Bioavailability of and US Infant Exposure to Arsenic, Cadmium, Lead, Mercury, and Per- and Polyfluoroalkyls from Human Milk and Infant Formula: Results from a Series of Systematic Reviews

Overview

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Author, year, and title are taken from the Crossref record for the DOI, not scraped from the PDF text.

Key numbers

Each analyte named in metals: is listed below with the measurement-bearing lines that caused it to be asserted. Lines are copied from the verified extraction and retain the source units and wording where legible. An analyte with no lines here would not appear in the frontmatter.

Cd

• 2 Bioavailability of and US Infant Exposure to Arsenic, Cadmium, Lead, 67
• 32 geographic diversity. Therefore, conclusions could not be made about exposure to arsenic, cadmium, lead, or mercury from HM and/or IF 98
• 4 This series of systematic reviews highlights critical research gaps about US infant exposure to and bioavailability of arsenic, cadmium, lead, 70
• 41 ciding with the introduction of complementary foods. Infants (n cohort (n = 187, in 2014‒2019), paired median cadmium con­ 107
• 50 All evidence for arsenic was from a single cohort in 1 measured cadmium exposure of infants consuming HM and/or 116
• 64 cadmium concentration from infants at 6 wk of age (n = 462, 1994 (Table 2). Concentrations across the 3 studies ranged from 130
• 66 μg/L) (55). Urinary cadmium concentrations were not (59). In Iowa, a nonrandomized intervention with IF showed a 132
• 21 specimens of infants consuming HM and/or IF in the United fant exposure to arsenic, cadmium, lead, mercury, and legacy 87
• 23 cadmium, lead, mercury, or PFAS exposure as measured in 89
• 36 economic heterogeneity in estimates of infant exposure to U-bags (86) for cadmium, total arsenic, and elemental and 102
• 36 Changes in body burden of mercury, lead, arsenic, cadmium and (85) L. Zajac, S.A. Johnson, M. Hauptman, Doc, can you test me for “toxic 102

tAs

• 2 Bioavailability of and US Infant Exposure to Arsenic, Cadmium, Lead, 67
• 32 geographic diversity. Therefore, conclusions could not be made about exposure to arsenic, cadmium, lead, or mercury from HM and/or IF 98
• 4 This series of systematic reviews highlights critical research gaps about US infant exposure to and bioavailability of arsenic, cadmium, lead, 70
• gible because exposure to HM and/or IF did not precede bio­ Urinary arsenic concentrations were reported in 4 articles 99
• 37 Of 544 additional unique records identified via other urinary total arsenic (minus arsenobetaine) as 0.23 μg/L (95% 103
• 40 and both were excluded: 1 was a duplicate with the database nary total arsenic concentration (including arsenobetaine) as 106
• 48 interest for our review. in the NHBC. Specifically, median urinary arsenic concentra­ 114
• 60 renovation intervention, but contaminant concentrations were centrations associated with HM or IF intake. Urinary arsenic was 126
• 43 had 1.6-fold higher median urinary arsenic concentration 0.20) at 6 wk to 0.13 μg/L (IQR = 0.08‒0.22) at 1 y (P = 0.046) 109
• 50 All evidence for arsenic was from a single cohort in 1 measured cadmium exposure of infants consuming HM and/or 116
• 21 specimens of infants consuming HM and/or IF in the United fant exposure to arsenic, cadmium, lead, mercury, and legacy 87
• 42 Contaminant bioavailability from HM or IF arsenic exposure from the granite bedrock is high (73,74). The 108

tHg

• 32 geographic diversity. Therefore, conclusions could not be made about exposure to arsenic, cadmium, lead, or mercury from HM and/or IF 98
• 44 lead, and mercury, were also detected in HM as well as in IF, SRs are presented in this manuscript (Figure 1; PROSPERO: 110
• 95% of all samples were above machine detection limits, except mercury, in which only 19%‒31% of samples were detected and thus imputed.
• 21 specimens of infants consuming HM and/or IF in the United fant exposure to arsenic, cadmium, lead, mercury, and legacy 87
• 23 cadmium, lead, mercury, or PFAS exposure as measured in 89
• 2019 (Table 1). Median mercury concentrations were 0.14 μg/L
• 48 (28) M.L. Kile, A.G. Ronnenberg, Can folate intake reduce arsenic toxicity? (49) W.A. Galster, Mercury in Alaskan Eskimo mothers and infants, Environ 114
• 36 Changes in body burden of mercury, lead, arsenic, cadmium and (85) L. Zajac, S.A. Johnson, M. Hauptman, Doc, can you test me for “toxic 102

