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Spaur M, Nigra AE, Sanchez TR, Navas-Acien A, Lazo M, Wu HC. Association of blood manganese, selenium with steatosis, fibrosis in the National Health and Nutrition Examination Survey, 2017-18. Environ Res 2022; 213:113647. [PMID: 35691383 PMCID: PMC10031575 DOI: 10.1016/j.envres.2022.113647] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/10/2022] [Accepted: 06/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND & AIMS Chronic liver disease is a growing health burden worldwide. Chronic metal exposures may be associated with non-alcoholic fatty liver disease (NAFLD). We aimed to evaluate the association of blood cadmium (Cd), mercury (Hg), lead (Pb), manganese (Mn), and selenium (Se) with two hallmark features of NAFLD: liver steatosis and fibrosis in the general U.S. METHODS We analyzed transient liver elastography data from participants of the National Health and Nutrition Examination Survey (NHANES) 2017-18, using ordinal logistic regression analyses to evaluate the cross-sectional association between blood metal concentrations and clinical stages of steatosis and fibrosis. We applied survey weights, strata, and primary sampling units and analyses were conducted using the R survey package. RESULTS 4,154 participants were included. Median (IQR) for blood Mn and blood Se were 9.28 (7.48-11.39) and 191.08 (176.55-207.16) μg/L, respectively. Per interquartile range increase of natural log transformed blood Mn, the adjusted odds ratio (OR) (95% CI) was 1.59 (1.13-2.23) for a higher grade of steatosis and 1.16 (0.67-2.00) for liver fibrosis. The corresponding OR for steatosis was 2.00 (1.24-3.24) and 2.14 (1.04-4.42) in Black and Mexican American participants, respectively. The corresponding OR for liver fibrosis was 2.96 (1.42-6.17) for females. Per interquartile range increase of natural log transformed blood Se, the adjusted OR was 2.25 (1.30-3.89) for steatosis but 0.31 (0.13-0.72) for liver fibrosis. The inverse association of blood Se with liver fibrosis was also observed in males and White participants. Blood Cd, Hg, and Pb were not associated with liver steatosis and fibrosis in fully-adjusted models overall. CONCLUSIONS In NHANES 2017-18, higher blood Mn was positively associated with liver steatosis, and higher Se was positively associated with liver steatosis but negatively associated with liver fibrosis. Longitudinal studies are needed to examine the association of Mn and Se with fibrosis progression.
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Affiliation(s)
- Maya Spaur
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, W 168th St, Room 1107, New York, NY, USA.
| | - Anne E Nigra
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, W 168th St, Room 1107, New York, NY, USA.
| | - Tiffany R Sanchez
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, W 168th St, Room 1107, New York, NY, USA.
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, W 168th St, Room 1107, New York, NY, USA.
| | - Mariana Lazo
- Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA.
| | - Hui-Chen Wu
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, W 168th St, Room 1107, New York, NY, USA; Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA.
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Moon J, Kim HC. Case-only approach applied in environmental epidemiology: 2 examples of interaction effect using the US National Health and Nutrition Examination Survey (NHANES) datasets. BMC Med Res Methodol 2022; 22:254. [PMID: 36175835 PMCID: PMC9520813 DOI: 10.1186/s12874-022-01706-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 08/08/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION By substituting the general 'susceptibility factor' concept for the conventional 'gene' concept in the case-only approach for gene-environment interaction, the case-only approach can also be used in environmental epidemiology. Under the independence between the susceptibility factor and environmental exposure, the case-only approach can provide a more precise estimate of an interaction effect. METHODS Two analysis examples of the case-only approach in environmental epidemiology are provided using the 2015-2016 and 2017-2018 US National Health and Nutritional Examination Survey (NHANES): (i) the negative interaction effect between blood chromium level and glycohemoglobin level on albuminuria and (ii) the positive interaction effect between blood cobalt level and old age on albuminuria. The second part of the methods (theoretical backgrounds) summarized the logic and equations provided in previous studies about the case-only approach. RESULTS (i) When a 1 μg/L difference of both blood chromium level (mcg/L) and a 1% difference in blood glycohemoglobin level coincide, the multiplicative interaction contrast ratio (ICRc/nc) was 0.72 (95% CI 0.35-1.60), with no statistical significance. However, when only the cases were analyzed, the case-only ICR (ICRCO) was 0.59 (95% CI 0.28-0.95), with a statistical significance (a negative interaction effect). (ii) When a 1 μg/L difference of both blood cobalt levels and a 1-year difference in age coincide, the multiplicative interaction contrast ratio (ICRc/nc) was 1.13 (95% CI 0.99-1.37), with no statistical significance. However, when only the cases were analyzed, the case-only ICR (ICRCO) was 1.21 (95% CI 1.06-1.51), with a statistical significance (a positive interaction effect). DISCUSSION The discussion suggested the theoretical background and previous literature about the possible protective interaction effect between blood chromium levels and blood glycohemoglobin levels on the incidence of albuminuria and the possible aggravating interaction effect between blood cobalt levels and increasing ages on the incidence of albuminuria. If the independence assumption between a susceptibility factor and environmental exposure in a study with cases and non-cases is kept, the case-only approach can provide a more precise interaction effect estimate than conventional approaches with both cases and non-cases.
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Affiliation(s)
- Jinyoung Moon
- Department of Environmental Health Science, Graduate School of Public Health, Seoul National University, Gwanak-ro 1, Gwanak-gu, Seoul, 08826, Republic of Korea.,Department of Occupational and Environmental Medicine, Inha University Hospital, Inhang-ro 27, Jung-gu, Incheon, 22332, Republic of Korea
| | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, Inha University Hospital, Inhang-ro 27, Jung-gu, Incheon, 22332, Republic of Korea. .,Department of Social and Preventive Medicine, College of Medicine, Inha University, Inha-ro 100, Michuhol-gu, Incheon, 22212, Republic of Korea.
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Højsager FD, Andersen M, Juul A, Nielsen F, Möller S, Christensen HT, Grøntved A, Grandjean P, Jensen TK. Prenatal and early postnatal exposure to perfluoroalkyl substances and bone mineral content and density in the Odense child cohort. Environ Int 2022; 167:107417. [PMID: 35914335 DOI: 10.1016/j.envint.2022.107417] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 07/12/2022] [Accepted: 07/13/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Exposure to perfluoroalkyl substances (PFAS) has been associated with lower bone mineral density (BMD) in animal and human studies, but prospective data from children are limited. OBJECTIVES To determine associations between prenatal and early postnatal PFAS exposure and BMD at age 7 years. METHODS In the Odense Child Cohort, Denmark, pregnant women were recruited in 2010-2012, and their children were invited for subsequent health examinations. At 12 weeks of gestation the pregnant women delivered a serum sample, and at age 18 months serum was obtained from the child to measure perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorohexane sulfonic acid (PFHxS), perfluorononanoic acid (PFNA) and perfluorodecanoic acid (PFDA) by LC-MS/MS. At age 7 years DXA scans were performed to measure bone mineral content (BMC) and BMD Z-score. PFAS in pregnancy (n = 924) and/or at age 18 months (n = 511) were regressed against DXA measurements, adjusted for maternal education, child height Z-score, sex (for BMC) and for postnatal exposure, additionally duration of total breastfeeding. We additionally performed structural equation models determining combined effects of pre-and postnatal PFAS exposures. RESULTS Higher prenatal and early postnatal serum concentrations of all measured PFAS were associated with lower BMC and BMD Z-scores at age 7 years, all estimates were negative although not all significant. For each doubling of prenatal or 18-month exposure to PFDA, BMD Z-scores were lowered by -0.07 (95 % CI -0.10; -0.03) and -0.14 (-0.25; -0.03), respectively after adjustment. Pre- and postnatal PFAS were correlated, but structural equation models suggested that associations with BMD were stronger for 18-month than prenatal PFAS exposure. DISCUSSION Bone density is established in childhood, and a reduction in BMD during early childhood may have long-term implication for peak bone mass and lifelong bone health. Future studies of the impact of PFAS exposure on fracture incidence will help elucidate the clinical relevance.
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Affiliation(s)
- F D Højsager
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, Institute of Public Health, University of Southern Denmark, J.B. Winsløwsvej 17A, 5000 Odense, Denmark.
| | - M Andersen
- Department of Endocrinology and Metabolism, Odense University, Denmark; Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark
| | - A Juul
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark; International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Denmark
| | - F Nielsen
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, Institute of Public Health, University of Southern Denmark, J.B. Winsløwsvej 17A, 5000 Odense, Denmark
| | - S Möller
- Odense Patient data Explorative Network (OPEN), Odense, Denmark
| | - H T Christensen
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - A Grøntved
- Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - P Grandjean
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, Institute of Public Health, University of Southern Denmark, J.B. Winsløwsvej 17A, 5000 Odense, Denmark; Depertment of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, USA
| | - T K Jensen
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, Institute of Public Health, University of Southern Denmark, J.B. Winsløwsvej 17A, 5000 Odense, Denmark; Odense Patient data Explorative Network (OPEN), Odense, Denmark; Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
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Gorski-Steiner I, Bandeen-Roche K, Volk HE, O'Dell S, Schwartz BS. The association of unconventional natural gas development with diagnosis and treatment of internalizing disorders among adolescents in Pennsylvania using electronic health records. Environ Res 2022; 212:113167. [PMID: 35341757 PMCID: PMC9233008 DOI: 10.1016/j.envres.2022.113167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 03/01/2022] [Accepted: 03/21/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Unconventional natural gas development (UNGD) introduces physical and psychosocial hazards into communities, which could contribute to psychosocial stress in adolescents and an increased risk of internalizing disorders, common and impactful health outcomes. OBJECTIVES To evaluate associations between a 180-day composite UNGD activity metric and new onset of internalizing disorders, overall and separately for anxiety and depressive disorders, and effect modification by sex. METHODS We used a nested case-control design from 2008 to 2016 in 38 Pennsylvania counties using electronic health records from adolescent Geisinger subjects. Cases were defined by at least two diagnoses or medication orders indicating new onset of an internalizing disorder, and controls frequency-matched 4:1 on age, sex, and year. To evaluate associations, we used generalized estimating equations, with logit link, robust standard errors, and an exchangeable correlation structure within community. RESULTS We identified 7,974 adolescents (65.9% female, mean age 15.0 years) with new onset internalizing disorders. There were no associations when we used data from the entire study period. When restricted to years with higher UNGD activity (2010-2016), comparing the highest to lowest quartile, UNGD activity was associated (odds ratio [95% confidence level]) with new onset internalizing disorders (1.15 [1.06, 1.25]). Associations were slightly stronger for depressive disorders. Associations were only present in females (p = 0.009). DISCUSSION This is the first epidemiologic study of UNGD in relation to adolescent mental health, an important health outcome in a potentially susceptible group to the environmental and community impacts of UNGD. UNGD activity was associated with new onset internalizing disorders in females in this large sample in an area of active UNGD.
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Affiliation(s)
- Irena Gorski-Steiner
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Karen Bandeen-Roche
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Heather E Volk
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sean O'Dell
- Department of Psychiatry and Behavioral Health, Geisinger, Danville, PA, USA
| | - Brian S Schwartz
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Population Health Sciences, Geisinger, Danville, PA, USA; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Mangrio GR, Maneengam A, Khalid Z, Jafar TH, Chanihoon GQ, Nassani R, Unar A. RP-HPLC Method Development, Validation, and Drug Repurposing of Sofosbuvir Pharmaceutical Dosage Form: A Multidimensional Study. Environ Res 2022; 212:113282. [PMID: 35487258 DOI: 10.1016/j.envres.2022.113282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 04/05/2022] [Accepted: 04/08/2022] [Indexed: 06/14/2023]
Abstract
A smooth, exceptionally sensitive, correct, and extra reproducible RP-HPLC technique was developed and demonstrated to estimate Sofosbuvir (SOF) in pharmaceutical dosage formulations. This process was carried out by Agilent High-Pressure Liquid Chromatograph 1260 with GI311C Quat. Pump, Phenomenex Luna C-18 (150 mm × 4.6 mm × 5 μm) (USA), and Photodiode Array Detector (PDA) G1315D. The cell section, including acetonitrile and methanol with 80:20 v/v and solution (B) 0.1% phosphoric acid (40:60), was used for the study. However, 10 μL of the sample was injected with a drift flow of 1 mL/min. The separation occurred at a column temperature of 30 °C, and the eluents used PDA set at 260 nm. The retention time of SOF was 5 min. The calibration curve was modified linearly within the range of 0.05-0.15 mg/mL with a correlation coefficient of 0.99 and genuine linear dating among top vicinity and consciousness in the calibration curve. The detection and quantification restrictions were 0.001 and 0.003 mg/mL, respectively. SOF recovery from pharmaceutical components ranged from 98% to 99%. The percentage assay of SOF was 99%. Analytical validation parameters, such as specificity, linearity, precision, accuracy, and selectivity, were studied, and the percentage relative standard deviation (%RSD) was less than 2%. All other key parameters were observed within the desired thresholds. Hence, the proposed RP-HPLC technique was proven effective for developing SOF in bulk and pharmaceutical pill dosage forms. SOF was found to interact with SARS-COV-2 nsp12, and molecular docking results revealed its high affinity and firm binding within the active site groove of nsp12. The key interacting residues include; LYS-72, GLN-75, MET-80 ALA-99, ASN-99, TRP-100, TYR-101 with ASN-99 and TRP-100 forming hydrogen bonds. Molecular Dynamics simulation of SOF and nsp12 complex elucidated that the system was stable throughout 20ns. Therefore, this drug repurposing strategy for SOF can be used for treating COVID-19 infections by performing animal experiments and accurate clinical trials in the future.
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Affiliation(s)
| | - Apichit Maneengam
- Department of Mechanical Engineering Technology, College of Industrial Technology, King Mongkut's University of Technology North Bangkok, Wongsawang, Bangsue, Bangkok, 10800, Thailand
| | - Zunera Khalid
- School of Life Sciences, University of Science and Technology of China, Hefei, 230027, PR China
| | | | - Ghulam Qadir Chanihoon
- National Center of Excellence in Analytical Chemistry, University of Sindh, Jamshoro, 76090, Pakistan
| | - Rayan Nassani
- Center for Computational Biology, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Ahsanullah Unar
- School of Life Sciences, University of Science and Technology of China, Hefei, 230027, PR China.
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Cui Z, Cai M, Xiao Y, Zhu Z, Yang M, Chen G. Forecasting the transmission trends of respiratory infectious diseases with an exposure-risk-based model at the microscopic level. Environ Res 2022; 212:113428. [PMID: 35568232 PMCID: PMC9095069 DOI: 10.1016/j.envres.2022.113428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/30/2022] [Accepted: 05/02/2022] [Indexed: 05/03/2023]
Abstract
Respiratory infectious diseases (e.g., COVID-19) have brought huge damages to human society, and the accurate prediction of their transmission trends is essential for both the health system and policymakers. Most related studies focus on epidemic trend forecasting at the macroscopic level, which ignores the microscopic social interactions among individuals. Meanwhile, current microscopic models are still not able to sufficiently decipher the individual-based spreading process and lack valid quantitative tests. To tackle these problems, we propose an exposure-risk-based model at the microscopic level, including 4 modules: individual movement, virion-laden droplet movement, individual exposure risk estimation, and prediction of transmission trends. Firstly, the front two modules reproduce the movements of individuals and the droplets of infectors' expiratory activities, respectively. Then, the outputs are fed to the third module to estimate the personal exposure risk. Finally, the number of new cases is predicted in the final module. By predicting the new COVID- 19 cases in the United States, the performances of our model and 4 other existing macroscopic or microscopic models are compared. Specifically, the mean absolute error, root mean square error, and mean absolute percentage error provided by the proposed model are respectively 2454.70, 3170.51, and 3.38% smaller than the minimum results of comparison models. The quantitative results reveal that our model can accurately predict the transmission trends from a microscopic perspective, and it can benefit the further investigation of many microscopic disease transmission factors (e.g., non-walkable areas and facility layouts).
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Affiliation(s)
- Ziwei Cui
- School of Intelligent System Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, Guangdong, China.
| | - Ming Cai
- School of Intelligent System Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, Guangdong, China.
| | - Yao Xiao
- School of Intelligent System Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, Guangdong, China.
| | - Zheng Zhu
- College of Civil Engineering and Architecture, Zhejiang University, Hangzhou, Zhejiang, China.
| | - Mofeng Yang
- Maryland Transportation Institute, Department of Civil and Environmental Engineering, University of Maryland at College Park, Maryland, USA.
| | - Gongbo Chen
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.
