Health Canada
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Environmental and Workplace Health

Zinc

1979

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Table of Contents

The aesthetic objective for zinc is ≤5.0 mg/L. Zinc is an essential element and is generally considered to be non-toxic. Intake of zinc from food is more than sufficient to satisfy the recommended daily requirements. Drinking water is not regarded as an important nutritional source of this element. Water containing zinc at concentrations above 5.0 mg/L tends to be opalescent, develops a greasy film when boiled, and has an undesirable astringent taste.

General

Zinc is an abundant element and constitutes approximately 0.004 percent of the Earth's substance.Footnote 11The most common zinc mineral is sphalerite (ZnS), which is often associated with the sulphides of other metallic elements, e.g., lead, copper, cadmium, and iron.Footnote 22 Zinc is also found as calamine (ZnCO3) in carbonate sediments; other forms of zinc are usually products of the oxidation of sphalerite.Footnote 22,Footnote 33

During 1984, the zinc content of ores and concentrates produced in Canada was 1 207 098 tonnes; domestic zinc consumption was 150 528 tonnes.Footnote 44Canadian zinc reserves in known deposits have been estimated at 20 492 700 tonnes.Footnote 44 The main use for zinc in Canada is for galvanizing iron and steel, which accounted for 40 percent of the zinc consumption in 1984. A further 20 percent went towards the production of brass plumbing and heating fittings, and 15 percent was used in the die-casting industry to produce builders' hardware and automobile fittings.Footnote 55 The remaining consumption of zinc is divided among many industries. Zinc oxide is used in the manufacture of paints, rubber, rayons, yarns, inks, matches, and chemicals; zinc "dust" is used in printing, textile dyeing, and fat purification, and for cementing metals in metallurgical processing; rolled zinc is used in ornamental work and batteries; and zinc salts are used as wood preservatives and pesticides.

Occurrence

Industrial and domestic emissions contribute a considerable quantity of zinc to the air and water environments. In Canada during 1972, primary iron and steel production accounted for the emission of 2690 tonnes of zinc (in the form of zinc oxide) to the atmosphere. Primary copper and nickel production contributed a similar quantity (2290 tonnes). Total industrial emissions of zinc amounted to 6340 tonnes. Fuel combustion from stationary sources (coal and heavy oils) added a further 134 tonnes. Transportation, solid waste incineration, and pesticide application contributed 794, 124, and 1.8 tonnes, respectively. Emissions from all sources for 1972 totalled 7400 tonnes.Footnote 55

In a 1980 study, it was estimated that the annual contribution of zinc to the Canadian environment from natural and anthropogenic sources was 768 000 and 414 000 tonnes, respectively.Footnote 66

Analyses for zinc in airborne particulate matter over urban areas showed concentrations ranging from 0.32 mg/g in Toronto to 5.40 mg/g in Vancouver.Footnote 77Concentrations as high as 6 mg/g were found in dust along Toronto's waterfront.Footnote 88

Analyses of the total suspended particulates in the air over Edmonton during 1978 and 1979 showed a mean concentration of 0.085 µg/m3 with little seasonal variation. During one event in November 1978, the concentration reached 0.6 µg/m3, possibly as a result of fugitive emissions from incinerators.Footnote 99

In a 1982 survey across Ontario, the spatial pattern of precipitation and air quality regarding trace metal content, including zinc, was monitored.Footnote 1010 The mean air concentration of zinc ranged from 0.019 µg/m3 in the south to 0.007 µg/m3 in the north. Similarly, the annual dry deposition of zinc ranged from 1.51 µg/m2 in the south to 0.51 µg/m2 in the north. The mean concentration of zinc in the annual precipitation ranged from 0.0083 mg/L in the south to 0.0055 mg/L in the north.Footnote 88The trace metal concentration across Ontario showed a general decreasing trend from south to north. The quantity of zinc found in precipitation reflects the presence of zinc-emitting operations. The mean concentration of zinc in precipitation near Sudbury, Ontario, during 1972 to 1973 was 0.028 mg/L, but reached 120 mg/L during one rainfall.Footnote 1111 The average concentration of zinc in rain falling in the United States was 0.107 mg/L.Footnote 1212

