51
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Mallick P, Song G, Efremenko AY, Pendse SN, Creek MR, Osimitz TG, Hines RN, Hinderliter P, Clewell HJ, Lake BG, Yoon M, Moreau M. Physiologically Based Pharmacokinetic Modeling in Risk Assessment: Case Study With Pyrethroids. Toxicol Sci 2020; 176:460-469. [PMID: 32421774 PMCID: PMC7416317 DOI: 10.1093/toxsci/kfaa070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
The assessment of potentially sensitive populations is an important application of risk assessment. To address the concern for age-related sensitivity to pyrethroid insecticides, life-stage physiologically based pharmacokinetic (PBPK) modeling supported by in vitro to in vivo extrapolation was conducted to predict age-dependent changes in target tissue exposure to 8 pyrethroids. The purpose of this age-dependent dosimetry was to calculate a Data-derived Extrapolation Factor (DDEF) to address age-related pharmacokinetic differences for pyrethroids in humans. We developed a generic human PBPK model for pyrethroids based on our previously published rat model that was developed with in vivo rat data. The results demonstrated that the age-related differences in internal exposure to pyrethroids in the brain are largely determined by the differences in metabolic capacity and in physiology for pyrethroids between children and adults. The most important conclusion from our research is that, given an identical external exposure, the internal (target tissue) concentration is equal or lower in children than in adults in response to the same level of exposure to a pyrethroid. Our results show that, based on the use of the life-stage PBPK models with 8 pyrethroids, DDEF values are essentially close to 1, resulting in a DDEF for age-related pharmacokinetic differences of 1. For risk assessment purposes, this indicates that no additional adjustment factor is necessary to account for age-related pharmacokinetic differences for these pyrethroids.
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Affiliation(s)
| | - Gina Song
- ScitoVation, LLC, Durham, North Carolina 27713
| | | | | | - Moire R Creek
- Moire Creek Toxicology Consulting Services, Lincoln, California 95648
| | | | - Ronald N Hines
- US EPA, Office of Research and Development, Center for Public Health and Environmental Assessment, Research Triangle Park, North Carolina 27709
| | | | | | - Brian G Lake
- Faculty of Health and Medical Sciences, University of Surrey, Surrey GU2 7XH, UK
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Abstract
Fluorochemicals are a widely distributed class of compounds and have been utilized across a wide range of industries for decades. Given the environmental toxicity and adverse health threats of some fluorochemicals, the development of new methods for their decomposition is significant to public health. However, the carbon-fluorine (C-F) bond is among the most chemically robust bonds; consequently, the degradation of fluorinated hydrocarbons is exceptionally difficult. Here, metalloenzymes that catalyze the cleavage of this chemically challenging bond are reviewed. These enzymes include histidine-ligated heme-dependent dehaloperoxidase and tyrosine hydroxylase, thiolate-ligated heme-dependent cytochrome P450, and four nonheme oxygenases, namely, tetrahydrobiopterin-dependent aromatic amino acid hydroxylase, 2-oxoglutarate-dependent hydroxylase, Rieske dioxygenase, and thiol dioxygenase. While much of the literature regarding the aforementioned enzymes highlights their ability to catalyze C-H bond activation and functionalization, in many cases, the C-F bond cleavage has been shown to occur on fluorinated substrates. A copper-dependent laccase-mediated system representing an unnatural radical defluorination approach is also described. Detailed discussions on the structure-function relationships and catalytic mechanisms provide insights into biocatalytic defluorination, which may inspire drug design considerations and environmental remediation of halogenated contaminants.
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Affiliation(s)
- Yifan Wang
- Department of Chemistry, University of Texas at San Antonio, 1 UTSA Circle, San Antonio, TX 78249, USA.
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Feng YX, Feng NX, Zeng LJ, Chen X, Xiang L, Li YW, Cai QY, Mo CH. Occurrence and human health risks of phthalates in indoor air of laboratories. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 707:135609. [PMID: 31771853 DOI: 10.1016/j.scitotenv.2019.135609] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 11/14/2019] [Accepted: 11/17/2019] [Indexed: 06/10/2023]
Abstract
Phthalate acid esters (PAEs) are of serious concern as a human health risk due to their ubiquitous presence in indoor air. In the present study, fifteen PAEs in the indoor air samples from physical, chemical, and biological laboratories in Guangzhou, southern China were analysed using gas chromatography mass spectrometry. Extremely high levels of PAEs of up to 6.39 × 104 ng/m3 were detected in some laboratories. Diisobutyl phthalate (DiBP), di(methoxyethyl) phthalate (DMEP), and di-n-butyl phthalate (DBP) were the dominant PAEs with median levels of 0.48 × 103, 0.44 × 103, and 0.39 × 103 ng/m3, respectively, followed by di-(2-propylheptyl) phthalate (DPHP) and di(2-ethylhexyl) phthlate (DEHP) (median levels: 0.16 × 103 and 0.13 × 103 ng/m3, respectively). DMEP and DPHP were found for the first time in indoor air. Principal component analysis indicated that profiles of PAEs varied greatly among laboratory types, suggesting notable variations in sources. The results of independent samples t-tests showed that levels of PAEs were significantly influenced by various environmental conditions. Both the non-carcinogenic and carcinogenic health risks from human exposure to PAEs based on the daily exposure dose in laboratory air were acceptable. Further research should be conducted to investigate the long-term health effects of exposure to PAEs in laboratories.
