Health Risks, Toxicological and Cellular Tissue Effects of Heavy Metals

**48**

*Heavy Metal Toxicity in Public Health*

[62] Banerjee S, Manna S, Saha P, Panda C, Das S. Black tea polyphenols

suppress cell proliferation and induce apoptosis during benzo(a) pyrene-induced lung carcinogenesis. European Journal of Cancer Prevention.

2005;**14**(3):215-221

potential cancer risk in female smokers. Cancer Epidemiology, Biomarkers & Prevention. 2005;**14**(1):237-242

**51**

**Chapter 4**

**Abstract**

**1. Introduction**

proteins and causes many diseases.

*Narjala Rama Jyothi* 

Mercury Toxicity in Public Health

Mercury was the name of the Roman messenger of god who can move really fast. It is also called as quicksilver due to its fast movement and silvery tinge. Liquid metal state mercury (Hg) has little to no solubility and is not poisonous. But the liquid mercury can vaporize, and gaseous mercury becomes poisonous due to its nature of being absorbed into the blood. Mercury in +2 state is more poisonous due to high solubility. Mercury is the only metal that exists in liquid state at normal temperature and pressure. Mercury poisoning occurs by exposure to mercury, i.e., acute and chronic exposures. Symptoms of mercury poisoning depend on the type, dose, method, and duration of exposure. Mercury poisoning effects on the human body are not limited to reddishness of hands and feet; renal failures; cardiovascular, liver, brain, and hormonal issues; and intestinal ulceration. The present chapter describes the mercury sources, types of exposures, types of poisoning, treatments,

**Keywords:** mercury, heavy metal toxicity, sources, exposure of mercury, mercury

Heavy metal contamination is a serious problem to the environment, because they are not only biodegradable but also toxic to living organisms. The metals such as cadmium, mercury, and lead are owing much more interest to environmental scientists due to their accumulation in vital organs of the living beings. Once these metals are absorbed into the human body, they can be a threat with more health issues [1]. The absorbed mercury in humans becomes more toxic due to its prolonged half-life and lack of decomposition, and its interaction is not limited with various enzymes and proteins. Mercury has a great affinity with thiol group in

Mercury is the only metal that exists in liquid state among the total periodic table elements. It is very important to measure the concentration of mercury in the environment due to its bioaccumulative property in its elemental and organic forms (i.e., methylmercury) and toxic nature. Mercury (Hg) is a naturally occurring element that is toxic in nature. According to the US Environmental Protection Agency, the safe limit of mercury ion in drinking water is 10 nM to avoid the serious health problems to humans [2]. Mercury is a pollutant of global concern. The Minamata Convention on Mercury entered into force from 2017, regarding the protection of human and environmental health. A recent review reported about the worldwide

*and Nainar Abdulkhader Mohamed Farook*

and preventive measures of mercury poisoning.

poisoning, toxicity of mercury, prevention mercury toxicity

#### **Chapter 4**

## Mercury Toxicity in Public Health

*Narjala Rama Jyothi and Nainar Abdulkhader Mohamed Farook*

#### **Abstract**

Mercury was the name of the Roman messenger of god who can move really fast. It is also called as quicksilver due to its fast movement and silvery tinge. Liquid metal state mercury (Hg) has little to no solubility and is not poisonous. But the liquid mercury can vaporize, and gaseous mercury becomes poisonous due to its nature of being absorbed into the blood. Mercury in +2 state is more poisonous due to high solubility. Mercury is the only metal that exists in liquid state at normal temperature and pressure. Mercury poisoning occurs by exposure to mercury, i.e., acute and chronic exposures. Symptoms of mercury poisoning depend on the type, dose, method, and duration of exposure. Mercury poisoning effects on the human body are not limited to reddishness of hands and feet; renal failures; cardiovascular, liver, brain, and hormonal issues; and intestinal ulceration. The present chapter describes the mercury sources, types of exposures, types of poisoning, treatments, and preventive measures of mercury poisoning.

**Keywords:** mercury, heavy metal toxicity, sources, exposure of mercury, mercury poisoning, toxicity of mercury, prevention mercury toxicity

#### **1. Introduction**

Heavy metal contamination is a serious problem to the environment, because they are not only biodegradable but also toxic to living organisms. The metals such as cadmium, mercury, and lead are owing much more interest to environmental scientists due to their accumulation in vital organs of the living beings. Once these metals are absorbed into the human body, they can be a threat with more health issues [1]. The absorbed mercury in humans becomes more toxic due to its prolonged half-life and lack of decomposition, and its interaction is not limited with various enzymes and proteins. Mercury has a great affinity with thiol group in proteins and causes many diseases.

Mercury is the only metal that exists in liquid state among the total periodic table elements. It is very important to measure the concentration of mercury in the environment due to its bioaccumulative property in its elemental and organic forms (i.e., methylmercury) and toxic nature. Mercury (Hg) is a naturally occurring element that is toxic in nature. According to the US Environmental Protection Agency, the safe limit of mercury ion in drinking water is 10 nM to avoid the serious health problems to humans [2]. Mercury is a pollutant of global concern. The Minamata Convention on Mercury entered into force from 2017, regarding the protection of human and environmental health. A recent review reported about the worldwide

and regional time trends in total mercury levels in the human blood and breast milk and their associations with health effects [3].

Mercury is a metal that appears as silver balls, and its liquid form is called elemental mercury. Mercury in the environment can exist in different forms, such as mercurous ion (Hg+1), mercuric ion (Hg+2), methylmercury (CH3Hg+ ), ethylmercury (C2H5Hg+ ), and phenylmercury (C6H5Hg+ ). The chemical forms of mercury in the environment are broadly divided into three, i.e., (1) elemental mercury, (2) inorganic salts, and (3) organic compounds.

*Elemental mercury*: The atmosphere consists of mercury in elemental form, and at room temperature it is present in liquid form. It is used in thermometers and fluorescent bulbs.

*Inorganic mercury*: It occurs in several forms: metallic (Hg), mercurous (Hg1+), or mercuric form (Hg2+). This is present in crystal form, and it is used in pesticides and antiseptics.

*Organic mercury*: It is in the forms of aryl and alkyl. Methylmercury is the best example; it mixes with the food chain.

Nagpal et al. [4] reviewed the mercury exposure and health effects of dental personnel. Bernhoft [5] reviewed about the mercury toxicity and its treatments. Driscoll et al. [6] reviewed the sources, pathways, and effects of mercury in global environment. O'Connor et al. [7] reviewed about the mercury speciation, transformation, and transportation in soils, atmospheric flux, and implications for risk management. Taber et al. [8] studied the mercury exposure and effects across the life span. Antoszczyszyn and Michalska [9] reported the potential risk of environmental contamination by mercury contained in Polish coal mining waste. The toxic effects of mercury on human beings depend on several factors, such as chemical form of mercury, age, health condition of person exposed, and type of exposure. A study [10] regarding mercury toxicity reported that yearly around 60,000 babies were born with neurological problems due to their mothers poisoned with mercury.

The present chapter describes the mercury sources, types of exposures, types of poisoning, and preventions to avoid mercury poisoning.

#### **2. Sources of mercury**

The sources of mercury in the environment are classified into two types, i.e., natural and anthropogenic. The natural and anthropogenic sources of mercury in the environment are presented in **Table 1**.


**53**

as post-impoundment is 0.2–0.4 μg g<sup>−</sup><sup>1</sup>

impoundment is 0.7–2.6 μg g<sup>−</sup><sup>1</sup>

*Mercury Toxicity in Public Health*

**3. Natural sources**

fossil fuels.

*DOI: http://dx.doi.org/10.5772/intechopen.90333*

A number of studies worldwide reported the determination of mercury in naturally available sources, such as volcanic eruptions, forest fires, cinnabar, and

Regarding volcanic eruptions, a research study reported the determination of mercury at Masaya caldera complex, Santiago, Nicaragua. This study found the concentration of mercury at 232 selected points at the research area. They found higher concentrations of Hg(0) at their sampling sites [11]. Speciation of mercury in volcanic eruptions at Mount Etna, Sicily, Italy, was reported by Baganto et al. [12]. This study represents a systematic characterization of mercury partitioning between gaseous mercury and particulate forms in the volcanic eruptions.

Another study reported the determination of mercury in the volcanic eruptions at Kilauea volcano, Hawaii. This study found the low concentrations of mercury at soils with more sulfur content [13]. In Western Wyoming, Hg accumulation was examined between burned and unburned sampling sites with the total tree species composition. Results show that Hg emitted from forest fires depends on the forest fire intensity and Hg formation before the firing [14]. Atmospheric mercury species emitted due to forest fires were studied in three rural sites (southern Quebec, Canada, and northern New York). MODIS satellite reports show forest fires transmitted from Quebec, Canada to northern New York. Accumulation of Hg species in the atmosphere after the forest fire incidents is higher than the normal environmental conditions [15]. In Europe and North African countries, mercury emissions from

Mercury is a volatile metal due to its nature; it easily gets away from its deposits and enters into the atmosphere. Globally it was reported that 2000 to 8000 metric tons of Hg emissions takes place during the years 1550–1880. In Florida and the USA, speciation of mercury emissions was studied. Globally more Hg emissions are happening in industrialized areas [17]. At present years, industrial areas are the interesting research zones due to its huge Hg emissions; transport modeling is the tool used for calculating Hg emissions, and this is used for the analysis of Hg emissions in industrial zones [18]. Cinnabar is a toxic mercury sulfide (HgS), and it is the main ore of mercury. It is chemically inert and has low toxic potential when taken orally. Isonzo river (Gulf of Trieste) is the area in which high cinnabar is accumulated and Hg is bounded to it as fine particles [19]. Liu et al. [20] reported that Hg is a toxic metal. Cinnabar is used in Chinese medicines. Heating the ore leads to production of vapors, which are dangerous if inhaled and enter the stomach where it is not absorbed and finally deposits on the kidneys. Prolonged use of cinnabar inhalation leads to kidney damage.

