<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.2 20190208//EN" "http://jats.nlm.nih.gov/publishing/1.2/JATS-journalpublishing1.dtd"><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" article-type="review-article" dtd-version="1.2" xml:lang="en">
    <front>
        <journal-meta>
            <journal-id journal-id-type="pmc">F1000Research</journal-id>
            <journal-title-group>
                <journal-title>F1000Research</journal-title>
            </journal-title-group>
            <issn pub-type="epub">2046-1402</issn>
            <publisher>
                <publisher-name>F1000 Research Limited</publisher-name>
                <publisher-loc>London, UK</publisher-loc>
            </publisher>
        </journal-meta>
        <article-meta>
            <article-id pub-id-type="doi">10.12688/f1000research.160148.2</article-id>
            <article-categories>
                <subj-group subj-group-type="heading">
                    <subject>Review</subject>
                </subj-group>
                <subj-group>
                    <subject>Articles</subject>
                </subj-group>
            </article-categories>
            <title-group>
                <article-title>Heavy Metal Contamination: Sources, Health Impacts, and Sustainable Mitigation Strategies with Insights from Nigerian Case Studies</article-title>
                <fn-group content-type="pub-status">
                    <fn>
                        <p>[version 2; peer review: 2 approved with reservations]</p>
                    </fn>
                </fn-group>
            </title-group>
            <contrib-group>
                <contrib contrib-type="author" corresp="yes">
                    <name>
                        <surname>Laoye</surname>
                        <given-names>Babafemi</given-names>
                    </name>
                    <role content-type="http://credit.niso.org/">Conceptualization</role>
                    <role content-type="http://credit.niso.org/">Resources</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Original Draft Preparation</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Review &amp; Editing</role>
                    <uri content-type="orcid">https://orcid.org/0000-0003-0903-754X</uri>
                    <xref ref-type="corresp" rid="c1">a</xref>
                    <xref ref-type="aff" rid="a1">1</xref>
                </contrib>
                <contrib contrib-type="author" corresp="no">
                    <name>
                        <surname>Olagbemide</surname>
                        <given-names>Peter</given-names>
                    </name>
                    <role content-type="http://credit.niso.org/">Resources</role>
                    <role content-type="http://credit.niso.org/">Supervision</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Original Draft Preparation</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Review &amp; Editing</role>
                    <uri content-type="orcid">https://orcid.org/0000-0003-4127-8132</uri>
                    <xref ref-type="aff" rid="a1">1</xref>
                </contrib>
                <contrib contrib-type="author" corresp="no">
                    <name>
                        <surname>Ogunnusi</surname>
                        <given-names>Tolulope A.</given-names>
                    </name>
                    <role content-type="http://credit.niso.org/">Resources</role>
                    <role content-type="http://credit.niso.org/">Supervision</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Original Draft Preparation</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Review &amp; Editing</role>
                    <xref ref-type="aff" rid="a1">1</xref>
                </contrib>
                <contrib contrib-type="author" corresp="no">
                    <name>
                        <surname>Akpor</surname>
                        <given-names>Oghenerobor B.</given-names>
                    </name>
                    <role content-type="http://credit.niso.org/">Conceptualization</role>
                    <role content-type="http://credit.niso.org/">Resources</role>
                    <role content-type="http://credit.niso.org/">Supervision</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Original Draft Preparation</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Review &amp; Editing</role>
                    <uri content-type="orcid">https://orcid.org/0000-0002-4256-1549</uri>
                    <xref ref-type="aff" rid="a1">1</xref>
                </contrib>
                <aff id="a1">
                    <label>1</label>Department of Biological Sciences, Afe Babalola University, Afe Babalola University, Ado-Ekiti, Ekiti, 360101, Nigeria</aff>
            </contrib-group>
            <author-notes>
                <corresp id="c1">
                    <label>a</label>
                    <email xlink:href="mailto:babafemif@abuad.edu.ng">babafemif@abuad.edu.ng</email>
                </corresp>
                <fn fn-type="conflict">
                    <p>No competing interests were disclosed.</p>
                </fn>
            </author-notes>
            <pub-date pub-type="epub">
                <day>18</day>
                <month>2</month>
                <year>2025</year>
            </pub-date>
            <pub-date pub-type="collection">
                <year>2025</year>
            </pub-date>
            <volume>14</volume>
            <elocation-id>134</elocation-id>
            <history>
                <date date-type="accepted">
                    <day>14</day>
                    <month>2</month>
                    <year>2025</year>
                </date>
            </history>
            <permissions>
                <copyright-statement>Copyright: &#x00a9; 2025 Laoye B et al.</copyright-statement>
                <copyright-year>2025</copyright-year>
                <license xlink:href="https://creativecommons.org/licenses/by/4.0/">
                    <license-p>This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
                </license>
            </permissions>
            <self-uri content-type="pdf" xlink:href="https://f1000research.com/articles/14-134/pdf"/>
            <abstract>
                <p>Heavy metal contamination has gradually become a very much important significant global issue due to its continual existence in the environment and bioaccumulation in the ecosystems, posing deleterious risks to human health. This review aims to investigate the sources, pathways, and toxicological impacts of heavy metals such as cadmium, lead, mercury, and arsenic, elucidating their health consequences and plausible mitigation strategies. Furthermore, the review explores the dual origins of heavy metal contamination; natural geological processes and anthropogenic activities such as industrial emissions, mining, and agricultural practices. These heavy metals sip into soil, water, and food chains, leading to bioaccumulation, bio-magnification and causing significant health risks, including cardiovascular diseases, neurological disorders, and reproductive toxicity. Additionally, the addition of indigenous case studies from Nigeria, such as lead poisoning in Zamfara State and contamination in the Great Kwa River of Cross Rivers State underscores the disproportionate impact of heavy metal pollution in developing nations. These case studies reveal the socio-economic and environmental dimensions of the issue, providing a contextual understanding of region-specific vulnerabilities and health outcomes. To address these problems, the review evaluates already existing mitigation strategies, including chelation therapy and phytoremediation, while proposing sustainable, cost-effective solutions for reducing exposure and mitigating impacts. It emphasizes the importance of integrative approaches involving policy, community engagement, and technological innovations to fight heavy metal contamination effectively. In conclusion, this seminar contributes to the understanding of heavy metal toxicity, giving and showcasing very much important insights into the sources and health implications of contamination. By integrating theoretical perspectives with practical solutions, this review provides a robust framework for informing policy makers and advancing sustainable environmental management practices.</p>
            </abstract>
            <kwd-group kwd-group-type="author">
                <kwd>Heavy metal; Phytoremediation; DNA; Cadmium; Lead; Arsenic; Mecury Anthropogenic; Bioaccumulation; Bio-magnification.</kwd>
            </kwd-group>
            <funding-group>
                <funding-statement>The author(s) declared that no grants were involved in supporting this work.</funding-statement>
            </funding-group>
        </article-meta>
        <notes>
            <sec sec-type="version-changes">
                <label>Revised</label>
                <title>Amendments from Version 1</title>
                <p>In this version, the conclusion has been revised and limitations of the review indicated. In addition, the introduction has been amended.</p>
            </sec>
        </notes>
    </front>
    <body>
        <sec id="sec1" sec-type="intro">
            <title>1. Introduction</title>
            <p>Heavy metals are naturally occurring elements with a relatively high density present in the ecosystem (
                <xref ref-type="bibr" rid="ref65">De Carvalho Machado and Dinis-Oliveira, 2023</xref>; 
                <xref ref-type="bibr" rid="ref21">Ali and Khan, 2018</xref>). They are popularly known as metals of environmental concern (
                <xref ref-type="bibr" rid="ref151">Kothapalli, 2021</xref>; 
                <xref ref-type="bibr" rid="ref232">Rahman and Singh, 2020</xref>). Heavy metal pollution or contamination in water is one of the most consequential environmental issues (
                <xref ref-type="bibr" rid="ref183">Mishra 

                    <italic toggle="yes">et al.</italic>, 2019</xref>). This is due to the sturdiness of heavy metals, which cannot be consumed by the body, and the danger they pose to the health of humans contaminated water with heavy metals is used for irrigating crops, and during the rainy season, the water fills groundwater sources, contaminating the drinking water. Thus, heavy metals present in the crops, groundwater, and drinking water lead to several health risks (
                <xref ref-type="bibr" rid="ref306">Vielee and Wise Jr, 2023</xref>; 
                <xref ref-type="bibr" rid="ref305">Vetrimurugan 

                    <italic toggle="yes">et al.</italic>, 2017</xref>). Heavy metals are stable and do not break down into less toxic products. Heavy metals bio accumulate in the food chain and can therefore have debilitating impacts on the health of humans (
                <xref ref-type="bibr" rid="ref8">Acharya, 2024</xref>). The complex metabolic machinery in our body is affected by heavy metal pollution or toxicity, leading to negative health manifestations such as hemolytic anemia (
                <xref ref-type="bibr" rid="ref292">Teschke, 2024</xref>), nerve damage (
                <xref ref-type="bibr" rid="ref23">Aljelehawy, 2022</xref>), nausea (
                <xref ref-type="bibr" rid="ref84">Engwa 
                    <italic toggle="yes">et al.</italic>, 2019</xref>) diarrhea (
                <xref ref-type="bibr" rid="ref284">Su 

                    <italic toggle="yes">et al.</italic>, 2023</xref>) and feto-maternal bleeding (
                <xref ref-type="bibr" rid="ref291">Tabassum 

                    <italic toggle="yes">et al.</italic>, 2023</xref>). Lead is toxic to the kidney (
                <xref ref-type="bibr" rid="ref144">Khalaf 

                    <italic toggle="yes">et al.</italic>, 2024</xref>), liver (
                <xref ref-type="bibr" rid="ref55">Chen 

                    <italic toggle="yes">et al.</italic>, 2023</xref>) reproductive and nervous systems of people of all ages. Mainly, lead poisoning in children can cause behavioral and cognitive problems (
                <xref ref-type="bibr" rid="ref108">Gudadhe 

                    <italic toggle="yes">et al.</italic>, 2024</xref>). Inorganic arsenic (iAs) is the most prevalent toxic form of arsenic in drinking water, which increases the rate of skin diseases in humans (
                <xref ref-type="bibr" rid="ref6">Abtahi 

                    <italic toggle="yes">et al.</italic>, 2023</xref>). Cadmium has been implicated to cause hypercalciuria in humans (
                <xref ref-type="bibr" rid="ref207">Obaid 

                    <italic toggle="yes">et al.</italic>, 2023</xref>). A recent review revealed that of this exposure to cadmium in human leads to a 31% increase in risk of lung cancer (
                <xref ref-type="bibr" rid="ref88">Farahmandian 

                    <italic toggle="yes">et al.</italic>, 2024</xref>). Moreso, mercury have been implicated to cause kidney diseases in humans as a result of bioaccumulation (
                <xref ref-type="bibr" rid="ref158">Kumar 

                    <italic toggle="yes">et al.</italic>, 2023</xref>). Also, occupational exposure to chronic viral infections can lead to skin and nasal ulcers, as well as lung cancer (
                <xref ref-type="bibr" rid="ref327">Yasmeen and Hafeez, 2023</xref>) Heavy metals have also been implicated to cause skin pigmentation (
                <xref ref-type="bibr" rid="ref65">de Carvalho, 2023</xref>) skin tumors (
                <xref ref-type="bibr" rid="ref94">Fu and Xi, 2020</xref>) and dermatitis (
                <xref ref-type="bibr" rid="ref18">Alam 

                    <italic toggle="yes">et al.</italic>, 2019</xref>).</p>
            <p>Moreso, it is imperative to be abreast of the rationale and significance of this review shedding light on the impacts of &#x201c;Heavy Metal Contamination on Human Health&#x201d;. Water is very much the most vigorous arsenal for life, however when water is polluted or contaminated with heavy metals like Mercury (Hg), Chromium (Cr), Cadmium (Cd), Pb (lead), As (Arsenic), and Nickel (Ni) it leads to vulnerable diseases such as neural disorders (
                <xref ref-type="bibr" rid="ref272">Singh and Sharma, 2024</xref>), psychosomatic (
                <xref ref-type="bibr" rid="ref292">Teschke, 2024</xref>; 
                <xref ref-type="bibr" rid="ref118">Hosen, 2021</xref>) mental retardation in neonates (
                <xref ref-type="bibr" rid="ref73">D&#x00f3;rea, 2019</xref>) tumorigenesis and even death (
                <xref ref-type="bibr" rid="ref151">Kothapalli, 2021</xref>). Heavy metal contamination cannot be overemphasized heavy contamination in the food chain, e.g. in fish, milk, drinking water, and also crops irrigated with polluted water that accumulate heavy metals (
                <xref ref-type="bibr" rid="ref299">Ugoeze 

                    <italic toggle="yes">et al.</italic>, 2021</xref>). Research have shown that the irrigation water had not only been responsible for the contamination of the crops but also the water sources in the surroundings of the dumping site areas (
                <xref ref-type="bibr" rid="ref206">Nyiramigisha, 2021</xref>). For example, the potential health hazard due to the consumption of contaminated vegetables may arise when the heavy metals are ingested by the consumer (
                <xref ref-type="bibr" rid="ref233">Rai 

                    <italic toggle="yes">et al.</italic>, 2019</xref>), or the soils are contaminated to such an extent that they enter into the food chain, and dietary intake as well as drinking water become further contaminated (
                <xref ref-type="bibr" rid="ref201">Nkwunonwo 

                    <italic toggle="yes">et al.</italic>, 2020</xref>).</p>
            <p>Heavy metals have received considerable attention as a result of too much utilization in different industries, as well as their debilitating injurious impact on human health and the environment (
                <xref ref-type="bibr" rid="ref306">Vielee and Wise Jr, 2023</xref>; 
                <xref ref-type="bibr" rid="ref143">Kaur and Sharma, 2021</xref>). Heavy metal contamination in the ecosystem as an effect human health via different routes, including soil, water, and industrial emissions (
                <xref ref-type="bibr" rid="ref45">Briffa 

                    <italic toggle="yes">et al.</italic>, 2020</xref>). There is a great need to pin point risk populations, and identify plausible avenues and methodology to ameliorate the debilitating effects of heavy metals in our environment.</p>
        </sec>
        <sec id="sec2">
            <title>2. Sources of heavy metal contamination</title>
            <p>In the natural ecosystem, heavy metals are introduced to the environment perpetually from bed rocks and volcanic substances as a result of disintegration of rocks (weathering) (
                <xref ref-type="bibr" rid="ref66">Deng 

                    <italic toggle="yes">et al.</italic>, 2022</xref>). Contamination of heavy metals in the environment is largely due to human interferences (anthropogenic activities) (
                <xref ref-type="bibr" rid="ref60">Christophoridis 

                    <italic toggle="yes">et al.</italic>, 2019</xref>). Anthropogenic heavy metals are derived from (a) industrial activities, including the mining, smelting and refining of ores, steel production, and other metallurgical operations; electrical products manufacturing; product finishing and surface coating such as painting and electroplating; the application of heavy metal-based pesticides; preservation of woods and leather (
                <xref ref-type="bibr" rid="ref176">Marriage and Gjerde, 2024</xref>; 
                <xref ref-type="bibr" rid="ref208">Obasi 

                    <italic toggle="yes">et al.</italic>, 2022</xref>), (b) uncontrolled disposal of effluents and smudges from heavy industries (
                <xref ref-type="bibr" rid="ref81">Elbasiouny 

                    <italic toggle="yes">et al.</italic>, 2021</xref>); household disposal of domestic hazardous wastes (
                <xref ref-type="bibr" rid="ref82">Elbeshbishy and Okoye, 2019</xref>) and (c) other sources such as the disposal of domestic sewage sludge on agricultural land (
                <xref ref-type="bibr" rid="ref160">Latosi&#x0144;ska 

                    <italic toggle="yes">et al.</italic>, 2021</xref>) sewer drop manholes (
                <xref ref-type="bibr" rid="ref314">Wicke 

                    <italic toggle="yes">et al.</italic>, 2021</xref>) and gully traps made of cast iron (
                <xref ref-type="bibr" rid="ref238">Rana 

                    <italic toggle="yes">et al.</italic>, 2024</xref>) welding operations (
                <xref ref-type="bibr" rid="ref3">Abdullahi and Sani, 2020</xref>), motor vehicles, source of emissions (
                <xref ref-type="bibr" rid="ref154">Kryshtopa 

                    <italic toggle="yes">et al.</italic>, 2019</xref>) and second-hand tobacco smoke (
                <xref ref-type="bibr" rid="ref137">Karatela 

                    <italic toggle="yes">et al.</italic>, 2019</xref>).</p>
            <p>Furthermore, besides point sources (mainly from industrial processes), whereas they can also get into the environment from nonpoint sources (from the atmosphere and from the water, land and biomass already contaminated by a previous heavy metals pollution (
                <xref ref-type="bibr" rid="ref310">Wang 

                    <italic toggle="yes">et al.</italic>, 2022a</xref>). When introduced into the environment, heavy metals are exposed to a plethora of environmental processes and are distributed into the atmosphere, water and soil. Once in the environment, heavy metals are either degraded or stored (
                <xref ref-type="bibr" rid="ref72">Dongre, 2021</xref>). The net effect, whether the heavy metals are degraded or accumulated, depends on the duration and the quantity of the release and the difficulty in degrading the compound (
                <xref ref-type="bibr" rid="ref232">Rahman and Singh, 2020</xref>).</p>
            <p>As a result of numerous geochemical, mineral residues and deposits, it is very much difficult to categorize heavy metals. Classifying the source of contamination of heavy metals is very difficult because of the various linkage and interconnectivity of a plethora of courses or regions associated with the same origin and nature. Moreso, research has shown different sources following sources based on mechanism of release (
                <xref ref-type="bibr" rid="ref209">Obasi and Akudinobi, 2020</xref>). It is imperative to understand that heavy metals are present in the earth&#x2019;s crust and are part of the exponential scale of the naturally occurring elements (
                <xref ref-type="bibr" rid="ref21">Ali and Khan, 2018</xref>). The primary source of heavy metals in the environment is the geologic origin of the major and accessory minerals contained in the soil and rocks (
                <xref ref-type="bibr" rid="ref285">Subasinghe 