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Affiliation(s)
- Yu-Xi Feng
- Guangdong Provincial Research Center for Environment Pollution Control and Remediation Materials, College of Life Science and Technology, Jinan University, Guangzhou 510632, China
| | - Nai-Xian Feng
- Guangdong Provincial Research Center for Environment Pollution Control and Remediation Materials, College of Life Science and Technology, Jinan University, Guangzhou 510632, China
| | - Li-Juan Zeng
- Guangdong Provincial Research Center for Environment Pollution Control and Remediation Materials, College of Life Science and Technology, Jinan University, Guangzhou 510632, China
| | - Xin Chen
- Guangdong Provincial Research Center for Environment Pollution Control and Remediation Materials, College of Life Science and Technology, Jinan University, Guangzhou 510632, China
| | - Lei Xiang
- Guangdong Provincial Research Center for Environment Pollution Control and Remediation Materials, College of Life Science and Technology, Jinan University, Guangzhou 510632, China
| | - Yan-Wen Li
- Guangdong Provincial Research Center for Environment Pollution Control and Remediation Materials, College of Life Science and Technology, Jinan University, Guangzhou 510632, China
| | - Quan-Ying Cai
- Guangdong Provincial Research Center for Environment Pollution Control and Remediation Materials, College of Life Science and Technology, Jinan University, Guangzhou 510632, China
| | - Ce-Hui Mo
- Guangdong Provincial Research Center for Environment Pollution Control and Remediation Materials, College of Life Science and Technology, Jinan University, Guangzhou 510632, China.
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54
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Yin S, Zhang J, Guo F, Poma G, Covaci A, Liu W. Transplacental transfer mechanism of organochlorine pesticides: An in vitro transcellular transport study. ENVIRONMENT INTERNATIONAL 2020; 135:105402. [PMID: 31869730 DOI: 10.1016/j.envint.2019.105402] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 12/07/2019] [Accepted: 12/09/2019] [Indexed: 06/10/2023]
Abstract
Recent studies show that, even after being banned for agricultural applications for over 30 years, organochlorine pesticides (OCPs), including hexachlorocyclohexanes (HCHs) and dichlorodiphenyltrichloroethane (DDT) and its metabolites (DDXs), can still be found in various biological matrices and pose a potential hazard to the fetus in the womb. This study aimed to investigate the possible transplacental transfer mechanism of OCPs using an in vitro placental model. The results showed that for HCHs and DDXs, the placenta had a potential protection mechanism for the fetus by having higher efflux than intake active transport efficiency to transfer the xenobiotic out of the fetal circulation. No enantiomer-specific transport was observed for the chiral OCPs in vitro, hints simple diffusion played the major role in the transplacental transfer. Metabolic and transporter inhibitors were applied in the transepithelial transport experiment to evaluate the role that major transporting protein played in the active efflux process. The ATP production inhibitors were observed to have significant inhibition on transfer, proving the hypothesis that active transport participates in the transplacental transport of OCPs in humans. Multiple transporters contributed simultaneously in the active transport for the OCPs. In this study, we could confirm that the transplacental transfer of OCPs is a combination of simple diffusion and active transport. ATP-binding cassette (ABC) superfamily transporters on the placenta contribute in the active transport. These findings could improve the understanding of the mechanisms of transplacental transfer of the OCPs.
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Affiliation(s)
- Shanshan Yin
- Institution of Environmental Health, College of Environmental and Resource Sciences, Zhejiang University, Hangzhou 310058, China
| | - Jianyun Zhang
- Institution of Environmental Health, College of Environmental and Resource Sciences, Zhejiang University, Hangzhou 310058, China; Department of Preventive Medicine, School of Medicine, Hangzhou Normal University, Hangzhou 310036, China
| | - Fangjie Guo
- Institution of Environmental Health, College of Environmental and Resource Sciences, Zhejiang University, Hangzhou 310058, China
| | - Giulia Poma
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Adrian Covaci
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium.
| | - Weiping Liu
- Institution of Environmental Health, College of Environmental and Resource Sciences, Zhejiang University, Hangzhou 310058, China.
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Li ZM, Albrecht M, Fromme H, Schramm KW, De Angelis M. Persistent Organic Pollutants in Human Breast Milk and Associations with Maternal Thyroid Hormone Homeostasis. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2020; 54:1111-1119. [PMID: 31867966 DOI: 10.1021/acs.est.9b06054] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Epidemiological studies have indicated the thyroid-disrupting effects of persistent organic pollutants (POPs). However, the association of low-exposure POPs with thyroid hormones (THs) remains unclear. Here, we aim to assess the association of low exposure of POPs, including polybrominated diphenyl ethers (PBDEs), polychlorinated biphenyls (PCBs), polychlorinated dibenzo-p-dioxins and furans (PCDD/Fs), and polybrominated dibenzo-p-dioxins and furans, with THs [total L-thyroxine (TT4), total 3,3',5-triiodo-L-thyronine (TT3), and total 3,3',5'-triiodo-L-thyronine (TrT3)] measured in human breast milk. Ninety-nine breast milk samples were collected from the LUPE cohort (2015-2016, Bavaria, Germany). Fourteen PBDEs, 17 PCBs, and 5 PCDD/Fs had quantification rates of >80%. Nonmonotonic associations were observed. In adjusted single-pollutant models, (1) TT4 was inversely associated with BDE-99, -154, and -196; (2) TT3 was inversely associated with BDE-47, -99, -100, -197, -203, -207, and OCDD; and (3) TrT3 was inversely associated with BDE-47, -99, -183, and -203. Multipollutant analysis using principal component analysis and hierarchical clustering revealed inverse associations of PBDEs (BDE-28, -47, -99, -100, -154, -183, and -197) with TT4 and TrT3. These results indicate that POPs at low levels might be related to reduced THs. This study shows that human breast milk might be an appropriate specimen to evaluate the thyroid disruption of POPs.