In unpolluted snow sampled in a remote area of northern Manitoba, the concentrations of zinc were less than 0.001 mg/L.Footnote 1111

The average soil concentration of zinc in Canada is 90 mg/kg.Footnote 77 A similar value was found in soils not associated with sulphide ores in New Brunswick.Footnote 1313The zinc content of representative soils from industrial locations in Canada ranged from 106 to 2095 mg/kg (the maximum value was found in Toronto).Footnote 88 Urban soil samples from Vancouver and Toronto contained 395 and 220 mg/kg, respectively.Footnote 77

The carbonates, oxides, and sulphides of zinc are sparingly soluble, and therefore zinc is present in natural waters at low concentrations. The highly soluble chloride and sulphate salts are hydrolyzed to form the hydroxide and carbonate. Adsorption onto hydrolysate sediments further depletes the levels of dissolved zinc.Footnote 33

The environmental concentration of zinc in Canadian surface waters ranged from 0.001 mg/L to a high of 1.17 mg/L over a 1980 to 1985 sampling period.Footnote 1414 Analysis of several lakes in Ontario (used as sources of drinking water) showed that the mean concentration of zinc was less than 0.010 mg/L.Footnote 1515

In surveys of river water in central and western Canada, it was found that the level of zinc varied widely with both the location and the season. The range was 0.001 to 0.096 mg/L, with maximum levels observed in the Slave River in the Northwest Territories; normally, the concentrations in river water do not exceed 0.04 mg/L.Footnote 1616

The concentration of zinc can be considerably higher in tap water than in surface water because of the leaching of zinc from galvanized pipes, hot water tanks, and brass fittings.Footnote 1717

In a national survey of Canadian drinking water supplies, it was found that the median zinc content in the raw, treated, and distributed water samples rarely exceeded 0.01 mg/L. However, zinc was frequently picked up while passing through the distribution network. In New Brunswick and Saskatchewan, pickup was negligible, whereas in British Columbia and Quebec, pickup was found in over half the distribution systems.Footnote 1818

Recent data from Ontario have corroborated these findings, with zinc in water withdrawn after an overnight stand sometimes reaching levels 100 times greater than that of the treated water. Thus, in Gananoque on the St. Lawrence River, the concentration of zinc after treatment was less than 0.01 mg/L in 1986, whereas the mean concentration at seven stations after an overnight stand was 0.309 mg/L (range: 0.03 to 1.17 mg/L). Water sampled after a five-minute flush had a mean zinc concentration of 0.014 mg/L.Footnote 1515

Because of the nutritional value of zinc, several studies have been undertaken to determine the zinc content of foods and total diets. Two surveys have been carried out to establish the zinc content of representative Canadian diets. These showed that meat, fish, poultry, cereals, oils, and fats have the highest zinc content, with meat, fish, and poultry contributing most to the daily dietary intake.Footnote 1919,Footnote 2020

Canadian Exposure

The average daily intake from a "representative Canadian diet" has been estimated to be between 15.2 and 19.9 mg.Footnote 1919,Footnote 2020 The average daily intake for a "normal" man was reported to be 12 mg,Footnote 77 whereas other estimates of the normal daily intake range from 13.0 to 16.1 mg.Footnote 2121

Based on a 1981 national survey of trace metals in drinking water supplies, it was estimated that the average daily intake of zinc from drinking water for Canadian adults is ≤13.0 µg/day.Footnote 1818 Based on a 1984 study, this value ranged from 33.8 to 97.5 µg/day and was found to be highly dependent on the sampling strategy.Footnote 2222

If the average concentration of zinc in air in Canada is assumed to be 0.035 µg/m3 and the daily respiratory volume 20 m3, then the daily intake from air would be 0.7 µg.

Based on the above considerations, the total daily intake of zinc from food, air, and water is estimated to be about 16 mg, with food contributing over 99 percent of the intake.

