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Li L, Guo Z, Deng R, Fan T, Dong D, Dai Y, Li C. The concentrations and behavior of classic phthalates and emerging phthalate alternatives in different environmental matrices and their biological health risks. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024:10.1007/s11356-024-34213-w. [PMID: 38977546 DOI: 10.1007/s11356-024-34213-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 06/28/2024] [Indexed: 07/10/2024]
Abstract
Because of their excellent plasticity, phthalates or phthalic acid esters (PAEs) are widely used in plastic products. However, due to the recognized toxicity of PAEs and legislative requirements, the production and use of emerging PAE alternatives have rapidly grown, such as di-isononyl cyclohexane-1,2-dicarboxylate (DINCH) and di(2-ethylhexyl) terephthalate (DEHTP) which are the primary replacements for classic PAEs. Nowadays, PAEs and emerging PAE alternatives are frequently found in a variety of environmental media, including the atmosphere, sludge, rivers, and seawater/sediment. PAEs and emerging PAE alternatives are involved in endocrine-disrupting effects, and they affect the reproductive physiology of different species of fish and mammals. Therefore, their presence in the environment is of considerable concern due to their potential effects on ecosystem function and public health. Nevertheless, current research on the prevalence, destiny, and conduct of PAEs in the environment has primarily focused on classic PAEs, with little attention given to emerging PAE alternatives. The present article furnishes a synopsis of the physicochemical characteristics, occurrence, transport, fate, and adverse effects of both classic PAEs and emerging PAE alternatives on organisms in the ecosystem. Our analysis reveals that both classic PAEs and emerging PAE alternatives are widely distributed in all environmental media, with emerging PAE alternatives increasingly replacing classic PAEs. Various pathways can transform and degrade both classic PAEs and emerging PAE alternatives, and their own and related metabolites can have toxic effects on organisms. This research offers a more extensive comprehension of the health hazards associated with classic PAEs and emerging PAE alternatives.
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Affiliation(s)
- Lele Li
- School of Resources and Environmental Engineering, Hefei University of Technology, No. 193 Tunxi Road, Hefei, 230009, China
- Anhui Engineering Research Center of Industrial Wastewater Treatment and Resource Recovery, Hefei University of Technology, Hefei, 230009, China
| | - Zhi Guo
- School of Resources and Environmental Engineering, Hefei University of Technology, No. 193 Tunxi Road, Hefei, 230009, China.
- Anhui Engineering Research Center of Industrial Wastewater Treatment and Resource Recovery, Hefei University of Technology, Hefei, 230009, China.
| | - Rui Deng
- School of Resources and Environmental Engineering, Hefei University of Technology, No. 193 Tunxi Road, Hefei, 230009, China
- Anhui Engineering Research Center of Industrial Wastewater Treatment and Resource Recovery, Hefei University of Technology, Hefei, 230009, China
| | - Ting Fan
- School of Resources and Environment, Anhui Agricultural University, Hefei, 230036, China
| | - Dazhuang Dong
- School of Resources and Environmental Engineering, Hefei University of Technology, No. 193 Tunxi Road, Hefei, 230009, China
- Anhui Engineering Research Center of Industrial Wastewater Treatment and Resource Recovery, Hefei University of Technology, Hefei, 230009, China
| | - Yaodan Dai
- School of Resources and Environmental Engineering, Hefei University of Technology, No. 193 Tunxi Road, Hefei, 230009, China
- Anhui Engineering Research Center of Industrial Wastewater Treatment and Resource Recovery, Hefei University of Technology, Hefei, 230009, China
| | - Chenxuan Li
- School of Resources and Environmental Engineering, Hefei University of Technology, No. 193 Tunxi Road, Hefei, 230009, China
- Anhui Engineering Research Center of Industrial Wastewater Treatment and Resource Recovery, Hefei University of Technology, Hefei, 230009, China
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Rodríguez-Carrillo A, Remy S, Koppen G, Wauters N, Mustieles V, Desalegn A, Iszatt N, den Hond E, Verheyen VJ, Fábelová L, Murinova LP, Pedraza-Díaz S, Esteban M, Poyatos RM, Govarts E, van Nuijs ALN, Covaci A, Schoeters G, Olea N, Fernández MF. Urinary phthalate/DINCH metabolites associations with kisspeptin and reproductive hormones in teenagers: A cross-sectional study from the HBM4EU aligned studies. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 929:172426. [PMID: 38631641 DOI: 10.1016/j.scitotenv.2024.172426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Exposure to phthalate/DINCH metabolites can induce human reproductive toxicity, however, their endocrine-disrupting mechanisms are not fully elucidated. OBJECTIVE To investigate the association between concentrations of phthalate/DINCH metabolites, serum kisspeptin, and reproductive hormones among European teenagers from three of the HBM4EU Aligned Studies. METHODS In 733 Belgian (FLEHS IV study), Slovak (PCB cohort follow-up), and Spanish (BEA study) teenagers, ten phthalate and two DINCH metabolites were measured in urine by high-performance liquid chromatography-tandem mass spectrometry. Serum kisspeptin (kiss54) protein, follicle-stimulating hormone (FSH), total testosterone (TT), estradiol (E2), and sex hormone-binding globulin (SHBG) levels were measured by immunosorbent assays. Free Androgen Index (FAI) was calculated as a proxy of free testosterone. Adjusted sex-stratified linear regression models for individual studies, mixed effect models (LME) accounting for random effects for pooled studies, and g-computation and Bayesian kernel machine regression (BKMR) models for the phthalate/DINCH mixture were performed. RESULTS The LME suggested that each IQR increase in ln-transformed levels of several phthalates was associated with lower kisspeptin [MnBP: %change (95%CI): -2.8 (-4.2;-0.4); MEHP: -1.4 (-3.4,0.2)] and higher FSH [∑DINP: 11.8 (-0.6;25.1)] levels in females from pooled studies. G-computation showed that the phthalates/DINCH mixture was associated with lower kisspeptin [-4.28 (-8.07;-0.34)] and higher FSH [22.13 (0.5;48.4)] also in females; BKMR showed similar although non-significant pattern. In males, higher phthalates metabolites [MEHP: -12.22 (-21.09;-1.18); oxo-MEHP: -12.73 (-22.34;-1.93)] were associated with lower TT and FAI, although higher DINCH [OH-MINCH: 16.31 (6.23;27.35), cx-MINCH: 16.80 (7.03;27.46), ∑DINCH: 17.37 (7.26;29.74)] were associated with higher TT levels. No mixture associations were found in males. CONCLUSION We observed sex-specific associations between urinary concentrations of phthalate/DINCH metabolites and the panel of selected effect biomarkers (kisspeptin and reproductive hormones). This suggests that exposure to phthalates would be associated with changes in kisspeptin levels, which would affect the HPG axis and thus influence reproductive health. However, further research is needed, particularly for phthalate replacements such as DINCH.
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Affiliation(s)
- Andrea Rodríguez-Carrillo
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium; Toxicological Centre, University of Antwerp, Universiteitsplein, 1, 2610 Wilrijk, Belgium
| | - Sylvie Remy
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium
| | - Gudrun Koppen
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium
| | - Natasha Wauters
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium
| | - Vicente Mustieles
- Biomedical Research Center & School of Medicine, University of Granada, 18016 Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Spain
| | - Anteneh Desalegn
- Division of Climate and Environmental Health, Norwegian Institute of Public Health, Norway
| | - Nina Iszatt
- Division of Climate and Environmental Health, Norwegian Institute of Public Health, Norway
| | | | - Veerle J Verheyen
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium
| | - Lucia Fábelová
- Department of Environmental Medicine, Faculty of Public Health, Slovak Medical University, Bratislava, Slovakia
| | - Lubica Palkovicova Murinova
- Department of Environmental Medicine, Faculty of Public Health, Slovak Medical University, Bratislava, Slovakia
| | - Susana Pedraza-Díaz
- National Centre for Environmental Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Esteban
- National Centre for Environmental Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Rafael M Poyatos
- Unidad de Gestión Clínica de Laboratorios, Hospital Universitario Clínico San Cecilio, Granada, Spain
| | - Eva Govarts
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium
| | | | - Adrian Covaci
- Toxicological Centre, University of Antwerp, Universiteitsplein, 1, 2610 Wilrijk, Belgium
| | - Greet Schoeters
- Department of Radiology and Physical Medicine, School of Medicine, University of Granada, 18016 Granada, Spain
| | - Nicolás Olea
- Biomedical Research Center & School of Medicine, University of Granada, 18016 Granada, Spain; Department of Radiology and Physical Medicine, School of Medicine, University of Granada, 18016 Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Spain
| | - Mariana F Fernández
- Biomedical Research Center & School of Medicine, University of Granada, 18016 Granada, Spain; Department of Radiology and Physical Medicine, School of Medicine, University of Granada, 18016 Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Spain.
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Reale E, Zare Jeddi M, Paini A, Connolly A, Duca R, Cubadda F, Benfenati E, Bessems J, S Galea K, Dirven H, Santonen T, M Koch H, Jones K, Sams C, Viegas S, Kyriaki M, Campisi L, David A, Antignac JP, B Hopf N. Human biomonitoring and toxicokinetics as key building blocks for next generation risk assessment. ENVIRONMENT INTERNATIONAL 2024; 184:108474. [PMID: 38350256 DOI: 10.1016/j.envint.2024.108474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 12/15/2023] [Accepted: 02/01/2024] [Indexed: 02/15/2024]
Abstract
Human health risk assessment is historically built upon animal testing, often following Organisation for Economic Co-operation and Development (OECD) test guidelines and exposure assessments. Using combinations of human relevant in vitro models, chemical analysis and computational (in silico) approaches bring advantages compared to animal studies. These include a greater focus on the human species and on molecular mechanisms and kinetics, identification of Adverse Outcome Pathways and downstream Key Events as well as the possibility of addressing susceptible populations and additional endpoints. Much of the advancement and progress made in the Next Generation Risk Assessment (NGRA) have been primarily focused on new approach methodologies (NAMs) and physiologically based kinetic (PBK) modelling without incorporating human biomonitoring (HBM). The integration of toxicokinetics (TK) and PBK modelling is an essential component of NGRA. PBK models are essential for describing in quantitative terms the TK processes with a focus on the effective dose at the expected target site. Furthermore, the need for PBK models is amplified by the increasing scientific and regulatory interest in aggregate and cumulative exposure as well as interactions of chemicals in mixtures. Since incorporating HBM data strengthens approaches and reduces uncertainties in risk assessment, here we elaborate on the integrated use of TK, PBK modelling and HBM in chemical risk assessment highlighting opportunities as well as challenges and limitations. Examples are provided where HBM and TK/PBK modelling can be used in both exposure assessment and hazard characterization shifting from external exposure and animal dose/response assays to animal-free, internal exposure-based NGRA.
