e d . With the a s s i s t a n c e of V i r g i n i a Greene and Lew i s James (both of U.B.C. A r t s Computing), each q u e s t i o n on t h e i n t e r v i e w s c h e d u l e was a s s i g n e d a v a r i a b l e number and an a p p r o p r i a t e c o d i n g scheme was f o r m u l a t e d . S p e c i a l computer programmes were then designed t o a n a l y s e t h e d a t a . . Al t h o u g h the l a r g e s t sample p o s s i b l e was t a k e n , t h o s e i n t e r v i e w e d and those frcm whom food c o m p o s i t e s were c o l l e c t e d were not g r e a t enough i n number f o r t h e power n e c e s s a r y t o d e t e c t any but g r o s s d i f f e r e n c e s . T h e r e f o r e , means ± S.D., comparison of median v a l u e s and l i n e a r c o r r e l a t i o n a n a l y s e s t o measure r e l a t i o n s h i p s between v a r i a b l e s were p r i m a r i l y u t i l i z e d , a l t h o u g h a few t e s t s f o r d i f f e r e n c e s were a l s o conducted where i t was f e l t t h a t a t r e n d a t l e a s t c o u l d be e s t a b l i s h e d . Using MIDAS, the i n t e r v i e w data was f i r s t a n a l y z e d t o d e s c r i b e t h e sample p o p u l a t i o n . S e c o n d l y , t e s t s were performed t o d e t e r m i n e amcunt of consumption of l o c a l l y - g r o w n f oods and p o s s i b l e d e t e r m i n a n t s of t h i s consumption. , V a r i a b l e s t e s t e d were c i t i e s , l e n g t h of r e s i d e n c e , b i r t h p l a c e , number of p e o p l e i n the ho u s e h o l d , supermarket s h o p p i n g h a b i t s , method o f p r e p a r a t i o n c r p r e s e r v a t i o n of food and season of consumption. Mean ± S.E.M. c f number of f a m i l y s e r v i n g s of l o c a l l y -grown f o o d s per week t y season were t a b l e d . A H o t e l l i n g ' s T-78 Square was th e n a p p l i e d t o t h i s i n f o r m a t i o n t o t e s t f o r d i f f e r e n c e s between B r o c k l e h u r s t and G e n e l l e i n t h e mean number of s e r v i n q s c f l o c a l l y - g r o w n f o o d s . One-way t a b u l a t i o n s l i s t e d the l o c a l l y - q r o w n foods most f r e q u e n t l y mentioned by th o s e i n t e r v i e w e d . These were l a t e r compared t o the i t e m s i n the 24-hcur c o m p o s i t e s which were c h e m i c a l l y a n a l y z e d . S c a t t e r p l o t s were done t o show r e l a t i o n s h i p s between: t o t a l amount of l o c a l l y - q r o w n foods consumed and t h e number of people i n t h e household; l e n g t h o f r e s i d e n c e a t the p r e s e n t a d d r e s s and amount of l o c a l l y - g r o w n foods consumed per season; and number of people i n the household and amount of l o c a l l y -grown f o o d s consumed per season. Pearsons C o r r e l a t i o n t e s t e d f o r l i n e a r r e l a t i o n s h i p s between t o t a l amount of l o c a l l y - g r o w n foods consumed and the number of people i n the h o u s e h o l d . A U n i v a r i a t e 1-way ANOVA t e s t e d t h e e f f e c t o f supermarket h a b i t s on the amount of l o c a l l y - g r o w n f o ods consumed. . S i g n and Wilco x o n M a t c h e d - P a i r s Signed-Eanks t e s t s were a p p l i e d t o the da t a t o determine i f d i f f e r e n c e s e x i s t e d between t h e amount o f l o c a l l y - g r o w n f o ods consumed i n t h e f r e s h s t a t e as opposed t o t h a t consumed p r e s e r v e d i n each season. These t e s t s were done w i t h the two c i t i e s t o g e t h e r and then w i t h each c i t y s e p a r a t e l y . 3-. RESULTS AND DISCUSSION A. D e s c r i p t i o n c f I n t e r v i e w P o p u l a t i o n Freguency d i s t r i b u t i o n s o f t h e demographic v a r i a b l e s from 79 the i n t e r v i e w p r o v i d e d the f o l l o w i n g d e s c r i p t i o n of the sample p o p u l a t i o n . I n a l l , 30 i n t e r v i e w s were conducted: 20 i n B r o c k l e h u r s t and 10 i n G e n e l l e . T a b l e 8 shows how t h e c h i l d r e n i n the sample are d i s t r i b u t e d among the s c h o o l s i n E r o c k l e h u r s t and G e n e l l e . B r o c k l e h u r s t s c h o o l s were a t t e n d e d by 66. 75? of t h e c h i l d r e n i n the t o t a l sample. Of t h i s 66.7%, 16.7% a t t e n d e d George H i l l i a r d , 15.5% a t t e n d e d A.E. E e r r y , 30% were e n r o l l e d a t Kay Bingham, and 6.7% were f r c m P a r k c r e s t . Of t h e 3 3.3% o f the c h i l d r e n i n the t o t a l sample who a t t e n d e d G e n e l l e s c h o o l s , 20% were e n r o l l e d a t G e n e l l e P u b l i c S c h o o l and 13.3% were from Webster P u b l i c S c h o o l . T able 9 g i v e s t h e fr e g u e n c y d i s t r i b u t i o n of t h e v a r i a b l e s from t h e i n t e r v i e w s . The c h i l d r e n were f a i r l y e v e n l y d i s t r i b u t e d by sex. Of the t o t a l sample, 56.7% were males and 43.3% were f e m a l e . I n t h e B r o c k l e h u r s t sample, 60% were male and 40% were f e m a l e , w h i l e t h e r e was an eq u a l number of males and f emales i n the G e n e l l e p o p u l a t i o n (50% male and 50% f e m a l e ) . The mean age of the c h i l d r e n i n the t o t a l sample was 9.7 y e a r s f o r males and 9.1 ye a r s f o r females (9.2 y e a r s f o r males and 9.0 y e a r s f c r females i n B r o c k l e h u r s t , and 10.8 y e a r s f o r males and 9.4 y e a r s f o r females i n G e n e l l e ) . Table 9 a l s o g i v e s t h e d i s t r i b u t i o n o f c h i l d r e n i n the sample a c c o r d i n g t o b i r t h p l a c e . Of the t o t a l number o f c h i l d r e n i n the sample p o p u l a t i o n , 60% were g e o g r a p h i c a l l y -s t a b l e (30% of t h e c h i l d r e n from B r o c k l e h u r s t and 30% of the c h i l d r e n frcm G e n e l l e ) . Of t h e 40% who were born o u t s i d e o f B r o c k l e h u r s t o r G e n e l l e , 13.3% of the B r o c k l e h u r s t c h i l d r e n Table 8 D i s t r i b u t i o n of Sample I n t e r v i e w P o p u l a t i o n Whose C h i l d r e n A ttend B r o c k l e h u r s t and G e n e l l e S c h o o l s S c h o o l l o c a t i o n n* % of Community C h i l d r e n A t t e n d i n g % of Sample From Both Communities George H i l l i a r d B r o c k l e h u r s t 5 25 16.7 A.£. P e r r y •i 4 20 13.5 Kay Bingham it 9 45 30.0 P a r k c r e s t 11 2 10 6.7 T o t a l I I 20 67.7 G e n e l l e G e n e l l e 6 60 20.0 Webster I I 4 40 13.3 T o t a l it 10 33. 3 *n=number o f c h i l d r e n 81 T a b l e 9 Frequency D i s t r i b u t i o n o f I n t e r v i e w V a r i a b l e s by Town V a r i a b l e B r o c k l e h u r s t G e n e l l e T o t a l Mean number P e r s o n s / Household 4. 3 5. 1 4. 9 Mean number C h i l d r e n / Household 2. 7 3. 1 2. 8 Mean number A d u l t s / Household 2. 0 2.0 2. 0 Sex of C h i l d : M 12 5 17 F 8 5 13 Mean Age of C h i l d : M 9. 2 10.8 9. 7 F 9 9.4 9. 1 Mean Length o f Residence at P r e s e n t Address (yrs.) 6. 0 6. 5 6. 2 I n t e r v i e w e e : Mother 18 7 25 Other 2 3 5 Water Source: Main 20 0 20 S p r i n g 0 9 9 Water Tower 0 1 1 P i p e s : P l a s t i c 5 1 6 Copper 7 3 10 E l a s t i c S Copper 4 1 5 G a l v a n i z e d , Copper S E l a s t i c 1 0 1 Don't Know 1 4 6 B i r t h p l a c e : B r o c k l e h u r s t 9 0 9 G e n e l l e 0 9 9 B r i t i s h Columbia 4 0 4 Saskatchewan 2 0 2 A l b e r t a 5 1 6 82 were born i n another c i t y i n E . C , 6.7% were born i n Saskatchewan, and 16.7% were born i n A l b e r t a , . The r e m a i n i n g 3.3% o f t h e c h i l d r e n i n t h e G e n e l l e p o p u l a t i o n were born i n A l b e r t a . Mean l e n g t h c f r e s i d e n c e a t the p r e s e n t a d d r e s s was 6.2 y e a r s (6 y e a r s i n B r o c k l e h u r s t and 6.5 y e a r s i n G e n e l l e ) . E i g h t y - t h r e e per c e n t c f t h o s e i n t e r v i e w e d were mothers of the c h i l d r e n i n t h e sample p o p u l a t i o n . (90% i n B r o c k l e h u r s t ; 70% i n G e n e l l e ) . The mean number o f persons per household i n the t o t a l sample was 4.9 (4.3 i n B r o c k l e h u r s t and 5.1 i n G e n e l l e ) . The mean number of c h i l d r e n per household was 2.8 (2.7 i n B r o c k l e h u r s t and 3.1 i n G e n e l l e ) ; mean number o f a d u l t s was 2.0 (2,0 i n both B r o c k l e h u r s t and G e n e l l e ) , With r e s p e c t t o water s u p p l y , of the t o t a l sample, 66.7% r e c e i v e d water from a main s o u r c e , 30% frcm a s p r i n g and 3.3% from a water tower. A breakdown by c i t y shows t h a t 100% o f the B r o c k l e h u r s t sample use a main water s o u r c e whereas 90% o f t h e G e n e l l e p o p u l a t i o n r e c e i v e d water from a s p r i n g and 1% from a water t o w e r . Of the t o t a l sample, 30% o f the p i p e s i n B r o c k l e h u r s t and 30% of the p i p e s i n G e n e l l e households were copper; 25% of the p i p e s d e l i v e r i n g water t o B r o c k l e h u r s t h o useholds were p l a s t i c and 1% of G e n e l l e p i p e s were p l a s t i c . I n B r o c k l e h u r s t , 30% of the households had both copper and p l a s t i c p i p e s whereas o n l y 1% of G e n e l l e h ouseholds used t h i s c o m b i n a t i o n . G a l v a n i z e d p i p e s were used by 5% of the households i n B r o c k l e h u r s t and by 1% o f those i n G e n e l l e . There were 5% of the B r o c k l e h u r s t households which used g a l v a n i z e d , copper and p l a s t i c p i p e s , but none i n G e n e l l e . No 83 l e a d p i p e s were i d e n t i f i e d . Ten per c e n t of the people i n B r o c k l e h u r s t and H0% o f those i n G e n e l l e d i d not know what k i n d of p i p e s were i n the household. The f o r e g o i n g i n f o r m a t i o n seems t o i n d i c a t e t h a t t h e r e s h o u l d be no problem w i t h r e g a r d t o p o t e n t i a l t o x i c i t y from the water s u p p l i e d t o the h ouseholds i n e i t h e r the B r o c k l e h u r s t o r G e n e l l e sample. In view of t h e o n - g c i n g s m e l t i n g o p e r a t i o n s i n both r e g i o n s , c o n s t a n t m o n i t o r i n g of the water s u p p l y i s s t i l l a d v i s a b l e even though t h e r e does not appear t o be cause f o r concern a t p r e s e n t . Those households which have copper p i p e s c o u l d p o s s i b l y be exposed t o e l e v a t e d copper c o n c e n t r a t i o n s i n t h e i r water s u p p l y . However, t h i s i s dependent on the pH of the water, age and c o n d i t i o n c f the p i p e s and the m i n e r a l s i n the water (hardness or s o f t n e s s of the water) (Schroeder e t a l . , 1966 ; Andelman and S h a p i r o 1973). B L o c a l ! y - G r o w n Food Consumption P a t t e r n s F i g u r e 5 shows the mean f a m i l y s e r v i n g s per week of l o c a l l y - g r o w n f oods by season. There i s a c o n s i d e r a b l e d e c l i n e i n mean number of s e r v i n g s from summer t o f a l l . Another d e c r e a s e , a l t h o u g h l e s s pronounced, o c c u r s from f a l l t o w i n t e r , but the p a t t e r n o f consumption remains f a i r l y c o n s t a n t from w i n t e r t o s p r i n g . F i g u r e 6 i l l u s t r a t e s t h e same t r e n d . Many more f a m i l i e s s e r v e d more than 13 meals per week which c o n t a i n e d l o c a l l y -grown f o o d s i n the summer months than d u r i n g t h e r e s t of the y e a r . C o n v e r s e l y , t h e r e i s an i n c r e a s e frcm summer through t o w i n t e r i n the number of f a m i l i e s s e r v i n g l e s s t h a n 12 meals per FIGURE 5 MEAN FAMILY SERVINGS/WEEK OF LOCALLY-GROWN FOODS BY SEASON BROCKLEHURST AND GENELLE ^ BROCKLEHURST GENELLE FIGURE 6 DISTRIBUTION OF MEALS CONTAINING LOCALLY-GROWN FOODS/WEEK/SEASON BROCKLEHURST AND GENELLE TOGETHER 2 5 4 t'.'.'.'.'.i 20 H SUMMER FALL WINTER SPRING BROCKLEHURST 2 0 H 1 5 A d 10-1 SUMMER FALL WINTER SPRING & 1 51 I 5 -GENELLE mm SUMMER 13+ MEALS FALL WINTER | [ 3 - 5 MEALS SPRING ^ 6 - 1 2 MEALS 0 - 2 MEALS 86 week which c o n t a i n l o c a l l y - g r o w n foods. T h i s i n c r e a s e i s more pronounced as the number of meals decreases. That i s , there was a g r e a t e r i n c r e a s e i n the number of f a m i l i e s s e r v i n g from 0 - 2 meals per week from summer t o winter than i n the number of f a m i l i e s s e r v i n g from 6-12 meals per week. The same tr e n d i s r e f l e c t e d i n B r o c k l e h u r s t and Genelle s e p a r a t e l y as i s found i n the t o t a l sample. The H o t e l l i n g ' s T-Sguare Test r e v e a l e d there was no s i g n i f i c a n t d i f f e r e n c e between B r o c k l e h u r s t and G e n e l l e i n the d i s t r i b u t i o n of the mean s e r v i n g s per week of l o c a l l y - g r o w n foods i n the d i f f e r e n t months. That i s , the t r e n d i n the p a t t e r n of consumption of l o c a l l y - g r o w n foods was the same f o r f a m i l i e s i n both areas. Season, t h e r e f o r e , appears to have a d e f i n i t e i n f l u e n c e on the amount c f l o c a l l y - g r o w n foods consumed.. The g r e a t e s t amount of l o c a l l y - g r o w n food i s served i n the growing seasons, summer and f a l l . As a v a i l a b i l i t y of f r e s h produce decreases i n winter and s p r i n g , there i s a s i m i l a r d e c l i n e i n amount consumed. Method of p r e p a r a t i o n of l o c a l l y - g r o w n food was next examined f o r i t s e f f e c t on amount of consumption. F i g u r e 7 g i v e s a d e s c r i p t i o n of the p r e f e r r e d methods of p r e p a r a t i o n according to season. Locally-grown foods are predominantly served f r e s h (raw or cooked) i n the summer months and preserved locally-'grcwn foods are served more f r e g u e n t l y i n the f a l l t o s p r i n g months. Of the methods of p r e s e r v a t i o n , canning appears to be more popular than f r e e z i n g . The r e s u l t s of the Sign T e s t and Wilcoxon Matched-Pairs 87 FIGURE 7 CONSUMPTION OF FRESH AND PRESERVED LOCALLY-GROWN FOODS BY SEASON 88 Signed-Ranks Test t o examine t h e r e l a t i o n s h i p between method of p r e p a r a t i o n and amount of consumption of l o c a l l y - g r o w n f o o d s a r e shown i n T a b l e 10. Table 10 W i l c o x o n M a t c h e d — P a i r s Signed—Ranks T e s t f o r D i f f e r e n c e s i n Amount of l o c a l l y - G r o w n Foods Served F r e s h and P r e s e r v e d T o t a l Sample B r o c k l e h u r s t G e n e l l e Season -Ranks Mean +Ranks Mean -Ranks Mean +Ranks Mean -Ranks Mean •Ranks Mean Summer 15. 50 0.0* 10. 50 70.0* 5. 50 0.0* F a l l 12. 90 14.65 10. 30 9.89 3. 80 5.67 W i n t e r 9. 29 16.82* 5. 17 10.91* 4. 63 6. 08 S p r i n g 9.39 16.31* 6.00 11.43* 3.63 5. 38 • S i g n i f i c a n t D i f f e r e n c e p<. 05 The S i g n Test showed t h a t a s i g n i f i c a n t (p<0.05) d i f f e r e n c e e x i s t s both i n summer and w i n t e r between the amount of l o c a l l y -grown f c o d s s e r v e d f r e s h and amounts s e r v e d i n t h e p r e s e r v e d s t a t e . The Wilcoxon M a t c h e d - P a i r s Signed-Ranks T e s t c o n f i r m e d t h a t , i n summer, consumption of f r e s h l o c a l l y - g r o w n f o o d s was s i g n i f i c a n t l y g r e a t e r (p<0.C5) than the amount of p r e s e r v e d f o o d s consumed. I t a l s o r e v e a l e d t h a t , i n w i n t e r and i n s p r i n g , t h i s p a t t e r n i s r e v e r s e d and consumption of p r e s e r v e d f o o d s i s s i g n i f i c a n t l y g r e a t e r (p<0.05) than t h a t of f r e s h f o o d s . When the Wilcoxon M a t c h e d - P a i r s Signed-Ranks T e s t t r e a t e d B r o c k l e h u r s t and G e n e l l e s e p a r a t e l y , the r e s u l t s were 89 the same f o r B r o c k l e h u r s t as was shown f o r the t o t a l sample . However, i n G e n e l l e , i t appears tha t s i g n i f i c a n t d i f f e r e n c e s between amount of f r e s h and p r e s e r v e d foods consumed occur o n l y i n summer. T h i s would i n d i c a t e f i r s t l y , t h a t the r e s u l t s wi th the t o t a l sample r e f l e c t the t r e n d c f on ly B r o c k l e h u r s t a n d , s e c o n d l y , t h a t the re i s e i t h e r more p r e s e r v a t i o n of l o c a l l y -grown foods i n B r o c k l e h u r s t or more even d i s t r i b u t i o n of l o c a l l y - g r o w n foods eaten f r e s h and p r e s e r v e d i n G e n e l l e . . S c a t t e r p l o t s , Pearsons C o r r e l a t i o n and U n i v a r i a t e 1-Way ANOVA r e v e a l e d t h a t number of people i n the h o u s e h o l d , l e n g t h o f r e s i d e n c e at p resen t address and supermarket shopping h a b i t s had no s i g n i f i c a n t e f f e c t on the amount of l o c a l l y - g r o w n f o o d s s e r v e d . These f a c t o r s are d i s c u s s e d f u r t h e r i n the f i n a l c h a p t e r . 