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Increased focus on renovating and maintaining the existing building stock is an integral part of the circular economy, however this might pose challenges to workers health. The aim of this study was to assess the renovation workers' exposure to inhalable dust, thoracic dust, respirable dust, and respirable crystalline silica (RCS). Personal aerosol samples were collected as full shift samples from 92 workers to a total of 407 samples. Fourteen locations around Oslo, Norway was visited for multiple days with repeated measurements of the same individual. Particulate matter from 3 aerosol fractions, respirable, thoracic, and inhalable, were analyzed gravimetrically, and the respirable fraction was analyzed for RCS by NIOSH 7500 method for X-ray diffraction (XRD) with low temperature plasma ashing sample preparation. The total measured concentrations of respirable dust (n = 192) had a geometric mean (GM) of 0.88 mg/m3, RCS concentrations (n = 182) had a GM of 0.040 mg/m3, thoracic dust (n = 131) had GM 2.4 mg/m3, and inhalable dust (n = 84) had a GM of 8.5 mg/m3. The maximum measured concentrations were 29 mg/m3, 3.2 mg/m3, 65 mg/m3, and 163 mg/m3, respectively. Workdays involving tasks such as mechanical demolition and clearing out demolished materials led to the highest exposure levels of both dust and RCS. However, other workers at the renovation sites were indirectly exposed to a considerable amount of RCS. This study revealed substantial exposure to both RCS and dust during renovation, and protective measures are warranted to reduce exposure levels in the industry., (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.)

Purpose: Populations following a plant-based diet may be at particular risk of thyroid dysfunction due to low iodine and selenium intakes. The main purpose was to assess thyroid function and urinary concentration of iodine, selenium, and arsenic, in subjects following a vegan, lacto-ovo vegetarian, or pescatarian diet., Methods: In Norway, a country without mandatory dietary iodine fortification, 205 adults, following vegan (n = 115), lacto-ovo vegetarian (n = 55) and pescatarian diet (n = 35) were included. Thyroglobulin (Tg), thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), and serum anti-TPO (S-anti-TPO) were measured in a venous blood sample and concentrations of iodine (UIC), creatinine (UCC), selenium, and arsenic were measured from single spot urine samples., Results: Subclinical hypothyroidism (TSH > 4.0 mU/L) was observed in 3% of subjects. The overall median (p25, p75) Tg was 17 (9, 30) µg/L and vegans had higher Tg compared to pescatarians. Vegans not consuming iodine-containing supplements (n = 43) had higher Tg, than supplement users (n = 72), 27 (11, 44) vs. 16 (8, 25) µg/L and higher fT4, 16 (15, 17) vs. 15 (14, 17) pmol/L, respectively. The overall median UIC was 57 (28, 130) µg/L, all dietary groups had median UIC below WHO thresholds. Median urinary selenium and arsenic concentration was 13 (6, 22) and 3 (2, 8) µg/L, respectively., Conclusion: The prevalence of subclinical hypothyroidism was low and fT4 and fT3 were within the normal range for all dietary groups. Vegans had significantly increased Tg compared to pescatarians., (© 2023. The Author(s).)

Background: As a component of the thyroid hormones (THs), iodine is vital for normal neurodevelopment during early life. However, both deficient and excess iodine may affect TH production, and data on iodine status in young children are scarce., Objectives: To describe iodine nutrition (iodine status and intake) in children ≤2 y of age in Innlandet County (Norway) and to describe the associations with maternal iodine nutrition., Methods: A cross-sectional study was performed in a representative sample of mother-child pairs selected from 30 municipalities from November 2020 until October 2021. Iodine status [child urinary iodine concentration (UIC), maternal UIC, and breast milk iodine concentration (BMIC)] was measured. Child's iodine intake was estimated using 2 24-h dietary recalls (24-HR) and a food frequency questionnaire. The Multiple Source Method was used to estimate the usual iodine intake distributions from the 24-HR assessments., Results: The median UIC in 333 children was 145 μg/L, indicating adequate iodine status according to the WHO cutoff (100 μg/L). The median usual iodine intake was 83 μg/d. Furthermore, 35% had suboptimal usual iodine intakes [below the proposed Estimated average requirement (72 μg/d)], whereas <1% had excessive usual iodine intakes [above the Upper intake level (200 μg/d)]. There was a positive correlation between children's iodine intake and BMIC (Spearman rank correlation coefficient r = 0.67, P < 0.001), and between children's UIC and BMIC (r = 0.43, P < 0.001), maternal UIC (r = 0.23, P = 0.001), and maternal iodine intake (r = 0.20, P = 0.004)., Conclusion: Despite a median UIC above the cutoff for iodine sufficiency, more than a third of the children had suboptimal usual iodine intakes. Our findings suggest that many children will benefit from iodine fortification and that risk of iodine excess in this age group is low., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