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Etzel TM, Braun JM, Kuiper JR, Calafat AM, Cecil KM, Chen A, Lanphear BP, Yolton K, Kalkwarf HJ, Buckley JP. Gestational and childhood phthalate exposures and adolescent body composition: The HOME study. Environ Res 2022; 212:113320. [PMID: 35461845 PMCID: PMC9233110 DOI: 10.1016/j.envres.2022.113320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 03/31/2022] [Accepted: 04/12/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Early life phthalate exposures may disrupt metabolism but results from human studies are inconsistent and few have examined body composition during adolescence. We investigated associations of gestational and childhood urinary phthalate biomarker concentrations with body composition at age 12 years. METHODS We used data from 206 mother-child pairs in a prospective pregnancy and birth cohort enrolled in Cincinnati, OH from 2003 to 2006. We measured nine phthalate metabolites in spot urine samples collected twice from mothers during pregnancy and up to seven times from children at 1, 2, 3, 4, 5, 8, and 12 years. At age 12 years, we assessed fat and lean mass of the whole body and android and gynoid subregions, and visceral fat area with dual x-ray absorptiometry, and calculated android to gynoid %fat ratio and age- and sex-standardized fat and lean mass index z-scores. Using a multiple informant model, we estimated covariate-adjusted associations between urinary phthalate biomarker concentrations at each time period and outcomes at age 12 years. We assessed effect measure modification by child sex using stratified models. RESULTS Generally, urinary mono-benzyl phthalate (MBzP) concentrations were modestly associated with lower fat and lean mass. Each 10-fold increase in urinary MBzP concentrations during gestation and at ages 5 and 8 years was associated with a -0.34 (95%CI: -0.72, 0.05), -0.44 (95% CI: -0.83, -0.05), and -0.35 (95% CI: -0.71, 0.00) z-score difference in lean body mass index, respectively. Urinary monoethyl phthalate, mono-(3-carboxypropyl) phthalate, and summed di(2-ethylhexyl) phthalate metabolites were associated with greater lean mass at some exposure periods. Slightly weaker but similar patterns of association were found with other body composition measures; associations did not differ by child sex. CONCLUSION While most associations were weak, exposure to certain phthalates during gestation and childhood may be associated with adolescent body composition, particularly lean mass.
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Affiliation(s)
- Taylor M Etzel
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA.
| | - Joseph M Braun
- Brown University, 121 S. Main St, Providence, RI, 02903, USA.
| | - Jordan R Kuiper
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA.
| | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, NE Atlanta, GA, 30341, USA.
| | - Kim M Cecil
- Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA; University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH, 45267, USA.
| | - Aimin Chen
- University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA.
| | - Bruce P Lanphear
- Simon Fraser University, 8888 University Dr, Burnaby, BC, V5A 1S6, Canada.
| | - Kimberly Yolton
- Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA; University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH, 45267, USA.
| | - Heidi J Kalkwarf
- Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA; University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH, 45267, USA.
| | - Jessie P Buckley
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA.
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Christensen GM, Rowcliffe C, Chen J, Vanker A, Koen N, Jones MJ, Gladish N, Hoffman N, Donald KA, Wedderburn CJ, Kobor MS, Zar HJ, Stein DJ, Hüls A. In-utero exposure to indoor air pollution or tobacco smoke and cognitive development in a South African birth cohort study. Sci Total Environ 2022; 834:155394. [PMID: 35460774 PMCID: PMC9177804 DOI: 10.1016/j.scitotenv.2022.155394] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/15/2022] [Accepted: 04/15/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND AIMS There is increasing evidence indicating that air pollution exposure is associated with neuronal damage. Since pregnancy is a critical window of vulnerability, air pollution exposure during this period could have adverse effects on neurodevelopment. This study aims 1) to analyze associations of prenatal exposure to indoor air pollution (particulate matter with diameters ≤10 μm, PM10) and tobacco smoke with neurodevelopment and 2) to determine whether these associations are mediated by deviations of epigenetic gestational age from chronological gestational age (ΔGA). METHODS Data of 734 children from the South African Drakenstein Child Health Study were analyzed. Prenatal PM10 exposure was measured using devices placed in the families' homes. Maternal smoking during pregnancy was determined by maternal urine cotinine measures. The Bayley Scales of Infant and Toddler Development III (BSID-III) was used to measure cognition, language and motor development and adaptive behavior at two years of age. Linear regression models adjusted for maternal age, gestational age, sex of child, ancestry, birth weight/length, and socioeconomic status were used to explore associations between air pollutants and BSID-III scores. A mediation analysis was conducted to analyze if these associations were mediated by ΔGA using DNA methylation measurements from cord blood. RESULTS An increase of one interquartile range in natural-log transformed PM10 (lnPM10; 1.58 μg/m3) was significantly associated with lower composite scores in cognition, language, and adaptive behavior sub-scores (composite score β-estimate [95%-confidence interval]: -0.950 [-1.821, -0.120]). Maternal smoking was significantly associated with lower adaptive behavior scores (-3.386 [-5.632, -1.139]). Associations were not significantly mediated by ΔGA (e.g., for PM10 and cognition, proportion mediated [p-value]: 4% [0.52]). CONCLUSION We found an association of prenatal exposure to indoor air pollution (PM10) and tobacco smoke on neurodevelopment at two years of age, particularly cognition, language, and adaptive behavior. Further research is needed to understand underlying biological mediators.
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Affiliation(s)
- Grace M Christensen
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Claire Rowcliffe
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Junyu Chen
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Aneesa Vanker
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa
| | - Nastassja Koen
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; South African Medical Research Council (SAMRC) Unit on Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - Meaghan J Jones
- Department of Biochemistry and Medical Genetics, University of Manitoba, Children's Hospital Research, Institute of Manitoba, Winnipeg, Canada
| | - Nicole Gladish
- Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada; BC Children's Hospital Research Institute, Vancouver, BC, Canada; Centre for Molecular Medicine and Therapeutics, Vancouver, BC, Canada
| | - Nadia Hoffman
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Kirsten A Donald
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Catherine J Wedderburn
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; Neuroscience Institute, University of Cape Town, Cape Town, South Africa; Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Michael S Kobor
- Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada; BC Children's Hospital Research Institute, Vancouver, BC, Canada; Centre for Molecular Medicine and Therapeutics, Vancouver, BC, Canada
| | - Heather J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; South African Medical Research Council (SAMRC) Unit on Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - Dan J Stein
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; South African Medical Research Council (SAMRC) Unit on Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - Anke Hüls
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, USA.
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Aerts R, Vanlessen N, Dujardin S, Nemery B, Van Nieuwenhuyse A, Bauwelinck M, Casas L, Demoury C, Plusquin M, Nawrot TS. Residential green space and mental health-related prescription medication sales: An ecological study in Belgium. Environ Res 2022; 211:113056. [PMID: 35248565 DOI: 10.1016/j.envres.2022.113056] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/18/2022] [Accepted: 02/27/2022] [Indexed: 05/17/2023]
Abstract
BACKGROUND Residential green space has been associated with mental health benefits, but how such associations vary with green space types is insufficiently known. OBJECTIVE We aimed to investigate associations between types and quantities of green space and sales of mood disorder medication in Belgium. METHODS We used aggregated sales data of psycholeptics and psychoanaleptics prescribed to adults from 2006 to 2014. Generalized mixed effects models were used to investigate associations between relative covers of woodland, low-green, grassland, and garden, and average annual medication sales. Models were adjusted for socio-economic background variables, urban-rural differences, and administrative region, and included random effects of latitude and longitude. RESULTS Urban census tracts were associated with 9-10% higher medication sales. In nationwide models, a 10% increase in relative cover of woodland, garden, and grass was associated with a 1-2% decrease in medication sales. The same association was found for low green but only for men. In stratified models, a 10% increase in relative cover of any green space type in urban census tracts was associated with a decrease of medication sales by 1-3%. In rural census tracts, no protective associations between green space and mood disorder medication sales were observed, with the exception of relative woodland cover for women (-1%), and low green was associated with higher medication sales (+6-7%). CONCLUSIONS Taken together, these results suggest that living in green environments may be beneficial for adult mental health. Woodland exposure seemed the most beneficial, but the amount of green space was more important than the type. Results underline the importance of conserving green space in our living environment, for the conservation of biodiversity and for human health.
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Affiliation(s)
- Raf Aerts
- Risk and Health Impact Assessment, Sciensano (Belgian Institute of Health), Juliette Wytsmanstraat 14, BE-1050, Brussels, Belgium; Division Ecology, Evolution and Biodiversity Conservation, University of Leuven (KU Leuven), Kasteelpark Arenberg 31-2435, BE-3001, Leuven, Belgium; Center for Environmental Sciences, University of Hasselt, Agoralaan D, BE-3590, Diepenbeek, Hasselt, Belgium.
| | - Naomi Vanlessen
- Division Ecology, Evolution and Biodiversity Conservation, University of Leuven (KU Leuven), Kasteelpark Arenberg 31-2435, BE-3001, Leuven, Belgium.
| | - Sebastien Dujardin
- Department of Geography, Institute of Life Earth and Environment (ILEE), University of Namur, Namur, Belgium.
| | - Benoit Nemery
- Center for Environment and Health, Department of Public Health and Primary Care, University of Leuven, Herestraat 49-706, BE-3000, Leuven, Belgium.
| | - An Van Nieuwenhuyse
- Risk and Health Impact Assessment, Sciensano (Belgian Institute of Health), Juliette Wytsmanstraat 14, BE-1050, Brussels, Belgium; Center for Environment and Health, Department of Public Health and Primary Care, University of Leuven, Herestraat 49-706, BE-3000, Leuven, Belgium.
| | - Mariska Bauwelinck
- Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Pleinlaan 5, BE-1050, Brussels, Belgium.
| | - Lidia Casas
- Epidemiology and Social Medicine, University of Antwerp, Universiteitsplein 1-R.232, BE-2610, Wilrijk, Antwerp, Belgium.
| | - Claire Demoury
- Risk and Health Impact Assessment, Sciensano (Belgian Institute of Health), Juliette Wytsmanstraat 14, BE-1050, Brussels, Belgium.
| | - Michelle Plusquin
- Center for Environmental Sciences, University of Hasselt, Agoralaan D, BE-3590, Diepenbeek, Hasselt, Belgium.
| | - Tim S Nawrot
- Center for Environmental Sciences, University of Hasselt, Agoralaan D, BE-3590, Diepenbeek, Hasselt, Belgium; Center for Environment and Health, Department of Public Health and Primary Care, University of Leuven, Herestraat 49-706, BE-3000, Leuven, Belgium.
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60
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Yu L, Liu W, Wang X, Ye Z, Tan Q, Qiu W, Nie X, Li M, Wang B, Chen W. A review of practical statistical methods used in epidemiological studies to estimate the health effects of multi-pollutant mixture. Environ Pollut 2022; 306:119356. [PMID: 35487468 DOI: 10.1016/j.envpol.2022.119356] [Citation(s) in RCA: 58] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/11/2022] [Accepted: 04/21/2022] [Indexed: 05/27/2023]
Abstract
Environmental risk factors have been implicated in adverse health effects. Previous epidemiological studies on environmental risk factors mainly analyzed the impact of single pollutant exposure on health, while in fact, humans are constantly exposed to a complex mixture consisted of multiple pollutants/chemicals. In recent years, environmental epidemiologists have sought to assess adverse health effects of exposure to multi-pollutant mixtures based on the diversity of real-world environmental pollutants. However, the statistical challenges are considerable, for instance, multicollinearity and interaction among components of the mixture complicate the statistical analysis. There is currently no consensus on appropriate statistical methods. Here we summarized the practical statistical methods used in environmental epidemiology to estimate health effects of exposure to multi-pollutant mixture, such as Bayesian kernel machine regression (BKMR), weighted quantile sum (WQS) regressions, shrinkage methods (least absolute shrinkage and selection operator, elastic network model, adaptive elastic-net model, and principal component analysis), environment-wide association study (EWAS), etc. We sought to review these statistical methods and determine the application conditions, strengths, weaknesses, and result interpretability of each method, providing crucial insight and assistance for addressing epidemiological statistical issues regarding health effects from multi-pollutant mixture.
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Affiliation(s)
- Linling Yu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Wei Liu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Xing Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Zi Ye
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Qiyou Tan
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Weihong Qiu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Xiuquan Nie
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Minjing Li
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Bin Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Weihong Chen
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
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Wing SE, Larson TV, Hudda N, Boonyarattaphan S, Del Rosario I, Fruin S, Ritz B. Aircraft noise and vehicle traffic-related air pollution interact to affect preterm birth risk in Los Angeles, California. Sci Total Environ 2022; 829:154678. [PMID: 35314238 DOI: 10.1016/j.scitotenv.2022.154678] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 03/11/2022] [Accepted: 03/15/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Air pollution has been linked to preterm birth (PTB) while findings for noise exposure have been mixed. Few studies - none considering airports - have investigated combined exposures. We explore the relationship between joint exposure to airport-related noise, airport ultrafine particles (UFP), and vehicle traffic-related air pollution (TRAP) on risk of PTB near Los Angeles International Airport (LAX). METHODS We used comprehensive birth data for mothers living ≤15 km from LAX from 2008 to 2016 (n = 174,186) Noise data were generated by monitor-validated models. NO2 was used as a TRAP proxy, estimated with a seasonally-adjusted, validated land-use regression model. We estimated the effects of exposure to airport-related noise and TRAP on PTB employing logistic regression models that adjusted for known maternal risk factors for PTB as well as aircraft-origin UFP and neighborhood characteristics. RESULTS The adjusted odds ratio (aOR) for PTB from high noise exposure (i.e. > 65 dB) was 1.10 (95% CI: 1.01-1.19). Relative to the first quartile, the aORs for PTB in the second, third, and fourth TRAP quartiles were 1.10 (95% CI: 1.05-1.16), 1.11 (95% CI: 1.05-1.16), and 1.15 (95% CI: 1.10-1.22), respectively. When stratifying by increasing TRAP quartiles, the aORs for PTB with high airport-related noise were 1.04 (95% CI: 0.91-1.18), 1.02 (95% CI: 0.88-1.19), 1.24 (95% CI: 1.03-1.48), and 1.44 (95% CI: 1.08-1.91) (p-interaction = 0.06). CONCLUSION Our results suggest a potential synergism between airport-related noise and TRAP exposures on increasing the risk of PTB in this metropolitan area.
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Affiliation(s)
- Sam E Wing
- Department of Epidemiology, University of California Los Angeles, 650 Charles E. Young Drive South, 71-254 Center for Health Sciences, Los Angeles, CA 90095, United States.
| | - Timothy V Larson
- Departments of Civil & Environmental Engineering and Occupational & Environmental Health Sciences, University of Washington, 201 More Hall, Box 352700, Seattle, WA 98195-2700, United States.
| | - Neelakshi Hudda
- Department of Civil & Environmental Engineering, Tufts University, 200 College Avenue, Medford, MA 02155, United States.
| | - Sarunporn Boonyarattaphan
- Departments of Civil & Environmental Engineering and Occupational & Environmental Health Sciences, University of Washington, 201 More Hall, Box 352700, Seattle, WA 98195-2700, United States
| | - Irish Del Rosario
- Department of Epidemiology, University of California Los Angeles, 650 Charles E. Young Drive South, 71-254 Center for Health Sciences, Los Angeles, CA 90095, United States.
| | - Scott Fruin
- Division of Environmental Health, University of Southern California, 2001 N. Soto St., Los Angeles, CA 90033, United States
| | - Beate Ritz
- Department of Epidemiology, University of California Los Angeles, 650 Charles E. Young Drive South, 71-254 Center for Health Sciences, Los Angeles, CA 90095, United States.