                    <italic toggle="yes">et al.</italic>, 2022</xref>; 
                <xref ref-type="bibr" rid="ref120">Hultman and Pollard, 2022</xref>).</p>
            <p>Heavy metals are naturally occurring elements and are released in diverse ways from rocks and soils (
                <xref ref-type="bibr" rid="ref37">Bharti and Sharma, 2022</xref>). Weathering, tectonic activity, and pan-genetic processes represent a trio of principal mechanisms of heavy metal geological introduction from primary or secondary minerals (
                <xref ref-type="bibr" rid="ref320">Wu 

                    <italic toggle="yes">et al.</italic>, 2021</xref>).</p>
            <p>Human activities in terms heavy metal release is categorized into two; Essential and non-essential (
                <xref ref-type="bibr" rid="ref49">Campbell and Gailer, 2016</xref>). Essential heavy metals such as copper, zinc, iron, and others are known for their vital role in human health, while non-essential heavy metals such as arsenic, lead, mercury, cadmium, and antimony have been reported to cause a high level of biological toxicity (
                <xref ref-type="bibr" rid="ref184">Mitra 

                    <italic toggle="yes">et al.</italic>, 2022</xref>). Human activities (anthropogenic), mainly industrial processes, have been reported to lead to an increase in the release of non-essential heavy metals into the environment at a dazzling rate, leading to an ecosystem crisis (
                <xref ref-type="bibr" rid="ref174">Mansor 

                    <italic toggle="yes">et al.</italic>, 2024</xref>). Heavy metal poisoning can lead to a variety of illnesses in humans, some potentially lethal, including blood (
                <xref ref-type="bibr" rid="ref330">Zahra 

                    <italic toggle="yes">et al.</italic>, 2017</xref>) and neuromuscular problems (
                <xref ref-type="bibr" rid="ref297">Toledano, 2020</xref>) and many forms of cancer (
                <xref ref-type="bibr" rid="ref145">Khanniri 

                    <italic toggle="yes">et al.</italic>, 2023</xref>). Moreso, as human population increases year in year out, heavy metal pollution never decreases instead it increases significantly, leading to potential health hazards as a result of changes in environmental conditions and demographic trends (
                <xref ref-type="bibr" rid="ref63">Crocetto 

                    <italic toggle="yes">et al.</italic>, 2023</xref>).</p>
            <p>Human beings and the environment is exposed to heavy metals via various sources. Human activities are responsible (anthropogenic activities) for approximately 60% of metal pollution in various terrestrial and aquatic ecosystems throughout the world (
                <xref ref-type="bibr" rid="ref184">Mitra 

                    <italic toggle="yes">et al.</italic>, 2022</xref>; 
                <xref ref-type="bibr" rid="ref186">Mondal, 2023</xref>). The joint precipitation of heavy metals from innate and anthropogenic activities in various environmental spaces has been revealed and reported in various research (
                <xref ref-type="bibr" rid="ref57">Chen 

                    <italic toggle="yes">et al.</italic>, 2021</xref>; 
                <xref ref-type="bibr" rid="ref304">Verma 

                    <italic toggle="yes">et al.</italic>, 2021</xref>; 
                <xref ref-type="bibr" rid="ref17">Akoto and Anning, 2021</xref>; 
                <xref ref-type="bibr" rid="ref163">Li 

                    <italic toggle="yes">et al.</italic>, 2020</xref>). Human activities are the major source of heavy metal pollution globally (
                <xref ref-type="bibr" rid="ref11">Adnan 

                    <italic toggle="yes">et al.</italic>, 2022</xref>; 
                <xref ref-type="bibr" rid="ref233">Rai 

                    <italic toggle="yes">et al.</italic>, 2019</xref>). The two most important anthropogenic sources of heavy metals are as follows: (1) Industrial sources: These sources are responsible for the deterioration of air quality within urban and industrial areas (
                <xref ref-type="bibr" rid="ref249">Roy 

                    <italic toggle="yes">et al.</italic>, 2024</xref>) (2) Non-point sources: Non-point sources are responsible for the overall deposition of heavy metals within the environment (
                <xref ref-type="bibr" rid="ref121">Hussain 

                    <italic toggle="yes">et al.</italic>, 2023</xref>). The focus of this review is to discuss the health impacts of heavy metal contamination in Nigeria. Although there are plethora of research studies that has reported the debilitating but no research has been done over the years to discuss the effects of heavy metals on the health due to contamination from various sources using case studies in the Nigerian environmental context.</p>
            <sec id="sec3">
                <title>2.3 Common heavy metals of concern</title>
                <p>Over the years, research have shown of that several heavy metals are ubiquitously prevalent in the ecosystem, which are of global concern as a result of to their deleterious effects on human health (
                    <xref ref-type="bibr" rid="ref45">Briffa 

                        <italic toggle="yes">et al.</italic>, 2020</xref>). Although, many heavy metals, such as copper (Cu), manganese (Mn), iron (Fe), and zinc (Zn), are essential for normal cellular performance, these metals, however, can also be toxic to the human body when present in excess of the normal concentration (
                    <xref ref-type="bibr" rid="ref128">Jomova 

                        <italic toggle="yes">et al.</italic>, 2022</xref>) Literature has revealed a few popular heavy metals which have shown to cause vicious health effects. Moreso, distinguishing and varying attributes have also been described a plethora of literature (
                    <xref ref-type="bibr" rid="ref182">Meharg and Meharg, 2021</xref>; 
                    <xref ref-type="bibr" rid="ref183">Mishra 
                        <italic toggle="yes">et al.</italic>, 2019</xref>: 
                    <xref ref-type="bibr" rid="ref52">Charkiewicz 
                        <italic toggle="yes">et al.</italic>, 2023</xref>; 
                    <xref ref-type="bibr" rid="ref28">Baig 
                        <italic toggle="yes">et al.</italic>, 2024a</xref>; 
                    <xref ref-type="bibr" rid="ref29">Baig 
                        <italic toggle="yes">et al.</italic>, 2024b</xref>).</p>
                <p>Lead is eccentrically the oldest popularly known and the most surplus heavy metal pollutant/contaminant (
                    <xref ref-type="bibr" rid="ref253">Sable 

                        <italic toggle="yes">et al.</italic>, 2024</xref>) and it is unsusceptible to corrosion under brassy environmental conditions while being easily transformed into various forms at room temperature (
                    <xref ref-type="bibr" rid="ref246">Rihan 

                        <italic toggle="yes">et al.</italic>, 2020</xref>). Over the years, lead has been widely used in gasoline (Collin 

                    <italic toggle="yes">et al.</italic>, 2022), paint (
                    <xref ref-type="bibr" rid="ref51">Charkiewicz and Backstrand, 2020</xref>), water pipelines (
                    <xref ref-type="bibr" rid="ref162">Levin 

                        <italic toggle="yes">et al.</italic>, 2021</xref>), and batteries (
                    <xref ref-type="bibr" rid="ref157">Kumar 

                        <italic toggle="yes">et al.</italic>, 2022</xref>), in the production of cooking utensils (
                    <xref ref-type="bibr" rid="ref155">Kuhangana 

                        <italic toggle="yes">et al.</italic>, 2024</xref>) construction materials (
                    <xref ref-type="bibr" rid="ref71">Dong 

                        <italic toggle="yes">et al.</italic>, 2023</xref>) and the toy industry (
                    <xref ref-type="bibr" rid="ref328">Yazdanfar 

                        <italic toggle="yes">et al.</italic>, 2022</xref>). As a result of this, the primary sources of lead exposure have been from the atmosphere (
                    <xref ref-type="bibr" rid="ref319">Wu 

                        <italic toggle="yes">et al.</italic>, 2022</xref>), water (
                    <xref ref-type="bibr" rid="ref51">Charkiewicz and Backstrand, 2020</xref>), food and drinking water (
                    <xref ref-type="bibr" rid="ref109">Gump 

                        <italic toggle="yes">et al.</italic>, 2020</xref>), contaminated soil and dust (
                    <xref ref-type="bibr" rid="ref280">Stanek 

                        <italic toggle="yes">et al.</italic>, 2020</xref>) or lead-containing consumer products, especially vintage items (
                    <xref ref-type="bibr" rid="ref110">Guney 

                        <italic toggle="yes">et al.</italic>, 2020</xref>) and flaking peeling paints (
                    <xref ref-type="bibr" rid="ref12">Afolayan 

                        <italic toggle="yes">et al.</italic>, 2021</xref>). Also, mercury has been reported in research as a key component of dental amalgam, and arsenic-containing compounds have also been reported being used for chemotherapeutic and insecticidal purposes (
                    <xref ref-type="bibr" rid="ref146">Khatun 

                        <italic toggle="yes">et al.</italic>, 2022</xref>; 
                    <xref ref-type="bibr" rid="ref103">Genchi 

                        <italic toggle="yes">et al.</italic>, 2020b</xref>). Also, mecury and arsenic take part in microbial methylation mechanisms in their inorganic forms which involves the addition of a methyl group to the toxic moiety to form a less toxic, but mainly water-soluble and easily absorbed, methylated compound (
                    <xref ref-type="bibr" rid="ref48">Byeon 

                        <italic toggle="yes">et al.</italic>, 2021</xref>). Precisely, chronic release of inorganic mercury or other organic moieties in the air to disrupt motor and sensory functions leads to the emergence of 
                    <italic toggle="yes">Minamata</italic> disease (
                    <xref ref-type="bibr" rid="ref199">Niede and Benbi, 2022</xref>). In the same vein, subtly, arsenic-laden underground water bombards cereals and tubers to develop a mild form of neurotoxicity in contaminated areas due to long-term arsenic exposure (
                    <xref ref-type="bibr" rid="ref266">Sevak and Pushkar, 2024</xref>), Methylmercury (Me-Hg) in seafood, particularly in pregnant mothers&#x2019; diet, has been implicated to sparks off neurobehavioral symptoms during early development (
                    <xref ref-type="bibr" rid="ref321">Wu 

                        <italic toggle="yes">et al.</italic>, 2024</xref>), and fish and seafood likely account for 90% of Hg exposure in people residing near rivers and lakes (
                    <xref ref-type="bibr" rid="ref303">Vergara 

                        <italic toggle="yes">et al.</italic>, 2024</xref>). Furthermore, Cadmium is a highly toxic non-essential element used in electroplating, the television industry, battery production, and coating agents of iron and steel products (
                    <xref ref-type="bibr" rid="ref253">Sable 

                        <italic toggle="yes">et al.</italic>, 2024</xref>). The major route of human exposure of cadmium is via the ingestion of polluted food, such as rice, shellfish and vegetables (
                    <xref ref-type="bibr" rid="ref332">Zhao 

                        <italic toggle="yes">et al.</italic>, 2023</xref>) or through inhalation of tobacco smoke (
                    <xref ref-type="bibr" rid="ref103">Genchi 

                        <italic toggle="yes">et al.</italic>, 2020b</xref>). Alarminly, a huge proportion of cigarettes are haphazardly intermittently irrigated with cadmium fertilizers, which may subsequently release the heavy metal (cadmium) from tobacco during smoking </p>
            </sec>
            <sec id="sec4">
                <title>3.1 Lead</title>
                <p>In recent years, widespread human exposure to heavy metals has fascinated increasing public awareness to the probable threat to public health (
                    <xref ref-type="bibr" rid="ref230">Qureshi, 2021</xref>). Lead (Pb) has much long been reported by researchers and medical experts to have baleful effects on human health (
                    <xref ref-type="bibr" rid="ref311">Wang 

                        <italic toggle="yes">et al.</italic>, 2022b</xref>). The major sources of lead exposure are environmental lead pollution (
                    <xref ref-type="bibr" rid="ref234">Raj and Das, 2023</xref>). Particularly, there is no safe portal for lead exposure, and the toxicological profile of lead is influenced by the age at exposure, sex (
                    <xref ref-type="bibr" rid="ref97">Gade 

                        <italic toggle="yes">et al.</italic>, 2021</xref>) and genetic polymorphism (
                    <xref ref-type="bibr" rid="ref264">Sekovani&#x0107; 

                        <italic toggle="yes">et al.</italic>, 2020</xref>). Furthermore, lead pollution is an environment-related global health concern, recognized as a public health issue by several global organizations (
                    <xref ref-type="bibr" rid="ref318">WHO, 2023</xref>; 
                    <xref ref-type="bibr" rid="ref193">Muzamil 

                        <italic toggle="yes">et al.</italic>, 2024</xref>; 
                    <xref ref-type="bibr" rid="ref276">S&#x0142;ota 

                        <italic toggle="yes">et al.</italic>, 2022</xref>; 
                    <xref ref-type="bibr" rid="ref210">Obeng-Gyasi, 2019</xref>).</p>
                <p>Metallic lead is relatively unreactive under many conditions (
                    <xref ref-type="bibr" rid="ref166">Liu 

                        <italic toggle="yes">et al.</italic>, 2021</xref>). When heated or subjected to moist air, it can be oxidized and form a variety of inorganic and organic lead compounds, which can further decompose into other lead materials, such as organo-lead and alkyllead (
                    <xref ref-type="bibr" rid="ref200">Nielsen, 2020</xref>). Inorganic and organic lead are the two main species linked with detrimental human health effects (
                    <xref ref-type="bibr" rid="ref42">Borah 

                        <italic toggle="yes">et al.</italic>, 2020</xref>). Due to the long-term presence of lead, in the atmosphere, soil, and water, the exposure of the global population to lead inevitably results in pollution of resources and impacts on the biota (
                    <xref ref-type="bibr" rid="ref189">Mousavi, 

                        <italic toggle="yes">et al.</italic>, 2022</xref>). Occupational exposures have long been closely associated with painters who use paints containing lead pigments and workers exposed to smoke from burning fuels containing added organic halogenated lead (
                    <xref ref-type="bibr" rid="ref313">Wei 

                        <italic toggle="yes">et al.</italic>, 2022</xref>; 
                    <xref ref-type="bibr" rid="ref293">Thangavel 

                        <italic toggle="yes">et al.</italic>, 2022</xref>). In addition to providing extensive exposure to lead, anthropogenic activities have been reported to trigger environmental spills, such as zinc-lead and copper-silver deposits in the Mississippi valley (
                    <xref ref-type="bibr" rid="ref248">Rosa 

                        <italic toggle="yes">et al.</italic>, 2023</xref>). The introduction of Tetraethyl lead (TEL) into gasoline supplies also contributed to significant environmental pollution, with large-scale human exposure (
                    <xref ref-type="bibr" rid="ref259">Sarkar, 2020</xref>). Lead has also been reported to be released from smelters, recycling centers in municipal areas (
                    <xref ref-type="bibr" rid="ref74">Du 

                        <italic toggle="yes">et al.</italic>, 2020</xref>) and young ones have been lead-exposed by previously used sources of drinking water (
                    <xref ref-type="bibr" rid="ref213">Olufemi 

                        <italic toggle="yes">et al.</italic>, 2022</xref>). However, lifestyle choices such as smoking and the use of lead-containing diet fillings have been reported as other means of human exposure to lead. Also research has shown that use of beauty products such as cosmetic products facial creams (
                    <xref ref-type="bibr" rid="ref245">Rico 

                        <italic toggle="yes">et al.</italic>, 2023</xref>) and surfactants containing lead-based chemicals can result in direct lead toxicity without consuming them (
                    <xref ref-type="bibr" rid="ref4">Abed 

                        <italic toggle="yes">et al.</italic>, 2023</xref>).</p>
                <p>Furthermore, in developing countries, increasing occurrences of lead poisoning have been reported and linked to informal or unregulated electronic waste (e-waste) management practices resulting in severe environmental contamination (
                    <xref ref-type="bibr" rid="ref106">Gollakota 

                        <italic toggle="yes">et al.</italic>, 2020</xref>) Through various exposure routes (ingestion, inhalation and dermal exposure), lead pollutants threaten human health (
                    <xref ref-type="bibr" rid="ref195">Natasha 

                        <italic toggle="yes">et al.</italic>, 2020</xref>). Particularly In humans, lead can trigger impacts widely, and these harmful effects are persistent (
                    <xref ref-type="bibr" rid="ref45">Briffa 

                        <italic toggle="yes">et al.</italic>, 2020</xref>), hence, long-term lead accumulated in the body can increase the gravity of the toxic effects with advancing age. Research have shown that lead exposure to humans can affect the following systems negatively; pulmonary (
                    <xref ref-type="bibr" rid="ref312">Wei 

                        <italic toggle="yes">et al.</italic>, 2020</xref>), bone (
                    <xref ref-type="bibr" rid="ref43">Boskabady 

                        <italic toggle="yes">et al.</italic>, 2022</xref>), hepatic and renal systems (
                    <xref ref-type="bibr" rid="ref262">Satarug 

                        <italic toggle="yes">et al.</italic>, 2020</xref>) neurologic (
                    <xref ref-type="bibr" rid="ref80">Eir&#x00f3; 

                        <italic toggle="yes">et al.</italic>, 2021</xref>) cognitive and behaviour system (
                    <xref ref-type="bibr" rid="ref270">Shvachiy 

                        <italic toggle="yes">et al.</italic>, 2020</xref>). Over the years, lead exposure have been reported in a plethora of articles to cause anemia in many individuals (
                    <xref ref-type="bibr" rid="ref308">Wang 

                        <italic toggle="yes">et al.</italic>, 2021</xref>; 
                    <xref ref-type="bibr" rid="ref190">Mukisa 

                        <italic toggle="yes">et al.</italic>, 2020</xref>; 
                    <xref ref-type="bibr" rid="ref133">Kaneko 

                        <italic toggle="yes">et al.</italic>, 2020</xref> ) particularly children being susceptible to the neurotoxic effects (
                    <xref ref-type="bibr" rid="ref46">Brittenham 

                        <italic toggle="yes">et al.</italic>, 2023</xref>) Some of the weighty consequences of chronic exposure are arthritis (
                    <xref ref-type="bibr" rid="ref87">Fang 

                        <italic toggle="yes">et al.</italic>, 2023</xref>) and chronic kidney disease that may lead to renal dysfunction (
                    <xref ref-type="bibr" rid="ref30">Balali-Mood 

