Lead and cadmium in meat and meat products consumed by the population in Tenerife Island, Spain

The aim of this study was to determine the levels of lead and cadmium in chicken, pork, beef, lamb and turkey samples (both meat and meat products), collected in the island of Tenerife (Spain). Lead and cadmium were measured by graphite furnace atomic absorption spectrometry (GFAAS). Mean concentrations of lead and cadmium were 6.94 and 1.68 µg kg^-1 in chicken meat, 5.00 and 5.49 µg kg^-1 in pork meat, 1.91 and 1.90 µg kg^-1 in beef meat and 1.35 and 1.22 µg kg^-1 in lamb meat samples, respectively. Lead was below the detection limit in turkey samples and mean cadmium concentration was 5.49 µg kg^-1. Mean concentrations of lead and cadmium in chicken meat product samples were 3.16 and 4.15 µg kg^-1, 4.89 and 6.50 µg kg^-1 in pork meat product, 6.72 and 4.76 µg kg^-1 in beef meat product and 9.12 and 5.98 µg kg^-1 in turkey meat product samples, respectively. The percentage contribution of the two considered metals to provisional tolerable weekly intake (PTWI) was calculated for meat and meat products. Statistically significant differences were found for lead content in meats between the chicken and pork groups and the turkey and beef groups, whereas for cadmium concentrations in meats, significant differences were observed between the turkey and chicken, beef and lamb groups. In meat products, no clear differences were observed for lead and cadmium between the various groups.     

Dietary intake of trace elements by the population of Catalonia (Spain): results from a total diet study

This study aimed to analyse the concentrations of Al, Ba, Bi, Cu, Cr, Ge, Mn, Mo, Ni, Sb, Se, Sr and Zn in food samples collected in 2008 in Catalonia (Spain). The dietary intake of these 13 trace elements was subsequently estimated by different age–gender groups of the population: children, adolescents, adults and seniors. In general terms, fish and shellfish, cereals, and pulses were the food groups showing the highest levels for most elements. Higher dietary intakes were associated with male groups (adolescents, adults and seniors). However, none exceeded the tolerable levels. When exposure was estimated based on body weight, children were the group with the highest dietary intake. Notwithstanding, only the weekly intake of Al by children exceeded the recommendations of the European Food Safety Authority (EFSA). It is a consequence of the higher intake of cereals in relation to their respective body weights. In addition to the periodical food surveillance of toxic metals (As, Cd, Hg and Pb), it is also important to determine the levels of other trace elements in order to ensure that the dietary exposure by the Catalan population is under control.     

Aluminium in food and daily dietary intake estimate in Greece

Aluminium content of foods, as well as dietary aluminium intake of the Greek adult population, was determined using graphite furnace atomic absorption spectroscopy after microwave sample digestion and food consumption data. Al content ranged from 0.02 to 741.2?mg?kg^?1, with spices, high-spice foods, cereal products, vegetables and pulses found to be high in Al. Differences in aluminium content were found between different food classes from Greece and those from some other countries. Aluminium intake of Greeks is 3.7?mg/day based on DAFNE Food Availability Databank, which uses data from the Household Budget Surveys. On the other hand, according to the per capita food consumption data collected by both national and international organisations, Al intake is 6.4?mg?day^?1. Greek adult population has an Al intake lower than the Provisional Tolerable Weekly Intake of 7?mg?kg^?1 body weight established by EFSA. Cereals and vegetables are the main Al contributors, providing 72.4% of daily intake.     

Copper in foods,beverages and waters from South East Spain: influencing factors and daily dietary intake by the Andalusian population

