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Zachek CM, Schwartz JM, Glasser M, DeMicco E, Woodruff TJ. A screening questionnaire for occupational and hobby exposures during pregnancy. Occup Med (Lond) 2020; 69:428-435. [PMID: 31247109 DOI: 10.1093/occmed/kqz094] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Occupational and environmental exposures during the prenatal period may be associated with adverse pregnancy outcomes and lifelong health effects. Yet, identification and evaluation of these potential hazards is lacking in routine obstetric care. AIMS To assess the feasibility of incorporating a self-administered occupational and environmental exposure questionnaire into obstetric clinics. METHODS A cross-sectional survey assessed prenatal clinic patients at a public hospital who were currently employed and <20 weeks gestation. Questionnaires evaluated job characteristics, workplace and hobby exposures, protective equipment use and symptoms during pregnancy. RESULTS Of 69 participants (96% response rate), 46% were predominantly Spanish-speaking. Primary occupations were caregiver (16%), cleaner (14%) and administrative assistant (14%). Overall, 93% were exposed to a workplace hazard, with most participants reporting physical stressors (82%) or organic solvent exposure (78%). Most women (74%) used some personal protective equipment. Nearly half (54%) reported at least one non-pregnancy symptom, and 52% were referred for follow-up with an occupational medicine practitioner. Household and hobby-related chemical exposures were common in our sample (91%). We observed moderate consistency between job task and chemical use responses: 67-99% of intentionally redundant questions were fully or partially matched. Closed- compared to open-ended activity questions identified a higher proportion of physical stressors (82% versus 12%) and cleaning product (76% versus 30%) exposures. CONCLUSIONS A self-administered questionnaire is an effective screening tool for identifying women with occupational and hobby-related exposures during pregnancy. Consistent incorporation of exposure assessment into prenatal care can improve clinical communications and early interventions for at-risk pregnant women.
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Affiliation(s)
- C M Zachek
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - J M Schwartz
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California San Francisco, San Francisco, CA, USA
| | - M Glasser
- Department of Anesthesiology, University of California San Diego, San Diego, CA, USA
| | - E DeMicco
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California San Francisco, San Francisco, CA, USA
| | - T J Woodruff
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California San Francisco, San Francisco, CA, USA
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Planchart A, Mattingly CJ, Allen D, Ceger P, Casey W, Hinton D, Kanungo J, Kullman SW, Tal T, Bondesson M, Burgess SM, Sullivan C, Kim C, Behl M, Padilla S, Reif DM, Tanguay RL, Hamm J. Advancing toxicology research using in vivo high throughput toxicology with small fish models. ALTEX 2016; 33:435-452. [PMID: 27328013 PMCID: PMC5270630 DOI: 10.14573/altex.1601281] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 05/31/2016] [Indexed: 12/18/2022]
Abstract
Small freshwater fish models, especially zebrafish, offer advantages over traditional rodent models, including low maintenance and husbandry costs, high fecundity, genetic diversity, physiology similar to that of traditional biomedical models, and reduced animal welfare concerns. The Collaborative Workshop on Aquatic Models and 21st Century Toxicology was held at North Carolina State University on May 5-6, 2014, in Raleigh, North Carolina, USA. Participants discussed the ways in which small fish are being used as models to screen toxicants and understand mechanisms of toxicity. Workshop participants agreed that the lack of standardized protocols is an impediment to broader acceptance of these models, whereas development of standardized protocols, validation, and subsequent regulatory acceptance would facilitate greater usage. Given the advantages and increasing application of small fish models, there was widespread interest in follow-up workshops to review and discuss developments in their use. In this article, we summarize the recommendations formulated by workshop participants to enhance the utility of small fish species in toxicology studies, as well as many of the advances in the field of toxicology that resulted from using small fish species, including advances in developmental toxicology, cardiovascular toxicology, neurotoxicology, and immunotoxicology. We alsoreview many emerging issues that will benefit from using small fish species, especially zebrafish, and new technologies that will enable using these organisms to yield results unprecedented in their information content to better understand how toxicants affect development and health.