                        <italic toggle="yes">et al.</italic>, 2021</xref>). Considering its plausible worrisome effects on the wellbeing of humans and the ecosystem lead exposure is very much a major public health concern globally (
                    <xref ref-type="bibr" rid="ref318">WHO, 2023</xref>).</p>
            </sec>
            <sec id="sec5">
                <title>3.2 Mercury</title>
                <p>Mercury contamination is amongst the most significant and universal pollution problems in the aquatic environment (
                    <xref ref-type="bibr" rid="ref112">Gupta and Yadav, 2024</xref>) It primarily occurs in the aquatic environment (
                    <xref ref-type="bibr" rid="ref168">Luo 

                        <italic toggle="yes">et al.</italic>, 2020</xref>). In industries, huge amounts of effluents containing mercury are discharged as a result of poor industrial operations (pharmaceutical, paint, paper, and other industries), fertilizer industry, landfill leaching, and carbon combustion. Dead zones, otherwise termed as zones of oxygen-depleted water, have been reported to be the repository of huge deposits of inorganic mercury (
                    <xref ref-type="bibr" rid="ref19">AlgarnI 

                        <italic toggle="yes">et al.</italic>, 2023</xref>; 
                    <xref ref-type="bibr" rid="ref129">Jonidi Jafari 

                        <italic toggle="yes">et al.</italic>, 2020</xref>).</p>
                <p>The mercury in the environment rapidly makes its entry into aquatic biota. The mercury is consecutively transported to the aquatic food chain via bioaccumulation (
                    <xref ref-type="bibr" rid="ref254">Saidon 

                        <italic toggle="yes">et al.</italic>, 2024</xref>). Aquatic diet have been reported to contain a huge amount of mercury (
                    <xref ref-type="bibr" rid="ref32">Barone 

                        <italic toggle="yes">et al.</italic>, 2021</xref>) which puts the concept of food from the aquatic environment in doubt. The widespread presence of mercury contaminated fish in all types of water bodies has grave effects on the global aquatic environment, economy, and public health (
                    <xref ref-type="bibr" rid="ref5">Abhishek 

                        <italic toggle="yes">et al.</italic>, 2022</xref>). Therefore, it imperative to fathom the coaction between mercury content in fish and the source of water, fish size, and type of species, well-known poisoning effects, extreme intolerance effects, and treatments. Hence, this review will provide an unbiased interpretation of the effects of heavy metal mercury on global health and the aquatic environment.</p>
            </sec>
            <sec id="sec6">
                <title>3.3 Cadmium</title>
                <p>Cadmium (Cd) is toxic, nonessential, and carcinogenic for humans and animals (
                    <xref ref-type="bibr" rid="ref103">Genchi 

                        <italic toggle="yes">et al.</italic>, 2020b</xref>). Cadmium exposure to the environment is primarily due to anthropogenic activities (
                    <xref ref-type="bibr" rid="ref332">Zhao 

                        <italic toggle="yes">et al.</italic>, 2023</xref>; 
                    <xref ref-type="bibr" rid="ref148">Knoell and Wyatt, 2021</xref>; 
                    <xref ref-type="bibr" rid="ref10">Adil 

                        <italic toggle="yes">et al.</italic>, 2020</xref>), just like every other heavy metals and not much of natural sources exist. Cadmium have been reported to be present in tobacco products , particularly cigarettes (
                    <xref ref-type="bibr" rid="ref69">Dinh 

                        <italic toggle="yes">et al.</italic>, 2021</xref>). Also, cadmium is also present in foods, such as shellfish, rice, mushrooms, drinking water, spinach, and other green leafy vegetables (
                    <xref ref-type="bibr" rid="ref103">Genchi 

                        <italic toggle="yes">et al.</italic>, 2020b</xref>), with rice being one of the major routes of exposure via food. Major sources of cadmium pollution are nonferrous smelters (
                    <xref ref-type="bibr" rid="ref313">Wei 

                        <italic toggle="yes">et al.</italic>, 2022</xref>), industrial production involving cadmium ( 
                    <xref ref-type="bibr" rid="ref286">Suhani 

                        <italic toggle="yes">et al.</italic>, 2021</xref>), incineration of municipal waste and sewage sludges 
                    <xref ref-type="bibr" rid="ref153">Kr&#x00f3;l 

                        <italic toggle="yes">et al.</italic>, 2022</xref>). Research have shown that bio- transfer is the common way for the entry of cadmium into the food web (
                    <xref ref-type="bibr" rid="ref222">Peana 

                        <italic toggle="yes">et al.</italic>, 2022</xref>; 
                    <xref ref-type="bibr" rid="ref289">Sun 

                        <italic toggle="yes">et al.</italic>, 2020</xref>) Cadmium is taken up by the plants and also accumulates in the soil (
                    <xref ref-type="bibr" rid="ref281">Sterckeman and Thomine, 2020</xref>), it is also easily ignored in the environment for a longer time due to its chemical nature and releases gradually unlike other metals. Also, cadmium takes a longer time to degrade in the environment due to its long biological half-life (
                    <xref ref-type="bibr" rid="ref102">Genchi 

                        <italic toggle="yes">et al.</italic>, 2020a</xref>).</p>
                <p>Human exposure to high-level of cadmium have been reported in a plethora of research to leading to severe damage to the liver, kidneys, and lungs (
                    <xref ref-type="bibr" rid="ref261">Satarug, 2012</xref>; 
                    <xref ref-type="bibr" rid="ref44">Branca 

                        <italic toggle="yes">et al.</italic>, 2020</xref>; 
                    <xref ref-type="bibr" rid="ref148">Knoell and Wyatt, 2021</xref>; 
                    <xref ref-type="bibr" rid="ref50">Chandravanshi, 

                        <italic toggle="yes">et al.</italic>, 2021</xref>; 
                    <xref ref-type="bibr" rid="ref215">Owonikoko 

                        <italic toggle="yes">et al.</italic>, 2023</xref>; 
                    <xref ref-type="bibr" rid="ref89">Farh 

                        <italic toggle="yes">et al.</italic>, 2024</xref>). Also, lots of animal studies have shown neurotoxic effects as a result of cadmium exposure (
                    <xref ref-type="bibr" rid="ref44">Branca 

                        <italic toggle="yes">et al.</italic>, 2020</xref>; 
                    <xref ref-type="bibr" rid="ref335">Zhou 

                        <italic toggle="yes">et al.</italic>, 2020</xref>; 
                    <xref ref-type="bibr" rid="ref97">Gade 

                        <italic toggle="yes">et al.</italic>, 2021</xref>; 
                    <xref ref-type="bibr" rid="ref251">Ruczaj and Brz&#x00f3;ska, 2023</xref>; 
                    <xref ref-type="bibr" rid="ref221">Patel 

                        <italic toggle="yes">et al.</italic>, 2021</xref>) Clinical symptoms such as headaches (
                    <xref ref-type="bibr" rid="ref277">S&#x00f6;derholm 

                        <italic toggle="yes">et al.</italic>, 2020</xref>), osteoarthritis (
                    <xref ref-type="bibr" rid="ref92">Frangos and Maret, 2020</xref>; 
                    <xref ref-type="bibr" rid="ref322">Xia 

                        <italic toggle="yes">et al.</italic>, 2022</xref>) dizziness (
                    <xref ref-type="bibr" rid="ref76">Dumpala 

                        <italic toggle="yes">et al.</italic>, 2024</xref>), cough (
                    <xref ref-type="bibr" rid="ref163">Li 

                        <italic toggle="yes">et al.</italic>, 2020</xref> ), bronchitis (
                    <xref ref-type="bibr" rid="ref122">Ibrahimou 

                        <italic toggle="yes">et al.</italic>, 2021</xref>), and fever has been reported via research to be associated with cadmium exposure (
                    <xref ref-type="bibr" rid="ref83">Elmas, 2023</xref>) Furthermore, plausible bone damages have been reported to be caused by cadmium exposure (
                    <xref ref-type="bibr" rid="ref170">Ma 

                        <italic toggle="yes">et al.</italic>, 2022</xref>). Also, research as also emphasized in recent years that low-level chronic cadmium may also lead to kidney damage (
                    <xref ref-type="bibr" rid="ref298">Tsai 

                        <italic toggle="yes">et al.</italic>, 2021</xref>), which primarily focuses on the degree of damage observed in the process of &#x03b2;2-microglobulin excretion and &#x03b1;-glutathione-S-transferase in the urine of human (
                    <xref ref-type="bibr" rid="ref227">Polaka 

                        <italic toggle="yes">et al.</italic>, 2023</xref>). A recent study has revealed that cadmium-induced renal tubulointerstitial injury might ultimately lead to decreased functionality (
                    <xref ref-type="bibr" rid="ref323">Xu 
                        <italic toggle="yes">et al.</italic>, 2021</xref>) Also a plethora of research have revealed that environmental that environmental exposure to cadmium also causes endocrine and hormone-disrupting effects (
                    <xref ref-type="bibr" rid="ref233">Rai 

                        <italic toggle="yes">et al.</italic>, 2019</xref>; 
                    <xref ref-type="bibr" rid="ref164">Li and Li, 2020</xref>; Di Ciaula and 
                    <xref ref-type="bibr" rid="ref196">Nazarian 

                        <italic toggle="yes">et al.</italic>, 2024</xref>; 
                    <xref ref-type="bibr" rid="ref326">Yang 

                        <italic toggle="yes">et al.</italic>, 2024</xref>). A recent study have also revealed that cadmium exposure in humans through inhalation may induce lung cancer (
                    <xref ref-type="bibr" rid="ref161">Lee and Lee, 2024</xref>) and cadmium ingestion through tobacco has been reported to cause oral cancer (
                    <xref ref-type="bibr" rid="ref263">Satir, 2022</xref>). In addition, environmental cadmium may be associated with primary liver cancer (
                    <xref ref-type="bibr" rid="ref62">Cirovic and Satarug, 2024</xref>) Research has also revealed that children exposed to cadmium via dietary intake exhibit lower intelligence than those not exposed (
                    <xref ref-type="bibr" rid="ref132">Kampouri 

                        <italic toggle="yes">et al.</italic>, 2024</xref>).</p>
            </sec>
            <sec id="sec7">
                <title>3.4 Arsenic</title>
                <p>Arsenic is a metalloid which is naturally present lithosphere (
                    <xref ref-type="bibr" rid="ref182">Meharg and Meharg, 2021</xref>). It enters the environment either due to anthropogenic usage or through removal from iron, manganese, and aluminum oxides (
                    <xref ref-type="bibr" rid="ref237">Raju, 2022</xref>). Several anthropogenic sources, such as mining activities, smelting, and burning of fossil fuels, release arsenic into the environment (
                    <xref ref-type="bibr" rid="ref135">Kar, 2022</xref>). Chronic or acute exposure to arsenic have been reported to cause debilitating health effects (
                    <xref ref-type="bibr" rid="ref294">Thankachan 

                        <italic toggle="yes">et al.</italic>, 2023</xref> 
                    <xref ref-type="bibr" rid="ref192">Muzaffar 

                        <italic toggle="yes">et al.</italic>, 2023</xref>; 
                    <xref ref-type="bibr" rid="ref242">Rehman 

                        <italic toggle="yes">et al.</italic>, 2020</xref>). Organo-arsenic compounds dominate arsenic exposure, but these compounds have been reported to transform into inorganic forms and hence more toxic forms in the body (
                    <xref ref-type="bibr" rid="ref301">Valskys 

                        <italic toggle="yes">et al.</italic>, 2022</xref>). Groundwater is the primary source of arsenic exposure (
                    <xref ref-type="bibr" rid="ref187">Monteiro De Oliveira 

                        <italic toggle="yes">et al.</italic>, 2021</xref>), about 21 countries have been found to contain arsenic-ridden drinking water (
                    <xref ref-type="bibr" rid="ref317">WHO, 2022</xref>).</p>
                <p>Chronic exposure to arsenic-rich drinking water may lead to the development of skin lesions (
                    <xref ref-type="bibr" rid="ref235">Rajiv 

                        <italic toggle="yes">et al.</italic>, 2023</xref>; 
                    <xref ref-type="bibr" rid="ref317">WHO, 2022</xref>), internal cancers of the blood vessels (
                    <xref ref-type="bibr" rid="ref231">Rahaman 

                        <italic toggle="yes">et al.</italic>, 2021</xref>) or urinary bladders among others (
                    <xref ref-type="bibr" rid="ref126">Jaafarzadeh 

                        <italic toggle="yes">et al.</italic>, 2023</xref>). This phenomenon have been reflected in a plethora of studies (
                    <xref ref-type="bibr" rid="ref179">Mayer and Goldman, 2016</xref>; 
                    <xref ref-type="bibr" rid="ref156">Kumar and Ghosh, 2019</xref>; 
                    <xref ref-type="bibr" rid="ref231">Rahaman 

                        <italic toggle="yes">et al.</italic>, 2021</xref>; 
                    <xref ref-type="bibr" rid="ref157">Kumar 

                        <italic toggle="yes">et al.</italic>, 2022</xref>; 
                    <xref ref-type="bibr" rid="ref242">Rehman 

                        <italic toggle="yes">et al.</italic>, 2020</xref>; 
                    <xref ref-type="bibr" rid="ref58">Chikkanna 

                        <italic toggle="yes">et al.</italic>, 2019</xref>). Cadmium has been implicated in several biological pathways to cause carcinogenesis (
                    <xref ref-type="bibr" rid="ref222">Peana 

                        <italic toggle="yes">et al.,</italic>
 2022</xref>; 
                    <xref ref-type="bibr" rid="ref336">Zhu and Costa, 2020</xref>; 
                    <xref ref-type="bibr" rid="ref64">Cui 

                        <italic toggle="yes">et al.</italic>, 2021</xref>; 
                    <xref ref-type="bibr" rid="ref169">Luparello, 2021</xref>) including oxidative stress (
                    <xref ref-type="bibr" rid="ref44">Branca 

                        <italic toggle="yes">et al.</italic>, 2020</xref>). mitochondrial DNA damage and apoptosis (
                    <xref ref-type="bibr" rid="ref185">Mohamed, 2022</xref>) impairment of DNA methylation (
                    <xref ref-type="bibr" rid="ref103">Genchi 

                        <italic toggle="yes">et al.</italic>, 2020b</xref>), and changes in methyltransferases (
                    <xref ref-type="bibr" rid="ref288">Sun 

                        <italic toggle="yes">et al.</italic>, 2021</xref>). Moreso, It is acute arsenic exposure can lead to systemic poisoning and ultimately death (
                    <xref ref-type="bibr" rid="ref98">Ganie 

                        <italic toggle="yes">et al.</italic>, 2024</xref>). A single lethal dose of arsenic compounds ranges between 100 to 200 mg (
                    <xref ref-type="bibr" rid="ref57">Chen 

                        <italic toggle="yes">et al.</italic>, 2021</xref>). Symptoms of acute poisoning include diarrhea, poor appetite, extreme tiredness, sores on the skin, numbness, muscle cramps and hair loss (
                    <xref ref-type="bibr" rid="ref241">Rehberg and Rehberg, 2024</xref>) However, acute poisonings from waterborne arsenic exposure are uncommon (
                    <xref ref-type="bibr" rid="ref250">Roy and Edwards, 2022</xref>). Long-term skin exposure may cause skin changes, such as darkening of the skin (
                    <xref ref-type="bibr" rid="ref220">Passeron 

                        <italic toggle="yes">et al.</italic>, 2020</xref>) and the appearance of small &#x201c;corns&#x201d; or &#x201c;warts&#x201d; on the palms soles, and body (
                    <xref ref-type="bibr" rid="ref114">Hamza 

                        <italic toggle="yes">et al.</italic>, 2022</xref>). Also, research studies have revealed plausible effects of arsenic exposure on reproductive health and impaired fetal brain development (
                    <xref ref-type="bibr" rid="ref78">Dutta 

                        <italic toggle="yes">et al.</italic>, 2022</xref>).</p>
            </sec>
        </sec>
        <sec id="sec8">
            <title>4. Routes of human exposure and mechanisms of heavy metal toxicity</title>
            <sec id="sec9">
                <title>4.1 Routes of human exposure to heavy metals</title>
                <p>The avenues through which humans come into contact with heavy metals vary greatly between different contaminants and among different populations. Ingestion represents the main route of exposure for most human population groups (
                    <xref ref-type="bibr" rid="ref130">Kabir 

                        <italic toggle="yes">et al.</italic>, 2022</xref>). Affected individuals generally include those living close to contaminated areas , those accidentally exposed to pollutants and occupationally-exposed individuals . Inhalation (
                    <xref ref-type="bibr" rid="ref45">Briffa 

                        <italic toggle="yes">et al.</italic>, 2020</xref>) and, to a lesser extent, dermal contact may also represent more relevant exposure routes for special populations, such as workers engaged in mining smelting (
                    <xref ref-type="bibr" rid="ref323">Xu 

                        <italic toggle="yes">et al.</italic>, 2021</xref>; 
                    <xref ref-type="bibr" rid="ref163">Li 

                        <italic toggle="yes">et al.</italic>, 2020</xref>) or in the production and application of herbicides, pesticides, and fertilizers . Human exposure to heavy metals includes, at least, ten different interconnected exposure pathways. These pathways include affected food and drinking water resources and lead to the wide distribution of hazardous heavy metals in the tissues, organs, and fluids of the human body (
                    <xref ref-type="bibr" rid="ref333">Zhao 

                        <italic toggle="yes">et al.</italic>, 2022</xref>). Taken together, human intake of heavy metals is driven by lifestyle local environment (
                    <xref ref-type="bibr" rid="ref184">Mitra 

                        <italic toggle="yes">et al.</italic>, 2022</xref>) occupation (
                    <xref ref-type="bibr" rid="ref29">Baig 

                        <italic toggle="yes">et al.</italic>, 2024b</xref>), nutrition and the occurrence and concentration of heavy metals in affected air, water, and soil resources (
                    <xref ref-type="bibr" rid="ref94">Fu and Xi, 2020</xref>).</p>
                <p>Ingestion represents the major pathway of human exposure to heavy metals . A number of food sources contain considerable levels of heavy metals, such as crops grown in heavy metals-contaminated soils (
                    <xref ref-type="bibr" rid="ref47">Bwatanglang 

                        <italic toggle="yes">et al.</italic>, 2022</xref>) fish from mercury-contaminated waters and beverages containing lead carried by deteriorated distribution systems. Human dietary intake typically ranges from approximately 0.1 to 1.0 g/day, with higher intake levels observed in diets rich in seafood and other wild foods. Overall, high daily intakes and the evidence from research suggest that moderate to high levels of heavy metal residues in food and water can trigger significant toxicological effects in humans (
                    <xref ref-type="bibr" rid="ref14">Ahmad 