There are two fish species, namely, piscivorous (northern pike and walleye) and non-piscivorous (lake white fish and longnose sucker). Hg concentration depends on fish species and type of reservoirs. After 5 years of rapid filling of reservoirs with water, the Hg level increases, and later in 10 years, Hg concentration will decrease [21]. Hydroelectric reservoirs are increasing rapidly due to the need of electricity. The present studies reported the Hg accumulation in water before and after flooding. The conversion of Hg to MeHg in the environment leads to an increase in the toxicity in water. In order to decline the toxicity, intensive fishing is the best remedy. Adding selenium to water is another best method to decrease the Hg content in water. MeHg is deposited in fishes, and eating such type of fishes leads to severe health risks [22]. Bodaly et al. [23] conducted a study on fish in the boreal reservoir of Northern Manitoba, Canada. In lake white fish, the Hg concentration after floods

Hg concentration in northern spike and walleye after flooding as below post-

and pre-impoundment is 0.06–0.14 μg g<sup>−</sup><sup>1</sup>

and pre-impoundment is 0.19–0.047 μg g<sup>−</sup><sup>1</sup>

.

.

forest fires are studied based on ground data and phytomass [16].

**Table 1.** *Sources of mercury.*

#### **3. Natural sources**

A number of studies worldwide reported the determination of mercury in naturally available sources, such as volcanic eruptions, forest fires, cinnabar, and fossil fuels.

Regarding volcanic eruptions, a research study reported the determination of mercury at Masaya caldera complex, Santiago, Nicaragua. This study found the concentration of mercury at 232 selected points at the research area. They found higher concentrations of Hg(0) at their sampling sites [11]. Speciation of mercury in volcanic eruptions at Mount Etna, Sicily, Italy, was reported by Baganto et al. [12]. This study represents a systematic characterization of mercury partitioning between gaseous mercury and particulate forms in the volcanic eruptions.

Another study reported the determination of mercury in the volcanic eruptions at Kilauea volcano, Hawaii. This study found the low concentrations of mercury at soils with more sulfur content [13]. In Western Wyoming, Hg accumulation was examined between burned and unburned sampling sites with the total tree species composition. Results show that Hg emitted from forest fires depends on the forest fire intensity and Hg formation before the firing [14]. Atmospheric mercury species emitted due to forest fires were studied in three rural sites (southern Quebec, Canada, and northern New York). MODIS satellite reports show forest fires transmitted from Quebec, Canada to northern New York. Accumulation of Hg species in the atmosphere after the forest fire incidents is higher than the normal environmental conditions [15]. In Europe and North African countries, mercury emissions from forest fires are studied based on ground data and phytomass [16].

Mercury is a volatile metal due to its nature; it easily gets away from its deposits and enters into the atmosphere. Globally it was reported that 2000 to 8000 metric tons of Hg emissions takes place during the years 1550–1880. In Florida and the USA, speciation of mercury emissions was studied. Globally more Hg emissions are happening in industrialized areas [17]. At present years, industrial areas are the interesting research zones due to its huge Hg emissions; transport modeling is the tool used for calculating Hg emissions, and this is used for the analysis of Hg emissions in industrial zones [18].

Cinnabar is a toxic mercury sulfide (HgS), and it is the main ore of mercury. It is chemically inert and has low toxic potential when taken orally. Isonzo river (Gulf of Trieste) is the area in which high cinnabar is accumulated and Hg is bounded to it as fine particles [19]. Liu et al. [20] reported that Hg is a toxic metal. Cinnabar is used in Chinese medicines. Heating the ore leads to production of vapors, which are dangerous if inhaled and enter the stomach where it is not absorbed and finally deposits on the kidneys. Prolonged use of cinnabar inhalation leads to kidney damage.

There are two fish species, namely, piscivorous (northern pike and walleye) and non-piscivorous (lake white fish and longnose sucker). Hg concentration depends on fish species and type of reservoirs. After 5 years of rapid filling of reservoirs with water, the Hg level increases, and later in 10 years, Hg concentration will decrease [21]. Hydroelectric reservoirs are increasing rapidly due to the need of electricity. The present studies reported the Hg accumulation in water before and after flooding. The conversion of Hg to MeHg in the environment leads to an increase in the toxicity in water. In order to decline the toxicity, intensive fishing is the best remedy. Adding selenium to water is another best method to decrease the Hg content in water. MeHg is deposited in fishes, and eating such type of fishes leads to severe health risks [22]. Bodaly et al. [23] conducted a study on fish in the boreal reservoir of Northern Manitoba, Canada. In lake white fish, the Hg concentration after floods as post-impoundment is 0.2–0.4 μg g<sup>−</sup><sup>1</sup> and pre-impoundment is 0.06–0.14 μg g<sup>−</sup><sup>1</sup> . Hg concentration in northern spike and walleye after flooding as below postimpoundment is 0.7–2.6 μg g<sup>−</sup><sup>1</sup> and pre-impoundment is 0.19–0.047 μg g<sup>−</sup><sup>1</sup> .

Insect larvae are another source of storage of Hg and MeHg in hydroelectric reservoir. The storage of mercury in hydroelectric reservoir is higher than natural lakes. The flooded soil is one of major sources for insect larvae which is studied by Tremblay and Lucotte [24]. Mining is the major anthropogenic source for the release of tones of mercury into the environment. In global consideration Brazil is the topmost country in gold production; nearly 2000 tons of mercury was released into the environment. In some areas there is a lot of Hg accumulation taking place without gold mining; it is due to man-made mistakes (sediments, human hair, and urine) [25].

Appleton et al. [26] reported that Naboc River water is highly contaminated with Hg. Rice paddy fields are present in the Naboc area and were irrigated with Naboc River water, so the soil was highly contaminated with mercury. In contrast the corn and banana crops that are not irrigated with Naboc river water produced mercuryfree crops.

Amalgamation is the process of using the mercury in mining gold and silver. Patio process is used in Spanish colonial America, Australia, Southeast Asia, and England. From 1550 to 1930, 260,000 tons of mercury was released into the atmosphere. South America (Amazon), China, Southeast Asia, and African countries have been using widely mercury amalgamation. Mining is the major anthropogenic source; 10% of mercury emissions is involved due to this. About 300 tons of mercury is released into the environment through gold and silver mining since the last 500 years [27].

Malm et al. [28] performed research studies on the sediments of Madeira River basin. The sediment particles are amalgamated with mercury; 30% of mercury was released into the river water, whereas 20% of mercury was released into the atmosphere.

#### **4. Types of exposure**

Mercury exposure to the humans can take place in three ways, through dermal contact from soil, through drinking water, and through inhalation of the atmosphere and intake by food. The mercury in the atmosphere can be dissolved into water and can change into a more toxic form of methylmercury by micro-organisms. Methylmercury is more toxic than elemental mercury. The historical incident of Minamata, Japan, was an evidence of the bioaccumulation of methylmercury in fishes in which it can enter into the food web and finally to the humans. The levels of methylmercury in fish depend on what they eat, how long they live, and how high they are in food chain.

There are two types of exposures that we can observe in human populations with mercury, i.e., acute exposure and chronic exposure. Acute exposure to inorganic mercury or mercuric salts is mostly like through oral route. Chronic exposure is usually related to prolonged exposure during occupational incidents.

The exposure of mercury has been historically reported since a few hundreds of years. Inorganic mercury compounds were used in skin ointments which were used to treat some skin diseases in ancient Egypt. In Korea, occupational mercury exposure to humans was observed in fluorescent lamp manufacturing and silver refining plants. In normal populations, mercury exposure is through inhalation by burning charms [29].

Based on the literature, it is concluded that there are no significant toxicological effects observed by the ingestion of elemental mercury by a healthy person because of its poor absorbance into the gastrointestinal tract. The chronic exposure to the mercury vapor mostly affects the central nervous system and the kidneys. The major exposure by the human population to the mercury vapor is through

**55**

adults [39].

discussed here under.

**6. Minamata disease**

Minamata Bay to Shiranui Sea.

*Mercury Toxicity in Public Health*

**5. Types of poisoning**

*DOI: http://dx.doi.org/10.5772/intechopen.90333*

in the blood reaching the different organs [30].

Autism due to Hg present in Thiomersal [31].

also affects the memory and involuntary actions.

inhalation route, because 80% of the mercury can reach the lungs and be dissolved

Mercury is a toxic metal, and it occurs naturally and exists in elemental (or metallic), inorganic (mercuric chloride), and organic (methyl- and ethylmercury) forms. Thiomersal (sodium ethylmercury thiosalicylate) contains 49.6% ethylmercury. It is used as a preservative in children vaccines. According to According to American Academy of Pediatricians (AAP) the vaccinated children are pronging to

Clarkson et al. [32] reported that the Hg poisoning results in psychiatric disturbances due to CNS dysfunction and it also effects listening and speaking abnormalities. Intention tremor is the abnormality created in speech and mouth disorders [33]. Sensory motor problems and defects (touch, excessive mouthing) are caused by mercury toxicity. According to a study [34], ADHD and ASD are the few abnormalities related to mental retardation, and abnormal behavior is exhibited by the affected people. Some of the abnormal behaviors [35] are seen due to mercury toxic nature, i.e., there is no controlled-on mind activities in babies. Mercury poisoning

Mercury toxicology effects on the visions of children and adults include poor visibility, blurriness, and no fixed visuality. Mercury toxic nature not only affects mental health, but also it creates several physical disturbances, such as hyper−/hypotonia [36]. Muscle weakness, shivering in arm, and few disturbances will occur in some patients, and in few cases, the complete chance of paralysis is also studied [37].