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Affiliation(s)
- Elena Reale
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Switzerland
| | - Maryam Zare Jeddi
- National Institute for Public Health and the Environment (RIVM), the Netherlands
| | | | - Alison Connolly
- UCD Centre for Safety & Health at Work, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, D04 V1W8, Dublin, Ireland for Climate and Air Pollution Studies, Physics, School of Natural Science and the Ryan Institute, National University of Ireland, University Road, Galway H91 CF50, Ireland
| | - Radu Duca
- Unit Environmental Hygiene and Human Biological Monitoring, Department of Health Protection, Laboratoire national de santé (LNS), 1, Rue Louis Rech, 3555 Dudelange, Luxembourg; Environment and Health, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35, 3000 Leuven, Belgium
| | - Francesco Cubadda
- Istituto Superiore di Sanità - National Institute of Health, Viale Regina Elena 299, 00161 Rome, Italy
| | - Emilio Benfenati
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156 Milano, Italy
| | - Jos Bessems
- VITO HEALTH, Flemish Institute for Technological Research, 2400 Mol, Belgium
| | - Karen S Galea
- Institute of Occupational Medicine (IOM), Research Avenue North, Riccarton, Edinburgh EH14 4AP, UK
| | - Hubert Dirven
- Department of Climate and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Tiina Santonen
- Finnish Institute of Occupational Health (FIOH), P.O. Box 40, FI-00032 Työterveyslaitos, Finland
| | - Holger M Koch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - Kate Jones
- HSE - Health and Safety Executive, Harpur Hill, Buxton SK17 9JN, UK
| | - Craig Sams
- HSE - Health and Safety Executive, Harpur Hill, Buxton SK17 9JN, UK
| | - Susana Viegas
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal
| | - Machera Kyriaki
- Benaki Phytopathological Institute, 8, Stephanou Delta Street, 14561 Kifissia, Athens, Greece
| | - Luca Campisi
- Department of Pharmacy, University of Pisa, Via Bonanno 6, 56126 Pisa, Italy; Flashpoint srl, Via Norvegia 56, 56021 Cascina (PI), Italy
| | - Arthur David
- Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)-UMR_S 1085, F-35000 Rennes, France
| | | | - Nancy B Hopf
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Switzerland.
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Ketema RM, Kasper-Sonnenberg M, Ait Bamai Y, Miyashita C, Koch HM, Pälmke C, Kishi R, Ikeda A. Exposure Trends to the Non-phthalate Plasticizers DEHTP, DINCH, and DEHA in Children from 2012 to 2017: The Hokkaido Study. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:11926-11936. [PMID: 37506071 DOI: 10.1021/acs.est.3c03172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
Phthalates owing to their endocrine-disrupting effects are regulated in certain products, leading to their replacement with substitutions such as di-2-ethylhexyl terephthalate (DEHTP), 1,2-cyclohexane dicarboxylic acid di(isononyl) ester (DINCH), and di(2-ethylhexyl) adipate (DEHA). However, information on human exposure to these substitutes, especially in susceptible subpopulations such as children, is limited. Thus, we examined the levels and exposure trends of DEHTP, DINCH, and DEHA metabolites in 7 year-old Japanese school children. In total, 180 urine samples collected from 2012 to 2017 were used to quantify 10 DEHTP, DINCH, and DEHA metabolites via isotope dilution liquid chromatography with tandem mass spectrometry. DEHTP and DINCH metabolites were detected in 95.6 and 92.2% of the children, respectively, and DEHA was not detected. This study, annually conducted between 2012 and 2017, revealed a significant (p < 0.05) 5-fold increase in DEHTP metabolites and a 2-fold increase in DINCH metabolites. However, the maximum estimated internal exposures were still below the health-based guidance and toxicological reference values. Exposure levels to DEHTP and DINCH have increased considerably in Japanese school children. DEHA is less relevant. Future studies are warranted to closely monitor the increasing trend in different aged and larger populations and identify the potential health effects and sources contributing to increasing exposure and intervene if necessary.
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Affiliation(s)
- Rahel Mesfin Ketema
- Center for Environmental and Health Sciences, Hokkaido University, North 12, West 7, Sapporo 060-0812, Japan
- Faculty of Health Sciences, Hokkaido University, North 12, West 5, Sapporo 060-0812, Japan
| | - Monika Kasper-Sonnenberg
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, Bochum 44789, Germany
| | - Yu Ait Bamai
- Center for Environmental and Health Sciences, Hokkaido University, North 12, West 7, Sapporo 060-0812, Japan
- Toxicological Center, University of Antwerp, Universiteitsplein 1, Wilrijk 2610, Belgium
| | - Chihiro Miyashita
- Center for Environmental and Health Sciences, Hokkaido University, North 12, West 7, Sapporo 060-0812, Japan
| | - Holger M Koch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, Bochum 44789, Germany
| | - Claudia Pälmke
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, Bochum 44789, Germany
| | - Reiko Kishi
- Center for Environmental and Health Sciences, Hokkaido University, North 12, West 7, Sapporo 060-0812, Japan
| | - Atsuko Ikeda
- Center for Environmental and Health Sciences, Hokkaido University, North 12, West 7, Sapporo 060-0812, Japan
- Faculty of Health Sciences, Hokkaido University, North 12, West 5, Sapporo 060-0812, Japan
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Useini A, Engelberger F, Künze G, Sträter N. Structural basis of the activation of PPARγ by the plasticizer metabolites MEHP and MINCH. ENVIRONMENT INTERNATIONAL 2023; 173:107822. [PMID: 36841188 DOI: 10.1016/j.envint.2023.107822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/20/2023] [Accepted: 02/11/2023] [Indexed: 06/18/2023]
Abstract
Di-2-ethylhexyl phthalate (DEHP) and its substitute 1,2-cyclohexane dicarboxylic acid diisononyl ester (DINCH) are widely used as plasticizers but may have adverse health effects. Via hydrolysis of one of the two ester bonds in the human body, DEHP and DINCH form the monoesters MEHP and MINCH, respectively. Previous studies demonstrated binding of these metabolites to PPARγ and the induction of adipogenesis via this pathway. Detailed structural understanding of how these metabolites interact with PPARγ and thereby affect human health is lacking until now. We therefore characterized the binding modes of MINCH and MEHP to the ligand binding domain of PPARγ by X-ray crystallography and molecular dynamics (MD) simulations. Both compounds bind to the activating function-2 (AF-2) binding site via an interaction of the free carboxylates with the histidines 323 and 449, tyrosine 473 and serine 289. The alkyl chains form hydrophobic interactions with the tunnel next to cysteine 285. These binding modes are generally stable as demonstrated by the MD simulations and they resemble the complexation of fatty acids and their metabolites to the AF-2 site of PPARγ. Similar to the situation for these natural PPARγ agonists, the interaction of the free carboxylate groups of MEHP and MINCH with tyrosine 473 and surrounding residues stabilizes the AF-2 helix in the upward conformation. This state promotes binding of coactivator proteins and thus formation of the active complex for transcription of the specific target genes. Moreover, a comparison of the residues involved in binding of the plasticizer metabolites in vertebrate PPARγ orthologs shows that these compounds likely have similar effects in other species.
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Affiliation(s)
- Abibe Useini
- Institute of Bioanalytical Chemistry, Centre for Biotechnology and Biomedicine, Leipzig University, Deutscher Platz 5, 04103 Leipzig, Germany
| | - Felipe Engelberger
- Institute for Drug Discovery, Leipzig University, Brüderstraße 34, 04103 Leipzig, Germany
| | - Georg Künze
- Institute for Drug Discovery, Leipzig University, Brüderstraße 34, 04103 Leipzig, Germany.
| | - Norbert Sträter
- Institute of Bioanalytical Chemistry, Centre for Biotechnology and Biomedicine, Leipzig University, Deutscher Platz 5, 04103 Leipzig, Germany.
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Apel P, Lamkarkach F, Lange R, Sissoko F, David M, Rousselle C, Schoeters G, Kolossa-Gehring M. Human biomonitoring guidance values (HBM-GVs) for priority substances under the HBM4EU initiative - New values derivation for deltamethrin and cyfluthrin and overall results. Int J Hyg Environ Health 2023; 248:114097. [PMID: 36577283 DOI: 10.1016/j.ijheh.2022.114097] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 12/27/2022]
Abstract
The European Initiative HBM4EU aimed to further establish human biomonitoring across Europe as an important tool for determining population exposure to chemicals and as part of health-related risk assessments, thus making it applicable for policy advice. Not only should analytical methods and survey design be harmonized and quality assured, but also the evaluation of human biomonitoring data. For the health-related interpretation of the data within HBM4EU, a strategy for deriving health-based human biomonitoring guidance values (HBM-GVs) for both the general population and workers was agreed on. On this basis, HBM-GVs for exposure biomarkers of 1,2-cyclohexane dicarboxylic acid diisononyl ester (DINCH), phthalates (diethyl hexyl phthalate (DEHP), di-n-butyl phthalate (DnBP), diisobutyl phthalate (DiBP), butyl benzyl phthalate (BBzP), and bis-(2-propylheptyl) phthalate (DPHP)), bisphenols A and S, pyrethroids (deltamethrin and cyfluthrin), solvents (1-methyl-2-pyrrolidone (NMP), 1-ethylpyrrolidin-2-one (NEP), N-dimethylformamide (DMF), N,N-dimethylacetamide (DMAC)), the heavy metal cadmium and the mycotoxin deoxynivalenol (DON) were developed and assigned a level of confidence. The approach to HBM-GV derivations, results, and limitations in data interpretation with special focus on the pyrethroids are presented in this paper.