Health Considerations

Essentiality

Zinc is an essential element for all living things, including man. Zinc-containing proteins and enzymes are involved in every aspect of metabolism, including the replication and translation of genetic material.Footnote 2323Nearly 200 zinc-containing enzymes have been identified from all species.Footnote 2424 A few of the well-characterized zinc-containing enzymes are carbonic anhydrase, aspartase, transcarbamylase, and alcohol dehydrogenase.

The Recommended Dietary Intake (RDI) for Canadians is 2 mg/day for young infants, 3 to 7 mg/day for children to age 12, and, from the age of 13, 9 mg/day for males and 8 mg/day for females.Footnote 2525 The United States Recommended Daily Allowance (RDA) is 15 mg/day for adults.Footnote 2626

Zinc deficiency is most often found in countries where the primary source of protein is cereal grains. Zinc absorption from these grains may be limited by high phosphate and phytate content.Footnote 2727 Zinc deficiency, however, has also been identified in some children in the United States.Footnote 2828 Zinc deficiency is most likely to occur in segments of the population with high zinc requirements, such as infants, adolescents, and pregnant women.Footnote 2929

General symptoms of zinc deficiency in humans include retarded growth, hypogonadism, anorexia, mental lethargy, skin changes, and night blindness.Footnote 2727Zinc deficiency may also impair the immune system,Footnote 30-32 slow wound healing,Footnote 2727,Footnote 3333 and lead to eczemaFootnote 3434 and acne.Footnote 3535,Footnote 3636 The importance of zinc in brain development and function has also been emphasized.Footnote 3737 Recently it was reported that hyperactive children showed some degree of zinc deficiency.Footnote 3838

Absorption

In humans, zinc is absorbed in the small intestine by a carrier-mediated mechanism.Footnote 3939 The fraction of zinc absorbed is difficult to determine because zinc is also secreted into the gut. Generally, 33 percent is accepted as the average zinc absorption in humans,Footnote 2525,Footnote 4040,Footnote 4141 although zinc may be more bioavailable from drinking water than from food.Footnote 4242 Zinc absorption increases with increasing dietary zinc up to a maximum rate, indicating a saturated carrier-mediated mechanism.Footnote 4343 In addition, zinc status may influence zinc absorption. Zinc-deprived humans absorb this element with increased efficiency, whereas humans on a high-zinc diet show a reduced efficiency of absorption.

Almost 20 regulatory and dietary factors have been reported to influence zinc absorption,Footnote 3939 one of the most important of which is phytate (myoinositol hexaphosphate).Footnote 4444 The bioavailability of zinc from cereals and legumes is greatly reduced by the phytate content of these foods,Footnote 4040,Footnote 4545 although some components of dietary fibre may also reduce zinc absorption.Footnote 4646,Footnote 4747 Phytate, particularly when ingested with calcium,Footnote 4848reduces zinc absorption by forming insoluble precipitates.

At high doses, zinc and iron appear to antagonize each others' absorption.Footnote 4949,Footnote 5050 In addition, excessive levels of both tin and copper in the diet may reduce zinc absorption.Footnote 51-54

Distribution

Zinc absorbed from the intestine is carried to the liver bound to albumin.Footnote 5555 Within the circulatory system, between 80 and 90 percent of the zinc found in whole blood is in the erythrocytes,Footnote 5656 where it is largely bound to carbonic anhydrase.Footnote 4949 The remaining plasma zinc is primarily bound to albumin, although other proteins and free amino acids also bind zinc.Footnote 5757 Only a small fraction of plasma zinc is in the ionic form.