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Affiliation(s)
- Zhong-Min Li
- Helmholtz Zentrum München-German Research Center for Environmental Health (GmbH), Molecular EXposomics , Ingolstädter Landstr. 1 , 85764 Neuherberg , Germany
- School of Life Sciences Weihenstephan (Nutrition) , Technische Universität München , 85354 Freising , Germany
| | - Michael Albrecht
- Department of Dioxins, Irradiation, Nitrosamines, Radioactivity , Bavarian Health and Food Safety Authority , Veterinaerstr. 2 , D-85764 Oberschleissheim , Germany
| | - Hermann Fromme
- Department of Chemical Safety and Toxicology , Bavarian Health and Food Safety Authority , Pfarrstrasse 3 , D-80538 Munich , Germany
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital , LMU Munich , Ziemssenstrasse 1 , D-80336 Munich , Germany
| | - Karl-Werner Schramm
- Helmholtz Zentrum München-German Research Center for Environmental Health (GmbH), Molecular EXposomics , Ingolstädter Landstr. 1 , 85764 Neuherberg , Germany
- Department für Biowissenschaftliche Grundlagen , Technische Universität München , Weihenstephaner Steig 23 , 85350 Freising , Germany
| | - Meri De Angelis
- Helmholtz Zentrum München-German Research Center for Environmental Health (GmbH), Molecular EXposomics , Ingolstädter Landstr. 1 , 85764 Neuherberg , Germany
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Collins SL, Patterson AD. The gut microbiome: an orchestrator of xenobiotic metabolism. Acta Pharm Sin B 2020; 10:19-32. [PMID: 31998605 PMCID: PMC6984741 DOI: 10.1016/j.apsb.2019.12.001] [Citation(s) in RCA: 149] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 09/21/2019] [Accepted: 11/07/2019] [Indexed: 02/06/2023] Open
Abstract
Microbes inhabiting the intestinal tract of humans represent a site for xenobiotic metabolism. The gut microbiome, the collection of microorganisms in the gastrointestinal tract, can alter the metabolic outcome of pharmaceuticals, environmental toxicants, and heavy metals, thereby changing their pharmacokinetics. Direct chemical modification of xenobiotics by the gut microbiome, either through the intestinal tract or re-entering the gut via enterohepatic circulation, can lead to increased metabolism or bioactivation, depending on the enzymatic activity within the microbial niche. Unique enzymes encoded within the microbiome include those that reverse the modifications imparted by host detoxification pathways. Additionally, the microbiome can limit xenobiotic absorption in the small intestine by increasing the expression of cell-cell adhesion proteins, supporting the protective mucosal layer, and/or directly sequestering chemicals. Lastly, host gene expression is regulated by the microbiome, including CYP450s, multi-drug resistance proteins, and the transcription factors that regulate them. While the microbiome affects the host and pharmacokinetics of the xenobiotic, xenobiotics can also influence the viability and metabolism of the microbiome. Our understanding of the complex interconnectedness between host, microbiome, and metabolism will advance with new modeling systems, technology development and refinement, and mechanistic studies focused on the contribution of human and microbial metabolism.
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Key Words
- 5-ASA, 5-aminosalicylic acid
- 5-FU, 5-fluorouracil
- AHR, aryl Hydrocarbon Receptor
- ALDH, aldehyde dehydrogenase
- Absorption
- BDE, bromodiphenyl ether
- BRV, brivudine
- BVU, bromovinyluracil
- Bioactivation
- CAR, constitutive androgen receptor
- CV, conventional
- CYP, cytochrome P450
- ER, estrogen receptor
- Enterohepatic circulation
- FXR, farnesoid X receptor
- GF, germ-free
- GUDCA, glycoursodeoxycholic acid
- Gastrointestinal tract
- Gut microbiome
- NSAID, non-steroidal anti-inflammatory drug
- PABA, p-aminobenzenesulphonamide
- PAH, polycyclic aromatic hydrocarbon
- PCB, polychlorinated biphenyl
- PD, Parkinson's disease
- PFOS, perfluorooctanesulfonic acid
- PXR, pregnane X receptor
- Pharmacokinetics
- SCFA, short chain fatty acid
- SN-38G, SN-38 glucuronide
- SULT, sulfotransferase
- TCDF, 2,3,7,8-tetrachlorodibenzofuran
- TUDCA, tauroursodeoxycholic acid
- UGT, uracil diphosphate-glucuronosyltransferase
- Xenobiotic metabolism
- cgr, cytochrome glycoside reductase
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Affiliation(s)
- Stephanie L. Collins
- Department of Biochemistry, Microbiology, and Molecular Biology, the Pennsylvania State University, University Park, PA 16802, USA
| | - Andrew D. Patterson
- Department of Veterinary and Biomedical Science, the Pennsylvania State University, University Park, PA 16802, USA
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Odintsova VV, Hagenbeek FA, Suderman M, Caramaschi D, van Beijsterveldt CEM, Kallsen NA, Ehli EA, Davies GE, Sukhikh GT, Fanos V, Relton C, Bartels M, Boomsma DI, van Dongen J. DNA Methylation Signatures of Breastfeeding in Buccal Cells Collected in Mid-Childhood. Nutrients 2019; 11:E2804. [PMID: 31744183 PMCID: PMC6893543 DOI: 10.3390/nu11112804] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/12/2019] [Accepted: 11/12/2019] [Indexed: 12/11/2022] Open
Abstract
Breastfeeding has long-term benefits for children that may be mediated via the epigenome. This pathway has been hypothesized, but the number of empirical studies in humans is small and mostly done by using peripheral blood as the DNA source. We performed an epigenome-wide association study (EWAS) in buccal cells collected around age nine (mean = 9.5) from 1006 twins recruited by the Netherlands Twin Register (NTR). An age-stratified analysis examined if effects attenuate with age (median split at 10 years; n<10 = 517, mean age = 7.9; n>10 = 489, mean age = 11.2). We performed replication analyses in two independent cohorts from the NTR (buccal cells) and the Avon Longitudinal Study of Parents and Children (ALSPAC) (peripheral blood), and we tested loci previously associated with breastfeeding in epigenetic studies. Genome-wide DNA methylation was assessed with the Illumina Infinium MethylationEPIC BeadChip (Illumina, San Diego, CA, USA) in the NTR and with the HumanMethylation450 Bead Chip in the ALSPAC. The duration of breastfeeding was dichotomized ('never' vs. 