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Wu T, Luo C, Li T, Zhang C, Chen HX, Mao YT, Wu YT, Huang HF. Effects of exposure to multiple metallic elements in the first trimester of pregnancy on the risk of preterm birth. MATERNAL & CHILD NUTRITION 2024:e13682. [PMID: 38925571 DOI: 10.1111/mcn.13682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 05/08/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024]
Abstract
Exposure to certain heavy metals has been demonstrated to be associated with a higher risk of preterm birth (PTB). However, studies focused on the effects of other metal mixtures were limited. A nested case‒control study enrolling 94 PTB cases and 282 controls was conducted. Metallic elements were detected in maternal plasma collected in the first trimester using inductively coupled plasma‒mass spectrometry. The effect of maternal exposure on the risk of PTB was investigated using logistic regression, least absolute shrinkage and selection operator, restricted cubic spline (RCS), quantile g computation (QGC) and Bayesian kernel machine regression (BKMR). Vanadium (V) and arsenic (As) were positively associated with PTB risk in the logistic model, and V remains positively associated in the multi-exposure logistic model. QGC analysis determined V (69.42%) and nickel (Ni) (70.30%) as the maximum positive and negative contributors to the PTB risk, respectively. BKMR models further demonstrated a positive relationship between the exposure levels of the mixtures and PTB risk, and V was identified as the most important independent variable among the elements. RCS analysis showed an inverted U-shape effect of V and gestational age, and plasma V more than 2.18 μg/L was considered a risk factor for shortened gestation length. Exposure to metallic elements mixtures consisting of V, As, cobalt, Ni, chromium and manganese in the first trimester was associated with an increased risk of PTB, and V was considered the most important factor in the mixtures in promoting the incidence of PTB.
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Affiliation(s)
- Ting Wu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Chuan Luo
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China
| | - Tao Li
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Chen Zhang
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China
| | - Hui-Xi Chen
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Yi-Ting Mao
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China
| | - Yan-Ting Wu
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Reproduction and Development, Shanghai, China
| | - He-Feng Huang
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Reproduction and Development, Shanghai, China
- Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences (No. 2019RU056), Shanghai, China
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- State Key Laboratory of Cardiology, Shanghai, China
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Marchellina A, Soegianto A, Putranto TWC, Mukholladun W, Payus CM, Irnidayanti Y. An assessment of the potential health hazards associated with metal contamination in a variety of consumable species living along the industrialized coastline of East Java, Indonesia. MARINE POLLUTION BULLETIN 2024; 202:116375. [PMID: 38621352 DOI: 10.1016/j.marpolbul.2024.116375] [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: 02/18/2024] [Revised: 03/31/2024] [Accepted: 04/10/2024] [Indexed: 04/17/2024]
Abstract
The massive industrial growth in Gresik, East Java, Indonesia has the potential to result in metal contamination in the nearby coastal waters. The purpose of this study was to analyze the metal concentrations in edible species from the Gresik coastal waters and evaluate the potential health risks linked to this metal contamination. Metal concentrations (Cu, Fe, Pb, Zn, As, Cd, Ni, Hg, and Cr) in fish and shrimp samples mostly met the maximum limits established by national and international regulatory organizations. The concentrations of As in Scatophagus argus exceed both the permissible limit established by Indonesia and the provisional tolerable weekly intake (PTWI). The As concentration in Arius bilineatus is equal to the PTWI. The target cancer risk (TCR) values for both As and Cr in all analyzed species exceed the threshold of 0.0001, suggesting that these two metals possess the potential to provide a cancer risk to humans.
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Affiliation(s)
- Ary Marchellina
- Department of Biology, Faculty of Science and Technology, Universitas Airlangga, Surabaya, Indonesia
| | - Agoes Soegianto
- Department of Biology, Faculty of Science and Technology, Universitas Airlangga, Surabaya, Indonesia.
| | | | - Wildanun Mukholladun
- Department of Biology, Faculty of Science and Technology, Universitas Airlangga, Surabaya, Indonesia
| | - Carolyn Melissa Payus
- Faculty of Science and Natural Resources, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Yulia Irnidayanti
- Department of Biology, Faculty of Mathematics and Natural Sciences, Universitas Negeri Jakarta, Jakarta, Indonesia
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Abd Elnabi MK, Elkaliny NE, Elyazied MM, Azab SH, Elkhalifa SA, Elmasry S, Mouhamed MS, Shalamesh EM, Alhorieny NA, Abd Elaty AE, Elgendy IM, Etman AE, Saad KE, Tsigkou K, Ali SS, Kornaros M, Mahmoud YAG. Toxicity of Heavy Metals and Recent Advances in Their Removal: A Review. TOXICS 2023; 11:580. [PMID: 37505546 PMCID: PMC10384455 DOI: 10.3390/toxics11070580] [Citation(s) in RCA: 40] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/14/2023] [Accepted: 06/24/2023] [Indexed: 07/29/2023]
Abstract
Natural and anthropogenic sources of metals in the ecosystem are perpetually increasing; consequently, heavy metal (HM) accumulation has become a major environmental concern. Human exposure to HMs has increased dramatically due to the industrial activities of the 20th century. Mercury, arsenic lead, chrome, and cadmium have been the most prevalent HMs that have caused human toxicity. Poisonings can be acute or chronic following exposure via water, air, or food. The bioaccumulation of these HMs results in a variety of toxic effects on various tissues and organs. Comparing the mechanisms of action reveals that these metals induce toxicity via similar pathways, including the production of reactive oxygen species, the inactivation of enzymes, and oxidative stress. The conventional techniques employed for the elimination of HMs are deemed inadequate when the HM concentration is less than 100 mg/L. In addition, these methods exhibit certain limitations, including the production of secondary pollutants, a high demand for energy and chemicals, and reduced cost-effectiveness. As a result, the employment of microbial bioremediation for the purpose of HM detoxification has emerged as a viable solution, given that microorganisms, including fungi and bacteria, exhibit superior biosorption and bio-accumulation capabilities. This review deals with HM uptake and toxicity mechanisms associated with HMs, and will increase our knowledge on their toxic effects on the body organs, leading to better management of metal poisoning. This review aims to enhance comprehension and offer sources for the judicious selection of microbial remediation technology for the detoxification of HMs. Microbial-based solutions that are sustainable could potentially offer crucial and cost-effective methods for reducing the toxicity of HMs.