Due to natural conditions such as geology, topography, and climate, and historical features such as resource utilization, land use, and settlement patterns, the drinking water supply in Norway is separated into many public and private water supply systems. This survey sheds light on whether the Drinking Water Regulation's limit values provide a sufficient basis for ensuring safe drinking water for the Norwegian population. Participating waterworks, both private and public, were spread throughout the country, in 21 municipalities with different geological conditions. The median value for the number of persons supplied by the participating waterworks was 155. The two largest waterworks, both of which supply >10,000 people, have water sources from unconsolidated surficial sediments of latest Quaternary age. Fourteen waterworks have water sources from bedrock aquifers. Raw and treated water were analysed for 64 elements and selected anions. The concentration of manganese, iron, arsenic, aluminium, uranium, and fluoride exceeded the respective drinking water regulations' parametric value given in Directive (EU) 2020/2184. Regarding the rare earth elements, neither WHO, EU, USA nor Canada have established any limit values. However, concentration of lanthanum in groundwater from a sedimentary well exceeded the health-based guideline value that applies in Australia. Results from this study raise the question of whether increased precipitation can have an impact on the mobility and concentration of uranium in groundwater from bedrock aquifers. Furthermore, findings of high levels of lanthanum in groundwater create uncertainty as to whether the current quality control of Norwegian drinking water is sufficient., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Exposure to heavy metals can affect cell differentiation, neurocognitive development, and growth during early life, even in low doses. Little is known about heavy metal exposure and its relationship with nutrition outcomes in non-mining rural environments. We carried out a community-based cross-sectional study to describe the distribution of four heavy metal concentrations [arsenic (As), cadmium (Cd), lead (Pb), and mercury (Hg)] in the serum of a representative population of children aged 12 to 59 months old from the rural region of Popokabaka, Democratic Republic of Congo. The four metals were measured in 412 samples using inductively coupled plasma-mass spectrometry (ICP-MS). Limits of detection (LoD) and quantification (LoQ) were set. Percentiles were reported. Statistical and geospatial bivariate analyses were performed to identify relationships with other nutrition outcomes. Arsenic was quantified in 59.7%, while Cd, Hg, and Pb were quantified in less than 10%, all without toxicities. The arsenic level was negatively associated with the zinc level, while the Hg level was positively associated with the selenium level. This common detection of As in children of Popokabaka requires attention, and urgent drinking water exploration and intervention for the profit of the Popokabaka community should be considered., (© 2022. The Author(s).)