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Affiliation(s)
- P Apel
- German Environment Agency (UBA), Corrensplatz 1, 14195, Berlin, Germany.
| | - F Lamkarkach
- French Agency for Food, Environmental and Occupational Health & Safety (ANSES), 14 Rue Pierre et Marie Curie, 94701, Maisons-Alfort, Cedex, France
| | - R Lange
- German Environment Agency (UBA), Corrensplatz 1, 14195, Berlin, Germany
| | - F Sissoko
- French Agency for Food, Environmental and Occupational Health & Safety (ANSES), 14 Rue Pierre et Marie Curie, 94701, Maisons-Alfort, Cedex, France
| | - M David
- German Environment Agency (UBA), Corrensplatz 1, 14195, Berlin, Germany
| | - C Rousselle
- French Agency for Food, Environmental and Occupational Health & Safety (ANSES), 14 Rue Pierre et Marie Curie, 94701, Maisons-Alfort, Cedex, France
| | - G Schoeters
- VITO Health, Flemish Institute for Technological Research, 2400, Mol, Belgium; Department of Biomedical Sciences, University of Antwerp, 2610, Antwerp, Belgium
| | - M Kolossa-Gehring
- German Environment Agency (UBA), Corrensplatz 1, 14195, Berlin, Germany
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Stuchlík Fišerová P, Melymuk L, Komprdová K, Domínguez-Romero E, Scheringer M, Kohoutek J, Přibylová P, Andrýsková L, Piler P, Koch HM, Zvonař M, Esteban-López M, Castaño A, Klánová J. Personal care product use and lifestyle affect phthalate and DINCH metabolite levels in teenagers and young adults. ENVIRONMENTAL RESEARCH 2022; 213:113675. [PMID: 35700762 DOI: 10.1016/j.envres.2022.113675] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 06/08/2022] [Accepted: 06/10/2022] [Indexed: 06/15/2023]
Abstract
Humans are widely exposed to phthalates and their novel substitutes, and considering the negative health effects associated with some phthalates, it is crucial to understand population levels and exposure determinants. This study is focused on 300 urine samples from teenagers (aged 12-17) and 300 from young adults (aged 18-37) living in Czechia collected in 2019 and 2020 to assess 17 plasticizer metabolites as biomarkers of exposure. We identified widespread phthalate exposure in the study population. The diethyl phthalate metabolite monoethyl phthalate (MEP) and three di (2-ethylhexyl) phthalate metabolites were detected in the urine of >99% of study participants. The highest median concentrations were found for metabolites of low-molecular-weight (LMW) phthalates: mono-n-butyl phthalate (MnBP), monoisobutyl phthalate (MiBP) and MEP (60.7; 52.6 and 17.6 μg/L in young adults). 1,2-cyclohexanedicarboxylic acid diisononyl ester (DINCH) metabolites were present in 68.2% of the samples with a median of 1.24 μg/L for both cohorts. Concentrations of MnBP and MiBP were similar to other European populations, but 5-6 times higher than in populations in North America. We also observed large variability in phthalate exposures within the study population, with 2-3 orders of magnitude differences in urinary metabolites between high and low exposed individuals. The concentrations varied with season, gender, age, and lifestyle factors. A relationship was found between high levels of MEP and high overall use of personal care products (PCPs). Cluster analysis suggested that phthalate exposures depend on season and multiple lifestyle factors, like time spent indoors and use of PCPs, which combine to lead to the observed widespread presence of phthalate metabolites in both study populations. Participants who spent more time indoors, particularly noticeably during colder months, had higher levels of high-molecular weight phthalate metabolites, whereas participants with higher PCP use, particularly women, tended to have higher concentration of LMW phthalate metabolites.
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Affiliation(s)
| | - Lisa Melymuk
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, Brno, Czech Republic.
| | - Klára Komprdová
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, Brno, Czech Republic
| | | | - Martin Scheringer
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, Brno, Czech Republic
| | - Jiří Kohoutek
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, Brno, Czech Republic
| | - Petra Přibylová
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, Brno, Czech Republic
| | - Lenka Andrýsková
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, Brno, Czech Republic
| | - Pavel Piler
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, Brno, Czech Republic
| | - Holger M Koch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance - Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, Bochum, Germany
| | - Martin Zvonař
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, Brno, Czech Republic; Faculty of Sports, Masaryk University, Kamenice, Brno, Czech Republic
| | - Marta Esteban-López
- National Centre for Environmental Health, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Argelia Castaño
- National Centre for Environmental Health, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Jana Klánová
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, Brno, Czech Republic
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8
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Harmon P, Otter R. A review of common non-ortho-phthalate plasticizers for use in food contact materials. Food Chem Toxicol 2022; 164:112984. [PMID: 35452769 DOI: 10.1016/j.fct.2022.112984] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/17/2022] [Accepted: 03/31/2022] [Indexed: 10/18/2022]
Abstract
Several non-ortho phthalate plasticizers, including ATBC, DEHA, DINCH, DOTP, and ESBO, are currently used in flexible PVC applications for food packaging and processing. The aim of this review is to summarize the available toxicity, migration, and human biomonitoring data. Available assessments from US CPSC, EFSA, other governmental and non-governmental organizations, and published toxicology studies were used to show that these plasticizers are generally well-studied and demonstrate low toxicity with a focus on potential carcinogenicity, reproductive, developmental, and endocrine related adverse effects as well as biodegradation, aquatic toxicity, and bioaccumulation. Seven other plasticizers, 2EHESBO, ASE, CMCHA, DBT, DEHCH, PETV, and TOTM, have at least some recent but limited food contact clearances; assessments from CPSC, EFSA, and robust summaries in the REACH dossiers were reviewed for these products. Data gaps were found for some of these products; however, there were no concerns raised by the existing data, and they for now have limited use in food contact applications. Migration of ASE, COMGHA, DINCH, DOTP, DEHCH, and TOTM in simulants for aqueous and low alcohol foods ranged from <0.02 to 0.165 mg/kg, which showed they are below established migration limits and well-suited for these applications. Human biomonitoring data are available for DINCH, DOTP, DEHA, DINA, and TOTM, and are essential for determining exposure from all uses.
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Affiliation(s)
- Patrick Harmon
- BASF Corporation, 11750 Katy Freeway, Houston, TX, 77079, United States.
| | - Rainer Otter
- BASF SE, Carl-Bosch-Strasse 38, Ludwigshafen am Rhein, D-67056, Germany
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9
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Frederiksen H, Upners EN, Ljubicic ML, Fischer MB, Busch AS, Hagen CP, Juul A, Andersson AM. Exposure to 15 phthalates and two substitutes (DEHTP and DINCH) assessed in trios of infants and their parents as well as longitudinally in infants exclusively breastfed and after the introduction of a mixed diet. ENVIRONMENT INTERNATIONAL 2022; 161:107107. [PMID: 35091377 DOI: 10.1016/j.envint.2022.107107] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/07/2021] [Accepted: 01/19/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Several phthalates have been restricted/banned due to their adverse endocrine disrupting properties. The use of other phthalates and substitutes has increased. Here we examine the current exposure to phthalates in family trios comprised of infants and their parents and in infants exclusive breastfed and following introduction to a mixed diet. METHODS Metabolites of 15 phthalates and two substitutes, di(2-ethylhexyl)-teraphthalate (DEHTP) and diisononyl-cyclohexane-1,2-dicarboxylate (DINCH), were measured in urine samples collected from >100 infants and their parents and in paired urine samples collected from 67 infants, while they were exclusively breastfed and when they got mixed diet. RESULTS Among infants and their parents, metabolites of nine out of 15 phthalates and both substitutes were detected in >74% of all samples. Estimated daily intake (DI) calculated as µg/kg/day, showed similar exposure levels among infants and their parents for several of the substances, and infants were more exposed to DEHTP than their mothers. Significantly higher estimated DIs were observed for some low-molecular phthalates in infants exclusively breastfed. In contrast, comparable estimated DIs were observed for many other phthalates and DEHTP regardless of feeding status. For most of the substances, the within-family variation, was lower than the between-family variation. Likewise, the within-infant variation on exclusively breast vs. mixed diet was lower than the between-infant variation. Independent of food status, some infants were concurrently exposed to almost all the measured phthalates and substitutes in higher amounts than others. CONCLUSION Surprisingly, irrespective of diet status infants were exposed to several phthalates and substitutes some of which have been regulated for years. Exposure patterns and levels were similar in infants and their parents. Importantly, risk assessment based on new refined reference doses (RfD-AA) exceeded the safety level for anti-androgenic effects in a number of infants and parents, which is of concern.
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Affiliation(s)
- Hanne Frederiksen
- Copenhagen University Hospital-Rigshospitalet, Department of Growth and Reproduction, Denmark; Copenhagen University Hospital-Rigshospitalet, International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Denmark.
| | - Emmie N Upners
- Copenhagen University Hospital-Rigshospitalet, Department of Growth and Reproduction, Denmark; Copenhagen University Hospital-Rigshospitalet, International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Denmark
| | - Marie Lindhardt Ljubicic
- Copenhagen University Hospital-Rigshospitalet, Department of Growth and Reproduction, Denmark; Copenhagen University Hospital-Rigshospitalet, International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Denmark
| | - Margit Bistrup Fischer
- Copenhagen University Hospital-Rigshospitalet, Department of Growth and Reproduction, Denmark; Copenhagen University Hospital-Rigshospitalet, International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Denmark
| | - Alexander Siegfried Busch
- Copenhagen University Hospital-Rigshospitalet, Department of Growth and Reproduction, Denmark; Copenhagen University Hospital-Rigshospitalet, International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Denmark
| | - Casper P Hagen
- Copenhagen University Hospital-Rigshospitalet, Department of Growth and Reproduction, Denmark; Copenhagen University Hospital-Rigshospitalet, International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Denmark
| | - Anders Juul
- Copenhagen University Hospital-Rigshospitalet, Department of Growth and Reproduction, Denmark; Copenhagen University Hospital-Rigshospitalet, International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Denmark; University of Copenhagen, Department of Clinical Medicine, Denmark
| | - Anna-Maria Andersson
- Copenhagen University Hospital-Rigshospitalet, Department of Growth and Reproduction, Denmark; Copenhagen University Hospital-Rigshospitalet, International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Denmark
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10
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Stajnko A, Runkel AA, Kosjek T, Snoj Tratnik J, Mazej D, Falnoga I, Horvat M. Assessment of susceptibility to phthalate and DINCH exposure through CYP and UGT single nucleotide polymorphisms. ENVIRONMENT INTERNATIONAL 2022; 159:107046. [PMID: 34920277 DOI: 10.1016/j.envint.2021.107046] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 12/08/2021] [Accepted: 12/09/2021] [Indexed: 06/14/2023]
Abstract
Single nucleotide polymorphisms (SNPs) of cytochrome P450 (CYPs) and UDP-glucuronosyltransferase (UGTs) genes have been proposed to influence phthalates and 1,2-cyclo-hexanedicarboxylic acid diisononyl ester (DINCH) biotransformation but have not been investigated on a populational level. We investigated the role of SNPs in CYP2C9, CYP2C19, CYP2D6, UGT2B15, and UGT1A7 genes in the biotransformation of phthalates (DEHP, DEP, DiBP, DnBP, BBzP, DiNP, DidP) and DINCH by determining their urine metabolites. From the Slovenian study population of 274 men and 289 lactating primiparous women we obtained data on phthalate and DINCH urine metabolite levels (MEHP, 5OH-MEHP, 5oxo-MEHP, 5cx-MEPP, MEP, MiBP, MnBP, MBzP, cx-MINP, OH-MiDP, MCHP, MnPeP, MnOP, 5OH-MINCH, 5oxo-MINCH), SNP genotypes (rs1057910 = CYP2C9*3, rs1799853 = CYP2C9*2, rs4244285 = CYP2C19*2, rs12248560 = CYP2C19*17, rs3892097 = CYP2D6*4, rs1902023 = UGT2B15*2, and rs11692021 = UGT1A7*3) and questionnaires. Associations of SNPs with levels of metabolites and their ratios were assessed by multiple linear regression and ordinary logistic regression analyses. Significant associations were observed for CYP2C9*2, CYP2C9*3, CYP2C19*17, and UGT1A7*3 SNPs. The most pronounced was the influence of CYP2C9*2 and *3 on the reduced DEHP biotransformation, with lower levels of metabolites and their ratios in men and women. In contrast, carriers of CYP2C19*17 showed higher urine levels of DEHP metabolites in both genders, and in women also in higher DiNP, DiDP, and DINCH metabolite levels. The presence of UGT1A7*3 was associated with increased metabolite levels of DINCH in men and of DiBP and DBzP in women. Statistical models explained up to 27% of variability in metabolite levels or their ratios. Our observations confirm the effect of CYP2C9*2 and *3 SNPs towards reduced DEHP biotransformation. We show that CYP2C9*2, CYP2C9*3, CYP2C19*17, and UGT1A7*3 SNPs might represent biomarkers of susceptibility or resilience in phthalates and DINCH exposure that have been so far unrecognised.