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Affiliation(s)
- Manar K. Abd Elnabi
- Botany Department, Faculty of Science, Tanta University, Tanta 31527, Egypt; (M.K.A.E.); (N.E.E.); (M.M.E.); (S.H.A.); (S.A.E.); (M.S.M.); (E.M.S.); (N.A.A.); (A.E.A.E.); (I.M.E.); (A.E.E.); (K.E.S.); (Y.A.-G.M.)
- Biotechnology Program, Institute of Basic and Applied Science (BAS), Egypt-Japan University of Science and Technology, New Borg El-Arab City 21934, Egypt
| | - Nehal E. Elkaliny
- Botany Department, Faculty of Science, Tanta University, Tanta 31527, Egypt; (M.K.A.E.); (N.E.E.); (M.M.E.); (S.H.A.); (S.A.E.); (M.S.M.); (E.M.S.); (N.A.A.); (A.E.A.E.); (I.M.E.); (A.E.E.); (K.E.S.); (Y.A.-G.M.)
| | - Maha M. Elyazied
- Botany Department, Faculty of Science, Tanta University, Tanta 31527, Egypt; (M.K.A.E.); (N.E.E.); (M.M.E.); (S.H.A.); (S.A.E.); (M.S.M.); (E.M.S.); (N.A.A.); (A.E.A.E.); (I.M.E.); (A.E.E.); (K.E.S.); (Y.A.-G.M.)
| | - Shimaa H. Azab
- Botany Department, Faculty of Science, Tanta University, Tanta 31527, Egypt; (M.K.A.E.); (N.E.E.); (M.M.E.); (S.H.A.); (S.A.E.); (M.S.M.); (E.M.S.); (N.A.A.); (A.E.A.E.); (I.M.E.); (A.E.E.); (K.E.S.); (Y.A.-G.M.)
| | - Shawky A. Elkhalifa
- Botany Department, Faculty of Science, Tanta University, Tanta 31527, Egypt; (M.K.A.E.); (N.E.E.); (M.M.E.); (S.H.A.); (S.A.E.); (M.S.M.); (E.M.S.); (N.A.A.); (A.E.A.E.); (I.M.E.); (A.E.E.); (K.E.S.); (Y.A.-G.M.)
| | - Sohaila Elmasry
- Microbiology Department, Faculty of science, Damanhour University, Behaira 22514, Egypt;
| | - Moustafa S. Mouhamed
- Botany Department, Faculty of Science, Tanta University, Tanta 31527, Egypt; (M.K.A.E.); (N.E.E.); (M.M.E.); (S.H.A.); (S.A.E.); (M.S.M.); (E.M.S.); (N.A.A.); (A.E.A.E.); (I.M.E.); (A.E.E.); (K.E.S.); (Y.A.-G.M.)
| | - Ebrahim M. Shalamesh
- Botany Department, Faculty of Science, Tanta University, Tanta 31527, Egypt; (M.K.A.E.); (N.E.E.); (M.M.E.); (S.H.A.); (S.A.E.); (M.S.M.); (E.M.S.); (N.A.A.); (A.E.A.E.); (I.M.E.); (A.E.E.); (K.E.S.); (Y.A.-G.M.)
| | - Naira A. Alhorieny
- Botany Department, Faculty of Science, Tanta University, Tanta 31527, Egypt; (M.K.A.E.); (N.E.E.); (M.M.E.); (S.H.A.); (S.A.E.); (M.S.M.); (E.M.S.); (N.A.A.); (A.E.A.E.); (I.M.E.); (A.E.E.); (K.E.S.); (Y.A.-G.M.)
| | - Abeer E. Abd Elaty
- Botany Department, Faculty of Science, Tanta University, Tanta 31527, Egypt; (M.K.A.E.); (N.E.E.); (M.M.E.); (S.H.A.); (S.A.E.); (M.S.M.); (E.M.S.); (N.A.A.); (A.E.A.E.); (I.M.E.); (A.E.E.); (K.E.S.); (Y.A.-G.M.)
| | - Ibrahim M. Elgendy
- Botany Department, Faculty of Science, Tanta University, Tanta 31527, Egypt; (M.K.A.E.); (N.E.E.); (M.M.E.); (S.H.A.); (S.A.E.); (M.S.M.); (E.M.S.); (N.A.A.); (A.E.A.E.); (I.M.E.); (A.E.E.); (K.E.S.); (Y.A.-G.M.)
