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Suhl J, Conway KM, Rhoads A, Langlois PH, Feldkamp ML, Michalski AM, Oleson JJ, Sidhu A, Kancherla V, Obrycki J, Mazumdar M, Romitti PA. Pre-pregnancy exposure to arsenic in diet and non-cardiac birth defects. Public Health Nutr 2022; 26:1-13. [PMID: 35620934 PMCID: PMC9989706 DOI: 10.1017/s1368980022001318] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 04/11/2022] [Accepted: 05/04/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To explore associations between maternal pre-pregnancy exposure to arsenic in diet and non-cardiac birth defects. DESIGN This is a population-based, case-control study using maternal responses to a dietary assessment and published arsenic concentration estimates in food items to calculate average daily total and inorganic arsenic exposure during the year before pregnancy. Assigning tertiles of total and inorganic arsenic exposure, logistic regression analysis was used to estimate OR for middle and high tertiles, compared to the low tertile. SETTING US National Birth Defects Prevention Study, 1997-2011. PARTICIPANTS Mothers of 10 446 children without birth defects and 14 408 children diagnosed with a non-cardiac birth defect. RESULTS Maternal exposure to total dietary arsenic in the middle and high tertiles was associated with a threefold increase in cloacal exstrophy, with weak positive associations (1·2-1·5) observed either in both tertiles (intercalary limb deficiency) or the high tertile only (encephalocele, glaucoma/anterior chamber defects and bladder exstrophy). Maternal exposure to inorganic arsenic showed mostly weak, positive associations in both tertiles (colonic atresia/stenosis, oesophageal atresia, bilateral renal agenesis/hypoplasia, hypospadias, cloacal exstrophy and gastroschisis), or the high (glaucoma/anterior chamber defects, choanal atresia and intestinal atresia stenosis) or middle (encephalocele, intercalary limb deficiency and transverse limb deficiency) tertiles only. The remaining associations estimated were near the null or inverse. CONCLUSIONS This exploration of arsenic in diet and non-cardiac birth defects produced several positive, but mostly weak associations. Limitations in exposure assessment may have resulted in exposure misclassification. Continued research with improved exposure assessment is recommended to identify if these associations are true signals or chance findings.
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Affiliation(s)
- Jonathan Suhl
- Department of Epidemiology, College of Public Health, The University of Iowa, 145 N Riverside Dr, S416 CPHB, Iowa City, IA52242, USA
| | - Kristin M Conway
- Department of Epidemiology, College of Public Health, The University of Iowa, 145 N Riverside Dr, S416 CPHB, Iowa City, IA52242, USA
| | - Anthony Rhoads
- Department of Epidemiology, College of Public Health, The University of Iowa, 145 N Riverside Dr, S416 CPHB, Iowa City, IA52242, USA
| | - Peter H Langlois
- Department of Epidemiology, Human Genetics, and Environmental Science, University of Texas, School of Public Health in Austin, Austin, TX, USA
| | - Marcia L Feldkamp
- Division of Medical Genetics, Department of Pediatrics, University of Utah, School of Medicine, Salt Lake City, UT, USA
| | - Adrian M Michalski
- New York State Department of Health, Bureau of Environmental and Occupational Epidemiology, Albany, NY, USA
| | - Jacob J Oleson
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Alpa Sidhu
- Division of Medical Genetics and Genomics, The Stead Family Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Vijaya Kancherla
- Department of Epidemiology, Emory University, Rollins School of Public Health, Atlanta, GA, USA
| | - John Obrycki
- Department of Neurology, Boston Children’s Hospital, Boston, MA, USA
| | - Maitreyi Mazumdar
- Department of Neurology, Boston Children’s Hospital, Boston, MA, USA
- Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Paul A Romitti
- Department of Epidemiology, College of Public Health, The University of Iowa, 145 N Riverside Dr, S416 CPHB, Iowa City, IA52242, USA
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Bulka CM, Scannell Bryan M, Lombard MA, Bartell SM, Jones DK, Bradley PM, Vieira VM, Silverman DT, Focazio M, Toccalino PL, Daniel J, Backer LC, Ayotte JD, Gribble MO, Argos M. Arsenic in private well water and birth outcomes in the United States. ENVIRONMENT INTERNATIONAL 2022; 163:107176. [PMID: 35349912 PMCID: PMC9052362 DOI: 10.1016/j.envint.2022.107176] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 05/03/2023]
Abstract