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Affiliation(s)
- Anja Stajnko
- Jožef Stefan Institute, Department of Environmental Sciences, Ljubljana, Slovenia.
| | - Agneta Annika Runkel
- Jožef Stefan Institute, Department of Environmental Sciences, Ljubljana, Slovenia; Jožef Stefan International Postgraduate School, Ljubljana, Slovenia
| | - Tina Kosjek
- Jožef Stefan Institute, Department of Environmental Sciences, Ljubljana, Slovenia; Jožef Stefan International Postgraduate School, Ljubljana, Slovenia
| | - Janja Snoj Tratnik
- Jožef Stefan Institute, Department of Environmental Sciences, Ljubljana, Slovenia
| | - Darja Mazej
- Jožef Stefan Institute, Department of Environmental Sciences, Ljubljana, Slovenia
| | - Ingrid Falnoga
- Jožef Stefan Institute, Department of Environmental Sciences, Ljubljana, Slovenia
| | - Milena Horvat
- Jožef Stefan Institute, Department of Environmental Sciences, Ljubljana, Slovenia; Jožef Stefan International Postgraduate School, Ljubljana, Slovenia
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11
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Runkel AA, Mazej D, Snoj Tratnik J, Tkalec Ž, Kosjek T, Horvat M. Exposure of men and lactating women to environmental phenols, phthalates, and DINCH. CHEMOSPHERE 2022; 286:131858. [PMID: 34399256 DOI: 10.1016/j.chemosphere.2021.131858] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 08/02/2021] [Accepted: 08/08/2021] [Indexed: 06/13/2023]
Abstract
Phthalates and 1,2-Cyclohexane dicarboxylic acid diisononyl ester (DINCH), bisphenols (BPs), parabens (PBs), and triclosan (TCS) are high-production-volume chemicals of pseudo-persistence that are concerning for the environment and human health. This study aims to assess the exposure to 10 phthalates, DINCH, and environmental phenols (3 BPs, 7 PBs, and TCS) of Slovenian men (n = 548) and lactating primiparous women (n = 536). We observed urinary concentrations comparable to studies from other countries and significant differences among the sub-populations. In our study, men had significantly higher levels of phthalates, DINCH, and BPs, whereas the concentrations of PBs in urine were significantly higher in women. The most significant determinant of exposure was the area of residence and the year of sampling (2008-2014) that mirrors trends in the market. Participants from urban or industrialized sampling locations had higher levels of almost all monitored analytes compared to rural locations. In an attempt to assess the risk of the population, hazard quotient (HQ) values were calculated for individual compounds and the chemical mixture. Individual analytes do not seem to pose a risk to the studied population at current exposure levels, whereas the HQ value of the chemical mixture is near the threshold of 1 which would indicate a higher risk. We conclude that greater emphasis on the risk resulting from cumulative exposure to chemical mixtures and additional studies are needed to estimate the exposure of susceptible populations, such as children.
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Affiliation(s)
- Agneta A Runkel
- Jožef Stefan Institute, Jamova cesta 39, 1000, Ljubljana, Slovenia; Jožef Stefan International Postgraduate School, Jamova cesta 39, 1000, Ljubljana, Slovenia
| | - Darja Mazej
- Jožef Stefan Institute, Jamova cesta 39, 1000, Ljubljana, Slovenia
| | | | - Žiga Tkalec
- Jožef Stefan Institute, Jamova cesta 39, 1000, Ljubljana, Slovenia; Jožef Stefan International Postgraduate School, Jamova cesta 39, 1000, Ljubljana, Slovenia
| | - Tina Kosjek
- Jožef Stefan Institute, Jamova cesta 39, 1000, Ljubljana, Slovenia
| | - Milena Horvat
- Jožef Stefan Institute, Jamova cesta 39, 1000, Ljubljana, Slovenia; Jožef Stefan International Postgraduate School, Jamova cesta 39, 1000, Ljubljana, Slovenia.
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12
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Lee I, Pälmke C, Ringbeck B, Ihn Y, Gotthardt A, Lee G, Alakeel R, Alrashed M, Tosepu R, Jayadipraja EA, Tantrakarnapa K, Kliengchuay W, Kho Y, Koch HM, Choi K. Urinary Concentrations of Major Phthalate and Alternative Plasticizer Metabolites in Children of Thailand, Indonesia, and Saudi Arabia, and Associated Risks. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2021; 55:16526-16537. [PMID: 34846872 DOI: 10.1021/acs.est.1c04716] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Phthalates are widely used in consumer products and are well-known for adverse endocrine outcomes. Di-(2-ethylhexyl) phthalate (DEHP), one of the most extensively used phthalates, has been rapidly substituted with alternative plasticizers in many consumer products. The aim of this study was to assess urinary phthalate and alternative plasticizer exposure and associated risks in children of three Asian countries with different geographical, climate, and cultural characteristics. Children were recruited from elementary schools of Saudi Arabia (n = 109), Thailand (n = 104), and Indonesia (n = 89) in 2017-2018, and their urine samples were collected. Metabolites of major phthalates and alternative plasticizers were measured in the urine samples by HPLC-MS/MS. Urinary metabolite levels differed substantially between the three countries. Metabolite levels of diisononyl phthalate (DiNP), diisodecyl phthalate (DiDP), di(2-ethylhexyl) terephthalate (DEHTP), and 1,2-cyclohexane dicarboxylic acid diisononyl ester (DINCH) were the highest in Saudi children: Median urinary concentrations of oxo-MiNP, OH-MiDP, 5cx-MEPTP, and OH-MINCH were 8.3, 8.4, 128.0, and 2.9 ng/mL, respectively. Urinary DEHP metabolite concentrations were the highest in the Indonesian children. The hazard index (HI) derived for the plasticizers with antiandrogenicity based reference doses (RfDAA) was >1 in 86%, 80%, and 49% of the Saudi, Indonesian, and Thai children, respectively. DEHP was identified as a common major risk driver for the children of all three countries, followed by DnBP and DiBP depending on the country. Among alternative plasticizers, urinary DEHTP metabolites were detected at levels comparable to those of DEHP metabolites or higher among the Saudi children, and about 4% of the Saudi children exceeded the health based human biomonitoring (HBM)-I value. Priority plasticizers that were identified among the children of three countries warrant refined exposure assessment for source identification and relevant exposure reduction measures.
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Affiliation(s)
- Inae Lee
- School of Public Health, Seoul National University, Seoul 08826, Republic of Korea
| | - Claudia Pälmke
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bochum 44789, Germany
| | - Benedikt Ringbeck
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bochum 44789, Germany
| | - Yunchul Ihn
- School of Public Health, Seoul National University, Seoul 08826, Republic of Korea
| | - Alexandra Gotthardt
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bochum 44789, Germany
| | - Gowoon Lee
- School of Public Health, Seoul National University, Seoul 08826, Republic of Korea
| | - Raid Alakeel
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - May Alrashed
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia
- Medical and Molecular Genetics Research, King Saud University, Riyadh 11451, Saudi Arabia
| | - Ramadhan Tosepu
- Department of Environmental Health, Faculty of Public Health, University of Halu Oleo, Kendari 93232, Indonesia
| | | | - Kraichat Tantrakarnapa
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Ratchathewi 10400, Thailand
| | - Wissanupong Kliengchuay
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Ratchathewi 10400, Thailand
| | - Younglim Kho
- Department of Health, Environment and Safety, Eulji University, Seongnam 13135, Republic of Korea
| | - Holger M Koch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bochum 44789, Germany
| | - Kyungho Choi
- School of Public Health, Seoul National University, Seoul 08826, Republic of Korea
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13
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Ringbeck B, Belov VN, Schmidtkunz C, Küpper K, Gries W, Weiss T, Brüning T, Hayen H, Bury D, Leng G, Koch HM. Human Metabolism and Urinary Excretion Kinetics of Nonylphenol in Three Volunteers after a Single Oral Dose. Chem Res Toxicol 2021; 34:2392-2403. [PMID: 34735116 DOI: 10.1021/acs.chemrestox.1c00301] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Nonylphenol (NP) is an endocrine-disrupting anthropogenic chemical that is ubiquitous in the environment. Human biomonitoring data and knowledge on internal NP exposure are still sparse, and its human metabolism is largely unknown. Therefore, in this study, we investigated human metabolism and urinary excretion of NP. Three male volunteers received a single oral dose of 1 mg 13C6-labeled NP (10.6-11.7 μg/kg body weight). Consecutive full urine voids were collected for 48 h. A metabolite screening identified nine ring- and/or side chain-oxidized metabolites. We chose the most promising hits, the alkyl chain-oxidized metabolites hydroxy-NP (OH-NP) and oxo-NP, for quantitative investigation next to the parent NP. For this purpose, we newly synthesized specific n - 1-oxidized monoisomeric analytical standards. Quantification of the polyisomeric metabolites was performed via online-solid phase extraction-LC-MS/MS with stable isotope dilution using a previously published consensus method. Alkyl chain hydroxylation (OH-NP) constituted the major metabolism pathway representing 43.7 or 62.2% (depending on the mass transition used for quantification) of the NP dose excreted in urine. The urinary excretion fraction (FUE) for oxo-NP was 6.0 or 9.3%. The parent NP, quantified via an analogous isomeric 13C6-NP standard, represented 6.6%. All target analytes were excreted predominately as glucuronic acid conjugates. Excretion was rather quick, with concentration maxima in urine 2.3-3.4 h after dosing and biphasic elimination kinetics (elimination half-times first phase: 1.0-1.5 h and second phase: 5.2-6.8 h). Due to its high FUE and insusceptibility to external contamination (contrary to parent NP), OH-NP represents a robust and sensitive novel exposure biomarker for NP. The novel FUEs enable to robustly back-calculate the overall NP intakes from urinary metabolite levels in population samples for a well-informed cumulative exposure and risk assessment.