The Mavrovouni refugee camp near the former Moria camp on the island of Lesvos, Greece, housed approximately 3000 asylum-seekers including children as of October 2021. The camp was built on the site of a military shooting range. This study aimed to characterize the soil contaminants and assess the risk of toxic environmental exposures for children living in Mavrovouni. Methods: Samples of surface soil (0−2 cm depth; particle size < 2 mm) from eight locations inside the camp were compared with two reference samples. Soil samples were microwave digested using a mixture of nitric and hydrofluoric acids and analyzed for lead (Pb), antimony (Sb), bismuth (Bi), and other metals using inductively coupled plasma mass spectrometry. These values were compared with action limits established by the Norwegian Environment Agency for kindergartens, playgrounds, and schools. Findings: Five of eight soil samples from inside the camp exceeded Pb levels of 100 mg/kg, which is currently the maximum acceptable value of Pb in soil for playgrounds in Norway. Two sites had extreme soil Pb levels of approximately 8000 mg/kg and 6000 mg/kg. The concen-tration of Sb and Bi in the surface soil of the firing range area strongly indicated environmental contamination, most likely from previous military activity and ammunition residue that has re-mained on the surface soil. Concentrations of arsenic (As), cadmium (Cd), copper (Cu), and zinc (Zn) in surface soil were lower than action limits. Discussion: Extremely high levels of Pb, together with high levels of Sb and Bi, were identified in soil where children live and play in the Mavrovouni refugee camp. This is the first independent study of environmental contamination at this camp and adds to the limited evidence base documenting Pb exposures prior to migrant and refugee reset-tlement. On top of the multiple existing public health crises and traumas that these asylum-seeking families face, exposure to toxic ammunition residues may have profound impacts on children’s development and health for years to come.

Considering the importance of iodine to support optimal growth and neurological development of the brain and central nervous system, this study aimed to assess and evaluate iodine status in Norwegian infants. We collected data on dietary intake of iodine, iodine knowledge in mothers, and assessed iodine concentration in mother's breast milk and in infant's urine in a cross-sectional study at two public healthcare clinics in the inland area of Norway. In the 130 mother-infant pairs, the estimated infant 24-h median iodine intake was 50 (IQR 31, 78) µg/day. The median infant urinary iodine concentration (UIC) was 146 (IQR 93, 250) µg/L and within the recommended median defined by the World Health Organization for this age group. Weaned infants had a higher UIC [210 (IQR 130, 330) µg/L] than exclusively breastfed infants [130 (IQR 78, 210) µg/L] and partially breastfed infants [135 (IQR 89, 250) µg/L], which suggest that the dietary data obtained in this study did not capture the accurate iodine intake of the included infants. The iodine status of infants in the inland area of Norway seemed adequate. Weaned infants had higher UIC compared to breastfed infants, suggesting early access and consumption of other sources of iodine in addition to breast milk.

Iron deficiency (ID), the leading cause of anemia and the most common nutritional deficiency globally, is not well reported among children in malaria-endemic settings, and little is known about its contribution to anemia in these settings. We aimed to assess the prevalence of anemia, the role of ID using multiple parameters, and the factors associated with anemia in a malaria-endemic rural area. We conducted a community-based cross-sectional study of 432 children aged 1-5 years from the Popokabaka Health Zone, Democratic Republic of Congo. Sociodemographic characteristics, medical history, anthropometric parameters, and biochemical parameters were considered. Hemoglobin and malaria prevalence were assessed using rapid finger-prick capillary blood testing in the field. Venous blood samples were analyzed for serum ferritin, serum iron, total iron-binding capacity, and C-reactive protein (CRP) in a laboratory. Anemia was found in 294 out of 432 (68%) patients. Malaria was found in 375 out of 432 (87%), and ID in 1.8% according to diagnosis by adjusted ferritin only and in 12.9% according to transferrin saturation. ID indicators were not significantly correlated with low hemoglobin levels. Malaria, fever, and CRP > 5 mg/L were major factors associated with anemia in Popokabaka. Anemia control should focus on treating inflammatory conditions and infectious diseases among children in such settings.

Breastfed infants are dependent on an adequate supply of iodine in human milk for the production of thyroid hormones, necessary for development of the brain. Despite the importance of iodine for infant health, data on Norwegian lactating women are scarce. We measured iodine intake and evaluated iodine status and iodine knowledge among lactating women. From October to December 2018, 133 mother-infant pairs were recruited in a cross-sectional study through two public health care centers in Lillehammer and Gjøvik. Each of the women provided two human milk specimens, which were pooled, and one urine sample for analysis of iodine concentration. We used 24-hour dietary recall and food frequency questionnaire (FFQ) to estimate short-term and habitual iodine intake from food and supplements. The median (P25, P75) human milk iodine concentration (HMIC) was 71 (45, 127) µg/L-of which, 66% had HMIC <100 µg/L. The median (P25, P75) urinary iodine concentration (UIC) was 80 µg/L (52, 141). The mean (± SD) 24-hour iodine intake and habitual intake was 78 ± 79 µg/day and 75 ± 73 µg/day, respectively. In conclusion, this study confirms inadequate iodine intake and insufficient iodine status among lactating women in the inland area of Norway and medium knowledge awareness about iodine.