                        <italic toggle="yes">et al.</italic>, 2021</xref>).</p>
                <p>

                    <bold>a. Ingestion</bold>
                </p>
                <p>The major medium for human exposure to toxic metals is ingestion (
                    <xref ref-type="bibr" rid="ref70">Dippong 

                        <italic toggle="yes">et al.</italic>, 2024</xref>). This is facilitated by the consumption of micro- or macro-nutrients and subsequent accumulation of metals in human food, water, air, or soil (
                    <xref ref-type="bibr" rid="ref136">Kara 

                        <italic toggle="yes">et al.</italic>, 2024</xref>). An acute part usually comes from water used for gardening or agriculture (
                    <xref ref-type="bibr" rid="ref191">Munir 

                        <italic toggle="yes">et al.</italic>, 2021</xref>). Stationary plants take up toxic metals from the soil and enrich the water table, this water is used for cultivating terrestrial and aqueous food as well (
                    <xref ref-type="bibr" rid="ref334">Zheng 

                        <italic toggle="yes">et al.</italic>, 2023</xref>; 
                    <xref ref-type="bibr" rid="ref53">Chaturvedi 

                        <italic toggle="yes">et al.</italic>, 2021</xref>; 
                    <xref ref-type="bibr" rid="ref314">Wicke 

                        <italic toggle="yes">et al.</italic>, 2021</xref>). Research have shown that children are particularly susceptible to soil contamination due to hand-to-mouth activities and due to their low body mass (
                    <xref ref-type="bibr" rid="ref138">Karatela 

                        <italic toggle="yes">et al.</italic>, 2020</xref>) and potential for higher ingestion of air, water, and food in comparison to adults on a body weight basis (
                    <xref ref-type="bibr" rid="ref93">Frings 

                        <italic toggle="yes">et al.</italic>, 2024</xref>; 
                    <xref ref-type="bibr" rid="ref14">Ahmad 

                        <italic toggle="yes">et al.</italic>, 2021</xref>). During pregnancy, the narrow teenaged pelvis tends to concentrate nutrients and lead into mothers&#x2019; bone thickness (
                    <xref ref-type="bibr" rid="ref113">Haeusler et al., 2021</xref>) calcium is rapidly pulled out during menopause. The lead stored in the bones may cause fetal wastage, fertility decrements, and low birth weight (Collin 

                    <italic toggle="yes">et al.</italic>, 2022). Exposure via this route may result in poor breathing and hence directly absorbed through cell membranes of the lung (
                    <xref ref-type="bibr" rid="ref147">Khoshakhlagh 

                        <italic toggle="yes">et al.</italic>, 2024</xref>). Water can also be very high in toxic metals and hence be detrimental to the consumer (
                    <xref ref-type="bibr" rid="ref45">Briffa 

                        <italic toggle="yes">et al.</italic>, 2020</xref>). Food grown near or processed with such commodities from contaminated water will also result in toxic ingestion (
                    <xref ref-type="bibr" rid="ref329">Y&#x00fc;ksel 

                        <italic toggle="yes">et al.</italic>, 2023</xref> ). The taste of water is important to determine when water becomes unfit for human consumption; therefore, heavy metals in solution or in a state of suspension can be ingested through water as drinking water or through food and is vital to prevent water and food pollution (
                    <xref ref-type="bibr" rid="ref180">Mazinder Baruah and Singh, 2022</xref>; 
                    <xref ref-type="bibr" rid="ref278">Sonone 

                        <italic toggle="yes">et al.</italic>, 2020</xref>). Fish rearing in polluted soil, nitrogenized ponds take up metals via food and gill; hence fish as a food can affect the public and should not be cooked and fed to children (
                    <xref ref-type="bibr" rid="ref228">Porretti 

                        <italic toggle="yes">et al.</italic>, 2022</xref>). Fish is a good indicator for bioaccumulation of metals (
                    <xref ref-type="bibr" rid="ref268">Sheikhzadeh and Hamidian, 2021</xref>; 
                    <xref ref-type="bibr" rid="ref225">Pironti 

                        <italic toggle="yes">et al.</italic>, 2021</xref>).</p>
                <p>

                    <bold>b. Inhalation</bold>
                </p>
                <p>Humans are predominantly exposed to toxic heavy metals from a plethora of industries in the surroundings (
                    <xref ref-type="bibr" rid="ref274">Singh 

                        <italic toggle="yes">et al.</italic>, 2023</xref>). Inhalation happens as a result of direct exposure; as a result, it is one of the most hazardous routes (
                    <xref ref-type="bibr" rid="ref327">Yasmeen and Hafeez, 2023</xref>; 
                    <xref ref-type="bibr" rid="ref279">Sonwani 

                        <italic toggle="yes">et al.</italic>, 2021</xref>; 
                    <xref ref-type="bibr" rid="ref159">Kurt and Basaran, 2020</xref>). The heavy metals are present both in particles and in fumes (
                    <xref ref-type="bibr" rid="ref115">Hedberg 

                        <italic toggle="yes">et al.</italic>, 2021</xref>; 
                    <xref ref-type="bibr" rid="ref279">Sonwani 

                        <italic toggle="yes">et al.</italic>, 2021</xref>). Inhalation of particles is more common, although heavy metals are excreted from the system as they are insoluble in water. Heavy metal inhalation have been reported to cause a plethora of disorders that exert their effects on numerous body systems (
                    <xref ref-type="bibr" rid="ref96">Fulke 

                        <italic toggle="yes">et al.</italic>, 2024</xref>). Even if the systemic manifestations are not noticeable at the outset, the disease will ultimately harm other systems, (
                    <xref ref-type="bibr" rid="ref1">Abd Elnabi 

                        <italic toggle="yes">et al.</italic>, 2023</xref>) particularly the central nervous system . Approximately 95% of inhaled lead particles are 1-2 &#x03bc;m in diameter and therefore do not eliminate easily and persist in the body for a long time. Respiratory disturbances can be induced by long-term or higher-lead exposure (
                    <xref ref-type="bibr" rid="ref75">Dumkov&#x00e1; 

                        <italic toggle="yes">et al.</italic>, 2020</xref>). Airborne free cadmium have shown to produce hazardous effects by the respiratory system (
                    <xref ref-type="bibr" rid="ref39">Bhattacharyya 

                        <italic toggle="yes">et al.</italic>, 2023</xref>); conversely, its oxide and chloride have been reported to have no effect (
                    <xref ref-type="bibr" rid="ref102">Genchi 

                        <italic toggle="yes">et al.</italic>, 2020a</xref>). Moreso, exposure to a higher level of cadmium have been reported via literature to cause inflammation and emphysema (
                    <xref ref-type="bibr" rid="ref309">Wang 

                        <italic toggle="yes">et al.</italic>, 2024</xref>). Also, there is strong evidence from literature that heavy metal have impacted workers; revealing nickel refinery workers have been reported to have more nasal and nasal-chronic disorders than non-impacted workers (
                    <xref ref-type="bibr" rid="ref159">Kurt and Basaran, 2020</xref>; 
                    <xref ref-type="bibr" rid="ref290">Syurin and Vinnikov, 2022</xref>). Cadmium sulfate and smoker&#x2019;s cadmium have been revealed to be deleterious to the upper respiratory pathways (
                    <xref ref-type="bibr" rid="ref103">Genchi 

                        <italic toggle="yes">et al.</italic>, 2020b</xref>).</p>
                <p>

                    <bold>c. Dermal contact</bold>
                </p>
                <p>Heavy metals are a growing threat to general public health and exhibit known toxic impacts on humans and the environment (
                    <xref ref-type="bibr" rid="ref184">Mitra 

                        <italic toggle="yes">et al.</italic>, 2022</xref>) Nowadays, heavy metals are scattered in every nook and cranny of the environment (
                    <xref ref-type="bibr" rid="ref9">Adeola, 2020</xref>; 
                    <xref ref-type="bibr" rid="ref158">Kumar 

                        <italic toggle="yes">et al.</italic>, 2023</xref>). The circulation of heavy metals occurs through the air, water, and food cycle, with plants representing the primary source (
                    <xref ref-type="bibr" rid="ref278">Sonone 

                        <italic toggle="yes">et al.</italic>, 2020</xref>). Nonetheless exposure to heavy metals can also be via the skin. The dermal surface area in adults varies from 1.5 to 2 m
                    <sup>2</sup>, whereas in children, the ratio of skin surface area to body weight is higher (
                    <xref ref-type="bibr" rid="ref332">Zhao 

                        <italic toggle="yes">et al.</italic>, 2023</xref>). Hence, children are at a higher risk of exposure to heavy metals in the environment compared to adults (
                    <xref ref-type="bibr" rid="ref334">Zheng 

                        <italic toggle="yes">et al.</italic>, 2023</xref>). Even dust on the floor of houses and soil can cause health problems when inhaled or ingested with food (
                    <xref ref-type="bibr" rid="ref249">Roy 

                        <italic toggle="yes">et al.</italic>, 2024</xref>). The uptake of heavy metals, either through respiration or via the skin, now creates debilitating health hazards (
                    <xref ref-type="bibr" rid="ref79">Edo 

                        <italic toggle="yes">et al.</italic>, 2024</xref>; 
                    <xref ref-type="bibr" rid="ref220">Passeron 

                        <italic toggle="yes">et al.</italic>, 2020</xref>). To determine the significance of dermal contact as a route of human exposure to toxic metals, it is imperative to fathom that wherever required, metal ions must be mobilized from the surface of a contaminant particle that contacts human skin. However, toxic metals are normally present in an oxidized or insoluble state in natural environmental particles (
                    <xref ref-type="bibr" rid="ref258">Saravanan 

                        <italic toggle="yes">et al.</italic>, 2022</xref>).</p>
            </sec>
            <sec id="sec10">
                <title>4.2 Mechanisms of heavy metal toxicity</title>
                <p>Heavy metals exert their toxic effects in a highly complex process with thorough mechanisms which are yet to be understood (
                    <xref ref-type="bibr" rid="ref184">Mitra 

                        <italic toggle="yes">et al.</italic>, 2022</xref>; 
                    <xref ref-type="bibr" rid="ref84">Engwa 

                        <italic toggle="yes">et al.</italic>, 2019</xref>). However, several direct mechanisms have been proven to be involved in exerting the deleterious effects of heavy metals including oxidative stress DNA damage (
                    <xref ref-type="bibr" rid="ref94">Fu and XI, 2020</xref>), membrane damage quenching of in vivo antioxidants (
                    <xref ref-type="bibr" rid="ref226">Pisoschi 

                        <italic toggle="yes">et al.</italic>, 2021</xref>), protein dysfunction and enzyme inactivation (
                    <xref ref-type="bibr" rid="ref30">Balali-Mood 

                        <italic toggle="yes">et al.</italic>, 2021</xref>).</p>
                <p>In an effort to elucidate the mechanisms of metal toxicity, 
                    <xref ref-type="bibr" rid="ref269">Shi 
                        <italic toggle="yes">et al.</italic> (2004)</xref> reported that via oxidative stress, heavy metals were able to form complexes with biological molecules such as lipids, proteins, and DNA, which lead to cell injury by generating or regulating the content of reactive oxygen species (ROS) effects (
                    <xref ref-type="bibr" rid="ref8">Acharya, 2024</xref>; 
                    <xref ref-type="bibr" rid="ref91">Fasae and Abolaji, 2022</xref>). Reduced antioxidant status effects and dysregulation of antioxidant enzymes have been reported to decrease antioxidant status effects and allow formation of free radicals, thus cumulative body injury (
                    <xref ref-type="bibr" rid="ref100">Garc&#x00ed;a-S&#x00e1;nchez 

                        <italic toggle="yes">et al.</italic>, 2020</xref>). Metallic oxides are able to reduce cytochromes and to generate active oxygen species this can further result in cellular levels of adsorption and the resultant genomic deoxyribonucleic acid (DNA) methylation (
                    <xref ref-type="bibr" rid="ref184">Mitra 

                        <italic toggle="yes">et al.</italic>, 2022</xref>). All of the aforementioned mechanisms may gradually results into carcinogenesis. A review by 
                    <xref ref-type="bibr" rid="ref10">Adil 
                        <italic toggle="yes">et al.</italic> (2020)</xref> heavy metals in various cells were able to induce changes in signal transduction pathways, thus alterations in gene expression, DNA repair organelles, cause inflammation, and genotoxic stress. All these changes ultimately lead to carcinogenesis. One highly prominent DNA modifying mechanism that is thought to occur is the generation of ROS. In addition to ROS generation, metals have also been found to have a direct effect on DNA via the formation of metal-DNA adducts where a single base pair is displaced and metal ions then sit in the space created (
                    <xref ref-type="bibr" rid="ref175">Marchi, 2023</xref>).</p>
                <p>

                    <bold>a. Oxidative stress</bold>
                </p>
                <p>The human body has a conglomerate of elements such as heavy metals that perform numerous functions in the body (
                    <xref ref-type="bibr" rid="ref184">Mitra 

                        <italic toggle="yes">et al.</italic>, 2022</xref>: Some metals are essential for the homeostasis of the organisms (REF). while some are toxic when they overly interact and get supplemented in the cells (REF). A plethora of heavy metals such as lead, mercury, arsenic, and cadmium have no specified physiological function (
                    <xref ref-type="bibr" rid="ref30">Balali-Mood 

                        <italic toggle="yes">et al.</italic>, 2021</xref>). Above that, they disrupt numerous enzymatic processes happening inside the body (
                    <xref ref-type="bibr" rid="ref192">Muzaffar 

                        <italic toggle="yes">et al.</italic>, 2023</xref>). The generation of reactive oxygen species (ROS) is noticeable by metals, concerning oxidative stress that ultimately leads to imbalances between the body&#x2019;s antioxidant defense mechanisms and prooxidants (
                    <xref ref-type="bibr" rid="ref13">Afzal 

                        <italic toggle="yes">et al.</italic>, 2023</xref>). In recent years, extensive heavy metal poisoning cases have been reported in a plethora of research (
                    <xref ref-type="bibr" rid="ref111">Guo 

                        <italic toggle="yes">et al.</italic>, 2020</xref>; 
                    <xref ref-type="bibr" rid="ref119">Hu 

                        <italic toggle="yes">et al.</italic>, 2020</xref>; 
                    <xref ref-type="bibr" rid="ref209">Obasi and Akudinobi, 2020</xref>). Hence, it has become an imperative area of research to investigate the source and remediation of heavy metals. Oxidative stress is an unpleasant condition created by the buildup of free radicals or any mismatch between the production of free radicals and application of antioxidants (
                    <xref ref-type="bibr" rid="ref175">Marchi 2023</xref>; 
                    <xref ref-type="bibr" rid="ref177">Martemucci 

                        <italic toggle="yes">et al.</italic>, 2022</xref>). Many pathological and psychological disorders have been reported to have been caused by oxidative stress in the human body (
                    <xref ref-type="bibr" rid="ref152">Kowalczyk 

                        <italic toggle="yes">et al.</italic>, 2021</xref>). It can further spur up numerous acute or chronic diseases (
                    <xref ref-type="bibr" rid="ref316">Wood 

                        <italic toggle="yes">et al.</italic>, 2021</xref>). If the balance between the formation of free radicals and the ability of cells to survive against a redox any of an abnormality in the production of antioxidants surpasses the free radicals, oxidative stress will occur (
                    <xref ref-type="bibr" rid="ref54">Chaudhary 

                        <italic toggle="yes">et al.</italic>, 2023</xref>). In the cells of humans oxidative stress gives rise to the formation of free radical products that are life-threatening to the physiology of the cell (
                    <xref ref-type="bibr" rid="ref330">Zahra 

                        <italic toggle="yes">et al.</italic>, 2017</xref>). Heavy metal toxicity can directly be linked with oxidative stress, either by redox-cycling or by deactivation of antioxidant systems (
                    <xref ref-type="bibr" rid="ref204">Nowicka, 2022</xref>). Antioxidants act as a natural defense system and neutralize excessive production of oxidants in the body due to any plausible agents (
                    <xref ref-type="bibr" rid="ref226">Pisoschi 

                        <italic toggle="yes">et al.</italic>, 2021</xref>).</p>
                <p>

                    <bold>b. DNA damage</bold>
                </p>
                <p>Over the years, several studies, including in vitro and in vivo studies, have shown the direct and indirect genotoxic and cytogenetic effects of several metals (
                    <xref ref-type="bibr" rid="ref257">S&#x00e1;nchez-Alarc&#x00f3;n 

                        <italic toggle="yes">et al.</italic>, 2021</xref>). Damage of DNA can be caused by metals such as Ni, NiO, and NiSO4 (
                    <xref ref-type="bibr" rid="ref102">Genchi 

                        <italic toggle="yes">et al.</italic>, 2020a</xref>). DNA damage have been investigated in irradiated and non-irradiated cells/nickel-containing solution, revealing he results of this study showed that DNA strand breaks, induced by nickel-titanium (NiTi) and pure nickel under the presence of ultraviolet light caused the result of the synergy between the UV light and the nickel (
                    <xref ref-type="bibr" rid="ref300">Uma&#x00f1;a 

                        <italic toggle="yes">et al.</italic>, 2024</xref>). The mechanism(s) leading to nicking of DNA by nickel is not yet fully understood in the scientific world understood, but studies have shown that nickel binding to chromatin can affect the structure of the DNA and greatly increase susceptibility to strand scission by stripping the histone proteins from the chromatin (
                    <xref ref-type="bibr" rid="ref140">Kasprzak, 2023</xref>; 
                    <xref ref-type="bibr" rid="ref264">Sekovani&#x0107; 

                        <italic toggle="yes">et al.</italic>, 2020</xref>).</p>
                <p>Heavy metal-induced DNA damage is a serious risk factor for many human health issues, including cancer (
                    <xref ref-type="bibr" rid="ref216">Paithankar 

                        <italic toggle="yes">et al.</italic>, 2021</xref>), aging (
                    <xref ref-type="bibr" rid="ref306">Vielee and Wise JP Jr 

                        <italic toggle="yes">.</italic>, 2023</xref>), and neurodegenerative diseases (
                    <xref ref-type="bibr" rid="ref282">Stoccoro and Copped&#x00e8;, 2024</xref>). The damaging effect of exposure to metal ions and other nonessential metals on DNA has been investigated in many in vitro and in vivo studies (
                    <xref ref-type="bibr" rid="ref243">Ren 