Poor blood circulation led to a change in color of feet and hands to red and blue color which is one of the toxic effects of mercury poisoning [38]. Sweating-related problems, i.e., excessive sweating (acrodynia) and fast heartbeat, are seen in few

The toxic nature of mercury mostly effects gastrointestinal systems of humans. The inhalation of mercury led to several discomforts in the abdominal region such as

The historical incident happened regarding mercury compound poisoning in Minamata Bay, Japan, in 1956. The important features of Minamata diseases are

It is a chronic disease due to methylmercury coming from industrial wastes, and such wastes deposit in water sources as sediments. The deposited methylmercury enters the fishes available in the water sources and enters the food chain and finally reaches the humans. In New Mexico, USA, research were performed on seed grain treated with methylmercury and reported that those grains are exposed to Minamata disease (https://www.medicinenet.com/script/main/art.asp? articlekey=14084). Akagi et al. [41] reported the methylmercury dose based on umbilical

Matsumoto et al. [42] had reported the clinical survey regarding Minamata disease in children and found symptoms such as cerebral palsy. Ekino et al. [43] studied methylmercury poisoning effects and reviewed the history of its toxicity (1950–1968) for about 20 years and found that methylmercury spread from

gut-related problems, lesions in colon, and severe abdominal pain [40].

cord concentrations of the patients suffering from Minamata disease.

inhalation route, because 80% of the mercury can reach the lungs and be dissolved in the blood reaching the different organs [30].

#### **5. Types of poisoning**

Mercury is a toxic metal, and it occurs naturally and exists in elemental (or metallic), inorganic (mercuric chloride), and organic (methyl- and ethylmercury) forms. Thiomersal (sodium ethylmercury thiosalicylate) contains 49.6% ethylmercury. It is used as a preservative in children vaccines. According to According to American Academy of Pediatricians (AAP) the vaccinated children are pronging to Autism due to Hg present in Thiomersal [31].

Clarkson et al. [32] reported that the Hg poisoning results in psychiatric disturbances due to CNS dysfunction and it also effects listening and speaking abnormalities. Intention tremor is the abnormality created in speech and mouth disorders [33].

Sensory motor problems and defects (touch, excessive mouthing) are caused by mercury toxicity. According to a study [34], ADHD and ASD are the few abnormalities related to mental retardation, and abnormal behavior is exhibited by the affected people. Some of the abnormal behaviors [35] are seen due to mercury toxic nature, i.e., there is no controlled-on mind activities in babies. Mercury poisoning also affects the memory and involuntary actions.

Mercury toxicology effects on the visions of children and adults include poor visibility, blurriness, and no fixed visuality. Mercury toxic nature not only affects mental health, but also it creates several physical disturbances, such as hyper−/hypotonia [36]. Muscle weakness, shivering in arm, and few disturbances will occur in some patients, and in few cases, the complete chance of paralysis is also studied [37].

Poor blood circulation led to a change in color of feet and hands to red and blue color which is one of the toxic effects of mercury poisoning [38]. Sweating-related problems, i.e., excessive sweating (acrodynia) and fast heartbeat, are seen in few adults [39].

The toxic nature of mercury mostly effects gastrointestinal systems of humans. The inhalation of mercury led to several discomforts in the abdominal region such as gut-related problems, lesions in colon, and severe abdominal pain [40].

The historical incident happened regarding mercury compound poisoning in Minamata Bay, Japan, in 1956. The important features of Minamata diseases are discussed here under.

#### **6. Minamata disease**

It is a chronic disease due to methylmercury coming from industrial wastes, and such wastes deposit in water sources as sediments. The deposited methylmercury enters the fishes available in the water sources and enters the food chain and finally reaches the humans. In New Mexico, USA, research were performed on seed grain treated with methylmercury and reported that those grains are exposed to Minamata disease (https://www.medicinenet.com/script/main/art.asp? articlekey=14084). Akagi et al. [41] reported the methylmercury dose based on umbilical cord concentrations of the patients suffering from Minamata disease.

Matsumoto et al. [42] had reported the clinical survey regarding Minamata disease in children and found symptoms such as cerebral palsy. Ekino et al. [43] studied methylmercury poisoning effects and reviewed the history of its toxicity (1950–1968) for about 20 years and found that methylmercury spread from Minamata Bay to Shiranui Sea.

The consumption of fish or shellfish with mercury by pregnant women affects the fetus brain (Harada 1978). Another study [44] reported at Minamata disease affected people in Kumamoto and found the damage of cerebral cortex.

In addition to the Minamata disease, the other major disease caused due to the mercury poisoning through teething powder is pink disease, in which the foot and hand turn into pink color. The pink disease-affected children were found to have high mercury content in their urine samples [45]. Other than the teething powder, the reasons for the pink disease in young children were viral infections and nutrition deficiency [46].

#### **7. Renal and bone-related effects due to mercury poisoning**

Gottelli et al. [47] have studied the effect of mercury on renal function. Phenylmercury enters in the renal tubes through the contaminated diapers, with the excretion of gamma glutamyl transpeptidase in renal cells leading to increase urinary volume and toxicity. Osteoporosis and osteopenia diseases in Korean men due to mercury were studied by Kim et al. [48]. The analysis was performed on Korean men's blood samples, and high mercury range in younger people was found. The analysis was performed on different categories people like alcoholic and in fish consumers, the content of mercury range was found in them due to their intakes. Parejo et al. [49] have studied some cases related to low bone density which is due to the contaminated food and water sources. The intake of Hg was calculated in women in Spain, and studies were related on bone disorder reasons. Garcia et al. [50] reveal that bone disorders, like osteoporosis, are due to heavy toxic metals like mercury, etc. and due to dietary mercury intake which is the reason of accumulation of mercury in the bones. In a study of 158 women, 25.29 μg/day of dietary heavy metal intake leads to several osteoporosis cases and fracturing. Dainowski et al. [51] studied the total mercury (THg) concentration on muscle, kidney, and liver of red foxes in Western Alaska. It was seen that total mercury concentration in hair is correlated with muscle, kidney, and liver. The major reason of mercury content is due to industrialization in Arctic areas. Accumulation of mercury in human tissues and severe knee-related problems were studied by Bogacka et al. [52]. In northwestern Poland, the total mercury percentage in women cartilage was high compared to selenium, and moreover knee joint-related problems in patients are also due to selenium to total mercury ratio.

#### **8. Hormonal effects of mercury poisoning**

Adipogenesis is the process of cell differentiation and study on adipocytes (lipocytes, fat cells). Adiposeness is the process of study modules of cell differentiation. Telapolu et al. [53] studied on MD-1, it is a polyherbal used in management of Diabetes mellitus. α-Glycosidase and α-amylase are the two carbohydrate digestive enzymes, HAEF is the extract, and its effect on digestive enzymes was studied. The effect of MD-1 on adipogenesis was studied, and the effect of HAEF on mRNA expression of peroxisome proliferator-activated receptor gamma (PPARγ) and glucose transporter 4 (GLUT4) in 3T3L1 adipocytes was investigated.

#### **9. Liver-related effects due to mercury poisoning**

Hussain et al. [54] studied about the effects of mercurous chloride on the liver, brain, and kidney which are due to enzymes like superoxide dismutase (SOD),

**57**

*Mercury Toxicity in Public Health*

was decreased.

the vaccine.

*DOI: http://dx.doi.org/10.5772/intechopen.90333*

inhibitor is the cause of periodontal disease in beagles.

**10. Prevention measures of mercury poisoning**

glutathione peroxidase (GPx), and glutathione reductase. The increase in the mercury levels is correlated with enzyme activities, and generation of reactive oxygen species (ROS) is the cause of mercury accumulation. Fish is the major source of mercury; consuming such mercury stored in fish leads to exposure of human tissues to high mercury levels. Pelletier et al. [55] examined by checking mercury levels in rodents as they are exposed frequently with *Rhododendron tomentosum* extract and their blood is with higher mercury levels. Williams et al. [56] reported flurbiprofen (anti-inflammatory drug) is the cause of bone resorption disease. Cyclooxygenase

Crespo et al. [57] studied *Lactobacillus casei effect on mercury*, and results show the decreased methylmercury bioavailability in acutely exposed mice. Mercury accumulation in the liver and kidney was not affected by *Lactobacillus* supplementation. Adult male rats are exposed to Labrador tea and antibiotic cocktail in which methylmercury is present in it. It was observed that when the rats were treated with antibiotics, increased Hg levels in blood levels were observed. El- Demerdash [58] studies reported on oxidative stress of Hg and selenium. Rats were given Hg (0.5 μmol/ml), for 5 days, and several biochemical assays were done on them, and it was observed that after the Hg treatment, the protein content in the brain and liver

Consuming of fish two servings per a week leads to good cordial health, but the presence of mercury, especially in oil fish like salmon and sardines, leads to an increased risk of cardiovascular health. Avoiding such sort of fish is one of the best prevention measures. Davis (http://www.emedicine health.com/mercury\_poisoning/article\_em.htm) reported on the prevention measures of mercury at various areas. In home broken thermometers and fluorescent light tubes are the major sources; awareness and preventive measures should be taken into account in disposing them far away. Dental amalgam fillings should be avoided by mercury, and any other alternative material should be used. The mothers feeding the infants should be most aware of taking fishes because the mercury content present may affect the infant brain and spine; this is one of the good preventive measures. Thiomersal is the preservative used in flu vaccines; usage of such vaccines may affect the child, so clear precautions are needed for preventing mercury entry into children through

#### *Mercury Toxicity in Public Health DOI: http://dx.doi.org/10.5772/intechopen.90333*

glutathione peroxidase (GPx), and glutathione reductase. The increase in the mercury levels is correlated with enzyme activities, and generation of reactive oxygen species (ROS) is the cause of mercury accumulation. Fish is the major source of mercury; consuming such mercury stored in fish leads to exposure of human tissues to high mercury levels. Pelletier et al. [55] examined by checking mercury levels in rodents as they are exposed frequently with *Rhododendron tomentosum* extract and their blood is with higher mercury levels. Williams et al. [56] reported flurbiprofen (anti-inflammatory drug) is the cause of bone resorption disease. Cyclooxygenase inhibitor is the cause of periodontal disease in beagles.