24-HOUR RECALLS J L PUR1QSE The 24 -hcur d i e t a r y r e c a l l was used as a t o o l f o r a s s e s s i n g the n u t r i e n t i n t a k e and food h a b i t s of the sample p o p u l a t i o n . A l though a recen t s tudy by Beaton (1979) i n d i c a t e d problems with the use of 24-hour r e c a l l s , t h i s i s c e r t a i n l y a s h o r t e r and more economica l method of a s s e s s i n g n u t r i e n t i n t a k e s f o r l a r g e groups than the 7-day r e c o r d , d i e t h i s t o r y , or d i r e c t measurement of food i n t a k e methods. S e v e r a l s t u d i e s have shown t h a t , not o n l y i s i t f a s t e r and more e c o n o m i c a l , 90 b u t , f o r l a r g e groups i t y i e l d s a p p r o x i m a t e l y t h e same v a l u e s as the 7^day r e c o r d (Young et a l . , 1952; Madden e t a l . , 1976; Nutn. Canada, 1976; Beaton et a l . , 1979). The 24-hour r e c a l l has a l s o been r e p o r t e d t o have been used s u c c e s s f u l l y w i t h c h i l d r e n . Emmons and Hayes (1973) s t u d i e d c h i l d r e n i n the same age group as thos e s t u d i e d i n t h e s c h o o l s i n B r o c k l e h u r s t (age 6-12 y e a r s ) . They reached t h e f o l l o w i n g c o n c l u s i o n s : "1) Young c h i l d r e n can p r o v i d e i n f o r m a t i o n cn t h e i r d i e t as a c c u r a t e l y , or more a c c u r a t e l y , than t h e i r mothers; 2) The a b i l i t y t o r e c a l l c o r r e c t l y t h e foods e a t e n improved w i t h age." In a d d i t i o n , r e c a l l s i n the c l a s s r o o m s were c o l l e c t e d between Tuesday and F r i d a y , a v o i d i n g n a t i o n a l h o l i d a y s as w e l l as weekends as i t i s known t h a t weekend d i e t a r y p r a c t i c e s d i f f e r f r c m s c h o o l - d a y h a b i t s ( E p p r i g h t et a l . , 1952).. The r e c a l l s which accompanied t h e food c o m p o s i t e s , however, d i d c o n t a i n d i e t i n f o r m a t i o n f o r a h o l i d a y s i n c e t h e s e c o l l e c t i o n s had t o be made p r i o r t o the r e t u r n o f t h e c h i l d r e n t o s c h o o l i n th e f a l l . C o l l e c t i o n o f t h e 24-hour r e c a l l s i n t h e c l a s s r o o m s took p l a c e on two d i f f e r e n t o c c a s i o n s , once i n September and a g a i n i n A p r i l , t o a l l o w f o r s e a s o n a l v a r i a t i o n and t o p r o v i d e an i n s i g h t i n t o the " t y p i c a l " food consumption p a t t e r n of t h e s c h o o l c h i l d r e n i n B r o c k l e h u r s t . The p r i n c i p a l s i n each of the 4 B r o c k l e h u r s t s c h o o l s s e l e c t e d the c l a s s r o o m t o be v i s i t e d and i n t r o d u c e d the i n t e r v i e w e r and her a s s i s t a n t t c the t e a c h e r . The c h i l d r e n , as a group, were g i v e n an example of what a 24-hour r e c a l l would 91 i n c l u d e and s p e c i f i c i n s t r u c t i o n s as t o how t o complete th e b l a n k form each c f them r e c e i v e d . The u n l i n e d format was chosen t o accommodate the l a r g e h a n d w r i t i n g of grade 4 c h i l d r e n and t o a v o i d d i r e c t i n g t h e i r r e c a l l s which c c c u r s when s p e c i f i c p a t t e r n s are s t a t e d on the 24-hour r e c a l l form.. The c h i l d r e n were encouraged t o t h i n k about the o r d e r i n which t h e y at e r a t h e r t h a n t o r e c a l l what they at e t y meals. They were a s k e d , f o r example, what was the f i r s t t h i n g they at e or drank r a t h e r than what they had f o r b r e a k f a s t . I n d i v i d u a l a t t e n t i o n u s i n g spocns and measuring cups as v i s u a l a i d s was then g i v e n t o each s t u d e n t i n o r d e r t o e nsure as much a c c u r a c y of r e c a l l as p o s s i b l e . Rn a s s i s t a n t who accompanied the i n t e r v i e w e r on each v i s i t and the t e a c h e r a l s o s u p e r v i s e d t h e c h i l d r e n and a s s i s t e d w i t h t h e i r r e c a l l s . R e c a l l s a l s o were t a k e n w i t h the i n t e r v i e w s and f o o d c o m p o s i t e s i n B r o c k l e h u r s t and G e n e l l e and were added t o t h e c l a s s r o o m sample f o r a n a l y s i s . Is. DATA ANALYSIS Those from whom 24-hour r e c a l l s were c o l l e c t e d formed a l a r g e enough sample (177 r e c o r d s ) t o p e r m i t t e s t s f o r d i f f e r e n c e s and c o r r e l a t i o n s . The 24-hcur r e c a l l s were a n a l y z e d wi t h t h e use of a s p e c i a l d i e t programme c a l l e d G e n e r a l N u t r i e n t A n a l y s i s (GNA) . T h i s programme was o r i g i n a l l y d e v e l o p e d by R o b e r t Meldrum (1967) and was r e v i s e d by Lewis James (1979). I t matches a f i l e of r e s p o n d e n t s ' food i n t a k e data w i t h a f i l e o f f o o d 9 2 composition i n f o r m a t i o n producing n u t r i e n t i n t a k e s f o r the respondents. The computer used was Amdahl 470 V/6, Model I I under the Michigan Terminal System (MTS) . In a d d i t i o n to the GNA programme, s t a t i s t i c a l package MIDAS was used to determine " t y p i c a l " e a t i n g h a b i t s of the s c h o o l c h i l d r e n i n B r o c k l e h u r s t . The r e c a l l s were d i v i d e d i n t o f o u r groups r e p r e s e n t i n g f a l l and s p r i n g r e c a l l s given by the c h i l d r e n themselves and r e c a l l s given by parents on t h e i r c h i l d r e n. Mean d a i l y n u t r i e n t i n t a k e s per c h i l d per survey group were t a b l e d and compared to the Becommended D a i l y Intakes (E.D.I.) f o r ages 7-11. Two-sample t - t e s t s were then a p p l i e d to see i f d i f f e r e n c e s e x i s t e d between mean n u t r i e n t i n t a k e s i n each group. Mean n u t r i e n t intakes by sex were a l s o t a b l e d and Student's t t e s t e d f o r d i f f e r e n c e s i n mean i n t a k e s between males and females. Number of s e r v i n g s of each f o c d from each food group per c h i l d was t a b l e d . This i n f o r m a t i o n was used to c a l c u l a t e the amount of l e a d , copper and z i n c i n the r e c a l l e d i n f o r m a t i o n . I t was a l s o used t c compare with Canada's Food Guide t o determine i f t h e r e were any i n a d e g u a c i e s i n s e r v i n g s from any of the f o u r food groups. In a d d i t i o n , mean n u t r i e n t i n t a k e s f o r i n d i v i d u a l menus from a subsample of 80 c h i l d r e n were c a l c u l a t e d and compared with mean number of s e r v i n g s from each of the f o c d groups. T h i s was done to determine i f any c h i l d r e n met the Food Guide recommendations and yet d i d not meet the E.D.I. , f o r the i n d i v i d u a l n u t r i e n t s or v i c e v e r s a . Comparison 93 of i n t a k e of v a r i o u s foods w i t h the M o d i f i e d B a s i c Four (King e t a l . , 1978) was a l s o made. To f u r t h e r d e s c r i b e t h e food h a b i t s of B r o c k l e h u r s t c h i l d r e n , the number and t y p e s of meals missed and number and type of s n a c k s consumed were c a l c u l a t e d . i i - RESULTS AND DISCUSSION Table 11 l i s t s t he mean d a i l y n u t r i e n t i n t a k e s per c h i l d by i n d i v i d u a l s u r v ey groups and as a t o t a l group. A c c o r d i n g t o the two-sample t - t e s t , t h e r e were no s i g n i f i c a n t d i f f e r e n c e s i n n u t r i e n t i n t a k e s between the 4 survey groups; t h i s i n d i c a t e s t h a t t h e r e i s no d i f f e r e n c e i n s e a s o n a l i n t a k e or between 2 i n t a k e s g i v e n by t h e same c h i l d on two d i f f e r e n t o c c a s i o n s , o r between i n f o r m a t i o n p r o v i d e d by t h e c h i l d or by the paren t on the c h i l d . T h e r e f o r e , mean i n t a k e s o f the group as a t o t a l were compared t o the B.D.I. For ease i n ccmparison o f mean n u t r i e n t i n t a k e s t o the R.D.I. (which a re g i v e n a c c o r d i n g t c sex of c h i l d ) , and t o determine i f d i f f e r e n c e s i n i n t a k e s e x i s t between males and females i n the sample, mean n u t r i e n t i n t a k e s o f the c h i l d r e n are l i s t e d t y sex i n Table 12.. St u d e n t ' s t - t e s t r e v e a l e d t h e r e a r e s i g n i f i c a n t d i f f e r e n c e s (p<0.05) between males and females i n the i n t a k e o f s e v e r a l n u t r i e n t s . Males had a h i g h e r mean i n t a k e of p r o t e i n , i r o n , n i a c i n , t h i a m i n , p o t a s s i u m , magnesium and chromium. I t seems l i k e l y t h a t a s i n g l e component c o u l d be r e s p o n s i b l e f o r a l l d i f f e r e n c e s . The i n c r e a s e d i n t a k e of the m i n e r a l s and 94 Table 11 Mean Daily Nutrient Intake/Child/Group Group 50a 51b 52c 53d Total Nutr ient (n=94) (n = 58) (n=22) (n=19) (n=193) Kcal 1638. 6 1786.8 1843.1 1794.5 1721. 8 Protein (g) 67. 5 75. 3 73.4 65.5 70. 3 Fat(g) 65. 3 71. 6 68.9 64. 3 67. 5 CHO(g) 203. C 216.7 236.9 249. 1 215. 8 Ca (mg) 890. 1 951. 1 885.0 839. 8 903. 2 Fe (mg) 9. 2 10. 8 9.9 9.9 9. 8 Vit . .A(I.0.) 5471. i 3227.2 3864.3 9448.5 5005. 2 Thiamin (mg) 1. 0 1. 4 1.4 1.0 1. 2 Eiboflavin (mg) 2 . 1 2.7 2.0 1. 5 2. 2 Niacin (mg) 12. 0 13. 1 15.3 14. 1 12. 9 Vit . C (mg) 69. 1 77. 2 112.7 78. 4 77. 4 Phosphorus (mg) 1244. c 1313.7 1277.7 1162.0 1261. 0 Potassium (mg) 2580. 9 2658.4 2600.5 2787.7 2626. 7 Sodium (mg) 2255. 9 2522.3 2335.7 2215.8 2341. 1 Magnesium (mg) 258. 4 273. 1 273.3 277. 2 266. 4 Copper (mg) 1. 3 1. 4 1.7 1.3 1. 4 Zinc (mg) 8. 4 8. 8 7.7 7. 3 8. 4 Manganese (mg) 1. 4 1. 9 2.4 1.8 1. 7 Chromium (ug) 992. 8 985. 9 1204.8 1155.4 1030. 9 Selenium (ug) 89. 2 98. 3 99.9 100. 6 94. 3 a this group comprised children from whom 1 reca l l was obtained in the f a l l b children from whom 2 recalls were obtained (1 in f a l l ; 1 in spring) c children from whcm 1 reca l l was obtained in the spring d children whose 24-hr. diet intake was recalled for them by a parent Table 12 Mean N u t r i e n t I n t a k e s of S c h o o l c h i l d r e n by Sex Compared t o Recommended D i e t a r y I n t a k e s N u t r i e n t Sex+ Mean I n t a k e ± SEM RDI** K c a l F 1639.0 53.9 2150 M 1803. 8 72.2 2350 P r o t e i n (g) F 65.7 2.3* 36.5 M 74.9 3.3 37.0 Ca (mg) F 879.3 47.8 8 50 M 926.9 58.3 800 Fe (mg) F 9.0 0.3 10.5 M 10.7 0.5 10.5 V i t . A ( I O ) F 4051.0 49.3 2498 M 5949.6 94.0 2498 T h i . (mg) F 1. 1 0.06 1. 1 M 1.3 0.09 1.2 Ribo (mg) F 2. 1 0.2 1.3 M 2.4 0.3 1.4 Nia(mg) F 11.7 0.6* 14.0 M 14. 1 0.7 15.5 V i t . C (mg) F 68.5 5.4* 30 M 86.3 7.7 30 Phos. (mg) F 1202.3 46.8 850 M 1319.0 63.6 800 Mg(mg) F 249. 1 9.9* 175.0 M 283. 5 13.9 162.5 Z i n c (mg) F 7.9 0.3 8.0 M 8.8 0.5 7.5 • S i g n i f i c a n t D i f f e r e n c e between Males & Females (p<0.05) + nF=96; nM=97 ••average o f 2 age grps (7-9,10-12) from H e a l t h and Welfare Canada, 1975. 96 v i t a m i n s c o u l d be due s o l e l y to the i n c r e a s e d i n t a k e o f p r o t e i n . P r o t e i n i n t a k e i s d i s c u s s e d f u r t h e r when a n a l y z i n g d a t a on t h e subsample. The mean n u t r i e n t i n t a k e s f o r c h i l d r e n 7-9 y e a r s i n t h e p r e s e n t s t u d y are c o n s i d e r a b l y l o w e r , except f o r t h i a m i n and r i b o f l a v i n , than mean n u t r i e n t i n t a k e s as e s t i m a t e d by N u t r i t i o n Canada i n t h e i r 1976 survey ( N u t r i t i o n Canada, 1976). The d i f f e r e n c e i s d i f f i c u l t t c e x p l a i n because of the l a c k o f i n f o r m a t i o n r e g a r d i n g s a m p l i n g p r o c e d u r e s used by N u t r i t i o n Canada. The d i s t r i b u t i o n of c h i l d r e n a c c o r d i n g t o age i n the n a t i o n a l s u r vey i s a l s c not known. When f u r t h e r d e s c r i p t i v e i n f o r m a t i o n from the r e c a l l s p e r t a i n i n g t c meal and s n a c k i n g p a t t e r n s was i n v e s t i g a t e d , i t was found t h a t 16% c f the c h i l d r e n missed meals. Of the meals missed, b r e a k f a s t was most f r e g u e n t l y mentioned; l u n c h was a l s o s k i p p e d f a i r l y o f t e n , and a few c h i l d r e n missed both b r e a k f a s t and l u n c h . Ncne of the c h i l d r e n missed supper. With r e s p e c t t o s n a c k s , 62% c f the c h i l d r e n r e p o r t e d h a v i n g s n a c k s ; 60% c f t h o s e who had snacks l i s t e d o n l y 1 snack/day, 34% had 2 snacks and 5% had 3 or more snacks.. The snacks were c a t e g o r i z e d as t o t h e i r n u t r i t i o n a l c o n t r i b u t i o n t o the t o t a l d i e t as f o l l o w s : N u t r i t i o u s s n a c k s : those t h a t c o n t r i b u t e d n u t r i e n t s t o t h e t o t a l d i e t w i t h a minimum of c a l o r i e s and s i m p l e s u g a r s ; P a r t l y n u t r i t i o u s s n a c k s : t h o s e t h a t c o n t r i b u t e d some n u t r i e n t s but were h i g h i n c a l o r i e s and s i m p l e s u g a r s ; N o n - n u t r i t i o u s s n a c k s : those t h a t c n l y c o n t r i b u t e d c a l o r i e s , u s u a l l y i n the form of s i m p l e s u g a r s . 97 The f o l l o w i n g p a t t e r n r e l a t i n g t o type of snacks emerged: 35% of the snacks were n u t r i t i o u s ; 37% were p a r t l y n u t r i t i o u s s n a c k s ; and 28% were c a t e g o r i z e d as n o n - n u t r i t i o u s . Examples of most f r e g u e n t l y - m e n t i o n e d f o o d s i n each snack c a t e g o r y are as f o l l o w s : N u t r i t i o u s s n acks: a p p l e (or o t h e r f r u i t ) , m i l k , peanut b u t t e r and banana sandwich, bread and m i l k , c r a c k e r w i t h peanut b u t t e r , r a i s i n s , c a r r o t s (or o t h e r v e g e t a b l e ) ; P a r t l y n u t r i t i o u s s n a c k s : c o o k i e s and m i l k (or any l o w - n u t r i e n t food w i t h m i l k ) , sesame snaps, i c e cream; N o n - n u t r i t i o u s s n a c k s : coke pop t a r t , gum, c h i p s , c h o c o l a t e b a r , d i l l y b a r , candy, t e a , p o p s i c l e . (See Table 13). Of t h e 109 c h i l d r e n who r e p o r t e d s n a c k s , 31 c h i l d r e n a t e o n l y n u t r i t i o u s s n a c k s . Most (35) c h i l d r e n a t e o n l y p a r t l y n u t r i t i o u s s n a c k s , and 17 c h i l d r e n ' s snacks were a l l non-n u t r i t i o u s . S e v e r a l c h i l d r e n a t e snacks which v a r i e d i n n u t r i t i o n a l g u a l i t y . E i g h t c h i l d r e n had s n a c k s , some of which were n u t r i t i o u s and o t h e r s o f which were o n l y p a r t l y n u t r i t i o u s . Ten c h i l d r e n had b o t h n u t r i t i o u s and non-n u t r i t i c u s snacks and 8 c h i l d r e n chcse both n o n - n u t r i t i o u s and p a r t l y - n u t r i t i o u s s n a c k s . . (See Table 14). These r e s u l t s suggest t h a t , w h i l e many o f t h e c h i l d r e n chose snacks which were e i t h e r w h o l l y or p a r t l y n u t r i t i o u s , t h e r e were s t i l l many whose snacks o f f e r e d l i t t l e t o no n u t r i e n t s to t h e i r t o t a l d i e t , I n view of the f a c t t h a t 62% o f the t o t a l sample p o p u l a t i o n d i d snack t h r o u g h o u t the day and 39% had 2 or more s n a c k s , n u t r i t i o n e d u c a t i o n , p a r t i c u l a r l y w i t h r e g a r d t o more wholesome f o c d c h o i c e s f o r s n a c k s , would 98 T a b l e 13 Snacks Eaten by C h i l d r e n C a t e g o r y % o f Snacks n Type of Foods Nutr i t i o u s 35 68 Apple (or o t h e r f r u i t ) ; m i l k ; peanut b u t t e r and banana sandwich; bread and m i l k ; c r a c k e r ; w i t h peanut b u t t e r ; r a i s i n s ; c a r r o t s (or o t h e r v e g e t a b l e . P a r t l y N u t r i t i o u s 37 71 C o o k i e s and m i l k (or any low n u t r i e n t f o o d w i t h m i l k ) ; sesame snaps; i c e cream. N o n — N u t r i t i o u s 28 54 Coke; pop t a r t ; gum; c h i p s ; c h o c o l a t e b a r ; d i l l y b a r ; candy; t e a ; p o p s i c l e . Table 14 Snacking P a t t e r n s o f C h i l d r e n % of C a t e g o r y n T o t a l (n= 109) Only n u t r i t i o u s 31 28. 