The body tissues high in zinc include bone, liver, kidney, pancreas, retina, and prostate.Footnote 5858,Footnote 5959 Redistribution of zinc can occur under stress.Footnote 6060

Excretion

Zinc is primarily excreted via the gastrointestinal tract; zinc excreted in this way consists of unabsorbed dietary zinc, endogenous zinc secreted into the gastrointestinal tract, and zinc from mucosal cell desquamation.Footnote 6161 Excretory mechanisms contribute to zinc homeostasis; however, regulation of zinc absorption is the major homeostatic mechanism. Under normal circumstances, about 0.5 mg of zinc may be lost in perspiration,Footnote 6262 and about an equal amount is lost in daily urine. Although the kidney nephrons appear capable of secreting and reabsorbing zinc, urinary zinc does not appear to fluctuate with diet.Footnote 6363 High-protein diets, however, are reported to increase urinary zinc.Footnote 6464

Toxicity

Toxicity from dietary zinc has not been reported, although occupational exposureFootnote 6565 or pharmacological interventionsFootnote 6666 can produce symptoms. There have been reports of teratogenic effects in sheepFootnote 6767 and disrupted cholesterol metabolism in man,Footnote 6868,Footnote 6969 both thought to be due to the adverse effects of high zinc concentrations on copper metabolism. The copper status of individuals consuming high-zinc diets, therefore, should be monitored. The immune response in humans is reported to be impaired by excessive zinc intake.Footnote 7070

Other Considerations

Taste threshold tests have shown that 5 percent of the population can taste zinc at about 5 mg/L.Footnote 7171 At a concentration of 40 mg/L, zinc gives water a milky appearance.Footnote 7272

Rationale

  1. Zinc is an essential element for human nutrition. The daily requirement is between 4 and 10 mg depending on age and sex, but pregnant women and new mothers may require up to 16 mg/day. Food constitutes the most important source of zinc. Long-term ingestion of quantities considerably in excess of these amounts has not resulted in adverse effects. Furthermore, because of efficient homeostatic control mechanisms, the occurrence of chronic zinc toxicity is extremely unlikely. A maximum acceptable concentration (MAC) for zinc in drinking water has therefore not been set.
  2. Although surface waters seldom have zinc concentrations greater than 0.1 mg/L, levels in tap water can be considerably higher because of the use of zinc in plumbing materials. Water containing zinc at concentrations in excess of 5.0 mg/L has an undesirable astringent taste and may be opalescent and develop a greasy film on boiling.
  3. The aesthetic objective for zinc in drinking water is therefore ≤5.0 mg/L.

References

Footnotes

Footnote 1

Browing, E. Toxicity of industrial metals. 2nd edition. Butterworths, London. p. 348 (1969).

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Footnote 2

U.S. Environmental Protection Agency. Quality criteria for water. Washington, DC. p. 481 (1976).

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Footnote 3

Hem, J.K. Zinc. In: Study and interpretation of the chemical characteristics of natural water. Geological Survey Water Supply Paper No. 1473, Washington, DC. p. 125 (1970).

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Footnote 4

Gauvin, M.J. Zinc. In: Canadian minerals yearbook. Mineral Resources Branch, Department of Energy, Mines and Resources (1985).

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Footnote 5

Environment Canada. National inventory of sources and emissions of zinc (1972). Internal Report APCD 76-1, Air Pollution Control Directorate, June (1976).

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Footnote 6

Taylor, M.C. and Demayo, A. Zinc. In: Guidelines for surface water quality. Vol. 1. Inorganic chemical substances. Inland Waters Directorate, Water Quality Branch, Environment Canada, Ottawa (1980).

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Footnote 7

Warren, H.V. Some trace element concentrations in various environments. In: Environmental medicine. G.M. Howe and J.A. Loraine (eds.). William Heinemann Medical Books Ltd., London. p. 9 (1973).

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Footnote 8

Van Loon, J.C. Toronto's precipitation analysed for heavy metal content. Water Pollut. Control, 111: 38 (1973).

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Footnote 9

Klemm, R.F. and Gray, J.M.L. A study of the chemical composition of particulate matter and aerosols over Edmonton. Report RMD 82/9, prepared for the Research Management Division by the Alberta Research Council. p. 125 (1982).

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Footnote 10

Chan, W.H., Tang, A.J.S., Chung, D.H.S. and Lusis, M.A. Concentrations and deposition of trace metals in Ontario -- 1982. Water Air Soil Pollut., 29: 373 (1986).