Crespo et al. [57] studied *Lactobacillus casei effect on mercury*, and results show the decreased methylmercury bioavailability in acutely exposed mice. Mercury accumulation in the liver and kidney was not affected by *Lactobacillus* supplementation. Adult male rats are exposed to Labrador tea and antibiotic cocktail in which methylmercury is present in it. It was observed that when the rats were treated with antibiotics, increased Hg levels in blood levels were observed. El- Demerdash [58] studies reported on oxidative stress of Hg and selenium. Rats were given Hg (0.5 μmol/ml), for 5 days, and several biochemical assays were done on them, and it was observed that after the Hg treatment, the protein content in the brain and liver was decreased.

#### **10. Prevention measures of mercury poisoning**

Consuming of fish two servings per a week leads to good cordial health, but the presence of mercury, especially in oil fish like salmon and sardines, leads to an increased risk of cardiovascular health. Avoiding such sort of fish is one of the best prevention measures. Davis (http://www.emedicine health.com/mercury\_poisoning/article\_em.htm) reported on the prevention measures of mercury at various areas. In home broken thermometers and fluorescent light tubes are the major sources; awareness and preventive measures should be taken into account in disposing them far away. Dental amalgam fillings should be avoided by mercury, and any other alternative material should be used. The mothers feeding the infants should be most aware of taking fishes because the mercury content present may affect the infant brain and spine; this is one of the good preventive measures. Thiomersal is the preservative used in flu vaccines; usage of such vaccines may affect the child, so clear precautions are needed for preventing mercury entry into children through the vaccine.

*Heavy Metal Toxicity in Public Health*

### **Author details**

Narjala Rama Jyothi1 \* and Nainar Abdulkhader Mohamed Farook<sup>2</sup>

1 Department of Chemistry, School of Engineering, Sri Padmavathi Mahila Visvavidyalayam, Tirupati, Andhra Pradesh, India

2 Department of Chemistry, Khadir Mohideen College, Adhirampattinam, Tamil Nadu, India

\*Address all correspondence to: ramadasaradhi@gmail.com

© 2020 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

**59**

*Mercury Toxicity in Public Health*

**References**

2015;**757**:235-242

[3] Sharma BM, Sanka O,

2019;**125**:300-319

2017;**8**:1-10

460508

*DOI: http://dx.doi.org/10.5772/intechopen.90333*

and Clinical Neurosciences.

of mercury threat. Nature.

[12] Baganto E, Aiuppa A,

[11] Crenshaw WB, Williams SN, Stoiber RE. Fault location by radon and mercury detection at an active volcano in Nicaragua. Nature. 1982;**300**:345-346

2001;**409**:124

[9] Antoszczyszyn T, Michalska A. The potential risk of environmental contamination by mercury contained in polish coal mining waste. Journal of Sustainable Mining. 2016;**15**:191-196

[10] Schrope M. US to take temperature

Parello F, Calabrese S, Alessandro WD, Mather TA, et al. Degassing of gaseous (elemental and reactive) and particulate mercury from Mount Etna volcano (southern Italy). Atmospheric Environment. 2007;**41**(35):7377-7388

[13] Cox ME. Summit out gassing as indicated by radon mercury and pH mapping, Kilauea volcano, Hawaii. Journal of Volcanology and Geothermal

Research. 1983;**16**(1-2):131-151

[14] Biswas A, Blum JD, Klaue B, Keeler GJ. Release of mercury form rocky mountain forest fires. Global Biogeochemical Cycles. 2007;**21**:GB1002

[15] Wang Y, Huang J, Zananski TJ, Hopke PK, Holsen TM. Impacts of the Canadian forest fires on atmospheric

Environmental Science and Technology.

[16] Cinnirella S, Pirrone N. Spatial and temporal distributions of mercury emissions form forest fires in Mediterranean region and Russian federation. Atmospheric Environment.

mercury and carbonaceous particles in northern New York.

2010;**44**(22):8435-8440

2006;**40**(38):7346-7361

2008;**20**(4):384-389

[1] Xie YL, Zhao SQ, Ye HL, Yuan J, Song P, Hu SQ. Graphene/CeO2 hybrid

electrochemical detection of cadmium (II), copper(II), and mercury(II). Journal of Electroanalytical Chemistry.

[2] USEPA. United States Environmental Protection Agency, National Primary Drinking Water Regulations. 2009. Available from: http://www.epa.gov

Kalina J, Scheringer M. An overview of worldwide and regional time trends in total mercury levels in human blood and breast milk from 1966 to 2015 and their associations with health effects. Environmental International.

[4] Nagpal N, Bettiol SS, Isham A, Hoang H, Crocombe LA. A review of mercury exposure and health of dental personnel. Safety and Health at Work.

[5] Bernhoft RA. Mercury toxicity and treatment: A review of the

literature. Journal of Environmental and Public Health. 2012;**2012**: Article ID:

[6] Driscoll CT, Mason RP, Chan HM, Jacob DJ, Pirrone N. Mercury as a global pollutant: Sources, pathways, and effects. Environmental Science and Technology. 2013;**47**:4967-4983

[7] O'Connor D, Hou D, Ok YS,

speciation, transportation, and

[8] Taber KH, Hurley RA. Mercury exposure: Effects across the lifespan. The Journal of Neuropsychiatry

Mulder J, Duan L, Wu Q, et al. Mercury

transportation in soils, atmospheric flux and implications for risk management: A critical review. Environmental International. 2019;**126**:747-761

materials for the simultaneous

*Mercury Toxicity in Public Health DOI: http://dx.doi.org/10.5772/intechopen.90333*

#### **References**

[1] Xie YL, Zhao SQ, Ye HL, Yuan J, Song P, Hu SQ. Graphene/CeO2 hybrid materials for the simultaneous electrochemical detection of cadmium (II), copper(II), and mercury(II). Journal of Electroanalytical Chemistry. 2015;**757**:235-242

[2] USEPA. United States Environmental Protection Agency, National Primary Drinking Water Regulations. 2009. Available from: http://www.epa.gov

[3] Sharma BM, Sanka O, Kalina J, Scheringer M. An overview of worldwide and regional time trends in total mercury levels in human blood and breast milk from 1966 to 2015 and their associations with health effects. Environmental International. 2019;**125**:300-319

[4] Nagpal N, Bettiol SS, Isham A, Hoang H, Crocombe LA. A review of mercury exposure and health of dental personnel. Safety and Health at Work. 2017;**8**:1-10

[5] Bernhoft RA. Mercury toxicity and treatment: A review of the literature. Journal of Environmental and Public Health. 2012;**2012**: Article ID: 460508

[6] Driscoll CT, Mason RP, Chan HM, Jacob DJ, Pirrone N. Mercury as a global pollutant: Sources, pathways, and effects. Environmental Science and Technology. 2013;**47**:4967-4983

[7] O'Connor D, Hou D, Ok YS, Mulder J, Duan L, Wu Q, et al. Mercury speciation, transportation, and transportation in soils, atmospheric flux and implications for risk management: A critical review. Environmental International. 2019;**126**:747-761

[8] Taber KH, Hurley RA. Mercury exposure: Effects across the lifespan. The Journal of Neuropsychiatry

and Clinical Neurosciences. 2008;**20**(4):384-389

[9] Antoszczyszyn T, Michalska A. The potential risk of environmental contamination by mercury contained in polish coal mining waste. Journal of Sustainable Mining. 2016;**15**:191-196

[10] Schrope M. US to take temperature of mercury threat. Nature. 2001;**409**:124

[11] Crenshaw WB, Williams SN, Stoiber RE. Fault location by radon and mercury detection at an active volcano in Nicaragua. Nature. 1982;**300**:345-346

[12] Baganto E, Aiuppa A, Parello F, Calabrese S, Alessandro WD, Mather TA, et al. Degassing of gaseous (elemental and reactive) and particulate mercury from Mount Etna volcano (southern Italy). Atmospheric Environment. 2007;**41**(35):7377-7388

[13] Cox ME. Summit out gassing as indicated by radon mercury and pH mapping, Kilauea volcano, Hawaii. Journal of Volcanology and Geothermal Research. 1983;**16**(1-2):131-151

[14] Biswas A, Blum JD, Klaue B, Keeler GJ. Release of mercury form rocky mountain forest fires. Global Biogeochemical Cycles. 2007;**21**:GB1002

[15] Wang Y, Huang J, Zananski TJ, Hopke PK, Holsen TM. Impacts of the Canadian forest fires on atmospheric mercury and carbonaceous particles in northern New York. Environmental Science and Technology. 2010;**44**(22):8435-8440