                        <italic toggle="yes">et al.</italic>, 2024</xref>; 
                    <xref ref-type="bibr" rid="ref140">Kasprzak, 2023</xref>; 
                    <xref ref-type="bibr" rid="ref91">Fasae and Abolaji, 2022</xref>; 
                    <xref ref-type="bibr" rid="ref275">Slobodian 

                        <italic toggle="yes">et al.</italic>, 2021</xref>; 
                    <xref ref-type="bibr" rid="ref223">Peana 

                        <italic toggle="yes">et al.</italic>, 2021</xref>). The negative effects of heavy metals on genetic material occur mainly at four major levels: cytotoxic, genotoxic, mutagenic, and carcinogenic, depending on the exposure dose, duration, and concentration (
                    <xref ref-type="bibr" rid="ref77">Dutta and Ruden, 2024</xref>; 
                    <xref ref-type="bibr" rid="ref282">Stoccoro and Copped&#x00e8;, 2024</xref>; 
                    <xref ref-type="bibr" rid="ref184">Mitra 

                        <italic toggle="yes">et al.</italic>, 2022</xref>).</p>
                <p>

                    <bold>c. Protein dysfunction</bold>
                </p>
                <p>Changes in protein expression and phosphorylation have been reported in several tissues after exposure to heavy metals (
                    <xref ref-type="bibr" rid="ref186">Mondal, 2023</xref>; 
                    <xref ref-type="bibr" rid="ref173">Mansoor 

                        <italic toggle="yes">et al.</italic>, 2023</xref>; 
                    <xref ref-type="bibr" rid="ref244">Renu 

                        <italic toggle="yes">et al.</italic>, 2021</xref>; 
                    <xref ref-type="bibr" rid="ref94">Fu and Xi 

                        <italic toggle="yes">et al.</italic>, 2020</xref>). The human body has several classes of proteins, including enzymes with well-conserved active sites, transmembrane proteins, signal transduction proteins, or transporters that heavy metals may bind to, disrupting their function (
                    <xref ref-type="bibr" rid="ref247">Riziotis and Thornton, 2022</xref>). Consequently, heavy metal-binding proteins may not be released from the transporter or receptor, forming a new entity that may continuously send signal transduction, resulting in persistent acute or chronic contamination, e.g. lead intoxication , Furthermore, some proteins have been reported to be sensitive to heavy metals (
                    <xref ref-type="bibr" rid="ref224">Pillai 

                        <italic toggle="yes">et al.</italic>, 2020</xref>). Although, the effect that heavy metals have on proteins is not always very much clear but there may be a catalytic role for the heavy metals, for example Cd have been reported to collapse the structure of the hemoglobin tetramer, leading to the release of free alpha plus Cd and beta chains (
                    <xref ref-type="bibr" rid="ref224">Pillai 

                        <italic toggle="yes">et al.</italic>, 2020</xref>).</p>
                <p>Furthermore, cadmium have been implicated to affect the enzymatic function of several proteins, including kinases, transcription factors, and metalloprotease (
                    <xref ref-type="bibr" rid="ref186">Mondal, 2023</xref>). Chronic exposure of patients (humans) to cadmium (i.e., Cd-induced itai-itai disease) has been reported by medical experts (
                    <xref ref-type="bibr" rid="ref78">Dutta 

                        <italic toggle="yes">et al.</italic>, 2022</xref>; 
                    <xref ref-type="bibr" rid="ref255">Sakurai 

                        <italic toggle="yes">et al.</italic>, 2023</xref>) and sporadically accelerating breakdown of postmenopausal women bone by inhibiting the function of matrix metalloproteases, which stimulates bone formation and thus exacerbates the hypercalciuretic effect on the body (
                    <xref ref-type="bibr" rid="ref61">Ciosek 

                        <italic toggle="yes">et al.</italic>, 2023</xref> 
                    <xref ref-type="bibr" rid="ref239">Rastgar 

                        <italic toggle="yes">et al.</italic>, 2022</xref>). Also, lead exposure have shown to cause causes amino acid substitution and increased expression of heavy metal-responsive proteins, accompanied by the induction of heme oxygenase-1 (
                    <xref ref-type="bibr" rid="ref134">Kapoor 

                        <italic toggle="yes">et al.</italic>, 2021</xref>; 
                    <xref ref-type="bibr" rid="ref113">Haeusler 
                        <italic toggle="yes">et al.</italic> 2021</xref>).</p>
            </sec>
        </sec>
        <sec id="sec11">
            <title>5. Health effects of heavy metal exposure and case studies</title>
            <p>Throughout the regions of the world, humans are habitually exposed to various toxic metals via water, food, and air (
                <xref ref-type="bibr" rid="ref219">Parui 

                    <italic toggle="yes">et al.</italic>, 2024</xref>). In the Homo sapiens species these metals are known to bioaccumulate and biomagnify thereby leading to injury in a plethora of body systems (
                <xref ref-type="bibr" rid="ref217">Parida and Patel 2023</xref>; 
                <xref ref-type="bibr" rid="ref267">Shah and Kumar, 2022</xref>; 
                <xref ref-type="bibr" rid="ref265">Semwal 

                    <italic toggle="yes">et al.</italic>, 2022</xref>). High level of heavy metal in the blood may result into a negative cardiovascular effects with individuals showing signs like increase in heart rate (
                <xref ref-type="bibr" rid="ref184">Mitra 

                    <italic toggle="yes">et al.</italic>, 2022</xref>) and arterial stiffness (
                <xref ref-type="bibr" rid="ref307">Wan 

                    <italic toggle="yes">et al.</italic>, 2023</xref>). Some heavy metals that can cross the blood-brain barrier induce neurotoxic effects such as neuropathy and cognitive dysfunction or encephalopathy (
                <xref ref-type="bibr" rid="ref273">Singh and Sharma, 2021</xref>; 
                <xref ref-type="bibr" rid="ref28">Baig 

                    <italic toggle="yes">et al.</italic>, 2024a</xref>). Other non-neurotoxic symptoms, such as gastric erosion and vomiting, increase the mortality risk for poisonings and septicemia when exposed to high levels (
                <xref ref-type="bibr" rid="ref217">Parida and Patel 2023</xref>; 
                <xref ref-type="bibr" rid="ref35">Benhalima 

                    <italic toggle="yes">et al.</italic>, 2023</xref>).</p>
            <p>Long-term exposure to lead and cadmium is the most common causes of chronic kidney disease and is significantly associated with decreased estimated glomerular filtration rate, consistent with the underlying pathology of chronic kidney disease (
                <xref ref-type="bibr" rid="ref262">Satarug 

                    <italic toggle="yes">et al.</italic>, 2020</xref>). In pregnant mothers, babies, research has shown that at a level of mercury in the form of methylmercury of 1 ppm can result into numerous inappropriate effects on brain development (
                <xref ref-type="bibr" rid="ref95">Fujimura and Usuki, 2022</xref>). Also, research has shown via animal experimental studies that low accumulation of heavy metals in tissues can cause adverse effects on the reproductive system such as sperm quality (
                <xref ref-type="bibr" rid="ref116">Heidari 

                    <italic toggle="yes">et al.</italic>, 2021</xref>) hormone levels, mutations, sperm necrosis, fertilization capacity and pregnancy . However, some cases of human death have been reported via due to oral exposure to heavy metals (
                <xref ref-type="bibr" rid="ref283">Street 

                    <italic toggle="yes">et al.</italic>, 2024</xref>; 
                <xref ref-type="bibr" rid="ref94">Fu and Xi, 2020</xref>; 
                <xref ref-type="bibr" rid="ref262">Satarug 

                    <italic toggle="yes">et al.</italic>, 2020</xref> 
                <xref ref-type="bibr" rid="ref30">M Balali-Mood 

                    <italic toggle="yes">et al.</italic>, 2021</xref>). Besides all of these aforementioned effects, heavy metals have also been reported to propagate tumorigenesis, thereby leading to cancer (
                <xref ref-type="bibr" rid="ref45">Briffa 

                    <italic toggle="yes">et al.</italic>, 2020</xref>). A detailed understanding of the mechanisms of improvement and toxicity of heavy metals will help to provide an improved specialized approach.</p>
            <p>Taken together, a plethora of studies have described and shown the toxic effects on the nervous, cardiovascular and reproductive systems after exposure to heavy metals, and also suggest that the administration of heavy metals in medical applications should be viewed by the accumulating body of evidence as a potentially hazardous route ( 
                <xref ref-type="bibr" rid="ref184">Mitra 

                    <italic toggle="yes">et al.</italic>, 2022</xref>; 
                <ext-link ext-link-type="uri" xlink:href="https://scholar.google.com/citations?user=QNAfyXoAAAAJ&amp;hl=en&amp;oi=sra">Taslima</ext-link> 

                <italic toggle="yes">et al.</italic>, 2022). In addition, these heavy metal-induced diseases have deleterious impact on the quality of life of individuals (
                <xref ref-type="bibr" rid="ref45">Briffa 

                    <italic toggle="yes">et al.</italic>, 2020</xref>).</p>
            <sec id="sec12">
                <title>5.1 Neurological effects</title>
                <p>The deleterious effects observed by the effects of heavy metals may be in the form of neurodevelopmental disorders like autism (
                    <xref ref-type="bibr" rid="ref41">B&#x0142;a&#x017c;ewicz and Grabrucker, 2022</xref>) and attention deficit/hyperactivity disorders (
                    <xref ref-type="bibr" rid="ref107">Gu 

                        <italic toggle="yes">et al.</italic>, 2024</xref>). Medical experts have reported cognitive impairments in patients and seizures as a result of heavy metal contamination (Singh and Sharma). Along with these, changes in the level of some neurotransmitters like acetylcholine, noradrenaline, and dopamine in humans as a result of heavy metal accumulation (
                    <xref ref-type="bibr" rid="ref229">Pyatha 

                        <italic toggle="yes">et al.</italic>, 2023</xref>). Hence, suggesting that neurotoxicity has a huge health effect which should be considered at heavy metal-contaminated sites (
                    <xref ref-type="bibr" rid="ref29">Baig 

                        <italic toggle="yes">et al.</italic>, 2024b</xref>). Also, Heavy metals are known to act as neurotoxicants to all age groups of humans (
                    <xref ref-type="bibr" rid="ref97">Gade 

                        <italic toggle="yes">et al.</italic>, 2021</xref>). Exposure to heavy metals during pregnancy have been reported to result into various neurodevelopmental disorders in children (
                    <xref ref-type="bibr" rid="ref124">Ijomone 

                        <italic toggle="yes">et al.</italic>, 2020</xref>; 
                    <xref ref-type="bibr" rid="ref117">Heng 

                        <italic toggle="yes">et al.</italic>, 2022</xref>; 
                    <xref ref-type="bibr" rid="ref68">Ding 

                        <italic toggle="yes">et al.</italic>, 2023</xref>; 
                    <xref ref-type="bibr" rid="ref90">Farmani 

                        <italic toggle="yes">et al.</italic>, 2024</xref>; 
                    <xref ref-type="bibr" rid="ref197">Nehzomi and Shirani, 2024</xref>). The cognitive functions of exposed children have been reported to be pathetic (
                    <xref ref-type="bibr" rid="ref68">Ding 

                        <italic toggle="yes">et al.</italic>, 2023</xref>). Lead has been implicated to cause as a result of exposure in children (
                    <xref ref-type="bibr" rid="ref218">Parithathvi 

                        <italic toggle="yes">et al.</italic>, 2024</xref>). About 1 in 100 children has autism of people have been diagnosed with autism (
                    <xref ref-type="bibr" rid="ref197">Nehzomi and Shirani, 2024</xref>; 
                    <xref ref-type="bibr" rid="ref318">WHO, 2023</xref>). A study shows that children with autism spectrum disorder have lifted harbors of various heavy metals-small molecular weight proteins such as zinc and copper (
                    <xref ref-type="bibr" rid="ref41">B&#x0142;a&#x017c;ewicz and Grabrucker, 2022</xref>). In recent literature, mercury, lead, arsenic and cadmium have emerged as the two most common heavy metals linked to attention deficit hyper activity disorder (ADHD) in recent literature (
                    <xref ref-type="bibr" rid="ref78">Dutta 

                        <italic toggle="yes">et al.</italic>, 2022</xref>). The deficiency in zinc in the body of the individual is responsible. Noradrenergic and dopaminergic dysfunction have also been reported in heavy metal neurotoxicity (
                    <xref ref-type="bibr" rid="ref181">Medda 

                        <italic toggle="yes">et al.</italic>, 2020</xref>). Other forms of toxicity reported via literature in terms of prolonged exposure, is a decrease in the level of acetylcholine, which leads to cognitive and behavioral alterations (
                    <xref ref-type="bibr" rid="ref24">Althobaiti, 2024</xref>). Apart from all of these, effects like Parkinsonism, depression and anxiety have also been reported in recent studies (
                    <xref ref-type="bibr" rid="ref184">Mitra 

                        <italic toggle="yes">et al.</italic>, 2022</xref>; 
                    <xref ref-type="bibr" rid="ref302">Vellingiri 

                        <italic toggle="yes">et al.</italic>, 2022</xref>; 
                    <xref ref-type="bibr" rid="ref28">Baig 

                        <italic toggle="yes">et al.</italic>, 2024a</xref>; 
                    <xref ref-type="bibr" rid="ref296">Tizabi 

                        <italic toggle="yes">et al.</italic>, 2024</xref>). The presence of genotoxicity on neurological systems of patients on exposure to heavy metals has also been reported via literature (
                    <xref ref-type="bibr" rid="ref282">Stoccoro and Copped&#x00e8;, 2024</xref>). Taken together, neurotoxicity is basically one of the important endpoints for site assessment and clean-up goals, and immediate action should be taken to prevent heavy metal exposure.</p>
            </sec>
            <sec id="sec13">
                <title>5.2 Cardiovascular effects</title>
                <p>Animal studies of heavy metals have revealed cardiovascular effects (
                    <xref ref-type="bibr" rid="ref278">Sonone 

                        <italic toggle="yes">et al.</italic>, 2020</xref>; 
                    <xref ref-type="bibr" rid="ref184">Mitra 

                        <italic toggle="yes">et al.</italic>, 2022</xref>). This strongly indicates an association between heavy metals and the development of hypertension or hypertension-induced end-organ damage. Cadmium is the most widely studied heavy metal with respect to cardiovascular toxicity (
                    <xref ref-type="bibr" rid="ref99">Garai 

                        <italic toggle="yes">et al.</italic>, 2021</xref>). Experimental studies suggest that Cd in a general population is associated with atherosclerosis or peripheral arterial disease (
                    <xref ref-type="bibr" rid="ref33">Barregard 

                        <italic toggle="yes">et al.</italic>, 2021</xref>). Also, lead has been implicated in numerous processes associated with cellular stimulation leading to atherosclerotic plaque formation (
                    <xref ref-type="bibr" rid="ref165">Libby, 2021</xref>), as well as affecting the integrity of blood vessel walls through neurotoxic and cardiotoxic effects (
                    <xref ref-type="bibr" rid="ref236">Rajpoot 

                        <italic toggle="yes">et al.</italic>, 2024</xref>). The mechanism that shows the effects of another heavy metal, arsenic, on cardiovascular health is yet to be understood. In a study that included some Bangladesh&#x2019;s rural community members as well as individuals from a more general (urban as well as rural) health center, the authors reported an exposure-response relation between arthritis and heavy metal exposure, particularly for inorganic arsenic (
                    <xref ref-type="bibr" rid="ref59">Choi 

                        <italic toggle="yes">et al.</italic>, 2011</xref>). Taken together, evidence suggests that agricultural tasks can inadvertently lead to the uptake of high levels of heavy metals and that these heavy metals may act in a discriminatory nature, targeting the meninges and/or dopaminergic system, culminating in Parkinson&#x2019;s disease.</p>
            </sec>
            <sec id="sec14">
                <title>5.3 Reproductive effects</title>
                <p>Reproductive structures are very much imperative not only for existence of an individual but also for growth, enlargement and multiplication (
                    <xref ref-type="bibr" rid="ref178">Mass&#x00e1;nyi 

                        <italic toggle="yes">et al.</italic>, 2020</xref>). The response of reproductive organs to toxic substances differs from that of other target organs, and they may serve as an ideal measurement for the deleterious effects of environmental contamination on animal and human health (
                    <xref ref-type="bibr" rid="ref178">Mass&#x00e1;nyi 

                        <italic toggle="yes">et al.</italic>, 2020</xref>). Heavy metal exposure can cause a plethora of deleterious effects on the reproductive region of human health (
                    <xref ref-type="bibr" rid="ref96">Fulke 

                        <italic toggle="yes">et al.</italic>, 2024</xref>). Heavy metals can cause sperm DNA damage and lower sperm quality, thus affecting male fertility (
                    <xref ref-type="bibr" rid="ref167">L&#x00f3;pez-Botella 

                        <italic toggle="yes">et al.</italic>, 2021</xref>) Heavy metals can also disturb sex steroid hormone levels and types of semen, resulting in subfertility (
                    <xref ref-type="bibr" rid="ref36">Bhardwaj 

                        <italic toggle="yes">et al.</italic>, 2021</xref>). On the other hand, lead, cadmium, and mercury can damage the ovaries of females who are then further at the risk of giving birth to anatomically or neurologically malformed offspring because of heavy metal-induced prenatal effects (
                    <xref ref-type="bibr" rid="ref325">Yan 

                        <italic toggle="yes">et al.</italic>, 2023</xref>). During the entire process of maturation of sperm, the cells are exposed to generated reactive oxygen species. This excessive exposure can lead to oxidative stress resulting in sperm DNA damage (
                    <xref ref-type="bibr" rid="ref101">Gautam 

                        <italic toggle="yes">et al.</italic>, 2024</xref>), which can be one of the reasons for making sperm immobile. Lead has been reported in literature to disrupt sex steroid homeostasis in human circulation (
                    <xref ref-type="bibr" rid="ref141">Kasten-Jolly and Lawrence, 2017</xref>). Lower levels of luteinizing hormone, progesterone, and 17OH-progesterone have been linked with an increase in cadmium accumulation in testes and seminal plasma of infertile and asthenospermic men (
                    <xref ref-type="bibr" rid="ref208">Obasi 