4 Only p a r t l y n u t r i t i o u s 35 32. 1 Only n o n - n u t r i t i o u s 17 15.6 N u t r i t i o u s and p a r t l y n u t r i t i o u s 8 7.3 N u t r i t i o u s and n o n - n u t r i t i o u s 10 9.2 P a r t l y n u t r i t i o u s and n o n — n u t r i t i o u s 6 5. 5 99 seem war r a n t e d i n B r o c k l e h u r s t f a m i l i e s and grade s c h o o l s . R e s e a r c h e r s and e d u c a t o r s a l i k e have emphasized the v a l u e of b e g i n n i n g v e r y e a r l y i n l i f e t o a c q u i r e knowledge which w i l l be b e n e f i c i a l over a l i f e t i m e . The a c g u i s i t i o n of sound n u t r i t i o n a l knowledge a t a young age p r o v i d e s the i n d i v i d u a l w i t h t h e b a s i s f o r a h e a l t h y , p r o d u c t i v e l i f e . . There are many o p p o r t u n i t i e s f o r i n t r o d u c i n g n u t r i t i o n t o young c h i l d r e n . The media, t h e c l a s s r o o m , the s c h o o l lunchroom and the home can a l l r e p r e s e n t l e a r n i n g c e n t r e s . (Litman et a l . , 1964; B r i g g s and Calloway 1979; M o r r i s , 1974). The mean number of s e r v i n g s from each of the f o u r f o o d groups compared to Canada's Food Guide (Table 1 5 ) , i n d i c a t e s t h a t most c h i l d r e n comply w i t h t h e s e g u i d e l i n e s . T able 15 Mean Number of S e r v i n g s / C h i l d / D a y From Each Food Group S e r v i n g s / Food Group d a y / c h i l d Recommended* M i l k and D a i r y 2.30 2-3 svgs. Meat and Meat A l t e r n a t e s 2. 64 2 svgs. V e g e t a b l e s and F r u i t s 4. 38 4-5 s v g s . . Breads and C e r e a l s 3. 61 3-5 svgs. *by Canada's Food Guide When i n d i v i d u a l menus from a subsample of 80 c h i l d r e n were examined f o r adequacy c f n u t r i e n t i n t a k e and c o m p l i a n c e w i t h Canada's Food G u i d e , a d i f f e r e n t p i c t u r e emerged. (Table 16). F i r s t of a l l , mean number of s e r v i n g s from the f o u r f o o d groups were e s t i m a t e d and compared t o Canada's Food Guide. Table U Mean Nutrient Intake and Mean Number of Servings/Child/Day from each Food Qroup Fr.& Pro. Ca Fe ' Thi Hibo Nia Vit.C Zn P Mg Grp. Dairy Meat Veg Bread Sex Age g Cals Dg mg mg mg mg mg mg mg mg M 7-9 82.9 1881.5 9^ 7.9 12.3 1.3 2.'* 17.0 109.1 10.1 1440.1 293.1 2.7 2.6 J,M 3.2 ^ ^ ' g 2 6 5 > 2 1737.5 ioio.4 8.4 1.0 2.0 11.4 42.6 8.8 1314.7 254.0 10-12 7-9 72.9 1"»68.1 830.5 11.0 1.9 6.3 8.9* 62.0 6.5 1504.6 239.1 2.5 2.6 3.6* 3.<» ^ J 2 5^ .0 1 5 7 6 < 7 730.7 8.6 1.1 1.6 10.7 51.3 5.8 1563.4 228.1 10-12 - - - - - - - - -2.6 2.5 2.6* 3.'-2.3 3.0 3.5* M F M F 7-9 67.4 1820.6 816.4 8.5 1.1 1.7 13.2 48.0 8.0 1230.9 10-12 _ - - - - - - - - -7-9 74.0 1783.5 956.8 9.8 1.1 2.7 11.0 52.5 8.5 1336.0 10-12 59.5 1200.5* - 12.9 0.7 3.6 13.8 29.0 11.0 1226.8 7-9 89.I 19^ 5.5 1052.0 11.1 1.2 2.5 15.0 57.7 11.4 10-12 73.0 1895.3 682.7 11.4 1.5 1.8 153.5 7.0 7-9 77.3 1906.1 984.4 10.4 1.1 2.0 15.2 106.1 9.2 10-12 53.1 15H.0* 762.4 8.6 1.6 2.1 18.3 70.6 5.0* leeo than 2/3 recommended intake. 101 These were t a b l e d b e s i d e t h e mean n u t r i e n t i n t a k e s f o r the same 4 groups i n t h e subsample. The mean n u t r i e n t i n t a k e s were as s e s s e d f o r t h e i r adeguacy compared t o the R.D.I. Mean number of s e r v i n g s from the f r u i t s and v e g e t a b l e s group were below 2/3 of the recommended amount. As a whole, a l l g roups met (>2/3) recommendations f o r d a i r y , meats and br e a d s . A l l , i n f a c t , exceeded t h e recommended number of s e r v i n g s f o r t h e meat group. I n terms o f adequacy o f n u t r i e n t i n t a k e s , most o f the comparisons were made w i t h the R.D.I. f o r 7-9 y e a r o l d s . A l l groups as a whole had lower c a l o r i c i n t a k e s than p r e s c r i b e d by the R.D.I. . Cook e t a l . (1973), who found the c h i l d r e n i n t h e i r s t u d y a l s o t o be below recommended a l l o w a n c e s , s uggest t h a t t h e lower i n t a k e s were due p o s s i b l y t o de c r e a s e d energy e x p e n d i t u r e and t h e r e f o r e d e c r e a s e d need. They a l s o s uggest t h a t , " . . . w i t h i n c r e a s e d t r a n s p o r t f a c i l i t i e s and s e d e n t a r y amusements ( e s p e c i a l l y t e l e v i s i o n ) , the recommended v a l u e s may r e p r e s e n t t e c h i g h an energy i n t a k e f o r c u r r e n t c o n d i t i o n s . " S e v e r a l s t u d i e s r e p o r t i n t a k e s f o r c h i l d r e n i n t h i s age group which c l o s e l y resemble t h o s e found i n the p r e s e n t s t u d y . Peckos and Ross (1973) found t h a t mean c a l o r i c i n t a k e s were low f o r g i r l s a t a l l ages (3-17 y e a r s o f age) and f o r t h e boys a f t e r 8 y e a r s . A l l s u b j e c t s a t a l l ages exceeded the p r o t e i n a l l o w a n c e by 25 per c e n t c r more, w i t h t h e boys c o n s i s t e n t l y consuming mere p r c t e i n than the g i r l s . Wait (1973) s t u d i e d p r o t e i n i n t a k e o f w e l l - n o u r i s h e d c h i l d r e n and a d o l e s c e n t s and d i s c o v e r e d t h a t by 2 years of age, t h e mean p r o t e i n i n t a k e o f the boys i n her s t u d y was s l i g h t l y h i g h e r t h a n t h a t o f g i r l s . The gap widened even though 11- and 1 3 - y e a r - o l d g i r l s were 102 l a r g e r than boys of t h o s e ages. Wait a t t r i b u t e s t h e d i f f e r e n c e between the sexes i n p r o t e i n i n t a k e s t o d i f f e r e n c e s i n growth p a t t e r n s and a c t i v i t y . G i r l s mature a t an e a r l i e r age and u s u a l l y engage i n l e s s s t r e n u o u s a c t i v i t i e s than boys. With r e s p e c t t c number of s e r v i n g s o f items i n t h e i n d i v i d u a l f o o d g r o u p s , Eobson (1971) s t u d i e d t h e food h a b i t s of Canadian c h i l d r e n i n 2 J u n i o r High S c h o o l s i n North York. A l l c h i l d r e n were found t o be much below the recommended a l l o w a n c e s f o r m i l k , f r u i t and v e g e t a b l e s . B a r e l y 10% of the c h i l d r e n had 3 v e g e t a b l e s and o n l y h a l f o f the c h i l d r e n had the recommended 2 s e r v i n g s of f r u i t . Not o n l y were g e n e r a l i n t a k e s of f o o d s i n the f o u r food groups s i m i l a r t o those found i n the p r e s e n t s t u d y , snacks a l s o p l a y e d a major r o l e and were c o n s i d e r e d s e p a r a t e l y . Meal p a t t e r n s were a l s o s i m i l a r . B r e a k f a s t was t h e l e a s t p o p u l a r meal and l u n c h was a l s o o f t e n s k i p p e d . Only 3 out of 4 of the c h i l d r e n who met t h e recommendations of Canada's Food Guide a l s o had adequate n u t r i e n t i n t a k e s (see Table 17). Comparison of n u t r i e n t i n t a k e w i t h t h e M o d i f i e d B a s i c Four d e v i s e d by King would i n d i c a t e t h a t t h i s g uide w i l l not always ensure adequacy of n u t r i e n t i n t a k e e i t h e r . None o f the c h i l d r e n i n the subsample met the M o d i f i e d B a s i c Four and yet 25 s u b j e c t s had adeguate i n t a k e s o f a l l n u t r i e n t s s t u d i e d . (Table 18).. Of t h e s t u d e n t s whose i n t a k e was l e s s t h a n 2/3 o f the E.D.I., 41 had i n a d e g u a t e i n t a k e s of 1-2 n u t r i e n t s , 7 were i n a d e q u a t e i n 3-4 n u t r i e n t s , 5 c h i l d r e n were i n a d e q u a t e i n 5-6 n u t r i e n t s and t h e r e were even c h i l d r e n whose i n t a k e was i n a d e q u a t e f o r 7-8 and 9-10 n u t r i e n t s (1 i n each c a t e q o r y ) . Table 17 Nutrient Intake of Children Who Met Recommended Dietary Intakes Subject Pro. Fat CHO Ca Fe T h i . Ribo. Nia. Vit.C Zn P M R Number * (g) ( s) ( g) fog) (mS) (mg) (mg) (mg) (mg) („ s) (mg) fag) C a l a . 0024/50 58.3 230.2 792.9 7.8 1.0 1.6 10.8 43.9 8.5 1145.9 220.6 1648.5 0027^0 87.7 82.1 208.1 Il42.8 9.2 1.0 2.1 12.1 25.6 9 9 1546 7 209 4 lfcS 0 0028/50V 121.1 105.6 423.5 1917.0 13.6 1.6 3.3 15.4 57.0 18 0 2715 0 568 9 3089 0 0029/50' 142.1 148.6 507.1 1739.3 19.5 2.7 3.2 32.5 1?3.5 13 6 2726 8 598 5 $6*7? 0030/50 106.5 66.2 203.0 1907.1 9.3 1.1 3.2 12.8 56.O 15.5 2l80 8 438 9 I76O 0 0037/50 79.1 55.5 258.8 1449.9 14.2 1.1 2.2 13.4 281.0 9 1 16954 329 I 180? 0 0040/50 103.0 105.0 285.5 929.0 16.0 2.0 2.0 18.6 243.5 9.8 1422 8 240 4 2463 0 0045/50 71.5 94.8 216.0 1008.9 8.2 1.3 2.0 11.2 173.5 10 2 13330 334 7 l o t , * 0023/50 112.4 58.3 324.4 953.1 21.0 1.7 3.7 23 5 37 6 $6.? gl.3 2334.6 0030/51* 176.2 106.2 388.8 1742.3 29.4 6.7 25.4 11.4 102.1 19 1 334? 7 682 1 3S06 5 0034/51 79.5 55.5 142.0 840.0 9.8 0.7 1.6 16.3 87.O 14 5 11532 190 1 1347 0 0007/50 93.0 86.0 193.5 1547.2 8.7 0.8 2.6 11 6 34 1 13 7 1817 8 44? 4 lt™0 0010/50 86.2 97.7 I65.2 I638.I 8.3 1.1 2.6 11.6 70.6 14.3 1945 2 372 3 I837 0 0014/50 78.6 72.0 261.1 811.0 9.6 0.8 1.2 15,8 72.2 8.8 1551.7 388.6 2005.0 0018/50 115.4 88.7 390.6 2351.9 13.6 1.8 4.6 14.4 27.6 16.2 2583 4 435 9 2769 7 0020/50 130.4 89.3 178.2 1099.1 18.0 4.2 14.1 9.3 26.O 12.0 1849.8 287.I 1971 0 0021/50 69.0 62.7 291.0 848.1 10.7 1.3 1.4 11.1 104.0 7.9 U91.4 280.9 1897.O 0022/50 62.5 118.4 520.5 891.7 12.2 0.9 1.6 10.5 99.2 5.5 1530.8 398.6 3339 0 0014/51 75.5 79.5 286.5 II69.O 15.6 1.2 1.8 14.7 147.5 10.4 1492.1 383.6 2096.0 0013/51 83.O 96.O 186.0 835.0 11.0 1.0 1.8 19.0 39.0 7.9 1303.9 277.3 1895.0 0104/52 98.O 77.0 260.0 795.0 14.6 1.8 4.5 14.3 112.0 12.4 1560.2 283.2 2144 0 0109/52 87.1 94.0 289.O 981.0 10.3 1.0 1.7 17.3 84.2 *10.0 1345.3 332.9 2309.5 n^JB 2?*2 ^°* 5  k** Z 1 3 5 7 ' 5 1 0 / 7 1 , 5 2' 2 w«5 32.6 8.9 1818.6 400.7 2810.5 0115/52 84.3 63.3 313.9 1410.1 8.3 0.9 2.3 9.5 55.5 9.2 1509.2 303.9 2118.0 •AIBO met Basic Four recommendations +51 = 2 recalls *50, 52 = 1 r e c a l l 104 Table 18 Adequacy o f D i e t s o f Students No. Students*-Meet B a s i c Four 4 Meet M o d i f i e d B a s i c 4 0 Meet >2/3 RDI* 25 Meet E a s i c 4 and Meet > 2/3 RDI* 3 <2/3 RDI* i n 1-2 N u t r i e n t s 41 <2/3 RDI* i n 3-4 N u t r i e n t s 7 <2/3 RDI* i n 5-6 N u t r i e n t s 5 <2/3 RDI* i n 7-8 N u t r i e n t s 1 <2/3 RDI* i n 9-10 N u t r i e n t s 1 •Recommended D i e t a r y I n t a k e s •out of 80 s t u d e n t s T a ble 19 E s t i m a t e d Mean D a i l y I n t a k e o f Lead, Copper and Z i n c by B r o c k l e h u r s t C h i l d r e n Food Group Pb (mg) Cu (mg) Zn (mg) M i l k 6 D a i r y P r o d u c t s .01705 .20675 2. 8977 Meat & A l t e r n a t e s ,00660 . 25959 3. 7477 F r u i t 6 V e g e t a b l e s .11985 .39487 • 5703 Breads S C e r e a l s .0 1153 .34172 1. 4243 F a t s .00031 .01147 • 0336 Sugars .00120 .22230 • 0393 T o t a l . 1 5 6 5 4 1. 43670 8. 7099 105 T h i r t y - - f i v e c f t h e 55 c h i l d r e n who had l e s s than adequate n u t r i e n t i n t a k e s were adequate i n c a l o r i c i n t a k e . T h i s would suggest t h a t many c h i l d r e n a r e consuming food i t e m s which c o n t r i b u t e l i t t l e more than c a l o r i e s t o t h e i r d i e t . . These r e s u l t s a g a i n emphasize the need f o r e d u c a t i o n which w i l l p r o v i d e B r o c k l e h u r s t s c h o o l c h i l d r e n w i t h enough n u t r i t i o n knowledge to make b e t t e r food c h o i c e s . The amount c f l e a d , copper and z i n c p r o v i d e d by each fo o d group i s shown i n Table 19. R e s u l t s from a s i m i l a r s tudy o f t r a c e m i n e r a l c o n c e n t r a t i o n s i n a r e p r e s e n t a t i v e Canadian d i e t o f a d u l t s by K i r k p a t r i c k and C o f f i n (1977) compare f a v o u r a b l y c w i t h r e s u l t s o b t a i n e d frcm the r e c a l l e d i n f o r m a t i o n i n t h i s s t u d y . (Table 20). Table 20 Sources of Trace Elements i n t h e D a i l y D i e t of Canadian A d u l t s (Average of 4 Qua r t e r s ) Food Group M i l k & D a i r y P r o d u c t s Meat & A l t e r n a t e s F r u i t s S V e g e t a b l e s Breads S C e r e a l s F a t s Sugars Pb (mg) Cu (mg) Zn (mg) .018 .095 2.593 .015 .351 9.377 .029 .472 1.318 .008 .430 1.907 .001 .042 .174 .005 .206 .148 from: K i r k p a t r i c k , D.C. and D.E. C o f f i n 1977, pp 165 n.b. R e s u l t s of t r a c e element a n a l y s e s f o r composite f o o d samples o b t a i n e d g u a r t e r l y i n t h e Winnipeg area i n 1972. . E s t i m a t e d mean d a i l y i n t a k e s o f l e a d , copper and z i n c were a l s o t a b l e d a c c o r d i n g t o s u r v e y group which took s e a s o n a l d i f f e r e n c e s i n t o a c c o u n t . (Table 21). Values from a l l groups 106 ar e s i m i l a r t o t h o s e shown i n T a b l e 22 which averages t o t a l d a i l y i n t a k e c f t r a c e metals over 4 q u a r t e r s ( K i r k p a t r i c k and C o f f i n 1977) . C i FOOD CCMEOSITES JL COLLECTION FBOCED0EES Of t h e 20 f a m i l i e s i n t e r v i e w e d i n B r o c k l e h u r s t , 10 were asked t o c o l l e c t d u p l i c a t e 24-hour co m p o s i t e s of t h e f o o d consumed by the t h i r d - g r a d e c h i l d . Each o f the 10 f a m i l i e s was p r o v i d e d w i t h two o n e - l i t e r acid-washed p o l y e t h y l e n e c o n t a i n e r s and was i n s t r u c t e d t o d i v i d e a l l foods eaten by the c h i l d d u r i n g t h e f o l l o w i n g 24-hour p e r i o d i n t o t h e a p p r o p r i a t e c o n t a i n e r s marked e i t h e r " L o c a l Foods" or "Non-Local Foods". No beverages were i n c l u d e d s i n c e t h i s type of c o l l e c t i o n i s d i f f i c u l t t c t r a n s p o r t and would r e g u i r e s p e c i a l c o n t a i n e r s . As f o o d i t e m s were p l a c e d i n t o the c o n t a i n e r s , t h e y were noted as t o f o o d i t e m , q u a n t i t y , source and amount u s u a l l y consumed/week cn a l i s t p r o v i d e d w i t h each c o n t a i n e r . A 24-hour r e c a l l f o r the p e r i o d d u r i n g which the c o n t a i n e r s were f i l l e d was t a k e n when th e food c o m p o s i t e s were c o l l e c t e d . The fo o d i t e m s r e c a l l e d as h a v i n g been s e r v e d t o the c h i l d were compared w i t h those r e c o r d e d on t h e l i s t s t o ensure t h a t samples o f a l l food i t e m s eaten by the c h i l d had been p l a c e d i n the c o n t a i n e r s . C o n t a i n e r s were c o l l e c t e d , f r o z e n i m m e d i a t e l y , and s e n t t o Vancouver where t h e y were kept i n t h e f r o z e n s t a t e u n t i l a n a l y z e d . 107 Table 21 E s t i m a t e d Mean D a i l y I n t a k e / C h i l d of Lead, Copper & Z i n c by Survey Group F a l l S p r i n g S p r i n g R e c a l l s One Two One Given by T o t a l R e c a l l * R e c a l l s * R e c a l l 3 P a r e n t * M i n e r a l n=193 n=94 n=5 8 n=2 2 n = 19 Cu (mg) 1. 4213 1.3042 1.4436 1.6922 1.3490 Zn (mg) 8.0689 8.4545 8.7825 7.7417 7.2967 Pb (mg) . 1597 .1310 . 1456 . 1514 .2107 * 1 r e c a l l o b t a i n e d i n t h e f a l l 2 2 r e c a l l s ; 1 o b t a i n e d i n t h e f a l l , 1 o b t a i n e d i n t h e s p r i n g 3 1 r e c a l l o b t a i n e d i n the s p r i n g * 1 r e c a l l g i v e n by the paren t on the c h i l d i n t h e f a l l T a b l e 22 E s t i m a t e d T o t a l D a i l y I n t a k e c f Trace M e t a l s from Foods (Average c f 4 Quarters) D a i l y I n t a k e M i n e r a l (mg/person/day) Copper 1. 606 Z i n c 15. 550 Lead . 077 from: K i r k p a t r i c k , E.C. S D.E. C o f f i n , 1977, pp 164 n.b. R e s u l t s of t r a c e element a n a l y s e s f o r composite food sample o b t a i n e d g u a r t e r l y i n the Winnipeg a r e a i n 1972. 