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Affiliation(s)
- Benedikt Ringbeck
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - Vladimir N Belov
- Facility for Synthetic Chemistry, Max Planck Institute for Biophysical Chemistry (MPI BPC), Am Fassberg 11, 37077 Göttingen, Germany
| | | | - Katja Küpper
- Currenta GmbH & Co. OHG, Institute of Biomonitoring, 51368 Leverkusen, Germany
| | - Wolfgang Gries
- Currenta GmbH & Co. OHG, Institute of Biomonitoring, 51368 Leverkusen, Germany
| | - Tobias Weiss
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - Heiko Hayen
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstraße 30, 48149 Münster, Germany
| | - Daniel Bury
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - Gabriele Leng
- Currenta GmbH & Co. OHG, Institute of Biomonitoring, 51368 Leverkusen, Germany
| | - Holger M Koch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
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14
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Ringbeck B, Bury D, Hayen H, Weiss T, Brüning T, Koch HM. Determination of specific urinary nonylphenol metabolites by online-SPE-LC-MS/MS as novel human exposure biomarkers. J Chromatogr B Analyt Technol Biomed Life Sci 2021; 1177:122794. [PMID: 34098181 DOI: 10.1016/j.jchromb.2021.122794] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/18/2021] [Accepted: 05/21/2021] [Indexed: 11/19/2022]
Abstract
Nonylphenol (NP) is an endocrine disrupting and ecotoxic substance that has been detected in a variety of environmental matrices. It is utilized for the production of non-ionic nonylphenol ethoxylate (NPEO) detergents and other high production volume chemicals. Human biomonitoring data are scarce and mostly limited to the non-oxidized NP, which is ubiquitous in the (laboratory) environment and susceptible to external contamination. Here, we describe a sensitive, precise, accurate and rugged analytical method for the determination of OH-NP and oxo-NP, two potential alkyl-chain-oxidized metabolites of NP in human urine. We used single isomer standards, obtained by custom synthesis, for the quantification of the sum of the respective isomers. After enzymatic hydrolysis of potential urinary phase II conjugates, urine samples were analyzed by online turbulent flow chromatography for analyte enrichment and matrix depletion coupled to reversed phase liquid chromatography with negative electrospray-ionization triple quadrupole tandem mass spectrometry detection (online-SPE-LC-MS/MS). Quantification was performed by stable isotope dilution analysis. Limits of quantification in urinary matrix were 0.5 µg/L for OH-NP and 0.25 µg/L for oxo-NP. Mean relative recoveries were 101-105% (OH-NP) and 112-117% (oxo-NP) and the method imprecision (CV) in matrix was below 5%. In spite of extensive use restrictions in the EU since 2003, we could quantify OH-NP and oxo-NP in 94% and 47% of spot urine samples from the general German population (n = 32) collected in 2014. Thus, both metabolites seem suitable as sensitive and specific urinary biomarkers of NP exposure for future human biomonitoring population studies. Currently this method is used to quantitatively investigate human NP metabolism and to derive urinary metabolite excretion fractions that can be used to calculate external doses based on urinary biomarker concentrations.
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Affiliation(s)
- Benedikt Ringbeck
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, Bochum 44789, Germany.
| | - Daniel Bury
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, Bochum 44789, Germany.
| | - Heiko Hayen
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstraße 30, Münster 48149, Germany.
| | - Tobias Weiss
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, Bochum 44789, Germany.
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, Bochum 44789, Germany.
| | - Holger M Koch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, Bochum 44789, Germany.
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15
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Association between Urinary Metabolites and the Exposure of Intensive Care Newborns to Plasticizers of Medical Devices Used for Their Care Management. Metabolites 2021; 11:metabo11040252. [PMID: 33921860 PMCID: PMC8073472 DOI: 10.3390/metabo11040252] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 11/24/2022] Open
Abstract
Care management of newborns in the neonatal intensive care unit (NICU) requires numerous PVC (PolyVinyl Chloride) medical devices (MD) containing plasticizers that can migrate and contaminate the patient. We measured the magnitude of neonates’ exposure to plasticizers (di-ethylhexylphthalate (DEHP) and alternatives) in relation to urinary concentrations of their metabolites. Plasticizers’ exposure was evaluated (1) by calculating the amounts of plasticizers prone to be released from each MD used for care management, and (2) by measuring the patients’ urinary levels of each plasticizers’ metabolites. 104 neonates were enrolled. They were exposed to di-isononylphthalate (DINP), especially via transfusion and infusion MD, and to DEHP via ECMO (Extra Corporeal Membrane Oxygenation) and respiratory assistance MD. Mean exposure doses exceeded the derived no-effect level of DINP and DEHP by a 10-fold and a 1000-fold factor. No PVC MD were plasticized with di-isononylcyclohexane-1,2-dicarboxylate (DINCH). High urinary concentrations of DEHP metabolites were directly correlated with DEHP exposure through ECMO MD. Urinary concentrations of DINP metabolites in transfused patients were also high. DINCH metabolites were found in urine, suggesting another route of exposure. Neonates in NICU are considerably exposed to plasticizers, with magnitudes varying with the type of MD used. The high exposure to DEHP and DINP leads to a risk of their metabolites’ toxicity.
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16
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Vorkamp K, Castaño A, Antignac JP, Boada LD, Cequier E, Covaci A, Esteban López M, Haug LS, Kasper-Sonnenberg M, Koch HM, Pérez Luzardo O, Osīte A, Rambaud L, Pinorini MT, Sabbioni G, Thomsen C. Biomarkers, matrices and analytical methods targeting human exposure to chemicals selected for a European human biomonitoring initiative. ENVIRONMENT INTERNATIONAL 2021; 146:106082. [PMID: 33227583 DOI: 10.1016/j.envint.2020.106082] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/11/2020] [Accepted: 08/19/2020] [Indexed: 05/27/2023]
Abstract
The major purpose of human biomonitoring is the mapping and assessment of human exposure to chemicals. The European initiative HBM4EU has prioritized seven substance groups and two metals relevant for human exposure: Phthalates and substitutes (1,2-cyclohexane dicarboxylic acid diisononyl ester, DINCH), bisphenols, per- and polyfluoroalkyl substances (PFASs), halogenated and organophosphorous flame retardants (HFRs and OPFRs), polycyclic aromatic hydrocarbons (PAHs), arylamines, cadmium and chromium. As a first step towards comparable European-wide data, the most suitable biomarkers, human matrices and analytical methods for each substance group or metal were selected from the scientific literature, based on a set of selection criteria. The biomarkers included parent compounds of PFASs and HFRs in serum, of bisphenols and arylamines in urine, metabolites of phthalates, DINCH, OPFRs and PAHs in urine as well as metals in blood and urine, with a preference to measure Cr in erythrocytes representing Cr (VI) exposure. High performance liquid chromatography-tandem mass spectrometry (LC-MS/MS) was the method of choice for bisphenols, PFASs, the HFR hexabromocyclododecane (HBCDD), phenolic HFRs as well as the metabolites of phthalates, DINCH, OPFRs and PAHs in urine. Gas chromatographic (GC) methods were selected for the remaining compounds, e.g. GC-low resolution MS with electron capture negative ionization (ECNI) for HFRs. Both GC-MS and LC-MS/MS were suitable for arylamines. New developments towards increased applications of GC-MS/MS may offer alternatives to GC-MS or LC-MS/MS approaches, e.g. for bisphenols. The metals were best determined by inductively coupled plasma (ICP)-MS, with the particular challenge of avoiding interferences in the Cd determination in urine. The evaluation process revealed research needs towards higher sensitivity and non-invasive sampling as well as a need for more stringent quality assurance/quality control applications and assessments.
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Affiliation(s)
- Katrin Vorkamp
- Aarhus University, Department of Environmental Science, Denmark.
| | - Argelia Castaño
- Instituto de Salud Carlos III, National Centre for Environmental Health, Spain.
| | | | - Luis D Boada
- University of Las Palmas de Gran Canaria, Institute for Biomedical and Health Research, Spain.
| | | | - Adrian Covaci
- University of Antwerp, Toxicological Centre, Belgium.
| | - Marta Esteban López
- Instituto de Salud Carlos III, National Centre for Environmental Health, Spain.
| | - Line S Haug
- Norwegian Institute of Public Health, Norway.
| | - Monika Kasper-Sonnenberg
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance - Institute of the Ruhr-University, Germany.
| | - Holger M Koch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance - Institute of the Ruhr-University, Germany.
| | - Octavio Pérez Luzardo
- University of Las Palmas de Gran Canaria, Institute for Biomedical and Health Research, Spain.
| | - Agnese Osīte
- University of Latvia, Department of Analytical Chemistry, Latvia.
| | - Loïc Rambaud
- Santé Publique France, Department of Environmental and Occupational Health, France.