[16] Cinnirella S, Pirrone N. Spatial and temporal distributions of mercury emissions form forest fires in Mediterranean region and Russian federation. Atmospheric Environment. 2006;**40**(38):7346-7361

[17] Hanisch C. Where is mercury deposition coming from? Environmental Science and Technology. 1998;**3297**:176A-179A

[18] Pacyna JM, Munch J. Anthropogenic mercury emission in Europe. Water, Air, and Soil Pollution. 1991;**56**(1):51-61

[19] Covelli S, Faganeli J, Horvat M, Brambati A. Mercury contamination of coastal sediments as the results of longterm cinnabar mining activity (Gulf of Trieste, northern Adriatic Sea). Applied Geochemistry. 2001;**16**(50):541-558

[20] Liu J, Shi JZ, Yu LM, Goyer RA, Waalkes MP. Mercury in traditional medicines: Is cinnabar toxicologically similar to common mercurials? Experimental Biology and Medicine. 2008;**233**(7):810-817

[21] Verdon R, Brouard D, Demers C, Lalumiere R, Laperle M, Schetagne R. Mercury evolution (1978-1988) in fishes of the La Grande hydroelectric complex, Quebec, Canada. Water, Air, and Soil Pollution. 1991;**56**(1):405-417

[22] Maliman M, Stepnuk L, Cicek N, Bodaly RAD. Strategies to lower methyl mercury concentrations in hydroelectric reservoirs and lakes: A review. The Science of the Total Environment. 2006;**368**(1):224-235

[23] Bodaly RA, Jansen WA, Majewski AR, Fudge JP, Strange NE, Derksen AJ, et al. Postimpoundment time course of increased mercury concentrations in fish in hydroelectric reservoirs of northern Manitoba, Canada. Archives of Environmental Contamination and Toxicology. 2007;**53**(3):379-389

[24] Tremblay A, Lucotte M. Accumulation of total mercury and methyl mercury in insect larvae of hydroelectric reservoirs. Canadian Journal of Fisheries and Aquatic Sciences. 1997;**54**(4):832-841

[25] Malm O. Gold mining as a source of mercury exposure in the Brazilian Amazon. Environmental Research. 1998;**77**(2):73-78

[26] Appleton JD, Weeks JM, Calvez JPS, Beinhoff C. Impacts of mercury contaminated mining waste on soil quality, crops, bivalves, and fish in the Naboc river area, Mindanao, Philippines. Science of the Total Environment. 2006;**354**(2-3):198-211

[27] Lacerda LD. Global mercury emissions from gold and silver mining. Water, Air, and Soil Pollution. 1997;**97**(3-4):209-221

[28] Malm O, Pfeiffer WC, Souza CMM, Reuther R. Mercury pollution due to gold mining in the Madeira river basin, Brazil. Ambio. 1990;**19**(1):11-15

[29] Lee HY, Kang GH, Nam KH, Kim MH, Jung BH, Kang HD, et al. Acute mercury vapor inhalation toxicity after burning charms: A case report. Korean Journal of Critical Care Medicine. 2010;**25**(3):182-185. (Korean)

[30] Kim MK, Zoh KD. Fate and transport of mercury in environmental media and human exposure. Journal of Preventive Medicine and Public Health. 2012;**45**:335-343

[31] Bernard S, Enayati A, Redwood L, Roger H, Binstock T. Autism: A Unique Form of Mercury Poisoning. 2000. Available from: http://citeseerx.ist. psu.edu/viewdoc/download?doi= 10.1.1.384.1456& rep=rep1 &type=pdf

[32] Clarkson T. The toxicology of mercury. Critical Reviews in Clinical Laboratory Sciences. 1997;**34**(3):369-403

[33] Kark RA, Poskanzer DC, Bullock JD, Boylen G. Mercury poisoning and its treatment with N-acetyl-D,

**61**

*Mercury Toxicity in Public Health*

of Medicine. 1971;**285**(1):10-16

[35] Teitelbaum P, Teitelbaum O,

[36] Nordin V, Gillberg C. Autism Spectrum disorders in children with physical or mental disability or both. I: Clinical and epidemiological aspects. Developmental Medicine and Child Neurology. 1996;**8**(4):297-313

[37] Amin-Zaki L, Majeed MA, Clarkson TW, Greenwood MR. Methylmercury poisoning in Iraqi children: Clinical observations over two years. British Medical Journal.

of acrocyanosis with Asperger's

Research. 1990;**34**:87-90

bigpond.com/difarnsworth

[40] Horvath K, Papadimitriou JC, Rabsztyn A, Drachenberg C, Tildon JT. Gastrointestinal abnormalities in children

with autistic disorder. Journal of Pediatrics. 1999;**135**(5):559-563

Takizawa Y, Weihe P. Methyl mercury dose estimation from umbilical cord concentrations in patients with Minamata disease. Environmental

Takeuchi T. Fetal Minamata disease: A neuropathological study of two

[41] Akagi H, Grandjean P,

Research. 1998;**77**:98-103

[42] Matsumoto H, Koya G,

[38] Carpenter PK, Morris D. Association

syndrome. Journal of Mental Deficiency

[39] Farnsworth D. Pink Disease Survey Results. Pink Disease Support Group Site. 1997. Available from: www.users.

1978;**1**:613-616

USA. 1998;**75**:13982-13987

*DOI: http://dx.doi.org/10.5772/intechopen.90333*

L-penicillamine. New England Journal

cases of intrauterine intoxication by a methylmercury compound. Journal of Neuropathology and Experimental Neurology. 1965;**24**(4):563-574

[43] Ekino S, Susa M, Ninomiya T, Imamura K, Kitamura T. Minamata disease revisited: An update on the acute and chronic manifestations of methyl mercury poisoning. Journal of Neurological Sciences.

[44] Eto K. Review article: Pathology of Minamata disease. Toxicologic Pathology. 1997;**25**(6):614-623

Raimer SS, Cobos R, Pupo R. Cutaneous manifestations of Acrodynia (pink disease). Archives of Dermatology.

[46] Dally A. The rise and fall of pink disease. Social History of Medicine.

[47] Gotelli CA, Astolfi E, Cox C, Cernichiari E, Clarkson TW. Early biochemical effects of an organic mercury fungicide on infants: "dose makes the poison". Science.

[48] Kim YH, Shim JY, Seo MS, Yim HJ, Cho MR. Relationship between blood mercury concentration and bone mineral density in Korean men in the 2008- 2010 Korean national health nutrition examination survey. Korean Journal of Family Medicine. 2016;**37**(5):273-278

[49] Parejo LMP, Aliga I, Macias MLC, Hernandez OL, Martin RR, Martin SR, et al. Evaluation of the dietary intake of cadmium, lead and mercury and its relationship with bone health among postmenopausal women in Spain. International Journal of Environmental Research and Public Health. 2017;**14**(6):564

[50] Garcia JML, Parejo LMP, Martin RR, Moran JM, Zamorano JDP, Aliaga IJ,

2007;**262**(1-2):131-144

[45] Dinehart SM, Dillard R,

1988;**124**(1):107-109

1997;**10**(2):291-304

1985;**227**(4687):638-640

[34] Gillberg C, Coleman M. The Biology of the Autistic Syndromes. 2nd ed. London, UK; Mac Keith Press; 1992

Nye J, Fryman J, Maurer RG. Movement analysis in infancy may be useful for early diagnosis of autism. Proceedings of theNational Academy of Sciences,

#### *Mercury Toxicity in Public Health DOI: http://dx.doi.org/10.5772/intechopen.90333*

L-penicillamine. New England Journal of Medicine. 1971;**285**(1):10-16

[34] Gillberg C, Coleman M. The Biology of the Autistic Syndromes. 2nd ed. London, UK; Mac Keith Press; 1992

[35] Teitelbaum P, Teitelbaum O, Nye J, Fryman J, Maurer RG. Movement analysis in infancy may be useful for early diagnosis of autism. Proceedings of theNational Academy of Sciences, USA. 1998;**75**:13982-13987

[36] Nordin V, Gillberg C. Autism Spectrum disorders in children with physical or mental disability or both. I: Clinical and epidemiological aspects. Developmental Medicine and Child Neurology. 1996;**8**(4):297-313

[37] Amin-Zaki L, Majeed MA, Clarkson TW, Greenwood MR. Methylmercury poisoning in Iraqi children: Clinical observations over two years. British Medical Journal. 1978;**1**:613-616

[38] Carpenter PK, Morris D. Association of acrocyanosis with Asperger's syndrome. Journal of Mental Deficiency Research. 1990;**34**:87-90

[39] Farnsworth D. Pink Disease Survey Results. Pink Disease Support Group Site. 1997. Available from: www.users. bigpond.com/difarnsworth

[40] Horvath K, Papadimitriou JC, Rabsztyn A, Drachenberg C, Tildon JT. Gastrointestinal abnormalities in children with autistic disorder. Journal of Pediatrics. 1999;**135**(5):559-563

[41] Akagi H, Grandjean P, Takizawa Y, Weihe P. Methyl mercury dose estimation from umbilical cord concentrations in patients with Minamata disease. Environmental Research. 1998;**77**:98-103

[42] Matsumoto H, Koya G, Takeuchi T. Fetal Minamata disease: A neuropathological study of two

cases of intrauterine intoxication by a methylmercury compound. Journal of Neuropathology and Experimental Neurology. 1965;**24**(4):563-574