'ever'). In the total sample, no robustly associated epigenome-wide significant CpGs were identified (α = 6.34 × 10-8). In the sub-group of children younger than 10 years, four significant CpGs were associated with breastfeeding after adjusting for child and maternal characteristics. In children older than 10 years, methylation differences at these CpGs were smaller and non-significant. The findings did not replicate in the NTR sample (n = 98; mean age = 7.5 years), and no nearby sites were associated with breastfeeding in the ALSPAC study (n = 938; mean age = 7.4). Of the CpG sites previously reported in the literature, three were associated with breastfeeding in children younger than 10 years, thus showing that these CpGs are associated with breastfeeding in buccal and blood cells. Our study is the first to show that breastfeeding is associated with epigenetic variation in buccal cells in children. Further studies are needed to investigate if methylation differences at these loci are caused by breastfeeding or by other unmeasured confounders, as well as what mechanism drives changes in associations with age.
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Affiliation(s)
- Veronika V. Odintsova
- Department of Biological Psychology, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands (D.I.B.)
- Amsterdam Public Health Research Institute, 1081 BT Amsterdam, The Netherlands
- Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow 101000, Russia
| | - Fiona A. Hagenbeek
- Department of Biological Psychology, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands (D.I.B.)
- Amsterdam Public Health Research Institute, 1081 BT Amsterdam, The Netherlands
| | - Matthew Suderman
- MRC Integrative Epidemiology Unit, Bristol Medical School, Population Health Science, University of Bristol, Bristol BS8 1TH, UK
| | - Doretta Caramaschi
- MRC Integrative Epidemiology Unit, Bristol Medical School, Population Health Science, University of Bristol, Bristol BS8 1TH, UK
| | | | - Noah A. Kallsen
- Avera Institute for Human Genetics, Sioux Falls, SD 57101, USA
| | - Erik A. Ehli
- Avera Institute for Human Genetics, Sioux Falls, SD 57101, USA
| | | | - Gennady T. Sukhikh
- Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow 101000, Russia
| | - Vassilios Fanos
- Neonatal Intensive Care Unit, Department of Surgical Sciences, AOU and University of Cagliari, 09121 Cagliari, Italy
| | - Caroline Relton
- MRC Integrative Epidemiology Unit, Bristol Medical School, Population Health Science, University of Bristol, Bristol BS8 1TH, UK
| | - Meike Bartels
- Department of Biological Psychology, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands (D.I.B.)
- Amsterdam Public Health Research Institute, 1081 BT Amsterdam, The Netherlands
| | - Dorret I. Boomsma
- Department of Biological Psychology, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands (D.I.B.)
- Amsterdam Public Health Research Institute, 1081 BT Amsterdam, The Netherlands
| | - Jenny van Dongen
- Department of Biological Psychology, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands (D.I.B.)
- Amsterdam Public Health Research Institute, 1081 BT Amsterdam, The Netherlands
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58
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Zielinska MA, Hamulka J. Protective Effect of Breastfeeding on the Adverse Health Effects Induced by Air Pollution: Current Evidence and Possible Mechanisms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4181. [PMID: 31671856 PMCID: PMC6862650 DOI: 10.3390/ijerph16214181] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 10/22/2019] [Accepted: 10/25/2019] [Indexed: 02/08/2023]
Abstract
Air pollution is a major social, economic, and health problem around the world. Children are particularly susceptible to the negative effects of air pollution due to their immaturity and excessive growth and development. The aims of this narrative review were to: (1) summarize evidence about the protective effects of breastfeeding on the adverse health effects of air pollution exposure, (2) define and describe the potential mechanisms underlying the protective effects of breastfeeding, and (3) examine the potential effects of air pollution on breastmilk composition and lactation. A literature search was conducted using electronic databases. Existing evidence suggests that breastfeeding has a protective effect on adverse outcomes of indoor and outdoor air pollution exposure in respiratory (infections, lung function, asthma symptoms) and immune (allergic, nervous and cardiovascular) systems, as well as under-five mortality in both developing and developed countries. However, some studies reported no protective effect of breastfeeding or even negative effects of breastfeeding for under-five mortality. Several possible mechanisms of the breastfeeding protective effect were proposed, including the beneficial influence of breastfeeding on immune, respiratory, and nervous systems, which are related to the immunomodulatory, anti-inflammatory, anti-oxidant, and neuroprotective properties of breastmilk. Breastmilk components responsible for its protective effect against air pollutants exposure may be long chain polyunsaturated fatty acids (LC PUFA), antioxidant vitamins, carotenoids, flavonoids, immunoglobins, and cytokines, some of which have concentrations that are diet-dependent. However, maternal exposure to air pollution is related to increased breastmilk concentrations of pollutants (e.g., Polycyclic aromatic hydrocarbons (PAHs) or heavy metals in particulate matter (PM)). Nonetheless, environmental studies have confirmed that breastmilk's protective effects outweigh its potential health risk to the infant. Mothers should be encouraged and supported to breastfeed their infants due to its unique health benefits, as well as its limited ecological footprint, which is associated with decreased waste production and the emission of pollutants.