| | - Alaa E. Etman
- Botany Department, Faculty of Science, Tanta University, Tanta 31527, Egypt; (M.K.A.E.); (N.E.E.); (M.M.E.); (S.H.A.); (S.A.E.); (M.S.M.); (E.M.S.); (N.A.A.); (A.E.A.E.); (I.M.E.); (A.E.E.); (K.E.S.); (Y.A.-G.M.)
| | - Kholod E. Saad
- Botany Department, Faculty of Science, Tanta University, Tanta 31527, Egypt; (M.K.A.E.); (N.E.E.); (M.M.E.); (S.H.A.); (S.A.E.); (M.S.M.); (E.M.S.); (N.A.A.); (A.E.A.E.); (I.M.E.); (A.E.E.); (K.E.S.); (Y.A.-G.M.)
| | - Konstantina Tsigkou
- Department of Chemical Engineering, University of Patras, 1 Karatheodori str, 26504 Patras, Greece;
| | - Sameh S. Ali
- Botany Department, Faculty of Science, Tanta University, Tanta 31527, Egypt; (M.K.A.E.); (N.E.E.); (M.M.E.); (S.H.A.); (S.A.E.); (M.S.M.); (E.M.S.); (N.A.A.); (A.E.A.E.); (I.M.E.); (A.E.E.); (K.E.S.); (Y.A.-G.M.)
- Biofuels Institute, School of the Environment and Safety Engineering, Jiangsu University, Zhenjiang 212013, China
| | - Michael Kornaros
- Department of Chemical Engineering, University of Patras, 1 Karatheodori str, 26504 Patras, Greece;
| | - Yehia A.-G. Mahmoud
- Botany Department, Faculty of Science, Tanta University, Tanta 31527, Egypt; (M.K.A.E.); (N.E.E.); (M.M.E.); (S.H.A.); (S.A.E.); (M.S.M.); (E.M.S.); (N.A.A.); (A.E.A.E.); (I.M.E.); (A.E.E.); (K.E.S.); (Y.A.-G.M.)
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Xu P, Lai S, Wu L, Chen W, Chen Y, Xu D, Xiang J, Cheng P, Chen Z, Wang X, Lou X, Tang J. Insights into the health status of the general population living near an electroplating industry zone: metal elevations and renal impairment. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:31905-31915. [PMID: 36459323 DOI: 10.1007/s11356-022-24411-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/22/2022] [Indexed: 06/17/2023]
Abstract
A cross-sectional study was conducted in 2016 in Zhejiang Province, China, to evaluate the body burdens of metals and metalloids associated with renal dysfunction in populations living near electroplating industries. We recruited 236 subjects and performed physical examinations, determined the blood and urinary levels of arsenic (As), cadmium (Cd), chromium (Cr), manganese (Mn), nickel (Ni), lead (Pb), antimony (Sb), and selenium (Se) by an inductively coupled plasma mass spectrometer (ICP-MS), and measured three renal impairment biomarkers, namely nacetyl-β-D-glucosaminidase (NAG), retinol-binding protein (RBP), and β2-microglobulin (BMG). The proportion of abnormal nasal symptoms in the exposure group (10.1%) was much higher than in the control group (0; p < 0.05). The blood and urinary levels of As, Cd, and Se in the exposure group were significantly higher than those in the control group (p < 0.05). The blood levels of Mn and Pb, as well as the urinary levels of Cr and Ni, were significantly higher in the exposure group than in the control group (p < 0.05). The exposure group demonstrated higher levels of NAG, RBP, and BMG than the control group (0.51 vs. 0.14 mg/g creatinine, 12.79 vs. 9.26 IU/g creatinine, and 1.39 vs. 0.78 mg/g creatinine, respectively; p < 0.05). Urinary BMG was positively correlated with urinary Cd levels (r = 0.223, p < 0.05), while urinary RBP was correlated with blood Cd levels (r = 0.151, p < 0.05) and urinary Cd, Cr, Ni, and Se levels (r = 0.220, 0.303, 0.162, and 0.306, respectively; p < 0.05). In conclusion, our study indicated that a population living in the vicinity of electroplating industries had high body burdens of certain metals and metalloids associated with non-negligible renal dysfunction.
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Affiliation(s)
- Peiwei Xu
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Shiming Lai
- Quzhou Center for Disease Control and Prevention, 154 Xi'an Road, Xin'an District, Quzhou, 324003, China
| | - Lizhi Wu
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Weizhong Chen
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Yuan Chen
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Dandan Xu
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Jie Xiang
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Ping Cheng
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Zhijian Chen
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Xiaofeng Wang
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Xiaoming Lou
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China
| | - Jun Tang
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Bin Sheng Road, Binjiang District, Hangzhou, 310051, China.