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Urbano T, Filippini T, Wise LA, Lasagni D, De Luca T, Sucato S, Polledri E, Malavolti M, Rigon C, Santachiara A, Pertinhez TA, Baricchi R, Fustinoni S, Vinceti M. Associations of urinary and dietary cadmium with urinary 8-oxo-7,8-dihydro-2'-deoxyguanosine and blood biochemical parameters. Environ Res 2022; 210:112912. [PMID: 35150710 DOI: 10.1016/j.envres.2022.112912] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/04/2022] [Accepted: 02/05/2022] [Indexed: 06/14/2023]
Abstract
Cadmium is a heavy metal with established adverse effects on human health, namely on bone, liver and kidney function and the cardiovascular system. We assessed cadmium exposure and its correlation with biomarkers of toxicity. We recruited 137 non-smoking blood donors without a history of chronic disease or cancer who resided in the Northern Italy province of Reggio Emilia (mean age 47 years, range 30-60 years) in the 2017-2019 period. We used a semi-quantitative food frequency questionnaire to estimate dietary cadmium intake and urine samples to assess concentrations of urinary cadmium and 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodG). Median urinary cadmium and 8-oxodG concentrations were 0.21 μg/L (interquartile range (IQR): 0.11-0.34 μg/L) and 3.21 μg/g creatinine (IQR: 2.21-4.80 μg/g creatinine), respectively, while median dietary cadmium intake was 6.16 μg/day (IQR: 5.22-7.93 μg/day). We used multivariable linear and spline regression models to estimate mean differences exposure concentrations. Dietary and urinary cadmium were positively correlated, and both were positively and linearly correlated with 8-oxodG. We found a positive association of urinary cadmium with blood alanine aminotransferase (ALT), total cholesterol, low-density lipoprotein (LDL)-cholesterol and thyroid-stimulating hormone (TSH) concentrations. We also observed a positive association with triglycerides, in both linear (beta regression coefficient = 77.03, 95% confidence interval 32.27-121.78) and non-linear spline regression analyses. Despite the positive correlation between dietary and urinary cadmium estimates, dietary cadmium intake showed inconsistent results with the study endpoints and generally weaker associations, suggesting a decreased capacity to reflect actual cadmium exposure. Overall, these findings suggest that even low levels of cadmium exposure may adversely alter hematological and biochemical variables and induce oxidative stress.
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Affiliation(s)
- Teresa Urbano
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Tommaso Filippini
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Daniela Lasagni
- Transfusion Medicine Unit, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Tiziana De Luca
- Transfusion Medicine Unit, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Sabrina Sucato
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Elisa Polledri
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Marcella Malavolti
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Chiara Rigon
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | | | | | - Roberto Baricchi
- Transfusion Medicine Unit, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Silvia Fustinoni
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; IRCCS Ca' Granda Foundation Maggiore Policlinico Hospital, Milan, Italy
| | - Marco Vinceti
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
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Komulainen K, Hakulinen C, Lipsanen J, Partonen T, Pulkki-Råback L, Kähönen M, Virtanen M, Ruuhela R, Raitakari O, Elovainio M. Associations of long-term solar insolation with specific depressive symptoms: Evidence from a prospective cohort study. J Psychiatr Res 2022; 151:606-610. [PMID: 35636039 DOI: 10.1016/j.jpsychires.2022.05.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 03/30/2022] [Accepted: 05/20/2022] [Indexed: 11/28/2022]
Abstract
Evidence suggests that sunlight counteracts depression, but the associations of long-term sunlight exposure with specific symptoms of depression are not well known. We evaluated symptom-specific associations of average 1-year solar insolation with DSM-5 depressive symptoms in a representative cohort of Finnish adults. The sample included 1,845 participants from the Cardiovascular Risk in Young Finns Study with data on DSM-5 depressive symptoms, place of residence and covariates. Daily recordings of global solar radiation were obtained from the Finnish Meteorological Institute. Each participant's residential zip code on each day one year prior to the assessment of depressive symptoms was linked to the solar radiation data, and 1-year average daily solar insolation was calculated. Associations of the average 1-year solar insolation with depressive symptoms were assessed with linear and logistic regression analyses adjusting for season, sex, age, as well as individual- and neighborhood-level socioeconomic characteristics. Average daily solar insolation over one year prior to the depressive symptom assessment was not associated with the total number of depressive symptoms reported by participants. In symptom-specific analyses, participants exposed to higher levels of solar insolation in their residential neighborhood were less likely to report suicidal thought (OR = 0.61, 95% CI, 0.39-0.94), and more likely to report changes in appetite (OR = 1.24, 95% CI, 1.00-1.54), changes in sleep (OR = 1.30, 95% CI, 1.06-1.59) and feelings of worthlessness/guilt (OR = 1.33, 95% CI = 1.07-1.65). These findings suggest that solar insolation may contribute to symptom-specific differences in depression. Studies in other populations residing in different geographical locations are needed.
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Affiliation(s)
- Kaisla Komulainen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland; Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.
| | - Christian Hakulinen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland; Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jari Lipsanen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Timo Partonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Laura Pulkki-Råback
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland; Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Reija Ruuhela
- Weather and Climate Change Impact Research, Finnish Meteorological Institute, Helsinki, Finland
| | - Olli Raitakari
- Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Center for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Marko Elovainio
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland; Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland; Research Program Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Kim S, Hollinger H, Radke EG. 'Omics in environmental epidemiological studies of chemical exposures: A systematic evidence map. Environ Int 2022; 164:107243. [PMID: 35551006 DOI: 10.1016/j.envint.2022.107243] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 03/25/2022] [Accepted: 04/10/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Systematic evidence maps are increasingly used to develop chemical risk assessments. These maps can provide an overview of available studies and relevant study information to be used for various research objectives and applications. Environmental epidemiological studies that examine the impact of chemical exposures on various 'omic profiles in human populations provide relevant mechanistic information and can be used for benchmark dose modeling to derive potential human health reference values. OBJECTIVES To create a systematic evidence map of environmental epidemiological studies examining environmental contaminant exposures with 'omics in order to characterize the extent of available studies for future research needs. METHODS Systematic review methods were used to search and screen the literature and included the use of machine learning methods to facilitate screening studies. The Populations, Exposures, Comparators and Outcomes (PECO) criteria were developed to identify and screen relevant studies. Studies that met the PECO criteria after full-text review were summarized with information such as study population, study design, sample size, exposure measurement, and 'omics analysis. RESULTS Over 10,000 studies were identified from scientific databases. Screening processes were used to identify 84 studies considered PECO-relevant after full-text review. Various contaminants (e.g. phthalate, benzene, arsenic, etc.) were investigated in epidemiological studies that used one or more of the four 'omics of interest: epigenomics, transcriptomics, proteomics, and metabolomics . The epidemiological study designs that were used to explore single or integrated 'omic research questions with contaminant exposures were cohort studies, controlled trials, cross-sectional, and case-control studies. An interactive web-based systematic evidence map was created to display more study-related information. CONCLUSIONS This systematic evidence map is a novel tool to visually characterize the available environmental epidemiological studies investigating contaminants and biological effects using 'omics technology and serves as a resource for investigators and allows for a range of applications in chemical research and risk assessment needs.
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Affiliation(s)
- Stephanie Kim
- Superfund and Emergency Management Division, Region 2, U.S. Environmental Protection Agency, NY, USA.
| | - Hillary Hollinger
- Office of Pollution Prevention and Toxics, U.S. Environmental Protection Agency, NC, USA.
| | - Elizabeth G Radke
- Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, D.C, USA.
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Kim S, White SM, Radke EG, Dean JL. Harmonization of transcriptomic and methylomic analysis in environmental epidemiology studies for potential application in chemical risk assessment. Environ Int 2022; 164:107278. [PMID: 35537365 DOI: 10.1016/j.envint.2022.107278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/27/2022] [Accepted: 05/02/2022] [Indexed: 06/14/2023]
Abstract
Recent efforts have posited the utility of transcriptomic-based approaches to understand chemical-related perturbations in the context of human health risk assessment. Epigenetic modification (e.g., DNA methylation) can influence gene expression changes and is known to occur as a molecular response to some chemical exposures. Characterization of these methylation events is critical to understand the molecular consequences of chemical exposures. In this context, a novel workflow was developed to interrogate publicly available epidemiological transcriptomic and methylomic data to identify relevant pathway level changes in response to chemical exposure, using inorganic arsenic as a case study. Gene Set Enrichment Analysis (GSEA) was used to identify causal methylation events that result in concomitant downstream transcriptional deregulation. This analysis demonstrated an unequal distribution of differentially methylated regions across the human genome. After mapping these events to known genes, significant enrichment of a subset of these pathways suggested that arsenic-mediated methylation may be both specific and non-specific. Parallel GSEA performed on matched transcriptomic samples determined that a substantially reduced subset of these pathways are enriched and that not all chemically-induced methylation results in a downstream alteration in gene expression. The resulting pathways were found to be representative of well-established molecular events known to occur in response to arsenic exposure. The harmonization of enriched transcriptional patterns with those identified from the methylomic platform promoted the characterization of plausibly causal molecular signaling events. The workflow described here enables significant gene and methylation-specific pathways to be identified from whole blood samples of individuals exposed to environmentally relevant chemical levels. As future efforts solidify specific causal relationships between these molecular events and relevant apical endpoints, this novel workflow could aid risk assessments by identifying molecular targets serving as biomarkers of hazard, informing mechanistic understanding, and characterizing dose ranges that promote relevant molecular/epigenetic signaling events occuring in response to chemical exposures.
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Affiliation(s)
- Stephanie Kim
- Superfund and Emergency Management Division, Region 2, U.S. Environmental Protection Agency, NY, USA.
| | - Shana M White
- Chemical and Pollutant Assessment Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Cincinnati, USA.
| | - Elizabeth G Radke
- Chemical and Pollutant Assessment Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, D.C., USA.
| | - Jeffry L Dean
- Chemical and Pollutant Assessment Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Cincinnati, USA.
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Casas L, Cox B, Nemery B, Deboosere P, Nawrot TS. High temperatures trigger suicide mortality in Brussels, Belgium: A case-crossover study (2002-2011). Environ Res 2022; 207:112159. [PMID: 34606845 DOI: 10.1016/j.envres.2021.112159] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/28/2021] [Accepted: 09/28/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Temperature may trigger the risk of suicide, however, the extent and shape of the associations show geographical variation. Here, we investigate the short-term effects of temperature on suicide deaths occurring in Brussels between January 1st, 2002 and December 31st, 2011. METHODS We conducted a bidirectional time-stratified case-crossover study with cases being suicide deaths occurring among Brussels residents aged 5 years or older. Cases were matched by day of the week with control days from the same month and year. The exposure was the daily average temperature measured at the Uccle station (Brussels) and obtained from the Belgian Royal Meteorological Institute. We combined conditional logistic regression with distributed lag non-linear models (DLNM) to obtain one week (lag 0-6) cumulative risk ratios (RR) and their 95% confidence intervals (CI) for the effects of moderate and extreme cold (5th and 1st percentiles of temperature, respectively) and moderate and extreme heat (95th and 99th percentiles of temperature, respectively), relative to the median temperature. RESULTS In total, 1891 suicide deaths were included. The median temperature was 11.6 °C, moderate and extreme cold temperatures were 0 and -3.1 °C, respectively, and moderate and extreme high temperatures were 20.9 and 24.4 °C, respectively. The cumulative risk of suicide mortality was almost twice higher among lags 0 to 6 for both moderate and extreme heat, relative to the period median temperature (e.g. moderate heat RR = 1.80 CI:1.27-2.54). No statistically significant associations were observed for cold temperatures. CONCLUSIONS In Brussels, a western European city with temperate climate, high temperatures may trigger suicide deaths up to one week later. In the context of climate change, adaptation strategies must take into consideration the effects of temperature on mental health.
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Affiliation(s)
- Lidia Casas
- Social Epidemiology and Health Policy, Department Family Medicine and Population Health, University of Antwerp, Doornstraat 331, 2610, Wilrijk, Belgium; Institute for Environment and Sustainable Development (IMDO), University of Antwerp, Belgium.
| | - Bianca Cox
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw, D 3590, Diepenbeek, Belgium
| | - Benoit Nemery
- Centre for Environment and Health - Department of Public Health and Primary Care, KU Leuven, Herestraat 49, Leuven, Belgium
| | - Patrick Deboosere
- Interface Demography, Sociology Department, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw, D 3590, Diepenbeek, Belgium; Centre for Environment and Health - Department of Public Health and Primary Care, KU Leuven, Herestraat 49, Leuven, Belgium
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Abstract
BACKGROUND The two-stage design has become a standard tool in environmental epidemiology to model multi-location data. However, its standard form is rather inflexible and poses important limitations for modelling complex risks associated with environmental factors. In this contribution, we illustrate multiple design extensions of the classical two-stage method, all implemented within a unified analytic framework. METHODS We extended standard two-stage meta-analytic models along the lines of linear mixed-effects models, by allowing location-specific estimates to be pooled through flexible fixed and random-effects structures. This permits the analysis of associations characterised by combinations of multivariate outcomes, hierarchical geographical structures, repeated measures, and/or longitudinal settings. The analytic framework and inferential procedures are implemented in the R package mixmeta. RESULTS The design extensions are illustrated in examples using multi-city time series data collected as part of the National Morbidity, Mortality and Air Pollution Study (NMMAPS). Specifically, four case studies demonstrate applications for modelling complex associations with air pollution and temperature, including non-linear exposure-response relationships, effects clustered at multiple geographical levels, differential risks by age, and effect modification by air conditioning in a longitudinal analysis. CONCLUSIONS The definition of several design extensions of the classical two-stage design within a unified framework, along with its implementation in freely-available software, will provide researchers with a flexible tool to address novel research questions in two-stage analyses of environmental health risks.
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Affiliation(s)
- Francesco Sera
- Department of Statistics, Computer Science and Applications “G. Parenti”, University of Florence, Florence, Italy
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- Centre On Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
- Centre for Statistical Modelling, London School of Hygiene & Tropical Medicine, London, UK
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Glenn BE, Espira LM, Larson MC, Larson PS. Ambient air pollution and non-communicable respiratory illness in sub-Saharan Africa: a systematic review of the literature. Environ Health 2022; 21:40. [PMID: 35422005 PMCID: PMC9009030 DOI: 10.1186/s12940-022-00852-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 04/04/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Aerosol pollutants are known to raise the risk of development of non-communicable respiratory diseases (NCRDs) such as asthma, chronic bronchitis, chronic obstructive pulmonary disease, and allergic rhinitis. Sub-Saharan Africa's rapid pace of urbanization, economic expansion, and population growth raise concerns of increasing incidence of NCRDs. This research characterizes the state of research on pollution and NCRDs in the 46 countries of Sub-Saharan Africa (SSA). This research systematically reviewed the literature on studies of asthma; chronic bronchitis; allergic rhinitis; and air pollutants such as particulate matter, ozone, NOx, and sulfuric oxide. METHODS We searched three major databases (PubMed, Web of Science, and Scopus) using the key words "asthma", "chronic bronchitis", "allergic rhinitis", and "COPD" with "carbon monoxide (CO)", "sulfuric oxide (SO)", "ozone (O3)", "nitrogen dioxide (NO2)", and "particulate matter (PM)", restricting the search to the 46 countries that comprise SSA. Only papers published in scholarly journals with a defined health outcome in individuals and which tested associations with explicitly measured or modelled air exposures were considered for inclusion. All candidate papers were entered into a database for review. RESULTS We found a total of 362 unique research papers in the initial search of the three databases. Among these, 14 met the inclusion criteria. These papers comprised studies from just five countries. Nine papers were from South Africa; two from Malawi; and one each from Ghana, Namibia, and Nigeria. Most studies were cross-sectional. Exposures to ambient air pollutants were measured using spectrometry and chromatography. Some studies created composite measures of air pollution using a range of data layers. NCRD outcomes were measured by self-reported health status and measures of lung function (spirometry). Populations of interest were primarily schoolchildren, though a few studies focused on secondary school students and adults. CONCLUSIONS The paucity of research on NCRDs and ambient air pollutant exposures is pronounced within the African continent. While capacity to measure air quality in SSA is high, studies targeting NCRDs should work to draw attention to questions of outdoor air pollution and health. As the climate changes and SSA economies expand and countries urbanize, these questions will become increasingly important.