The copper content of 225 food, 49 beverage and twelve potable water samples were determined using atomic absorption spectrometry (AAS). Analyses of NIST and BCR reference materials demonstrated the accuracy of this technique. The highest copper levels were found in dried fruit and legumes, followed by organ meats, molluscs and crustaceans, cephalopods, cereals and sausages, respectively. In cereals, legumes and fruit, copper levels increased significantly with increasing levels of protein and decreasing carbohydrate content (p?<?0.001). In meat and meat by-products, copper concentrations found in organ meats were significantly higher (p?<?0.01). In fresh fish products, copper levels in shellfish were significantly higher than those measured in fish (p?<?0.001). In vegetables, the copper concentrations found in mushrooms were significantly higher (p?<?0.005). Mean copper concentrations analysed in cheese were statistically higher than those determined in other dairy products (p?<?0.01). In beverages, copper levels determined in rum and juices were significantly higher (p?<?0.001). Beverages for which a vegetable component was directly used in their manufacturing process (juices, wines and beers) had statistically higher copper levels when compared with fresh drinks. The daily dietary intake (DDI) of copper in the Andalusian diet was 1979 μg day^?1 per person. Cereals, meat, meat by-products and vegetables are the food categories that are the main source of copper in the daily diet. Taking into account the dietary reference intakes and upper levels (900 and 10, 000 μg Cu day^?1 for healthy adults, respectively), the mean copper DDI found indicate that for most of healthy adult individuals from the area, no adverse effects occur in relation to copper nutrition (deficiency or toxicity). Potable waters supplied 53 μg day^?1, which constitutes on average 0.025% of the maximum tolerable daily intake of this element set by the Joint FAO/WHO Expert Committee.     

Risk assessment of the lead intake by consumption of red deer and wild boar meat in Southern Spain

The presence of heavy metals in big game meat may pose a risk to human health. The main objective of this paper is to carry out a risk assessment study (using a probabilistic and point-estimate approach) of lead intake by consumption of red deer and wild boar meat in Southern Spain based on Spanish data collected in the period 2003–2006. In general, the concentration levels found for wild boar meat (mean?=?1291?µg?kg^?1) were much higher than those observed in red deer meat (mean?=?326?µg?kg^?1). The results from a point-estimate risk assessment showed that the estimated average intake of lead among different exposure scenarios varied from 0.1 to 6.5 and from 0.3 to 38?µg?kg^?1?week^?1 for red deer and wild boar meat, respectively; and from 0.3 to 35?µg?kg^?1?week^?1 for individuals consuming both red deer and wild boar meat, and that the estimated intake of lead by consumption of big game meat differed significantly between hunters and non-hunters, it being higher for hunters. Besides this, results from the probabilistic risk assessment study corroborated the fact that risk is greater in hunter populations, reaching a maximum in individuals consuming only wild boar and both types of meat, with 0.4% and 0.2% of the population above the provisional tolerable weekly intake (PTWI), respectively. Likewise, the hunter populations consuming wild boar and both types of big game meat (red deer and wild boar meat) were exposed to the maximum lead level (56?µg?kg^?1?week^?1), which corresponded approximately to 224% of the PTWI. Further data and studies will be needed to give a complete risk estimation in which it will be crucial to consider the contribution to the lead intake level of other foods in the diet of both population groups.     

Contents of cadmium, copper, mercury and lead in fish from the Neretva river (Bosnia and Herzegovina) determined by inductively coupled plasma mass spectrometry (ICP-MS)

The concentrations of cadmium, copper, mercury and lead in fish from the Neretva river have been investigated in order to assess safety for consumers and the level of contamination. Samples of muscle and liver from six fish species (brown trout, common carp, prussian carp, chub, rudd and gray mullet) were collected at six locations upstream and downstream from the three largest towns along the Neretva river. Metal concentrations were determined by inductively coupled plasma mass spectrometry after microwave-assisted acid mineralisation. Accumulation of metals in fish tissues was species-dependent. The average content of metals in fish muscle samples was 0.013-0.055, 0.068-16.059, 0.050-0.401 and 0.055-0.703 mg/kg for Cd, Cu, Hg and Pb, respectively. Health effects due to fish consumption could not be excluded. Further investigation is recommended, including a survey of fish consumption frequency among the local inhabitants and sports fishermen.     

Essential and toxic heavy metals in cereals and agricultural products marketed in Kermanshah,Iran, and human health risk assessment

Levels of some essential and toxic heavy metals such as lead, cadmium, chromium, nickel, zinc and copper in cereals and agricultural products obtained from the markets in Kermanshah city, west Iran, were determined by inductively coupled plasma-optical emission spectrometry (ICP-OES). The average concentrations for lead and cadmium in some cereals were higher than the maximum levels set by the Codex Alimentarius. A potential human health risk assessment was conducted by calculating estimated weekly intake (EWI) of the metals from eating cereals and comparison of these values with provisional tolerable weekly intake (PTWI) values. In combination with recent cereal consumption data, the EWIs of heavy metals were calculated for the Kermanshah population. EWI data for the studied metals through cereal consumption were lower than the PTWI values. Cr, Ni, Zn and Cu levels in all samples analysed were within the ranges reported for similar cereals from various parts of the world.     