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Ho JC, Wen HJ, Sun CW, Tsai SF, Su PH, Chang CL, Sun HL, Wang SL, Lee CH. Prenatal exposure to nickel and atopic dermatitis at age 3 years: a birth cohort study with cytokine profiles. J Eur Acad Dermatol Venereol 2022; 36:2414-2422. [PMID: 35841308 DOI: 10.1111/jdv.18425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 06/15/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Nickel, the fifth most common element on Earth, is the leading inducer of contact allergies in humans, with potent immunological effects. Nickel-induced contact allergies predominantly affect females. Maternal exposure to nickel has been associated with several developmental abnormalities. However, how a maternal nickel exposure affects the development of atopic diathesis and immune abnormalities in children has never been addressed. OBJECTIVES We aimed to determine whether maternal Ni exposure affects the development of atopic dermatitis and immune abnormalities in their children. METHODS Using a birth cohort study, we analysed 140 mother-child pairs recruited in 2012-2015 from central Taiwan. Maternal exposure to nickel was estimated using urinary nickel levels measured by inductively coupled plasma mass spectrometry (ICP-MS). The serum levels of 65 analytes and IgE in 3-year-old children were profiled with a multiplex ELISA. The correlation between the maternal urinary nickel concentration and serum analyte levels was assessed using Spearmen's correlation. Multivariant regression analysis was performed to evaluate the association between maternal urinary nickel levels and serum analyte concentrations in their children. RESULTS The geometric means of the maternal urinary nickel and the children's serum IgE levels were 2.27 μg/L and 69.71 IU/ml, respectively. The maternal nickel exposure was associated with increased serum levels of IL-1β, IL-2, TNF-α, and leukaemia inhibitory factor (LIF) but with decreased serum levels of matrix metalloproteinase-1 (MMP-1), IL-2R, and eotaxin-1 in the children. In addition, the development of childhood atopic dermatitis at 3 years old was significantly associated with the child's serum levels of IgE and IL-2R, but it was negatively associated with the maternal nickel exposure. CONCLUSIONS This is the first study showing the potential immunological effects of maternal nickel exposure in their children at an early developmental stage.
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Affiliation(s)
- J C Ho
- Department of Dermatology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan.,Department of Dermatology, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - H J Wen
- National Institute of Environmental Health Sciences, National Health Research Institutes, Taiwan.,Institute of Earth Science, Academia Sinica, Taipei, Taiwan
| | - C W Sun
- National Institute of Environmental Health Sciences, National Health Research Institutes, Taiwan
| | - S F Tsai
- National Institute of Environmental Health Sciences, National Health Research Institutes, Taiwan
| | - P H Su
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - C L Chang
- Department of Pediatrics, Hsinchu Cathay General Hospital, Hsinchu, Taiwan
| | - H L Sun
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - S L Wang
- National Institute of Environmental Health Sciences, National Health Research Institutes, Taiwan.,Department of Public Health, National Defence Medical Centre, Taipei, Taiwan.,Department of Safety, Health, and Environmental Engineering, National United University, Miaoli, Taiwan
| | - C H Lee
- Department of Dermatology, Chang Gung University College of Medicine, Taoyuan, Taiwan.,Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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Chen X, Huang L, Li Q, Zhang X, Wang X, Sun G, Yi N, Xiong G, Yang X, Hao L, Yang H, Yang N. Effect of maternal thallium exposure in early pregnancy on the risk of preterm birth. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:49966-49975. [PMID: 35220538 DOI: 10.1007/s11356-022-19332-6] [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: 09/07/2021] [Accepted: 02/17/2022] [Indexed: 06/14/2023]
Abstract
Human activities have significantly increased the release of thallium (Tl) to the environment. However, the study of the relationship between maternal Tl exposure during pregnancy and the risk of preterm birth (PTB) is scarce so far. We aimed to investigate the association between Tl exposure in early pregnancy and the risk of PTB. A total of 2104 pregnant women from the Tongji Maternal and Child Health Cohort (TMCHC) in Wuhan, China were enrolled in the analysis. We collected the urine samples in early pregnancy (< 20 weeks) and inductively coupled plasma mass spectrometry (ICP-MS) was used to detect urinary Tl levels. The association between Tl levels and the risk of PTB was evaluated by an unconditional logistic regression. The median and geometric mean values of Tl levels were 0.35 μg/L (0.47 μg/g creatinine) and 0.33 μg/L (0.47 μg/g creatinine), respectively. Compared with the lowest tertile of Tl levels (≤ 0.37 μg/g creatinine), the highest tertile (> 0.57 μg/g creatinine) was associated with an increased risk of PTB with an adjusted odds ratio (OR) of 2.11 (95% confidence interval (CI): 1.08, 4.12). Stratified analyses showed an elevated risk of PTB related to the highest tertile of Tl levels for male newborns. After excluding women with miss covariate information, gestational diabetes mellitus, pregnancy-induced hypertension, reporting fish intake, or exposed to smoke, the association remained stable. Our results suggested that maternal Tl exposure during early pregnancy was positively associated with the risk of PTB, and Tl exposure may have a sex-specific effect on PTB.
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Affiliation(s)
- Xi Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Li Huang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Qian Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Xu Zhang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Xiaoyi Wang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Guoqiang Sun
- Maternal and Child Health Hospital of Hubei Province, Wuhan, Hubei, 430070, People's Republic of China
| | - Nianhua Yi
- Maternal and Child Health Hospital of Hubei Province, Wuhan, Hubei, 430070, People's Republic of China
| | - Guoping Xiong
- The Central Hospital of Wuhan, Wuhan, Hubei, 430013, People's Republic of China
| | - Xuefeng Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Liping Hao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China
| | - Hongying Yang
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei, 430079, People's Republic of China
| | - Nianhong Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China.