Methods (brief)

• Abbreviations: DMA, dimethylarsinic acid; MMA, monomethylarsonic acid; NHBC, New Hampshire birth cohort; PFAS, per- and polyfluoroalkyl substances; ROB,
• 59 also interfere with the absorption, digestion, metabolism, and tool to assess systematic reviews’ critical appraisal tool (32) 125
• 11 which can help mitigate publication bias. We conducted dual coupled plasma mass spectrometry in feces-free spot urine 77
• 50 search of the HOME study website (n = 24), the HOME study dimethylarsinic acid (DMA) but not including arsenobetaine) 116
• search (n = 6), population (n = 35 total; n = 10 maternal sam­ DMA (P = 0.01), and 3.8-fold for sum of these 3 (P = 0.01) from 122
• and/or blood of infants consuming HM and/or IF aged ≤12 mo ganic arsenic, MMA, DMA, and total arsenic (sum of inorganic,
• 38 MMA, and DMA minus arsenobetaine; data shown in Supple­ significantly different among infants fed HM, IF, or both (P = 104
• Total arsenic values were reported in each article. Pikounis et al. (55) and Signes-Pastor et al. (51,56), reported inorganic + MMA + DMA minus arsenobetaine, and Hoen et al. (57), reported Q15
• total arsenic including arsenobetaine. Individual values for inorganic, MMA, DMA, and arsenobetaine were reported by Signes-Pastor et al. (51), and are shown in Supplemental Table 10.
• All infants were from the New Hampshire birth cohort. All contaminants were measured via coupled plasma mass spectrometry in feces-free spot urine collected with supplied diapers and cotton
• Abbreviations: DMA, dimethylarsinic acid; HM, human milk; IF, infant formula; MMA, monomethylarsonic acid.
• 39 leveraged to assess infant contaminant exposure using bio­ arsenic) and species (e.g., the organic species of MMA and DMA 105
• cohort study lying-in hospital cohort) the highest, lowest, and Isomil; the number of Fed formula (n = NR): 5.6 ± acid digestion and ESA Human Development
• 64 by mechanistic study designs, such as animal or in vitro digestion types, such as cord blood and meconium, which were collected 130
• Astolfi et al. (69), 2019 Italy Probiotic supplement/placebo was Not analyzed because levels were below LOD.
• Astolfi et al. (69), 2019 Italy Probiotic supplement/placebo was Not analyzed because levels were below LOD.
• Abbreviations: As, arsenic; C, control; Cd, cadmium; Hg, mercury; HM, human milk; LOD, limit of detection; MeHg, methylmercury; NR, not reported; Pb, lead; PFHxS, perfluorohexanesulfonic Q18
• 22 from animal or in vitro digestion models that indirectly assess 88

Implications

This page makes the source discoverable for category-level evidence routing. Values remain source-native and should be used only with the stated matrix, species, basis, geography, and censoring context from the paper. The page does not convert total mercury to methylmercury or use total arsenic as inorganic arsenic.

Wiki pages this source may touch

• Infant Formula Powder
• Shellfish (shrimp, crab, lobster, clams, oysters, mussels)
• Cadmium
• Arsenic
• Mercury

Verification notes

• Identity check: DOI, raw handle, cite-key, and SHA-256 were compared against existing wiki/sources/ pages before creation.
• Provenance: first author and publication year resolved from Crossref for DOI 10.1016/j.advnut.2026.100628. PDFs whose DOI does not resolve are skipped, not given a fallback key.
• Full-PDF read: pdftotext -layout was run twice and the extraction hashes compared before the page was written.
• Analyte scope: each metal is asserted only where its spelled-out name appears on a line carrying a measurement. Element symbols alone never assert an analyte.
• Brand firewall: the worker skips PDFs whose numeric lines appear brand-sensitive; this page contains category-level or species-level evidence only.
• HMTc firewall: no threshold, percentile, pass/fail, clean/dirty, or certification math is stated.

Update history

The five most recent substantive edits to this page, classified major (evidence or structure moved), correction (a published value or statement was wrong and has been fixed), or minor (narrative rewritten without changing the underlying evidence). Each description is derived from what the edit did to this page; the linked commit is the authoritative record, routine regeneration passes are excluded, and the full version history lives in git. When DOI minting comes online (see schema docs), each entry below will also link to a version-pinned DataCite DOI.