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Senta I, Rodríguez-Mozaz S, Corominas L, Petrovic M. Wastewater-based epidemiology to assess human exposure to personal care and household products - A review of biomarkers, analytical methods, and applications. TRENDS IN ENVIRONMENTAL ANALYTICAL CHEMISTRY 2020; 28:e00103. [PMID: 38620429 PMCID: PMC7470864 DOI: 10.1016/j.teac.2020.e00103] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 08/26/2020] [Accepted: 08/28/2020] [Indexed: 05/24/2023]
Abstract
Humans are nowadays exposed to numerous chemicals in our day-to-day life, including parabens, UV filters, phosphorous flame retardants/plasticizers, bisphenols, phthalates and alternative plasticizers, which can have different adverse effects to human health. Estimating human's exposure to these potentially harmful substances is, therefore, of paramount importance. Human biomonitoring (HBM) is the existing approach to assess exposure to environmental contaminants, which relies on the analysis of specific human biomarkers (parent compounds and/or their metabolic products) in biological matrices from individuals. The main drawback is its implementation, which involves complex cohort studies. A novel approach, wastewater-based epidemiology (WBE), involves estimating exposure from the analysis of biomarkers in sewage (a pooled urine and feces sample of an entire population). One of the key challenges of WBE is the selection of biomarkers which are specific to human metabolism, excreted in sufficient amounts, and stable in sewage. So far, literature data on potential biomarkers for estimating exposure to these chemicals are scattered over numerous pharmacokinetic and HBM studies. Hence, this review provides a list of potential biomarkers of exposure to more than 30 widely used chemicals and report on their urinary excretion rates. Furthermore, the potential and challenges of WBE in this particular field is discussed through the review of pioneer WBE studies, which for the first time explored applicability of this novel approach to assess human exposure to environmental contaminants. In the future, WBE could be potentially applied as an "early warning system", which could promptly identify communities with the highest exposure to environmental contaminants.
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Key Words
- 3−OH-EtP, ethyl protocatechuate
- 3−OH-MeP, methyl protocatechuate
- 5−OH−OC, 2-ethyl-5-hydroxyhexyl 2-cyano-3,3-diphenyl acrylate
- ASE, accelerated solvent extraction
- BBOEHEP, bis(2-butoxyethyl) 2-hydroxyethyl phosphate
- BBOEP, bis(2-butoxyethyl) phosphate
- BP-3, 2,4-dihydroxybenzophenone (Benzophenone-3, Oxybenzone)
- BPA, bisphenol A
- BPA-Glu, bisphenol A glucuronide
- BPA-SO4, bisphenol A sulfate
- Biomarkers
- Bisphenols
- CPAA, 2-cyano-3,3-diphenylacrylic acid
- DEHA, di-2-ethylhexyl adipate
- DEHP, di(2-ethylhexyl) phthalate
- DEHTP, di(2-ethylhexyl) terephthalate
- DHB, 2,4-dihydroxybenzophenone (Benzophenone-1, BP-1)
- DHMB, 2,2′-dihydroxy-4-methoxybenzophenone (Benzophenone-8, BP-8)
- DINCH, di(isononyl)cyclohexane-1,2-dicarboxylate
- DNBP, di-n-butyl phosphate
- DPHP, di-(2-propylheptyl) phthalate
- DPhP, diphenyl phosphate
- EHDPhP, 2-ethylhexyldiphenyl phosphate
- EHS, 2-ethylhexyl salicylate (Octisalate)
- EI, electron ionization
- ESI, electrospray ionization
- EtP, ethylparaben
- Excretion rate
- Flame retardants
- GC–MS, gas chromatography‒mass spectrometry
- HBM, human biomonitoring
- HPLC-MS/MS, high performance liquid chromatography–tandem mass spectrometry
- LC–MS/MS, liquid chromatography‒tandem mass spectrometry
- MAE, microwave-assisted extraction
- MEHA, mono-2-ethylhexyl adipate
- MINCH, Monoisononyl-cyclohexane-1,2-dicarboxylate
- MQL, method quantification limit
- MRM, multiple reaction monitoring (MRM)
- MTBSTFA, N-tert-butyldimethylsilyl-N-methyltrifluoroacetamide
- MeP, methylparaben
- OC, Octocrylene
- OH-MINCH, Cyclohexane-1,2-dicarboxylate-mono-(7-hydroxy-4-methyl) octyl ester
- PE, primary effluent
- PFRs, phosphorous flame retardants/plasticizers
- PHBA, p-hydroxybenzoic acid
- PHHA, p-hydroxyhippuric acid
- Parabens
- Phthalates
- Plasticizers
- PrP, propylparaben
- Q-ToF, quadrupole-time-of-flight
- QTRAP, quadrupole-ion trap
- QqQ, triple quadrupole
- RW, raw wastewater
- SE, secondary (final) effluent
- SIM, selected ion monitoring
- SPE, solid-phase extraction
- SPM, suspended particulate matter
- Sewage chemical information mining
- Sewage epidemiology
- TBOEP, tris(2-butoxyethyl) phosphate
- TPhP, triphenyl phosphate
- UAE, ultrasonic-assisted extraction
- UHPLC-MS/MS, ultrahigh performance liquid chromatography–tandem mass spectrometry
- UV filters
- WBE, wastewater-based epidemiology
- WWTPs, wastewater treatment plants
- bbCID, broadband collision-induced dissociation
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Affiliation(s)
- Ivan Senta
- Catalan Institute for Water Research (ICRA), Emili Grahit 101, 17003 Girona, Spain
- Division for Marine and Environmental Research, Rudjer Boskovic Institute, Bijenicka 54, 10000 Zagreb, Croatia
| | - Sara Rodríguez-Mozaz
- Catalan Institute for Water Research (ICRA), Emili Grahit 101, 17003 Girona, Spain
- University of Girona, Girona, Spain
| | - Lluís Corominas
- Catalan Institute for Water Research (ICRA), Emili Grahit 101, 17003 Girona, Spain
- University of Girona, Girona, Spain
| | - Mira Petrovic
- Catalan Institute for Water Research (ICRA), Emili Grahit 101, 17003 Girona, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Passeig Lluís Companys 23, 08010, Barcelona, Spain
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Guo Z, Huang S, Wang J, Feng YL. Recent advances in non-targeted screening analysis using liquid chromatography - high resolution mass spectrometry to explore new biomarkers for human exposure. Talanta 2020; 219:121339. [DOI: 10.1016/j.talanta.2020.121339] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 05/16/2020] [Accepted: 06/09/2020] [Indexed: 12/29/2022]
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Campbell JL, Otter R, Anderson WA, Longnecker MP, Clewell RA, North C, Clewell HJ. Development of a physiologically based pharmacokinetic model of diisononyl phthalate (DiNP) in pregnant rat and human. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2020; 83:631-648. [PMID: 32757748 DOI: 10.1080/15287394.2020.1798831] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A physiologically based pharmacokinetic (PBPK) model for di-isononyl phthalate (DiNP) was developed by adapting the existing models for di(2-ethylhexyl) phthalate (DEHP) and di-butylphthalate (DBP). Both pregnant rat and human time-course plasma and urine data were used to address the hydrolysis of DiNP in intestinal tract, plasma, and liver as well as hepatic oxidative metabolism and conjugation of the monoester and primary oxidative metabolites. Data in both rats and humans were available to inform the uptake and disposition of mono-isononyl phthalate (MiNP) as well as the three primary oxidative metabolites including hydroxy (7-OH)-, oxo (7-OXO)-, and carboxy (7-COX)-monoisononyl phthalate in plasma and urine. The DiNP model was reliable over a wide range of exposure levels in the pregnant rat as well as the two low exposure levels in humans including capturing the nonlinear behavior in the pregnant rat after repeated 750 mg/kg/day dosing. The presented DiNP PBPK model in pregnant rat and human, based upon an extensive kinetic dataset in both species, may provide a basis for assessing human equivalent exposures based upon either rodent or in vitro points of departure.
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Affiliation(s)
| | - Rainer Otter
- Regulatory Affairs/Advocacy, Basf Se , Ludwigshafen, Germany
| | - Warwick A Anderson
- Food Safety, Fera Science Ltd., National Agri-Food Innovation Campus , York, UK
| | | | | | - Colin North
- Toxicology & Environmental Science, ExxonMobil Biomedical Sciences, Inc , Annandale, NJ, USA
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Guo Z, Zhu Z, Huang S, Wang J. Non-targeted screening of pesticides for food analysis using liquid chromatography high-resolution mass spectrometry-a review. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2020; 37:1180-1201. [DOI: 10.1080/19440049.2020.1753890] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Zeqin Guo
- College of Bioengineering, Chongqing University, Chongqing, P. R. China
| | - Zhiguo Zhu
- College of Pharmacy and Life Science, Jiujiang University, Jiujiang, P.R. China
| | - Sheng Huang
- College of Bioengineering, Chongqing University, Chongqing, P. R. China
| | - Jianhua Wang
- College of Bioengineering, Chongqing University, Chongqing, P. R. China
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Frederiksen H, Nielsen O, Koch HM, Skakkebaek NE, Juul A, Jørgensen N, Andersson AM. Changes in urinary excretion of phthalates, phthalate substitutes, bisphenols and other polychlorinated and phenolic substances in young Danish men; 2009–2017. Int J Hyg Environ Health 2020; 223:93-105. [DOI: 10.1016/j.ijheh.2019.10.002] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 10/06/2019] [Accepted: 10/06/2019] [Indexed: 02/07/2023]
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Campioli E, Lau M, Papadopoulos V. Effect of subacute and prenatal DINCH plasticizer exposure on rat dams and male offspring hepatic function: The role of PPAR-α. ENVIRONMENTAL RESEARCH 2019; 179:108773. [PMID: 31605871 DOI: 10.1016/j.envres.2019.108773] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 09/17/2019] [Accepted: 09/23/2019] [Indexed: 06/10/2023]
Abstract
Plasticizers are compounds added to plastics to modify their physical proprieties. The most well-known class of plasticizers, the phthalates, has been shown to possess antiandrogenic and tumor promoting activities. 1,2-Cyclohexane dicarboxylic acid diisononyl ester (DINCH) was approved for use in food contact containers in 2006 and has been used as a replacement for phthalates in toys and children products. However, we reported previously that the DINCH metabolite MINCH acts on primary rat adipocytes through the peroxisome proliferator activated receptor (PPAR)-α pathway in a manner similar to phthalates. Evidence from our studies, as well as from the current bibliography on DINCH, suggests that the liver might be one of its target organs. In the present study, we collected tissues from dams exposed subacutely and progeny at postnatal day (PND) 3 and 60 exposed in utero to DINCH (1, 10 and 100 mg/kg bw/day). Exposure to DINCH drastically affected liver gene expression in all 3 age groups tested and in particular at the dose of 1 mg/kg bw/day. The PPAR-α pathway along with other metabolic and DNA replication pathways were affected by DINCH. Modifications in PPAR-α and superoxide dismutase (SOD)-1 protein levels were observed in dams at PND21, as well as male progeny at PND3 and 60. No sign of fibrosis or direct liver toxicity was observed after 8 days of stimulus with low doses of DINCH. This study provides evidence that DINCH is not a biologically inert molecule in the rat, and in the liver its actions are mediated, at least in part, by PPAR-α.