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7
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Kim C, Ashrap P, Watkins DJ, Mukherjee B, Rosario-Pabón ZY, Vélez-Vega CM, Alshawabkeh AN, Cordero JF, Meeker JD. Maternal Metals/Metalloid Blood Levels Are Associated With Lipidomic Profiles Among Pregnant Women in Puerto Rico. Front Public Health 2022; 9:754706. [PMID: 35096734 PMCID: PMC8790322 DOI: 10.3389/fpubh.2021.754706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 12/13/2021] [Indexed: 12/13/2022] Open
Abstract
Background/Aim: The association between heavy metal exposure and adverse birth outcomes is well-established. However, there is a paucity of research identifying biomarker profiles that may improve the early detection of heavy metal-induced adverse birth outcomes. Because lipids are abundant in our body and associated with important signaling pathways, we assessed associations between maternal metals/metalloid blood levels with lipidomic profiles among 83 pregnant women in the Puerto Rico PROTECT birth cohort. Methods: We measured 10 metals/metalloid blood levels during 24–28 weeks of pregnancy. Prenatal plasma lipidomic profiles were identified by liquid chromatography–mass spectrometry-based shotgun lipidomics. We derived sums for each lipid class and sums for each lipid sub-class (saturated, monounsaturated, polyunsaturated), which were then regressed on metals/metalloid. False discovery rate (FDR) adjusted p-values (q-values) were used to account for multiple comparisons. Results: A total of 587 unique lipids from 19 lipid classes were profiled. When controlling for multiple comparisons, we observed that maternal exposure to manganese and zinc were negatively associated with plasmenyl-phosphatidylethanolamine (PLPE), particularly those containing polyunsaturated fatty acid (PUFA) chains. In contrast to manganese and zinc, arsenic and mercury were positively associated with PLPE and plasmenyl-phosphatidylcholine (PLPC). Conclusion: Certain metals were significantly associated with lipids that are responsible for the biophysical properties of the cell membrane and antioxidant defense in lipid peroxidation. This study highlighted lipid-metal associations and we anticipate that this study will open up new avenues for developing diagnostic tools.
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Affiliation(s)
- Christine Kim
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Pahriya Ashrap
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Deborah J Watkins
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Bhramar Mukherjee
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Zaira Y Rosario-Pabón
- University of Puerto Rico Graduate School of Public Health, UPR Medical Sciences Campus, San Juan, Puerto Rico
| | - Carmen M Vélez-Vega
- University of Puerto Rico Graduate School of Public Health, UPR Medical Sciences Campus, San Juan, Puerto Rico
| | - Akram N Alshawabkeh
- Department of Civil and Environmental Engineering, College of Engineering, Northeastern University, Boston, MA, United States
| | - José F Cordero
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, United States
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
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8
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Deng Q, Wan Q, Liao J, Fang D, Wang L, Xiong S, Xu P, Shen X, Li Q, Zhou Y. Nickel nanoparticles affect the migration and invasion of HTR-8/SVneo cells by downregulating MMP2 through the PI3K/AKT pathway. Toxicol In Vitro 2022; 80:105328. [PMID: 35150872 DOI: 10.1016/j.tiv.2022.105328] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 01/06/2022] [Accepted: 02/05/2022] [Indexed: 12/24/2022]
Abstract
Proper migration and invasion of extravillous trophoblast cells into the endometrium in early gestation is essential for successful embryo implantation. The development of nanotechnology has led to the emergence of nickel nanoparticles (Ni NPs), for which attendant health concerns are widespread. Ni NPs are known to affect reproduction and be embryotoxic, but whether they affect the migration and invasion functions of trophoblast cells is unclear. We investigated the effects of Ni NPs on the migration and invasion of HTR-8/SVneo in extravillous trophoblast cells and explored the possible role of the PI3K/AKT/MMP2 signaling pathway in this regard. Results showed that the migration and invasion of cells was significantly inhibited by the exposure of Ni NPs. The protein and mRNA levels of PI3K/AKT/MMP2 signaling pathway were significantly reduced with the increase in Ni NPs concentration. The presence of the PI3K activator 740Y-P partially attenuated the inhibition of cell migration and invasion by Ni NPs, confirming the involvement of this pathway. Thus, Ni NPs inhibit migration and invasion of human trophoblast HTR-8/SVneo cells by downregulating the PI3K/AKT/MMP2 signaling pathway. This study is important for the development of safety evaluation criteria for Ni NPs.
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Affiliation(s)
- Qingfang Deng
- Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Qiyou Wan
- School of Public Health, Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Juan Liao
- Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Derong Fang
- Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Linglu Wang
- The second Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Shimin Xiong
- School of Public Health, Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Pei Xu
- School of Public Health, Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Xubo Shen
- School of Public Health, Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Quan Li
- Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China.
| | - Yuanzhong Zhou
- School of Public Health, Zunyi Medical University, Zunyi, 563000, Guizhou, China.
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9
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Wu Y, Wang J, Wei Y, Chen J, Kang L, Long C, Wu S, Shen L, Wei G. Maternal exposure to endocrine disrupting chemicals (EDCs) and preterm birth: A systematic review, meta-analysis, and meta-regression analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 292:118264. [PMID: 34606968 DOI: 10.1016/j.envpol.2021.118264] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 09/26/2021] [Accepted: 09/29/2021] [Indexed: 05/15/2023]
Abstract
Preterm birth is the second most common cause of death in children under 5 years of age. The etiology of preterm birth has not yet been elucidated. Although maternal exposure to endocrine disrupting chemicals (EDCs) may increase the risk for preterm birth, associations have not been confirmed. We performed a meta-analysis to elucidate the relationships between maternal exposure to EDCs and preterm birth. A systematic search of PubMed, Ovid-EMBASE, and the Cochrane Library (CENTRAL) for relevant published studies providing quantitative data on the association between maternal EDC exposure and preterm birth in humans was conducted in July 2021. To calculate the overall estimates, we pooled the adjusted regression coefficients with 95% confidence intervals (CIs) from each study by the inverse variance method. A total of 59 studies were included. The pooled results indicated that maternal exposure to metals (OR, 1.23; 95% CI, 1.17 to 1.29) and phthalates (OR, 1.31; 95% CI, 1.21 to 1.42) was related to an increased risk for preterm birth. Specifically, maternal exposure to lead, cadmium, chromium, copper and manganese appeared to be correlated with an elevated risk for preterm birth. Additionally, maternal exposure to monoethyl phthalate (MEP), mono-2-ethyl-5-carboxypentyl phthalate (MECPP), monobenzyl phthalate (MBzP), and di (2-ethylhexyl) phthalate (DEHP) was also associated with preterm birth. In conclusion, maternal exposure to metals and phthalates may increase the risk for preterm birth based on current evidence.