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Affiliation(s)
- Bailey E. Glenn
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA USA
| | - Leon M. Espira
- Center for Global Health Equity, University of Michigan, Ann Arbor, USA
| | | | - Peter S. Larson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA USA
- Social Environment and Health Program, Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI USA
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI USA
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Kupsco A, Wu H, Calafat AM, Kioumourtzoglou MA, Cantoral A, Tamayo-Ortiz M, Pantic I, Pizano-Zárate ML, Oken E, Braun JM, Deierlein AL, Wright RO, Téllez-Rojo MM, Baccarelli AA, Just AC. Prenatal maternal phthalate exposures and trajectories of childhood adiposity from four to twelve years. Environ Res 2022; 204:112111. [PMID: 34563522 PMCID: PMC8678304 DOI: 10.1016/j.envres.2021.112111] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 05/30/2023]
Abstract
BACKGROUND/AIM Adiposity trajectories reflect dynamic process of growth and may predict later life health better than individual measures. Prenatal phthalate exposures may program later childhood adiposity, but findings from studies examining these associations are conflicting. We investigated associations between phthalate biomarker concentrations during pregnancy with child adiposity trajectories. METHODS We followed 514 mother-child pairs from the Mexico City PROGRESS cohort from pregnancy through twelve years. We measured concentrations of nine phthalate biomarkers in 2nd and 3rd trimester maternal urine samples to create a pregnancy average using the geometric mean. We measured child BMI z-score, fat mass index (FMI), and waist-to-height ratio (WHtR) at three study visits between four and 12 years of age. We identified adiposity trajectories using multivariate latent class growth modeling, considering BMI z-score, FMI, and WHtR as joint indicators of latent adiposity. We estimated associations of phthalates biomarkers with class membership using multinomial logistic regression. We used quantile g-computation to estimate the potential effect of the total phthalate mixture and assessed effect modification by sex. RESULTS We identified three trajectories of child adiposity, a "low-stable", a "low-high", and a "high-high" group. A doubling of the sum of di (2-ethylhexyl) phthalate metabolites (ΣDEHP), was associated with 1.53 (1.08, 2.19) greater odds of being in the "high-high" trajectory in comparison to the "low-stable" group, whereas a doubling in di-isononyl phthalate metabolites (ΣDiNP) was associated with 1.43 (1.02, 2.02) greater odds of being in the "low-high" trajectory and mono (carboxy-isononyl) phthalate (MCNP) was associated with 0.66 (0.45, 97) lower odds of being in the "low-high" trajectory. No sex-specific associations or mixture associations were observed. CONCLUSIONS Prenatal concentrations of urinary DEHP metabolites, DiNP metabolites, and MCNP, a di-isodecyl phthalate metabolite, were associated with trajectories of child adiposity. The total phthalate mixture was not associated with early life child adiposity.
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Affiliation(s)
- Allison Kupsco
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA.
| | - Haotian Wu
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA
| | - Antonia M Calafat
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Marianthi-Anna Kioumourtzoglou
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA
| | | | - Marcela Tamayo-Ortiz
- Occupational Health Research Unit, Mexican Social Security Institute, Mexico City, Mexico
| | - Ivan Pantic
- National Institute of Perinatology, Mexico City, Mexico
| | | | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Joseph M Braun
- Department of Epidemiology, Brown University, Providence, RI, USA
| | - Andrea L Deierlein
- Department of Epidemiology, School of Global Public Health, New York University, New York, NY, USA
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Martha M Téllez-Rojo
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Andrea A Baccarelli
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA
| | - Allan C Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Ao J, Huo X, Zhang J, Mao Y, Li G, Ye J, Shi Y, Jin F, Bao S, Zhang J. Environmental exposure to bisphenol analogues and unexplained recurrent miscarriage: A case-control study. Environ Res 2022; 204:112293. [PMID: 34728239 DOI: 10.1016/j.envres.2021.112293] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 10/24/2021] [Accepted: 10/25/2021] [Indexed: 06/13/2023]
Abstract
The use of bisphenol A (BPA) has been substantially limited since 2010 due to its toxicity to human health. A group of bisphenol analogues that are structurally similar to BPA have been developed as the alternatives and used widely. The reproductive toxicity of these emerging chemicals has caused substantial concerns in recent years. Whether bisphenol analogues affect miscarriage, especially unexplained recurrent miscarriage (URM), remains to be explored. We conducted a hospital-based, case-control study with 1180 URM cases and 571 controls in China from 2014 to 2016. Concentrations of six bisphenol analogues (BPA, BPAF, BPAP, BPB, BPP and BPS) were measured in the urine samples collected at median intervals of 7.6 months after last miscarriage (interquartile ranges: 4.8, 14.7 months). Multiple logistic regression, Bayesian kernel machine regression (BKMR) and quantile g-computation (q-gcomp) were used to assess the relationship of bisphenol analogues with URM risk. We observed significantly higher levels of all urinary bisphenols in the cases than the controls. After controlling for potential confounders, bisphenol analogues were significantly associated with increased odds of URM in varying degrees. A dose-response pattern was observed for the associations of BPAF, BPAP and BPB quartiles with URM. The mixed exposure of six bisphenol analogues was positively associated with the risk of URM (adjusted odds ratio (aOR) = 1.25; 1.11-1.42), which was mainly driven by BPAP (60.1%), BPAF (25.1%) and BPA (14.8%). After age stratification, the risks tended to be higher in women aged 30 years or older, compared to women <30 years. Our large case-control study indicates that environmental exposure to bisphenol analogues is associated with an increased risk of URM. Older women may be more vulnerable to the insult.
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Affiliation(s)
- Junjie Ao
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Xiaona Huo
- Obstetrics Department, International Peace Maternity and Child Health Hospital of China, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Jiangtao Zhang
- Center for Reproductive Medicine, Provincial Hospital Affiliated to Shandong University, Jinan, 250001, China
| | - Yuchan Mao
- Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
| | - Guohua Li
- Department of Reproductive Immunology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, 201204, China
| | - Jiangfeng Ye
- Department of Clinical Epidemiology, Institute of Obstetrics and Gynecology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai, 200011, China
| | - Yuhua Shi
- Center for Reproductive Medicine, Provincial Hospital Affiliated to Shandong University, Jinan, 250001, China
| | - Fan Jin
- Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China.
| | - Shihua Bao
- Department of Reproductive Immunology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, 201204, China.
| | - Jun Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China; School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China.
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Quist AJL, Fliss MD, Wade TJ, Delamater PL, Richardson DB, Engel LS. Hurricane flooding and acute gastrointestinal illness in North Carolina. Sci Total Environ 2022; 809:151108. [PMID: 34688737 PMCID: PMC8770555 DOI: 10.1016/j.scitotenv.2021.151108] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/15/2021] [Accepted: 10/16/2021] [Indexed: 05/28/2023]
Abstract
Hurricanes often flood homes and industries, spreading pathogens. Contact with pathogen-contaminated water can result in diarrhea, vomiting, and/or nausea, known collectively as acute gastrointestinal illness (AGI). Hurricanes Matthew and Florence caused record-breaking flooding in North Carolina (NC) in October 2016 and September 2018, respectively. To examine the relationship between hurricane flooding and AGI in NC, we first calculated the percent of each ZIP code flooded after Hurricanes Matthew and Florence. Rates of all-cause AGI emergency department (ED) visits were calculated from NC's ED surveillance system data. Using controlled interrupted time series, we compared AGI ED visit rates during the three weeks after each hurricane in ZIP codes with a third or more of their area flooded to the predicted rates had these hurricanes not occurred, based on AGI 2016-2019 ED trends, and controlling for AGI ED visit rates in unflooded areas. We examined alternative case definitions (bacterial AGI) and effect measure modification by race and age. We observed an 11% increase (rate ratio (RR): 1.11, 95% CI: 1.00, 1.23) in AGI ED visit rates after Hurricanes Matthew and Florence. This effect was particularly strong among American Indian patients and patients aged 65 years and older after Florence and elevated among Black patients for both hurricanes. Florence's effect was more consistent than Matthew's effect, possibly because little rain preceded Florence and heavy rain preceded Matthew. When restricted to bacterial AGI, we found an 85% (RR: 1.85, 95% CI: 1.37, 2.34) increase in AGI ED visit rate after Florence, but no increase after Matthew. Hurricane flooding is associated with an increase in AGI ED visit rate, although the strength of effect may depend on total storm rainfall or antecedent rainfall. American Indians and Black people-historically pushed to less desirable, flood-prone land-may be at higher risk for AGI after storms.
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Affiliation(s)
- Arbor J L Quist
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA.
| | - Mike Dolan Fliss
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27514, USA
| | - Timothy J Wade
- Public Health and Environmental Systems Division, United States Environmental Protection Agency, Chapel Hill, NC 27514, USA
| | - Paul L Delamater
- Department of Geography, University of North Carolina, Chapel Hill, NC 27514, USA
| | - David B Richardson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Lawrence S Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
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Abstract
PURPOSE OF REVIEW Tropical cyclones impact human health, sometimes catastrophically. Epidemiological research characterizes these health impacts and uncovers pathways between storm hazards and health, helping to mitigate the health impacts of future storms. These studies, however, require researchers to identify people and areas exposed to tropical cyclones, which is often challenging. Here we review approaches, tools, and data products that can be useful in this exposure assessment. RECENT FINDINGS Epidemiological studies have used various operational measures to characterize exposure to tropical cyclones, including measures of physical hazards (e.g., wind, rain, flooding), measures related to human impacts (e.g., damage, stressors from the storm), and proxy measures of distance from the storm's central track. The choice of metric depends on the research question asked by the study, but there are numerous resources available that can help in capturing any of these metrics of exposure. Each has strengths and weaknesses that may influence their utility for a specific study. Here we have highlighted key tools and data products that can be useful for exposure assessment for tropical cyclone epidemiology. These results can guide epidemiologists as they design studies to explore how tropical cyclones influence human health.
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Freisthler MS, Robbins CR, Benbrook CM, Young HA, Haas DM, Winchester PD, Perry MJ. Association between increasing agricultural use of 2,4-D and population biomarkers of exposure: findings from the National Health and Nutrition Examination Survey, 2001-2014. Environ Health 2022; 21:23. [PMID: 35139875 PMCID: PMC8830015 DOI: 10.1186/s12940-021-00815-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 12/08/2021] [Indexed: 05/15/2023]
Abstract
BACKGROUND 2,4-Dichlorophenoxyacetic acid (2,4-D) is one of the most extensively used herbicides in the United States. In 2012, 2,4-D was the most widely used herbicide in non-agricultural settings and the fifth most heavily applied pesticide in the US agricultural sector. The objective of this study was to examine trends in 2,4-D urinary biomarker concentrations to determine whether increases in 2,4-D application in agriculture are associated with increases in biomonitoring levels of urine 2,4-D. METHODS Data from the National Health and Nutrition Examination Survey (NHANES) with available urine 2,4-D biomarker measurements from survey cycles between 2001 and 2014 were utilized. Urine 2,4-D values were dichotomized using the highest limit of detection (LOD) across all cycles (0.40 μg/L or 0.4 ppb). Agricultural use of 2,4-D was estimated by compiling publicly available federal and private pesticide application data. Logistic regression models adjusted for confounders were fitted to evaluate the association between agricultural use of 2,4-D and urine 2,4-D level above the dichotomization threshold. RESULTS Of the 14,395 participants included in the study, 4681 (32.5%) had urine 2,4-D levels above the dichotomization threshold. The frequency of participants with high 2,4-D levels increased significantly (p < .0001), from a low of 17.1% in 2001-2002 to a high of 39.6% in 2011-2012. The adjusted odds of high urinary 2,4-D concentrations associated with 2,4-D agricultural use (per ten million pounds applied) was 2.268 (95% CI: 1.709, 3.009). Children ages 6-11 years (n = 2288) had 2.1 times higher odds of having high 2,4-D urinary concentrations compared to participants aged 20-59 years. Women of childbearing age (age 20-44 years) (n = 2172) had 1.85 times higher odds than men of the same age. CONCLUSIONS Agricultural use of 2,4-D has increased substantially from a low point in 2002 and it is predicted to increase further in the coming decade. Because increasing use is likely to increase population level exposures, the associations seen here between 2,4-D crop application and biomonitoring levels require focused biomonitoring and epidemiological evaluation to determine the extent to which rising use and exposures cause adverse health outcomes among vulnerable populations (particularly children and women of childbearing age) and highly exposed individuals (farmers, other herbicide applicators, and their families).
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Affiliation(s)
- Marlaina S Freisthler
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA
| | - C Rebecca Robbins
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA
| | | | - Heather A Young
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA
| | - David M Haas
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Paul D Winchester
- Neonatology, Indiana University School of Medicine/Riley Hospital, Indianapolis, Indiana, USA
| | - Melissa J Perry
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA.
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Groot J, Keller A, Pedersen M, Sigsgaard T, Loft S, Nybo Andersen AM. Indoor home environments of Danish children and the socioeconomic position and health of their parents: A descriptive study. Environ Int 2022; 160:107059. [PMID: 34959195 DOI: 10.1016/j.envint.2021.107059] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 12/19/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Housing and indoor home environments are associated with the risk of infections and asthma in children. To better understand the determinants and characteristics of these environments, we aimed to describe the associations between parental health and socioeconomic position and housing and indoor home environments of children in Denmark, and the clustering of the factors within these environments. METHODS Offspring in the Danish National Birth Cohort (DNBC) whose parents responded to the 11-year follow-up were eligible for inclusion. We included complete cases only. Data on the indoor and housing environments (i.e. variables on housing, sources of gaseous and particle pollution, mould and moisture, and pets) were collected through an online questionnaire responded to by a parent. Data on socioeconomic position were obtained through linkage with registry data on maternal education at offspring birth and household equivalized income at offspring birth. Data on parental health were obtained by linking self-reported data from the 11-year follow-up for mother and father with administrative registry data for the mother. We present descriptive statistics and exploratory factor analyses. RESULTS A total of 42 723 offspring were included for analyses. The distributions of nearly all indoor and housing environments differed according to educational and income strata, with patterns similar for both education and income. Generally, higher parental educational and income strata had more favorable indoor and housing environments (less secondhand smoking, gas stove use, mould and condensation and higher house ownership, detached house dwellings and newer building age). However, candle use was approximately similar between strata, fireplace use among lower educational and income strata tended towards the extremes (none or daily), and water damage was more common among higher educational and income strata. Parental health was strongly associated with housing and indoor home environment factors - especially parental affective disorders was strongly associated with mould. Four factors were extracted from the exploratory factor analyses, relating primarily in order of extraction to: housing ownership, mould and moisture, candle use and household density. CONCLUSION Parental health and socioeconomic position are strongly related to housing and indoor home environments. Additionally, several factors in these environments correlate strongly and cluster together. Observational studies on associations and causal effects of factors in the indoor and housing environments of children on their morbidity, must consider both of these conclusions to arrive at valid estimates and effects.
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Affiliation(s)
- Jonathan Groot
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Amélie Keller
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Marie Pedersen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Torben Sigsgaard
- Environment, Work and Health, Department of Public Health, University of Aarhus, Aarhus, Denmark
| | - Steffen Loft
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anne-Marie Nybo Andersen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Doubleday A, Knott CJ, Hazlehurst MF, Bertoni AG, Kaufman JD, Hajat A. Neighborhood greenspace and risk of type 2 diabetes in a prospective cohort: the Multi-Ethncity Study of Atherosclerosis. Environ Health 2022; 21:18. [PMID: 35034636 PMCID: PMC8762964 DOI: 10.1186/s12940-021-00824-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 12/22/2021] [Indexed: 05/25/2023]
Abstract
BACKGROUND Neighborhood greenspaces provide opportunities for increased physical activity and social interaction, and thus may reduce the risk of Type 2 diabetes. However, there is little robust research on greenspace and diabetes. In this study, we examine the longitudinal association between neighborhood greenspace and incident diabetes in the Multi-Ethnic Study of Atherosclerosis. METHODS A prospective cohort study (N = 6814; 2000-2018) was conducted to examine the association between greenspace, measured as annual and high vegetation season median greenness determined by satellite (Normalized Difference Vegetation Index) within 1000 m of participant homes, and incident diabetes assessed at clinician visits, defined as a fasting glucose level of at least 126 mg/dL, use of insulin or use of hypoglycemic medication, controlling for covariates in stages. Five thousand five hundred seventy-four participants free of prevalent diabetes at baseline were included in our analysis. RESULTS Over the study period, 886 (15.9%) participants developed diabetes. Adjusting for individual characteristics, individual and neighborhood-scale SES, additional neighborhood factors, and diabetes risk factors, we found a 21% decrease in the risk of developing diabetes per IQR increase in greenspace (HR: 0.79; 95% CI: 0.63, 0.99). CONCLUSIONS Overall, neighborhood greenspace provides a protective influence in the development of diabetes, suggesting that neighborhood-level urban planning that supports access to greenspace--along with healthy behaviors--may aid in diabetes prevention. Additional research is needed to better understand how an area's greenness influences diabetes risk, how to better characterize greenspace exposure and usage, and future studies should focus on robust adjustment for neighborhood-level confounders.
