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A Comprehensive Assessment of Health Risks Associated with Heavy Metal Through Ingestion of Two Predominant Fish Species in a Developing Country

Roy TK, Nag SK, Antu UB, Hossain SA, Al Bakky A, Anjum MT, et al.

Biol Trace Elem Res, 2025 Feb 06.
PMID: 39912998 DOI: 10.1007/s12011-025-04540-1

The existence of heavy metal pollutants in fish within aquatic ecosystems presents a threat to human health due to trophic shift. This research sought to identify the concentrations of cadmium (Cd), arsenic (As), copper (Cu), lead (Pb), and chromium (Cr) in two economically significant cultured fish species, pangus (Pangasius hypophthalmus) and catla (Labeo catla), which were sourced from key fish markets in Khulna, Bangladesh. Nevertheless, there has been a scarcity of studies addressing the metal concentrations in these species within this region. To evaluate the levels of trace elements, atomic absorption spectrophotometry (AAS) was employed following the acid digestion of the samples. The concentrations of Cd, As, Cu, Pb, and Cr were observed as 0.372, 0.232, 0.741, 0.758, and 1.356 mg/kg in pangus and 0.395, 0.297, 1.175, 0.616, and 0.959 mg/kg in catla fish, respectively. The concentrations of Pb and Cd exceeded the maximum permissible limits established by the FAO and WHO. Apart from Cu, the estimated daily intakes (EDI) for both seasons and age groups exceeded the recommended daily allowance (RDA), indicating that other trace elements could be detrimental to human health. In contrast, the calculated hazard index (HI) and total hazard quotient (THQ) remained below 1, suggesting that the fish examined would not pose health risks to adults but the HI value for children surpassed the acceptable limit. Moreover, Cd (for adult group) and Cd and Cr (for children group) surpassed the acceptable range for carcinogenic risk (CR), and the total carcinogenic risk (TCR) exceeded the permissible limit for both groups. This study concluded that studied fishes may represent a health risk for consumers, underscoring the necessity for ongoing monitoring of trace elements in other fish species within that catchment area.
Fulltext Global Retinoblastoma Presentation and Analysis by National Income Level

Global Retinoblastoma Study Group, Fabian ID, Abdallah E, Abdullahi SU, Abdulqader RA, Adamou Boubacar S, et al.

JAMA Oncol, 2020 May 01;6(5):685-695.
PMID: 32105305 DOI: 10.1001/jamaoncol.2019.6716

IMPORTANCE: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale.
OBJECTIVES: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis.
DESIGN, SETTING, AND PARTICIPANTS: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017.
MAIN OUTCOMES AND MEASURES: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis.
RESULTS: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]).
CONCLUSIONS AND RELEVANCE: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs.

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