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Affiliation(s)
- Yuhao Wu
- Department of Urology, Children's Hospital of Chongqing Medical University; Ministry of Education Key Laboratory of Child Development and Disorders; International Science and Technology Cooperation Base of Child Development and Critical Disorders; National Clinical Research Center for Child Health and Disorders; Chongqing Key Laboratory of Pediatrics; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China
| | - Junke Wang
- Department of Urology, Children's Hospital of Chongqing Medical University; Ministry of Education Key Laboratory of Child Development and Disorders; International Science and Technology Cooperation Base of Child Development and Critical Disorders; National Clinical Research Center for Child Health and Disorders; Chongqing Key Laboratory of Pediatrics; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China
| | - Yuexin Wei
- Department of Urology, Children's Hospital of Chongqing Medical University; Ministry of Education Key Laboratory of Child Development and Disorders; International Science and Technology Cooperation Base of Child Development and Critical Disorders; National Clinical Research Center for Child Health and Disorders; Chongqing Key Laboratory of Pediatrics; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China
| | - Jiadong Chen
- Department of Urology, Children's Hospital of Chongqing Medical University; Ministry of Education Key Laboratory of Child Development and Disorders; International Science and Technology Cooperation Base of Child Development and Critical Disorders; National Clinical Research Center for Child Health and Disorders; Chongqing Key Laboratory of Pediatrics; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China
| | - Lian Kang
- Department of Urology, Children's Hospital of Chongqing Medical University; Ministry of Education Key Laboratory of Child Development and Disorders; International Science and Technology Cooperation Base of Child Development and Critical Disorders; National Clinical Research Center for Child Health and Disorders; Chongqing Key Laboratory of Pediatrics; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China
| | - Chunlan Long
- Department of Urology, Children's Hospital of Chongqing Medical University; Ministry of Education Key Laboratory of Child Development and Disorders; International Science and Technology Cooperation Base of Child Development and Critical Disorders; National Clinical Research Center for Child Health and Disorders; Chongqing Key Laboratory of Pediatrics; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China
| | - Shengde Wu
- Department of Urology, Children's Hospital of Chongqing Medical University; Ministry of Education Key Laboratory of Child Development and Disorders; International Science and Technology Cooperation Base of Child Development and Critical Disorders; National Clinical Research Center for Child Health and Disorders; Chongqing Key Laboratory of Pediatrics; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China
| | - Lianju Shen
- Department of Urology, Children's Hospital of Chongqing Medical University; Ministry of Education Key Laboratory of Child Development and Disorders; International Science and Technology Cooperation Base of Child Development and Critical Disorders; National Clinical Research Center for Child Health and Disorders; Chongqing Key Laboratory of Pediatrics; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China
| | - Guanghui Wei
- Department of Urology, Children's Hospital of Chongqing Medical University; Ministry of Education Key Laboratory of Child Development and Disorders; International Science and Technology Cooperation Base of Child Development and Critical Disorders; National Clinical Research Center for Child Health and Disorders; Chongqing Key Laboratory of Pediatrics; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, China.
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10
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Xu R, Meng X, Pang Y, An H, Wang B, Zhang L, Ye R, Ren A, Li Z, Gong J. Associations of maternal exposure to 41 metals/metalloids during early pregnancy with the risk of spontaneous preterm birth: Does oxidative stress or DNA methylation play a crucial role? ENVIRONMENT INTERNATIONAL 2022; 158:106966. [PMID: 34735952 DOI: 10.1016/j.envint.2021.106966] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 10/27/2021] [Accepted: 10/27/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Few studies have explored the effects of multiple types of metals/metalloids on spontaneous preterm birth (SPB). A nested case-control study was conducted in Shanxi Province to investigate the associations between maternal exposure to 41 metals/metalloids during early pregnancy and the risk of SPB, and to clarify the underlying mechanisms of oxidative stress and DNA methylation. METHODS A total of 74 controls with full-term delivery and 74 cases with SPB were included in the nested case-control study. The metals/metalloids in serum and the DNA adducts in peripheral blood cell DNA were determined using ICP-MS and UPLC-QqQ-MS/MS, respectively. Unconditional logistic regression models were employed to estimate the associations of the risk of SPB with the metal concentrations, as well as with the levels of oxidative stress/DNA methylation. In addition, linear regression models were used to investigate the associations between the metal/metalloid concentrations and the levels of oxidative stress/DNA methylation. RESULTS After adjusting for potential confounders, the concentrations of Mn, Fe, Cu, Nd, Hg, and Pb in maternal serum during early pregnancy were positively associated with the risk of SPB. Compared with the lowest levels (Quartile 1) of Mn, Fe, Cu, Nd, Hg, and Pb, the odds ratios of SPB increased to 5.21 (95% CI: 1.63, 16.68), 3.47 (95% CI: 1.07, 11.21), 16.23 (95% CI: 3.86, 68.18), 10.54 (95% CI: 2.79, 39.86), 5.88 (95% CI: 1.72, 20.11), and 4.09 (95% CI: 1.31, 12.77) in the highest levels (Quartile 4), respectively. A significant increase in 8-OHdG was associated with the increased exposure to Fe, Pr, Eu, Er, and Lu. The levels of 5-MdC, 5-HmdC, and N6-MdA-the indicators of DNA methylation-were associated with exposure to multiple metals/metalloids. However, no significant associations were observed between the levels of oxidative stress or DNA methylation and the risk of SPB. CONCLUSIONS Exposure to multiple types of metals/metalloids during early pregnancy is positively associated with the risk of SPB. Oxidative stress and DNA methylation are significantly associated with exposure to multiple metals/metalloids. Systemic oxidative stress and DNA methylation have not been proven to be the mediating mechanisms of metals increasing the risk of SPB.