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Affiliation(s)
- Annie Doubleday
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA.
| | - Catherine J Knott
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | | | - Alain G Bertoni
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Joel D Kaufman
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Anjum Hajat
- Department of Epidemiology, University of Washington, Seattle, WA, USA
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Lu W, Levin R, Schwartz J. Lead contamination of public drinking water and academic achievements among children in Massachusetts: a panel study. BMC Public Health 2022; 22:107. [PMID: 35033038 DOI: 10.1186/s12889-021-12474-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 12/24/2021] [Indexed: 11/10/2022] Open
Abstract
Background Public drinking water can be an important source exposure to lead, which can affect children’s cognitive development and academic performance. Few studies have looked at the impact of lead exposures from community water supplies or their impact on school achievements. We examined the association between annual community water lead levels (WLLs) and children’s academic performances at the school district level. Methods We matched the 90th percentile WLLs with the grade 3–8 standardized test scores from the Stanford Education Data Archive on Geographic School Districts by geographic location and year. We used multivariate linear regression and adjusted for urbanicity, race, socioeconomic characteristics, school district, grade, and year. We also explored potential effect measure modifications and lag effects. Results After adjusting for potential confounders, a 5 μg/L increase in 90th percentile WLLs in a GSD was associated with a 0.00684 [0.00021, 0.01348] standard deviation decrease in the average math test score in the same year. No association was found for English Language Arts. Conclusions We found an association between the annual fluctuation of WLLs and math test scores in Massachusetts school districts, after adjusting for confounding by urbanicity, race, socioeconomic factors, school district, grade, and year. The implications of a detectable effect of WLLs on academic performance even at the modest levels evident in MA are significant and timely. Persistent efforts should be made to further reduce lead in drinking water. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12474-1.
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Eggers S, Safdar N, Kates A, Sethi AK, Peppard PE, Kanarek MS, Malecki KMC. Urinary lead level and colonization by antibiotic resistant bacteria: Evidence from a population-based study. Environ Epidemiol 2021; 5:e175. [PMID: 34909555 DOI: 10.1097/EE9.0000000000000175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 09/28/2021] [Indexed: 11/25/2022] Open
Abstract
Background Infection by antibiotic resistant bacteria (ARB) is a global health crisis and asymptomatic colonization increases risk of infection. Nonhuman studies have linked heavy metal exposure to the selection of ARB; however, few epidemiologic studies have examined this relationship. This study analyzes the association between urinary lead level and colonization by ARB in a nonclinical human population. Methods Data came from the Survey of the Health of Wisconsin 2016-2017, and its ancillary Wisconsin Microbiome Study. Urinary lead levels, adjusted for creatinine, were used to assess exposure. ARB included methicillin resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), fluoroquinolone resistant Gram-negative bacilli (RGNB), and Clostridium difficile (C. diff), from skin, nose, and mouth swabs, and saliva and stool samples. Logistic regression, adjusted for covariates, was used to evaluate associations between Pb and ARB. Secondary analysis investigated Pb resistance from ARB isolates. Results Among 695 participants, 239 (34%) tested positive for ARB. Geometric mean urinary Pb (unadjusted) was 0.286 µg/L (95% confidence intervals [CI] = 0.263, 0.312) for ARB negative participants and 0.323 µg/L (95% CI = 0.287, 0.363) for ARB positive participants. Models adjusted for demographics, diet, and antibiotic use showed elevated odds of positive colonization for those in the 95th percentile (vs. below) of Pb exposure (odds ratio [OR] = 2.05, 95% CI = 0.95, 4.44), and associations were highest in urban residents (OR = 2.85, 95% CI = 1.07, 7.59). RGNB isolates were most resistant to Pb. Discussion These novel results suggest that Pb exposure is associated with increased colonization by ARB, and that RGNB are particularly resistant to Pb.
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Zhang H, Liu L, Zeng Y, Liu M, Bi J, Ji JS. Effect of heatwaves and greenness on mortality among Chinese older adults. Environ Pollut 2021; 290:118009. [PMID: 34523521 DOI: 10.1016/j.envpol.2021.118009] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 08/13/2021] [Accepted: 08/18/2021] [Indexed: 06/13/2023]
Abstract
Heatwaves and greenness have been shown to affect health, but the evidence on their joint effects is limited. We aim to assess the associations of the combined exposure to greenness and heatwaves. We utilized five waves (February 2000-October 2014) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a prospective cohort of older adults aged 65. We defined heatwaves as the daily maximum temperature ≥92.5th percentile with duration ≥3 days. We calculated the number of heatwave days in one year before death to and cumulative Normalized Difference Vegetation Index (NDVI) during follow-up to assess individual long-term exposure to heatwaves and greenness. Cox proportional hazards models were used to assess the effects of greenness, heatwaves, and their interaction on mortality, adjusted for covariates. We conducted subgroup analyses by residence, gender, and age. There were 20,758 participants in our study, totaling 67,312 person-years of follow-up. The mean NDVI was 0·41 (SD 0.13), and the mean number of heatwave days was 8.92 (2.04). In the adjusted model, the mortality hazard ratio (HR) for each 3-day increase in heatwave days was 1.04 (95% CI 1.04, 1.05), each 0.1-unit decrease in cumulative NDVI was 1.06 (1.05, 1.07). In the adjusted model with an interaction term, the HR for the interaction term was 1.01 (1.01, 1.02) with a p-value less than 0.001. In our subgroup analyses, the HR for each 3-day increase in heatwave days was higher in urban areas than in rural areas (1.06 vs. 1.03), and the HR for 0.1-unit decrease in NDVI was higher in urban areas than in rural areas (1.08 vs. 1.04). Greenness can protect against the effect of heatwaves on mortality, and heatwaves affect the health effects of greenness. Urban dwellers have a higher response to the detrimental effect of heatwaves and a higher marginal benefit from greenness exposure.
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Affiliation(s)
- Haofan Zhang
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, China; Environmental Research Center, Duke Kunshan University, Kunshan, Jiangsu, China.
| | - Linxin Liu
- Environmental Research Center, Duke Kunshan University, Kunshan, Jiangsu, China.
| | - Yi Zeng
- Center for the Study of Aging and Human Development, Duke Medical School, Durham, NC, USA; Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China.
| | - Miaomiao Liu
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, China.
| | - Jun Bi
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, China.
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China.
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Perry MJ, Arrington S, Freisthler MS, Ibe IN, McCray NL, Neumann LM, Tajanlangit P, Trejo Rosas BM. Pervasive structural racism in environmental epidemiology. Environ Health 2021; 20:119. [PMID: 34784917 PMCID: PMC8595076 DOI: 10.1186/s12940-021-00801-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 10/22/2021] [Indexed: 05/22/2023]
Abstract
BACKGROUND Epistemological biases in environmental epidemiology prevent the full understanding of how racism's societal impacts directly influence health outcomes. With the ability to focus on "place" and the totality of environmental exposures, environmental epidemiologists have an important opportunity to advance the field by proactively investigating the structural racist forces that drive disparities in health. OBJECTIVE This commentary illustrates how environmental epidemiology has ignored racism for too long. Some examples from environmental health and male infertility are used to illustrate how failing to address racism neglects the health of entire populations. DISCUSSION While research on environmental justice has attended to the structural sources of environmental racism, this work has not been fully integrated into the mainstream of environmental epidemiology. Epidemiology's dominant paradigm that reduces race to a mere data point avoids the social dimensions of health and thus fails to improve population health for all. Failing to include populations who are Black, Indigenous, and people of color (BIPOC) in health research means researchers actually know very little about the effect of environmental contaminants on a range of population health outcomes. This commentary offers different practical solutions, such as naming racism in research, including BIPOC in leadership positions, mandating requirements for discussing "race", conducting far more holistic analyses, increasing community participation in research, and improving racism training, to address the myriad of ways in which structural racism permeates environmental epidemiology questions, methods, results and impacts.
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Affiliation(s)
- Melissa J Perry
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA.
| | - Suzanne Arrington
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA
| | - Marlaina S Freisthler
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA
| | - Ifeoma N Ibe
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA
| | - Nathan L McCray
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA
| | - Laura M Neumann
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA
| | - Patrick Tajanlangit
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA
| | - Brenda M Trejo Rosas
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA
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Déglin SE, Chen CL, Miller DJ, Lewis RJ, Chang ET, Hamade AK, Erickson HS. Environmental epidemiology and risk assessment: Exploring a path to increased confidence in public health decision-making. Glob Epidemiol 2021; 3:100048. [PMID: 37635726 PMCID: PMC10445995 DOI: 10.1016/j.gloepi.2021.100048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 11/16/2020] [Accepted: 11/16/2020] [Indexed: 01/25/2023] Open
Abstract
Throughout history, environmental epidemiology has proven crucial to identify certain threats to human health and to provide a basis for the development of life-saving public health policies. However, epidemiologists are facing challenges when studying tenuous threats such as environmental exposure to chemicals, whose association with adverse health effects may be difficult to characterize. As a result, epidemiological data can seldom be fully leveraged for quantitative risk assessment and decision-making. Despite two decades of efforts to improve a more systematic integration of human data to evaluate human health risks, assessors still heavily rely on animal data to do so, while epidemiology plays more of a secondary role. Although the need for more and better collaboration between risk assessors and epidemiologists is widely recognized, both fields tend to remain siloed. In 2017, the Health and Environmental Sciences Institute initiated a project engaging the epidemiology, exposure science, and regulatory communities with tripartite representation from regulators, industry, and academia in a dialogue on the use of environmental epidemiology for regulatory decision-making. Several focus groups attended by epidemiology, exposure science, and risk assessment experts were organized to explore incentives and barriers to collaboration, to ultimately bridge the gap between the various disciplines, and to realize the full potential of epidemiological data in risk assessment. Various ideas that have emerged from these meetings could help ensure the better integration of epidemiological data in quantitative risk assessment and contribute to building confidence in a robust and science-based regulatory decision-making process.
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Affiliation(s)
- Sandrine E. Déglin
- Health and Environmental Sciences Institute, Washington, DC, United States of America
| | - Connie L. Chen
- Health and Environmental Sciences Institute, Washington, DC, United States of America
| | - David J. Miller
- U.S. Environmental Protection Agency, Washington, DC, United States of America
| | - R. Jeffrey Lewis
- ExxonMobil Biomedical Sciences, Inc., Annandale, NJ, United States of America
| | - Ellen T. Chang
- Center for Health Sciences, Exponent, Inc., Menlo Park, CA, United States of America
| | - Ali K. Hamade
- Oregon Health Authority, Portland, OR, United States of America
| | - Heidi S. Erickson
- Health & Medical, Chevron Services Company (a division of Chevron USA Inc.), Houston, TX, United States of America
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Yoo EH, Eum Y, Roberts JE, Gao Q, Chen K. Association between extreme temperatures and emergency room visits related to mental disorders: A multi-region time-series study in New York, USA. Sci Total Environ 2021; 792:148246. [PMID: 34144243 DOI: 10.1016/j.scitotenv.2021.148246] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/21/2021] [Accepted: 05/31/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND There is growing evidence suggesting that extreme temperatures have an impact on mental disorders. We aimed to explore the effect of extreme temperatures on emergency room (ER) visits for mental health disorders using 2.8 million records from New York State, USA (2009-2016), and to examine potential effect modifications by individuals' age, sex, and race/ethnicity through a stratified analysis to determine if certain populations are more susceptible. METHOD To assess the short-term impact of daily average temperature on ER visits related to mental disorders, we applied a quasi-Poisson generalized linear model combined with a distributed lag non-linear model (DLNM). The model was adjusted for day of the week, precipitation, as well as long-term and seasonal time trends. We also conducted a meta-analysis to pool the region-specific risk estimates and construct the overall cumulative exposure-response curves for all regions. RESULTS We found positive associations between short-term exposure to extreme heat (27.07 ∘C) and increased ER visits for total mental disorders, as well as substance abuse, mood and anxiety disorders, schizophrenia, and dementia. We did not find any statistically significant difference among any subgroups of the population being more susceptible to extreme heat than any other. CONCLUSIONS Our findings suggest that there is a positive association between short-term exposure to extreme heat and increased ER visits for total mental disorders. This extreme effect was also found across all sub-categories of mental disease, although further research is needed to confirm our finding for specific mental disorders, such as dementia, which accounted for less than 1% of the total mental disorders in this sample.
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Affiliation(s)
- Eun-Hye Yoo
- Department of Geography, State University of New York at Buffalo, NY, USA.
| | - Youngseob Eum
- Department of Geography, State University of New York at Buffalo, NY, USA
| | - John E Roberts
- Department of Psychology, State University of New York at Buffalo, NY, USA
| | - Qi Gao
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, China; Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA
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Donat-Vargas C, Perez-Carrascosa F, Gomez-Peña C, Mustieles V, Salcedo-Bellido I, Frederiksen H, Åkesson A, Arrebola JP. Associations of serum phthalate metabolites with thyroid hormones in GraMo cohort, Southern Spain. Environ Pollut 2021; 287:117606. [PMID: 34426375 DOI: 10.1016/j.envpol.2021.117606] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/26/2021] [Accepted: 06/14/2021] [Indexed: 06/13/2023]
Abstract
The general population is continuously exposed to phthalates via various consumer products. Epidemiological research relating phthalate exposure to thyroid function during non-developmental periods is limited. This study aimed to investigate the associations between specific serum phthalate metabolites and indicators of thyroid function in adults. We measured 10 serum phthalate metabolites and thyroid hormones - total triiodothyronine (TT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) - in a subsample of 207 adults from the GraMo cohort. This subsample was made up of men and women (in equal proportions) of middle age (49 ± 17 years) and from Southern Spain (province of Granada). Data on age, sex, body mass index, residence area, tobacco use, alcohol consumption and attained education were obtained from a questionnaire. Phthalate metabolites were log-transformed and categorized into tertiles. Cross-sectional associations of each metabolite with thyroid hormones were analyzed using multivariable-adjusted linear regression models. The mixture effect of metabolite phthalates was assessed using weighted quantile sum regression. After multivariable-adjustment, the following phthalate metabolites were significantly associated with TT3 in a dose-response manner: MMP (β = 0.90: 95% confidence interval 0.68,1.12), MEP (β = 0.67: 0.44, 0.90), MiBP (β = 0.49: 0.21, 0.77), MiDP (β = 0.27: 0.03, 0.52), MBzP (β = 0.51: 0.28, 0.73), MEHP (β = -0.59: -0.82, -0.35) and MiNP (β = -0.43: -0.71, -0.14), when comparing highest vs. lowest exposed. The sum of all metabolites was also linked to FT4 levels. No significant associations were observed for TSH except for MiNP. Although phthalate metabolites with different molecular weight showed opposite associations, overall metabolite concentrations seem to associate with increased TT3 and FT4 serum levels. The cross-sectional nature of this analysis limits causal inference.
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Affiliation(s)
- Carolina Donat-Vargas
- IMDEA-Food Institute. CEI UAM+CSIC, Madrid, Spain; Autonomous University of Madrid, Madrid, Spain; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Francisco Perez-Carrascosa
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain; Biosanitary Research Institute, ibs.GRANADA, Granada, Spain; Radiation Oncology Department, University Hospital Virgen de las Nieves, Granada, Spain
| | | | - Vicente Mustieles
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Biosanitary Research Institute, ibs.GRANADA, Granada, Spain
| | - Inmaculada Salcedo-Bellido
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain; Biosanitary Research Institute, ibs.GRANADA, Granada, Spain
| | - Hanne Frederiksen
- Department of Growth and Reproduction, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Agneta Åkesson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Juan Pedro Arrebola
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain; University of Granada, Center for Biomedical Research (CIBM), Granada, Spain.
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Ezell JM, Chase EC. A Population-Based Assessment of Physical Symptoms and Mental Health Outcomes Among Adults Following the Flint Water Crisis. J Urban Health 2021; 98:642-53. [PMID: 33788147 DOI: 10.1007/s11524-021-00525-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/02/2021] [Indexed: 10/21/2022]
Abstract
Little is known about the physical and mental health outcomes of adults in the low-income, predominantly Black city of Flint, Michigan, following the city's water crisis which began in April 2014 after austerity policies led to the city switching its water source. We investigate these dynamics using data from a longitudinal community-based cohort in Flint. Between June and November 2019, surveys were administered at nine public sites across Flint. Nested models were employed to assess relationships between respondent demographics, including race/ethnicity, and self-report of clinician-diagnosed blood lead levels (BLLs) and various physical symptoms and mental health outcomes, including depression/anxiety (PHQ-4) and psychological trauma (PC-PTSD-5). Of the 331 respondents (mean age: 47.9 + 16.5), most were women (58.6%) and Black (57.7%). In total, 10.0% self-reported elevated BLLs, with borderline significantly higher reports among Blacks (p = 0.07). Skin rashes (58.1% vs. 33.9%, p < 0.01), hair loss (45.5% vs. 30.3%, p = 0.01), and nausea (35.6% vs. 20.2%, p = 0.1) were significantly higher among Blacks versus Whites. Additionally, 29.0% and 26.3% of respondents met trauma and depression/anxiety criteria, respectively. Increasing physical symptoms was associated with psychological trauma (OR 2.1, p < 0.01) and depression/anxiety (OR 1.9, p < 0.01). In closing, Flint adults, particularly Blacks, experienced deleterious physical and mental health outcomes following the city's water crisis that appear to represent a substantial burden of excess cases. Further research is needed on how austerity impacts community health in economically distressed urban cities and ways to generate capacity to identify and curb adverse consequences.