108 S i n c e t h e sample p o p u l a t i o n i n G e n e l l e c o m p r ised o n l y 10 f a m i l i e s , each of the 10 was r e q u e s t e d t o c o l l e c t a 24-hour c o m p o s i t e . C o l l e c t i o n proceeded i n t h e same manner as d i d t h e c o l l e c t i o n i n B r o c k l e h u r s t . Table 23 g i v e s a l i s t of c o n t a i n e r s and d e s c r i p t i o n o f the foods c o l l e c t e d frcm B r o c k l e h u r s t and G e n e l l e . . (See Appendix E) . Alth o u g h the p a r t i c i p a n t s were i n s t r u c t e d t o g i v e d u p l i c a t e s of whatever the c h i l d a t e over a p r e s c r i b e d 24-hour p e r i o d , t h e r e was a m i s u n d e r s t a n d i n g as t o t h e d e f i n i t i o n of " d u p l i c a t e " . Even though examples were g i v e n t o c l a r i f y how the food was t o be c o l l e c t e d (e.g. " i f the c h i l d e a t s 1 s l i c e of b r e a d , p l a c e 1 s l i c e of bread i n t o t h e a p p r o p r i a t e c o n t a i n e r as w e l l ) , i t was apparent t h a t t h i s e x p l a n a t i o n was not s u f f i c i e n t . The c o n t a i n e r s were used as i n s t r u c t e d . However, w h i l e s u b j e c t s d i d d u p l i c a t e samples i n terms of a c t u a l f o o d i t e m , the q u a n t i t i e s g i v e n d i d not a c c u r a t e l y r e f l e c t t he q u a n t i t i e s s e r v e d t o the c h i l d . . S i n c e time was l i m i t e d , the f o o d samples had t o be used as g i v e n and, t h e r e f o r e , some m o d i f i c a t i o n s had t o be made t o t h e o r i g i n a l a n a l y t i c a l procedure. I n d i v i d u a l f o o d s c o u l d n o t be a n a l y z e d s e p a r a t e l y and, i n many c a s e s , t h e c o n t e n t s of one c o n t a i n e r had t o be combined w i t h o t h e r s t o produce a sample l a r g e enough t o a n a l y z e . The f a c t t h a t o n l y p o r t i o n s of the food i t e m s were g i v e n and not the e n t i r e s e r v i n g a l s o means t h a t t h e samples cannot be re g a r d e d as r e p r e s e n t a t i v e of t h o s e foods from which they came. However, the r e s u l t s from the a n a l y s i s o f the fo o d s c o l l e c t e d can g i v e some i n d i c a t i o n as t o 109 how l o c a l l y - g r o w n f c o d s and foods grown o u t s i d e the a r e a o f s t u d y compare i n terms o f t h e i r m i n e r a l c o n t e n t and how much of the t o t a l d i e t a r y l e a d , copper and z i n c might be d e r i v e d from l o c a l l y - g r o w n f o o d s . Zj. METHOD OF ANALYSIS As w i t h the a n a l y s i s o f t r a c e elements i n t e e t h , t h e r e are s e v e r a l p o s s i b l e methods f o r a n a l y s i s of t r a c e elements i n f o o d s . . The a v a i l a b i l i t y of a Unicam SP90 Atomic A b s o r p t i o n S p e c t r o p h c t c m e t e r (AAS) i n t h e department made t h i s i n s t r u m e n t a l o g i c a l c h o i c e f o r the p r e s e n t s t u d y . The f o o d samples were pr e p a r e d and d i g e s t e d a c c o r d i n g t o a m o d i f i e d method of Gorsuch (1970) . S i n c e the AAS l a c k s the s e n s i t i v i t y n e c e s s a r y t o d e t e r m i n e amounts o f l e a d n o r m a l l y found i n f c o d s , samples were a n a l y z e d f o r l e a d a t the E n v i r o n m e n t a l L a b o r a t o r y , E.C. M i n i s t r y o f the Environment. Samples were prepar e d as d e s c r i b e d on page 113 and d i g e s t e d f o r ICP/AES a n a l y s i s as d e s c r i b e d on page 114. S i n c e the ICP/AES has a 20-element s c a n , copper and z i n c were a l s o determined and compared w i t h r e s u l t s o b t a i n e d w i t h a n a l y s i s by AAS. P r e l i m i n a r y a n a l y s e s were performed cn a f o o d c o m p o s i t e r e p r e s e n t a t i v e of the foods c o l l e c t e d from B r o c k l e h u r s t and G e n e l l e . The purpose of these p r e l i m i n a r y runs was t o t e s t f o r s u i t a b i l i t y of t h e method of p r e p a r a t i o n and d i g e s t i o n of the sample and t o ensure t h a t a n a l y s e s c o u l d be performed on the AAS. 110 A l l g l a s s w a r e used was washed i n an a u t o m a t i c washer and soaked i n 6N n i t r i c a c i d s o l u t i o n and r i n s e d t h o r o u g h l y w i t h double d i s t i l l e d water. A water p u r i f i c a t i o n c a r t r i d g e ( B a r n s t e a d High C a p a c i t y , B a r n s t e a d Company, B o s t o n , Mass.) was used t o produce t h e d e i c n i z e d water which was s u b s e g u e n t l y d i s t i l l e d and used throughout t h e e x p e r i m e n t s . A_j_ COPPER AND ZINC IN FOCDS 111 SAMPLE PJEPARATION There were s i x composites of l o c a l l y - g r o w n f oods from B r o c k l e h u r s t and G e n e l l e , and e i g h t c o m p o s i t e s o f n o n - l o c a l l y grown f o o d s from the two areas t o g i v e a t o t a l of 28 samples. Each o f t h e 28 samples was a n a l y z e d s e p a r a t e l y . An a d d i t i o n a l seven c o m p o s i t e s o f l o c a l l y - g r o w n B r o c k l e h u r s t foods were blended t o g e t h e r and a n a l y z e d as one sample. Four c o m p o s i t e s of f o o d s grown i n G e n e l l e were blended and a n a l y z e d as one. S i x c o m p o s i t e s from B r o c k l e h u r s t and f i v e c o m p o s i t e s from G e n e l l e were combined i n the same manner and p r o v i d e d a f u r t h e r two samples of n o n - l o c a l foods t o be a n a l y z e d . T h i s was done because p o r t i o n s c f food i t e m s of many of the c o m p o s i t e s were too s m a l l t o be c o n s i d e r e d r e p r e s e n t a t i v e o f t h e i n d i v i d u a l i t e m s . T h e r e f o r e , s e v e r a l c o m p o s i t e s from t h e same a r e a were combined to y i e l d a sample which c o u l d be a n a l y z e d s a t i s f a c t o r i l y . In o r d e r t o determine i f B r o c k l e h u r s t or G e n e l l e f o o d s c o n t a i n e d unduly e l e v a t e d c o n c e n t r a t i o n s of the t r a c e elements 111 i n q u e s t i o n , mimic composites were made from f o o d s purchased i n Vancouver which were e x a c t d u p l i c a t e s ( i n q u a n t i t y and f o o d item) o f the c o n t e n t s of the combined c o n t a i n e r s o f l o c a l l y -grown foods from B r o c k l e h u r s t and G e n e l l e . The mimics were a n a l y z e d a l o n g w i t h t h e i r c o r r e s p o n d i n g blended c o m p o s i t e s o f e i t h e r B r o c k l e h u r s t or G e n e l l e l c c a l l y - g r o w n f o o d s . R e s u l t s were compared t o see i f d i f f e r e n c e s i n m i n e r a l c o n c e n t r a t i o n s e x i s t e d between l c c a l l y - g r o w n and Vancouver-bought f o o d s . Table 24 l i s t s the food i t e m s of the combined l o c a l l y -grown B r o c k l e h u r s t and l o c a l l y - g r o w n G e n e l l e foods which were combined and f o r which mimics were made. I t i s e v i d e n t from t h i s t a b l e why the c o n t e n t s of the c o n t a i n e r s had t o be combined t o produce a s a t i s f a c t o r y sample f o r a n a l y s i s . No mimics were made f o r comparison w i t h the n o n - l o c a l l y grown foods from the two a r e a s . Weighed samples were homogenized i n a Waring B l e n d e r . . A l i q u o t s of the homogenate were weighed and kept i n the f r o z e n s t a t e i n acid-washed Nalgene b o t t l e s u n t i l a n a l y z e d by AAS or ICP/AES. A s t a n d a r d food sample from a composite of Vancouver f o o d s r e p r e s e n t a t i v e of the foods c o n t a i n e d i n t h e c o l l e c t i o n was run w i t h each s e t of a n a l y s e s performed. Working s t a n d a r d s o l u t i o n s were prepa r e d from r e a g e n t grade s t o c k s t a n d a r d s (1 mg/1 ml h y d r o c h l o r i c a c i d ) s u p p l i e d by F i s h e r S c i e n t i f i c . S e r i a l d i l u t i o n s commencing with a 1 ml a l i q u o t o f t h e 1 ppm s o l u t i o n i n 100 ml d i s t i l l e d water were used t o produce working s t a n d a r d s c o n t a i n i n g 50, 150, 300, 500 and 700 ug z i n c / 1 0 0 ml d i s t i l l e d water and .1, .2, .4, .6 and 112 Table 24 Co n t e n t s o f L o c a l l y - G r o w n Food Composites C o n t a i n e r Number Source Food Item Amount 9 E r o c k l e h u r s t Cue umber Apple 2 s l i c e s 1 s l i c e 14 I I Tomato Cucumber 1 s l i c e 1/8 23 I I Apple 1/4 26 I I L e t t u c e M e a t b a l l Corn 1 t s p . 1/2 s m a l l 1/2 s m a l l cob 27 I I C a r r o t Cucumber 1 s l i c e 1 s l i c e 30 I I C a r r o t Cucumber Apple Tomato 1 s m a l l 3 s l i c e s 1/2 s m a l l 1 s l i c e , 31 I I P o t a t o C a r r o t 1 t b s p , 1 t s p . 5 G e n e l l e Corn C a r r o t 1/2 s m a l l 1 s l i c e cob 7 I I Tomato Cucumber C a u l i f l o w e r 1 s l i c e 1 s l i c e 3 f l o w e r s 20 I I Peach 1 34 •i P o t a t o 1/8 113 .8 mg copper/100 ml d i s t i l l e d w ater. The s o l u t i o n s were s t o r e d i n acid-washed p o l y e t h y l e n e b o t t l e s and r e f r i g e r a t e d . A r e a g e n t blank was a l s o run w i t h each s e t of a n a l y s e s . A l l samples were a n a l y z e d i n t r i p l i c a t e . (2) SAMPLE DIGESTION AND ANALYSIS I n each e x p e r i m e n t a l r u n , 10-15 gram samples were p l a c e d on p l a s t i c p e t r i d i s h e s t a k e n from s e a l e d p l a s t i c bags, and p l a c e d i n a d r y i n g oven (70 ° C) f o r 24 h o u r s . , A f t e r w e i g h i n g , the samples were t r a n s f e r r e d t o p o r c e l a i n or s i l i c a c r u c i b l e s and p l a c e d i n a m u f f l e f u r n a c e (550 ° C) f c r 24 hours o r u n t i l a w h i t e ash remained. The ash was then c o o l e d i n a d e s s i c a t o r , weighed and an a p p r o p r i a t e amount of 6N h y d r o c h l o r i c a c i d was added t o d i s s o l v e t h e ash ( a p p r o x i m a t e l y 2 ml/.1 g a s h ) . . D i s t i l l e d water was then added i n s u f f i c i e n t amounts t o g i v e r e a d i n g s w i t h i n the working c u r v e ( u s u a l l y 4 t o 8 m l ) . D e t e r m i n a t i c n s of copper and z i n c were performed by AAS. ib. LEAD IN FOODS JL11 S A M l t J PREPARATION A l i g u c t s of each of the samples prepa r e d f o r d e t e r m i n a t i o n of copper and z i n c were r e s e r v e d f o r a n a l y s i s of l e a d by ICP/AES. 114 J 1 L SAMPLE DIGESTION AMD ANALYSIS The f o o d samples were d i g e s t e d and a n a l y z e d u s i n g t h e same procedure as o u t l i n e d f o r t r a c e element d e t e r m i n a t i o n i n the t o o t h samples. A 5.0 gram (wet weight) sample was d i g e s t e d i n the presence o f s u c c e s s i v e 15 and 10 ml a l i g u o t s o f n i t r i c a c i d ; a f t e r each a d d i t i o n , the sample was taken t o near d r y n e s s . Next, 5.5 ml p e r c h l o r i c a c i d was added and t h e sample d i g e s t e d u n t i l dense white fumes of p e r c h l o r i c a c i d appeared.. The p e r c h l o r i c a c i d s o l u t i o n was then t r a n s f e r r e d g u a n t i t a t i v e l y i n t o v o l u m e t r i c f l a s k s and b u l k e d t o a p p r o p r i a t e volumes (100 mis) . The samples were then f i l t e r e d t hrough Whatman #42 paper i n t o acid-washed p o l y b o t t l e s . A n a l y s i s was c a r r i e d out by ICP/AES and a 20-element scan was r u n . i i DATA ANALYSIS The amounts of l e a d , copper and z i n c i n t h e f o o d samples, determined by both AAS and ICP/AES, are g i v e n i n T a b l e 25. Other elements determined by ICE/AES a r e g i v e n i n Table 26. Tab l e 27 l i s t s d i f f e r e n c e s i n mean c o n c e n t r a t i o n s o f copper and z i n c found w i t h AAS and ICP/AES. Ta b l e 28 compares copper, z i n c and l e a d c o n c e n t r a t i o n s c a l c u l a t e d frcm 24-hour r e c a l l s c o l l e c t e d w i t h t h e f o o d c o m p o s i t e s w i t h c o n c e n t r a t i o n s r e s u l t i n g from c h e m i c a l a n a l y s i s of t h e s e c o m p o s i t e s by AAS and ICP/AES. 115 Table 25 Copper, Lead & Z i n c i n Food Samples from B r o c k l e h u r s t and G e n e l l e • Pb Cu Cu Zn Zn Source (ICP/AES) (AAS) (ICP/AES) (AAS) (ICP/AES) ug/g t r e s h weight G e n e l l e n=4 <1 1.6±.9 1.8±.8 3. 1± .9 5.0±1.6 B r o c k l e h u r s t n=4 <1 1.5±.4 1.3±.6 3.2±1.3 2.7±1.5 G e n e l l e Non—Local n=5 <1 1.6±.8 1.8±.4 6.5± .3 6.7±.5 B r o c k l e h u r s t Non-Local n=5 <1 1.11.2 1 . 0 l 0 5.811.9 6.8±2.6 •Lead determined by I n d u c t i v e l y Coupled Plasma Atomic E m i s s i o n S p e c t r o s c o p y ; Copper and Z i n c d etermined by Atomic A b s o r p t i o n S p e c t r o p h o t o m e t r y . 116 T a b l e 26 Other Elements Determined by ICE/AES i n L o c a l and Non-Local Food Composites Element L o c a l Food Non-Local Foods  ug/g G e n e l l e E r o c k l e h u r s t G e n e l l e B r o c k l e h u r s t wet wt. N=4 n=4 n=5 n=5 As 1 <1 0.4 0. 8 Sb <2 <2 <2 <2 P 430 427 695.4 875. 2 Cd <1 <1 <1 <1 Ni <1 <1 <1 <1 Mn 1. 5 1 3 1.8 Fe 3. 8 4. 3 6.4 10.5 Mg 16.7 138.6 211.8 154. 2 Mo <1 <1 <1 <1 Cr <1 <1 <1 <1 V <1 <1 <1 <1 T i <i <1 <1 <1 Co <2 <2 <2 <2 A l <1 1.3 0.4 2.0 Ca 175 192. 6 178.8 353. 5 Ba 0 0 0 0 Sr 1 1. 3 1 0.5 117 T a b l e 27 D i f f e r e n c e s i n Mean C o n c e n t r a t i o n s o f Focd Copper & Z i n c Found w i t h AAS and ICP/AES :ource D i f f e r e n c e s Cu Zn (ug/g f r e s h wt.) G e n e l l e n=4 0.6 0. 8 E r o c k l e h u r s t n=4 0.2 0.4 G e n e l l e N o n - l o c a l n = 5 0. 1 0. 2 E r o c k l e h u r s t N c n -Local n = 5 0.8 0. 3 118 Table 28 C a l c u l a t e d Mean Lead, Copper, G Z i n c i n 24-Hour D i e t R e c a l l s Compared t o Ana l y z e d C o n c e n t r a t i o n s i n Food Composites C a l c u l a t e d Analyzed (n=19) M i n e r a l n=53 AAS ICP/AES ifg7g Cu 1.2 1.5 1.1 Zn 7.3 5. 5 5.6 Eb 0.2 - <1 Tab l e 29 Most F r e q u e n t l y Mentioned Foods i n I n t e r v i e w s and Composites Composites* I n t e r v i e w s * Cucumber Cucumber C a r r o t C a r r o t Tomato Tcmato P o t a t o L e t t u c e Apple Apple Corn Ccrn Plum R a d i s h Peach Green Beans •fo o d s mentioned are i n no s p e c i a l o r d e r . 119 its. RESULTS AND DISCUSSION Table 29 l i s t s the l o c a l l y - g r o w n foods most f r e q u e n t l y found i n the 24-hour d i e t c o m p o s i t e s and the foods most f r e q u e n t l y mentioned i n t h e i n t e r v i e w s (not i n any p a r t i c u l a r o r d e r ) . I t can be seen t h a t t h e foods a n a l y z e d were v e r y r e p r e s e n t a t i v e c f those most f r e q u e n t l y consumed by the sample p o p u l a t i o n a c c o r d i n g t o the i n f o r m a t i o n c o n t a i n e d i n the i n t e r v i e w s . As seen i n Table 25, l e a d c o n c e n t r a t i o n s were u n d e t e c t a b l e at l e s s t h a n 1 ppm i n a l l food samples. Although both methods gave s i m i l a r r e s u l t s f o r copper and z i n c c o n c e n t r a t i o n s i n a l l f o o d samples, the copper c o n c e n t r a t i o n s tended t o be c o n s i s t e n t l y h i g h e r w i t h the AAS and t h e z i n c c o n c e n t r a t i o n s c o n s i s t e n t l y l o w e r . However, as shown i n Table 27, t h e d i f f e r e n c e s are not g r e a t . D i f f e r e n c e s i n r e s u l t s are not an unusual o c c u r r e n c e when two d i f f e r e n t methods a r e compared. V a l u e s i n ug/g f r e s h weight f o r copper and z i n c i n North American food composites were found t o be 1.3 and 5.6, and 1.1 and 6.3 i n Atomic A b s o r p t i o n s t u d i e s by Meranger and Smith (1972) and K i r k p a t r i c k and C o f f i n (1977) r e s p e c t i v e l y . These compare w e l l w i t h the data i n t h i s s t u d y . F i n a l l y , a l o o k at Table 28 shows t h a t m i n e r a l i n t a k e s as e s t i m a t e d from 24-hour r e c a l l s a r e i n good agreement w i t h c o n c e n t r a t i o n s found by c h e m i c a l l y a n a l y z i n g t h e f o o d c o m p o s i t e s which accompanied t h e 24-hour r e c a l l s . A l t h o u g h t h i s c omparison cannot p r o v i d e c o n c l u s i v e i n f o r m a t i o n w i t h r e g a r d t o t h e s i m i l a r i t y between the c a l c u l a t e d and a n a l y z e d 120 values, i t i s i n t e r e s t i n g t o note that c a l c u l a t e d values are very o f t e n s l i g h t l y higher than analyzed values as observed i n t h i s study (White, 1969). This a l s o i n d i c a t e s that the r e c a l l e d information can be considered an accurate r e p r e s e n t a t i o n cf what was a c t u a l l y given f o r a n a l y s i s and i n d i c a t e s that the 24-hour r e c a l l was indeed a s u i t a b l e t o o l f o r cross-checking the i n f o r m a t i o n l i s t e d on the c o n t a i n e r s . . 