Evaluation of heavy metals (lead, mercury, cadmium, manganese) level in blood, plasma and urine of adolescents with violent behavior

Aim: children with asymptomatic heavy metal poisoning caused by prolonged low-dose contact, non-specific symptoms such as behavioral disorder, difficulty in learning and perception, and tendency to violence are seen. There are several international publications stating that the ongoing heavy metal exposure increases the tendency to crime and violence, especially in adolescence. Studies have shown that in those exposed to heavy metals in the prenatal or postnatal period, there is an increased frequency of social introversion, depression, atypical body movements, neurological problems, aggression, sleep disturbance, even substance abuse and forensic incidents. Although there are studies to determine the heavy metal levels in children in our country, there are no studies specific to the adolescent age group. In this study, it was aimed to determine the relationship between the heavy metal level in blood, plasma and urine and the level of aggression in adolescents. Material-Methods We applied Demirtas Madran (2012)'s Aggression Scale, which is consisting of 29 questions and whose validity and reliability studies were conducted in Turkey, after taking medical history and doing physical examination to 228 adolescents aged between 13-19 years old who areregisteredtoDicleUniversitySchoolofMedicineAdolescentHealthClinic. Blood,plasma and urine heavy metal levels of the participants were measured ICP-MS with (Inductively Coupled Plasma – Mass Spectrometer), which is one of the most sensitive methods in quantitative measurements of heavy metals today, and measurements were made in Dicle University Science and Technology Application and Research Center (DÜBTAM). IV Ethics approval was obtained for this study from the ethics committee of Dicle University Faculty of Medicine. This study is financially supported by Dicle University Scientific Research Projects (DUBAP) coordinator (project number: TIP.19.025). Findings In our study with a total of 228 participants, 55.7% (n = 127) of the participants were women, and 44.3% (n = 101) of the participants were men, and the average age of the participants was 15.3 ± 1.8. Considering the distribution of the regions where the participants reside, it was seen as follows; Diyarbakır %54,8 (n=125), Mardin %32,5 (n=49), Batman %4,8 (n=11), Şırnak %4,8 (n=11), Şanlıurfa %3,9 (n=9), Hakkâri %3,1 (n=7), Van %2,6 (n=6), Siirt %2,2 (n=5) and Adıyaman %2,2 (n=5) According to result of analysis, lead blood (r =0,34, p <.01), lead plasma (r = 0,22, p <0,01), lead urine (r = .31, p <.01), mercury blood ( r = 0,35, p <0,01), mercury urine (r = 0,21, p <0,01), manganese blood (r = 0,34, p <0,01), manganese plasma (r = 0,33, p <0,01) and manganese urine (r = 0,39, p <0,01) were found to be positively correlated with general tendency to aggression. Accordingly, as the level of lead (blood, plasma, urine), mercury (blood, urine) and manganese (blood, plasma, urine) increases, the general tendency to aggression increases. In general, levels of cadmium in blood, plasma and urine and mercury in plasma were not found to be correlated with tendency to aggression. Conclusion According to the results of our study, the general aggression tendency increases as the level of lead (blood, plasma, urine), mercury (blood, urine) and manganese (blood, plasma, urine) increases in adolescents. However, no significant correlation was found between tendency to aggression and cadmium (blood, plasma, urine) or for plasma mercury. There is an undeniable relationship between child health and environmental pollution caused by heavy metal. For this reason, taking necessary measures to prevent environmental pollution caused by heavy metals is vital for public health. Keywords: Adolescent, heavy metal, aggression, lead, mercury, cadmium, manganese