                        <italic toggle="yes">et al.</italic>, 2022</xref>). Also, research as shown that once copper gets absorbed into the systemic circulation, it temporarily disrupts spermatozoa production, maturation, and hormonal homeostasis (
                    <xref ref-type="bibr" rid="ref36">Bhardwaj 

                        <italic toggle="yes">et al.</italic>, 2021</xref>). Meta-analysis evidence has revealed that the epididymis is very much sensitive to heavy metal contamination (
                    <xref ref-type="bibr" rid="ref171">Machado-Neves, 2022</xref>). Furthermore, lead and cadmium are endocrine disruptors that harm the male and female reproductive system, thereby disturbing the fertility of humans. Cadmium for example was reported by 
                    <xref ref-type="bibr" rid="ref171">Machado-Neves (2022)</xref> to be deleterious to the epididymis, leading reduction in the weight of the epidermis and reducing the number of sperms. Moreso, aluminum has also been implicated cause reduction in blood level of FSH and LH (
                    <xref ref-type="bibr" rid="ref211">Ojoghoro 

                        <italic toggle="yes">et al.</italic>, 2021</xref>), therefore affecting male fertility (
                    <xref ref-type="bibr" rid="ref20">Ali 

                        <italic toggle="yes">et al.</italic>, 2024</xref>; 
                    <xref ref-type="bibr" rid="ref67">Di Ciaula and Portincasa, 2021</xref>). Similarly in females, heavy metals can cause negative effects in the female reproductive tracts, a recent study by 
                    <xref ref-type="bibr" rid="ref295">Tian 
                        <italic toggle="yes">et al.</italic> (2024)</xref> revealed that lead is highly linked to diminished ovarian reserve at during the reproductive age of females. A plethora of research over the years have implicated cadmium in the reduction of ovaries in females (
                    <xref ref-type="bibr" rid="ref202">Nna 

                        <italic toggle="yes">et al.</italic>, 2017</xref>; 
                    <xref ref-type="bibr" rid="ref194">Nasiadek 

                        <italic toggle="yes">et al.</italic>, 2019</xref>; 
                    <xref ref-type="bibr" rid="ref178">Mass&#x00e1;nyi 

                        <italic toggle="yes">et al.</italic>, 2020</xref>; 
                    <xref ref-type="bibr" rid="ref252">Ruslee 

                        <italic toggle="yes">et al.</italic>, 2020</xref>). Exposure to lead and transfer of lead across the placenta may cause miscarriage in females and subfertility (
                    <xref ref-type="bibr" rid="ref78">Dutta 

                        <italic toggle="yes">et al.</italic>, 2022</xref>). An increased spontaneous abortion rate as a result of lead poisoning has also been reported in animals (
                    <xref ref-type="bibr" rid="ref188">Mosaad 

                        <italic toggle="yes">et al.</italic>, 2024</xref>). Therefore, essential to assess the reproductive health of females areas in the environment likely to be contaminated with heavy metals.</p>
            </sec>
            <sec id="sec15">
                <title>5.4 Itai-Itai disease</title>
                <p>Itai-itai disease is the most popular case of cadmium (Cd) pollution reported in Japan (
                    <xref ref-type="bibr" rid="ref260">Sasaki 

                        <italic toggle="yes">et al.</italic>, 2024</xref>). The term 
                    <italic toggle="yes">"itai-itai"</italic> is from a Japanese word which means &#x201c;it hurts, it hurts&#x201d; in English vocabulary (
                    <xref ref-type="bibr" rid="ref131">Kaji, 2015</xref>). Around 1500 people had severe symptoms such as liver damage, osteomalacia, and bone deformities during the initial phase of the outbreak. Mostly women were the victims, and the male to female ratio of the patients was 1:2 or 1:3 (
                    <xref ref-type="bibr" rid="ref142">Kasuya, 2000</xref>) Furthermore, The damage it caused in the Jinzu River basin (Japan) and surrounding areas in Toyama Prefecture was recorded by Kozukue as early as 1981. It was reported that the cause of the itai-itai disease was huge ingestion of rice. Much higher cadmium levels were found in the rice which was consumed by patients than by people living in the non-polluted areas (
                    <xref ref-type="bibr" rid="ref142">Kasuya, 2000</xref>).</p>
                <p>The main clinical symptoms were osteomalacia, renal dysfunctions, and pathological fractures. It was also reported that there were single cases of lung and prostatic cancers among the patients (
                    <xref ref-type="bibr" rid="ref331">Zhang 

                        <italic toggle="yes">et al.</italic>, 2023</xref>). The cases of chemical-induced itai-itai patients, especially, showed severe osteomalacia manifested in similar deformities of the elbow, femoral neck, and knee.</p>
            </sec>
        </sec>
        <sec id="sec16">
            <title>6. Case studies of heavy metal pollution in Nigeria</title>
            <sec id="sec17">
                <title>6.1 A case study at Ondo Town, Nigeria</title>
                <p>In a recent study by 
                    <xref ref-type="bibr" rid="ref214">Orimisan 
                        <italic toggle="yes">et al.</italic> (2024)</xref> investigation of precisely five heavy metals (copper, lead, and nickel iron, cadmium,) were scrutinized in two vegetables (
                    <italic toggle="yes">Talinum triangulare</italic> and 
                    <italic toggle="yes">Chromolaena odorata</italic>) at two dumpsites in Ondo town, Nigeria. A dumpsite located between Ondo Town and Okeigbo was represented as site A and another dumpsite located at Okelaje-Ondo road was represented as Site B. Surprisingly the heavy metal levels identified in and vegetables were below WHO threshold limit with the exception of Cadmium in the control site except for cadmium in site A which was slightly higher. The heavy metals concentration examined in this investigation followed the sequence Fe &gt; Cu &gt; Cd &gt; Ni &gt; Pb for soil from locations A, and Fe &gt; Pb &gt; Cu &gt; Ni &gt; Cd for soil from sites B The dumpsites and the tested two vegetables revealed elevated levels of the heavy metals in comparison to the control area, suggesting a gradual accumulation of these metals in these vegetables. Although the concentration of heavy metals detected in the vegetables in these areas in Ondo town had minimal levels of the selected heavy metals tested, but the fact that they were present in the vegetables is a huge problem, hence may bio accumulate gradually, integrate into the food chain causing chronic debilitating health hazards.</p>
            </sec>
            <sec id="sec18">
                <title>6.2 Case study of Gashua town, Bade Local Government area Yobe</title>
                <p>A study by 
                    <xref ref-type="bibr" rid="ref287">Suleiman 
                        <italic toggle="yes">et al.</italic> (2021)</xref> revealed heavy metal contamination in drinking water at six wards in Bade local government area, Yobe, Nigeria, which was as a turnout of pollution in the environment, ultimately affecting the drinking water in Gahua town Gombe negatively. The level of concentration of the following heavy metals; Iron, Manganese, Cadmium, Cobalt, Copper, Mercury and Nickel in boreholes across six wards the Gashua metropolis were assayed. The wards are as follows; Lawan Musa, Sabon Gari, Sarkin Hausawa Katuzu, Lawan Fannami, and Zango Wards. Water samples collected from eighteen sampling point across six urban wards showed no significant difference in terms of heavy metal contamination. Albeit, 
                    <xref ref-type="bibr" rid="ref287">Suleiman 
                        <italic toggle="yes">et al.</italic> (2021)</xref> suggested that water from some ward were not suitable for drinking because of the huge build up some of the heavy metals that may cause kidney stones or renal failure.</p>
                <p>The mean concentration from the study by 
                    <xref ref-type="bibr" rid="ref287">Suleiman 
                        <italic toggle="yes">et al.</italic> (2021)</xref> for Cadmium showed higher levels in Lawan Fannami, Zango and Lawan Musa wards. Sabon Gari and Lawan Musa revealed higher values of Copper (Cu). Katuzu and Lawan Fannami have higher value of iron concentration that is higher than the acceptable standard, suggesting if precautionary measures are not taken it may lead to hideous diseases which can lead death. Alarmingly, all the six wards from this study have higher value of Lead (Pb) that is higher than the accepted standard using USEPA standard of 0.015 mg/kg. The continuous accumulation of this element may lead to serious health problem such as renal failure and kidney stones. Katuzu ward revealed higher concentration of Manganese (Mn) of 0.27, which is higher than the accepted standard. Zango, Sarkin Hausawa. The mean concentration for Mercury (Hg) shows that they are within acceptable value with no trace in Sabon Gari ward while a higher value in Lawan Fannami ward.</p>
                <p>Taken together, this case study suggests a heavy metal contamination is of great concern in Nigeria owing to the fact that there is the presence of very much common heavy metals that may be injurious to the health and can cause serious havoc to the body of human and may even results into death.</p>
            </sec>
            <sec id="sec19">
                <title>6.3 Case at the Great Kwa River, Calabar</title>
                <p>A recent study by 
                    <xref ref-type="bibr" rid="ref203">Nneoyi-Egbe (2024)</xref> on heavy metal contamination on shrimps and water at the great Kwa river, Calabar Cross River, Nigeria revealed pollution of both the shrimps and water from the Great Kwa River by a plethora of heavy metals, which in turn poses a health risk to aquatic ecosystem and humans. Amongst the heavy metals studied in this research in Calabar, Copper had the highest concentrations in shrimps (33.17 &#x00b1; 0.79 ppm) and chromium water (27.68 &#x00b1; 0.34ppm). The heavy metals were found in higher concentrations in the shrimp than in water, except for manganese which had a significantly (p&lt;0.05) higher concentration in water (15.05 &#x00b1; 0.67ppm) as against 14.02 &#x00b1; 0.93ppm in shrimp).</p>
                <p>The results of the research indicate significant Lead, Cadmium, Nickel, Chromium, Copper and Manganese content in shrimps and water from the Great Kwa River. It is a matter of great concern for both the environment and public health. Heavy metals are known to be toxic and can cause a range of health problems in humans, including neurological disorders, cancer, and kidney damage. Lead, Cadmium, Nickel and Chromium are particularly dangerous because they can accumulate in the body over time and cause chronic health effects. Moreover exposure to these heavy metals is associated with an increased risk of cardiovascular diseases, hypertension, and impaired cognitive function, neurological and behavioral changes, leading to decreased mobility, altered swimming behavior, and reduced foraging abilities. Moreover, lead can accumulate in the tissues of shrimps over time, leading to chronic exposure and bioaccumulation. This can result in bio magnification, a process where the concentration of lead increases as it moves up the food chain, ultimately affecting humans who consume contaminated seafood. Lead contamination in water can also have significant environmental and public health impacts. High levels of lead in water can cause a range of health problems in humans, including developmental delays in children, decreased intelligence quotient, and an increased risk of cardiovascular disease in adults. Taken together, for this case study, heavy metal concentration was present more in Fish than water at the great Kwa river, and this may cause deleterious effect to the humans consuming shrimps and periwinkle in that area.</p>
            </sec>
            <sec id="sec20">
                <title>6.4 Case of lead poisoning in Zamfara state</title>
                <p>Following a report on 6th November 2009, the Zamfara State Ministry of Health confirmed an unprecedented outbreak of child mortality in eight of the fourteen local government areas of the Shinkafi and Bakura communities in Zamfara State, Northern Nigeria. Affected communities were predominantly peasant farmers. (
                    <xref ref-type="bibr" rid="ref27">Augusto 

                        <italic toggle="yes">et al.</italic>, 2021</xref>). The mortality affected 34.6% of the population, with a case fatality rate of 30.5%. Over 52% of those who died were children less than five years old (
                    <xref ref-type="bibr" rid="ref27">Augusto 

                        <italic toggle="yes">et al.</italic>, 2021</xref>). It was further reported that the cause of the deaths was that the children had excessively high levels of lead in their blood. Four to five months later, two sister communities in the Gusau local government area of the state became afflicted as well. These two affected communities are situated away from the six contaminated villages in Bukuyyum and Anka local government areas of Zamfara State (
                    <xref ref-type="bibr" rid="ref2">Abdullahi and Lasisi, 2024</xref>).</p>
            </sec>
            <sec id="sec21">
                <title>6.5 Case of Ogoni, River state</title>
                <p>The Ogoni land is an oil-rich region located in the Niger Delta region of Nigeria. The land and its ethnic group, the Ogoni people, shot to worldwide attention in 1992 when the Nigerian military dictator suppressed a demonstration by the Ogoni people. The Ogoni land can best be described as the treasure or scrap of Nigeria (
                    <xref ref-type="bibr" rid="ref25">Amosu and Adeosun, 2021</xref>). The authorities ordered the arrest and subsequently the trial and execution of nine of the movement&#x2019;s leaders, including the most prominent and their offense was murder (
                    <xref ref-type="bibr" rid="ref212">Okpebenyo 

                        <italic toggle="yes">et al.</italic>, 2023</xref>). They had been convicted on what are generally considered to be false testimony and mishandled evidence. The movement fought against the disregard of environmental best practices by oil prospecting companies that held sway in the Ogoni land (
                    <xref ref-type="bibr" rid="ref212">Okpebenyo 

                        <italic toggle="yes">et al.</italic>, 2023</xref>). Companies developing the area were particularly criticized. Areas were inadequately treated after drilling had been completed, and the local people received little or no benefits from oil prospecting (
                    <xref ref-type="bibr" rid="ref256">Sam 

                        <italic toggle="yes">et al.</italic>, 2022</xref>).</p>
                <p>Many lives have been lost indirectly and directly from the activities of the oil and gas explorers in Ogoni land and other inhabitants near these wells and rigs (
                    <xref ref-type="bibr" rid="ref205">Nwoma and Anyika, 2024</xref>). The entire ecological system of Ogoni land is severely compromised, and the future of the people of Ogoni is shaky. Cases of massive standing surface oil pollution are very visible in numerous places in the area. Ogoni oil has gained a bad reputation among heavy metal users. In some cases, just the mention of the origin of the crude oil is enough to lose a sale or a customer (
                    <xref ref-type="bibr" rid="ref34">Ben, 2022</xref>). Any breakdown of the process control in the industry processing Ogoni crude oil must result in a heavy metal disaster of of world proportions. The Ogoni land can best be described as the treasure or scrap of Nigeria (
                    <xref ref-type="bibr" rid="ref123">Idialu, 2021</xref>).</p>
            </sec>
            <sec id="sec22">
                <title>6.6 Case of Zamfara gold mine cases and the Itakpe Iron ore mine</title>
                <p>Three major goldmines attributed to two distinct lead poisoning epidemics of extraordinary scale and remarkable geological background were recorded in Nigeria in recent history. The first, recorded in Bagega, was in 2010 (
                    <xref ref-type="bibr" rid="ref127">Jamilu, 2023</xref>). In the aftermath of an episode of acute fatal childhood lead poisoning, with more than 400 elevated blood lead levels. What can be described as the second major goldmine activity occurred in Anka Local Government of Zamfara in 2020, with a similarity to the Bagega contamination (
                    <xref ref-type="bibr" rid="ref7">Abu Khatita, 2024</xref>). Recorded cases of children with elevated blood lead levels have ranged from 24.3% to 60%; over 350 children were reported to have died, and in both of these cases, (
                    <xref ref-type="bibr" rid="ref16">Akinwumi 

                        <italic toggle="yes">et al.</italic>, 2023</xref>; 
                    <xref ref-type="bibr" rid="ref86">Ezechukwu, 2023</xref>; 
                    <xref ref-type="bibr" rid="ref315">Wilde 

                        <italic toggle="yes">et al.</italic>, 2024</xref>) the mining involved grinding and milling of lead-rich ore, exposures from dust inhalation, and other pathways of the soil and water compartments (
                    <xref ref-type="bibr" rid="ref172">Mahdi 

                        <italic toggle="yes">et al.</italic>, 2023</xref>). Yet a third contamination with no epidemic status and of considerably fewer numbers was recorded in the Tsafe area in 2020, and the 2020 official status alone still pins both it and the 2020 exceedance incidences as being among the largest recorded in research that examined this throughout the world (
                    <xref ref-type="bibr" rid="ref139">Kasongo 

                        <italic toggle="yes">et al.</italic>, 2024</xref>). A characteristic that has generally defined gold mining in Nigeria is that the mining and grinding of ore releases airborne dust that contains lead, cadmium, mercury, cyanide, and/or other substances used in the process (
                    <xref ref-type="bibr" rid="ref85">Escobedo-Monge 

                        <italic toggle="yes">et al.</italic>, 2024</xref>).</p>
                <p>Another incident of heavy metal contamination with conditions similar to the case described above occurred at the Itakpe iron ore mine in Nigeria in 1985 (
                    <xref ref-type="bibr" rid="ref15">Akande 

                        <italic toggle="yes">et al.</italic>, 2020</xref>). Geologically, there are suspicions that manganese was present in heavy metal concentrations, both as an oxide and as a carbonate (
                    <xref ref-type="bibr" rid="ref31">Barde 

                        <italic toggle="yes">et al.</italic>, 2024</xref>). The incident affected over 10 km of creeks lying near the exploration mine. The river contained high concentrations of iron and manganese deriving from the presence of iron ore on the plateau (
                    <xref ref-type="bibr" rid="ref125">Isinkaye 

                        <italic toggle="yes">et al.</italic>, 2023</xref>).</p>
            </sec>
        </sec>
        <sec id="sec23">
            <title>7. Heavy metal pollution mitigation strategies</title>
            <p>Mitigation of heavy metal bioaccumulation, contamination and pollution is very much imperative in terms of the environment, as widespread pollution increases human exposure and will definitely cause debilitating effects on the human body. Several strategies exist for the decontamination and removal of heavy metals from both the environment and the human body (
                <xref ref-type="bibr" rid="ref310">Wang 

                    <italic toggle="yes">et al.</italic>, 2022a</xref>; 
                <xref ref-type="bibr" rid="ref152">Kowalczyk 

                    <italic toggle="yes">et al.</italic>, 2021</xref>).</p>
            <p>Since the discovery of the problem of environmentally accumulated heavy metals, various technologies have been developed to reduce or eliminate the concentration of heavy metals that have polluted the soil and water. The three main technologies are in situ stabilization and phytoremediation in the environment and chelation therapy to reduce metal-induced oxidative stress, signal transduction, and organ-specific physiology within human beings (
                <xref ref-type="bibr" rid="ref158">Kumar 