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Zamboni M, Fin G, Scatton N, Facciolo L, Stoppa G, Catelan D, Ungherese G, Biggeri A. [Perfluoroalchilic food contamination in the PFAS high-risk area of the Veneto Region (Northern Italy)]. Epidemiol Prev 2021; 45:387-394. [PMID: 34841841 DOI: 10.19191/ep21.5.p387.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
In a wide area among the provinces of Vicenza, Verona, and Padua (Veneto Region, Northern Italy), one of the larger known massive contamination of the environment by per- and polyfluoroalkyl substances (PFASs) occurred since the year 1965. The most important source of human exposure was through aquiferous and contaminated water supplies (the regional authorities distinguished red zone A - aquiferous - and red zone B - water supply) for a total of slightly less than two hundred thousand exposed people. Food contamination and food contribution to total human exposure were assessed by a food monitoring campaign on the years 2016-2017 by the National Health Institute sponsored by Veneto Region.Thanks to the availability of the individual records of the monitoring campaign, we evaluated the spatial distribution of PFAS contamination by food matrix. Generally speaking, PFAS contamination was widespread over the entire red zone (either A or B). Some zones appeared to be higher contaminated consistently with the water plume. Other higher contaminated zones were less consistent and such result raises questions about routes of environmental pollution.
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Affiliation(s)
| | | | | | | | - Giorgia Stoppa
- Unità di biostatistica epidemiologia e sanità pubblica, Dipartimento di scienze cardio-toraco-vascolari e sanità pubblica, Università degli studi di Padova;
| | - Dolores Catelan
- Unità di biostatistica epidemiologia e sanità pubblica, Dipartimento di scienze cardio-toraco-vascolari e sanità pubblica, Università degli studi di Padova
| | | | - Annibale Biggeri
- Unità di biostatistica epidemiologia e sanità pubblica, Dipartimento di scienze cardio-toraco-vascolari e sanità pubblica, Università degli studi di Padova
- Dipartimento di statistica, informatica e applicazioni "G. Parenti", Università di Firenze
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Julvez J, López-Vicente M, Warembourg C, Maitre L, Philippat C, Gützkow KB, Guxens M, Evandt J, Andrusaityte S, Burgaleta M, Casas M, Chatzi L, de Castro M, Donaire-González D, Gražulevičienė R, Hernandez-Ferrer C, Heude B, Mceachan R, Mon-Williams M, Nieuwenhuijsen M, Robinson O, Sakhi AK, Sebastian-Galles N, Slama R, Sunyer J, Tamayo-Uria I, Thomsen C, Urquiza J, Vafeiadi M, Wright J, Basagaña X, Vrijheid M. Early life multiple exposures and child cognitive function: A multi-centric birth cohort study in six European countries. Environ Pollut 2021; 284:117404. [PMID: 34077897 PMCID: PMC8287594 DOI: 10.1016/j.envpol.2021.117404] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 05/04/2021] [Accepted: 05/16/2021] [Indexed: 05/04/2023]
Abstract
Epidemiological studies mostly focus on single environmental exposures. This study aims to systematically assess associations between a wide range of prenatal and childhood environmental exposures and cognition. The study sample included data of 1298 mother-child pairs, children were 6-11 years-old, from six European birth cohorts. We measured 87 exposures during pregnancy and 122 cross-sectionally during childhood, including air pollution, built environment, meteorology, natural spaces, traffic, noise, chemicals and life styles. The measured cognitive domains were fluid intelligence (Raven's Coloured Progressive Matrices test, CPM), attention (Attention Network Test, ANT) and working memory (N-Back task). We used two statistical approaches to assess associations between exposure and child cognition: the exposome-wide association study (ExWAS) considering each exposure independently, and the deletion-substitution-addition algorithm (DSA) considering all exposures simultaneously to build a final multiexposure model. Based on this multiexposure model that included the exposure variables selected by ExWAS and DSA models, child organic food intake was associated with higher fluid intelligence (CPM) scores (beta = 1.18; 95% CI = 0.50, 1.87) and higher working memory (N-Back) scores (0.23; 0.05, 0.41), and child fast food intake (-1.25; -2.10, -0.40), house crowding (-0.39; -0.62, -0.16), and child environmental tobacco smoke (ETS) (-0.89; -1.42, -0.35), were all associated with lower CPM scores. Indoor PM2.5 exposure was associated with lower N-Back scores (-0.09; -0.16, -0.02). Additional associations in the unexpected direction were found: Higher prenatal mercury levels, maternal alcohol consumption and child higher perfluorooctane sulfonic acid (PFOS) levels were associated with better cognitive performance; and higher green exposure during pregnancy with lower cognitive performance. This first comprehensive and systematic study of many prenatal and childhood environmental risk factors suggests that unfavourable child nutrition, family crowdedness and child indoor air pollution and ETS exposures adversely and cross-sectionally associate with cognitive function. Unexpected associations were also observed and maybe due to confounding and reverse causality.
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Affiliation(s)
- Jordi Julvez
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, Reus (Tarragona), Catalonia, Spain; Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
| | - Mónica López-Vicente
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Universitat Pompeu Fabra, Barcelona, Catalonia, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre-Sophia Children's Hospital, PO Box 2060, 3000 CB, Rotterdam, the Netherlands
| | - Charline Warembourg
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
| | - Lea Maitre
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
| | - Claire Philippat
- Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences (IAB), Inserm U1209, CNRS UMR 5309, Université Grenoble Alpes, 38000, Grenoble, France
| | - Kristine B Gützkow
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Monica Guxens
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Universitat Pompeu Fabra, Barcelona, Catalonia, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre-Sophia Children's Hospital, PO Box 2060, 3000 CB, Rotterdam, the Netherlands
| | - Jorunn Evandt
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Miguel Burgaleta
- Center for Brain and Cognition, Department of Technology, Universitat Pompeu Fabra, Roc Boronat 138, 08018, Barcelona, Catalonia, Spain
| | - Maribel Casas
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
| | - Leda Chatzi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece; Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Montserrat de Castro
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
| | - David Donaire-González
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Universitat Pompeu Fabra, Barcelona, Catalonia, Spain; Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | | | - Carles Hernandez-Ferrer
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
| | - Barbara Heude
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, Paris, France
| | - Rosie Mceachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Mark Mon-Williams
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Mark Nieuwenhuijsen
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
| | - Oliver Robinson
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, UK
| | - Amrit K Sakhi
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Nuria Sebastian-Galles
- Center for Brain and Cognition, Department of Technology, Universitat Pompeu Fabra, Roc Boronat 138, 08018, Barcelona, Catalonia, Spain
| | - Remy Slama
- Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences (IAB), Inserm U1209, CNRS UMR 5309, Université Grenoble Alpes, 38000, Grenoble, France
| | - Jordi Sunyer
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
| | - Ibon Tamayo-Uria
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Universitat Pompeu Fabra, Barcelona, Catalonia, Spain; Division of Immunology and Immunotherapy, Cima Universidad de Navarra and "Instituto de Investigación Sanitaria de Navarra (IdISNA)", Pamplona, Spain
| | - Cathrine Thomsen
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Jose Urquiza
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
| | - Marina Vafeiadi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Xavier Basagaña
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
| | - Martine Vrijheid
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
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Radke EG, Glenn BS, Kraft AD. Integrated Risk Information System (IRIS) response to "Assessing risk of bias in human environmental epidemiology studies using three tools: different conclusions from different tools". Syst Rev 2021; 10:235. [PMID: 34419159 DOI: 10.1186/s13643-021-01783-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/28/2021] [Indexed: 11/13/2022] Open
Abstract
"Assessing risk of bias in human environmental epidemiology studies using three tools: different conclusions from different tools," a recent publication in this journal, applied the study evaluation approach developed by the U.S. Environmental Protection Agency's Integrated Risk Information System (IRIS), as well as other approaches, to a set of studies examining polybrominated diphenyl ethers (PBDEs) and neurodevelopment. They concluded that use of the IRIS approach resulted in exclusion of studies, which would lead to hazard conclusions based on an incomplete body of evidence. As scientists in the IRIS program, we support the comparison of approaches to improve systematic review methods for environmental exposures; however, we believe the IRIS approach was misrepresented. In this letter, we demonstrate that the ratings attributed to the IRIS approach were not consistent with our own application of the tool. We also clarify the use of studies rated as "low confidence" and the use of an overall study confidence rating in our systematic reviews. In conclusion, the IRIS study evaluation approach is a transparent method to inform certainty in our evidence synthesis decisions and ensures consistency in the development of IRIS health assessments.
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Abstract
Two tendencies have emerged in environmental epidemiology that hamper the translation of research findings into prevention of environmental hazards. One is the increased focus on highlighting weaknesses of epidemiology research that is clearly meant to explain away the research conclusions and weaken their possible implications for interventions to control environmental hazards. Another is the voluminous amount of information sharing that involves a substantial amount of misinformation, as part of the ongoing infodemic. In this light, the appearance of the catalogue of doubt-raising strategies, indeed the worst practices of scientific inference, is good news. Collected under the auspices of the International Network for Epidemiology in Policy, it serves to illustrate the range of possible (and impossible) forms of critique that may be raised on behalf of vested interests or other groups who for some reason disagree with the epidemiological conclusions. We believe that this systematic list will be useful in our field and help to identify critiques of policy options that are hidden and sometimes suppressed in weighing the epidemiological evidence.
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Affiliation(s)
- Ruth A. Etzel
- Milken Institute School of Public Health, The George Washington University, D. C, Washington, 20052 USA
| | - Philippe Grandjean
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA 02115 USA
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - David M. Ozonoff
- Department of Environmental Health, Boston University School of Public Health, Boston, USA
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Yoo EH, Eum Y, Gao Q, Chen K. Effect of extreme temperatures on daily emergency room visits for mental disorders. Environ Sci Pollut Res Int 2021; 28:39243-39256. [PMID: 33751353 DOI: 10.1007/s11356-021-12887-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 02/08/2021] [Indexed: 06/12/2023]
Abstract
Relatively few studies investigated the effects of extreme temperatures (both heat and cold) on mental health (ICD-9: 290-319; ICD-10: F00-F99) and the potential effect modifications by individuals' age, sex, and race. We aimed to explore the effect of extreme temperatures of both heat and cold on the emergency room (ER) visits for mental health disorders, and conducted a stratified analysis to identify possible susceptible population in Erie and Niagara counties, NY, USA. To assess the short-term impacts of daily maximum temperature on ER visits related to mental disorders (2009-2015), we applied a quasi-Poisson generalized linear model combined with a distributed lag non-linear model (DLNM). The model was adjusted for day of the week, precipitation, long-term time trend, and seasonality. We found that there were positive associations between short-term exposure to extreme ambient temperatures and increased ER visits for mental disorders, and the effects can vary by individual factors. We found heat effect (relative risk (RR) = 1.16; 95% confidence intervals (CI), 1.06-1.27) on exacerbated mental disorders became intense in the study region and subgroup of population (the elderly) being more susceptible to extreme heat than any other age group. For extreme cold, we found that there is a substantial delay effect of 14 days (RR = 1.25; 95% CI = 1.08-1.45), which is particularly burdensome to the age group of 50-64 years old and African-Americans. Our findings suggest that there is a positive association between short-term exposure to extreme ambient temperature (heat and cold) and increased ER visits for mental disorders, and the effects vary as a function of individual factors, such as age and race.
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Affiliation(s)
- Eun-Hye Yoo
- Department of Geography, State University of New York at Buffalo, Buffalo, NY, USA.
| | - Youngseob Eum
- Department of Geography, State University of New York at Buffalo, Buffalo, NY, USA
| | - Qi Gao
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, China
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
- Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
- Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA
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Noël C, Vanroelen C, Gadeyne S. Qualitative research about public health risk perceptions on ambient air pollution. A review study. SSM Popul Health 2021; 15:100879. [PMID: 34355057 PMCID: PMC8325091 DOI: 10.1016/j.ssmph.2021.100879] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/19/2021] [Accepted: 07/19/2021] [Indexed: 11/13/2022] Open
Abstract
Background Understanding public health risk perceptions is essential in efficient environmental health management. In the light of the negative impact of air pollution on health and the direct and indirect mediation of this impact through risk perceptions, it is crucial to better understand the lay perceptions of air pollution. Since qualitative research methods are well suited for this aim, the central objective of this study is to present a review of qualitative research articles in the field of environmental epidemiology that investigate health risk perceptions of ambient air pollution since the 2000s. Methods We followed the PRISMA-guidelines which resulted in a selection of 20 scientific articles published in peer-reviewed academic journals that used qualitative research methods and reported on health risk perceptions about ambient air pollution. Results Qualitative research in the field of environmental epidemiology is still scarce. Most of the studies included in the review were based on face-to-face interviews and focus group discussions; a minority used a mixed-method approach. Interesting contributions were made with respect to both the perception of exposure to air pollution and the perception of the health effect associated with air pollution. Conclusions The review suggests that data generated through qualitative research might complement the traditionally quantitative field of environmental epidemiology. Mixed method multidisciplinary research is likely to provide a more holistic explanation of environmental health patterns observed through quantitative research. These explanations are key in managing environmental health and in developing successful prevention, mitigation and communication strategies. Implementing qualitative research methods contribute to the field of environmental epidemiology as it i) allows for triangulation of findings; ii) generates nuanced findings and new research questions; iii) triggers in-depth understandings of quantitatively identified patterns; iv) leads to additional surprising and/or multifaceted responses; v) enhances relationships between researcher and respondent; vi) increases the awareness of important context-dependent dynamics or interactions that may generate biases and vii) grasps the local, contextual, situational and cultural elements that interact with health risk perceptions. Qualitative research in the field of environmental epidemiology is scarce. Qualitative research data (QRD) can contribute to understand perceptions about exposure to air pollution and its effects. QRD can complement the traditionally quantitative field of environmental epidemiology. Mixed methods multidisciplinary research is likely to provide the most holistic explanations for environmental health research. These explanations are key in managing environmental health.
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Affiliation(s)
- Charlotte Noël
- Interface Demography, Vrije Universiteit Brussel, Brussel, Belgium
| | | | - Sylvie Gadeyne
- Interface Demography, Vrije Universiteit Brussel, Brussel, Belgium
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Froeling F, Gignac F, Hoek G, Vermeulen R, Nieuwenhuijsen M, Ficorilli A, De Marchi B, Biggeri A, Kocman D, Robinson JA, Grazuleviciene R, Andrusaityte S, Righi V, Basagaña X. Narrative review of citizen science in environmental epidemiology: Setting the stage for co-created research projects in environmental epidemiology. Environ Int 2021; 152:106470. [PMID: 33677244 DOI: 10.1016/j.envint.2021.106470] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 02/16/2021] [Indexed: 06/12/2023]
Abstract
Several citizen science (CS) initiatives have been adopted in environmental science to monitor air and noise pollution, and water quality related to civic concerns. Nevertheless, CS projects in environmental epidemiology remain scarce. This is because little attention has been paid to evaluate associations of environmental exposures with health effects directly. This narrative review aims to promote the understanding and application of CS in environmental epidemiology. There are many commonalities between CS and other participatory approaches in environmental epidemiology. Yet, CS can foster the democratization of scientific governance and enhance the sustainability of research projects more effectively than other existing participatory approaches. This is especially the case in projects where citizens are invited to participate, engage and become involved throughout all the phases of a research project (co-created projects). This paper identifies various challenges and opportunities specific to the implementation of co-created CS projects in environmental epidemiology. The development of more locally relevant research designs, using local knowledge, obtaining medical ethical clearance, and co-analysing the association between exposure and health, are examples of opportunities and challenges that require epidemiologists to go beyond the traditional research framework and include more outreach activities. Continued efforts, particularly the sharing of information about projects' collaborative processes, are needed to make CS a more concrete and cohesive approach in environmental epidemiology.