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Affiliation(s)
- Antonio Planchart
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA
| | - Carolyn J. Mattingly
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA
| | - David Allen
- Integrated Laboratory Systems, Inc., Research Triangle Park, NC, USA
| | - Patricia Ceger
- Integrated Laboratory Systems, Inc., Research Triangle Park, NC, USA
| | - Warren Casey
- National Toxicology Program Interagency Center for the Evaluation of Alternative Toxicological Methods, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - David Hinton
- Nicholas School of the Environment, Duke University, Durham, NC, USA
| | - Jyotshna Kanungo
- National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, AR, USA
| | - Seth W. Kullman
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA
| | - Tamara Tal
- Integrated Systems Toxicology Division, National Health and Environmental Effects Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Maria Bondesson
- Department of Pharmacological and Pharmaceutical Sciences, University of Houston, Houston, TX, USA
| | | | - Con Sullivan
- Department of Molecular & Biomedical Sciences, University of Maine, Orono, ME, USA
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, ME, USA
| | - Carol Kim
- Department of Molecular & Biomedical Sciences, University of Maine, Orono, ME, USA
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, ME, USA
| | - Mamta Behl
- Division of National Toxicology Program, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Stephanie Padilla
- Integrated Systems Toxicology Division, National Health and Environmental Effects Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
| | - David M. Reif
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA
| | - Robert L. Tanguay
- Department of Environmental & Molecular Toxicology, Oregon State University, Corvallis, OR, USA
| | - Jon Hamm
- Integrated Laboratory Systems, Inc., Research Triangle Park, NC, USA
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Seo J, Lee BK, Jin SU, Park JW, Kim YT, Ryeom HK, Lee J, Suh KJ, Kim SH, Park SJ, Jeong KS, Ham JO, Kim Y, Chang Y. Lead-induced impairments in the neural processes related to working memory function. PLoS One 2014; 9:e105308. [PMID: 25141213 PMCID: PMC4139362 DOI: 10.1371/journal.pone.0105308] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 07/22/2014] [Indexed: 11/18/2022] Open
Abstract
Background It is well known that lead exposure induces neurotoxic effects, which can result in a variety of neurocognitive dysfunction. Especially, occupational lead exposures in adults are associated with decreases in cognitive performance including working memory. Despite recent advances in human neuroimaging techniques, the neural correlates of lead-exposed cognitive impairment remain unclear. Therefore, this study was aimed to compare the neural activations in relation to working memory function between the lead-exposed subjects and healthy controls. Methodology/Principal Findings Thirty-one lead-exposed subjects and 34 healthy subjects performed an n-back memory task during MRI scan. We performed fMRI using the 1-back and 2-back memory tasks differing in cognitive demand. Functional MRI data were analyzed using within- and between-group analysis. We found that the lead-exposed subjects showed poorer working memory performance during high memory loading task than the healthy subjects. In addition, between-group analyses revealed that the lead-exposed subjects showed reduced activation in the dorsolateral prefrontal cortex, ventrolateral prefrontal cortex, pre supplementary motor areas, and inferior parietal cortex. Conclusions/Significance Our findings suggest that functional abnormalities in the frontoparietal working memory network might contribute to impairments in maintenance and manipulation of working memory in the lead-exposed subjects.
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Affiliation(s)
- Jeehye Seo
- Department of Medical & Biological Engineering, Kyungpook National University, Dong-In dong, Jung-gu, Daegu, Korea
| | | | - Seong-Uk Jin
- Department of Medical & Biological Engineering, Kyungpook National University, Dong-In dong, Jung-gu, Daegu, Korea
| | - Jang Woo Park
- Department of Medical & Biological Engineering, Kyungpook National University, Dong-In dong, Jung-gu, Daegu, Korea
| | - Yang-Tae Kim
- Department of Psychiatry, School of Medicine, Keimyung University, Daegu, Korea
| | - Hun-Kyu Ryeom
- Department of Radiology, Kyungpook National University College of Medicine, Dong-In dong, Jung-gu, Daegu, Korea
| | - Jongmin Lee
- Department of Radiology, Kyungpook National University College of Medicine, Dong-In dong, Jung-gu, Daegu, Korea
| | - Kyung Jin Suh
- Department of Radiology, College of Medicine, Dongguk University, Gyeongju, Korea
| | - Suk Hwan Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Sin-Jae Park
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Kyoung Sook Jeong
- Department of Occupational and Environmental Medicine, Dongguk University College of Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Jung-O Ham
- Department of Occupational and Environmental Medicine, Soonchunhyan University Hospital, Cheonan, Korea
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
- * E-mail: (YC); (YK)
| | - Yongmin Chang
- Department of Medical & Biological Engineering, Kyungpook National University, Dong-In dong, Jung-gu, Daegu, Korea
- Department of Radiology, Kyungpook National University College of Medicine, Dong-In dong, Jung-gu, Daegu, Korea
- Department of Molecular Medicine, Kyungpook National University College of Medicine, Dong-In dong, Jung-gu, Daegu, Korea
- * E-mail: (YC); (YK)
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Grason HA, Misra DP. Reducing exposure to environmental toxicants before birth: moving from risk perception to risk reduction. Public Health Rep 2009; 124:629-41. [PMID: 19753941 DOI: 10.1177/003335490912400505] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
In this study, we considered approaches to reducing maternal exposure to hazardous environmental toxicants, focusing on risk communication to pregnant women and providers, but also considering identification of environmental toxicants in the community and reduction of environmental toxicants. We addressed the following questions: (1) What do pregnant women and their providers know about environmental toxicants and perinatal health? and (2) What policy strategies are needed (should be considered) to move forward in risk reduction in this area? We reviewed the literature on knowledge of pregnant women and providers regarding these issues. While there is limited research on what pregnant women and their providers know about environmental toxicants and perinatal health, there is evidence of reproductive and perinatal toxicity. This article describes a wide range of policy strategies that could be implemented to address environmental toxicants in the context of perinatal health. Effective leadership in this area will likely require collaboration of both environmental health and maternal and child health leaders and organizations.
