BASIC KNOWLEDGE OF THE PRESENCE OF LEAD AND CADMIUM IN FOOD, THEIR TOXICITY, AND PROTECTION METHODS AMONG THE POPULATION OF SKOPJE, NORTH MACEDONIA

Abstract

Heavy metals are present in the soil, where their concentration is constantly increasing due to modern lifestyles and industrialization. Through environmental pollution via soil, air, and water they enter the human food chain. Plants absorb heavy metals from the soil through their roots and accumulate them in various parts, such as roots, stems, leaves, and fruits. Different types of vegetables and fruits exhibit varying capacities for heavy metal accumulation. By consuming plants, fruits, and vegetables, heavy metals are transferred to animals and humans, accumulating in specific body parts where they can remain for several years, causing chronic toxicity. Certain heavy metals, such as copper (Cu), iron (Fe), nickel (Ni), and zinc (Zn), are required by living organisms in low concentrations, but become toxic at higher levels. In contrast, lead (Pb) and cadmium (Cd) pose a significant hazard to human health even at very low concentrations. They are carcinogenic and induce neurotoxicity, nephrotoxicity, anemia, hypertension, and other severe diseases, with cadmium being markedly more toxic than lead. Nevertheless, certain types of food can reduce their absorption. To determine the public awareness regarding the presence of lead and cadmium in food and their toxicity, a study was conducted using a 16-question survey. The survey was administered to 100 respondents comprising employees and patients at the "Bukurešt" Polyclinic in Skopje. The findings revealed that a large proportion of respondents are aware that these metals are toxic even at low concentrations; however, they are uncertain which of the two is more toxic. More than half (62–68%) know which types of food contain the highest concentrations, yet only 40–47% are aware of the organs in which they accumulate and their retention duration within the organism. While over half of the respondents correctly identified diseases not caused by lead and cadmium, only 46% know how to reduce their absorption. Participants demonstrated high awareness and concern for their health, with 96% stating a need for additional education on this topic. Ultimately, the survey indicates that individuals require greater education regarding the harmful effects of these metals, their presence in food, and protective measures. Therefore, educational initiatives are necessary both within formal education and externally through various lectures, courses, and guidance provided by qualified professionals such as nutritionists.