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Footnote 11

Beamish, R.J. and Van Loon, J.C. Precipitation loading of acid and heavy metals to a small acid lake near Sudbury, Ontario. J. Fish. Res. Board Can., 34: 649 (1977).

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Footnote 12

Lazrus, A.L., Lorange, E. and Lodge, J.P. Lead and other metal ions in United States precipitation. Environ. Sci. Technol., 4: 55 (1970).

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Footnote 13

Presant, E.W. and Tupper, W.M. Trace elements in some New Brunswick soils. Can. J. Soil Sci. 45: 305 (1965).

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Footnote 14

National Water Quality Data Bank (NAQUADAT). Water Quality Branch, Inland Waters Directorate, Environment Canada, Ottawa (1985).

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Footnote 15

Ontario Ministry of the Environment. Survey of water quality in the distribution systems, Ontario 1981-1986. Unpublished data (1987).

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Footnote 16

Environment Canada. Detailed surface water quality data, Northwest Territories 1980-1981, Alberta 1980-1981, Saskatchewan 1980-1981, Manitoba 1980-1981. Inland Waters Directorate (1984).

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Footnote 17

National Academy of Sciences. Water quality criteria. Vol. 93. Washington, DC (1972).

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Footnote 18

Méranger, J.C., Subramanian, K.S. and Chalifoux, C. Metals and other elements. Int. J. Assoc. Anal. Chem., 64: 44 (1981).

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Footnote 19

Kirkpatrick, D.C. and Coffin, D.E. The trace metal content of representative Canadian diets in 1970 and 1971. J. Inst. Can. Sci. Technol. Aliment., 7: 56 (1974).

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Footnote 20

Méranger, J.C. and Smith, D.C. The heavy metal content of a typical Canadian diet. Can. J. Public Health, 62: 53 (1972).

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Footnote 21

Hamilton, E.I. Relations between metal elements in man's diet and environmental factors. Trace Subst. Environ. Health, 13: 3 (1979).

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Footnote 22

Méranger, J.C., Subramanian, K.S., Langford, C.H. and Umbrasas, R. Use of an on-site integrated pump sampler for estimation of total daily intake of some metals from tap water. Int. J. Environ. Anal. Chem., 17: 307 (1984).

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Footnote 23

Galdes, A. and Vallee, B.L. Categories of zinc metalloenzymes. Metal Ions Biol. Syst., 15: 2 (1983).

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Footnote 24

O'Dell, B.L. History and status of zinc in nutrition. Fed. Proc.,43:2821 (1984).

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Footnote 25

Department of National Health and Welfare. Recommended nutrient intakes for Canadians. Ottawa (1983).

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Footnote 26

National Academy of Sciences. Recommended daily allowances. 8th edition. Washington, DC (1974).

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Footnote 27

Prasad, A.S. Clinical biochemical and nutritional spectrum of zinc deficiency in human subjects: an update. Nutr. Rev., 41: 197 (1983).

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Footnote 28

Hambridge, K.M. and Walrauens, P.A. In: Trace elements in human health and disease. Vol. 1. A.S. Prasad (ed.). Academic Press, New York, NY. p. 21 (1976).

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Footnote 29

Pleban, P.A., Numerof, B.S. and Wirth, F.H. Trace element metabolism in the fetus and neonate. Clin. Endocrinol. Metab., 14:545 (1985).

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Footnote 30

Fraker, P.S., Haas, S.M. and Luecke, R.W. Effect of zinc deficiency on the immune response of young adult A/J mouse. J.Nutr., 107: 1889 (1977).

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Footnote 31

De Pasquale-Jardieu, P. and Fraker, P.J. Interference in the development of a secondary immune response in mice by zinc deprivation: persistence of effects. J. Nutr., 114: 1762 (1984).

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Footnote 32

Baer, M.T., King, J.C., Tamura, T., Morgen, S., Bradfield, R.B., Weston, W.L. and Daugherty, N.A. Nitrogen utilization, enzyme activity, glucose intolerance and leukocyte chemotaxis in human zinc depletion. Am. J. Clin. Nutr., 41: 1220 (1985).