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Affiliation(s)
| | - Florence Gignac
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
| | - Gerard Hoek
- Universiteit Utrecht (UU), Utrecht, the Netherlands
| | - Roel Vermeulen
- Universiteit Utrecht (UU), Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands
| | - Mark Nieuwenhuijsen
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Antonella Ficorilli
- Epidemiologia e Prevenzione "Giulio A. Maccacaro" Social Enterprise, Milan, Italy
| | - Bruna De Marchi
- Epidemiologia e Prevenzione "Giulio A. Maccacaro" Social Enterprise, Milan, Italy; SVT, University of Bergen, Bergen, Norway
| | - Annibale Biggeri
- Epidemiologia e Prevenzione "Giulio A. Maccacaro" Social Enterprise, Milan, Italy; Department of Statistics, Computer Science, Applications "G. Parenti" University of Florence, Florence, Italy
| | - David Kocman
- Jožef Stefan Institute, Department of Environmental Sciences, Ljubljana, Slovenia
| | - Johanna Amalia Robinson
- Jožef Stefan Institute, Department of Environmental Sciences, Ljubljana, Slovenia; Jožef Stefan International Postgraduate School, Ljubljana, Slovenia
| | | | - Sandra Andrusaityte
- Department of Environmental Science, Vytautas Magnus University, Kaunas, Lithuania
| | | | - Xavier Basagaña
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
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Kirwa K, Szpiro AA, Sheppard L, Sampson PD, Wang M, Keller JP, Young MT, Kim SY, Larson TV, Kaufman JD. Fine-Scale Air Pollution Models for Epidemiologic Research: Insights From Approaches Developed in the Multi-ethnic Study of Atherosclerosis and Air Pollution (MESA Air). Curr Environ Health Rep 2021; 8:113-126. [PMID: 34086258 PMCID: PMC8278964 DOI: 10.1007/s40572-021-00310-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Epidemiological studies of short- and long-term health impacts of ambient air pollutants require accurate exposure estimates. We describe the evolution in exposure assessment and assignment in air pollution epidemiology, with a focus on spatiotemporal techniques first developed to meet the needs of the Multi-ethnic Study of Atherosclerosis and Air Pollution (MESA Air). Initially designed to capture the substantial variation in pollutant levels and potential health impacts that can occur over small spatial and temporal scales in metropolitan areas, these methods have now matured to permit fine-scale exposure characterization across the contiguous USA and can be used for understanding long- and short-term health effects of exposure across the lifespan. For context, we highlight how the MESA Air models compare to other available exposure models. RECENT FINDINGS Newer model-based exposure assessment techniques provide predictions of pollutant concentrations with fine spatial and temporal resolution. These validated models can predict concentrations of several pollutants, including particulate matter less than 2.5 μm in diameter (PM2.5), oxides of nitrogen, and ozone, at specific locations (such as at residential addresses) over short time intervals (such as 2 weeks) across the contiguous USA between 1980 and the present. Advances in statistical methods, incorporation of supplemental pollutant monitoring campaigns, improved geographic information systems, and integration of more complete satellite and chemical transport model outputs have contributed to the increasing validity and refined spatiotemporal spans of available models. Modern models for predicting levels of outdoor concentrations of air pollutants can explain a substantial amount of the spatiotemporal variation in observations and are being used to provide critical insights into effects of air pollutants on the prevalence, incidence, progression, and prognosis of diseases across the lifespan. Additional enhancements in model inputs and model design, such as incorporation of better traffic data, novel monitoring platforms, and deployment of machine learning techniques, will allow even further improvements in the performance of pollutant prediction models.
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Affiliation(s)
- Kipruto Kirwa
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA.
| | - Adam A Szpiro
- Department of Biostatistics, University of Washington School of Public Health, Seattle, WA, USA
| | - Lianne Sheppard
- Departments of Biostatistics and Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA
| | - Paul D Sampson
- Department of Statistics, University of Washington School of Public Health, Seattle, WA, USA
| | - Meng Wang
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions Research and Education in Energy, Environment and Water Institute, University at Buffalo, Buffalo, NY, USA
| | - Joshua P Keller
- Department of Statistics, Colorado State University, Fort Collins, CO, USA
| | - Michael T Young
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA
| | - Sun-Young Kim
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA
- Institute of Health and Environment, Seoul National University, Seoul, South Korea
| | - Timothy V Larson
- Department of Civil and Environmental Engineering, University of Washington, Seattle, WA, USA
| | - Joel D Kaufman
- Departments of Environmental and Occupational Health Sciences, Epidemiology, and Medicine, University of Washington, Seattle, WA, USA
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Kalloo G, Wellenius GA, McCandless L, Calafat AM, Sjodin A, Sullivan AJ, Romano ME, Karagas MR, Chen A, Yolton K, Lanphear BP, Braun JM. Chemical mixture exposures during pregnancy and cognitive abilities in school-aged children. Environ Res 2021; 197:111027. [PMID: 33744271 PMCID: PMC9022783 DOI: 10.1016/j.envres.2021.111027] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 03/12/2021] [Accepted: 03/14/2021] [Indexed: 05/23/2023]
Abstract
INTRODUCTION Gestational exposure to chemical mixtures, which is prevalent among pregnant women, may be associated with adverse childhood neurodevelopment. However, few studies have examined relations between gestational chemical mixture exposure and children's cognitive abilities. METHODS In a cohort of 253 pregnant women and their children from Cincinnati, OH (enrolled 2003-2006), we quantified biomarker concentrations of 43 metals, phthalates, phenols, polybrominated diphenyl ethers, organophosphate and organochlorine pesticides, polychlorinated biphenyls, perfluoroalkyl substances, and environmental tobacco smoke in blood or urine. Using k-means clustering and principal component (PC) analysis, we characterized chemical mixtures among pregnant women. We assessed children's cognitive abilities using the Wechsler Preschool and Primary Scale of Intelligence-III and Wechsler Intelligence Scale for Children-IV at ages 5 and 8 years, respectively. We estimated covariate-adjusted differences in children's cognitive ability scores ]=cross clusters, and with increasing PC scores and individual biomarker concentrations. RESULTS Geometric mean biomarker concentrations were generally highest, intermediate, and lowest among women in clusters 1, 2, and 3, respectively. Children born to women in clusters 1 and 2 had 5.1 (95% CI: 9.4,-0.8) and 2.0 (95% CI: 5.5, 1,4) lower performance IQ scores compared to children in cluster 3, respectively. PC scores and individual chemical biomarker concentrations were not associated with cognitive abilities. CONCLUSIONS In this cohort, combined prenatal exposure to phenols, certain phthalates, pesticides, and perfluoroalkyl substances was inversely associated with children's cognition, but some individual chemical biomarker concentrations were not. Additional studies should determine if the aggregate impact of these chemicals on cognition is different from their individual effects.
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Affiliation(s)
- Geetika Kalloo
- Department of Epidemiology, Brown University, Providence, RI, USA.
| | | | | | | | - Andreas Sjodin
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Adam J Sullivan
- Department of Epidemiology, Brown University, Providence, RI, USA
| | - Megan E Romano
- Department of Epidemiology, Dartmouth College, Hanover, NH, USA
| | | | - Aimin Chen
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA
| | - Kimberly Yolton
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Bruce P Lanphear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada; Child and Family Research Institute, BC Children's and Women's Hospital, Vancouver, BC, Canada
| | - Joseph M Braun
- Department of Epidemiology, Brown University, Providence, RI, USA
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Iyer HS, James P, Valeri L, Bajunirwe F, Nankya-Mutyoba J, Njelekela M, Chiwanga F, Sewram V, Ajayi I, Adebamowo C, Dalal S, Reid TG, Rebbeck TR, Adami HO, Holmes MD. Neighborhood greenness and burden of non-communicable diseases in Sub-Saharan Africa: A multi-country cross-sectional study. Environ Res 2021; 196:110397. [PMID: 33130166 PMCID: PMC8085185 DOI: 10.1016/j.envres.2020.110397] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 10/15/2020] [Accepted: 10/23/2020] [Indexed: 05/04/2023]
Abstract
Population growth, demographic transitions and urbanization in sub-Saharan Africa (SSA) will increase non-communicable disease (NCD) burden. We studied the association between neighborhood greenness and NCDs in a multi-country cross-sectional study. Among 1178 participants, in adjusted models, a 0.11 unit NDVI increase was associated with lower BMI (β: -1.01, 95% CI: -1.35, -0.67), and lower odds of overweight/obesity (aOR: 0.73, 95% CI: 0.62, 0.85), diabetes (aOR: 0.77, 95% CI: 0.62, 0.96), and having ≥3 allostatic load components compared to none (aOR: 0.66, 95% CI: 0.52, 0.85). Except for diabetes, these remained statistically significant after Bonferroni correction. We observed no association between NDVI and hypertension or cholesterol. Our findings are consistent with health benefits of neighborhood greenness reported in other countries, suggesting greening strategies could be considered as part of broader public health interventions for NCDs.
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Affiliation(s)
- Hari S Iyer
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA.
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, USA
| | - Linda Valeri
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, USA
| | - Francis Bajunirwe
- Department of Community Health, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Joan Nankya-Mutyoba
- Department of Epidemiology & Biostatistics, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Marina Njelekela
- Department of Physiology, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania; Department of Internal Medicine, Muhimbili National Hospital, Dar Es Salaam, Tanzania; Deloitte Consulting Limited, Dar Es Salaam, Tanzania
| | - Faraja Chiwanga
- Department of Internal Medicine, Muhimbili National Hospital, Dar Es Salaam, Tanzania
| | - Vikash Sewram
- African Cancer Institute, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - IkeOluwapo Ajayi
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Clement Adebamowo
- Institute of Human Virology, Abuja, Nigeria; Greenebaum Comprehensive Cancer Center and Institute of Human Virology, University of Maryland School of Medicine, Baltimore, USA
| | - Shona Dalal
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA
| | - Todd G Reid
- Media Lab and Connection Science, Massachusetts Institute of Technology, Boston, USA; Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, USA
| | - Timothy R Rebbeck
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA
| | - Hans-Olov Adami
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Michelle D Holmes
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, USA; Channing Division of Network Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, USA
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Pelgrims I, Devleesschauwer B, Guyot M, Keune H, Nawrot TS, Remmen R, Saenen ND, Trabelsi S, Thomas I, Aerts R, De Clercq EM. Association between urban environment and mental health in Brussels, Belgium. BMC Public Health 2021; 21:635. [PMID: 33794817 PMCID: PMC8015067 DOI: 10.1186/s12889-021-10557-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 03/04/2021] [Indexed: 12/11/2022] Open
Abstract
Background Mental health disorders appear as a growing problem in urban areas. While common mental health disorders are generally linked to demographic and socioeconomic factors, little is known about the interaction with the urban environment. With growing urbanization, more and more people are exposed to environmental stressors potentially contributing to increased stress and impairing mental health. It is therefore important to identify features of the urban environment that affect the mental health of city dwellers. The aim of this study was to define associations of combined long-term exposure to air pollution, noise, surrounding green at different scales, and building morphology with several dimensions of mental health in Brussels. Methods Research focuses on the inhabitants of the Brussels Capital Region older than 15 years. The epidemiological study was carried out based on the linkage of data from the national health interview surveys (2008 and 2013) and specifically developed indicators describing each participant’s surroundings in terms of air quality, noise, surrounding green, and building morphology. These data are based on the geographical coordinates of the participant’s residence and processed using Geographical Information Systems (GIS). Mental health status was approached through several validated indicators: the Symptom Checklist-90-R subscales for depressive, anxiety and sleeping disorders and the 12-Item General Health Questionnaire for general well-being. For each mental health outcome, single and multi-exposure models were performed through multivariate logistic regressions. Results Our results suggest that traffic-related air pollution (black carbon, NO2, PM10) exposure was positively associated with higher odds of depressive disorders. No association between green surrounding, noise, building morphology and mental health could be demonstrated. Conclusions These findings have important implications because most of the Brussel’s population resides in areas where particulate matters concentrations are above the World Health Organization guidelines. This suggests that policies aiming to reduce traffic related-air pollution could also reduce the burden of depressive disorders in Brussels. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10557-7.
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Affiliation(s)
- Ingrid Pelgrims
- Risk and Health Impact Assessment, Sciensano, Rue Juliette Wytsman 14, BE-1050, Brussels, Belgium. .,Applied Mathematics, Computer Science and Statistics, Ghent University, Krijgslaan 281, S9, BE-9000, Ghent, Belgium. .,Epidemiology and Public Health, Sciensano, Rue Juliette Wytsman 14, BE-1050, Brussels, Belgium.
| | - Brecht Devleesschauwer
- Epidemiology and Public Health, Sciensano, Rue Juliette Wytsman 14, BE-1050, Brussels, Belgium.,Department of Veterinary Public Health and Food Safety, Ghent University, Salisburylaan 133, Hoogbouw, BE-9820, Merelbeke, Belgium
| | - Madeleine Guyot
- Louvain Institute of Data Analysis and Modelling in Economics and Statistics, UCLouvain, Voie du Roman Pays, 34 bte L1.03.01, BE-1348, Louvain-La-Neuve, Belgium
| | - Hans Keune
- Nature and Society, Own-Capital Research Institute for Nature and Forest (EV-INBO), Vlaams Administratief Centrum Herman Teirlinckgebouw, Havenlaan 88 bus 73, BE-1000, Brussels, Belgium.,Centre of General Practice, University of Antwerp, Doornstraat 331, BE-2610, Antwerp, Belgium
| | - Tim S Nawrot
- Center for Environmental Sciences, University of Hasselt, Agoralaan D, BE-3590, Hasselt, Belgium.,Center for Environment and Sciences, Department of Public Health and Primary Care, University of Leuven (KU Leuven), Herestraat 49-706, BE-3000, Leuven, Belgium
| | - Roy Remmen
- Centre of General Practice, University of Antwerp, Doornstraat 331, BE-2610, Antwerp, Belgium
| | - Nelly D Saenen
- Center for Environmental Sciences, University of Hasselt, Agoralaan D, BE-3590, Hasselt, Belgium
| | - Sonia Trabelsi
- Louvain Institute of Data Analysis and Modelling in Economics and Statistics, UCLouvain, Voie du Roman Pays, 34 bte L1.03.01, BE-1348, Louvain-La-Neuve, Belgium
| | - Isabelle Thomas
- Louvain Institute of Data Analysis and Modelling in Economics and Statistics, UCLouvain, Voie du Roman Pays, 34 bte L1.03.01, BE-1348, Louvain-La-Neuve, Belgium.,Fund of scientific research, FNRS, Brussels, Belgium
| | - Raf Aerts
- Risk and Health Impact Assessment, Sciensano, Rue Juliette Wytsman 14, BE-1050, Brussels, Belgium.,Center for Environmental Sciences, University of Hasselt, Agoralaan D, BE-3590, Hasselt, Belgium.,Division Ecology, Evolution and Biodiversity Conservation, University of Leuven (KU Leuven), Kasteelpark Arenberg 31-2435, BE-3001, Leuven, Belgium
| | - Eva M De Clercq
- Risk and Health Impact Assessment, Sciensano, Rue Juliette Wytsman 14, BE-1050, Brussels, Belgium
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95
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Dalsager L, Christensen N, Halekoh U, Timmermann CAG, Nielsen F, Kyhl HB, Husby S, Grandjean P, Jensen TK, Andersen HR. Exposure to perfluoroalkyl substances during fetal life and hospitalization for infectious disease in childhood: A study among 1,503 children from the Odense Child Cohort. Environ Int 2021; 149:106395. [PMID: 33508532 DOI: 10.1016/j.envint.2021.106395] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/10/2020] [Accepted: 01/09/2021] [Indexed: 05/14/2023]
Abstract
INTRODUCTION The immunosuppressive properties of PFASs are widely recognized. Early-life exposure to PFAS has been linked to reduced immune response to childhood vaccinations and increased rates of common infectious diseases, but implications for hospitalizations are unclear. OBJECTIVES To investigate the association between maternal serum concentrations of five PFASs during pregnancy and the child's rate of hospitalization due to common infectious diseases between birth and 4 years of age. METHODS Serum samples from first trimester pregnant women from the Odense Child Cohort (OCC) collected in 2010-2012 were analyzed for concentrations of perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA) and three other PFASs. Data on child hospitalizations with an ICD-10 code for infectious disease was obtained from the Danish National Patient Register. The following were identified: upper respiratory tract infections (URTI), lower respiratory tract infections (LRTI), gastrointestinal infections (GI), and other infections. The Andersen-Gill Cox proportional hazard model for recurrent events was used to investigate the association between PFAS exposure and hospitalizations. The resulting estimates were hazard ratios (HRs), which express the relative change in the instantaneous risk of hospitalization with a doubling in maternal PFAS concentration. RESULTS A total of 1,503 mother-child pairs were included, and 26% of the children were hospitalized at least once for infectious disease. A doubling in maternal PFOS concentration was associated with a 23% increase in the risk of hospitalization due to any infection (HR: 1.23 (95% CI: 1.05, 1.44). There was indication of an interaction between child sex and PFOS (p = 0.07) and PFDA (p = 0.06), although in opposite directions. Further, every doubling of PFOA or PFOS increased the risk of LRTI by 27% (HR: 1.27 (1.01, 1.59)) and 54% (HR: 1.54 (1.11, 2.15)), respectively. Similar tendencies were seen for URTI and the group of other infections. For GIs, the opposite pattern of association was seen as HR's were consistently below 1 (PFOA, HR: 0.55 (0.32, 0.95)). DISCUSSION We found an association between PFOS and the overall risk of infectious disease, and between PFOS and PFOA exposures and the risk of LRTI's. These results are in agreement with previous findings from the OCC, in which maternal PFOS and PFOA concentrations were positively associated with the number of days that the children experienced fever, thereby suggesting that PFOS and PFOA may affect the prevalence of both mild and more severe infectious diseases even in a rather low-exposed population.
