{
    "abstract": "Guatemala has the highest child stunting prevalence in the Americas and is ranked sixth internationally. This paper examines concentrations of toxic metals and metalloids in the breastmilk of Mayan women in the Lake Atitl\u00e1n watershed and explores potential relationships with stunting prevalence and demographic parameters to guide future research. We completed a cross-sectional study in 2022 (n\u00a0=\u00a080 mother/infant dyads) with 20 mother/infant dyads from each of four communities: San Juan La Laguna, San Pedro La Laguna, Panajachel, and Santiago Atitl\u00e1n. We collected a breastmilk sample from each mother and measured the length of each infant (90-182 days old) to assess stunting (<-2 SD length-for-age below WHO growth standards median), and we collected community drinking water samples. The mean Z-score for stunting was -1.39 (SD\u00a0=\u00a01.24). Infants from Panajachel had a higher prevalence of stunting (x\u0305\u00a0=\u00a0-2.06) than did infants from the other three communities. Metals and metalloids were quantified in breastmilk and water samples using inductively coupled plasma - mass spectrometry (ICP-MS). The concentrations of arsenic and lead in breastmilk were above the WHO safety standards in Panajachel and Santiago Atitl\u00e1n, and concentrations of toxic metal(loid)s overall were highest in Panajachel. For infants from Panajachel and Santiago Atitl\u00e1n, reduced Z-scores for stunting were associated with higher breastmilk concentrations of arsenic, barium, beryllium, and lead (p\u00a0=\u00a00.02-0.04). Water samples from these two communities exhibited greater concentrations of arsenic and barium than did water from other communities (p\u00a0=\u00a00.003-0.03). Significant associations between concentrations of arsenic, barium, beryllium, and lead with stunting score warrant a comprehensive assessment of the potential role of toxic metal(loid)s in child development. Stunting is a complex multifactorial problem; our results indicate that investigations of stunting should also evaluate exposures to toxic metal(loid)s in addition to the traditional causal factors such as malnutrition and chronic infections.",
    "authors": [
        {
            "affiliation": "Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.",
            "firstname": "Sandra",
            "initials": "S",
            "lastname": "Rodr\u00edguez Quintana"
        },
        {
            "affiliation": "Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA. Electronic address: frankvonhippel@arizona.edu.",
            "firstname": "Frank A",
            "initials": "FA",
            "lastname": "von Hippel"
        },
        {
            "affiliation": "Center for Studies of Sensory Impairment, Aging and Metabolism (CeSSIAM), Ciudad de Guatemala, Guatemala.",
            "firstname": "M\u00f3nica",
            "initials": "M",
            "lastname": "Orozco"
        },
        {
            "affiliation": "Center for Studies of Sensory Impairment, Aging and Metabolism (CeSSIAM), Ciudad de Guatemala, Guatemala.",
            "firstname": "Noel",
            "initials": "N",
            "lastname": "Solomons"
        },
        {
            "affiliation": "Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.",
            "firstname": "Dean",
            "initials": "D",
            "lastname": "Billheimer"
        },
        {
            "affiliation": "BIO5 Institute, Statistics Consulting Laboratory, University of Arizona, Tucson, AZ, USA.",
            "firstname": "Maria A",
            "initials": "MA",
            "lastname": "Sans-Fuentes"
        },
        {
            "affiliation": "Arizona Laboratory for Emerging Contaminants, University of Arizona, Tucson, AZ, USA.",
            "firstname": "Mary Kay",
            "initials": "MK",
            "lastname": "Amistadi"
        },
        {
            "affiliation": "Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.",
            "firstname": "Sam",
            "initials": "S",
            "lastname": "Sneed"
        },
        {
            "affiliation": "Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.",
            "firstname": "Paloma",
            "initials": "P",
            "lastname": "Beamer"
        },
        {
            "affiliation": "Center for Studies of Sensory Impairment, Aging and Metabolism (CeSSIAM), Ciudad de Guatemala, Guatemala.",
            "firstname": "Alejandra",
            "initials": "A",
            "lastname": "Zamora"
        },
        {
            "affiliation": "Center for Studies of Sensory Impairment, Aging and Metabolism (CeSSIAM), Ciudad de Guatemala, Guatemala.",
            "firstname": "Eileen",
            "initials": "E",
            "lastname": "Rivera"
        },
        {
            "affiliation": "Center for Studies of Sensory Impairment, Aging and Metabolism (CeSSIAM), Ciudad de Guatemala, Guatemala.",
            "firstname": "Ruth",
            "initials": "R",
            "lastname": "Forsten"
        },
        {
            "affiliation": "Department of Medicine, University of British Columbia, Canada.",
            "firstname": "Preet",
            "initials": "P",
            "lastname": "Gandhi"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2025 Elsevier Ltd. All rights reserved.",
    "doi": "10.1016/j.envpol.2025.126273",
    "journal": "Environmental pollution (Barking, Essex : 1987)",
    "keywords": [
        "Arsenic",
        "Barium",
        "Beryllium",
        "Breastfeeding",
        "Childhood development",
        "Infant growth",
        "Lead",
        "Mayan",
        "Water contamination"
    ],
    "methods": null,
    "publication_date": "2025-04-20",
    "pubmed_id": "40252752",
    "results": null,
    "title": "Exposure to toxic metal(loid)s via breastmilk and stunting in infants living in the Lake Atitl\u00e1n watershed, Guatemala.",
    "xml": "<Element 'PubmedArticle' at 0x788504e5f5b0>"
}