[43] Ekino S, Susa M, Ninomiya T, Imamura K, Kitamura T. Minamata disease revisited: An update on the acute and chronic manifestations of methyl mercury poisoning. Journal of Neurological Sciences. 2007;**262**(1-2):131-144

[44] Eto K. Review article: Pathology of Minamata disease. Toxicologic Pathology. 1997;**25**(6):614-623

[45] Dinehart SM, Dillard R, Raimer SS, Cobos R, Pupo R. Cutaneous manifestations of Acrodynia (pink disease). Archives of Dermatology. 1988;**124**(1):107-109

[46] Dally A. The rise and fall of pink disease. Social History of Medicine. 1997;**10**(2):291-304

[47] Gotelli CA, Astolfi E, Cox C, Cernichiari E, Clarkson TW. Early biochemical effects of an organic mercury fungicide on infants: "dose makes the poison". Science. 1985;**227**(4687):638-640

[48] Kim YH, Shim JY, Seo MS, Yim HJ, Cho MR. Relationship between blood mercury concentration and bone mineral density in Korean men in the 2008- 2010 Korean national health nutrition examination survey. Korean Journal of Family Medicine. 2016;**37**(5):273-278

[49] Parejo LMP, Aliga I, Macias MLC, Hernandez OL, Martin RR, Martin SR, et al. Evaluation of the dietary intake of cadmium, lead and mercury and its relationship with bone health among postmenopausal women in Spain. International Journal of Environmental Research and Public Health. 2017;**14**(6):564

[50] Garcia JML, Parejo LMP, Martin RR, Moran JM, Zamorano JDP, Aliaga IJ,

et al. Dietary intake of cadmium, lead and mercury and its association with bone health in healthy premenopausal women. Journal of Environmental Research and Public Health. 2017;**14**(12):1437

[51] Dainowski BH, Duffy LK, Mcintyre J, Jones P. Hair and bone as predictors of tissular mercury concentrations in the Western Alaska red fox, *Vulpes vulpes*. The Science of the Total Environment. 2015;**518-519**:526-533

[52] Bogacka DIK, Arendarczyk NL, Kot K, Ciosek Z, Zietek P, Karaczun M, et al. Effects of biological factors and health condition on mercury and selenium concentrations in the cartilage, meniscus and anterior cruciate ligament. Journal of Trace Elements in Medicine and Biology. 2017;**44**:201-208

[53] Telapolu S, Kalachavedu M, Punnoose AM, Bilikere D. MD-1, a poly herbal formulation indicated in diabetes mellitus ameliorates glucose uptake and inhibits adipogenisis-an in vitro study. BMC Complementary and Alternative Medicine. 2018;**18**:113

[54] Hussain S, Atkinson A, Thompson SJ, Khan AT. Accumulation of mercury and its effects on antioxidant enzymes in brain, liver, and kidneys of mice. Journal of Environmental Science and Health, Part B. 1999;**34**:645-660

[55] Pelletier G, Feng YL, Leingartner K, Black P. Co-administration of *Rhododendron tomentosum* extract does not affect mercury tissue concentrations and excretion rate in methylmercury-treated adult male rats. BMC Research Notes. 2019;**12**: Article Number 369

[56] Williams RC, Jeffcoat MK, Kaplan ML, Goldhaber P, Johnson HG, Wechter WJ. Flurbiprofen: A potent inhibitor of alveolar bone resorption in beagles. Science. 1985;**227**(4687): 640-642

[57] Jadán-Piedra C, Crespo Á, Monedero V, Vélez D, Devesa V, Zúñiga M. Effect of lactic acid bacterial on mercury toxicokinetic. Food and Chemical Toxicology. 2019;**128**:147-153

**Chapter 5**

**Abstract**

*Om Prakash Bansal*

eases are some other health's risks to human.

resistance, fishes

**1. Introduction**

**63**

Health Risks of Potentially Toxic

Groundwater which fulfills globally 50–80% need of drinking water, due to Anthropogenic and geologic activities, has been continuously contaminated by potentially toxic metals, causing a range of effects to animals and citizenry. In the developing countries, about 80% of diseases are waterborne diseases. Bio accumulation of these metals in citizenry due to intake of contaminated vegetables, fruits, fishes, seafood and drinking water and beverages causes a serious threat to citizenry. Toxicity of these metals is due to metabolic interference and mutagenesis, interference in the normal functioning of structural proteins, enzymes, and nucleic acids by binding them, adversely affecting the immune and hematopoietic systems in citizenry and animals. The toxic metals also enrich antibiotic resistant microbes particularly bacteria by Co-selection (occurring by Co-resistance and cross-resistance) as it promotes antibiotic resistance in bacteria even in absence of antibiotics. These metals in living cells cause cytotoxicity, oxidative stress resulting in the damages of antioxidants, enzyme inhibition, loss of DNA repair mechanism, protein dysfunction and damage to lipid per oxidase. Endocrine disruption, neuro-developmental toxicity, biosynthesis of hemoglobin, metabolism of vitamin D, renal toxicity, damage to central nervous system, hearing speech and visual disorders, hypertension, anemia, dementia, hematemesis, bladder, lung, nose, larynx, prostate cancer, and bone dis-

**Keywords:** pollution, human, potentially toxic metals, health risks, heavy metals

Water the "life-blood of the biosphere" may be an alcahest which dissolves different chemicals and environmental pollutants. Globally, groundwater is the main source of domestic drinking water both in rural and urban areas and fulfills approximately 80% need of drinking water in the rural areas and 50% of urban water need. As surface water infiltrates to unconfined aquifers easily, these aquifers are contaminated very easily. The pollution of groundwater causes significant alteration in the environment. The most sources of lakes, rivers, ponds, and streams are the groundwater. When contaminated groundwater is supplied to those sources, the surface water is additionally contaminated which causes harm to birds, animals, and plants. Because of population growth over the last 50 years, the abstraction of groundwater has increased leading to reduce natural discharge flows and groundwater quality. Groundwater quality is additionally suffering from recharge rate and recharge quality. Existence of human on earth without potentially toxic metals is not possible.

Metals Contaminated Water

[58] El-Demerdash FM. Effects of selenium and mercury on the enzymatic activities and lipid peroxidation in brain, liver, and blood of rats. Journal of Environmental Science and Health Part B. 2001;**36**(4):488-499

#### **Chapter 5**

## Health Risks of Potentially Toxic Metals Contaminated Water

*Om Prakash Bansal*

#### **Abstract**

Groundwater which fulfills globally 50–80% need of drinking water, due to Anthropogenic and geologic activities, has been continuously contaminated by potentially toxic metals, causing a range of effects to animals and citizenry. In the developing countries, about 80% of diseases are waterborne diseases. Bio accumulation of these metals in citizenry due to intake of contaminated vegetables, fruits, fishes, seafood and drinking water and beverages causes a serious threat to citizenry. Toxicity of these metals is due to metabolic interference and mutagenesis, interference in the normal functioning of structural proteins, enzymes, and nucleic acids by binding them, adversely affecting the immune and hematopoietic systems in citizenry and animals. The toxic metals also enrich antibiotic resistant microbes particularly bacteria by Co-selection (occurring by Co-resistance and cross-resistance) as it promotes antibiotic resistance in bacteria even in absence of antibiotics. These metals in living cells cause cytotoxicity, oxidative stress resulting in the damages of antioxidants, enzyme inhibition, loss of DNA repair mechanism, protein dysfunction and damage to lipid per oxidase. Endocrine disruption, neuro-developmental toxicity, biosynthesis of hemoglobin, metabolism of vitamin D, renal toxicity, damage to central nervous system, hearing speech and visual disorders, hypertension, anemia, dementia, hematemesis, bladder, lung, nose, larynx, prostate cancer, and bone diseases are some other health's risks to human.

**Keywords:** pollution, human, potentially toxic metals, health risks, heavy metals resistance, fishes

#### **1. Introduction**

Water the "life-blood of the biosphere" may be an alcahest which dissolves different chemicals and environmental pollutants. Globally, groundwater is the main source of domestic drinking water both in rural and urban areas and fulfills approximately 80% need of drinking water in the rural areas and 50% of urban water need. As surface water infiltrates to unconfined aquifers easily, these aquifers are contaminated very easily. The pollution of groundwater causes significant alteration in the environment. The most sources of lakes, rivers, ponds, and streams are the groundwater. When contaminated groundwater is supplied to those sources, the surface water is additionally contaminated which causes harm to birds, animals, and plants. Because of population growth over the last 50 years, the abstraction of groundwater has increased leading to reduce natural discharge flows and groundwater quality. Groundwater quality is additionally suffering from recharge rate and recharge quality. Existence of human on earth without potentially toxic metals is not possible.

These potentially toxic metals (Cd, Cu, Pb, Zn, Cr (III), Cr (VI), and Hg) have high relative atomic mass and density. Hindu Business on Feb 20, 2019 reported that "more than forty million people in rural India drinks to water contaminated by heavy metals, arsenic, fluoride, etc." The results are devastating. Diarrhea, often caused by exposure to fecal matter, kills 600,000 Indians per annum and waterborne diseases throughout the Ganges basin. In India, 25% of water sources is River Ganga. These metals participate within the redox reactions and are an important part of enzymes. Cobalt is a constituent of vitamin B12, and manganese acts as an activator of the enzymes within the physical body [1]. Copper is important for enzyme ascorbate oxidase, cytochrome oxidase, plastocyanin oxidase, and photosynthesis in plants. As these metals cannot be degraded, they persist in the environment (in soils, industrial effluents, groundwater) for a long period; easily bio accumulated and bio magnify within the food chains poses a significant threat to the consumer and pollution of water sources by potentially toxic metals became a worldwide problem [2]. The toxic effect of these metals could also be because of metabolic interference and mutagenesis. These metals interfere in the normal functioning of structural proteins, enzymes, and nucleic acids by binding them. Even a smaller amount of potentially toxic metals/ metalloid arsenic, lead, cadmium, nickel, mercury, chromium, cobalt, and zinc beyond their permissible limit in body became harmful. These metals also enrich antibiotic resistant microbes even in the absence of antibiotics. This study discusses the health risks of potentially toxic metals contaminated water to the citizenry accumulated via intake of contaminated vegetables, fruits, fishes (freshwater or marine), drinking water, and beverages. The consequences of those metals on antibiotic resistant genes and bacteria have also been discussed.