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Affiliation(s)
- Enrico Campioli
- Research Institute of the McGill University Health Centre, Montréal, Québec, Canada; Department of Medicine, McGill University, Montréal, Québec, Canada
| | - Matthew Lau
- Research Institute of the McGill University Health Centre, Montréal, Québec, Canada; Department of Pharmacology & Pharmaceutical Sciences, School of Pharmacy, University of Southern California, Los Angeles, CA, USA
| | - Vassilios Papadopoulos
- Research Institute of the McGill University Health Centre, Montréal, Québec, Canada; Department of Medicine, McGill University, Montréal, Québec, Canada; Department of Pharmacology & Pharmaceutical Sciences, School of Pharmacy, University of Southern California, Los Angeles, CA, USA.
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23
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Castagnoli E, Backlund P, Talvitie O, Tuomi T, Valtanen A, Mikkola R, Hovi H, Leino K, Kurnitski J, Salonen H. Emissions of DEHP-free PVC flooring. INDOOR AIR 2019; 29:903-912. [PMID: 31348556 PMCID: PMC6856815 DOI: 10.1111/ina.12591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 06/26/2019] [Accepted: 07/23/2019] [Indexed: 05/08/2023]
Abstract
Degrading 2-ethylhexyl-containing PVC floorings (eg DEHP-PVC floorings) and adhesives emit 2-ethylhexanol (2-EH) in the indoor air. The danger of flooring degradation comes from exposing occupants to harmful phthalates plasticisers (eg DEHP), but not from 2-EH as such. Since the EU banned the use of phthalates in sensitive applications, the market is shifting to use DEHP-free and alternative types of plasticisers in PVC products. However, data on emissions from DEHP-free PVC floorings are scarce. This study aimed at assessing the surface and bulk emissions of two DEHP-free PVC floorings over three years. The floorings were glued on the screed layer of concrete casts at 75%, 85%, and 95% RH. The volatile organic compounds (VOCs) were actively sampled using FLEC (surface emissions) and micro-chamber/thermal extractor (µ-CTE, bulk emissions) onto Tenax TA adsorbents and analyzed with TD-GC-MS. 2-EH, C9-alcohols, and total volatile organic compound (TVOC) emissions are reported. Emissions at 75% and 85% RH were similar. As expected, the highest emissions occurred at 95% RH. 2-EH emissions originated from the adhesive. Because the two DEHP-free floorings tested emitted C9-alcohols at all tested RH, it makes the detection of flooring degradation harder, particularly if the adhesive used does not emit 2-EH.
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Affiliation(s)
| | | | | | - Tapani Tuomi
- Finnish Institute of Occupational HealthHelsinkiFinland
| | - Arja Valtanen
- The Building Information Foundation RTS srHelsinkiFinland
| | - Raimo Mikkola
- Department of Civil EngineeringAalto UniversityEspooFinland
| | - Hanna Hovi
- Finnish Institute of Occupational HealthHelsinkiFinland
| | - Katri Leino
- Finnish Institute of Occupational HealthHelsinkiFinland
| | - Jarek Kurnitski
- Department of Civil EngineeringAalto UniversityEspooFinland
- Tallinn University of TechnologyTallinnEstonia
| | - Heidi Salonen
- Department of Civil EngineeringAalto UniversityEspooFinland
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24
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Kasper-Sonnenberg M, Koch HM, Apel P, Rüther M, Pälmke C, Brüning T, Kolossa-Gehring M. Time trend of exposure to the phthalate plasticizer substitute DINCH in Germany from 1999 to 2017: Biomonitoring data on young adults from the Environmental Specimen Bank (ESB). Int J Hyg Environ Health 2019; 222:1084-1092. [PMID: 31378638 DOI: 10.1016/j.ijheh.2019.07.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 07/11/2019] [Accepted: 07/22/2019] [Indexed: 10/26/2022]
Abstract
DINCH (cyclohexane-1,2-dicarboxylic acid-diisononyl ester) is a phthalate plasticizer substitute introduced into the market in 2002. It is increasingly used especially in the production of toys, food contact materials and medical devices. In this measurement campaign on 24-h urine samples of young adults (20-29 years) from the German Environmental Specimen Bank (ESB) collected in 2010, 2011, 2013, 2015 and 2017 (in total 300 samples, 60 samples/year) we analyzed three specific, oxidized DINCH metabolites (OH-MINCH: cyclohexane-1,2-dicarboxylic acid-mono(hydroxy-isononyl) ester; cx-MINCH: cyclohexane-1,2-dicarboxylic acid-mono(carboxy-isooctyl) ester, oxo-MINCH: cyclohexane-1,2-dicarboxylic acid-mono(oxo-isononyl) ester). We merged these data with earlier data of the ESB from the years 1999-2012 and are now able to report levels and time trends of internal DINCH exposure from 1999 to 2017. After first detections of the major oxidized DINCH metabolite OH-MINCH in 2006 (6.7%) detection rates rapidly increased to 43.3% in 2009, 80% in 2010 and 98.3% in 2011 and 2012. From the year 2013 on we could detect OH-MINCH in every urine sample analyzed. The median concentrations of OH-MINCH rapidly increased from 0.15 μg/L in 2010 to twice the concentration in 2011 (0.31 μg/L) with further increases in 2013 (0.37 μg/L), 2015 (0.59 μg/L) and 2017 (0.70 μg/L). Similar increases, albeit at lower detection rates and concentration levels, could be observed for cx-MINCH and oxo-MINCH. All metabolites strongly correlate with each other. For the ESB study population, DINCH exposures are still far below health based guidance values such as the German Human Biomonitoring Value (HBM-I; 4,500 μg/L for the sum of OH-MINCH and cx-MINCH) or the tolerable daily intake (TDI) of EFSA (1 mg/kg bw/d). The median daily DINCH intake (DI) calculated for 2017 was 0.23 μg/kg bw/d, thus 4,310-times lower than the TDI. The maximum DI calculated for one individual in 2012 (42.60 μg/kg bw/d) was a factor of more than 20 below the TDI. The ongoing increase in DINCH exposure needs to be closely monitored in the future, including populations with potentially higher exposures such as children. This close monitoring will enable timely exposure and risk reduction measures if exposures reached critical levels, or if new toxicological data lead to lower health based guidance values. DINCH belongs to the European Human Biomonitoring Initiative (HBM4EU) priority substances for which policy relevant questions still have to be answered.
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Affiliation(s)
- Monika Kasper-Sonnenberg
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, D-44789, Bochum, Germany
| | - Holger M Koch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, D-44789, Bochum, Germany.
| | - Petra Apel
- German Environment Agency (UBA), Corrensplatz 1, D-14195, Berlin, Germany
| | - Maria Rüther
- German Environment Agency (UBA), Corrensplatz 1, D-14195, Berlin, Germany
| | - Claudia Pälmke
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, D-44789, Bochum, Germany
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, D-44789, Bochum, Germany
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Vasconcelos AL, Silva MJ, Louro H. In vitro exposure to the next-generation plasticizer diisononyl cyclohexane-1,2-dicarboxylate (DINCH): cytotoxicity and genotoxicity assessment in human cells. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2019; 82:526-536. [PMID: 31242819 DOI: 10.1080/15287394.2019.1634376] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Plasticizers are currently present in many consumer products, particularly food packaging, children's toys, and medical devices. There are concerns regarding potential leaching to environment or food, thus increasing the risk of human exposure by inhalation, ingestion and/or dermal absorption potentially leading to adverse health consequences. Hexamoll diisononyl cyclohexane-1,2-dicarboxylate (Hexamoll® DINCH®), a non-phthalate plasticizer, has been used as a safer alternative to hazardous phthalates. In contrast to phthalates, evidence indicates that DINCH did not produce endocrine disruption, reproductive dysfunctions, genotoxicity or mutagenicity. However, there are limited data available regarding safety assessment, especially with respect to genotoxicity in human cells. The aim of this study was to assess DINCH cytotoxic and genotoxic effects in human liver and kidney cell lines following several exposure periods. For this purpose, the MTT cell viability, micronucleus, conventional and formamidopyrimidine DNA glycosylase (FPG)-modified comet assays were employed to detect cell death and genotoxicity, respectively. Data demonstrated that DINCH induced cytotoxicity in kidney cells exposed for 48hr, but not in liver cells. No marked chromosomal damage was noted after short-term or longer following treatment of both cell lines. However, DINCH produced oxidative DNA damage in liver cells exposed for 3 h, which decreased after a more prolonged incubation period. The occurrence of oxidative lesions, even transiently, indicates that mutation fixation may occur leading to adverse effects in liver. Therefore, these findings suggest that DINCH may be hazardous to humans and that further investigation is necessary to warrant its safety.
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Affiliation(s)
- Ana Luísa Vasconcelos
- a Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge, I.P. (INSA) , Lisbon , Portugal
- b Faculdade de Ciências, Universidade de Lisboa , Lisbon , Portugal
| | - Maria João Silva
- a Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge, I.P. (INSA) , Lisbon , Portugal
- c Centre for Toxicogenomics and Human Health (ToxOmics), Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa , Lisbon , Portugal
| | - Henriqueta Louro
- a Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge, I.P. (INSA) , Lisbon , Portugal
- c Centre for Toxicogenomics and Human Health (ToxOmics), Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa , Lisbon , Portugal
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Shih CL, Hsu JY, Tien CP, Chung YN, Zgoda VG, Liao PC. Exposure marker discovery of di-2(propylheptyl) phthalate using ultra-performance liquid chromatography-mass spectrometry and a rat model. J Food Drug Anal 2019; 27:585-594. [PMID: 30987730 PMCID: PMC9296194 DOI: 10.1016/j.jfda.2018.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 11/04/2018] [Accepted: 11/05/2018] [Indexed: 11/28/2022] Open
Abstract
Di-(2-propylheptyl) phthalate (DPHP) is a plasticizer and has been suggested to be a subchronic toxicant in rats. DPHP has been approved to be used in food containers and handling by the U.S. Food and Drug Administration. The use of DPHP is still increasing, and the risk of human exposure to DPHP via food may be high. Exposure markers measured in human samples are commonly used to monitor human exposure levels. Ultra-performance liquid chromatography-mass spectrometry (UPLC-MS) and a rat model were used to discover tentative DPHP exposure markers. DPHP and mono-(2-propylheptyl) phthalate (MPHP) were used as the precursors for calculating metabolite candidates using biotransformation mass changes of known enzymatic reactions. A rat model was designed to validate these metabolite candidates as tentative exposure markers. A total of 28 signals show dose–response relationships and these signals contain a few isomers. The chemical structures of 15 tentative exposure marker signals were speculated based on the product ion mass spectra from MS/MS analysis. These 15 signals included 7 chemical structures and some of them may be isomers. The different arrangement of the atoms in space of these isomers should be validated by standard compounds in the future studies. Among the 7 speculated chemical structures, 2 structures were novel tentative DPHP metabolites, and 5 structures have been previously reported in the literature. The results indicate that using UPLC-MS and a rat model can be used to identify tentative toxicant exposure markers.