Total dietary intake of mercury in the Canary Islands,Spain

Estimating the risk associated with dietary intake of heavy metals by consumers is a vital and integral part of regulatory processes. The assessment of exposure to mercury shown in this paper has been performed by means of a study on the whole diet. Total mercury (Hg) levels were determined by cold vapour atomic absorption spectrometry (AAS) in 420 samples of regularly consumed food and drink. The total Hg concentrations measured in the different groups of food ranged from non-detectable to 119 µg kg^?1 w/w. The fish group had the highest concentrations of total Hg. All groups of food with regulated Hg content showed levels that were lower than the legally set values. The food consumption data used in the analysis were taken from the latest nutritional survey made in the Canary Islands, Spain. The estimated total Hg intake of local population (5.7 µg/person day^?1) did not exceed the provisional tolerable weekly intake (PTWI) limit of 0.3 mg week^?1 of total mercury (43 µg/person day^?1) fixed by the Joint Food and Agricultural Organization/World Health Organization (FAO/WHO) Expert Committee on Food Additives. Fishery products contributed 96% of the total Hg intake. The mean Hg intake for each island in this archipelago, formed by seven, has also been calculated. Fuerteventura, Lanzarote and El Hierro are the islands with the highest level of Hg intake (7.0, 7,0 and 6.1 µg/person day^?1, respectively). La Palma Island, due to its low fish consumption, had the lowest level of Hg intake (4.5 µg/person day^?1), followed by La Gomera (5.4 µg/person day^?1), Tenerife (5.5 µg/person day^?1) and Gran Canaria (5.6 µg/person day^?1). A comparison has been made of the results obtained in this study with those found for other national and international communities.     

Heavy metals in aromatic spices by inductively coupled plasma-mass spectrometry

Objective of this study was to determine the content of Cd, Hg, As and Pb in common spices traded in the Italian market, using inductively coupled plasma-mass spectrometry (ICP-MS). The results were compared with the maximum limits established by the national Legislative Decree (LD) no. 107 implementing the Council Directive 88/388/EEC and by international organisations, such as Food and Agriculture Organization (FAO) and World Health Organization (WHO). Food safety for spices was assessed considering the tolerable weekly intake (TWI) and the provisional tolerable weekly intake (PTWI), respectively, for Cd and Hg and the 95% lower confidence limit of the benchmark dose of 1% extra risk (BMDL₀₁) for As and Pb. Investigated elements in all samples were within the maximum limits as set by the national and international normative institutions. Nevertheless, the heavy metal content of some spices exceeded the PTWI, TWI and BMDL₀₁, which needs attention when considering consumer’s health.     

Levels of heavy metals in candy packages and candies likely to be consumed by small children

Ninety two samples of child-consumed candies and candy packages were analyzed for seven heavy metals. Lead (Pb) was detected at concentrations of 110.3–6394.1 mg kg⁻¹ in ten of 92 candy packages. The directive factor of Pb contamination had originated in the lead-based ink of the outer cover. Particularly, Pb was detected at high concentrations in case of green- or yellow-colored packages. Chromium (Cr) was detected at high concentrations in cases where Pb was also detected at high concentrations, and the Cr levels ranged from 136.9 mg kg⁻¹ to 1429.3 mg kg⁻¹ in seven of the 92 candy packages. Hexavalent chromium [Cr(VI)] was detected at 87–105.0% of the total Cr in polypropylene-coated wrappers with printed outer covers. The migration of Cr(VI) increased with elution time up to 0.20 μg (cm²)⁻¹ for 30 days in basic (pH 10.0) solution; however, there were no migrations in acidic (pH 4.0) and neutral (pH 7.0) solutions. The migration of Pb increased with elution time up to 0.65 μg (cm²)⁻¹ and 0.28 μg (cm²)⁻¹ in basic (pH 10.0) and acidic (pH 4.0) solutions, respectively. However, any migration was hardly observed in neutral (pH 7.0) solution.     