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Footnote 33

Senapati, A. and Thompson, R.P.H. Zinc deficiency and the prolonged accumulation of zinc in wounds. Br. J. Surg., 72: 583 (1985).

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Footnote 34

David, T.J., Wells, F.E., Sharpe, T.C. and Gibbs, A.C.C. Low serum zinc in children with atopic eczema. Br. J. Dermatol., 111: 597 (1984).

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Footnote 35

Fritzherbert, J.C. Acne vulgaris -- zinc deficiency? Med. J. Aust., 1: 848 (1976).

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Footnote 36

Pohit, J., Saha, K.C. and Pal, B. Zinc status of acne vulgaris patients. J. Appl. Nutr., 37: 18 (1985).

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Footnote 37

Sandstead, H.H. Zinc: essential for brain development and function. Nutr. Rev., 43: 129 (1985).

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Footnote 38

Barlow, P.J. and Sidani, S.A. Metal imbalance and hyperactivity. Acta Pharmacol. Toxicol., 59: 458 (1986).

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Footnote 39

Cousins, R.J. Absorption, transport and hepatic metabolism of copper and zinc: special reference to metallothionine and ceruloplasmin. Physiol. Rev., 65: 238 (1985).

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Footnote 40

Turnlund, J.R., King, J.C., Keyes, W.R., Gong, B. and Michel, M.C. A stable isotope study of zinc absorption in young men: effects of phytate and a-cellulose. Am. J. Clin. Nutr., 40: 1071 (1984).

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Footnote 41

Honstead, J.F. and Brady, D.N. The uptake and retention of 32P and 65Zn from the consumption of Columbia River fish. Health Phys., 13: 455 (1967).

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Footnote 42

Van Barneveld, A.A. and Van Den Hamer, C.J.A. Influence of isotope administration mode and of food consumption on absorption and retention of 65Zn in mice. Trace Subst. Environ. Health, 16: 196 (1983).

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Footnote 43

Steel, L. and Cousins, R.J. Kinetics of zinc absorption by luminally and vascularly perfused rat intestine. Am. J. Physiol., 248: G46 (1985).

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Footnote 44

House, W.A., Welch, R.M. and Van Campen, D.R. Effect of phytic acid on the absorption, distribution and endogenous excretions of zinc in rats. J. Nutr., 112: 941 (1982).

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Footnote 45

O'Dell, B.L. and Savage, J.E. Effect of phytate on zinc availability. Proc. Soc. Exp. Biol. Med., 103: 304 (1960).

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Footnote 46

Reinhold, J.G., Faradji, B., Abade, P. and Ismail-Beigi, F. Decreased absorption of calcium, magnesium, zinc and phosphorus by humans due to increased fiber and phosphorus consumption as wheat bread. J. Nutr., 106: 493 (1976).

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Footnote 47

Kelsay, J.L., Jacob, R.A. and Prather, E.S. Effect of fiber from fruits and vegetables on metabolic responses of human subjects: III --Zinc, copper and phosphorus balances. Am. J. Clin. Nutr., 32: 2307 (1979).

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Footnote 48

Sandstead, J.J., Dintzis, F. and Johnson, L. Influence of diet fiber, phytate and calcium on human zinc absorption. Fed. Proc., 43: 851 (1984).

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Footnote 49

Crofton, R.W., Gvozdanociv, D. and Agget, P.J. A study of the effect of zinc on iron absorption in Man. Proc. Nutr. Soc., 41: 17 (abstr.) (1962).

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Footnote 50

Solomons, N.W. and Jacob, R.A. Studies on the bioavailability of zinc in humans: effect of heme and non-heme iron on absorption of zinc. Am. J. Clin. Nutr., 34: 475 (1981).

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Footnote 51

Valberg, L.S., Flanagan, P.R. and Chamberlain, M.J. Effects of iron, tin and copper on zinc absorption in humans. Am. J. Clin. Nutr., 40:536 (1984).

