Pathogenetic pathways of adverse health effects in children exposed to airborne metals: quantification of cause-effect relations

Introduction. Aerogenic exposure to metals coming from industrial emissions is a leading factor in the formation of associated non-infectious morbidity in children. Digitalization of cause-and-effect relationships with verification of the fact of exposure based on biomarkers of exposure and adverse effects increases the accuracy of hygienic assessments and the effectiveness of preventive measures.

The aim of this study was to identify peculiarities of pathogenetic pathways responsible for adverse health effects in children exposed to airborne metals based on quantification of cause-effect relations (exemplified by manganese, copper, nickel, chromium, and aluminum oxides).

Materials and methods. Based on in-depth medical studies of two thousand fifty five children in the Krasnoyarsk Territory and Irkutsk Region, for 2016–2025, cascade regression modeling was carried out along a deterministic chain from external aerogenic exposure to the development of associated diseases.

Results. The contribution of the inhalation route to the formation of increased concentrations of metals in biological media (R² = 0.23–0.70), which occurs against the background of the concomitant intake of toxicants through other routes, has been established. Reference concentrations of exposure biomarkers (mg/dm³) were determined in the blood: chromium (0.0011), manganese (0.011), nickel (0.002) and copper (0.912), in the urine: aluminum (0.0032). The profile of prenosological biomarkers of adverse effects is substantiated: oxidative stress (increase in lipid hydroperoxides and malondialdehyde), mitochondrial apoptosis (expression of the Bax protein), imbalance of cellular (increase in CD16⁺56⁺ and CD19⁺ lymphocytes) and humoral immunity (metal-specific immunoglobulins), local eosinophilia. Differentiation of pathogenesis trajectories in girls and boys was revealed.

Limitations. Retrospective data analysis, range of exposure levels, focus on the age group of 4–7 years, inhalation route of entry of metals without taking into account the nutritional and percutaneous routes.

Conclusion. Quantitative parameters of cause-and-effect relationships serve as an evidence base for verifying the conditions for the occurrence of non-infectious diseases under aerogenic exposure to metals. Taking into account the identified features of pathogenesis and gender differences makes it possible to increase the effectiveness of prevention programs for children under conditions of aerogenic exposure to metals.

Compliance with ethical standards. The study did not require approved by an ethics committee.

Contributions:
Zaitseva N.V. – study design;
Koldibekova Yu.V. – Data collection and literature analysis, wiring the text;
Zemlyanova М.А. – editing the text.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Conflict of interest. The authors declare no conflict of interest.

Funding. The study had no sponsorship.

Received: July 27, 2026 / Revised: August 19, 2026 / Accepted: September 15, 2026 / Published: October 20, 2026

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