Human exposure to lead,cadmium and mercury through fish and seafood product consumption in Italy: a pilot evaluation

The presence of selected toxic heavy metals, such as cadmium (Cd), lead (Pb) and mercury (Hg), was investigated in fish and seafood products, namely, blue mussel, carpet shell clam, European squid, veined squid, deep-water rose shrimp, red mullet, European seabass, gilthead seabream, Atlantic cod, European hake, Atlantic bluefin tuna and swordfish so as to assess their human exposure through diet. Metals were detected by quadrupole inductively coupled plasma mass spectrometry (Q-ICP-MS) and hydride generation atomic absorption spectrometry (Hg-AAS). Measurements of Cd, Pb and Hg were performed by means of analytical methods validated in compliance with UNI CEI EN ISO/IEC 17025 [2005. General requirements for the competence of testing and calibration laboratories. Milano (Italy): UNI Ente Nazionale Italiano di Unificazione]. The exposure assessment was undertaken matching the levels of Cd, Pb and total Hg with consumption data related to fish and seafood products selected for this purpose. In order to establish human health implications, the estimated weekly intakes (EWIs) for Cd, Pb and Hg were compared with the standard tolerable weekly intakes (TWI) for Cd and provisional tolerable weekly intakes (PTWIs) for Pb and Hg stipulated by the European Food Safety Authority (EFSA) and the Food and Agriculture Organization/World Health Organization (FAO/WHO) Joint Expert Committee on Food Additives (JECFA). The found metal concentrations were largely below the maximum levels (MLs) established at the European Union level with the exception of Cd. This metal exceeded the MLs in squid, red mullet, European hake and Atlantic cod. Squid and blue mussel showed the highest Pb concentrations which accounted for 60% and 10% of the MLs, respectively. Highest Hg levels were found in predatory fish. The concentrations of Hg in swordfish, Atlantic bluefin tuna and red mullet accounted for 50%, 30% and 30% of the MLs, respectively. The EWIs for Cd, Pb and Hg related to the consumption of fish and seafood products by the median of the Italian total population accounted for 20%, 1.5% and 10% of the standard TWI for Cd as well as PTWIs for Pb and Hg, respectively. Furthermore, the EWIs estimated using consumption data concerning Italian consumers did not exceed the standard TWI and PTWIs, except for Cd at 95th percentile.     

植物油脂中反式脂肪酸含量及人体摄入量初估

采用气相色谱法对我国常见植物油脂中的反式脂肪酸含量和分布进行了分析,初步估算了我国居民反式脂肪酸的人均日摄入量。精炼植物油脂中反式脂肪酸含量为：大豆油0．89％～3．48％,菜籽油1．97％～4．76％,玉米油1．75％～6．19％,葵花籽油1．48％～2．36％,花生油0．10％～0．47％,棕榈油0．12％～0．28％,其存在形式以反式多不饱和脂肪酸（t—C18：2、t—C18：3）为主;专用油脂中反式脂肪酸含量为：替可可脂（CBR）和植脂末用油40％～50％,代可可脂（CBS）、烘焙和夹心用油中3％～5％,其存在形式以反式单不饱和脂肪酸（t—C18：1）为主。我国居民反式脂肪酸人均日摄入量为1．06g,其中城市1．44g,农村0．92g,分别占日摄入总能量的0．42％、0．61％和0．36％。     

Organophosphorus pesticide residues in Greek virgin olive oil: levels,dietary intake and risk assessment

The occurrence of organophosphorus pesticide (OPs) and their metabolite residues was investigated in 167 samples of Greek virgin olive oil during a 2-year (2004–2005) sampling campaign. A total of 30.5% of samples contained detectable residues, although only one sample contained dimethoate residues above the maximum residue limit. Among the seven detected OPs, fenthion and fenthion sulfoxide residues were detected in 10.8 and 14.4% of the samples, respectively, at levels of 0.003–0.61 mg kg^?1. Dimethoate was detected in 10.2% of the samples at 0.003–0.057 mg kg^?1. The acute dietary risk assessment was undertaken by determining the national estimated short-term intake (NESTI); for chronic dietary risk assessment, the national theoretical maximum daily intake (NTMDI) and national estimated daily intake (NEDI) were calculated. The estimated intakes (NESTI and NEDI) of each pesticide were <7 and <0.86% of the corresponding acute reference doses (ARfDs) and acceptable daily intakes (ADIs), respectively. A cumulative risk assessment was performed using the hazard index (HI) and toxicity equivalence factor (TEF), taking into account that OPs share the same toxicological mechanism. The determined HI and TEF values were found to represent only a small portion of the respective ADIs or ARfDs. These results indicate that there is neither acute nor chronic risk for the Greek population through olive oil consumption.     