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Affiliation(s)
- Monika A Zielinska
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences-SGGW, 159C Nowoursynowska Street, 02-776 Warsaw, Poland.
| | - Jadwiga Hamulka
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences-SGGW, 159C Nowoursynowska Street, 02-776 Warsaw, Poland.
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Dórea JG. Environmental exposure to low-level lead (Pb) co-occurring with other neurotoxicants in early life and neurodevelopment of children. ENVIRONMENTAL RESEARCH 2019; 177:108641. [PMID: 31421445 DOI: 10.1016/j.envres.2019.108641] [Citation(s) in RCA: 108] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 08/08/2019] [Accepted: 08/08/2019] [Indexed: 06/10/2023]
Abstract
Lead (Pb) is a worldwide environmental contaminant that even at low levels influences brain development and affects neurobehavior later in life; nevertheless it is only a small fraction of the neurotoxicant (NT) exposome. Exposure to environmental Pb concurrent with other NT substances is often the norm, but their joint effects are challenging to study during early life. The aim of this review is to integrate studies of Pb-containing NT mixtures during the early life and neurodevelopment outcomes of children. The Pb-containing NT mixtures that have been most studied involve other metals (Mn, Al, Hg, Cd), metalloids (As), halogen (F), and organo-halogen pollutants. Co-occurring Pb-associated exposures during pregnancy and lactation depend on the environmental sources and the metabolism and half-life of the specific NT contaminant; but offspring neurobehavioral outcomes are also influenced by social stressors. Nevertheless, Pb-associated effects from prenatal exposure portend a continued burden on measurable neurodevelopment; they thus favor increased neurological health issues, decrements in neurobehavioral tests and reductions in the quality of life. Neurobehavioral test outcomes measured in the first 1000 days showed Pb-associated negative outcomes were frequently noticed in infants (<6 months). In older (preschool and school) children studies showed more variations in NT mixtures, children's age, and sensitivity and/or specificity of neurobehavioral tests; these variations and choice of statistical model (individual NT stressor or collective effect of mixture) may explain inconsistencies. Multiple exposures to NT mixtures in children diagnosed with 'autism spectrum disorders' (ASD) and 'attention deficit and hyperactivity disorders' (ADHD), strongly suggest a Pb-associated effect. Mixture potency (number or associated NT components and respective concentrations) and time (duration and developmental stage) of exposure often showed a measurable impact on neurodevelopment; however, net effects, reversibility and/or predictability of delays are insufficiently studied and need urgent attention. Nevertheless, neurodevelopment delays can be prevented and/or attenuated if public health policies are implemented to protect the unborn and the young child.
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Affiliation(s)
- José G Dórea
- Universidade de Brasília, Brasília, 70919-970, DF, Brazil.
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60
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Ma J, Zhu H, Kannan K. Organophosphorus Flame Retardants and Plasticizers in Breast Milk from the United States. ENVIRONMENTAL SCIENCE & TECHNOLOGY LETTERS 2019; 6:525-531. [PMID: 31534982 PMCID: PMC6740186 DOI: 10.1021/acs.estlett.9b00394] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/02/2019] [Accepted: 08/09/2019] [Indexed: 05/09/2023]
Abstract
Organophosphate esters (OPEs) are used in consumer products as flame retardants and plasticizers. Little is known, however, about the occurrence and profiles of OPEs in human milk. In this study, 14 OPEs were measured in 100 breast milk samples collected from the United States during the period of 2009-2012, using high-performance liquid chromatography and tandem mass spectrometry. The sum concentrations of 14 OPEs in human milk ranged from 0.670 to 7.83 ng/mL, with a mean value of 3.61 ng/mL. The highest mean concentration was found for tris-2-butoxyethyl phosphate (TBOEP, 1.44 ± 0.789 ng/mL), followed by tri-iso-butyl phosphate (TIBP, 0.569 ± 0.272 ng/mL) and tri-n-butyl phosphate (TNBP, 0.539 ± 0.265 ng/mL), which were the dominant OPEs found in breast milk at detection frequencies of >80%. No significant differences were observed between various maternal/infant characteristics and OPE concentrations (p > 0.05), except for TBOEP, for which the median concentrations in Hispanic mothers (0.765 ng/mL) were 2 times lower than those in non-Hispanic mothers (1.48 ng/mL) (p < 0.05). On the basis of the recommended daily milk ingestion rate, the average and the highest daily intakes of total OPEs were calculated to be in the range of 300-542 and 504-911 ng (kg of body weight)-1 day-1, respectively. The estimated daily intakes of OPEs did not exceed the current reference doses. Our study establishes baseline data for OPE exposure in breast-fed American children.
