Public health concerns of multifaceted exposures to metal and metalloid mixtures: a systematic review

Abstract

Exposure to metals and metalloids presents a significant global public health threat due to their widespread presence in natural, industrial, and occupational environments. These substances, such as arsenic, lead, cadmium, and mercury, accumulate in biological systems, leading to chronic and acute health conditions. The review focuses on investigating the health risks, pathways of exposure, and the associated regulatory frameworks. A review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Two main databases (PubMed and Toxline) and a search engine (Google Scholar) were searched in September 2024, and 23 articles met the eligibility criteria and were included in the review. The quality of all the articles that met the inclusion criteria was assessed using the Newcastle–Ottawa scale. The review examined exposure pathways in different settings (natural, industrial, and occupational), health outcomes, mechanisms of toxicity, and vulnerable populations. The synthesis highlights the current gaps in regulatory frameworks and identifies areas for future research. Exposure to metals and metalloids occurs through contaminated water, soil, and air in natural settings, and through industrial activities and occupational hazards in sectors like manufacturing, construction, and agriculture. Adverse health outcomes include neurological disorders, cardiovascular diseases, renal dysfunction, and cancers. Vulnerable populations, such as children, pregnant women, and workers in high-risk industries, face elevated risks, with socioeconomic factors and inadequate regulatory protections exacerbating these health disparities. To mitigate the public health risks posed by metal and metalloid exposure, a multifaceted approach is necessary. This includes enhanced environmental monitoring, public awareness campaigns, stricter occupational safety regulations, and international cooperation in pollution control. Future research should prioritize understanding the synergistic effects of metal mixtures and developing innovative strategies for detection and intervention. Safeguarding public health and promoting environmental justice requires urgent action to address the multifaceted impacts of metal exposures.