The figure to the left presents the presumed mechanism. Ambient exposure is getting its way into human body and can be traced by pollutants' concentrations, a.k.a. exposure biomarkers. In theory, this is when the oxidative stress occurs, by producing a damage, as can be reflects by the biomarkers of an effect. The latter reflect a predisposition for developing the disease.
- Together with the Magen David Blood Services and the national laboratory of public health, we are measuring the concentrations of heavy metals (the biomarkers of an exposure) in the blood samples of 900 donors from all over Israel and looking for their association with ambient pollution around the donors' residence. The methodology of this study has been described by Hassan et al, 2020.
- We tested the link between ambient exposure and its biomarker on a smaller scale, in a subgroup of women of Bedouin-Arab origin giving birth in Soroka 2011-2013. The women contributed their samples of spot urine prior to going into labor, and answered a questionnaire on details about their household and possible hazardous exposures like heating or cooking on open fire, smell from nearby sewage and vehicles parked nearby. The ambient pollution was estimated based on monitoring stations. The urine samples were tested to 4 metalss: aluminum, cadmium, arsenic and nickel (Karakis et al, 2014 and 2015) and 7 years later - to 25 metals using more advanced lab methodology (Karakis et al, 2020 ). The results showed clear links between the environment and biomarker of exposure.
- Whether environment can be linked to a biomarker of an effect was tested in the same project above, by collecting umbilical cord blood at delivery and analyzing their cell proliferation function (a biomarker of an effect). The association with environment was summarized in two publications (Novack et al, 2016 and Novack et al, 2015).