                    <italic toggle="yes">et al.</italic>, 2023</xref>). 
                <italic toggle="yes">&#x2019;In situ&#x2019;</italic> refers to on-site or on-area-site and can be accomplished without removing soil from contaminated sites. Chelation is a demure and direct strategy for scavenging the excess metal ions in vital organs of the body, which shows excellent results in flu treatment. In the environmental field, research focusing on bioaccumulation of metals by plants led to the development of technologies to extract heavy metals from the environment, so-called phytoremediation. Phytoremediation is a green technology and is a site-specific technology, which can ultimately reduce the risk of human exposure to toxic substances and environmental remediation costs. Phytoremediation technology includes phytoextraction, phytodegradation, phytostabilization, rhizofiltration, phytovolatilization, phytostimulation, rhizodegradation, rhizofiltration, and hyperaccumulation (
                <xref ref-type="bibr" rid="ref161">Lee and Lee, 2024</xref>; 
                <xref ref-type="bibr" rid="ref22">Ali, 2023</xref>; 
                <xref ref-type="bibr" rid="ref56">Chen and Costa, 2021</xref>).</p>
            <p>The term phytoremediation is used to describe a set of processes involving the ability of certain plants to remove, degrade, or immobilize a variety of contaminants present in the environment so they are no longer harmful (
                <xref ref-type="bibr" rid="ref324">Yaashikaa 

                    <italic toggle="yes">et al.</italic>, 2022</xref>). In the case of heavy metals, the term was coined by the US EPA in the early 90s to define the &#x201c;use of green plants to remove pollutants from the environment or render them harmless&#x201d;. Phytoremediation is being envisaged as a sustainable approach for in situ remediation of contaminated soils, sediments, and groundwater, due to economic and environmental considerations. This technology can be used to reduce the level of metals in a toxic range for human health and greatly reduce the uptake of these contaminants by plants. In fact, it seems to be effective in plant-only systems, where metals do not accumulate in the food chain, and whenever proper disposal procedures for the harvested material are followed. Since the steel industry is a primary source of contamination by metals and metalloids like chromium, lead, and zinc, good results in terms of removal, stabilization, or reduction can be of interest. In particular, phytoremediation technology appears to be particularly suitable for agricultural substrates or in regions with a view to re-cultivation. Taken together it is very much imperative that safe phytoremediation technology is used to avoid potential harm.</p>
            <p>Chelation therapy is a therapeutic intervention in which chelating agents are administered to individuals for the removal of toxic heavy metals from the body (
                <xref ref-type="bibr" rid="ref40">Bj&#x00f8;rklund 

                    <italic toggle="yes">et al.</italic>, 2020</xref>). Chelating agents are essentially metal binders and remove them from their sites of deposition in the tissues, in this way, the heavy metal toxins are eliminated in the urine (
                <xref ref-type="bibr" rid="ref104">Gerhardsson, 2022</xref>). There are two routes of administration, namely by the oral and parenteral routes, of which the parenteral route is the most effective. Chelation therapy is of benefit in cases of lead and mercury poisoning (
                <xref ref-type="bibr" rid="ref26">Angle, 2023</xref>). Chelation could prevent various toxicological manifestations of heavy metals, thus markedly improving various pathophysiological functions. Chelation therapy has been shown to have successful outcomes in cases of lead overload in patients such as children and pregnant women (
                <xref ref-type="bibr" rid="ref271">Singh 

                    <italic toggle="yes">et al.</italic>, 2021</xref>). However, chelation therapy is ineffective in treating advanced malignancies (
                <xref ref-type="bibr" rid="ref149">Kontoghiorghes, 2022</xref>). Despite such knowledge, chelation therapy has also been reported to be effective in the treatment of other heavy metals in the environmental setting (
                <xref ref-type="bibr" rid="ref105">Glicklich 

                    <italic toggle="yes">et al.</italic>, 2020</xref>).</p>
            <p>Another most common use of chelation therapy is in the treatment of cardiac and cerebral vascular ailments (
                <xref ref-type="bibr" rid="ref240">Ravalli 

                    <italic toggle="yes">et al.</italic>, 2022</xref>). This therapy is aimed at removing the vascular oxidative injury caused by superoxide and hydroxyl anions by binding these mobilized metal ions (Fe2+ and Ca2+) (
                <xref ref-type="bibr" rid="ref150">Kontoghiorghes 

                    <italic toggle="yes">et al.</italic>, 2020</xref>). Lead poisoning is the most common cause of neuropathy, and it usually requires an individual to undergo chelation therapy to excrete lead out (
                <xref ref-type="bibr" rid="ref38">Bhasin 

                    <italic toggle="yes">et al.</italic>, 2023</xref>).</p>
        </sec>
        <sec id="sec24" sec-type="conclusion">
            <title>8. Conclusion</title>
            <p>In conclusion, heavy metals are major sources of contamination and have adverse effects on human health when their levels exceed the regulatory standards. Heavy metal residues in food, water, and air occurs can lead to debilitating health problems, e.g., anemia, cancer, kidney disease and neurologic disorders. The removal of metals from the body appears to be limited and slow and may depend on age, sex, and individual genetic variation. This review has been able to indicate chronic heavy metals across different sectors in Nigeria including recent contamination as in the case of the great Kwa river in Calabar in the year 2024.</p>
            <p>Taken together, several challenges, including bioavailability assessment to predict the potential for heavy metal bioaccumulation and toxicity in humans, and reducing heavy metal intake, legislations to ensure enforcement of existing and future regulatory methods, and encouraging food production in uncontaminated areas, must be addressed by scientists, regulatory bodies, and stakeholders in order to protect human health.</p>
            <p>Additional studies are required to find an effective, quick, and safe method for the removal of these metals. This study was limited to areas agricultural, riverine, and mining and oil exploratory areas and existing technologies were not considered in this review. Future research studies should focus on tracing the sources of heavy metals in the environment to find effective ways to overcome this contamination. Moreover, future practices and policies should focus on the development and implementation of economic strategies to mitigate contamination with toxic heavy metals.</p>
            <sec id="sec25">
                <title>Ethics and consent</title>
                <p>Ethics and consent were not required.</p>
            </sec>
        </sec>
    </body>
    <back>
        <sec id="sec28" sec-type="data-availability">
            <title>Data availability</title>
            <p>No data are associated with this article.</p>
        </sec>
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                    <source>