BACKGROUND Prenatal exposure to drinking water with arsenic concentrations >50 μg/L is associated with adverse birth outcomes, with inconclusive evidence for concentrations ≤50 μg/L. In a collaborative effort by public health experts, hydrologists, and geologists, we used published machine learning model estimates to characterize arsenic concentrations in private wells-federally unregulated for drinking water contaminants-and evaluated associations with birth outcomes throughout the conterminous U.S. METHODS Using several machine learning models, including boosted regression trees (BRT) and random forest classification (RFC), developed from measured groundwater arsenic concentrations of ∼20,000 private wells, we characterized the probability that arsenic concentrations occurred within specific ranges in groundwater. Probabilistic model estimates and private well usage data were linked by county to all live birth certificates from 2016 (n = 3.6 million). We evaluated associations with gestational age and term birth weight using mixed-effects models, adjusted for potential confounders and incorporated random intercepts for spatial clustering. RESULTS We generally observed inverse associations with term birth weight. For instance, when using BRT estimates, a 10-percentage point increase in the probability that private well arsenic concentrations exceeded 5 μg/L was associated with a -1.83 g (95% CI: -3.30, -0.38) lower term birth weight after adjusting for covariates. Similarly, a 10-percentage point increase in the probability that private well arsenic concentrations exceeded 10 μg/L was associated with a -2.79 g (95% CI: -4.99, -0.58) lower term birth weight. Associations with gestational age were null. CONCLUSION In this largest epidemiologic study of arsenic and birth outcomes to date, we did not observe associations of modeled arsenic estimates in private wells with gestational age and found modest inverse associations with term birth weight. Study limitations may have obscured true associations, including measurement error stemming from a lack of individual-level information on primary water sources, water arsenic concentrations, and water consumption patterns.
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Affiliation(s)
- Catherine M Bulka
- Department of Environmental Sciences and Engineering, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC 27599, USA.
| | - Molly Scannell Bryan
- Institute for Minority Health Research, University of Illinois at Chicago, 1819 W. Polk Street, Chicago, IL 60612, USA.
| | - Melissa A Lombard
- U.S. Geological Survey, New England Water Science Center, 331 Commerce Way, Pembroke, NH 03275, USA.
| | - Scott M Bartell
- Department of Environmental and Occupational Health, University of California, 653 E. Peltason Drive, Irvine, CA 92697, USA; Department of Statistics, University of California, Bren Hall 2019, Irvine, CA 92697, USA.
| | - Daniel K Jones
- U.S. Geological Survey, Utah Water Science Center, 2329 West Orton Circle, West Valley City, UT 84119, USA.
| | - Paul M Bradley
- U.S. Geological Survey, South Atlantic Water Science Center, 720 Gracern Rd, Columbia, SC 29210, USA.
| | - Veronica M Vieira
- Department of Environmental and Occupational Health, University of California, 653 E. Peltason Drive, Irvine, CA 92697, USA.
| | - Debra T Silverman
- Occupational and Environmental Epidemiology Branch, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850, USA.
| | - Michael Focazio
- U.S. Geological Survey, National Center, 12201 Sunrise Valley Dr, Reston, VA 20192, USA.
| | - Patricia L Toccalino
- U.S. Geological Survey, Northwest-Pacific Region, 2130 SW 5th Ave, Portland, OR 97201, USA.
| | - Johnni Daniel
- National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Atlanta, GA 30341, USA.
| | - Lorraine C Backer
- National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Atlanta, GA 30341, USA.
| | - Joseph D Ayotte
- U.S. Geological Survey, New England Water Science Center, 331 Commerce Way, Pembroke, NH 03275, USA.
| | - Matthew O Gribble
- Department of Epidemiology, University of Alabama at Birmingham, 217G Ryals Public Health Building, 1665 University Boulevard, Birmingham AL 35294, USA.
| | - Maria Argos
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, 1603 West Taylor Street, Office 878A, Chicago, IL 60612, USA.
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Abstract
PURPOSE OF REVIEW Arsenic is associated with cancer, heart disease, diabetes, and other outcomes that are also related to obesity. These similar effects raise the possibility that arsenic plays a role in obesity causation. They also raise the possibility that obesity may be an important effect modifier of arsenic-caused disease. This review summarizes the complex relationship between arsenic and obesity, with an emphasis on current research from human studies. RECENT FINDINGS Experimental studies provide some evidence that arsenic could play a role in obesity pathogenesis. To date, however, these associations have not been confirmed in human studies. In contrast, several epidemiologic studies have shown that the risks of arsenic-caused disease are markedly higher in obese individuals, highlighting obesity as an important susceptibility factor. Arsenic exposure and obesity are prevalent and widespread. Research identifying vulnerable populations, including obese individuals, could lead to new interventions having broad public health effects.
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Affiliation(s)
- Stephanie M Eick
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Craig Steinmaus
- Arsenic Health Effects Research Program, School of Public Health, University of California, Berkeley, 2470 Telegraph Ave., Suite 301, Berkeley, CA, 94704, USA.
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