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Affiliation(s)
- Jing Ma
- Wadsworth
Center, New York State Department of Health, Albany, New York 12201, United States
- School
of Environmental and Chemical Engineering, Shanghai University, Shanghai 200444, China
| | - Hongkai Zhu
- Wadsworth
Center, New York State Department of Health, Albany, New York 12201, United States
| | - Kurunthachalam Kannan
- Wadsworth
Center, New York State Department of Health, Albany, New York 12201, United States
- Department
of Environmental Health Sciences, School of Public Health, State University of New York at Albany, Albany, New York 12201, United States
- Telephone: 518-474-0015. Fax: 518-473-2895. E-mail:
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Casavale KO, Ahuja JKC, Wu X, Li Y, Quam J, Olson R, Pehrsson P, Allen L, Balentine D, Hanspal M, Hayward D, Hines EP, McClung JP, Perrine CG, Belfort MB, Dallas D, German B, Kim J, McGuire M, McGuire M, Morrow AL, Neville M, Nommsen-Rivers L, Rasmussen KM, Zempleni J, Lynch CJ. NIH workshop on human milk composition: summary and visions. Am J Clin Nutr 2019; 110:769-779. [PMID: 31274142 PMCID: PMC6895543 DOI: 10.1093/ajcn/nqz123] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 05/27/2019] [Indexed: 12/19/2022] Open
Abstract
Nationally representative data from mother-child dyads that capture human milk composition (HMC) and associated health outcomes are important for advancing the evidence to inform federal nutrition and related health programs, policies, and consumer information across the governments in the United States and Canada as well as in nongovernment sectors. In response to identified gaps in knowledge, the National Institute of Diabetes and Digestive and Kidney Diseases of the NIH sponsored the "Workshop on Human Milk Composition-Biological, Environmental, Nutritional, and Methodological Considerations" held 16-17 November 2017 in Bethesda, Maryland. Through presentations and discussions, the workshop aimed to 1) share knowledge on the scientific need for data on HMC; 2) explore the current understanding of factors affecting HMC; 3) identify methodological challenges in human milk (HM) collection, storage, and analysis; and 4) develop a vision for a research program to develop an HMC data repository and database. The 4 workshop sessions included 1) perspectives from both federal agencies and nonfederal academic experts, articulating scientific needs for data on HMC that could lead to new research findings and programmatic advances to support public health; 2) information about the factors that influence lactation and/or HMC; 3) considerations for data quality, including addressing sampling strategies and the complexities in standardizing collection, storage, and analyses of HM; and 4) insights on how existing research programs and databases can inform potential visions for HMC initiatives. The general consensus from the workshop is that the limited scope of HM research initiatives has led to a lack of robust estimates of the composition and volume of HM consumed and, consequently, missed opportunities to improve maternal and infant health.
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Affiliation(s)
- Kellie O Casavale
- Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD, USA,Address correspondence to KOC (e-mail: ). Present address for KOC: US Food and Drug Administration, Center for Food Safety and Applied Nutrition, College Park, MD, USA
| | - Jaspreet K C Ahuja
- Nutrient Data Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture, Beltsville, MD, USA
| | - Xianli Wu
- Nutrient Data Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture, Beltsville, MD, USA
| | - Ying Li
- Nutrient Data Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture, Beltsville, MD, USA
| | - Julia Quam
- Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD, USA
| | - Richard Olson
- Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD, USA
| | - Pamela Pehrsson
- Nutrient Data Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture, Beltsville, MD, USA
| | - Lindsay Allen
- Western Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture, Davis, CA, USA
| | - Douglas Balentine
- Center for Food Safety and Applied Nutrition, US Food and Drug Administration, US Department of Health and Human Services, College Park, MD, USA
| | - Manjit Hanspal
- Environmental influences on Child Health Outcomes (ECHO) program, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
| | - Deborah Hayward
- Bureau of Nutritional Sciences, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Erin Pias Hines
- National Center for Environmental Assessment, US Environmental Protection Agency, Research Triangle Park, NC, USA
| | - James P McClung
- US Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Cria G Perrine
- Centers for Disease Control and Prevention; US Department of Health and Human Services, Atlanta, GA, USA
| | | | - David Dallas
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Bruce German
- Department of Food Science and Technology, University of California, Davis, Davis, CA, USA
| | - Jae Kim
- Divisions of Neonatology and Pediatric Gastroenterology, University of California, San Diego, San Diego, CA, USA
| | - Mark McGuire
- College of Agricultural and Life Sciences, University of Idaho, Moscow, ID, USA
| | - Michelle McGuire
- School of Biological Sciences, Washington State University, Pullman, WA, USA,Present address for Michelle McGuire: University of Idaho, Moscow, ID, USA
| | - Ardythe L Morrow
- Center for Interdisciplinary Research in Human Milk and Lactation, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Margaret Neville
- Department of Physiology and Biophysics, University of Colorado, Denver, Denver, CO, USA
| | | | | | - Janos Zempleni
- Nebraska Center for the Prevention of Obesity Diseases, University of Nebraska–Lincoln, Lincoln, NE, USA
| | - Christopher J Lynch
- Office of Nutrition Research, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
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62
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Rehman H, Ullah I, David M, Ullah A, Jahan S. Neonatal exposure to furan alters the development of reproductive systems in adult male Sprague Dawley rats. Food Chem Toxicol 2019; 130:231-241. [DOI: 10.1016/j.fct.2019.05.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 05/02/2019] [Accepted: 05/13/2019] [Indexed: 01/10/2023]