                        <italic toggle="yes">Carcinogenesis.</italic>
</source>
                    <year>2020</year>;<volume>41</volume>:<fpage>1161</fpage>&#x2013;<lpage>1172</lpage>.
                    <pub-id pub-id-type="pmid">32674145</pub-id>
                    <pub-id pub-id-type="doi">10.1093/carcin/bgaa076</pub-id>
                    <pub-id pub-id-type="pmcid">PMC7513952</pub-id>
                </mixed-citation>
            </ref>
        </ref-list>
    </back>
    <sub-article article-type="reviewer-report" id="report372442">
        <front-stub>
            <article-id pub-id-type="doi">10.5256/f1000research.178309.r372442</article-id>
            <title-group>
                <article-title>Reviewer response for version 2</article-title>
            </title-group>
            <contrib-group>
                <contrib contrib-type="author">
                    <name>
                        <surname>Ullah</surname>
                        <given-names>Qudrat</given-names>
                    </name>
                    <xref ref-type="aff" rid="r372442a1">1</xref>
                    <role>Referee</role>
                    <uri content-type="orcid">https://orcid.org/0000-0003-3881-0917</uri>
                </contrib>
                <aff id="r372442a1">
                    <label>1</label>Agriculture and Food Science, Walailak University (Ringgold ID: 65133), Thai Buri, Nakhon Si Thammarat, Thailand</aff>
            </contrib-group>
            <author-notes>
                <fn fn-type="conflict">
                    <p>
                        <bold>Competing interests: </bold>No competing interests were disclosed.</p>
                </fn>
            </author-notes>
            <pub-date pub-type="epub">
                <day>12</day>
                <month>4</month>
                <year>2025</year>
            </pub-date>
            <permissions>
                <copyright-statement>Copyright: &#x00a9; 2025 Ullah Q</copyright-statement>
                <copyright-year>2025</copyright-year>
                <license xlink:href="https://creativecommons.org/licenses/by/4.0/">
                    <license-p>This is an open access peer review report distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
                </license>
            </permissions>
            <related-article ext-link-type="doi" id="relatedArticleReport372442" related-article-type="peer-reviewed-article" xlink:href="10.12688/f1000research.160148.2"/>
            <custom-meta-group>
                <custom-meta>
                    <meta-name>recommendation</meta-name>
                    <meta-value>approve-with-reservations</meta-value>
                </custom-meta>
            </custom-meta-group>
        </front-stub>
        <body>
            <p>Summary of the Article</p>
            <p> The review article by Laoye et al. explores the critical issue of heavy metal contamination, focusing on its sources, health impacts, and sustainable mitigation strategies, with a particular emphasis on case studies from Nigeria. The authors discuss heavy metals such as lead, mercury, cadmium, and arsenic, detailing their natural and anthropogenic origins, including geological processes and human activities like industrial emissions, mining, and agriculture. The article highlights how these metals enter environmental systems (soil, water, and food chains), leading to bioaccumulation and biomagnification, which pose significant health risks, including cardiovascular diseases, neurological disorders, and cancers. Nigerian case studies, such as lead poisoning in Zamfara State and contamination in the Great Kwa River, provide region-specific insights into the socio-economic and environmental impacts of heavy metal pollution. The review evaluates mitigation strategies like chelation therapy and phytoremediation, advocating for integrative approaches involving policy, community engagement, and technological innovation. The authors conclude that understanding heavy metal toxicity and implementing sustainable solutions are vital for environmental management and public health.</p>
            <p> Detailed Assessment and Recommendations 
                <list list-type="order">
                    <list-item>
                        <p>
                            <bold>Comprehensiveness in the Context of Current Literature (Partly)</bold>
                        </p>
                        <p> The article provides a broad overview of heavy metal contamination, covering sources, health impacts, exposure routes, toxicity mechanisms, and mitigation strategies. It effectively integrates Nigerian case studies, which add contextual relevance and highlight challenges in developing nations. The inclusion of recent references (up to 2024) demonstrates engagement with current literature, and the discussion of specific heavy metals (lead, mercury, cadmium, arsenic) is detailed and well-supported.</p>
                        <p> However, the review could be more comprehensive in several areas: 
                            <list list-type="bullet">
                                <list-item>
                                    <p>
                                        <bold>Global Context</bold>: While the Nigerian case studies are valuable, the article could strengthen its global perspective by comparing these cases with similar incidents in other regions (e.g., Minamata Bay for mercury or arsenic contamination in Bangladesh). This would enhance the universality of the findings and situate the Nigerian experience within a broader framework.</p>
                                </list-item>
                                <list-item>
                                    <p>
                                        <bold>Emerging Research Areas</bold>: The review briefly mentions oxidative stress and DNA damage as toxicity mechanisms but does not explore newer research areas, such as epigenetic effects or the role of the microbiome in heavy metal toxicity. Including these could make the review more forward-looking.</p>
                                </list-item>
                                <list-item>
                                    <p>
                                        <bold>Mitigation Technologies</bold>: The discussion of phytoremediation and chelation therapy is adequate but lacks depth on emerging technologies like nanotechnology or bioremediation using genetically modified organisms. Expanding this section would align the article with cutting-edge developments.</p>
                                </list-item>
                            </list> 
                            <bold>Recommendations</bold>: 
                            <list list-type="bullet">
                                <list-item>
                                    <p>Add a subsection comparing Nigerian case studies with global examples to provide a more comprehensive context.</p>
                                </list-item>
                                <list-item>
                                    <p>Include recent studies on emerging toxicity mechanisms (e.g., epigenetic changes) and cite relevant literature (e.g., studies from 2023&#x2013;2024 on heavy metal epigenetics).</p>
                                </list-item>
                                <list-item>
                                    <p>Expand the mitigation section to cover novel technologies, such as nanomaterial-based remediation, with appropriate citations.</p>
                                </list-item>
                            </list> </p>
                    </list-item>
                    <list-item>
                        <p>
                            <bold>Accuracy and Support of Factual Statements (Yes)</bold>
                        </p>
                        <p> The factual statements in the article appear correct and are well-supported by citations from reputable sources. The authors draw on a wide range of studies (e.g., WHO, 2023; Genchi et al., 2020; Mitra et al., 2022) to substantiate claims about heavy metal sources, health impacts, and mitigation strategies. The Nigerian case studies are grounded in specific incidents (e.g., Zamfara lead poisoning), and the cited references align with the claims made.</p>
                        <p> 
                            <bold>Observation</bold>: While the citations are robust, some sections (e.g., mechanisms of toxicity) rely heavily on older references (e.g., Shi et al., 2004). Incorporating more recent studies would strengthen the article&#x2019;s currency.</p>
                        <p> 
                            <bold>Recommendation</bold>: 
                            <list list-type="bullet">
                                <list-item>
                                    <p>Review sections like &#x201c;Mechanisms of Heavy Metal Toxicity&#x201d; and update with citations from 2023&#x2013;2024 to reflect the latest understanding of oxidative stress, DNA damage, or other mechanisms.</p>
                                </list-item>
                            </list> </p>
                    </list-item>
                    <list-item>
                        <p>
                            <bold>Accessibility of Language (Yes)</bold>
                        </p>
                        <p> The review is written in clear, accessible language suitable for a broad scientific audience, including researchers, policymakers, and environmental scientists. Technical terms like &#x201c;bioaccumulation,&#x201d; &#x201c;phytoremediation,&#x201d; and &#x201c;oxidative stress&#x201d; are used appropriately and explained implicitly through context, making the article approachable without oversimplification. The structure, with clear headings (e.g., &#x201c;Sources of Heavy Metal Contamination,&#x201d; &#x201c;Health Impacts&#x201d;), aids readability.</p>
                        <p> 
                            <bold>Observation</bold>: Minor typographical errors and awkward phrasing (e.g., &#x201c;sip into soil&#x201d; instead of &#x201c;seep into soil&#x201d; on Page 1) slightly detract from the polished presentation.</p>
                        <p> 
                            <bold>Recommendation</bold>: 
                            <list list-type="bullet">
                                <list-item>
                                    <p>Conduct a thorough proofreading to correct minor errors and improve sentence flow (e.g., revise &#x201c;sip into soil&#x201d; to &#x201c;seep into soil&#x201d; and &#x201c;very much important significant&#x201d; to &#x201c;highly significant&#x201d; on Page 1).</p>
                                </list-item>
                            </list> </p>
                    </list-item>
                    <list-item>
                        <p>
                            <bold>Appropriateness of Conclusions (Partly)</bold>
                        </p>
                        <p> The conclusions emphasize the need for integrative approaches to combat heavy metal contamination, highlighting policy, community engagement, and technological innovation. These are appropriate given the evidence presented and align with the literature&#x2019;s call for multidisciplinary solutions. The focus on Nigerian case studies supports the conclusion&#x2019;s emphasis on region-specific vulnerabilities.</p>
                        <p> However, the conclusions could be strengthened in the following ways: 
                            <list list-type="bullet">
                                <list-item>
                                    <p>
                                        <bold>Specificity</bold>: The conclusion is somewhat general, stating the importance of &#x201c;sustainable environmental management practices&#x201d; without detailing actionable steps or prioritizing strategies based on the Nigerian context. For example, it could specify whether phytoremediation or policy enforcement is more feasible in resource-constrained settings like Nigeria.</p>
                                </list-item>
                                <list-item>
                                    <p>
                                        <bold>Comparison with Other Studies</bold>: The conclusion does not explicitly compare the findings with other reviews, missing an opportunity to highlight what this study uniquely contributes (e.g., the Nigerian case studies).</p>
                                </list-item>
                                <list-item>
                                    <p>
                                        <bold>Limitations</bold>: While Version 2 mentions limitations, the conclusion does not fully address how these (e.g., lack of discussion on certain technologies) impact the proposed strategies.</p>
                                </list-item>
                            </list> 
                            <bold>Recommendations</bold>: 
                            <list list-type="bullet">
                                <list-item>
                                    <p>Revise the conclusion to include specific, prioritized recommendations for Nigeria, such as strengthening regulatory frameworks for mining or scaling up phytoremediation pilot projects.</p>
                                </list-item>
                                <list-item>
                                    <p>Compare the review&#x2019;s findings with other studies to clarify its unique contributions (e.g., how the Nigerian focus adds to global heavy metal research).</p>
                                </list-item>
                                <list-item>
                                    <p>Explicitly address limitations in the conclusion, such as the scope of mitigation strategies discussed, and suggest how future research could fill these gaps.</p>
                                </list-item>
                            </list> </p>
                    </list-item>
                </list> Additional Comments 
                <list list-type="bullet">
                    <list-item>
                        <p>
                            <bold>Nigerian Case Studies</bold>: The inclusion of Zamfara and Great Kwa River case studies is a strength, but more detail on their outcomes (e.g., current status, long-term health impacts, or remediation efforts) would enhance their impact. For instance, what lessons from Zamfara have informed national policy?</p>
                    </list-item>
                    <list-item>
                        <p>
                            <bold>Structure</bold>: The article is well-organized, but a dedicated section on research gaps and future directions (beyond the brief mention in the conclusion) would add value. This could outline unanswered questions, such as the long-term efficacy of phytoremediation in tropical climates.</p>
                    </list-item>
                    <list-item>
                        <p>
                            <bold>Response to Previous Review</bold>: The authors&#x2019; response to Reviewer 1 (Rupesh Kumar) shows they addressed concerns like revising the conclusion and noting limitations. However, their dismissal of alternative technologies (e.g., AI predictive models) as outside the scope seems limiting. While not central, a brief mention of data-driven approaches for monitoring contamination could broaden the mitigation discussion.</p>
                    </list-item>
                </list> Points to Address for Scientific Soundness</p>
            <p> To ensure the article is scientifically sound, the authors must: 
                <list list-type="order">
                    <list-item>
                        <p>Enhance comprehensiveness by comparing Nigerian case studies with global examples and including emerging research areas (e.g., epigenetics, novel remediation technologies).</p>
                    </list-item>
                    <list-item>
                        <p>Update citations in the toxicity mechanisms section with recent studies to maintain currency.</p>
                    </list-item>
                    <list-item>
                        <p>Revise the conclusion to provide specific, actionable recommendations and explicitly address limitations, ensuring alignment with the evidence presented.</p>
                    </list-item>
                    <list-item>
                        <p>Proofread the manuscript to eliminate minor errors and improve clarity.</p>
                    </list-item>
                </list> Approval Status</p>
            <p> 
                <bold>Approved with Reservations</bold>
            </p>
            <p> The article is a valuable contribution to the literature on heavy metal contamination, particularly for its focus on Nigerian case studies and integration of health and mitigation perspectives. However, addressing the above recommendations will improve its comprehensiveness, specificity, and alignment with current research, making it more robust and impactful.</p>
            <p>Is the review written in accessible language?</p>
            <p>Yes</p>
            <p>Are all factual statements correct and adequately supported by citations?</p>
            <p>Yes</p>
            <p>Are the conclusions drawn appropriate in the context of the current research literature?</p>
            <p>Partly</p>
            <p>Is the topic of the review discussed comprehensively in the context of the current literature?</p>
            <p>Partly</p>
            <p>Reviewer Expertise:</p>
            <p>As Qudrat, I specialize in environmental toxicology and public health, with a focus on the impacts of environmental contaminants, such as heavy metals, on human health and ecosystems. My expertise includes assessing sources and pathways of contamination, evaluating toxicological mechanisms (e.g., oxidative stress, bioaccumulation), and reviewing mitigation strategies like phytoremediation and policy interventions. I am well-equipped to evaluate the scientific validity of the article&#x2019;s discussion on heavy metal sources, health effects, and mitigation approaches, as well as its use of Nigerian case studies to highlight regional vulnerabilities. However, I may have limited capacity to assess highly specialized aspects outside my scope, such as advanced biochemical modeling or cutting-edge nanotechnology applications, though these are not central to the article&#x2019;s current content.</p>
            <p>I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.</p>
        </body>
        <back>
            <ref-list>
                <title>References</title>
                <ref id="rep-ref-372442-1">
                    <label>1</label>
                    <mixed-citation publication-type="journal">
                        <person-group person-group-type="author"/>:
                        <article-title>Water Quality Degradation Due to Heavy Metal Contamination: Health Impacts and Eco-Friendly Approaches for Heavy Metal Remediation.</article-title>
                        <source>
                            <italic>Toxics</italic>
                        </source>.<year>2023</year>;<volume>11</volume>(<issue>10</issue>) :
                        <elocation-id>10.3390/toxics11100828</elocation-id>
                        <pub-id pub-id-type="pmid">37888679</pub-id>
                        <pub-id pub-id-type="doi">10.3390/toxics11100828</pub-id>
                    </mixed-citation>
                </ref>
                <ref id="rep-ref-372442-2">
                    <label>2</label>
                    <mixed-citation publication-type="journal">
                        <person-group person-group-type="author"/>:
                        <article-title>Assessment of heavy metal contamination levels and health risks in environmental media in the northeast region</article-title>.
                        <source>
                            <italic>Sustainable Cities and Society</italic>
                        </source>.<year>2022</year>;<volume>80</volume>:
                        <elocation-id>10.1016/j.scs.2022.103796</elocation-id>
                        <pub-id pub-id-type="doi">10.1016/j.scs.2022.103796</pub-id>
                    </mixed-citation>
                </ref>
            </ref-list>
        </back>
        <sub-article article-type="response" id="comment13784-372442">
            <front-stub>
                <contrib-group>
                    <contrib contrib-type="author">
                        <name>
                            <surname>Laoye</surname>
                            <given-names>Babafemi</given-names>
                        </name>
                        <aff>Biological Sciences, Afe Babalola University, Ado Ekiti, Ekiti, Nigeria</aff>
                    </contrib>
                </contrib-group>
                <author-notes>
                    <fn fn-type="conflict">
                        <p>
                            <bold>Competing interests: </bold>The authors have no competing interest(s)</p>
                    </fn>
                </author-notes>
                <pub-date pub-type="epub">
                    <day>22</day>
                    <month>4</month>
                    <year>2025</year>
                </pub-date>
            </front-stub>
            <body>
                <p>
                    <bold>Reviewer&#x2019;s comments</bold>
                </p>
                <p> 
                    <bold>Recommendations</bold>: 
                    <list list-type="bullet">
                        <list-item>
                            <p>Add a subsection comparing Nigerian case studies with global examples to provide a more comprehensive context.</p>
                        </list-item>
                        <list-item>
                            <p>Include recent studies on emerging toxicity mechanisms (e.g., epigenetic changes) and cite relevant literature (e.g., studies from 2023&#x2013;2024 on heavy metal epigenetics).</p>
                        </list-item>
                        <list-item>
                            <p>Expand the mitigation section to cover novel technologies, such as nanomaterial-based remediation, with appropriate citations.</p>
                        </list-item>
                    </list> </p>
                <p> 
                    <bold>Authors&#x2019; response</bold>
                </p>
                <p> This has been harmonized and well attend to in the manuscript.</p>
                <p> </p>
                <p> 
                    <bold>Reviewers&#x2019; comments</bold>
                </p>
                <p> 
                    <bold>Recommendation</bold>:</p>
                <p> Review sections like &#x201c;Mechanisms of Heavy Metal Toxicity&#x201d; and update with citations from 2023&#x2013;2024 to reflect the latest understanding of oxidative stress, DNA damage, or other mechanisms</p>
                <p> </p>
                <p> 
                    <bold>Authors&#x2019; response</bold>
                </p>
                <p> This has been harmonized, citations from 2023-2024 has been added</p>
                <p> </p>
                <p> 
                    <bold>Reviewers&#x2019; comments</bold>
                </p>
                <p> 
                    <bold>Recommendation</bold>: 
                    <list list-type="bullet">
                        <list-item>
                            <p>Conduct a thorough proofreading to correct minor errors and improve sentence flow (e.g., revise &#x201c;sip into soil&#x201d; to &#x201c;seep into soil&#x201d; and &#x201c;very much important significant&#x201d; to &#x201c;highly significant&#x201d; on Page 1).</p>
                        </list-item>
                    </list> </p>
                <p> 
                    <bold>Authors&#x2019; response</bold>
                </p>
                <p> The correction has been made and well harmonized</p>
                <p> </p>
                <p> 
                    <bold>Reviewers&#x2019; comments</bold>
                </p>
                <p> 
                    <bold>Recommendations</bold>: 
                    <list list-type="bullet">
                        <list-item>
                            <p>Revise the conclusion to include specific, prioritized recommendations for Nigeria, such as strengthening regulatory frameworks for mining or scaling up phytoremediation pilot projects.</p>
                        </list-item>
                        <list-item>
                            <p>Compare the review&#x2019;s findings with other studies to clarify its unique contributions (e.g., how the Nigerian focus adds to global heavy metal research).</p>
                        </list-item>
                        <list-item>
                            <p>Explicitly address limitations in the conclusion, such as the scope of mitigation strategies discussed, and suggest how future research could fill these gaps.</p>
                        </list-item>
                    </list> </p>
                <p> 
                    <bold>Authors&#x2019; response</bold>
                </p>
                <p> This has been well harmonized</p>
                <p> </p>
                <p> 
                    <bold>Reviewers&#x2019; comments</bold>
                </p>
                <p> Additional Comments 
                    <list list-type="bullet">
                        <list-item>
                            <p>Nigerian Case Studies: The inclusion of Zamfara and Great Kwa River case studies is a strength, but more detail on their outcomes (e.g., current status, long-term health impacts, or remediation efforts) would enhance their impact. For instance, what lessons from Zamfara have informed national policy?</p>
                        </list-item>
                        <list-item>
                            <p>Structure: The article is well-organized, but a dedicated section on research gaps and future directions (beyond the brief mention in the conclusion) would add value. This could outline unanswered questions, such as the long-term efficacy of phytoremediation in tropical climates.</p>
                        </list-item>
                        <list-item>
                            <p>Response to Previous Review: The authors&#x2019; response to Reviewer 1 (Rupesh Kumar) shows they addressed concerns like revising the conclusion and noting limitations. However, their dismissal of alternative technologies (e.g., AI predictive models) as outside the scope seems limiting. While not central, a brief mention of data-driven approaches for monitoring contamination could broaden the mitigation discussion.</p>
                        </list-item>
                    </list> </p>
                <p> 
                    <bold>Authors&#x2019; response</bold>
                </p>
                <p> This has been addressed and harmonized in the revised manuscript. A brief mention of Ai data driven approaches has been duly mention and harmonized in the conclusion of the revised manuscript</p>
                <p> </p>
                <p> 
                    <bold>Reviewers&#x2019; comments</bold> 
                    <list list-type="bullet">
                        <list-item>
                            <p>Points to Address for Scientific Soundness</p>
                            <p> To ensure the article is scientifically sound, the authors must:</p>
                        </list-item>
                        <list-item>
                            <p>Enhance comprehensiveness by comparing Nigerian case studies with global examples and including emerging research areas (e.g., epigenetics, novel remediation technologies).</p>
                        </list-item>
                        <list-item>
                            <p>Update citations in the toxicity mechanisms section with recent studies to maintain currency.</p>
                        </list-item>
                        <list-item>
                            <p>Revise the conclusion to provide specific, actionable recommendations and explicitly address limitations, ensuring alignment with the evidence presented.</p>
                        </list-item>
                        <list-item>
                            <p>Proofread the manuscript to eliminate minor errors and improve clarity.</p>
                        </list-item>
                    </list> </p>
                <p> 
                    <bold>Authors&#x2019; response</bold>
                </p>
                <p> All the corrections emphasized has been made and incorporated in the revised manuscript.</p>
            </body>
        </sub-article>
    </sub-article>
    <sub-article article-type="reviewer-report" id="report363027">
        <front-stub>
            <article-id pub-id-type="doi">10.5256/f1000research.175987.r363027</article-id>
            <title-group>
                <article-title>Reviewer response for version 1</article-title>
            </title-group>
            <contrib-group>
                <contrib contrib-type="author">
                    <name>
                        <surname>Kumar</surname>
                        <given-names>Rupesh</given-names>
                    </name>
                    <xref ref-type="aff" rid="r363027a1">1</xref>
                    <role>Referee</role>
                    <uri content-type="orcid">https://orcid.org/0000-0002-6590-4313</uri>
                </contrib>
                <aff id="r363027a1">
                    <label>1</label>O P Jindal Global University, Sonipat, Haryana, India</aff>
            </contrib-group>
            <author-notes>
                <fn fn-type="conflict">
                    <p>
                        <bold>Competing interests: </bold>No competing interests were disclosed.</p>
                </fn>
            </author-notes>
            <pub-date pub-type="epub">
                <day>8</day>
                <month>2</month>
                <year>2025</year>
            </pub-date>
            <permissions>
                <copyright-statement>Copyright: &#x00a9; 2025 Kumar R</copyright-statement>
                <copyright-year>2025</copyright-year>
                <license xlink:href="https://creativecommons.org/licenses/by/4.0/">
                    <license-p>This is an open access peer review report distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
                </license>
            </permissions>
            <related-article ext-link-type="doi" id="relatedArticleReport363027" related-article-type="peer-reviewed-article" xlink:href="10.12688/f1000research.160148.1"/>
            <custom-meta-group>
                <custom-meta>
                    <meta-name>recommendation</meta-name>
                    <meta-value>approve-with-reservations</meta-value>
                </custom-meta>
            </custom-meta-group>
        </front-stub>
        <body>
            <p>Few important observations needs to be addressed for improving the quality of work:</p>
            <p> 1) What is the novelty of study? Is there any existing work supporting or motivating to do this study? Please explain in Introduction part.</p>
            <p> 2) Author should also mention some other existing technologies may be considered or used instead of AI predictive.</p>
            <p> 3) I unable to see the research gaps and objectives. Please include latest references which will give you an idea of work in different sectors. Few important papers needs to be added:</p>
            <p> i.&#x00a0;Kumar R et al. (2014 [Ref-1])&#x00a0;</p>
            <p> ii.&#x00a0;Rajani R et al. (2022 [Ref-2])</p>
            <p> iii.&#x00a0;Kumar R (2017 [Ref-3])&#x00a0;</p>
            <p> 4) Methodology: Please check for proper citation of figures and tables in the text. In addition, there is no source given for figure and tables. If it is self then author should cite as &#x201c;Source: Author Composition&#x201d; or similar.</p>
            <p> 5) Implications should be added in this (Political, Practical and Social if any).</p>
            <p> 6)&#x00a0;Conclusion part is written in very short. Compare your study with other authors and write in conclusion and extend a bit more.</p>
            <p> 7) Limitations and future work should be included as a separate heading or may be a part of conclusion also in the last para.</p>
            <p> 8) Please make a proper structure of your manuscript like aligning with Introduction, LR, Gaps, Objectives, Methods and Materials, Analysis, Results and Discussion, Implications, Conclusion, Limitations and Future Scope and References.</p>
            <p> 9) Authors may proof read before submitting the revision.</p>
            <p>Is the review written in accessible language?</p>
            <p>Yes</p>
            <p>Are all factual statements correct and adequately supported by citations?</p>
            <p>Yes</p>
            <p>Are the conclusions drawn appropriate in the context of the current research literature?</p>
            <p>Yes</p>
            <p>Is the topic of the review discussed comprehensively in the context of the current literature?</p>
            <p>Yes</p>
            <p>Reviewer Expertise:</p>
            <p>Same area</p>
            <p>I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.</p>
        </body>
        <back>
            <ref-list>
                <title>References</title>
                <ref id="rep-ref-363027-1">
                    <label>1</label>
                    <mixed-citation publication-type="journal">
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        </back>
        <sub-article article-type="response" id="comment13351-363027">
            <front-stub>
                <contrib-group>
                    <contrib contrib-type="author">
                        <name>
                            <surname>Laoye</surname>
                            <given-names>Babafemi</given-names>
                        </name>
                        <aff>Biological Sciences, Afe Babalola University, Ado Ekiti, Ekiti, Nigeria</aff>
                    </contrib>
                </contrib-group>
                <author-notes>
                    <fn fn-type="conflict">
                        <p>
                            <bold>Competing interests: </bold>The authors have no competing interest(s)</p>
                    </fn>
                </author-notes>
                <pub-date pub-type="epub">
                    <day>14</day>
                    <month>2</month>
                    <year>2025</year>
                </pub-date>
            </front-stub>
            <body>
                <p>The authors are grateful for the feedback received from the reviewer. Where necessary, appropriate amendments have been made in the manuscript. Below are responses to the review queries:</p>
                <p> </p>
                <p> 
                    <bold>Reviewer&#x2019;s query:</bold> &#x00a0;What is the novelty of the study? Is there any existing work supporting or motivating to do this study? Please explain in the introduction part.</p>
                <p> </p>
                <p> 
                    <bold>Authors&#x2019; response:</bold> Although there are a plethora of research studies that have reported the debilitating effects of heavy metals on the health due to contamination from various sources, the focus of this review was that, apart from discussing the health impacts of heavy metal contamination, case studies in the Nigerian environmental context were discussed, which was a departure from existing literature. This is clearly embedded in the introduction.</p>
                <p> </p>
                <p> 
                    <bold>Reviewer&#x2019;s query</bold>: Author should also mention some other existing technologies that may be considered or used instead of AI predictive</p>
                <p> </p>
                <p> 
                    <bold>Authors&#x2019; response:</bold> The focus of the review did not include discussion on existing technologies. This could be a limitation of the review</p>
                <p> </p>
                <p> 
                    <bold>Reviewer&#x2019;s query</bold>: I am unable to see the research gaps and objectives. Please include the latest references, which will give you an idea of work in different sectors. A few important papers need to be added.</p>
                <p> </p>
                <p> i.&#x00a0;Kumar R et al. (2014 [Ref-1])&#x00a0;</p>
                <p> ii.&#x00a0;Rajani R et al. (2022 [Ref-2])</p>
                <p> iii.&#x00a0;Kumar R (2017 [Ref-3])&#x00a0;</p>
                <p> </p>
                <p> 
                    <bold>Authors&#x2019; response</bold>: Thank you for your kind observation; the research gap has been included, although the authors agree that there are a plethora of recent references included in this manuscript and the case studies in this manuscript reflect different sectors. In as much as the authors were willing to cite the aforementioned papers, perusing them revealed their focus did not align with the scope of this manuscript.</p>
                <p> </p>
                <p> 
                    <bold>Reviewer&#x2019;s query:</bold> Methodology: Please check for proper citation of figures and tables in the text. In addition, there is no source given for figures and tables. If it is self, then the author should cite as &#x201c;Source: Author Composition&#x201d; or similar.</p>
                <p> 
                    <bold>Authors&#x2019; response</bold>: All citations have been checked. However, the manuscript contained neither tables nor figures.</p>
                <p> </p>
                <p> 
                    <bold>Reviewer&#x2019;s query:</bold> Implications should be added in this (Political, Practical and Social if any).</p>
                <p> Authors&#x2019; response; Attended to and well noted.</p>
                <p> </p>
                <p> 
                    <bold>Reviewer&#x2019;s query:</bold> Conclusion part is written in very short. Compare your study with other authors and write in conclusion and extend a bit more.</p>
                <p> Authors&#x2019; response: The conclusion has been re-written.</p>
                <p> </p>
                <p> 
                    <bold>Reviewer&#x2019;s query:</bold> Limitations and future work should be included as a separate heading or may be a part of the conclusion also in the last paragraph.</p>
                <p> Authors&#x2019; response: That has been attended to.</p>
                <p> </p>
                <p> 
                    <bold>Reviewer&#x2019;s query</bold>: Please make a proper structure of your manuscript like aligning with Introduction, LR, Gaps, Objectives, Methods and Materials, Analysis, Results and Discussion, Implications, Conclusion, Limitations and Future Scope and References.</p>
                <p> 
                    <bold>Authors&#x2019; response:</bold> The suggested structure would have been appropriate if it were a research article. There is no way that structure can be followed for a review manuscript as in this case. A review paper (except it is a systematic review) cannot follow the conventional format.</p>
                <p> </p>
                <p> 
                    <bold>Reviewer&#x2019;s query</bold>: Authors may proof read before submitting the revision.</p>
                <p> 
                    <bold>Authors&#x2019; response</bold>: That has been attended to and well noted.</p>
            </body>
        </sub-article>
    </sub-article>
</article>