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Affiliation(s)
- Holly A Grason
- Department of Population and Family Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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McDiarmid MA, Gardiner PM, Jack BW. The clinical content of preconception care: environmental exposures. Am J Obstet Gynecol 2008; 199:S357-61. [PMID: 19081430 DOI: 10.1016/j.ajog.2008.10.044] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2008] [Revised: 10/03/2008] [Accepted: 10/13/2008] [Indexed: 11/19/2022]
Abstract
Environmental origins of disease risk and harm to health have been increasingly acknowledged for numerous outcomes, in both adult and pediatric populations. Adverse reproductive and developmental effects have also been linked to environmental exposures. In addition to the current queries about a patient's alcohol and smoking history, key determinants of a future pregnancy outcome should also be elicited during the preconception visit. These determinants include: (1) mercury intake via fish consumption; (2) nitrate exposure from well water sources; (3) exposure to chemical, physical, or biologic hazards on the job; and (4) lead and other toxic exposures--possibly from hobbies or the use of lead-glazed dinnerware in the home. Eliciting a detailed environmental history permits tailored recommendations to optimize the woman's health and that of her future pregnancy.
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McDiarmid MA, Gehle K. Preconception brief: occupational/environmental exposures. Matern Child Health J 2006; 10:S123-8. [PMID: 16897370 PMCID: PMC2335294 DOI: 10.1007/s10995-006-0089-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2005] [Accepted: 04/19/2006] [Indexed: 12/01/2022]
Abstract
In the last decade, more than half of U.S. children were born to working mothers and 65% of working men and women were of reproductive age. In 2004 more than 28 million women age 18–44 were employed full time. This implies the need for clinicians to possess an awareness about the impact of work on the health of their patients and their future offspring. Most chemicals in the workplace have not been evaluated for reproductive toxicity, and where exposure limits do exist, they were generally not designed to mitigate reproductive risk. Therefore, many toxicants with unambiguous reproductive and developmental effects are still in regular commercial or therapeutic use and thus present exposure potential to workers. Examples of these include heavy metals, (lead, cadmium), organic solvents (glycol ethers, percholoroethylene), pesticides and herbicides (ethylene dibromide) and sterilants, anesthetic gases and anti-cancer drugs used in healthcare. Surprisingly, many of these reproductive toxicants are well represented in traditional employment sectors of women, such as healthcare and cosmetology. Environmental exposures also figure prominently in evaluating a woman’s health risk and that to a pregnancy. Food and water quality and pesticide and solvent usage are increasingly topics raised by women and men contemplating pregnancy. The microenvironment of a woman, such as her choices of hobbies and leisure time activities also come into play. Caregivers must be aware of their patients’ potential environmental and workplace exposures and weigh any risk of exposure in the context of the time-dependent window of reproductive susceptibility. This will allow informed decision-making about the need for changes in behavior, diet, hobbies or the need for added protections on the job or alternative duty assignment. Examples of such environmental and occupational history elements will be presented together with counseling strategies for the clinician.
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Lawson CC, Grajewski B, Daston GP, Frazier LM, Lynch D, McDiarmid M, Murono E, Perreault SD, Robbins WA, Ryan MAK, Shelby M, Whelan EA. Workgroup report: Implementing a national occupational reproductive research agenda--decade one and beyond. ENVIRONMENTAL HEALTH PERSPECTIVES 2006; 114:435-41. [PMID: 16507468 PMCID: PMC1392239 DOI: 10.1289/ehp.8458] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2005] [Accepted: 10/26/2005] [Indexed: 05/06/2023]
Abstract
The initial goal of occupational reproductive health research is to effectively study the many toxicants, physical agents, and biomechanical and psychosocial stressors that may constitute reproductive hazards in the workplace. Although the main objective of occupational reproductive researchers and clinicians is to prevent recognized adverse reproductive outcomes, research has expanded to include a broader spectrum of chronic health outcomes potentially affected by reproductive toxicants. To aid in achieving these goals, the National Institute for Occupational Safety and Health, along with its university, federal, industry, and labor colleagues, formed the National Occupational Research Agenda (NORA) in 1996. NORA resulted in 21 research teams, including the Reproductive Health Research Team (RHRT). In this report, we describe progress made in the last decade by the RHRT and by others in this field, including prioritizing reproductive toxicants for further study; facilitating collaboration among epidemiologists, biologists, and toxicologists; promoting quality exposure assessment in field studies and surveillance; and encouraging the design and conduct of priority occupational reproductive studies. We also describe new tools for screening reproductive toxicants and for analyzing mode of action. We recommend considering outcomes such as menopause and latent adverse effects for further study, as well as including exposures such as shift work and nanomaterials. We describe a broad domain of scholarship activities where a cohesive system of organized and aligned work activities integrates 10 years of team efforts and provides guidance for future research.
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Affiliation(s)
- Christina C Lawson
- National Institute for Occupational Safety and Health, Cincinnati, Ohio 45226-1998, USA.
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