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Affiliation(s)
- Chia-Lung Shih
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan 704, Taiwan
| | - Jen-Yi Hsu
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan 704, Taiwan
| | - Chien-Ping Tien
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan 704, Taiwan
| | - Yi-Ning Chung
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan 704, Taiwan
| | - Victor G Zgoda
- Institute of Biomedical Chemistry, 119121 Moscow, Russia
| | - Pao-Chi Liao
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan 704, Taiwan.
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Eljezi T, Pinta P, Nativel F, Richard D, Pinguet J, Roy O, Sautou V, Grimandi G, Moreau E. In vitro cytotoxic effects of secondary metabolites of DEHP and its alternative plasticizers DINCH and DINP on a L929 cell line. Int J Hyg Environ Health 2019; 222:583-589. [DOI: 10.1016/j.ijheh.2019.03.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 03/09/2019] [Accepted: 03/12/2019] [Indexed: 11/29/2022]
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Urinary metabolites of the UV filter octocrylene in humans as biomarkers of exposure. Arch Toxicol 2019; 93:1227-1238. [DOI: 10.1007/s00204-019-02408-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 02/06/2019] [Indexed: 10/27/2022]
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Langsch A, David RM, Schneider S, Sperber S, Haake V, Kamp H, Leibold E, Ravenzwaay BV, Otter R. Hexamoll ® DINCH: Lack of in vivo evidence for obesogenic properties. Toxicol Lett 2018; 288:99-110. [PMID: 29474903 DOI: 10.1016/j.toxlet.2018.02.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 01/23/2018] [Accepted: 02/03/2018] [Indexed: 02/02/2023]
Abstract
Hexamoll® DINCH is an important alternative to phthalate plasticizers. Although regulatory reviews have not identified any potential hazards even in sensitive populations, an in vitro study by Campioli et al. (2015) suggested Hexamoll® DINCH might alter fat storage in adipocytes resulting in obesity. To evaluate this hypothesis, data from studies with Hexamoll® DINCH were reviewed for evidence of deposition in fat, changes in body weight, or changes in serum chemistry reflecting altered metabolic status. Body weights of F1 and F2 pups in a two-generation study did not differ from controls even at 1000 mg Hexamoll® DINCH/kg body weight. Mean relative liver weights from the 1000 and 300 mg/kg bw groups were increased, but without histopathologic changes. Triglyceride and cholesterol levels in serum were not affected. In addition, subchronic and chronic studies in rats did not give evidence of an obesogenic effect. Radioactivity from 20 or 1000 mg/kg bw 14C-labelled Hexamoll® DINCH dosed orally remained 2-3 times longer in adipose tissue than in well-perfused tissues; however, levels were 20-500% below other tissues at 1 and 8 h post dosing. Radioactivity concentrations in organs and tissues excluding the GI tract declined rapidly and continuously, and decreased in parallel to the concentration in plasma during the following 20 h. Both, initial and terminal half-lives of radioactivity concentration do not indicate a potential for accumulation. Furthermore, a metabolomic comparison of Hexamoll® DINCH with DEHP and other phthalates shows complete separation of the metabolomic profile of these two chemical classes, meaning that their effects on the body and the body's reaction to the substance are different. Hence, comprehensive in vivo data do not show any evidence of Hexamoll® DINCH altering fat metabolism or having obesogenic properties.
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Shih CL, Liao PM, Hsu JY, Chung YN, Zgoda VG, Liao PC. Identification of urinary biomarkers of exposure to di-(2-propylheptyl) phthalate using high-resolution mass spectrometry and two data-screening approaches. CHEMOSPHERE 2018; 193:170-177. [PMID: 29131975 DOI: 10.1016/j.chemosphere.2017.10.162] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Revised: 10/26/2017] [Accepted: 10/29/2017] [Indexed: 06/07/2023]
Abstract
Di-(2-propylheptyl) phthalate (DPHP) is a plasticizer used in polyvinyl chloride and vinyl chloride copolymer that has been suggested to be a toxicant in rats and may affect human health. Because the use of DPHP is increasing, the general German population is being exposed to DPHP. Toxicant metabolism is important for human toxicant exposure assessments. To date, the knowledge regarding DPHP metabolism has been limited, and only four metabolites have been identified in human urine. Ultra-performance liquid chromatography was coupled with Orbitrap high-resolution mass spectrometry (MS) and two data-screening approaches-the signal mining algorithm with isotope tracing (SMAIT) and the mass defect filter (MDF)-for DPHP metabolite candidate discovery. In total, 13 and 104 metabolite candidates were identified by the two approaches, respectively, in in vitro DPHP incubation samples. Of these candidates, 17 were validated as tentative exposure biomarkers using a rat model, 13 of which have not been reported in the literature. The two approaches generated rather different tentative DPHP exposure biomarkers, indicating that these approaches are complementary for discovering exposure biomarkers. Compared with the four previously reported DPHP metabolites, the three tentative novel biomarkers had higher peak intensity ratios, and two were confirmed as DPHP hydroxyl metabolites based on their MS/MS product ion profiles. These three tentative novel biomarkers should be further investigated for potential application in human exposure assessment.
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Affiliation(s)
- Chia-Lung Shih
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, 704, Taiwan
| | - Pao-Mei Liao
- Department of Environmental Science and Property Management, Jinwen University of Science and Technology, 99, Anzhong Road, Xindian District, New Taipei City, 23154, Taiwan
| | - Jen-Yi Hsu
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, 704, Taiwan
| | - Yi-Ning Chung
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, 704, Taiwan
| | - Victor G Zgoda
- Institute of Biomedical Chemistry, 119121, Moscow, Russia
| | - Pao-Chi Liao
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, 704, Taiwan.
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31
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Lessmann F, Correia-Sá L, Calhau C, Domingues VF, Weiss T, Brüning T, Koch HM. Exposure to the plasticizer di(2-ethylhexyl) terephthalate (DEHTP) in Portuguese children - Urinary metabolite levels and estimated daily intakes. ENVIRONMENT INTERNATIONAL 2017; 104:25-32. [PMID: 28407489 DOI: 10.1016/j.envint.2017.03.028] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 03/27/2017] [Accepted: 03/31/2017] [Indexed: 05/16/2023]
Abstract
Classical ortho-phthalate plasticizers are, due to their endocrine disrupting potency and reproductive toxicity, increasingly replaced by alternative plasticizers. Di(2-ethylhexyl) terephthalate (DEHTP) is one of these substitutes. In this study, we investigated DEHTP exposure in 107 Portuguese children (4-17years old) by analyzing specific DEHTP metabolites in their urine using a newly developed LC-MS/MS method. We could detect the major, specific DEHTP metabolite mono(2-ethyl-5-carboxypentyl) terephthalate (5cx-MEPTP) in 100% of the samples with levels above the limit of quantification in 96% of the samples (median concentration 4.19μg/L; 95th percentile 26.4μg/L; maximum 3400μg/L). Other minor DEHTP metabolites (5OH-MEHTP, 5oxo-MEHTP and 2cx-MMHTP) were detected at lower rates and levels. Daily DEHTP intakes calculated from urinary 5cx-MEPTP levels were generally far below the tolerable daily intake (TDI) of 1000μg/kgbw/d (median 0.67μg/kgbw/d; 95th percentile 6.25μg/kgbw/d; maximum 690μg/kgbw/d). However, for one child the biomarker-derived health-based guidance value (HBM-I value) for 5cx-MEPTP of 1800μg/L was exceeded by about a factor of two. Levels of 5cx-MEPTP and calculated daily DEHTP intakes were higher in normal/under-weight children who nourished on their usual diet compared to overweight/obese children who received nutritional guidance with fresh and unprocessed food (p=0.043 and p<0.001 respectively). This indicates to processed and fatty foodstuff as a major source of DEHTP exposure. Additionally, we found children of lower age having higher DEHTP intakes (p=0.045). Again, foodstuff as a major DEHTP source, together with other child specific DEHTP sources such as mouthing of toys or ingestion of dust might be contributing factors. With the present study, we provide a first data set on the omnipresent DEHTP exposure in children. So far, general levels of DEHTP exposure seem no cause for concern. However, due to the increasing use of DEHTP as an ortho-phthalate substitute, possible increasing exposures in the future should be followed closely.
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Affiliation(s)
- Frederik Lessmann
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - Luísa Correia-Sá
- REQUIMTE/LAQV-GRAQ, Instituto Superior de Engenharia do Porto do Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida, 431, 4200-072 Porto, Portugal; Centro de Investigação em Tecnologias e Sistemas de Informação em Saúde (CINTESIS), Centro de Investigação Médica, 2° piso, edif. Nascente, Faculdade de Medicina da Universidade do Porto, Rua Dr Plácido da Costa s/n, 4200-450 Porto, Portugal
| | - Conceição Calhau
- Centro de Investigação em Tecnologias e Sistemas de Informação em Saúde (CINTESIS), Centro de Investigação Médica, 2° piso, edif. Nascente, Faculdade de Medicina da Universidade do Porto, Rua Dr Plácido da Costa s/n, 4200-450 Porto, Portugal
| | - Valentina F Domingues
- REQUIMTE/LAQV-GRAQ, Instituto Superior de Engenharia do Porto do Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida, 431, 4200-072 Porto, Portugal
| | - Tobias Weiss
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - Holger M Koch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany.
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