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Affiliation(s)
- Ruiwei Xu
- SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China; Center for Environment and Health, Peking University, Beijing 100871, China
| | - Xin Meng
- SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China; Center for Environment and Health, Peking University, Beijing 100871, China
| | - Yiming Pang
- Institute of Reproductive and Child Health, Peking University/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Hang An
- Institute of Reproductive and Child Health, Peking University/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Bin Wang
- Institute of Reproductive and Child Health, Peking University/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Le Zhang
- Institute of Reproductive and Child Health, Peking University/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Rongwei Ye
- Institute of Reproductive and Child Health, Peking University/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Aiguo Ren
- Institute of Reproductive and Child Health, Peking University/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Zhiwen Li
- Institute of Reproductive and Child Health, Peking University/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
| | - Jicheng Gong
- SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China; Center for Environment and Health, Peking University, Beijing 100871, China.
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11
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Huang H, Wei L, Chen X, Zhang R, Su L, Rahman M, Golam Mostofa M, Qamruzzaman Q, Zhao Y, Yu H, Wei Y, Christiani DC, Chen F. Cord serum elementomics profiling of 56 elements depicts risk of preterm birth: Evidence from a prospective birth cohort in rural Bangladesh. ENVIRONMENT INTERNATIONAL 2021; 156:106731. [PMID: 34197971 PMCID: PMC11152765 DOI: 10.1016/j.envint.2021.106731] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/28/2021] [Accepted: 06/19/2021] [Indexed: 06/13/2023]
Abstract
Maternal exposure to some individual rare earth elements and trace elements is associated with preterm birth, but few elements have been studied and little is known about the potential effect of simultaneous exposure to multiple elements. We examined individual and mixture effects of elements on preterm birth among 745 pregnant women in a prospective birth cohort in Bangladesh (2008-2011). We measured 56 elements in umbilical cord blood collected during delivery using inductively coupled plasma-mass spectrometry. Using elastic net (ENET) regularization and multivariate logistic regression, we examined independent associations between element concentrations and preterm birth. Bayesian kernel machine regression identified mixture effects of elements most critical to preterm birth, accounting for correlated exposure and interaction. ENET identified titanium (Ti), arsenic (As), and barium (Ba) as the most important predictors of shortened gestational age and preterm birth. In adjusted models, cord blood Ti (OR = 2.52; 95% CI: 1.08-5.93; P = 0.033), As (odds ratio (OR) = 1.34; 95% CI: 1.04-1.73; P = 0.023), and Ba (OR = 1.18; 95% CI: 1.02-1.38; P = 0.029) were significantly associated with preterm birth. Bayesian kernel machine regression suggested an interaction effect between As and Ba. Further, we constructed an element risk score (ERS) using estimated weights from a multivariate regression model for Ti, As, and Ba and regressed preterm birth by this score (OR = 2.72, 95% CI: 1.57-4.69; P = 3.35 × 10-4). Additionally, we observed a significant modification effect of child marriage on ERS, which means marriage before the age of 18 (Pinteraction = 0.0438). This study identified element exposures profiles in cord blood and constructed metal risk score that are jointly associated with the risk of preterm birth. Ti, As, and Ba exposure may adversely affect birth outcomes as well as child marriage may be a modifiable factor potentially affecting environmental element exposure and preterm birth.
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Affiliation(s)
- Hui Huang
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing 211166, China; Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Liangmin Wei
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Xin Chen
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Ruyang Zhang
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China; China International Cooperation Center for Environment and Human Health, Center of Global Health, Nanjing Medical University, Nanjing 211166, China
| | - Li Su
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | | | | | | | - Yang Zhao
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Hao Yu
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Yongyue Wei
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China; China International Cooperation Center for Environment and Human Health, Center of Global Health, Nanjing Medical University, Nanjing 211166, China.