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Affiliation(s)
- Louise Dalsager
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark.
| | - Nikolas Christensen
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Ulrich Halekoh
- Department of Epidemiology, Biostatistics and Biodemography, University of Southern Denmark, Odense, Denmark
| | - Clara Amalie Gade Timmermann
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Flemming Nielsen
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | | | - Steffen Husby
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Philippe Grandjean
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
| | - Tina Kold Jensen
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark; Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark; Odense Patient data Explorative Network (OPEN), Odense, Denmark
| | - Helle Raun Andersen
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
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96
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Buller ID, Brown DW, Myers TA, Jones RR, Machiela MJ. sparrpowR: a flexible R package to estimate statistical power to identify spatial clustering of two groups and its application. Int J Health Geogr 2021; 20:13. [PMID: 33736677 PMCID: PMC7977178 DOI: 10.1186/s12942-021-00267-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 02/26/2021] [Indexed: 11/10/2022] Open
Abstract
Background Cancer epidemiology studies require sufficient power to assess spatial relationships between exposures and cancer incidence accurately. However, methods for power calculations of spatial statistics are complicated and underdeveloped, and therefore underutilized by investigators. The spatial relative risk function, a cluster detection technique that detects spatial clusters of point-level data for two groups (e.g., cancer cases and controls, two exposure groups), is a commonly used spatial statistic but does not have a readily available power calculation for study design. Results We developed sparrpowR as an open-source R package to estimate the statistical power of the spatial relative risk function. sparrpowR generates simulated data applying user-defined parameters (e.g., sample size, locations) to detect spatial clusters with high statistical power. We present applications of sparrpowR that perform a power calculation for a study designed to detect a spatial cluster of incident cancer in relation to a point source of numerous environmental emissions. The conducted power calculations demonstrate the functionality and utility of sparrpowR to calculate the local power for spatial cluster detection. Conclusions sparrpowR improves the current capacity of investigators to calculate the statistical power of spatial clusters, which assists in designing more efficient studies. This newly developed R package addresses a critically underdeveloped gap in cancer epidemiology by estimating statistical power for a common spatial cluster detection technique.
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Affiliation(s)
- Ian D Buller
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA. .,Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Rockville, MD, 20850, USA.
| | - Derek W Brown
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Rockville, MD, 20850, USA.,Integrative Tumor Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, 20850, USA
| | - Timothy A Myers
- Laboratory of Genetic Susceptibility, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, 20850, USA
| | - Rena R Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA
| | - Mitchell J Machiela
- Integrative Tumor Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, 20850, USA
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97
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Tyagi P, James-Todd T, Mínguez-Alarcón L, Ford JB, Keller M, Petrozza J, Calafat AM, Hauser R, Williams PL, Bellavia A. Identifying windows of susceptibility to endocrine disrupting chemicals in relation to gestational weight gain among pregnant women attending a fertility clinic. Environ Res 2021; 194:110638. [PMID: 33359703 PMCID: PMC7946748 DOI: 10.1016/j.envres.2020.110638] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 05/13/2023]
Abstract
BACKGROUND Exposure to endocrine disrupting chemicals (EDC), such as phthalates and phenols, during pregnancy may be associated with excessive gestational weight gain (GWG), an important predictor of future health of the mother and the offspring. There is however a paucity of literature examining this association, and no study has accounted for the complex nature of EDCs exposure as a time-varying mixture of chemicals. OBJECTIVE We examined the association between trimester-specific EDCs mixture and GWG in pregnant women attending a fertility clinic, to identify windows of susceptibility to such exposures, and assess the individual contribution of each chemical over pregnancy. METHODS We included 243 pregnant women from the Environment and Reproductive Health (EARTH) Study, who provided up to 3 urine samples (one per trimester), and with available data on GWG. Urinary concentrations of 7 phthalate metabolites, bisphenol A, and 2 parabens, corrected for specific gravity, were included in the analysis. The association between trimester-specific EDCs mixture and GWG was evaluated using multiple regression models - categorizing exposures into concentration quartiles- and with Bayesian Kernel Machine Regression (BKMR), while adjusting for potential confounders. Hierarchical BKMR (hBKMR) was used to account for the time-varying nature of chemical concentrations over pregnancy, identifying the most important trimester and most important EDC within each trimester. RESULTS During 1st trimester, higher GWG was observed at higher sum of metabolites of di (2-ethylhexyl) phthalate (ΣDEHP) from both multiple regression (e.g. comparing the 4th quartile with the 1st: β = 2.36 kg, 95% CI: 0.47, 5.19) and BKMR. During 2nd and 3rd trimesters, positive associations with mono-n-butyl phthalate and propylparaben, and negative with ΣDEHP and methylparaben were observed. When evaluating exposures as a time-varying mixture with hBKMR, 1st trimester was the most important exposure window when evaluating prenatal urinary EDCs in relation to GWG. Within the 1st trimester, urinary ΣDEHP, mono-isobutyl phthalate and propylparaben had the highest contribution in the positive association between the mixture and GWG. CONCLUSION We observed positive associations between urinary EDCs during pregnancy, especially DEHP metabolites, and GWG. Our results suggest the 1st trimester of pregnancy as the time window of highest susceptibility to the effects of EDCs on GWG, with potential indication for the design of public health interventions, informing prevention strategies for reducing sources of exposure at specific time points.
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Affiliation(s)
- Pooja Tyagi
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Tamarra James-Todd
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Lidia Mínguez-Alarcón
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Jennifer B Ford
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Myra Keller
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - John Petrozza
- Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Antonia M Calafat
- National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA, 30341, USA
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA; Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Paige L Williams
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Andrea Bellavia
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
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98
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Everson TM, Niedzwiecki MM, Toth D, Tellez-Plaza M, Liu H, Barr DB, Gribble MO. Metal biomarker mixtures and blood pressure in the United States: cross-sectional findings from the 1999-2006 National Health and Nutrition Examination Survey (NHANES). Environ Health 2021; 20:15. [PMID: 33583418 PMCID: PMC7883578 DOI: 10.1186/s12940-021-00695-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 01/18/2021] [Indexed: 05/14/2023]
Abstract
BACKGROUND The objective of this study was to identify conditional relationships between multiple metal biomarkers that predict systolic and diastolic blood pressure in the non-institutionalized United States adult population below the age of 60. METHODS We used inorganic exposure biomarker data and blood pressure data from three cycles (1999-2004) of the National Health and Nutrition Examination Survey (NHANES) to construct regression trees for blood pressure among adults ages 20-60 (adjusted for age, sex, body mass index, race, and smoking status) to identify predictors of systolic (SBP) and diastolic blood pressure (DBP). We also considered relationships among non-Hispanic black, Mexican-American, and white adults separately. RESULTS The following metal exposure biomarkers were conditionally predictive of SBP and/or DBP in the full sample: antimony (Sb), barium (Ba), cadmium (Cd), cesium (Cs), lead (Pb), tungsten (W) and molybdenum (Mo). The highest average SBP (> 120 mmHg) was observed among those with low Sb (≤ 0.21 μg/dL) high Cd (> 0.22 μg/g creatinine) and high Pb (> 2.55 μg/dL) biomarkers. Those with the highest average DBP had high urinary W levels (> 0.10 μg/g creatinine) in combination with either urinary Sb > 0.17 μg/g creatinine or those with urinary Sb ≤ 0.17 μg/g creatinine, but with high blood Pb levels (> 1.35 μg/dL). Predictors differed by ethnicity, with Cd as the main predictor of SBP among non-Hispanic black adults, and Pb not selected by the algorithm as a predictor of SBP among non-Hispanic white adults. CONCLUSIONS Combinations of metal biomarkers have different apparent relationships with blood pressure. Additional research in toxicological experimental models and in epidemiological studies is warranted to evaluate the suggested possible toxicological interactions between Sb, Cd, and Pb; and between W, Sb, and Pb; for cardiovascular (e.g., blood pressure) health. We also think future epidemiological research on inorganic exposure sets in relation to health outcomes like blood pressure might benefit from stratification by race and ethnicity.
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Affiliation(s)
- Todd M. Everson
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Mailstop 1518-002-2BB, Atlanta, GA 30322 USA
| | - Megan M. Niedzwiecki
- Department of Environmental Medicine & Public Health, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Daniell Toth
- U.S. Bureau of Labor Statistics, Office of Survey Methods Research, D. C, Washington, USA
| | | | - Haoran Liu
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Dana B. Barr
- Laboratory for Exposure Assessment and Development for Environmental Research, Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322 USA
| | - Matthew O. Gribble
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Mailstop 1518-002-2BB, Atlanta, GA 30322 USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Mailstop 1518-002-2BB, Atlanta, GA 30322 USA
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99
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Guercio V, Pojum IC, Leonardi GS, Shrubsole C, Gowers AM, Dimitroulopoulou S, Exley KS. Exposure to indoor and outdoor air pollution from solid fuel combustion and respiratory outcomes in children in developed countries: a systematic review and meta-analysis. Sci Total Environ 2021; 755:142187. [PMID: 33017761 DOI: 10.1016/j.scitotenv.2020.142187] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/28/2020] [Accepted: 09/02/2020] [Indexed: 06/11/2023]
Abstract
Epidemiological studies have shown a positive association between exposure to outdoor and indoor solid fuel combustion and adverse health effects. We reviewed the epidemiological evidence from Europe, North America, Australia and New Zealand on the association between outdoor and indoor exposure to solid fuel combustion and respiratory outcomes in children. We performed a systematic review and meta-analysis. Pooled relative risks (RRs) and 95% confidence intervals (CI) were calculated using random-effects models. We identified 74 articles. Due to limited evidence on other exposures and outcomes, we performed meta-analyses on the association between indoor wood burning exposure and respiratory outcomes. The RR for the highest vs the lowest category of indoor wood exposure was 0.90 (95% CI 0.77-1.05) considering asthma as an outcome. The corresponding pooled RRs for lower respiratory infection (LRI) and upper respiratory infection (URI) were 1.11 (95% CI 0.88, 1.41) and 1.11 (95% CI 0.85, 1.44) respectively. No association was found between indoor wood burning exposure and risk of wheeze and cough. Inconsistent and limited results were found considering the relationship between indoor wood burning exposure and other respiratory outcomes (rhinitis and hay fever, influenza) as well as indoor coal burning exposure and respiratory outcomes in children. Results from epidemiological studies that evaluated the relationship between the exposure to outdoor emissions derived from indoor combustion of solid fuels are too limited to allow firm conclusions. We found no association between indoor wood burning exposure and risk of asthma. A slight, but not significant, increased risk of LRI and URI was identified, although the available evidence is limited. Epidemiological studies evaluating the relationship between indoor coal burning exposure and respiratory outcomes, as well as, studies considering exposure to outdoor solid fuels, are too limited to draw any firm conclusions.
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Affiliation(s)
- Valentina Guercio
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxfordshire, OX11 0RQ, United Kingdom.
| | - Iulia C Pojum
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxfordshire, OX11 0RQ, United Kingdom
| | - Giovanni S Leonardi
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxfordshire, OX11 0RQ, United Kingdom
| | - Clive Shrubsole
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxfordshire, OX11 0RQ, United Kingdom
| | - Alison M Gowers
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxfordshire, OX11 0RQ, United Kingdom
| | - Sani Dimitroulopoulou
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxfordshire, OX11 0RQ, United Kingdom
| | - Karen S Exley
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxfordshire, OX11 0RQ, United Kingdom
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Fruh V, Claus Henn B, Weuve J, Wesselink AK, Orta OR, Heeren T, Hauser R, Calafat AM, Williams PL, Baird DD, Wise LA. Incidence of uterine leiomyoma in relation to urinary concentrations of phthalate and phthalate alternative biomarkers: A prospective ultrasound study. Environ Int 2021; 147:106218. [PMID: 33360166 PMCID: PMC8630749 DOI: 10.1016/j.envint.2020.106218] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 10/12/2020] [Accepted: 10/14/2020] [Indexed: 05/31/2023]
Abstract
BACKGROUND Numerous studies suggest that some phthalates have adverse reproductive effects. However, literature on the association between phthalates and incidence of uterine leiomyomata (UL) is limited and inconsistent, with no existing prospective studies. OBJECTIVES We examined the association of urinary concentrations of phthalate and phthalate alternative biomarkers with UL incidence. METHODS We conducted a case-cohort analysis within a subgroup of 754 participants in the Study of the Environment, Lifestyle, and Fibroids (SELF), a prospective cohort of premenopausal Black women aged 23-35 years who were recruited during 2010-2012. We quantified fourteen phthalates and two phthalate alternative [1,2-cyclohexane dicarboxylic acid, diisononyl ester (DINCH)] biomarkers in urine collected at baseline, 20 months, and 40 months. Transvaginal ultrasounds identified UL at baseline and every 20 months during 60 months of follow-up. We evaluated the individual biomarkers, molar sum of di(2-ethylhexyl) phthalate [ΣDEHP] and potency-weighted sum of anti-androgenic [WΣAA] biomarkers. We used Cox proportional hazards regression to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between biomarkers and UL incidence. We then used quantile g-computation to examine joint associations of multiple phthalate biomarkers with UL incidence. RESULTS Most individual biomarkers showed weak-to-moderate inverse associations with UL incidence. HRs comparing highest vs. lowest quartiles of mono-isobutyl phthalate (MiBP) and mono-hydroxyisobutyl phthalate (MHiBP) concentrations were 0.63 (95% CI: 0.40, 1.01) and 0.61 (95% CI: 0.38, 0.96), respectively. Inverse associations for specific phthalates were stronger among women with BMI ≥ 30 kg/m2. HRs comparing detectable vs. nondetectable concentrations of DINCH biomarkers were 0.92 (95% CI: 0.62, 1.35) for cyclohexane-1,2-dicarboxylic acid mono hydroxyisononyl ester (MHNCH) and 0.68 (95% CI: 0.38, 1.18) for cyclohexane-1,2-dicarboxylic acid mono carboxyisoocytl ester (MCOCH). For the DEHP metabolite of mono(2-ethylhexyl) phthalate (MEHP), we observed weak-to-moderate positive associations. HRs comparing highest vs. lowest quartiles for MEHP and ΣDEHP were 1.29 (95% CI: 0.82, 2.06) and 0.96 (95% CI: 0.61, 1.50), respectively. In the mixtures analysis, the HR for a joint quartile increase in phthalate biomarker concentrations was 0.90 (95% CI: 0.73, 1.08). DISCUSSION In this prospective ultrasound study of reproductive-aged Black women, urinary concentrations of phthalate and DINCH biomarkers were not appreciably associated with higher risk of UL, either individually or jointly.
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Affiliation(s)
- Victoria Fruh
- Department of Environmental Health, 715 Albany Street, Boston University School of Public Health, Boston, MA, United States.
| | - Birgit Claus Henn
- Department of Environmental Health, 715 Albany Street, Boston University School of Public Health, Boston, MA, United States
| | - Jennifer Weuve
- Department of Epidemiology, 715 Albany Street, Boston University School of Public Health, Boston, MA, United States
| | - Amelia K Wesselink
- Department of Epidemiology, 715 Albany Street, Boston University School of Public Health, Boston, MA, United States
| | - Olivia R Orta
- Department of Epidemiology, 715 Albany Street, Boston University School of Public Health, Boston, MA, United States
| | - Timothy Heeren
- Department of Biostatistics, 715 Albany Street, Boston University School of Public Health, Boston, MA, United States
| | - Russ Hauser
- Department of Environmental Health, 677 Huntington Avenue, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Antonia M Calafat
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, United States
| | - Paige L Williams
- Departments of Biostatistics and Epidemiology, 677 Huntington Avenue, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Donna D Baird
- National Institute of Environmental Health Sciences, 111 TW Alexander Drive, Durham, NC, United States
| | - Lauren A Wise
- Department of Epidemiology, 715 Albany Street, Boston University School of Public Health, Boston, MA, United States
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