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63
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Dong R, Wu Y, Chen J, Wu M, Li S, Chen B. Lactational exposure to phthalates impaired the neurodevelopmental function of infants at 9 months in a pilot prospective study. CHEMOSPHERE 2019; 226:351-359. [PMID: 30947045 DOI: 10.1016/j.chemosphere.2019.03.159] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 03/12/2019] [Accepted: 03/25/2019] [Indexed: 06/09/2023]
Abstract
Phthalates are widespread endocrine-disrupting chemicals (EDCs) that have been suggested to affect neurodevelopment. However, association between lactational exposure to phthalates and neurodevelopmental effects has rarely been reported in epidemiological studies. We conducted a pilot prospective study of 138 mother-infant pairs to evaluate whether lactational exposure to phthalates was associated with neurodevelopmental effects in infants. At baseline survey, the spot urine samples from both mothers and infants were collected for measuring ten metabolites of phthalates, and the food intake information of infants was assessed by the food-frequency questionnaire (FFQ). At the follow-up survey in 9 months of age, the neurodevelopmental Function of infants was assessed using the Ages and Stages Questionnaire Edition 3 (ASQ-3). Multivariate logistic regression models were used to calculate the odds ratio (OR) for delayed development according to the level of exposure to phthalates. Our results indicated that MnBP and MiBP were high in lactating infants and mothers. In the overall study population, most metabolites showed positive associations with delayed development of most ASQ-3 domains. In male, MMP, MEP, MiBP and MnBP but not DEHP metabolites were significantly associated with increased odds of delayed development of all domains. In female, most LMWP metabolites and the four oxidative metabolites of DEHP were significantly associated with increased odds of delayed development of most domains. In conclusion, we found a significant negative association between lactational exposure to phthalates and ASQ-3 domains. Some of the sex-specific observations warrant further investigation. The dietary source of lactational phthalates exposure may not the breast milk or infant formula but the complementary food.
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Affiliation(s)
- RuiHua Dong
- Key Laboratory of Public Health Safety of Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, 200032, China
| | - Yuxia Wu
- The Center for Disease Control and Prevention of Putuo District, Shanghai, 200333, China
| | - JingSi Chen
- Key Laboratory of Public Health Safety of Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, 200032, China
| | - Min Wu
- Key Laboratory of Public Health Safety of Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, 200032, China
| | - ShuGuang Li
- Key Laboratory of Public Health Safety of Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, 200032, China
| | - Bo Chen
- Key Laboratory of Public Health Safety of Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, 200032, China.
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64
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Arnold C. Baby Steps Forward: Recommendations for Better Understanding Environmental Chemicals in Breast Milk and Infant Formula. ENVIRONMENTAL HEALTH PERSPECTIVES 2019; 127:64001. [PMID: 31162980 PMCID: PMC6791535 DOI: 10.1289/ehp4804] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 11/29/2018] [Indexed: 05/29/2023]
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65
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Iszatt N, Janssen S, Lenters V, Dahl C, Stigum H, Knight R, Mandal S, Peddada S, González A, Midtvedt T, Eggesbø M. Environmental toxicants in breast milk of Norwegian mothers and gut bacteria composition and metabolites in their infants at 1 month. MICROBIOME 2019; 7:34. [PMID: 30813950 PMCID: PMC6393990 DOI: 10.1186/s40168-019-0645-2] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 02/03/2019] [Indexed: 05/21/2023]
Abstract
BACKGROUND Early disruption of the microbial community may influence life-long health. Environmental toxicants can contaminate breast milk and the developing infant gut microbiome is directly exposed. We investigated whether environmental toxicants in breastmilk affect the composition and function of the infant gut microbiome at 1 month. We measured environmental toxicants in breastmilk, fecal short-chain fatty acids (SCFAs), and gut microbial composition from 16S rRNA gene amplicon sequencing using samples from 267 mother-child pairs in the Norwegian Microbiota Cohort (NoMIC). We tested 28 chemical exposures: polychlorinated biphenyls (PCBs), polybrominated flame retardants (PBDEs), per- and polyfluoroalkyl substances (PFASs), and organochlorine pesticides. We assessed chemical exposure and alpha diversity/SCFAs using elastic net regression modeling and generalized linear models, adjusting for confounders, and variation in beta diversity (UniFrac), taxa abundance (ANCOM), and predicted metagenomes (PiCRUSt) in low, medium, and high exposed groups. RESULTS PBDE-28 and the surfactant perfluorooctanesulfonic acid (PFOS) were associated with less microbiome diversity. Some sub-OTUs of Lactobacillus, an important genus in early life, were lower in abundance in samples from infants with relative "high" (> 80th percentile) vs. "low" (< 20th percentile) toxicant exposure in this cohort. Moreover, breast milk toxicants were associated with microbiome functionality, explaining up to 34% of variance in acetic and propionic SCFAs, essential signaling molecules. Per one standard deviation of exposure, PBDE-28 was associated with less propionic acid (- 24% [95% CI - 35% to - 14%] relative to the mean), and PCB-209 with less acetic acid (- 15% [95% CI - 29% to - 0.4%]). Conversely, PFOA and dioxin-like PCB-167 were associated with 61% (95% CI 35% to 87%) and 22% (95% CI 8% to 35%) more propionic and acetic acid, respectively. CONCLUSIONS Environmental toxicant exposure may influence infant gut microbial function during a critical developmental window. Future studies are needed to replicate these novel findings and investigate whether this has any impact on child health.