Estimation of the dietary intake of pesticide residues, lead, cadmium, arsenic and radionuclides in France

Estimation of the dietary exposure of French consumers to 10 pesticides (omethoate, oxydemeton, phosalon, phosphamidon, triazophos, dicofol (op'+pp'), parathion ethyl, dichlorvos, procymidon and vinchlozolin), three heavy metals (lead, cadmium and arsenic) and three radionuclides (¹³⁴caesium, ¹³⁷caesium and ¹³¹iodine) from collected duplicate portion in mass catering establishments in 1998/1999 are reported, and compared with those from previous French studies as well as those from other countries. Dietary exposure estimates appear to be reassuring, in that Estimated Daily Intake (EDI) estimates are generally low, representing at maximum only 4% of the Acceptable Daily Intake (ADI) for pesticide residues and 28% of the Provisional Tolerable Weekly Intake (PTWI) for heavy metals. Moreover, none of the three radionuclides has been found in duplicate meals. When comparisons are possible, estimated dietary exposures for heavy metals are lower than those from previous French studies and similar or above those from other countries.     

Long-term daily intake estimates of polychlorinated dibenzo-p-dioxins and furans,polychlorinated biphenyls and polybrominated diphenylethers from food in Finnish children: risk assessment implications

Food is contaminated by polychlorinated dibenzo-p-dioxins and furans (PCDD/F), polychlorinated biphenyls (PCB) and polybrominated diphenylethers (PBDE) worldwide. Previous data show elevated intakes in children. We determined intakes of POPs in Finnish children. Because no children-specific safe limit values exist, we used tolerable daily intakes (TDIs) set for adults by international expert bodies to examine the proportion of the study population that exceed those limits. We utilised dietary monitoring data with food consumption of Finnish boys and girls aged 1–6 years, measured the contaminant concentrations in all the main food items and calculated age-specific contaminant sum and congener-specific long-term daily intake levels. Our food intake and contaminant data correspond to years 2002–2005. The long-term upper-bound dioxin intakes ranged between 0.1 and 12.8?pg WHO_PCDD/F-PCB-TEQ/kg bw/d (min and max). An immediate TDI for WHO_PCDD/F-PCB-TEQs of 4.0?pg/kg?bw/d were exceeded by 2.5%–7.5% of the children. PBDE long-term upper-bound intake was between 0.1 and 5.8?ng/kg bw/d (min and max). Congener-specific analyses indicated a typical Finnish adult exposure pattern of the children to PCDD/Fs, PCBs and PBDEs. The highest POP intakes were observed in children aged 3 years. Long-term daily PCDD/F, PCB and PBDE intakes among Finnish children varied greatly between individuals and ages. In each age group of the study population, there was a proportion of children with their WHO_PCDD/F-PCB-TEQ intake exceeding considered safe limits set for adults. Based on the exposure profile reported herein, children should be clearly considered as a specific sub-population in food-mediated contaminant risk assessment.     

Contents of cadmium,mercury and lead in edible mushrooms growing in a historical silver-mining area

Three harmful metals were determined using AAS techniques in 285 samples of fruiting bodies of 15 wild-growing edible mushroom species. The mushrooms were collected from a forest on the fringe of a historical area of silver mining. The metals were also determined in a topsoil organic layer sampled from nine sites within the observed area. As compared to background levels from unpolluted sites from several European countries, cadmium contents were considerably elevated in nearly all the tested species; lead contents were increased in most of the species, while mercury contents were elevated only in certain species. Thus, many species from the observed area may contribute considerably to the body burden of the metals. Agaricus silvaticus accumulated cadmium extremely and Lepista nuda accumulated mercury. There were no obvious simple positive relationships between the contents of the observed metals in fruiting bodies and the contents of total metals in the soil organic layer.     

