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A multi-environmental source approach to explore associations between metals exposure and olfactory identification among school-age children residing in northern Italy

Journal of Exposure Science & Environmental Epidemiology volume 34, pages 699–708 (2024)Cite this article

Abstract

Background

Metal exposures can adversely impact olfactory function. Few studies have examined this association in children. Further, metal exposure occurs as a mixture, yet previous studies of metal-associated olfactory dysfunction only examined individual metals. Preventing olfactory dysfunctions can improve quality of life and prevent neurodegenerative diseases with long-term health implications.

Objective

We aimed to test the association between exposure to a mixture of 12 metals measured in environmental sources and olfactory function among children and adolescents residing in the industrialized province of Brescia, Italy.

Methods

We enrolled 130 children between 6 and 13 years old (51.5% females) and used the “Sniffin’ Sticks” test to measure olfactory performance in identifying smells. We used a portable X-ray fluorescence instrument to determine concentrations of metals (arsenic (As), calcium, cadmium (Cd), chromium, copper, iron, manganese, lead (Pb), antimony, titanium, vanadium and zinc) in outdoor and indoor deposited dust and soil samples collected from participants’ households. We used an extension of weighted quantile sum (WQS) regression to test the association between exposure to metal mixtures in multiple environmental media and olfactory function adjusting for age, sex, socio-economic status, intelligence quotient and parents’ smoking status.

Results

A higher multi-source mixture was significantly associated with a reduced Sniffin’ Sticks identification score (β = −0.228; 95% CI −0.433, −0.020). Indoor dust concentrations of Pb, Cd and As provided the strongest contributions to this association (13.8%, 13.3% and 10.1%, respectively). The metal mixture in indoor dust contributed more (for 8 metals out of 12) to the association between metals and olfactory function compared to soil or outdoor dust.

Impact statement

Among a mixture of 12 metals measured in three different environmental sources (soil, outdoor and indoor dust), we identified Pb, Cd and As measured in indoor dust as the main contributors to reduced olfactory function in children and adolescents residing in an industrialized area. Exposure to indoor pollution can be effectively reduced through individual and public health interventions allowing to prevent the deterioration of olfactory functions. Moreover, the identification of the factors that can deteriorate olfactory functions can be a helpful instrument to improve quality of life and prevent neurodegenerative diseases as long-term health implications.

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Fig. 1: WQS approach to examine associations between multiple metals in three matrices and olfactory function.
Fig. 2: Distribution of the log-transformed metal concentrations by environmental sources.
Fig. 3: Spearman correlation matrix of the 12 metals measured in the 3 environmental sources and dendrogram that identifies 3 clusters based on the correlation matrix.
Fig. 4: Associations between multiple metals in each environmental matrix and olfactory function.
Fig. 5: Box plots of the weight estimates of each metal obtained by the MSEs and WQS regressions.
Fig. 6: Contribution of metals measured in the three environmental sources estimated by the MSEs WQS regression.
Fig. 7: Associations (β coefficients and 95% confidence intervals) of As and Pb in each environmental source concentration with the Sniffin’ identification score.

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Data availability

Data are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to thank all the participating children and their families for their outstanding contribution to this study.

Funding

SR work was funded by the Italian Ministry of University and Research through its program Programma Operativo Nazionale “Ricerca e Innovazione” 2014–2020 (PON R&I FSE-REACT EU), Azione IV.4 “Contratti di ricerca su tematiche dell’innovazione”.

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Authors and Affiliations

  1. Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, Università degli Studi di Brescia, Brescia, Italy

    Stefano Renzetti, Alessandra Patrono, Giuseppa Cagna, Stefania Idili, Elisa Ongaro & Donatella Placidi

  2. Leibniz Research Centre for Working Environment and Human Factors (IfADo), Neurotoxicology and Chemosensation, TU Dortmund, Dortmund, Germany

    Christoph van Thriel

  3. Department of Biochemical, Biomedical and Neurosciences, Università degli Studi di Modena e Reggio Emilia, Modena, Italy

    Roberto G. Lucchini

  4. Department of Environmental Health Sciences, School of Public Health, Florida International University, Miami, FL, USA

    Roberto G. Lucchini

  5. Department of Microbiology and Environmental Toxicology, University of California, Santa Cruz, CA, USA

    Donald R. Smith

  6. Department of Civil, Environmental, Architectural Engineering and Mathematics, Università degli Studi di Brescia, Brescia, Italy

    Marco Peli

  7. Department of Mechanical and Industrial Engineering, Università degli Studi di Brescia, Brescia, Italy

    Laura Borgese, Paola Cirelli & Fabjola Bilo

  8. Department of Molecular and Translational Medicine, Università degli Studi di Brescia, Brescia, Italy

    Alessandra Patrono, Stefano Calza & Matteo Rota

  9. Department of Environmental Medicine and Public Health, Icahn School of Medicine, New York, NY, USA

    Elza Rechtman, Robert O. Wright & Megan K. Horton

  10. Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA

    Birgit Claus Henn

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  1. Stefano Renzetti
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Contributions

SR: study design, manuscript drafting, data analysis and interpretation. CvT: study design, manuscript drafting and data interpretation. RGL: study design and manuscript drafting. DRS: study design and revised manuscript. MP: data acquisition and revised manuscript. LB: study design and revised manuscript. PC: data acquisition and revised manuscript. FB: data acquisition and revised manuscript. AP: data acquisition. GC: data acquisition. ER: data interpretation and revised manuscript. SI: data acquisition. EO: data acquisition. SC: data interpretation and revised manuscript. MR: data interpretation and revised manuscript. ROW: study design and revised manuscript. BCH: study design and revised manuscript. MKH: study design, data interpretation and manuscript drafting. DP: study design and manuscript drafting. All authors have read and approved the final manuscript.

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Correspondence to Stefano Renzetti.

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Consent from subjects participating in the study was received prior to conducting the study and the study has been reviewed and approved by the Ethics Committee of Brescia and Brindisi.

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Renzetti, S., van Thriel, C., Lucchini, R.G. et al. A multi-environmental source approach to explore associations between metals exposure and olfactory identification among school-age children residing in northern Italy. J Expo Sci Environ Epidemiol 34, 699–708 (2024). https://doi.org/10.1038/s41370-024-00687-6

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