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MESH Headings
- Adult
- Humans
- Infant, Newborn
- Bacteria/classification
- Bacteria/drug effects
- Bacteria/genetics
- Biodiversity
- Cohort Studies
- DNA, Bacterial/genetics
- DNA, Ribosomal/genetics
- Environmental Pollutants/adverse effects
- Environmental Pollutants/analysis
- Fatty Acids, Volatile/analysis
- Feces/chemistry
- Feces/microbiology
- Flame Retardants/adverse effects
- Flame Retardants/analysis
- Gastrointestinal Microbiome/drug effects
- Hydrocarbons, Chlorinated/adverse effects
- Hydrocarbons, Chlorinated/analysis
- Maternal Age
- Metabolomics
- Milk, Human/chemistry
- Norway
- Pesticides/adverse effects
- Pesticides/analysis
- Polychlorinated Biphenyls/adverse effects
- Polychlorinated Biphenyls/analysis
- RNA, Ribosomal, 16S/genetics
- Sequence Analysis, DNA/methods
- Female
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Affiliation(s)
- Nina Iszatt
- Department of Environmental Exposure and Epidemiology, Infection Control and Environmental Health, Norwegian Institute of Public Health, PO Box 222, Skøyen, 0213 Oslo, Norway
| | - Stefan Janssen
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093 USA
- Department of Pediatric Oncology, Hematology and Clinical Immunology, Heinrich-Heine University Dusseldorf, Dusseldorf, Germany
| | - Virissa Lenters
- Department of Environmental Exposure and Epidemiology, Infection Control and Environmental Health, Norwegian Institute of Public Health, PO Box 222, Skøyen, 0213 Oslo, Norway
| | - Cecilie Dahl
- Department of Community Medicine and Global Health, University of Oslo, Kirkeveien 166, Fredrik Holsts hus, 0450 Oslo, Norway
| | - Hein Stigum
- Department of Non-communicable Disease, Norwegian Institute of Public Health, PO Box 222, Skøyen, 0213 Oslo, Norway
| | - Rob Knight
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093 USA
- Center for Microbiome Innovation, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093 USA
- Department of Computer Science and Engineering, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093 USA
| | - Siddhartha Mandal
- Public Health Foundation of India, Delhi NCR, Plot No. 47, Sector 44, Institutional Area Gurgaon, Gurgaon 122002, India
| | - Shyamal Peddada
- Biostatistics Branch, National Institute of Environmental Health Sciences (NIEHS), 111 T.W. Alexander Drive, Durham, NC 27709 USA
| | - Antonio González
- Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093 USA
| | - Tore Midtvedt
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institute, Nobels väg 16, Solna Campus, Box 280, SE-171 77 Stockholm, Sweden
| | - Merete Eggesbø
- Department of Environmental Exposure and Epidemiology, Infection Control and Environmental Health, Norwegian Institute of Public Health, PO Box 222, Skøyen, 0213 Oslo, Norway
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66
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LaKind JS, Lehmann GM, Davis MH, Hines EP, Marchitti SA, Alcala C, Lorber M. Infant Dietary Exposures to Environmental Chemicals and Infant/Child Health: A Critical Assessment of the Literature. ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:96002. [PMID: 30256157 PMCID: PMC6375563 DOI: 10.1289/ehp1954] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 08/02/2018] [Accepted: 08/13/2018] [Indexed: 05/24/2023]
Abstract
BACKGROUND The benefits of breastfeeding to the infant and mother have been well documented. It is also well known that breast milk contains environmental chemicals, and numerous epidemiological studies have explored relationships between background levels of chemicals in breast milk and health outcomes in infants and children. OBJECTIVES In this paper, we examine epidemiological literature to address the following question: Are infant exposures to background levels of environmental chemicals in breast milk and formula associated with adverse health effects? We critically review this literature a) to explore whether exposure-outcome associations are observed across studies, and b) to assess the literature quality. METHODS We reviewed literature identified from electronic literature searches. We explored whether exposure-outcome associations are observed across studies by assessing the quality (using a modified version of a previously published quality assessment tool), consistency, and strengths and weaknesses in the literature. The epidemiological literature included cohorts from several countries and examined infants/children either once or multiple times over weeks to years. Health outcomes included four broad categories: growth and maturation, morbidity, biomarkers, and neurodevelopment. RESULTS The available literature does not provide conclusive evidence of consistent or clinically relevant health consequences to infants exposed to environmental chemicals in breast milk at background levels. CONCLUSIONS It is clear that more research would better inform our understanding of the potential for health impacts from infant dietary exposures to environmental chemicals. A critical data gap is a lack of research on environmental chemicals in formula and infant/child health outcomes. https://doi.org/10.1289/EHP1954.
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Affiliation(s)
- Judy S LaKind
- 1 LaKind Associates, LLC, Catonsville, Maryland, USA
- 2 Department of Epidemiology and Public Health, University of Maryland School of Medicine , Baltimore, Maryland, USA
| | - Geniece M Lehmann
- 3 Office of Research and Development (ORD), U.S. Environmental Protection Agency (EPA), Research Triangle Park , North Carolina, USA
| | - Matthew H Davis
- 4 Office of Children's Health Protection, U.S. EPA, Washington, District of Columbia, USA
| | - Erin P Hines
- 3 Office of Research and Development (ORD), U.S. Environmental Protection Agency (EPA), Research Triangle Park , North Carolina, USA
| | - Satori A Marchitti
- 5 Oak Ridge Institute for Science and Education (ORISE), ORD, U.S. EPA, Athens, Georgia, USA
| | - Cecilia Alcala
- 6 Association of Schools and Programs of Public Health (ASPPH), ORD, U.S. EPA, Washington, District of Columbia, USA
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