**3. Sources of potentially toxic element contaminants within the water**

*Health Risks of Potentially Toxic Metals Contaminated Water*

*DOI: http://dx.doi.org/10.5772/intechopen.92141*

Contamination of the environment by potentially toxic metals has increased after war II because of rapid industrialization and urbanization and increased rate of mobilization and transport [7]. The main sources of groundwater of contamination

Rock weathering, forest fires, volcanic eruptions, biogenic sources, and wind born soil particles are the natural sources of potentially toxic metals within the environment. Within the rocks, these metals are present as

hydroxides, sulphides, oxides, silicates, phosphates, and chelated with organic

Industrial manufacturing of products to satisfy with the stress of the massive population like to cement production, iron industry, steam power plants, glass production, paint, and tanning industries is one among the causes of environmental pollution because of human activities. Agricultural activities (use of sewage sludge as manure), irrigation by sewage wastewater, mining, and metallurgical processes, garbage and waste mud incineration facilities, combustion of fuels, surface emission, and traffic and runoffs are other ways to release the pollutants within the different environmental compartments. The main route of the groundwater and aquatic contamination by potentially toxic metals are the leaching from toxic industrial waste dumps and municipal landfills and leaching of agricultural chemicals from soils into the upper

As the concentration of potentially toxic metals within the environment is continuously increasing, and therefore, the soil retention capacity of those metals is decreasing and the resultant is the leaching of those metals within the groundwater [9]. Fertilizers and pesticides applied within the fields contain these potentially toxic metals (Cr, Cd, Cu, Zn, Ni, Mn, Pb, and As) as impurities [7]. Another source of groundwater contamination by potentially toxic metals is the urban runoffs which contain Pb, Cu, Zn, Fe, Cd, Cr, and Ni. The intrusion of seawater in aquifers also causes a rise in concentration levels of potentially toxic metals in the groundwater. Another anthropogenic source of the heavy metals in the environment is the burning of wastes at residential levels and

**4. Potentially toxic metals within the ground, surface water, and**

The pollution of water resources by potentially toxic metals affects plants, animals, and human health adversely [10]. These metals even at a low concentration are toxic to aquatic organisms as these metals alter the histopathology of the tissues of the organisms [11, 12]. The one among the main sources of potentially toxic metals within the aquatic environment are the sediments which act as a sink and

by heavy metals are:

**3.1 Natural**

compounds.

aquifers [8].

dumpsites.

**65**

**sediments**

reservoir of those metals [13].

**3.2 Anthropogenic activities**

#### **2. Potentially toxic metals**

Potentially toxic metals are essential in a small amount for various biochemical and physiological functions within the plants, animals, and humans. These metals participate in the redox reactions and are an important part of enzymes. A number of researchers [3–6] have reported that natural contaminates of natural water are potentially toxic metals and organometallic compounds. Based on their health importance, the potentially toxic elements are classified into four groups, (i) essential: Cu, Zn, Co, Cr, Mn, and Fe. These metals beyond their permissible limit become toxic, (ii) non-essential: Ba, Al, Li, (iii) less toxic: Sn, and (iv) highly toxic: Hg, Cd, Pb, As (metalloid).

#### **2.1 Routes of uptake**

Routes of uptake of those toxic metals by human and animals are:


#### **3. Sources of potentially toxic element contaminants within the water**

Contamination of the environment by potentially toxic metals has increased after war II because of rapid industrialization and urbanization and increased rate of mobilization and transport [7]. The main sources of groundwater of contamination by heavy metals are:

#### **3.1 Natural**

These potentially toxic metals (Cd, Cu, Pb, Zn, Cr (III), Cr (VI), and Hg) have high relative atomic mass and density. Hindu Business on Feb 20, 2019 reported that "more than forty million people in rural India drinks to water contaminated by heavy metals, arsenic, fluoride, etc." The results are devastating. Diarrhea, often caused by exposure to fecal matter, kills 600,000 Indians per annum and waterborne diseases throughout the Ganges basin. In India, 25% of water sources is River Ganga. These metals participate within the redox reactions and are an important part of enzymes. Cobalt is a constituent of vitamin B12, and manganese acts as an activator of the enzymes within the physical body [1]. Copper is important for enzyme ascorbate oxidase, cytochrome oxidase, plastocyanin oxidase, and photosynthesis in plants. As these metals cannot be degraded, they persist in the environment (in soils, industrial effluents, groundwater) for a long period; easily bio accumulated and bio magnify within the food chains poses a significant threat to the consumer and pollution of water sources by potentially toxic metals became a worldwide problem [2]. The toxic effect of these metals could also be because of metabolic interference and mutagenesis. These metals interfere in the normal functioning of structural proteins, enzymes, and nucleic acids by binding them. Even a smaller amount of potentially toxic metals/ metalloid arsenic, lead, cadmium, nickel, mercury, chromium, cobalt, and zinc beyond their permissible limit in body became harmful. These metals also enrich antibiotic resistant microbes even in the absence of antibiotics. This study discusses the health risks of potentially toxic metals contaminated water to the citizenry accumulated via intake of contaminated vegetables, fruits, fishes (freshwater or marine), drinking water, and beverages. The consequences of those metals on antibiotic

Potentially toxic metals are essential in a small amount for various biochemical and physiological functions within the plants, animals, and humans. These metals participate in the redox reactions and are an important part of enzymes. A number of researchers [3–6] have reported that natural contaminates of natural water are potentially toxic metals and organometallic compounds. Based on their health importance, the potentially toxic elements are classified into four groups, (i) essential: Cu, Zn, Co, Cr, Mn, and Fe. These metals beyond their permissible limit become toxic, (ii) non-essential: Ba, Al, Li, (iii) less toxic: Sn, and (iv) highly toxic:

Routes of uptake of those toxic metals by human and animals are:

drinking contaminated water and beverages.

alimentary tract from the fish food/prey.

i. Ingestion: it occurs via gastrointestinal route, that is, through the mouth by eating contaminated food, vegetables, fruits, seafood including fish, and by

ii. Dermal: dermal uptake means absorption through skin/gills, the aquatic animals' bio accumulates these toxic metals via dermal contact.

iii. Inhalation: inhalation uptake occurs via inhalation of the polluted air as dust fumes and through exposure at work place. In the fish, these metals enter the body directly from water or sediments via the gills/skin or via its

resistant genes and bacteria have also been discussed.

**2. Potentially toxic metals**

*Heavy Metal Toxicity in Public Health*

Hg, Cd, Pb, As (metalloid).

**2.1 Routes of uptake**

**64**

Rock weathering, forest fires, volcanic eruptions, biogenic sources, and wind born soil particles are the natural sources of potentially toxic metals within the environment. Within the rocks, these metals are present as hydroxides, sulphides, oxides, silicates, phosphates, and chelated with organic compounds.

#### **3.2 Anthropogenic activities**

Industrial manufacturing of products to satisfy with the stress of the massive population like to cement production, iron industry, steam power plants, glass production, paint, and tanning industries is one among the causes of environmental pollution because of human activities. Agricultural activities (use of sewage sludge as manure), irrigation by sewage wastewater, mining, and metallurgical processes, garbage and waste mud incineration facilities, combustion of fuels, surface emission, and traffic and runoffs are other ways to release the pollutants within the different environmental compartments. The main route of the groundwater and aquatic contamination by potentially toxic metals are the leaching from toxic industrial waste dumps and municipal landfills and leaching of agricultural chemicals from soils into the upper aquifers [8].

As the concentration of potentially toxic metals within the environment is continuously increasing, and therefore, the soil retention capacity of those metals is decreasing and the resultant is the leaching of those metals within the groundwater [9]. Fertilizers and pesticides applied within the fields contain these potentially toxic metals (Cr, Cd, Cu, Zn, Ni, Mn, Pb, and As) as impurities [7]. Another source of groundwater contamination by potentially toxic metals is the urban runoffs which contain Pb, Cu, Zn, Fe, Cd, Cr, and Ni. The intrusion of seawater in aquifers also causes a rise in concentration levels of potentially toxic metals in the groundwater. Another anthropogenic source of the heavy metals in the environment is the burning of wastes at residential levels and dumpsites.

#### **4. Potentially toxic metals within the ground, surface water, and sediments**

The pollution of water resources by potentially toxic metals affects plants, animals, and human health adversely [10]. These metals even at a low concentration are toxic to aquatic organisms as these metals alter the histopathology of the tissues of the organisms [11, 12]. The one among the main sources of potentially toxic metals within the aquatic environment are the sediments which act as a sink and reservoir of those metals [13].