Mild to moderate iodine deficiency is common among women of childbearing age. Data on iodine status in infants are sparse, partly due to the challenges in collecting urine. Urinary iodine concentration (UIC) is considered a good marker for recent dietary iodine intake and status in populations. The aim of this study was to investigate the reliability of iodine concentration measured in two spot-samples from the same day of diaper-retrieved infant urine and in their mothers' breastmilk. We collected urine and breastmilk from a sample of 27 infants and 25 mothers participating in a cross-sectional study at two public healthcare clinics in Norway. The reliability of iodine concentration was assessed by calculating the intraclass correlation coefficients (ICC) and the coefficient of variation (CV). The ICC for infants' urine was 0.64 (95% confidence interval (CI) 0.36-0.82), while the ICC for breastmilk was 0.83 (95% CI 0.65-0.92) Similarly, the intraindividual CV for UIC was 0.25 and 0.14 for breastmilk iodine concentration (BIC). Compared to standard methods of collecting urine for measuring iodine concentration, the diaper-pad collection method does not substantially affect the reliability of the measurements., Competing Interests: The authors declare no conflict of interest.

Mercury (Hg), cadmium (Cd), and lead (Pb) are of great concern for food safety and infants are especially sensitive to exposure to the maternal body burden. We quantified these elements in breast milk from Norwegian mothers and determined their association with dietary habits, maternal amalgam fillings, and smoking. Breast milk (n = 300) from the Norwegian Human Milk Study (HUMIS) was analyzed using triple quadrupole inductively coupled plasma mass spectrometry, after an acidic decomposition using microwave technique. We used multiple linear regression to examine predictors of Hg and Cd in breast milk, and logistic regression to test predictors of Pb above the quantification limit. The median breast milk concentrations (minimum - maximum) were 0.20 μg Hg/kg (<0.058-0.89), 0.057 μg Cd/kg (0.017-1.2), and <0.67 μg Pb/kg (<0.2-7.5). Cadmium showed no significant relation with any exposure variable investigated. Lead was associated with intake of liver and kidneys from game. For Hg concentration in breast milk, number of amalgam fillings and high fish consumption were significant predictors (p < 0.001). We detected a significant association (p < 0.01) between Hg in breast milk and maternal consumption of Atlantic halibut, lean fish, mussels and scallops and lifetime consumption of crab. Seafood intake alone explained 10% of variance, while together with amalgam explained 46% of variance in Hg concentration in breast milk. Our findings emphasize the importance of following consumer advice with respect to fish and seafood and points to amalgam as an important source for Hg exposure., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Previous studies have documented mild to moderate iodine deficiency in pregnant and lactating women in Norway. This study focused on non-pregnant young women because their future children may be susceptible to the adverse effects of iodine deficiency. We assessed urinary iodine concentration (UIC), iodine intake from food and supplements, and iodine knowledge in 403 non-pregnant women, mainly students, aged 18⁻30 years. Iodine concentration was measured in spot urine samples analyzed by inductively coupled plasma mass spectrometry and iodine intake was calculated from a self-reported food frequency questionnaire. Knowledge about iodine was collected through the self-administered, paper-based questionnaire. Median (p25⁻p75) UIC was 75 (42⁻130) µg/L and 31% had UIC < 50 µg/L. Habitual iodine intake was 100 (69⁻136) µg/day. In multiple regression models, supplemental iodine, use of thyroid medication, and iodine intake from food were positively associated with UIC, while vegetarian practice was negatively associated, explaining 16% of the variance. Approximately 40% of the young women had low iodine knowledge score and no differences were found between women in different study programs. Young women in Norway are mild to moderately iodine-deficient, and public health strategies are needed to improve and secure adequate iodine status.