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Footnote 52

Johnson, M.A., Baier, J.M. and Greger, J.L. Effect of dietary tin on zinc, copper, iron, manganese and magnesium metabolism of adult males. Am. J. Clin. Nutr., 35: 1332 (1982).

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Footnote 53

Van Campen, D.R. Copper interference with the intestinal absorption of zinc-65 by rats. J. Nutr., 97: 104 (1969).

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Footnote 54

Van Campen, D.R. and Scaife, P.U. Zinc interference with coffee absorption in rats. J. Nutr., 91: 473 (1967).

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Footnote 55

Smith, K.T., Failla, M.L. and Cousins, R.J. Identification of albumin as the plasma carriers for zinc absorption by perfused rat intestine. Biochem. J., 184: 627 (1979).

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Footnote 56

Scott, K.T. and Bradwell, A.R. Identification of the serum binding proteins for iron, zinc, cadmium, nickel and calcium. Clin. Chem., 29: 629 (1983).

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Footnote 57

Vallee, B.L., Lewis, H.D., Attschule, M.P. and Gibson, J.G. The relationship between carbonic anhydrase activity and zinc content of erythrocytes in normal, in anemic and other pathological conditions. Blood, 4: 467 (1949).

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Footnote 58

Underwood, E.J. In: Trace elements in human and animal nutrition. 4th edition. E. Underwood (ed.). Academic Press, New York, NY. p. 196 (1977).

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Footnote 59

Halsted, J.A., Smith, J.C. and Irwin, M.I. Conspectus of research on zinc requirements of man. J. Nutr., 104: 345 (1974).

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Footnote 60

Beisel, W.R., Pekarek, R.S. and Wannemacher, R.W., Jr. In: Trace elements in human health and disease. Vol. 1. A.S. Prasad (ed.). Academic Press, New York, NY. p. 87 (1976).

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Footnote 61

Kirchgessner, M. and Weigand, E. Zinc absorption and excretion in nutrition. Metal Ions Biol. Syst., 15: 319 (1983).

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Footnote 62

Prasad, A.S. Clinical, biochemical and nutritional spectrum of zinc deficiency in human subjects: an update. Nutr. Rev., 41: 197 (1983).

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Footnote 63

Abu-Hamdan, D.K., Migdal, S.O., Whitehorse, R., Rabbani, P., Prasad, A.S. and McDonald, F.D. Renal handling of zinc: effect of cysteine infusion. Am. J. Physiol., 241(F): 487 (1981).

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Footnote 64

Greger, J.L. and Snedeker, S.M. Effect of dietary protein and phosphorus levels on the utilization of zinc, copper and manganese by adult males. J. Nutr., 110: 243 (1980).

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Footnote 65

Papp, J.P. Metal fume fever. Postgrad. Med., 43: 160 (1968).

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Footnote 66

Prasad, A.S., Brewer, G.J., Schoomaker, E.B. and Rabbani, P. Hypocupremia induced by zinc therapy in adults. J. Am. Med. Assoc., 240: 2166 (1978).

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Footnote 67

Campbell, J.K. and Mills, C.F. Toxicity of zinc to pregnant sheep. Environ. Res., 20: 1 (1979).

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Footnote 68

Klevay, L.M. Interactions of copper and zinc in cardiovascular disease. Ann. N.Y. Acad. Sci., 355: 140 (1980).

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Footnote 69

Katya-Katya, M., Ensminger, A., Mejean, L. and Derley, G. The effect of zinc supplementation on plasma cholesterol levels. Nutr. Res., 4:663 (1984).

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Footnote 70

Chandra, R.K. Excessive intake of zinc impairs immune responses. J. Am. Med. Assoc., 252: 1443 (1984).

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Footnote 71

Cohen, J.M., Kamphake, L.J., Harris, E.K. and Woodward, R.L. Taste threshold concentrations of metals in drinking water. J. Am. Water Works Assoc., 52: 660 (1960).

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Footnote 72

Anderson, E., Reinhard, C. and Hammel, W. The corrosion of zinc in various waters. J. Am. Water Works Assoc., 26: 49 (1934).

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