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dc.contributor.authorSalcedo-Bellido, Inmaculada
dc.contributor.authorGutierrez-Gonzalez, Enrique 
dc.contributor.authorGarcía-Esquinas, Esther 
dc.contributor.authorFernandez de Larrea-Baz, Nerea 
dc.contributor.authorNavas Acien, Ana 
dc.contributor.authorTellez-Plaza, Maria 
dc.contributor.authorPastor-Barriuso, Roberto 
dc.contributor.authorLope Carvajal, Virginia 
dc.contributor.authorGómez-Ariza, José Luis
dc.contributor.authorGarcía-Barrera, Tamara
dc.contributor.authorPollan-Santamaria, Marina 
dc.contributor.authorJiménez Moleón, José Juan
dc.contributor.authorPerez-Gomez, Beatriz 
dc.date.accessioned2022-04-27T11:58:36Z
dc.date.available2022-04-27T11:58:36Z
dc.date.issued2021
dc.identifier.citationEnviron Res. 2021;197:111028.es_ES
dc.identifier.urihttp://hdl.handle.net/20.500.12105/14205
dc.description.abstractToenails have been used as biomarkers of exposure to toxic metals, but their validity for this purpose is not yet clear and might differ depending on the specific agent. To evaluate this issue, we reviewed the literature on: a) the time-window of exposure reflected by toenails; b) the reproducibility of toenail toxic-metal levels in repeated measures over time; c) their relationship with other biomarkers of exposure, and; d) their association with potential determinants (i.e. sociodemographic, anthropometric, or lifestyle characteristics) or with sources of exposure like diet or environmental pollution. Thus, we performed a systematic review, searching for articles that provided original data for levels of any of the following toxic metals in toenails: aluminum, beryllium, cadmium, chromium, mercury, nickel, lead, thallium and uranium. We identified 88 articles, reporting data from 67 different research projects, which were quite heterogeneous with regard to population profile, sample size and analytical technique. The most commonly studied metal was mercury. Concerning the time-window of exposure explored by toenails, some reports indicate that toenail cadmium, nickel and lead may reflect exposures that occurred 7-12 months before sampling. For repeated samples obtained 1-6 years apart, the range of intraindividual correlation coefficients of aluminum, chromium and mercury was 0.33-0.56. The correlation of toxic metal concentrations between toenails and other matrices was higher for hair and fingernails than for urine or blood. Mercury levels were consistently associated with fish intake, while other toxic metals were occasionally associated with specific sources (e.g. drinking water, place of residence, environmental pollution, and occupation). The most frequently evaluated health endpoints were cardiovascular diseases, cancer, and central nervous system diseases. Available data suggest that toenail mercury levels reflected long-term exposures and showed positive associations with fish intake. The lack of standardization in sample collection, quality control, analytical techniques and procedures - along with the heterogeneity and conflicting results among studies - mean it is still difficult to conclude that toenails are a good biomarker of exposure to toxic metals. Further studies are needed to draw solid conclusions about the suitability of toenails as biomarkers of exposure to toxic metals.es_ES
dc.description.sponsorshipThis work was supported by FIS grants PI12/00150, PI17CIII/00034, PI18/00287 (Instituto de Salud Carlos III, State Secretary of R + D + I and European Union (ERDF/ESF, “Investing in your future")), P42ES010349 and P30ES009089 (National Institute of Environmental Health Sciences).es_ES
dc.language.isoenges_ES
dc.publisherElsevier es_ES
dc.type.hasVersionVoRes_ES
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectBiomarkeres_ES
dc.subjectBiomonitoringes_ES
dc.subjectExposurees_ES
dc.subjectToenailes_ES
dc.subjectToxic metalses_ES
dc.subject.meshMercury es_ES
dc.subject.meshNails es_ES
dc.subject.meshAnimals es_ES
dc.subject.meshBiomarkers es_ES
dc.subject.meshEnvironmental Exposure es_ES
dc.subject.meshMetals es_ES
dc.subject.meshReproducibility of Results es_ES
dc.titleToxic metals in toenails as biomarkers of exposure: A reviewes_ES
dc.typejournal articlees_ES
dc.rights.licenseAttribution-NonCommercial-NoDerivatives 4.0 Internacional*
dc.identifier.pubmedID33753073es_ES
dc.format.volume197es_ES
dc.format.page111028es_ES
dc.identifier.doi10.1016/j.envres.2021.111028es_ES
dc.contributor.funderUnión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF) es_ES
dc.contributor.funderInstituto de Salud Carlos III es_ES
dc.contributor.funderPlan Nacional de I+D+i (España) es_ES
dc.contributor.funderNIH - National Institute of Environmental Health Sciences (NIEHS) (Estados Unidos) es_ES
dc.description.peerreviewedes_ES
dc.identifier.e-issn1096-0953es_ES
dc.relation.publisherversionhttps://doi.org/10.1016/j.envres.2021.111028es_ES
dc.identifier.journalEnvironmental Researches_ES
dc.repisalud.centroISCIII::Centro Nacional de Epidemiologíaes_ES
dc.repisalud.centroISCIII::Escuela Nacional de Sanidades_ES
dc.repisalud.institucionISCIIIes_ES
dc.rights.accessRightsopen accesses_ES
dc.relation.projectFISinfo:fis/Instituto de Salud Carlos III/Programa Estatal de Fomento de la Investigación Científica y Técnica de Excelencia/Subprograma Estatal de Generación de Conocimiento/PI17-ISCIII Modalidad Proyectos de Investigacion en Salud Intramurales. (2017)/PI17CIII/00034es_ES
dc.relation.projectFISinfo:fis/Instituto de Salud Carlos III/Programa Estatal de Fomento de la Investigación Científica y Técnica de Excelencia/Subprograma Estatal de Generación de Conocimiento/PI18 - Proyectos de investigacion en salud (AES 2018). Modalidad proyectos en salud. (2018)/PI18/00287es_ES
dc.relation.projectFISinfo:eu-repo/grantAgreement/ES/PI12/00150es_ES


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Attribution-NonCommercial-NoDerivatives 4.0 Internacional
Este Item está sujeto a una licencia Creative Commons: Attribution-NonCommercial-NoDerivatives 4.0 Internacional