Norway has been considered iodine replete for decades; however, recent studies indicate reemergence of inadequate iodine status in different population groups. We assessed iodine status in pregnant women based on urinary iodine concentration (UIC), urinary iodine excretion (UIE), and iodine intake from food and supplements. In 804 pregnant women, 24-h iodine intakes from iodine-rich foods and iodine-containing supplements were calculated. In 777 women, iodine concentration was measured in spot urine samples by inductively coupled plasma/mass spectrometry (ICP-MS). In addition, 49 of the women collected a 24-h urine sample for assessment of UIE and iodine intake from food frequency questionnaire (FFQ). Median UIC was 92 µg/L. Fifty-five percent had a calculated iodine intake below estimated average requirement (EAR) (160 µg/day). Iodine intake from food alone did not provide the amount of iodine required to meet maternal and fetal needs during pregnancy. In multiple regression models, hypothyroidism, supplemental iodine and maternal age were positively associated with UIC, while gestational age and smoking were negatively associated, explaining 11% of the variance. This study clearly shows that pregnant women in the Oslo area are mild to moderate iodine deficient and public health strategies are needed to improve and secure adequate iodine status., Competing Interests: The authors declare no conflict of interest. The founding sponsors had no role in the design of the study, in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

Breastfed infants depend on sufficient maternal iodine intake for optimal growth and neurological development. Despite this, few studies have assessed iodine concentrations in human milk and there is currently no published data on iodine status among lactating women in Norway. The aim of this study was to assess iodine concentrations in breast milk (BMIC) in lactating women and estimate iodine intake. Five Mother and Child Health Centres in Oslo were randomly selected during 2016, and 175 lactating women between 2nd and 28th weeks postpartum participated. Each of the women provided four breastmilk samples which were pooled and analysed for iodine concentrations. Participants also provided information on iodine intake from food and supplements covering the last 24 h and the habitual iodine intake (food frequency questionnaire). The median (p25, p75 percentiles) BMIC was 68 (45, 98) µg/L and 76% had BMIC <100 µg/L. Only 19% had taken an iodine-containing supplement during the last 24 h. The median 24 h iodine intake from food (p25, p75) was 121 (82, 162) µg/day and the total intake (food and supplements) was 134 (95, 222) µg/day. The majority of lactating women had suboptimal BMIC and inadequate intake of iodine from food and supplements., Competing Interests: The authors declare no conflict of interest. The founding sponsors had no role in the design of the study, in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

Because the toxicity of arsenic depends on its chemical form, risk assessments of arsenic exposure must consider the type of arsenic compound, and hence they require sensitive and robust methods for their determination. Furthermore, the assessment should include studies on the most vulnerable people within a population, such as newborns and infants, and thus there is a need to quantify arsenic species in human milk. Herein we report a method for the determination of arsenic species at low concentrations in human milk by HPLC/ICPMS. Comparison of single and triple quadrupole mass analysers showed comparable performance, although the triple quadrupole instrument more efficiently overcame the problem of ArCl + interference, from the natural chloride present in milk, without the need for gradient elution HPLC conditions. The method incorporates a protein precipitation step with trifluoroacetic acid followed by addition of dichloromethane or dibromomethane to remove the lipids. The aqueous phase was subjected to anion-exchange and cation-exchange/mixed mode chromatography with aqueous ammonium bicarbonate and pyridine buffer solutions as mobile phases, respectively. For method validation, a human milk sample was spiked with defined amounts of dimethylarsinate, arsenobetaine, and arsenate. The method showed good recoveries (99-103%) with detection limits (in milk) in the range of 10 ng As kg -1 . The method was further tested by analyzing two Norwegian human milk samples where arsenobetaine, dimethylarsinate, and a currently unknown As species were found, but iAs was not detected.