Abstract
Background and Aim Environmental exposure to metals may play a role in the pathogenesis of anemia, yet, nutrition may ameliorate adverse effects of these metals on hemoglobin (Hb) levels in humans. Although informal electronic waste (e-waste) recycling processes have recently drawn attention as an important source of pollution, there is almost no empirical evidence on the relationship between diet, metals exposure and anemia among e-waste recyclers. Therefore, we evaluated possible ameliorating effects of diet on metal-induced anemia, as measured by Hb levels of e-waste recyclers and a reference population in Ghana. Methods: Study employed a repeated-measures design to collect whole-blood samples from e-waste recyclers (n=142) and a reference population (n=65) between March 2017 and October 2018. Blood was analyzed for the following metals: Cd, Pb, Rb, Tb & Eu using the ICP-MS®. Dietary intake parameters; proteins, folate, carbohydrates, Fe, Ca, Mg, Se, Zn and Cu were assessed using a 48-hour-recall. Blood Hb levels were measured using the URIT-810® semi-automatic biochemistry analyzer. Ordinary least-square regression models were used to estimate joint effects of metals and nutrients on Hb levels. Results: At baseline, mean Hb was lower among recyclers (12.99±3.17g/dL) than the reference group (13.02±2.37g/dL). Blood Pb, Cd, Rb, Eu and Tb were associated with significant decreases in Hb levels of e-waste recyclers. Dietary intake of proteins and Fe was associated with concomitant increase in Hb levels of both groups as well as when analysis was restricted to recyclers. Despite the high exposure of e-waste recyclers to a myriad of metals, consumption of Fe-rich diets seemed to ameliorate anemia and improved Hb levels (β=0.229; 95% CI: 0.013, 0.445; p=0.04). Conclusion: Consumption of Fe and protein-rich foods was associated with significant increases in Hb levels of e-waste recyclers, even when exposed to high levels of these metals. Keywords: e-waste, hemoglobin, anemia, metals, diet
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