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Imprégnation aux métaux et métalloïdes en population générale du Nord–Pas-de-Calais : niveaux, déterminants et liens avec le débit de filtration glomérulaire

Abstract : Human Biomonitoring allows us to evaluate our exposure to chemicals by measuring substances themselves or their metabolites or markers of health effects, from body fluids or tissues. The information collected through epidemiological surveys provide information on human exposure and are valuable databases in the research of exposure-response relationships in humans. This thesis is part of the cross-sectional IMePoGe survey conducted between 2008-2010 in the Nord–Pas-de-Calais region (in northern France), including 2,000 adult residents aged 20 to 59 years old, and aimed to quantify the impregnation levels of the population to 14 metals and metalloids (aluminum, antimony, total arsenic, beryllium, cadmium, cobalt, chromium, mercury, manganese, nickel, lead, thallium, vanadium, zinc) chosen for their toxic effects and the frequency of occupational and environmental exposure. The specific objectives of this thesis were, which a special interest for lead and cadmium, two nephrotoxic metals known in the literature: i) to establish the distribution of impregnation metals into the northern population of France and compare the exposure regional level to metals and metalloids with the national and international data; ii) to identify the major factors of variation of the impregnation and the sources of exposure to lead and cadmium in the general population; iii) to study the relationship between the change in glomerular filtration rate and the impregnation levels to metals. Overall, blood and urinary concentrations of most metals and metalloids were higher than those found in the national nutritional health survey conducted during the same period in the French population, with the exception of urinary vanadium and blood lead. The regional mean of blood lead level (geometric mean) was 18.8 μg/L. Several sources of lead exposure existed in the population and were link to the occupational, environmental and consumption parameters. Regarding cadmium, smoking was the main source of recent or chronic exposure to metal: the geometric mean of blood cadmium, reflecting a recent exposure, was 0.39 μg/L and increased from 0.26 μg/L in non-smokers to 0.84 μg/L in smokers; the geometric mean of urinary cadmium, reflecting the chronic exposure, was 0.37 μg/L (0.33 μg/g creatinine) and increased from 0.33 μg/L (0.29 μg/g creatinine) in non-smokers to 0.46 μg/L (0.37 μg/g creatinine) in smokers. Finally, as part of the study of the relationship between the metal levels and the glomerular filtration rate, our study showed that taking into account the multiple exposure to the other potentially nephrotoxic metals and metalloids upset considerably the previous associations specifically reported with lead and cadmium, in the context of low levels exposure in the general population.
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Romuald Tagne Fotso. Imprégnation aux métaux et métalloïdes en population générale du Nord–Pas-de-Calais : niveaux, déterminants et liens avec le débit de filtration glomérulaire. Médecine humaine et pathologie. Université du Droit et de la Santé - Lille II, 2016. Français. ⟨NNT : 2016LIL2S031⟩. ⟨tel-02616992⟩

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