Toxic and essential elements in Nigerian rice and estimation of dietary intake through rice consumption

In this study, levels and estimated daily intake (EDI) of two toxic elements, Cd and Pb, and eight essential elements: Ca, P, Zn, Mn, Co, Cu, Se and Mo, were determined in Nigerian rice samples. The mean levels of Cd, Pb and Co were 5.43 ± 0.88, 38.66 ± 5.42, 25.8 ± 3.18 ng/g. The mean levels of Ca, P, Zn, Mn, Cu, Se and Mo were 71.5 ± 7.31, 951 ± 52.0, 10.2 ± 0.63, 8.5 ± 0.47, 3.07 ± 0.18, 40.1 ± 9.2 and 0.39 ± 0.05 µg/g, respectively. The percentage contribution to the reference values for each element was 0.54, 7.71, 0.38, 9.51, 8.97, 31.3, 30.7, 5.1 and 60.7% for Cd, Pb, Ca, P, Zn, Mn, Cu, Se and Mo, respectively. The elemental nutrient levels in Nigerian rice samples are comparable to those obtained from other regions and their consumption does not pose any serious health risk to consumers.     

Methylmercury determination in fish and seafood products and estimated daily intake for the Spanish population

The mercury content of 25 samples of fish and seafood products most frequently consumed in Spain was determined. A simple method comprising cold vapour and atomic absorption spectrometry was used to determine separately inorganic and organic mercury. In all samples inorganic mercury content was below 50 µg kg^-1. There was wide variability, among not only the mercury levels of different fish species, but also for different samples of the same species — with the methylmercury content ranging from below 54 to 662 µg kg^-1. The highest mean methylmercury content was found in fresh tuna. Based on an average total fish consumption of 363 g/person week^-1, the methylmercury intake was estimated to be 46.2 µg/person week^-1. Therefore, the mercury intake of Spanish people with a body weight ≤ 60 kg is lower than the Joint FAO/WHO Expert Committee on Food Additives (JECFA) provisional tolerable weekly intake (PTWI) of 1.6 µg kg^-1 body weight, but exceeds the US National Research Council (NRC) limit of 0.7 µg kg^-1 body weight week^-1 based on a benchmark dose.     

Cadmium, lead and mercury in human milk from Slovakia

The objective of this study was to investigate Cd, Pb, and Hg levels in the breast milk of 158 lactating healthy women who were not occupationally exposed and living in eight environmentally different polluted locations of the Slovak Republic. Levels of these metals were examined in relation to selected parameters, such as: location, mother's age, parity, number of mother's teeth fillings, newborn's gender and birth weight, and smoking habits in the family. Cd and Pb levels in human milk and reconstituted infant formula were determined by GFAAS. Hg levels were measured by amalgamation technique AAS. The average concentrations of Cd, Pb and Hg in breast milk samples, taken on the 4th postpartum day, were 0.43, 4.7 and 0.94 µg/kg, respectively, and those in infant formula (n = 10) were 0.40, 5.0 and 0.25 µg/kg, respectively. Dietary weekly intakes of Cd, Pb, and Hg from breast milk and infant formula in newborn babies were also estimated. Whereas the calculated average dietary intakes of Cd, Pb, and Hg in newborn babies from breast milk and infant formula were all far lower than the appropriate PTWI values recommended by WHO/FAO, two individual breast milk samples for Pb and one breast milk sample for Hg exceeded the PTWI values. Regarding the studied parameters, only the active/passive smoking of the mother at home significantly increased Pb levels in breast milk and amalgam teeth fillings increased Hg levels in breast milk.     

Lead and cadmium concentrations in goat,cow, sheep,and buffalo milks from different regions of Iran

In total, 137 goat, cow, sheep, and buffalo milk samples were collected in different regions of Iran and analysed to determine concentrations of lead and cadmium by a graphite furnace atomic absorption spectrometric method. The mean recovery of the analytical method was 96.3% and 104% for cadmium and lead, respectively. The mean lead and cadmium contents obtained from 137 samples were 1.93 ± 1.48 (range: 0.18–6.11 ng/ml) and 9.51 ± 4.93 ng/ml (range: 1.84 ng/ml–30.50 ng/ml), respectively. Lead concentration in 8.1% of sheep and 1.9% of cow milk samples was higher than the newly established Codex standard. The mean concentrations of cadmium and lead in animals aged ?3 years (n = 80; 1.40 ± 1.05 ng/ml and 7.91 ± 3.60 ng/ml, respectively) were lower than in animals aged >3 years (n = 58; 2.69 ± 1.67 ng/ml and 11.8 ± 5.71 ng/ml, respectively).