121 CHAPTER VI GENERAL DISCUSSION In t h i s s t u d y , l e a d , copper and z i n c were i n v e s t i g a t e d i n the human environment i n Kamloops and T r a i l , two towns i n B r i t i s h Columbia where metal s m e l t e r s are i n o p e r a t i o n . C o n c e n t r a t i o n s of these t h r e e elements were determined i n deciduous t e e t h as one i n d i c a t i o n o f human body c o n c e n t r a t i o n s . These e l e m e n t s were a l s o a s s e s s e d i n t h e food s u p p l y of t h e two communities u s i n g d i e t a r y r e c a l l s , q u e s t i o n n a i r e s on l o c a l f o o d p r o d u c t i o n and consumption, and food a n a l y s i s by a t o m i c a b s o r p t i o n and plasma e m i s s i o n s p e c t r o s c o p y . I n a d d i t i o n , the d i e t a r y p r a c t i c e s of s c h o o l c h i l d r e n i n the Kamloops a r e a were e v a l u a t e d u s i n q the 24-hcur r e c a l l method. L e a d x Copper and Z i n c i n Teeth R e s u l t s from the t o o t h a n a l y s e s demonstrate s i g n i f i c a n t l y h i g h e r (p <0.05) c o n c e n t r a t i o n s of l e a d i n t e e t h from c h i l d r e n l i v i n g i n T r a i l than i n t e e t h from c h i l d r e n i n Kamloops. Z i n c c o n c e n t r a t i o n s i n samples from T r a i l and Kamloops were not s i g n i f i c a n t l y d i f f e r e n t . , The h i g h e r l e a d c o n c e n t r a t i o n s i n T r a i l t e e t h may p o s s i b l y r e f l e c t enhanced c o n c e n t r a t i o n s r e s u l t i n g from the l e a d i n d u s t r y i n T r a i l . Copper s m e l t e r o p e r a t i o n s have o n l y r e c e n t l y begun i n Kamloops, whereas t h e l e a d / z i n c s m e l t e r i n T r a i l has been o p e r a t i n g f o r w e l l over 25 y e a r s . The h i g h e r l e a d c o n c e n t r a t i o n s i n T r a i l t e e t h c o u l d a l s o r e f l e c t t he age o f the T r a i l t o o t h donors who were g e n e r a l l y younger th a n c h i l d r e n from Kamloops. As d i s c u s s e d i n the Review of L i t e r a t u r e , younger c h i l d r e n a r e much more s u s c e p t i b l e t c l e a d a c c u m u l a t i o n than a r e o l d e r c h i l d r e n and 122 a d u l t s . Other s t u d i e s u s i n g t e e t h as i n d i c a t o r s of human exposure t o i n c r e a s e d i n d u s t r i a l c o n t a m i n a t i o n show s i m i l a r r e s u l t s t o t h o s e found i n t h e p r e s e n t s t u d y . Kaneko e t a l . (1974) found z i n c and l e a d c o n c e n t r a t i o n s t o be h i g h e r i n Tokyo as opposed t o t h r e e o t h e r l e s s i n d u s t r i a l i z e d a r e a s of Japan. The d i f f e r e n c e s i n l e a d c o n c e n t r a t i o n s were s i g n i f i c a n t . Fosse and J u s t e s e n (1978) a l s o found t h a t u r b a n i z a t i o n and i n d u s t r i a l i z a t i o n i n c r e a s e z i n c c o n c e n t r a t i o n s i n t e e t h and t h e r e was a s i g n i f i c a n t p o s i t i v e c o r r e l a t i o n between z i n c and l e a d i n the t e e t h w i t h an e x t r e m e l y h i g h z i n c l e v e l . As i n t h e p r e s e n t s t u d y , t o o t h copper c o n c e n t r a t i o n s were not e l e v a t e d . l e a d x Copper and Z i n c i n t h e Feed Supply S t u d i e s have shown t h a t m i n e r a l l e v e l s of f o o d grown i n the a r e a of heavy i n d u s t r i a l i z a t i o n can be c o n s i d e r a b l y e l e v a t e d ( S c h m i t t e t a l . , 1971; B e a v i n g t o n , 1975, 1977; P r e e r , 1977) . In t h e p r e s e n t s t u d y , c o n c e n t r a t i o n s of t h e t h r e e e lements i n b oth the l c c a l l y - g r c w n f o o d samples and samples of t h o s e f o o d s s u p p l i e d from o u t s i d e the two a r e a s were not e x c e s s i v e l y h i g h and a n a l y z e d v a l u e s compared f a v o u r a b l y w i t h c a l c u l a t e d v a l u e s from th e 24-hour r e c a l l s g i v e n by the c h i l d r e n i n the Kamloops a r e a . However, w h i l e t h e s e r e s u l t s seem t o i n d i c a t e t h a t t h e r e s h o u l d be a t p r e s e n t no cause f o r concern w i t h r e g a r d t o the c o n t r i b u t i o n of t h e s e elements e i t h e r by l o c a l l y -grown or n c n - l c c a l f o o d s , i t must be emphasized t h a t the samples cannot be c o n s i d e r e d t r u l y r e p r e s e n t a t i v e of the t o t a l f o o d s u p p l y and f u r t h e r a n a l y s i s i s recommended. I n a d d i t i o n , i t must a l s o be p o i n t e d out t h a t t h e f o o d samples were 123 c o l l e c t e d i n 1978. T h e r e f o r e , even i f f o o d c o l l e c t i o n p r o c e d u r e s had been more thorough, t h e f o o d would s t i l l not be r e p r e s e n t a t i v e of the f o o d which would have been c o n t r i b u t i n g m i n e r a l s t o t h e d i e t c f the c h i l d r e n p r e n a t a l l y and i n i n f a n c y when t o o t h m i n e r a l i z a t i o n t a k e s p l a c e . I t i s p o s s i b l e t h a t e n v i r o n m e n t a l l e a d and z i n c c o n c e n t r a t i o n s were h i g h e r a t t h a t time (1965-1970).. There a r e o t h e r p o s s i b l e s o u r c e s of human i n t a k e of l e a d and z i n c t h a t have not been s t u d i e d here. . These are d i s c u s s e d i n the Review of L i t e r a t u r e and i n c l u d e o c c u p a t i o n a l and e n v i r o n m e n t a l exposures such as d r i n k i n g water c o n t a m i n a t e d by m etal p i p e s c r by s t o r a g e i n metal t a n k s e s p e c i a l l y i n a s o f t water a r e a . P i c a a c c o u n t s f o r a g r e a t d e a l o f l e a d p o i s o n i n g among young c h i l d r e n (Andelman and S h a p i r o 1973; Goyer and Rhyne 1973; Kolbye e t a l . , 1975; S c h r o e d e r , 1975; G randjean, 1978; Moore e t a l . , 1978; NAS, 1979) . L o c a l Food Consumption Amount cf l c c a l l y - g r o w n f o o d s consumed by f a m i l i e s who were i n t e r v i e w e d was most s t r o n g l y i n f l u e n c e d by season of the y e a r . The seasons which would o f f e r g r e a t e s t a v a i l a b i l i t y o f "garden f r e s h " f o o d (summer and f a l l ) were th o s e i n which the g r e a t e s t amount of f r e s h f o o d s were consumed. In the B r o c k l e h u r s t a r e a of Kamloops, f o r each s e a s o n , as t h e amount of f r e s h f o o d s se r v e d d e c r e a s e d , t h e r e was a c o n c o m i t a n t i n c r e a s e i n the number c f s e r v i n g s of p r e s e r v e d f o o d s . There were s i g n i f i c a n t (p <0.05) d i f f e r e n c e s i n the amounts o f f r e s h and p r e s e r v e d l o c a l l y - g r o w n f o ods s e r v e d d u r i n g each season (except f a l l ) i n the Kamlcops area p o p u l a t i o n . . However, f o r 124 the G e n e l l e a r e a of T r a i l , d i f f e r e n c e s were s i g n i f i c a n t (p <0.05) o n l y i n the summer. Perhaps the Kamloops a r e a p o p u l a t i o n engages i n more home p r e s e r v a t i o n of l o c a l l y - g r o w n f o o d s . I t c o u l d a l s o be t h a t t h e r e i s s i m p l y a more even d i s t r i b u t i o n of l o c a l l y - g r o w n foods s e r v e d f r e s h and p r e s e r v e d by f a m i l i e s i n the T r a i l a r e a . Number of people i n the h o u s e h o l d , l e n g t h of r e s i d e n c e a t pr e s e n t a d dress and supermarket shopping h a b i t s d i d not a f f e c t home g a r d e n i n g and p r e s e r v a t i o n p r a c t i c e s . I t ap p e a r s , t h e n t h a t t h e people i n the sample would tend t o c o n t i n u e t h e s e p r a c t i c e s r e g a r d l e s s of where t h e y l i v e d o r how many supermarkets were a v a i l a b l e t o them or how many o t h e r f o o d s o u r c e s were p r e s e n t . I n any e v e n t , as would be e x p e c t e d , season appears t o be the most i n f l u e n t i a l f a c t o r d e t e r m i n i n g the number o f s e r v i n g s c f l c c a l l y - g r o w n f o o d s consumed/ h o u s e h o l d . D i e t a r y P r a c t i c e s o f S c h o o l c h i l d r e n While seascn determined the amount of l o c a l l y - g r o w n f o o d consumed, i t d i d not appear t o a f f e c t y e a r l y consumption of a l l k i n d s o f food by s c h o o l c h i l d r e n . Sex of c h i l d appeared t o i n f l u e n c e n u t r i e n t i n t a k e , p a r t i c u l a r l y p r o t e i n i n t a k e which was h i g h e r f o r males t h a n f o r f e m a l e s . C h i l d r e n i n t h e sample o f t e n missed meals, p a r t i c u l a r l y b r e a k f a s t , and appeared t c snack f r e g u e n t l y . . Snack c h o i c e s were very o f t e n t h o s e t h a t c o n t r i b u t e o n l y c a l o r i e s , u s u a l l y i n the form of s i m p l e s u g a r s . D i r e c t i o n s f o r F u r t h e r B esearch 125 A l t h o u g h t h e r e i s c o n s i d e r a b l e l i t e r a t u r e documentation on t h e p a t h o l o g y of o v e r t i n t o x i c a t i o n by t r a c e e l e m e n t s , l i t t l e i s known about e f f e c t s o f a g r a d u a l a c c u m u l a t i o n o f s l i g h t l y h i g h e r than normal c o n c e n t r a t i o n s i n the body. S e v e r a l q u e s t i o n s emerge from t h i s t y pe of problem. F i r s t of a l l , a r e s l i g h t l y e l e v a t e d c o n c e n t r a t i o n s , such as seen i n the t e e t h i n t h i s s t u d y , h a r m f u l ? S t u d i e s , on l e a d a t l e a s t , would i n d i c a t e t h a t t h e y d e f i n i t e l y are h a r m f u l . What c o n c e n t r a t i o n o f m i n e r a l s i n the body s h o u l d be suggested as t o l e r a b l e ? I t appears t h a t s u s c e p t i b i l i t y t o i n t o x i c a t i o n by m i n e r a l s i s dependent on a h o s t of f a c t o r s and i s a l s o very much an i n d i v i d u a l m a t t e r . . T h i r d l y , i f l e a d has no known f u n c t i o n i n the body, what e f f e c t s does i t s presence have? What symptoms s h o u l d we be l o o k i n g f o r ? These g u e s t i o n s r e q u i r e immediate r e s e a r c h a t t e n t i o n . There i s a l s o an apparent need t o monitor the a c c u m u l a t i o n of m e t a l s i n the environment and i n the human body, and t o develop and a s s e s s a p p r o p r i a t e means f o r e a r l y d e t e c t i o n of adverse h e a l t h e f f e c t s i n d u c e d by t h e presence o f metals i n abnormal q u a n t i t i e s . I n f o r m a t i o n g a t h e r e d on t h e d i e t a r y p r a c t i c e s of c h i l d r e n i n d i c a t e s t h a t n u t r i t i o n e d u c a t i o n i s a l s o i m p o r t a n t . N u t r i t i o n a l s t a t u s i s a major d e t e r m i n a n t of how t h e body han d l e s v a r i o u s c o n c e n t r a t i o n s o f the d i f f e r e n t m i n e r a l s . A b a l a n c e d and v a r i e d d i e t i s n e c e s s a r y t o ensure adeguate n u t r i e n t i n t a k e . The e f f e c t o f t o x i c m i n e r a l s i n the c o n t e x t of d i e t a r y adequacy o f s e v e r a l n u t r i e n t s i s an a c t i v e a r e a of r e s e a r c h , and s h o u l d be c o n t i n u e d (Goyer and Mahaffey 1972; 126 H u i s i n g h and H u i s i n g h 1974; Mahaffey, 1974 ; Levander, 1 9 7 9 ) . E d u c a t i o n of i n d u s t r y and t h e p u b l i c s h o u l d c o n t i n u e i n an e f f o r t to ensure c o n t r o l on a g l o b a l and p e r s o n a l l e v e l . There are ways and means t o reduce t h e a s s a u l t on the environment of m i n e r a l i n d u s t r i a l i z a t i o n . G l o b a l e n v i r o n m e n t a l m o n i t o r i n g systems a r e being planned and implemented. . I n d u s t r y has responded t o p u b l i c and government co n c e r n s by i m p r o v i n g methods o f waste rem o v a l . The A f t c n copper s m e l t e r i n Kamloops has been s a i d t o have the most e l a b o r a t e system on the c o n t i n e n t t c c o n t r o l e m i s s i o n of p a r t i c u l a t e s , s u l p h u r d i o x i d e and mercury. T h i s would encourage one t o expect t h a t t h i s w i l l be a c h a r a c t e r i s t i c of a l l o t h e r new o p e r a t i o n s as w e l l and t h a t a new t r e n d has been e s t a b l i s h e d . The Ccminco l e a d / z i n c s m e l t e r i n T r a i l e f f e c t i v e l y c o n t r o l s s u l p h u r d i o x i d e e m i s s i o n s from t h e i r r e f i n i n g o p e r a t i o n s , u t i l i z i n g a h i g h p r o p o r t i o n o f the s u l p h u r d i o x i d e f o r f e r t i l i z e r manufacture. C o n t r o l s cn a more p e r s o n a l l e v e l a r e a l s o p o s s i b l e . A v o i d i n g s t o r a g e of foods and beverages e s p e c i a l l y of an a c i d i c or c a r b o n a t e d n a t u r e i n metal c o n t a i n e r s and thorough washing of v e g e t a b l e s i s a d v i s e d . C h o i c e c f foods i s v e r y i m p o r t a n t . Most modern d i e t s c o n s i s t o f f o o d s of c o n s i d e r a b l e v a r i e t y and t y p e s . However, t h e r e are i n s t a n c e s where p o p u l a t i o n s r e l y on a p a r t i c u l a r s o u r c e f o r f o o d . T h i s dependence upon f o o d s d e r i v e d from l o c a l s o i l s h o u l d be d i s c o u r a g e d i n f a v o u r o f d i e t a r y h a b i t s i n v o l v i n g a g r e a t e r d i v e r s i t y o f f o o d s and w i d e r s o u r c e s o f s u p p l y . I t i s hoped t h a t r e s u l t s from s t u d i e s of t h i s k i n d w i l l encourage both p e r s o n a l and i n d u s t r i a l c o n t r o l s d i r e c t e d toward 127 decreasing human exposure to environmental mineral contamination. Emphasis should a l s o be placed on the importance of monitoring elevated concentrations of t r a c e elements and of developing and assessing appropriate means f o r e a r l y d e t e c t i o n of adverse hea l t h e f f e c t s induced by such elements as l e a d , copper and z i n c . r 128 BIBLIOGRAPHY A l e x a n d e r , F.A. The uptake o f l e a d by c h i l d r e n i n d i f f e r i n g e n v i r o n m e n t s . , E n v t l . , H e a l t h " P e r s p e c t . : 7 : 155, 1974. A l t s h u l l e r , W.F., D.B. H a l a k , B.H. L a n d i n g , and R.A. Kehoe. Deciduous t e e t h as an index of body burden of l e a d . J . P e d i a t . 60:224, 1962. Andelman, J.B. and M.A. S h a p i r o . Changes i n t r a c e element c o n c e n t r a t i o n s i n water t r e a t m e n t and d i s t r i b u t i o n systems. I n : Trace Substances i n E n y i r o n m e n t a l H e a l t h y V o l . V I . D.D. H e m p h i l l (ed). C o l u m b i a , Mo.: U n i v e r s i t y of M i s s o u r i P r e s s . 1973. A n n i s , L.F. The C h i l d B e f o r e B i r t h . , I t h a c a , N.Y.: C o r n e l l U n i v e r s i t y Press..1978. A t t r a m a d a l , A. and J . Jonsen. Heavy t r a c e elements i n a n c i e n t Norwegian t e e t h . Acta Odont. Scand._ 36 ( 2 ) : 97, 1978. Ba l o g h , M., H.A. Kahn, and J.H. M e d a l i e . Random r e p e a t 24-hr . d i e t a r y r e c a l l s . . A m . J . . C l i n . N u t r . 24:304, 1971. B a r r y , P.S.I. A comparison c f c o n c e n t r a t i o n s o f l e a d i n human t i s s u e s . B r . J.. I n d u s t r i a l Med. 32:119, 1975. B a r r y , S.A.S. and S.C. C l a r k . Problems of i n t e r p r e t i n g t h e r e l a t i o n s h i p between the amounts of l e a d and z i n c i n p l a n t s and s o i l on m e t a l l i f e r o u s wastes. The New l i l t o l o g i s t t . 8 (3) :773, 1978.. B a t c h e l o r , R.P., J.W. .F e n n e l , R.M..Thomson, and K.R. D r i n k e r . A c l i n i c a l and l a b o r a t o r y i n v e s t i g a t i o n o f t h e e f f e c t of m e t a l l i c z i n c , o f z i n c o x i d e , and of z i n c s u l p h i d e upon the h e a l t h o f workmen. J.. I n d u s t , Hygiene. 8 (8) :322, 1926. Beaton, G.H., J . M i l n e r , P. Corey, K.M. McGuire, M. C o u s i n s , E. S t e w a r t , M. deRamos, D. H e w i t t , P.V. Grambsch, N. Kassi m , and J.A. . L i t t l e . Sources of v a r i a n c e i n 24-hour d i e t a r y r e c a l l d a t a : i m p l i c a t i o n s f o r n u t r i t i o n s t u d y d e s i g n and i n t e r p r e t a t i o n . Am. J._ C l i n . N u t r . 32 (12): 2546, 1979. 129 B e a v i n g t o n , F. Some a s p e c t s o f c o n t a m i n a t i o n o f herbage w i t h c o p p e r , z i n c and i r o n . E n v i r o n . . P o l l u t . , 8 : 6 5 , 1975. B e a v i n g t o n , F. Heavy metal c o n t a m i n a t i o n of v e g e t a b l e s and s o i l i n d omestic gardens around a s m e l t i n g complex. E n v i r o n . P o l l u t . 9:211, 1975. B e a v i n g t o n , F. Trace elements i n r a i n w a t e r and d r y d e p o s t i o n around a s m e l t i n g ccmplex. E n v i r o n . . P o l l u t . 13:127, 1S77. B e y e r , N.B. and P.M. M o r r i s . Food a t t i t u d e s and s n a c k i n g p a t t e r n s of young c h i l d r e n . J.. Nutr. Educ. 6 ( 4 ) : 131, 1974. B i r c h , L.L. Dimensions o f p r e s c h o o l c h i l d r e n ' s f o o d p r e f e r e n c e s . J . . . N u t . E d u c . 