Date of Award

January 2020

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Caroline Johnson

Second Advisor

Eugen Gurzau


Heavy metal exposures have long been a public health concern, research on this field may promote policies and regulations to restrict or limit certain industrial practices. This study aims to evaluate potential associations between toxic heavy metal exposures via contaminated environmental media and the frequency of the birth defects in the designated area: Tarnaveni, Romania; historically contaminated by a former chemical plant. In 2018, a pilot investigation conducted on the site demonstrated that chromium (Cr), lead (Pb), and manganese (Mn) are common heavy metal contaminants found. Soil concentrations for all three metals exceeded normal background levels according to Romanian Environmental Law. This study highlights a mixed approach in terms of using both soil (environmental) and blood (biofluid) samples to identify exposures, stratifying the results into individual effects of different metals, and integrating the effects from all exposures. Data from 30 pregnant women in the area were collected and heavy metal concentrations were measured (Cr, Pb, Mn in soil and blood; in addition to Arsenic and Cadmium in blood) and correlated these exposures levels to birth outcomes. The estimated exposure intakes were calculated for the population using a probabilistic method. The end-point specific hazard quotients (HQs) and hazard index (HI) were calculated to evaluate the non-carcinogenic health risk. A spatial analysis was performed to investigate the relationship of metal concentration and cases. By assessing the population needs and communities’ health, it is hoped to raise awareness and potentially promote further studies in this subject.


This is an Open Access Thesis.

Open Access

This Article is Open Access