#### **4.1 Potentially toxic metals within the drinking, ground, and surface water**

A review of the literature showed that globally number of groundwater, drinking water, and surface water samples contains the potentially toxic metals beyond their permissible limit which affects adversely the human and ecological health. The arsenic concentration in the groundwater samples ranged from 0.0005 to 1.15 mg/L [14–16]. Author himself [17, 18] studied the concentration of potentially toxic metals in the groundwater samples for 20 years (1986–2005) and found that (i) concentration of those metals are increasing with time, (ii) concentration of those metals decreased with depth, and (iii) the concentration became beyond the permissible limit after the year 2000. The concentration of the toxic metals in the groundwater, drinking water, and surface water samples are recorded in **Table 1**.

#### **4.2 Potentially toxic metals within the sediments**

The accumulated amounts of the potentially toxic metals in the sediments are reported in **Table 1**.

#### **5. Bioaccumulation of probably toxic metals in vegetables and fruits irrigated by contaminated ground and surface water**

A long-term study made by the author himself [17, 18] found that the concentration of potentially toxic metals in the soils of agricultural fields of Aligarh irrigated by sewage effluent is continuously increasing, and therefore, the concentration of those metals in edible parts of the crops grown such soils were beyond toxic limits, and maximum accumulation was within the potato followed by maize [53]. Bansal [53] during their studies on the concentrations of Pb, Cd, Ni, Cr, Zn, and Cu in the vegetables palak, cabbage, brinjal, lady's finger, tomato, bitter gourd, radish, and cauliflower grown in the soils of periurban areas of Aligarh irrigated by sewage effluent water found that the concentration of the metals Cd, Pb, and Ni in all the studied vegetables were beyond their permissible limits for human consumption. The Target Hazard Quotient (THQ) values also denote that consumption of those vegetables will cause a potential risk for human health risk. Kabir and Bhuyan [54] found that the concentration of Cu in the hen's egg yolk (1.85–3.65 mg/kg) and albumin (0.5–1.15 mg/kg) were beyond permissible limits. The concentrations of these metals in the vegetables grown globally are given in **Table 1**.

#### **6. Bioaccumulation of potentially toxic metals in freshwater fish, marine fish aqueous flora and fauna**

Bioaccumulation of the potentially toxic heavy metals within the ecosystem of the Riverine has a negative impact on the ecological health of aquatic animals and causes decrease in their populations [55, 56]. Several researchers have reported fish deformities, decline of fish populations, and reduce in their growth rates if the concentration of potentially toxic metals increased beyond their tolerable limit [57, 58]. The concentrations of those metals in freshwater fish are reported in **Table 2**. The info in **Table 3** denotes the concentration of those metals in marine fish and other organisms.

**Sample**

**67**

Drinking

Lagos state, Nigeria

 0.0

0.009–0.021

0.0074–0.99

 0.001–0.12

0.012–0.087

 0.024 0.054–0.329

0.09–0.41

 0.0

0.027–0.060

 0.11–0.41

 0.098–0.14

 0.72–1.02

water

Drinking

Yobe State, Nigeria

> water and

surface water Surface water

Drinking

Egypt

0.002–0.049

water

Drinking

Nigeria

0.02–0.124;

0.009–0.057

 0.08–20.1

 0.04–0.57

0.091–0.485

[22]

[4]

water

Surface water Surface water

Surface water Ground water

Chembarambakkam

0.00–1.32

0.00–1.5

0.00

0.229–1.484

 0.001–0.128

 0.001–0.65 0.0021–0.0072

0.0006–0.0015

0.0001–0.0029

1.03–1.63 0.57–2.43

 0.0 0–0.0041,

0.031–0.781;

 0.01–0.695 0.00–0.0014

0.0–0.0009

 0.01–0.03

 0.01–0.70

 0.16–0.22

 0.00

 0.00–0.19

0.018–0.088

 0.008–2.45,

 0.172–0.486

 0.00–0.03

> lake (India)

> > Surface water

Surface water Surface water Solan district (India)

Ground water Surface water Surface water

 Kenya

 Bodo Creek water

 0.03–0.06 0.31–0.53

1.37–1.92

0.00–0.00004 0.00001–0.00033

 Tamilnadu

 Ganga River, India

 0.0–18.55

 0.003–6.28

 2.25–63.56

 4.70

0.166–107.34

 0.06–5.9

 4.73

[5, 6, 24]

[25]

[26]

[27]

[28]

[29]

 Dares salaam,

0.32

0.59

0.03

1.14

0.46–0.55

0.99–1.26

[23]

(Fe)

Tanzania

 Pearl River, China

0.0005–0.0075

0.0035–0.011

0.003–0.005

0.0165–0.0607

0.0006–0.0011

 0.0014–

0.0045

 Nile River and its

0.001–0.048

canals

**Source** **Cd**

**Cr**

**Cu**

**Zn**

**Pb**

**Ni**

**As**

 **Others** [19]

[20]

[21]

*DOI: http://dx.doi.org/10.5772/intechopen.92141*

*Health Risks of Potentially Toxic Metals Contaminated Water*

**Concentration**

 **of metal (mg/L) or (mg/kg)**

#### *Health Risks of Potentially Toxic Metals Contaminated Water DOI: http://dx.doi.org/10.5772/intechopen.92141*

**4.1 Potentially toxic metals within the drinking, ground, and surface water**

A review of the literature showed that globally number of groundwater, drinking water, and surface water samples contains the potentially toxic metals beyond their permissible limit which affects adversely the human and ecological health. The arsenic concentration in the groundwater samples ranged from 0.0005 to 1.15 mg/L [14–16]. Author himself [17, 18] studied the concentration of potentially toxic metals in the groundwater samples for 20 years (1986–2005) and found that (i) concentration of those metals are increasing with time, (ii) concentration of those metals decreased with depth, and (iii) the concentration became beyond the permissible limit after the year 2000. The concentration of the toxic metals in the groundwater, drinking water, and surface water samples are recorded

The accumulated amounts of the potentially toxic metals in the sediments are

A long-term study made by the author himself [17, 18] found that the concentration of potentially toxic metals in the soils of agricultural fields of Aligarh irri-

**5. Bioaccumulation of probably toxic metals in vegetables and fruits**

concentration of those metals in edible parts of the crops grown such soils were beyond toxic limits, and maximum accumulation was within the potato followed by maize [53]. Bansal [53] during their studies on the concentrations of Pb, Cd, Ni, Cr, Zn, and Cu in the vegetables palak, cabbage, brinjal, lady's finger, tomato, bitter gourd, radish, and cauliflower grown in the soils of periurban areas of Aligarh irrigated by sewage effluent water found that the concentration of the metals Cd, Pb, and Ni in all the studied vegetables were beyond their permissible limits for human consumption. The Target Hazard Quotient (THQ) values also denote that consumption of those vegetables will cause a potential risk for human health risk. Kabir and Bhuyan [54] found that the concentration of Cu in the hen's egg yolk (1.85–3.65 mg/kg) and albumin (0.5–1.15 mg/kg) were beyond permissible limits. The concentrations of these metals in the vegetables grown globally are given in

**6. Bioaccumulation of potentially toxic metals in freshwater fish,**

Bioaccumulation of the potentially toxic heavy metals within the ecosystem of the Riverine has a negative impact on the ecological health of aquatic animals and causes decrease in their populations [55, 56]. Several researchers have reported fish deformities, decline of fish populations, and reduce in their growth rates if the concentration of potentially toxic metals increased beyond their tolerable limit [57, 58]. The concentrations of those metals in freshwater fish are reported in **Table 2**. The info in **Table 3** denotes the concentration of those metals in marine

**marine fish aqueous flora and fauna**

**irrigated by contaminated ground and surface water**

gated by sewage effluent is continuously increasing, and therefore, the

**4.2 Potentially toxic metals within the sediments**

in **Table 1**.

**Table 1**.

**66**

fish and other organisms.

reported in **Table 1**.

*Heavy Metal Toxicity in Public Health*



**Sample**

**69**

Vegetables Vegetables

Vegetables Vegetables

Vegetables

Vegetables Vegetables

Vegetables

**Table 1.**

*The* 

*concentration*

 *of different potentially*

 *toxic metals (mg/L) in drinking, ground, and surface water and in sediments and vegetables (mg/kg).*

 Germany

0.01–0.79

 0.03–4.69

 3.2–23.2

 11.7–122.8

 0.1–31.3

 0.03–1.93

 Indonesia

 Imported

1.6–5.8

 1.03–1.15

 17.3–33.5

 17.3–33.5

 0.32–1.55

 7.1–10.3

vegetables,

 Iraq

> China

0.004–0.51

0.015–1.31

0.0–152.8

 4.3–150.1

 5.1–90.7

 11.1–347.5

 1.4–24.2

 0.004–1.16

 Local vegetables,

1.5–6.0

 1.02–1.13

 7.3–37.2

 25.3–43.8

 0.5–1.48

 6.3–7.9

 4.73

 2.83–3.09

[49]

*Health Risks of Potentially Toxic Metals Contaminated Water*

(Co)

3.08–3.10

(Co)

0.014–0.66

[50]

[51]

[52]

Iraq

Nigeria

0.11–0.43

 5.1–9.9

 4.7–75

 38.1–335.2

 2.6–9.2

 Pakistan

 0.045–0.39

 2.72–6.62

 22.2–65.2

 19.5–41

Iran

0.030.55

**Source** **Cd**

**Cr**

**Cu** 0.85–4.1

**Zn**

**Pb** 0.5–1.5 1.8–5.0

**Ni**

**As**

 **Others** 0.69 (Co) 18.7–137.3

[47]

(Mn)

19.3–33.3

[48]

*DOI: http://dx.doi.org/10.5772/intechopen.92141*

(Mn)

 [45, 46]

**Concentration**

 **of metal (mg/L) or (mg/kg)**

**Reference**

#### *Heavy Metal Toxicity in Public Health*