1 1 (2):77, 1979, B i r c h , L.L. P r e s c h o o l c h i l d r e n ' s f o o d p r e f e r e n c e s and consumption p a t t e r n s . . J . N u t r . Educ. ; 11 ( 4 ) : 189, 1979. B l a i r , J.A., I.P.L. Coleman, and M.E. H i l b u r n . . T h e t r a n s p o r t of the l e a d c a t i o n a c r o s s the i n t e s t i n a l membrane. J._ RhlSiOi- 286:343, 1979. B l o c h , P., G. G a r a v a g l i a , G.. M i t c h e l l , and I.M.. S h a p i r o . Measurement o f l e a d c o n t e n t of c h i l d r e n ' s t e e t h i n s i t u by x-ray f l u o r e s c e n c e . Phys,. Med, B i o l . 20: 4140, 1S76. Bremner, I . The t o x i c i t y of cadmium, z i n c and molybdenum and t h e i r e f f e c t s cn copper metabolism..Proc, Nutr. Soc^ 38(2):235, 1979. B r i g g s , G.M. and D.H. .Calloway, Bpgert* s N u t r i t i o n and P h y s i c a l F i t n e s s . 10th Ed. P a r t 4. A p p l i e d N u t r i t i o n . Chapter 21. N u t r i t i o n i n I n f a n c y and C h i l d h o o d . . T o r o n t o : W,B. Saunders Co. , 1979. Brown, G., B.W. Hyse, and E.G. Hansen. A n u t r i e n t d e n s i t y -n u t r i t i o n e d u c a t i o n program f o r e l e m e n t a r y s c h o o l s . J . N u t r . Educ. 11 (1) : 31, 1979. B r u d e v o l d , F. and L.T.. Steadman. A s t u d y o f copper i n human enamel. J.. D e n t a l Ees_. 34:209, 1955. 130 B r u d e v o l d , F., L.T. Steadman, and F.A. Smith.. I n o r g a n i c and o r g a n i c components of t o o t h s t r u c t u r e . Ann. N. Y. Acad_. S c i . 85:110, 1960. B u l l , E . J . , S.D. L u t k e n h o f f , G.E. McCarty, and E.G. M i l l e r . D e l a y s i n t h e p o s t n a t a l i n c r e a s e o f c e r e b r a l cytochrome c o n c e n t r a t i o n s i n lead-e x p o s e d r a t s . Neuropharmacology. 18:83, 1979. Bur c h , R.E., H.K.J. Hahn, and J.F. S u l l i v a n . Newer a s p e c t s o f the r o l e s c f z i n c , manganese, and copper i n human n u t r i t i o n . C l i n . Chem. 2 1 ( 4 ) : 5 0 1 , 1975.. B u r t , J . V . a n d A.A. . H e r t z l e r . P a r e n t a l i n f l u e n c e on the c h i l d ' s f o c d p r e f e r e n c e . J.. Nutr. Educ. 10 (3) : 127, 1979.. C a l i e n d o , M.A. and D. S a n j u r . The d i e t a r y s t a t u s of p r e s c h o o l c h i l d r e n : an e c o l o g i c a l approach. J.. Nutr. Educ.. 10(2):69, 1S78. C a p r i o , E . J . , H.L. M a r g u l i s , and M.M. Jos e l o w . Lead a b s o r p t i o n i n c h i l d r e n and i t s r e l a t i o n s h i p t o urban t r a f f i c d e n s i t i e s . Arch. . E n v i r o n . H e a l t h . 28: 195, 1974. C a r p e n t e r , S.J. P l a c e n t a l p e r m e a b i l i t y of l e a d . E n y t l . H e a l t h Persjj.. May: 129, 1974. C a r r o l l , K.G., H. Needleman, O.C. Tuncay, and I.M..Shapiro. The d i s t r i b u t i o n c f l e a d i n human decid u o u s t e e t h . E x ^ e r i e n t i a 28:424, 1S72. Casey, C.E. and M.F.. Eobinson. Cu, Mn, Zn, N i , Cd, and Pb i n human f e t a l t i s s u e s . B r i t . . J_. Nutr.. 39 ( 3 ) : 639, 1978. C a s s e l , G.H. Z i n c : A re v i e w of c u r r e n t t r e n d s i n t h e r a p y and our knowledge o f i t s t o x i c i t y . _ D e l . Med. J . 50 ( 6 ) : 323, 1978. C a v a l l e r i , A., C. M i n c i a , L.. P o z z o l i , F. P o l a t t i , and P.F.. B o l i s . Lead i n r e d b l o o d c e l l s and i n plasma o f pregnant women and t h e i r o f f s p r i n g . E n v i r o n . Bes.. 17(3):405, 1978. Chatman, T. And D.J. W i l s o n . Lead l e v e l s i n human deciduous t e e t h i n Tennessee. E n v i r o n . . L e t t . 8:173, 1975.. 131 Chez, R.A., R.I. Henkin, and R. Fox. A m n i o t i c f l u i d copper and z i n c c o n c e n t r a t i o n s i n human pregnancy. Obst. and Gyn A 52 (1) : 125, 1978. C h i s h o l m , J.W. P o s i o n i n g due t o heavy m e t a l s . P e d i a t . C l i n . N.. Am. 17 (3) :591, 1970. Commentary, 1980 R e v i s e d Recommended D i e t a r y A l l o w a n c e s . J.. Am D i e t e t . Assoc. 75(6):623, 1979. Committee on N u t r i t i o n . Z i n c . P e d i a t r i c s . 6 2 ( 3 ) : 408, 1978. Conrad. M.E.and J.C. B a r t o n . F a c t o r s a f f e c t i n g t h e a b s o r p t i o n and e x c r e t i o n of l e a d i n the r a t . g a s t r o e n t e r o l o g y . 74 (4) :731 , 1978. Cook, J . E n v i r o n m e n t a l p o l l u t i o n by heavy m e t a l s . I n t e r n . J.. E n v t l . . S t u d i e s . 9:253, 1977. Cook, J . , D.G. Altman, D.C. Moore, S.G. Topp, W.W. H o l l a n d , and A. E l l i o t t . A s u r vey c f n u t r i t i o n a l s t a t u s of s c h o o l c h i l d r e n , J . P r e y . Soc. Med. 27:91, 1973. C o u s i n s , R.J. R e g u l a t o r y a s p e c t s of z i n c metabolism i n l i v e r and i n t e s t i n e . N u t r ^ Rey^ 37 ( 4 ) : 97, 1979. C o u s i n s , R.J. R e g u l a t i o n o f z i n c a b s o r p t i o n : r o l e o f i n t r a c e l l u l a r l i g a n d s . Am.. J . C l i n . N u t r . 32 ( 2 ) : 339, 1979. D a v i d , O.J., J . C l a r k , and S. Hoffman.. C h i l d h o o d l e a d p o i s o n i n g : a r e - e v a l u a t i c n . . Arch. E n v t l . . H e a l t h . Mar/Apr.:106, 1979. D a v i e s , N.T. And R . B . , W i l l i a m s . Z i n c a b s o r p t i o n i n pregnancy and l a c t a t i o n . • l r o c a . . N u t r . Soc.. 35 {1} : 5a, 1976. i Deeming, S.E. and C.W. Weber. H a i r a n a l y s i s o f t r a c e m i n e r a l s i n human s u b j e c t s as i n f l u e n c e d by age, s e x , and c o n t r a c e p t i v e drugs. Am.. J_. C l i n . . N u t r . 31:1175, 1S78. . D e r i s e , N.L. and S.J. R i t c h e y . M i n e r a l c o m p o s i t i o n of normal human enamel and d e n t i n and the r e l a t i o n of 132 c o m p o s i t i o n t c d e n t a l c a r i e s . J . Dent. Res. J u l y / Aug.:53, 1974.. • . Drews, L.M., C. K i s s , and H.M. Fox. E f f e c t o f d i e t a r y f i b r e on copper, z i n c and manganese u t i l i z a t i o n by a d o l e s c e n t beys. Am. J . C l i n . N u t r . 32:1893, 1979. . Emmons, L. and M. Hayes. Accuracy o f 24-hcur r e c a l l s of young c h i l d r e n . J . Am D i e t e t . Assoc. 62:409, 197 3. E p p r i g h t , E.S., M. Brown p a t t o n , A.L. M a r l a t t , and M.L. Hathaway. D i e t a r y s t u d y methods. 5. Some problems i n c o l l e c t i n g d i e t a r y i n f o r m a t i o n about groups o f c h i l d r e n . ,J._.Am D i e t e t . . A s s o c . 28{1):43, 1952. E p p r i g h t , E.S., H.M. Fox, B.A. F r y e r , G.H. Lamkin, and V.M. V i v i a n . E a t i n g b e h a v i o u r c f p r e s c h o o l c h i l d r e n . J . Nutr.. -Educ. . Summer: 16 , 1969. Evans, G.W..Zinc a b s o r p t i o n and t r a n s p o r t . I n : Trace Elements i n Human H e a l t h and D i s e a s e . Volume 1. Z i n c and Copper. A.S. Pras a d and D. O b e r l e a s ( e d s ) . New York: Academic P r e s s , 1976. Evans, G.W., C.I. Gr a c e , and C. Hahn. Homeostatic r e g u l a t i o n of z i n c a b s o r p t i o n i n t h e r a t . Prog. Soc. E x p t l . B i g l . Med. 143:723, 1973. Evans, G.W., E.C. J o h n s t o n , and P.E. Johnson. Z i n c a b s o r p t i o n i n t h e r a t determined by r a d i o i s o t o p e d i l u t i o n . J.. Nutr . 109 ( 7 ) : 1258, 1979.. Evans, G.W. and W.E. C o r n a t z e r , E i l i a r y copper e x c r e t i o n i n the r a t . P r o c . Sec. E x p t l . B i c l . Meek 136:719, 1971.. Evans, G.W. Copper homeostasis i n the mammalian system. P h j f s i c l i ReVi 53 (3) :535, 1973. Evans, G.W., P.F. M a j o r s , and W.E. C o r n a t z e r . A s c o r b i c a c i d i n t e r a c t i o n w i t h m e t a l l o t h i o n e i n . Biochem. B i o p h y s . R e C c m m u r u 4 1: 1244, 1970. F e l l , G.S. T c x i c metal exposure d u r i n g m e d i c a t i o n . Proc. Nutr.. Soc.. 38 (2) : 263, 1 S79-133 Food Consumption P a t t e r n s . N u t r i t i o n Canada, by t h e Bureau o f N u t r i t i o n a l S c i e n c e s . H e a l t h P r o t e c t i o n Branch. Dept. N a t l . H e a l t h and W e l f a r e . Ottawa. 1976.. F o r b e s , G.B. and J.C. E e i n a . E f f e c t of age on g a s t r o i n t e s t i n a l a b s o r p t i o n (Fe, S r , Pb) i n the r a t . J.. Nutr. 102:647, 1972. F o s s e , G..And N.-P..Berg J u s t e s e n . Z i n c and copper i n d e c i d u o u s t e e t h of Norwegian c h i l d r e n . I n t e r n . J . En v t l o_ Studies.. 13 :19, 1S78. F r i e d e n , E. The e v o l u t i o n o f m e t a l s as e s s e n t i a l elements ( w i t h s p e c i a l r e f e r e n c e t c i r o n and c o p p e r ) . Adv. . Exp.. Med, .and B i o l , 48: 1, 1974. G a r r y , J . The KamlccFS t r a c e m e t a l s u r v e y : A p r e l i m i n a r y r e p o r t . B.C. M e d i c a l J.. 20 (3) :73, 1978. . G i l f i l l a n , S.C. Lead p o i s o n i n g and the f a l l of Rome, J.. Occup. Med-. 7 (2) :53, 1965. G i r o n , H.C. Ccmpaiison between d ry a s h i n g and wet d i g e s t i o n i n the p r e p a r a t i o n of p l a n t m a t e r i a l f o r at o m i c a b s o r p t i o n a n a l y s i s . Atomic A b s o r p t i o n N e w s l e t t e r . 12 (1):28, 1973. G o l d b e r g , A. D r i n k i n g water as a s o u r c e of l e a d p o l l u t i o n . E n v t l . H e a l t h P e r s p . May:10 3, 1974. Gordon, N . C , S. Brown, V.M. K h o s l a , and L.S. Hanson. Lead p o i s o n i n g . O r a l S u r g e r y , O r a l Med, and O r a l P a t h , 4 7 ( 6 ) : 500, 1S79. Gorsuch, T.T. S e l e c t e d d e c o m p o s i t i o n p r o c e d u r e s . . I n : The D e s t r u c t i o n of O r g a n i c M a t t e r , O x f o r d : Permagon P r e s s , 1970. Goyer, R.A. Lead t o x i c i t y : a problem i n e n v i r o n m e n t a l p a t h o l o g y . .Am.. J. Path.. 64: 167, 1971. Goyer, R.A. and K.R. Mahaffey. S u s c e p t i b i l i t y t o l e a d t o x i c i t y . E n y t l . . H e a l t h Persp,.2:73, 1972. 134 Goyer, R.A. and B.C..Rhyne. P a t h o l o g i c a l e f f e c t s o f l e a d . I n t l . Rev., of Exp... Path.. 12:2, 1973. G r a n d j e a n , P. Widening p e r s p e c t i v e s of l e a d t o x i c i t y . E n v i r o n . Res.. 17 (2) :303, 1978. G r a n d j e a n , P. and B. Holma. A h i s t o r y of l e a d r e t e n t i o n i n t h e Danish p o p u l a t i o n . E n v i r o n . P h y s i o l . Biochem. 3:268, 1973. • ' G u t h r i e , B.E..Chromium, manganese, c o p p e r , z i n c and cadmium c o n t e n t of New Zealand f o o d s . New Zealand Med., 82:418, 1975. . Habercam, J.W., J.E. K e i l , J.R. R e i g a r t , and H,W. C r o f t , Lead c o n t e n t of human b l o o d , h a i r and deciduous t e e t h : c o r r e l a t i o n w i t h e n v i r o n m e n t a l f a c t o r s and growth. .J.. Dent.. Res... Sept/Oct.: 1 160, 1974. H a l l , A.C., B.W. Young, and I . Bremner, I n t e s t i n a l m e t a l l o t h i o n e i n and the mutual antagonism between copper and z i n c i n t h e r a t . , J.. , I n o r g a n i c Biochem. 11(1): 57, 1979. H a l s t e a d , J.A., J.C. .Smith J r . and M.I. I r w i n . A c o n spectus of r e s e a r c h on z i n c r e g u i r e m e n t s of man. J j . N u t r , . 104:347, 1974. H e a l t h and W e l f a r e . N u t r i e n t Value c f Some Some Common Foods. R e v i s e d 1979. Ottawa: M i n i s t e r of N a t i o n a l H e a l t h and W e l f a r e . H e a l t h and W e l f a r e Canada. D i e t a r y Standard f o r Canada. (Bureau of N u t r i t i o n a l S c i e n c e s Food D i r e c t o r a t e , H e a l t h P r o t e c t i o n Branch, Dept. of N a t l , H e a l t h and W e l f a r e ) . Ottawa: I n f o r m a t i o n Canada, 1975. Hecker, L.H., H.E. A l l e n , D.B. Dinman, and J.V.. N e e l , Heavy metal l e v e l s i n a c c u l t u r a t e d and u n a c c u l t u r a t e d p o p u l a t i o n s . Arch. E n v i r o n . H e a l t h 29:181, 1974. Henkin, R . I . , J.R. Marshall, and S. Meret. Maternal- f e t a l metabolism cf copper and zinc at term. Am, J . .Qbstet. Gy.nec.cl. 110:131, 1971. 135 H e r t z l e r , A.A. and C.E. . Vaughan. The r e l a t i o n s h i p of f a m i l y s t r u c t u r e and i n t e r a c t i o n t o n u t r i t i o n . . J L Am D i e t e t . Assoc.. 74 (1):23, 1979. H i l l , C.H.. T o x i c o l o g y o f c o p p e r . I n : Advances i n Modern T o x i c o l o g y V o l . 2± . R.A. Goyer and M.A. Mehlman (eds) Wash.: Hemisphere P u b l i s h i n g Corp., 1977.. Holden, J.M., W.E. Wolf, and W. Mertz. Z i n c and copper i n s e l f -s e l e c t e d d i e t s . Am D i e t e t . Assoc. 75:23, 1979. H u i s i n g h , D. and J . H u i s i n g h . F a c t o r s i n f l u e n c i n g the t o x i c i t y of heavy metals i n f o o d . . E c o l . Food N u t r . 3:263, 1974. H u r l e y , L.S. Developmental N u t r i t i o n . Englewood C l i f f s , N.J.: P r e n t i c e - H a l l , I n c . 1980. J a c o b , E.A., L. M. . K l e v a y , and G.M. Logan.. H a i r as b i o p s y m a t e r i a l . V. H a i r m etal as an index of h e p a t i c m etal i n r a t s : copper and z i n c . Am.. J ^ C l i n . N u t r . 31 (3 ) : 477, 1S78. Jacoby, A., D.G. Altman, J . C o o l , W.W. H o l l a n d , and A. E l l i o t t . I n f l u e n c e o f some s o c i a l and e n v i r o n m e n t a l f a c t o r s on the n u t r i e n t i n t a k e and n u t r i t i o n a l s t a t u s of s c h o o l c h i l d r e n . J . Pr e v . Soc. Med. 29:116, 1973.. Johnson, N.C. Study of copper and z i n c metabolism d u r i n g pregnancy. P r o c . Soc. E x p t l . B i c l . Med. . 108(3):518, 1961. . . ~ Jugo, S. M e t a b c l i s m o f t o x i c heavy metals i n growing organisms. A r e v i e w . . E n v i r o n . Bes. 13:36, 1977, Jugo, S., T. M a l j k o v i c , and K. K o s t i a l . The e f f e c t of c h e l a t i n g agents on l e a d e x c r e t i o n i n r a t s i n r e l a t i o n t o age.. Environ.. Res.. 10: 271, 1975. Kaneko, Y., I . I n a m o r i , and M..Nishimura. Zn, Pb, Cu and Cd i n human t e e t h from d i f f e r e n t g e o g r a p h i c a l a r e a s i n Japan. B u l l . Tokyo Dejrt^ C e l l . . 15 (4) : 233, 1974. . K i n g , B.G. Maximum d a i l y i n t a k e of l e a d w i t h o u t e x c e s s i v e body l e a d burden i n c h i l d r e n . Am.. J.. D i s e a s e s C h i l d h o o d 136 122:337, 1S71. K i n g , J.C., S.H. Cohenour, C,G. C o r r u c c i n i , and P. Schneeman. . E v a l u a t i o n and m o d i f i c a t i o n of the B a s i c Four Food Guide. Jy_ J u t r . Educ;.. 10 (1) :27, 1S78. K i r k p a t r i c k , D.C. and D.E. C o f f i n . The t r a c e metal c o n t e n t o f r e p r e s e n t a t i v e Canadian d i e t s i n 1970 and 1971. Can. I n s t , Food S c i . T e c h n o l . J . 7:56, 1974. K i r k p a t r i c k , D.C. and D.E. C o f f i n . The t r a c e metal c o n t e n t o f a r e p r e s e n t a t i v e Canadian d i e t i n 1972.-Cdn. J . P u b l i c H e a l t h 68: 162, 1977. K l a u d e r , D.S. and H.G. P e t e r i n g . Anemia of l e a d i n t o x i c a t i o n : a r o l e f c r copper, J ^ Nutr.. 107 : 1779,. 1977. K l e v a y , L.M. Coronary h e a r t d i s e a s e : - t h e z i n c : c o p p e r h y p o t h e s i s . Am.. J.. C l i n . . Nutr.. 28:764, 1975.. K l e v a y , L.M. The r a t i o o f Zn t o Cu of d i e t s i n the U n i t e d S t a t e s . N u t r . .Rept. I n t e r n a t . 1 1 (3):237, 1975. K l e v a y , L.M., S.J. Peck, and D.F. Barcome. Ev i d e n c e of d i e t a r y copper and z i n c d e f i c i e n c i e s . J . Amer. . Med, Assoc.. 241 (18) : 1916, 1979. K o l b y e , A.C. S r . , K.R. . Mahaffey, J.A. . F i o r i n o , P.C, C o r n e l i u s s e n , and C.F. J e l i n e J i . Food exposures t o l e a d . E n v t l i H e a l t h Persp... 7:65, 1974. K o s t i a l , K. and B. M o m c i l o v i c . T r a n s p o r t o f l e a d 20 3 and c a l c i u m 47 from mother t o o f f s p r i n g . . A r c h . . E n v i r o n . . H e a l t h 29:28, 1974.. K o s t i a l , K., I . Rabar, M. B l a n u s a , and M. Landeka. E f f e c t of age on heavy metal a b s o r p t i o n . . Proc.. Nutr. Soc, 38(2):251 , 1979.. Kuh n e r t , P.M., P. E r h a r d , and B.R. Kuhnert. Lead and d e l t a -A m i n o l e v u l i n i c A c i d Dehydratase i n RBC's of urban mothers and f e t u s e s . E n v i r o n . Res. 14:73, 1977.. K u h n l e i n , H. and D.H.. C a l l o w a y . M i n e r a l s i n human t e e t h : 137 d i f f e r e n c e s between p r e i n d u s t r i a l and contemporary Hopi I n d i a n s . . A a u . J g . _ C . l i n a . Nutr.. 30:883, 1977. Lau, S . J. and B. S a r k a r . Ternary c o o r d i n a t i o n complex between human serum a l b u m i n , Cu ( I I ) and L - H i s t i d i n e . . J... ' E i o l . Chenii 246 (19) 5938, 1971 . Lead i n f o o d . Er.. Food J.. 78 (872): 72, 1 976. Levander, O.A. Lead t o x i c i t y and n u t r i t i o n a l d e f i c i e n c i e s . E n v t l i H e a l t h Persp..29: 1 15, 1979. L i l i s , R., A. F i s c h b e i n , J . E i s i n g e r , W.E. . Blumberg, S. Diamond, H.A. Anderson, W. Rom, C. R i c e , L. S a r k o z i , S. Kon, and I . J . . S e l i k o f f . P r e v a l e n c e o f l e a d d i s e a s e among secondary l e a d s m e l t e r workers and b i o l o g i c a l i n d i c a t o r s of l e a d e x p o s u r e . E n v i r o n . Res.. 14: 255, 1977. L o c k e r e t z , W. Lead c o n t e n t of deciduous t e e t h of c h i l d r e n i n d i f f e r e n t e nvironments. A r c h . E n v i r o n . Health.. 30:583, 1975. . Lewenberg, R. N u t r i t i o n e d u c a t i o n i n a r e a d i n g enrichment program, J... Nutr. Educ. 10 (1):22, 1978, Mackie, A . C , R. Stephens, A. Tcwnsend, and H.A, Waldron. Tooth l e a d l e v e l s i n Birmingham c h i l d r e n . Arch. E n v i r o n . H e a l t t u J u l / A u g . : 1 4 8 , 1977. Madden, J.P., S.J. . Goodman, and H.A. . G u t h r i e . V a l i d i t y of t h e 24-Hour r e c a l l . J.. Am D i e t e t . . Assoc_y_ 68: 143, 1976. . Mahaffey, K.R. N u t r i t i o n a l f a c t o r s and s u s c e p t i b i l i t y t o l e a d t o x i c i t y . E n v t l . H e a l t h Persp... May: 107, 1974. Mahaffey, K.R., P.E. C o r n e l i u s s e n , C F . J e l i n e k , and J.A. F i c r i n o . Heavy metal exposure from f o o d s . E n v t l . . H e a l t h Persp... 12:63, 1975. M a l i k , S.A. and J.H. . F r a n k l i n . A s t u d y of l e a d d i s t r i b u t i o n i n human t e e t h , u s i n g charged p a r t i c l e a c t i v a t i o n a n a l y s i s . C a r i e s Res.. 8:283, 1974. 138 Mason, K.E. A co n s p e c t u s of r e s e a r c h on copper metabolism and r e g u i r e m e n t s o f man. Jj. N u t r . 109 (11) : 1979, 1979. McCauley, P.T., E . J . B u l l , and S.D. L u t k e n h o f f . A s s o c i a t i o n of a l t e r a t i o n s i n energy metabolism w i t h l e a d - i n d u c e d d e l a y s i n r a t c e r e b r a l c o r t i c a l development. NgijroEharmacclcay. .18:93, 1979. McDonald, C..and H.J..Duncan. V a r i a b i l i t y of a t m o s p h e r i c l e v e l s o f metals i n an i n d u s t r i a l environment.. J.. Environ.. S c i i . H e a l t h y . A 13 (9 ) : 687, 1978. McKenzie, J.M. A l t e r a t i o n of t h e z i n c and copper c o n c e n t r a t i o n of h a i r . Am.. J . C l i n . . Nutr.. 31 (3):470, 1978. McKenzie, J.M., B. C . . G u t h r i e , and I.A.M. P r i o r . Z i n c and copper s t a t u s o f P o l y n e s i a n r e s i d e n t s i n the T o k e l a u I s l a n d s . .Am-. £lAlLi. N u t r ^ 31 (3) :422, 1978. McLean, R.O. and B. S h i e l d s . A st u d y of f a c t o r s c a u s i n g changes i n the l e a d l e v e l s of c r o p s growing b e s i d e roadways. Environ.. P o l l u t . 14: 267, 1977. McQuaker, N.E., D.F. Erown, and P.D. K l u c k n e r . D i g e s t i o n of e n v i r o n m e n t a l m a t e r i a l s f o r a n a l y s i s by i n d u c t i v e l y c o u p l e d plasma-atomic e m i s s i o n s p e c t r o m e t r y . A n a l l t i c a l Chem. 51(7):1082, 1979.. McQuaker, N.E., P. D. K l u c k n e r , and G.N. Chang, C a l i b r a t i o n of an i n d u c t i v e l y c o u p l e d plasma-atomic e m i s s i o n s p e c t r o m e t e r f o r the a n a l y s i s o f e n v i r o n m e n t a l m a t e r i a l s . A n a l y t i c a l Chem.. 51 (7) :888, 1979. Meranger, J.C. and D.C. . Smith. The heavy metal c o n t e n t of a t y p i c a l Canadian d i e t . Cdn. J.. P u b l i c . H e a l t h 63: 53, 1972. Merck Index (The). Seventh E d i t i o n . P.G. S t e c h e r ( e d ) , M. Windhalz, D.S. Leahy ( a s s t e d s ) . Bahway, N. J . : Merck and Co. , I n c . , 1960. M i n i s t r y of H e a l t h , O n t a r i o . Committee t o I n q u i r e i n t o and Eeport upon the E f f e c t on Human H e a l t h of Lead from the Environment. Queens P a r k , 1974. 139 Moore, J.F. and E.A. Goyer. Lead-induced i n c l u s i o n b o d i e s : c o m p o s i t i o n and p r o b a b l e r o l e i n l e a d metabolism. J&IiJU. H e a l t h Persp. May: 121, 1974. Moore, M.R. D i e t and l e a d t o x i c i t y . Proc.. Nutr. . Soc. 38 (2) : 243, 1979. Moore, M.R., E.C. C a m p b e l l , P.A. M e r e d i t h , A.D. B e a t t i e , A. G o l d b e r g , and D. Campbell. The a s s o c i a t i o n between l e a d c o n c e n t r a t i o n s i n t e e t h and domestic water l e a d c o n c e n t r a t i o n s . C l i n . .Chim. A c t a 87 (1):77, 1978. Moore, M.R., A. G o l d b e r g , P.A. M e r e d i t h , R. Lees , R.A. Low and S.J. Pocock. The c o n t r i b u t i o n of d r i n k i n g water l e a d t o m a t e r n a l b l o o d l e a d c o n c e n t r a t i o n s . C l i n . Chim. Acta 95 (1) : 129, 1979. Morse, D.L., W.N. Watson, J . Housworth, L.E. . W i t h e r e l l , . and P.J. L a n d r i g a n . Exposure o f c h i l d r e n t o l e a d i n d r i n k i n g water. Amer. - J . P u b l i c H e a l t h 6 9 ( 7 ) : 7 1 1 , 1979. ' Murphy, E.W., L. Page, and B. K. Watt. .Trace m i n e r a l s i n Type A Sch o o l l u n c h e s . J_. Am D i e t e t . Assoc. , 58: 115, 1971.. M y l r o i e , A.A., L. Moore, and U. Erogbogbo. I n f l u e n c e o f d i e t a r y f a c t o r s on b l o o d and t i s s u e l e a d c o n c e n t r a t i o n s and l e a d t o x i c i t y . T o x i c o l o g y and A p p l i e d Pharmacology. 41:361, 1977. . N a t i o n a l Academy of S c i e n c e s . L e a d A i r b o r n e Lead i n i§rsp.ectiye. Committee on B i o l o g i c E f f e c t s o f Atmospheric P o l l u t a n t s . Wash., 1972. N a t i o n a l Research C o u n c i l . Subcommittee on Z i n c . . Zinc.. B a l t i m o r e : U n i v e r s i t y Park P r e s s , 1979. N a t i o n a l Research C o u n c i l , NRC A s s o c i a t e Committee on S c i e n t i f i c C r i t e r i a f o r E n v i r o n m e n t a l Q u a l i t y . Lead i n t h e Canadian Environment. Ottawa: P u b l i c a t i o n s , NRCC/CNRC, 19737 Needleman, H.I. and I.M. S h a p i r o . Lead i n deciduous t e e t h : a marker of exposure i n h e r e t o f o r e asymptomatic c h i l d r e n . I n t e r n a t . S^mp. on E n v i r o n . H e a l t h A s p e c t s of Lead. J . E a r t h ( e d ) . Luxembourg. .1973. n o Needleman, H.L., I . D a v i d s o n , E . M . S e w e l l , and I.M. S h a p i r o . S u b c l i n i c a l l e a d exposure i n P h i l a d e l p h i a s c h o o l c h i l d r e n . New Ena. J . Med. 290: 245, 1974. . Needleman, H.L. and I.M.. S h a p i r o . D e n t i n e l e a d l e v e l s i n asymptomatic P h i l a d e l p h i a s c h o o l c h i l d r e n : S u b c l i n i c a l exposure i n h i g h and low r i s k groups. E n v t l . H e a l t h j.ers£_. May: 27, 1974. Needleman, H.L., C. Gunnoe, A. L e v i t o n , R. Reed, H. P e r e s i e , C. Maher, P. B a r r e t t . D e f i c i t s i n p s y c h o l o g i c and c l a s s r o o m performance o f c h i l d r e n w i t h e l e v a t e d d e n t i n e l e a d l e v e l s . New Eng.. Jj, Med. 300 (13): 689, 1S79. Neumann, P . Z . a n d A. S a s s - K o r t s a k . The s t a t e of copper i n human serum: ev i d e n c e f o r an amino acid-bound f r a c t i o n . Jj, C l i £ i II3ies ± i - 4 6 (4) :646, 1967. N i c h o l a s , P.O. and M . E . . E r i s t . Food p o i s o n i n g due t o copper i n the morning t e a . L a n c e t J u l y 6:40, 1968. N i e , N.H., C. H a d l a i H u l l , J.G. J e n k i n s , K. S t e i n b r e n n e r , and D.H. Bent. SPSS; S t a t i s t i c a l Package f o r the S o c i a l S c i e n c e s . Second E d i t i o n , T o r o n t o : M c G r a w - H i l l Book Company, 1975. O ' D e l l , B.L.: B i o c h e m i s t r y and p h y s i o l o g y of copper i n v e r t e b r a t e s . . I n : T r a c e Elements i n Human H e a l t h and D i s e a s e r Volume 1. A.S. P r a s a d and D. O b e r l e a s ( e d s ) . New York: Academic P r e s s , 1976. . O s t e r , G. and M.P. S a l g o . Copper i n mammalian r e p r o d u c t i o n . Advances i n Pharmacology and Chemotherapy. 14:327, 1S77. Peckos, P.S., M.I. Ross. l o n g i t u d i n a l s t u d y of t h e c a l o r i c and n u t r i e n t i n t a k e o f i n d i v i d u a l t w i n s . . 1. C a l o r i e , p r o t e i n , f a t and CHO i n t a k e s . J.. Am D i e t e t . Assoc. 62:399, 1973. P r a s a d , A.S. Trace elements: b i o c h e m i c a l and c l i n i c a l e f f e c t s of z i n c and copper. Amer. J . .Hematology 6:77, 1979.. P r a s a d , A.S., G.J. Brewer, E.B. Schoomaker, and P. Rabbani. Hypocupremia induced by z i n c t h e r a p y i n a d u l t s . J.. 141 Amer.. Med.. . Assoc. . 240 (20) : 2166, 1 978. . Pr a s a d , A.S.(ed) and D. O b e r l e a s ( a s s . ed) Trace Elements i n Human H e a l t h and D i s e a s e . Volume 1: Z i n c and Copper. New York: Academic P r e s s , 1976. P r e e r , J.R. Lead and cadmium c o n t e n t of urban garden v e g e t a b l e s . I n : Tra c e Substances i n E n v i r o n m e n t a l H e a l t h . V o l . X I . D.D, H e m p h i l l (ed). C o l u m b i a , Mo.: U n i v e r s i t y c f M i s s o u r i P r e s s , 1977. Quarterman, J . and E.. M o r r i s o n . The e f f e c t o f age on the a b s o r p t i o n and e x c r e t i o n o f l e a d . . E n v i r o n . , Res. 17:78, 1978.. Quarterman, J . , E. M o r r i s o n , J.N. M o r r i s o n , and W.R. Humphries. D i e t a r y p r o t e i n and l e a d r e t e n t i o n . . E n v i r o n . Res.. 17 (1):68, 1578. Quarterman, J . , J.N. M o r r i s o n , and W.E. Humphries.. The i n f l u e n c e o f h i g h d i e t a r y c a l c i u m and phosphate on l e a d uptake and r e l e a s e . E n v i r o n . Bes. 17:60, 1978. B e i l l y , C. Z i n c , i r o n and copper b i n d i n g by d i e t a r y f i b r e . Eicchem. Sec. Trans. .7 (1) : 202, 1979. E e i n h o l d , J.G. Trace elements. A s e l e c t i v e s u r v e y . C l i n . Chem. 21 (4) :476, 1975. E i c e , C. Lead c o n t a m i n a t i o n i n t h e homes o f employees o f secondary l e a d s m e l t e r s . . E n v i r o n . Bes. 15:375, 1978. E i o r d a n , J.F. and B.L. V a l l e e . S t r u c t u r e and f u n c t i o n o f z i n c metalloenzymes. I n : Trace Elements i n Human H e a l t h and Disease... Volume 1. Z i n c and Copper, A.S. P r a s a d and D. Ob e r l e a s ( e d s ) . New York: Academic P r e s s , 1976. Eobson, R.H. Changing food h a b i t s of Canadian c h i l d r e n . Cdn, Heme Ec. . J . .Jan:14, 1971. Rosen, J.F. and M. , S o r e l l . . The metabolism and s u b c l i n i c a l e f f e c t s of l e a d i n c h i l d r e n . The B i o g e p c h e m i s t r y o f Lead i n t h e Environment. E l s e v i e r / N o r t h - H o l l a n d B i o m e d i c a l P r e s s , 1978. 142 Eummo, J.H., P.K. South, N. J . Eummo, and J.F. Brown. B e h a v i o r a l and n e u r o l o g i c a l e f f e c t s of symptomatic and asymptomatic l e a d exposure i n c h i l d r e n . . A r c h . E n v i r o n . H e a l t h Mar/Apr:120, 19 79. Salmon, M.A. and T. Wright. C h r o n i c copper p o i s o n i n g p r e s e n t i n g as Pink D i s e a s e . A r c h . P i s . C h i l d . ,46:108, 1971. Samuelson, G., H. Grahnen, and E. A r v i d s s o n . An e p i d e m i o l o g i c a l study o f c h i l d h e a l t h and n u t r i t i o n i n a n o r t h e r n Swedish c o u n t y . V I . E e l a t i c n s h i p between g e n e r a l and o r a l h e a l t h , food h a b i t s , and ' so c i o e c o n o m i c c o n d i t i o n s . Am, J . C l i n . N u t r . 24: 1361, 1971. . S c h e i n b e r g , I.H. and I . S t e r n l i e b . Copper t o x i c i t y and W i l s o n ' s P i s e a s e . I n : Trace Elements i n Human H e a l t h and D i s e a s e . A.S. Prasad and D. O b e r l e a s ( e d s ) . New York: Academic P r e s s , 1976. S c h l a g e , C. and B. Wortberg. Z i n c i n t h e d i e t of h e a l t h y p r e s c h o o l and s c h o o l c h i l d r e n . A c t a . , P e d i a t . , Scand. . 61 :421, 1972. . S c h m i t t , N., G. Brown, E.L, D e v l i n , A.A. L a r s e n , E. P o u g l a s , and J.M. S a v i l l e . Lead p o i s o n i n g i n h o r s e s . A r c h . E n v i r o n . H e a l t h 23:185, 1971. Sc h r o e d e r , H.A. Lead: an i n c r e a s i n g p o t e n t i a l h a z a r d . I n : The Trace Elements and N u t r i t i o n . Some P o s i t i v e and Ne g a t i v e A s p e c t s . London: Faber and Fa b e r , 1976. Sc h r o e d e r , H.A., A.P. Nason, I.H. T i p t o n , and J . J . B a l a s s a . E s s e n t i a l t r a c e m e t a l s i n man: cop p e r . J... Chron.. D i s e a s e 19:1007, 1966. Sc h r o e d e r , H.A.and I.H. T i p t o n . The human body burden o f l e a d . . Arch.. E n v i r o n . H e a l t h 17: 965, 1968. S h a p i r o , I . M., H.L- Needleman, and 0. C. . Tuncay. The l e a d c o n t e n t o f human deciduous and permanent t e e t h . E n v i r o n . . Res.. .5:467, 1972. S h a p i r o , I.M., B. Do b k i n , O.C. Tuncay, and H,L. Needleman. Lead l e v e l s i n d e n t i n e and c i r c u m p u l p a l d e n t i n e o f deciduous t e e t h o f normal and l e a d p o i s o n e d c h i l d r e n . C l i n . Chim. Acta 46:119, 1973. 143 S h a p i r o , I.M., G . . M i t c h e l l , I. D a v i d s o n , and S.H. K a t z . The l e a d c o n t e n t of t e e t h . A r c h . . E n v i r o n . H e a l t h 30:483, 1975. S h a p i r o , I.M., A. Burke, G. M i t c h e l l , and P. B l o c h . . X-ray f l u o r e s c e n c e a n a l y s i s o f l e a d i n t e e t h of urban c h i l d r e n i n s i t u : c o r r e l a t i o n between the t o o t h l e a d l e v e l and the c o n c e n t r a t i o n of b l o o d l e a d and f r e e e r y t h r o p o r p h y r i n s . E n v i r o n . Res...17:46, 1978.. Shaw, J.H. Changing food h a b i t s and our need f o r e v a l u a t i o n s of the c a r i o g e n i c p o t e n t i a l of f o o d s and c o n f e c t i o n s , l e d . Dent.. .1 (3) : 192, 1979.. S i n h a , S.N. and E.G. G a b r i e l . Serum copper and z i n c l e v e l s i n v a r i o u s p a t h o l o g i c a l c o n d i t i o n s . Am._J, C l i n . . P a t h o l . 54:570, 197C. Smith, H.M..and C . L . . J u s t i c e . E f f e c t s of n u t r i t i o n programs on t h i r d grade s t u d e n t s . J ^ - N u t r . Educ^ 11 (2):92, 1979. Sm i t h , J . L . . M e t a b o l i s m and t o x i c i t y c f l e a d . I n : Trace Elements i n Human H e a l t h and D i s e a s e . Volume I I . ; E s s e n t i a l and T o x i c Elements. .A7S. .Prasad, ( e d ) . New York: Academic P r e s s , 1976. Solomons, N.W. On t h e assessment o f z i n c and copper n u t r i t u r e i n man. Am.. J.. C l i n , Nutr.. 32 (4):856, 1979.. Soremark, R. and K. Samsahl. Gamma-ray s p e c t r o m e t r i c a n a l y s i s of elements i n normal human d e n t i n . J . Dent. .Res. May/June:603, 1961. S o r r e l l , M. and J.F.. Rosen. I n t e r a c t i o n s of l e a d , c a l c i u m , v i t a m i n D and n u t r i t i o n i n lead-burdened c h i l d r e n . Arch.. E n v i r o n . H e a l t h . 32: 160, 1977. Spencer, H., D. O s i s , I . Kramer, and C. N o r r i s . I n t a k e , e x c r e t i o n and r e t e n t i o n of z i n c i n man. I n : Tra c e Elements i n Human H e a l t h and D i s e a s e . Volume I : Z i n c and Copper. .A.S. P r a s a d , D. O b e r l e a s ( e d s ) . New York: Academic P r e s s , 1976. Steadman, L.T., F. .. B r u d e v o l d , F.A. Smith, D.E. Gardner, and M.F. L i t t l e . Trace elements i n a n c i e n t I n d i a n t e e t h . Is. D e n t i Res.. Mar/Apr: 285, 1959. 144 Stewart, D.J. Teeth as i n d i c a t o r s of exposure of c h i l d r e n t o l e a d . A r c ^ Di s . Child.. 49 (1 1): 895, 1974.. Suso, F.A. and H.M. Edwards, J r . Binding c a p a c i t y of i n t e s t i n a l mucosa and bleed plasma f o r z i n c . Proc. Soc. Exp_tl._ E i c l i Med. 137:306, 1971. Tephly, T.R., G. Wagner, F>. Sedman, and W. P i p e r . E f f e c t s of metals on heme b i o s y n t h e s i s and metabolism. Fe d e r a t i o n Proc i.37(1):35, 1976, T r o w e l l , H. . Coronary heart disease and d i e t a r y f i b r e . Am. J.. Clin.. Nutr.., 28:798, 1975. Ulmer, D.D. Ketal s - f r c m p r i v a t i o n t o p o l l u t i o n . Fed.. Proc. 32 (7): 1758, 1972.. Underwood, E.J. Copper. In: Trace Elements i n Human and Animal N u t r i t i o n . New York: Academic Press, 1971. Underwood, E . J . Lead. In: Trace Elements i n Human and Animal N u t r i t i o n . New York: Academic Press, 1977, Underwood, E.J. S o i l - p l a n t - a n i m a l i n t e r r e l a t i o n s . In: Trace Elements i n Human and Animal N u t r i t i o n . New York: Academic P r e s s , 1971. Vogel, J . J . M i n e r a l i z a t i o n of bones and t e e t h . In: Dental Biochemistry. E.P. L a z z a r i (ed). P h i l a d e l p h i a : Lea and F e b i g e r , 1968. . Wait, B. P r o t e i n i n t a k e of we l l - n o u r i s h e d c h i l d r e n and ad o l e s c e n t s . Am. . J . C l i n . Nutr.. 26: 1303, 1973. Waldron, H.A. Lead poisoning i n the an c i e n t world. Med. H i s t ^ 17:391, 1973. White, H.S. Zinc content and the z i n c - t o - c a l o r i e r a t i o of weighed d i e t s , J.. Am D i e t e t . Assoc. 6 8: 243, 1976. . White, H.S. I n o r g a n i c elements i n weighed d i e t s of g i r l s and young women. J.. Am D i e t e t . Assoc. 55:38, 1969., 145 WHO E x p e r t Committee. Trace elements i n human n u t r i t i o n . WHO T e c h n i c a l R e p c r t S e r i e s No.. 532.. Geneva: World H e a l t h O r g a n i z a t i o n , 1973. Young, CM., G.C. , Hagan, F.E. T u c k e r , and W.D. F o s t e r . A comparison of d i e t a r y s t u d y methods.. I I . D i e t a r y h i s t o r y vs seven-day r e c o r d vs 24-hr r e c a l l . J.. Am Dietet.. Assoc. 28(3) : 218, 1952. Yperman, A.A. and J.A. Vermeersch. F a c t o r s a s s o c i a t e d w i t h c h i l d r e n ' s food h a b i t s . J.. Nutr. . Educ. ,11(2) :72, 1979. Z i e g l e r , E., R.B. Edwards, R, L. .Jensen, K.R. Mahaffey, and S.J. Fomon. A b s o r p t i o n and r e t e n t i o n of l e a d by i n f a n t s . . Fediat.. Res.. 12:29, 1S78. Z i m d a h l , R.L. and J.H. A r v i k . Lead i n s o i l s and p l a n t s : a l i t e r a t u r e r e v i e w . CRC Rev. E n v t l . C o n t r o l . Feb.:213, 1S73. 148 APPENDIX C "Coupon" and Questionnaire Distxibuted to the SchcxDldiildren in Kamloops Requesting "a baby tooth for science" COULD YOU GIVE A BABY TOOTH FOR SCIENCE? We are working with "baby teeth" from children in the Kamloops area to find out how much zinc, copper and lead . are accumulated in the body. Since the environment i s a ' contributing factor to tooth minerals, we are interested in the geographical area where the teeth were formed. { We would Like to obtain as many teeth as possible from children who have lived a l l their lives in Kamloops. If you would like to help, save your baby tooth when i t naturally comes out and complete the small questionnaire on the back of this paper. Put the tooth and the paper inside the small white envelope and seal. F i l l out the front of the envelope and return to your teacher, or the Health Unit, 519 Columbia Street. Thank you! P.S. Use the coupon for the tooth fairy. ONE COUPON FOR THE TOOTH FAIRY! Good only i f placed lander pillow, and you give your tooth to {the science project! Side Two Please t e l l us where (town, province) you lived and for how long (years) when your teeth were growing. During Mother's pregnancy From ages 1-3 From ages 4 to present Town, Province Years APPENDIX © Poster Sent to Schools l n Kamloops 150 APPENDIX E Table 23 D e s c r i p t i o n of Foods C o l l e c t e d From F a m i l i e s i n B r o c k l e h u r s t and G e n e l l e C o n t a i n e r No. Source Wt. Of Food (gms.) Food Amount *1 G e n e l l e l o c a l 100.62 Tomato 1 S l i c e Cucumber 1/3 Med. C o l e s l a w 1/2 Cup 2 G e n e l l e NL* 76.21 Bread 1/2 S l i c e Jam Weiner 1/3 Pancake 1 S m a l l *3 G e n e l l e NL* 89.26 S p a g h e t t i 1/4 Cup M e a t b a l l 1 Sm a l l E a i s i n Bran 1 Cup 4 G e n e l l e L o c a l 355.26 Cucumber 1 Med. . C a r r o t 1 Med. . Egg 1 Med. Cookie 1 Tomato 1 S m a l l Peach 1 Med. *5 G e n e l l e l o c a l 69.74 6 G e n e l l e NL* 128. 19 *7 G e n e l l e L o c a l 114.19 8 G e n e l l e NL* 214.05 *9 B r o c k l e h u r s t L o c a l 35.79 Corn C a r r o t 1T+1/2 Cob 1 S l i v e r Peanut B u t t e r Sand. 1/2 Choc. Bar 1/6 Ham 1 oz. Po t a t o 1/2 French Toast 1/2 s i . Tomato Cucumber C a u l i f l o w e r 1 S I . 1 S I . 3 Flow e r s F r u i t Loops 1 T Lunch Meat Sand. 1/2 Macaroni + Hamb. 1 Cup Cucumber Apple 2 S I . 1 SI. 10 E r o c k l e h u r s t NI* 109.99 E r o c k l e h u r s t NI* 24.42 Toast + Cheese Whiz 1 s l S h r e d d i e s 2 T Noodles + Cheese 1/4 Cup Weiner 1/2 F r u i t Loops 1 T P o t a t o Pancake 1 E r o c k l e h u r s t L o c a l 270.59 Veg. Soup 1 Cup Plum 1 Peach 1 E r o c k l e h u r s t NL* 13.07 E r o c k l e h u r s t L o c a l 43.05 E r o c k l e h u r s t NL 98.13 B r o c k l e h u r s t L o c a l 160.61 G e n e l l e NL* 91.81 G e n e l l e L o c a l 220.64 E r o c k l e h u r s t NL* 14. 33 ftll Bran 1/4 Cup Hamburger 1 T Bread 1/4 S I . Tomato 1 S I . Cucumber 1/8 Egg 1 Cheese 1 S I . Bread 1 S I . Cucumber 1/2 B r o c c o l i 1 F l o w e r C a r r o t 1 Sm. P o t a t o 1 Sm. Onion 1 Sm. C o r n f l a k e s 1 T Grape J e l l y Sand. 1/2 Pork Steak 1/2 S I . C a r r o t s 3 T P o t a t o 4 T Tomato 1 Cucumber 1/2 Apple 1 , Sausage 1/2 Toast Bread 1/8 S i . E r o c k l e h u r s t L c c a l 85.17 C a r r o t Plum Yellow Bean 1/3 1/2 1 152 G e n e l l e N l * 10.34 P o t a t o Tomato 1/4 1 SI. F r u i t Loops 1 T Weiners 1/8 Bread 1 T G e n e l l e L o c a l 126.48 Peach 1 B r o c k l e h u r s t L o c a l 28.16 B r o c k l e h u r s t NI* 61.27 Apple 1/4 Shredded Wheat Brown Bread S p a g h e t t i M e a t b a l l G a r l i c Bread Meat 1/2 1/4 s i . 1/4 Cup 1/2 1/4 R o l l 1 oz. E r o c k l e h u r s t NL* 15.68 B r o c k l e h u r s t L o c a l 51.33 B r o c k l e h u r s t L o c a l 8.26 R i c e K r i s p i e s 1 T C h e r r i e s 2 Large L e t t u c e M e a t b a l l Corn C a r r o t Cucumber 1 t s p . V 2 1/3 Cob 1 S I . 1 S l i c e B r o c k l e h u r s t NI* 42.80 Toast 1/4 S I . Peanut B u t t e r and Honey Sand. 1/4 C h i c k e n P o t a t o E i s c u i t 1 t s p . 1/8 1 T B r o c k l e h u r s t NL* 132.97 Cookie P o t a t o C h i c k e n Graham C r a c k e r C e r e a l Peach Toast Salmon S a l a d Sand. . 1 1 Sm. 1 oz. 1 1 t s p . 1 S I . 1/2 S I . 1/8 E r o c k l e h u r s t L c c a l 153 91.46 *31 E r o c k l e h u r s t L o c a l 32 E r o c k l e h u r s t NL* 7. 13 40.23 33 G e n e l l e NL* 12.89 34 G e n e l l e L c c a l 32.99 35 G e n e l l e NL* 60.55 C a r r o t Cucumber Apple Tomato P o t a t o C a r r o t F r . F l a k e s C r a c k e r Eean L o l l i p o p Ean. Cake Ch i c k e n Toast B i t z C r a c k e r Grape Steak Peas 1 3 S I . 1/2 Sm. 1 S I . 1 T 1 t s p . 1 T 1/2 1 t s p V 4 t s P 1 T 1 t s p 1 T 1 T 1 1 T 5 B i c e K r i s p i e s 1 t s p . Po t a t o 1/2 B i c e K r i s p i e s 1 Cup Toast 1 S i . *Non L o c a l . 154 APPENDIX F PJTEPyLEW SCHEDULE NAME OF INTEFMIEWER '. DATE LENGTH OF JOTEBVTEW C O N F I D E N T I A L 1. Name: 2. Hone Address: 3. Child's School: 4. Relationship of Interviewee to Child: 5. Child's Birthplace: 6. Child's Birthdate: 7 . Sex of Child: M Q F j | 8. Length of Residence at Present Address: (Repeat above address) 9. Previous Address and Length of Residence: 10. Number of Household Members (inmediate family only): Number of Adults: Number of Children: Child Age The next section deals with questions regarding the family food consumption patterns. 11. Can you t e l l me what supermarket or grocery store i s used most frequently by the family? (Write i n name of supermarket or store). 12. Are foods grown i n the (Trail/Kamloops) area ever served i n the household? Yes • N o Q I f yes, could you please in d i c a t e how many meals per week during each of the following seasons contain lc>cally-grown foods. Summer F a l l Winter Spring (June-Sept.) (Oct.-Dec.) (Jan.-Mar.) (Apr.-May) 0-2 meals/week a a • D 3-5 mealsA^eek ^ r^j | | | | 6-12 meals/week I—J '— |~~f | [ 13+ meals/week Q Q Q | f CONTINUED ON BACK OF PAGE 1 5 5 - 2 -N o w I ' d l i k e y o u t o t h i n k s p e c i f i c a l l y a b o u t f o o d s t h a t a r e g r o w n i n y o u r g a r d e n o r i n s o m e o n e e l s e ' s g a r d e n i n ( T r a i l / K a m l o o p s ) e i t h e r a f r i e n d ' s g a r d e n o r g a r d e n p r o d u c e f r o m t h e l o c a l m a r k e t , s u p e r m a r k e t o r r o a d s i d e s t a n d w h i c h s e l l s f o o d s g r o w n i n ( T r a i l / K a m l o o p s ) . 1 3 . C o u l d y o u p l e a s e t e l l m e w h i c h f o o d s f r o m a n y o f t h e s e s o u r c e s y o u r f a m i l y c o n s u m e s . W e ' l l s t a r t w i t h v e g e t a b l e s . W h i c h v e g e t a b l e s c o m e f r o m y o u r g a r d e n o r a r e g r o w n e l s e w h e r e i n ( T r a i l / K a m l o o p s ) a n d a r e s e r v e d i n y o u r h o m e ? H o w m u c h i s s e r v e d o f e a c h o f t h e s e v e g e t a b l e s p e r w e e k d u r i n g e a c h s e a s o n a n d d o y o u p r e s e r v e a n y o f t h e m . I f s o , w h a t m e t h o d d o y o u u s e ? ( A l l o w p e r s o n t o l i s t v e g e t a b l e s a n d t h e n g o b a c k a n d a s k a b o u t a n y v e g e t a b l e s o n t h e l i s t w h i c h w e r e n o t m e n t i o n e d . S t a r t w i t h t h e m o s t c o i t m o n o n e s f i r s t , i . e . l e t t u c e , t o m a t o e s , c e l e r y , c u c u m b e r s e t c . ) . V E G E T A B L E S F a m i l y S v g s . U s u a l M e t h o d o f F o o d I t e m ' 1 S e r v i n g C o n s u m e d / W e e k P r e s . o r P r e p n . S o u r c e Y r . A s p a r a g u s 6 o z . S F W s E s F W S p B e a n s , g r e e n 1 / 2 c u p " , y e l l o w " B e e t s " B r o c c o l i " B r u s s e l s S p r o u t s " C a b b a g e , r e d " " , g r e e n " C a r r o t s " C a u l i f l o w e r " C e l e r y ( 1 l a r g e o u t e r = 3 i n n e r s t a l k s ) C h a r d C o r n ( 5 " x l - 3 / 4 " c o b ) C u c u m b e r 6 x ( l / 8 " x 2 " ) E g q p l a n t 4 , 1 / 2 " s l i c e s E n d i v e 2 o z . K a l e 1 / 2 c u p L e t t u c e , B o s t o n 2 x 8 " d i a . l e a f " , L e a f 2 l g e . l e a v e s 3 / . 156 Food Item 1 Serving Mushrooms 1/2 cup Onions, white •§ cup shredded " green 3 onions Family Svgs. Consumed/Week Usual Method of Pres. or Prepn. Source Year Parsley 1 tablespoon Peas, reg. l/2 cup Snow Feppers, green 1/8 pod red Potatoes 1 (2|" Dia.) Pumpkin 1/2 cup Radishes Spinach 1/2 cup Squash, summer winter Tomato 1 ned. (2" dia. ) Turnip 1/2 cup Zucchini Other 157 - k -We'd l i k e the same Information about the fruit-jconsumed by your family which come from your garden or other Trai£^gar&enfe. (Follow the sane procedure f o r f r u i t s . Ask the person to l i s t the f r u i t s and then go back to l i s t and mention those not stated, starting with most common f r u i t ) . F R U I T Food Item 1 Serving Apple 1 (2|" dia.) Family Svgs. Consumed/Week Sp Usual Method of Pres. or Prepn. Source Year Sp Apricot 4 med. Blackberries l/2 cup Blueberries Cherries Crabapples Peaches 1 (2" dia.) 1 (3>2£") Flums 1 (2" dia.) Raspberries l/2 cup Rhubarb Red Currant Strawberries Vaterroelon Other x 8" wedge 5/.. 158 - 5-tfhat about Meat, Fish, Poultry, Eggs, Cheese or other Dairy Products? Family Svgs. Usual Method of Food Item 1 Serving Consumed/Week_ Prea. or Prepn, . Source Year S£ these beverages and how much is Juice (State Kind) 1/2 cup con sume d. Wine (State kind) 1 OZ. Other (Flease specify) *-1n=11y. r . i u i n V O U pj.ease W X A Je wun. Leirumes (i.e. kldr.ev beans, s p l i t peas soyb jar.s et P . ; F ;ons - .u,es. by j c u r family are locally-grown. — .... i 1 cavrL'.T33 o i : B A C K , C ? W . 3 . 1 5 9 6 -The questions ln the following section are related more specifically to the third-grade child and his/her mother. • 14. Does your family consume this variety of local foods each year? (quickly review P I 1 Items mentioned," ««» LJ If no, can you recall the years of the third-grade child's l i f e when the pattern was different? (record under column headed Year beside each• Item that was different). 15. Is (are) there any ltem(s) the third-grade child does not consume? Yes £ 3 Wo | f If yes, please specify. (Kark a star beside each item) 16. Does the third-grade child take any medication or vitamin/mineral supplements? Y e s t Z l wo | | If yes, please Itemize "by brand name and year started. 17. Did the third-grade child's mother take any medication or vitamin/ mineral supplements during her pregnancy? Yes If yes, please itemize i f possible. 18. If the third-grade child was brsast-fed, did the isother take any medi-cation or vitamin/mineral supplements during this tine? Yes I j No { | If yes, please itemize i f possible. . /"'tf»r«let?«). 19. Did the third-grade child's aother eat locally-grown ( Trail area) foods during her pregnancy? Yes 1 j N*o ( | Ii* yes, were the Items consumed generally the same as previously listed? Yes Q Ko i 7/.. l6o - 7 -If no, what were the differences? 20. If the third-grade child was breast-fed, did the child's mother eat foods grown In T r a i l during this time? i—| r-n r ^ ' e t f v Yes I I Mo I I If yes, were the Items consumed generally the same as previously listed? Yes HH Mo CH If no, what were the differences? 21. Can you t e l l me what the water source Is ln the current household? Main Well Spring (a) for drinking | \ | j \ | (b) for cooking and food preparation J J I I | I (c) for cleaning and bathing • • • (d) for watering of garden | | I j | 1 22. Do you know what kind of pipes are ln the current household. Yes| | No | | If yes, please check: Galvanized a Copper I I Unknown j [ Other, please specify [ \ j THANK YOU. FOR YOUR COOPERATION! 163 APPENDIX I 24-Hour R e c a l l Forms Completed by Third Graders l n Brocklehurst Schools, 24-HR D I E T A R Y RECALL  N a n i e : Age: School: Grade: Did 700 give a tooth to the Trace Metal Survey? Yea Q Ho Q APPENDIX J 1 6 4 Food Record L i s t s f o r Families l n Brocklehurst and Genelle ft v5 J cr o 3v* o o • 3 3 o - J "5 i t •2 2 -1 3 Q •> 3 -* si It A P P E N D I X K R e c o n t n e n d e d D a i l y N u t r i e n t I n t a k e , R e v i s e d 1 9 7 5 , S h o w i n g Z i n c I n t a k e s R e c o i m i e n d e d f o r t h e V a r i o u s A g e G r o u p s . A g e G r o u p S e x W e i g h t ( k g ) H e i g h t ( c m ) Z i n c (mg) 7 - 9 y e a r s M 2 7 1 2 9 7 F 2 7 1 2 8 7 1 0 - 1 2 y e a r s M 3 6 1 4 4 8 F 3 8 1 4 5 9 A d a p t e d f r o m : N u t r i e n t V a l u e s o f S o m e C o m m o n F o o d s , 1 9 7 9 . APPENDIX L Recommended Dietary Allowances, Revised 1980, Showing Recommendations f o r Copper and Zinc Allowances. Age Group Sex Weight (kg) Height (an) Copper (mg) Zinc(mg) 7-10 years Both 28 132 2.0-2.5 10 11-14 years M 45 157 2.0-3.0 15 F . 46 157 2.0-3.0 15 Adapted from: J. Amer. Dietet. Assoc., 1979. APPENDIX M Other Elements Determined by ICP/AES i n Teeth frcm Kamloops Tooth Number 1 2 3 4 5 6 7 8 13 14 15 16 17 18 19 As Sb P Cd Ni Mn Fe Mg Mo Cr V T i Co A l Ca Ba Sr ug/g wet weight <6 20 157752 <1 46 <1 2 4305 3 1 l <1 14 4 22 310461 3 103 5 17 152371 <1 <4 41 4 4319 3 41 l 1 15 416 306965 3 50 48 19 144374 <2 48 <2 <2 4969 4 <2 <2 <.2 16 4 32 284523 3 79 <5 21 160788 41 <5 <1 2 4726 4 <1 1 <1 17 <20 317801 3 65 <5 20 152767 < i <5 <1 8 5743 3 1 1 <1 12 4 2 1 299623 5 55 <10 22 137669 <2 410 <2 7 6769 5 4 2 <2 <2 20 4 39 268408 5 61 4 12 149638 4 1 <3 4 1 2 3094 2 1 1 <1 11 417 302510 2 39 6 20 153746 41 <5 1 5 4412 4 1 2 <1 19 4 2 0 308203 4 76 44 17 115102 <i 44 <1 2 6723 3 1 1 <1 13 91 238796 10 91 6 21 128307 41 <7 <1 7 4968 5 2 2 <.l 22 110 262080 7 89 48 21 140179 <2 <8 <2 4 4971 4 2 1 <2 21 118 13703 5 87 4 12 146269 41 43 41 1 3507 3 1 1 1 11 121 321864 4 58 <10 19 140455 42 410 <T2 4 2 4400 4 4 2 <2 <2 420 9 1 , 300747 5 59 6 20 154112 <1 45 4 1 41 4263 4 <ri 1 41 16 130 333503 5 73 7 17 146525 <1 <5 <1 4 4733 4 l 1 <1 14 102 318400 5 82 APPENDIX N Other Elements Deterrriined by ICP/AES in Teeth from Trail Tooth _. Element •  Number As Sb P Cd Ni Mn Fe Mg Mo Cr V T i Co Al Ca Ba Sr ug/g wet weight 20 <6 21 144258 41 46* 41 8 5556 4 1 1 41 16 124 302793 7 85 21 6 21 144842 41 <6 41 41 6316 4 41 2 41 18 109 303532 3 57 22 8 15 134420 4l <6 41 44 5513 4 41 2 <1 16 104 281603 6 80 23 9 16 139459 <1 <7 41 5 6462 5 2 2 41 18 105 285364 5 50 24 8 19 133980 1 44 1 5 5829 4 1 2 41 17 107 284082 5 44 25 11 27 145356 <2 <9 42 5 5380 5 2 2 <2 22 112 313443 7 89 26 11 22 162357 41 46 41 6 3880 5 2 2 41 22 116 350601 4 52 27 7 18 140215 <1 <5 41 2 5619 4 1 2 1 16 110 236267 6 75 28 19 433 147204 a 417 43 6 5066 7 4 3 43 43 4 33 467 314929 7 69 29 16 45 137552 43 416 43 43 5739 6 43 4,3 11 4 32 463 294083 7 23 30 <is 41 137378 <3 416 <3 <3 5717 43 43 43 43 4 33 4 65 283153 7 61 31 49 29 140840 42 49 42 42 5310 2 <2 42 <2 <1Q 109 301956 8 94 32 <s 24 143197 1 <6 1 3 5785 2 41 1 41 4.13 114 295788 7 79 33 4 8 28 129740 <2 48 42 42 4266 42 42 42 <2 416 106 268808 5 53 34 415 47 147346 <3 415 43 43 3668 4 43 <3 43 4 30 113 299173 7 88 35 <21 54 146030 44 <21 44 44 5754 44 44 44 44 <43 486 301801 8 92 36 <12 48 162445 42 412 42 6 3322 4 4 2 42 42 4 24 79 344718 6 71 37 ( 9 43 151062 3 <9 42 42 4876 3 42 2 42 19 102 317383 5 71 38 <e 32 139160 41 46 -41 <1 6350 3 41 2 41 15 94 291731 10 96 CO 

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