| | - David C Christiani
- China International Cooperation Center for Environment and Human Health, Center of Global Health, Nanjing Medical University, Nanjing 211166, China; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Feng Chen
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing 211166, China; Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China; China International Cooperation Center for Environment and Human Health, Center of Global Health, Nanjing Medical University, Nanjing 211166, China
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12
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Ashrap P, Watkins DJ, Mukherjee B, Rosario-Pabón Z, Vélez-Vega CM, Alshawabkeh A, Cordero JF, Meeker JD. Performance of urine, blood, and integrated metal biomarkers in relation to birth outcomes in a mixture setting. ENVIRONMENTAL RESEARCH 2021; 200:111435. [PMID: 34097892 PMCID: PMC8403638 DOI: 10.1016/j.envres.2021.111435] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/07/2021] [Accepted: 05/27/2021] [Indexed: 05/08/2023]
Abstract
BACKGROUND Studies on the health effects of metal mixtures typically utilize biomarkers measured in a single biological medium, such as blood or urine. However, the ability to evaluate mixture effects are limited by the uncertainty whether a unified medium can fully capture exposure for each metal. Therefore, it is important to compare and assess metal mixtures measured in different media in epidemiology studies. OBJECTIVES The aim of this study was to examine the mixture predictive performance of urine and blood metal biomarkers and integrated multi-media biomarkers in association with birth outcomes. METHODS In our analysis of 847 women from the Puerto Rico PROTECT Cohort, we measured 10 essential and non-essential metals in repeated and paired samples of urine and blood during pregnancy. For each metal, we integrated exposure estimates from paired urine and blood biomarkers into multi-media biomarkers (MMBs), using intraclass-correlation coefficient (ICC) and weighted quantile sum (WQS) approaches. Using Ridge regressions, four separate Environmental risk scores (ERSs) for metals in urine, blood, MMBICC, and MMBWQS were computed as a weighted sum of the 10 metal concentrations. We then examined associations between urine, blood, and multi-media biomarker ERSs and birth outcomes using linear and logistic regressions, adjusting for maternal age, maternal education, pre-pregnancy body mass index (BMI), and second-hand smoke exposure. The performance of each ERS was evaluated with continuous and tertile estimates and 95% confidence intervals of the odds ratio of preterm birth using area under the curve (AUC). RESULTS Pb was the most important contributor of blood ERS as well as the two integrated multi-media biomarker ERSs. Individuals with high ERS (3rd tertile) showed increased odds of preterm birth compared to individuals with low ERS (1st tertile), with 2.8-fold (95% CI, 1.49 to 5.40) for urine (specific gravity corrected); 3.2- fold (95% CI, 1.68 to 6.25) for blood; 3.9-fold (95% CI, 1.72 to 8.66) for multi-media biomarkers composed using ICC; and 5.2-fold (95% CI, 2.34 to 11.42) for multi-media biomarkers composed using WQS. The four ERSs had comparable predictive performances (AUC ranging from 0.64 to 0.68) when urine is examined with specific gravity corrected concentrations. CONCLUSIONS Within a practical metal panel, measuring metals in either urine or blood may be an equally good approach to evaluate the metals as a mixture. Applications in practical study design require validation of these methods with other cohorts, larger panels of metals and within the context of other adverse health effects of interest.
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Affiliation(s)
- Pahriya Ashrap
- University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI, United States
| | - Deborah J Watkins
- University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI, United States
| | - Bhramar Mukherjee
- University of Michigan School of Public Health, Department of Biostatistics, Ann Arbor, MI, United States
| | - Zaira Rosario-Pabón
- University of Puerto Rico Graduate School of Public Health, UPR Medical Sciences Campus, San Juan, PR, USA
| | - Carmen M Vélez-Vega
- University of Puerto Rico Graduate School of Public Health, UPR Medical Sciences Campus, San Juan, PR, USA
| | - Akram Alshawabkeh
- College of Engineering, Northeastern University, Boston, MA, United States
| | - José F Cordero
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, Georgia, United States
| | - John D Meeker
- University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI, United States.
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13
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Comess S, Donovan G, Gatziolis D, Deziel NC. Exposure to atmospheric metals using moss bioindicators and neonatal health outcomes in Portland, Oregon. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 284:117343. [PMID: 34030082 DOI: 10.1016/j.envpol.2021.117343] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/07/2021] [Accepted: 05/07/2021] [Indexed: 06/12/2023]
Abstract
Studying the impacts of prenatal atmospheric heavy-metal exposure is challenging, because biological exposure monitoring does not distinguish between specific sources, and high-resolution air monitoring data is lacking for heavy metals. Bioindicators - animal or plant species that can capture environmental quality - are a low-cost tool for evaluating exposure to atmospheric heavy-metal pollution that have received little attention in the public-health literature. We obtained birth records for Portland, Oregon live births (2008-2014) and modeled metal concentrations derived from 346 samples of moss bioindicators collected in 2013. Exposure estimates were assigned using mother's residential address at birth for six metals with known toxic and estrogenic effects (arsenic, cadmium, chromium, cobalt, nickel, lead). Associations were evaluated for continuous (cts) and quartile-based (Q) metal estimates and three birth outcomes (preterm birth (PTB; <37 weeks)), very PTB (vPTB; <32 weeks), small for gestational age (SGA; 10th percentile of weight by age and sex)) using logistic regression models with adjustment for demographic characteristics, and stratified by maternal race. Chromium and cobalt were associated with increased odds of vPTB (chromium - odds ratio (OR)cts = 1.09, 95% CI: 1.00, 1.17; cobalt - ORQ4vsQ1 = 1.33, 95% CI: 1.03, 1.71). Cobalt, chromium and cadmium were significantly associated with odds of SGA, although the direction of association differed by metal (cobalt - ORcts = 1.04, 95% CI: 1.01, 1.07; chromium - ORQ3vsQ1 = 0.91, 95% CI: 0.83, 0.99; cadmium - ORcts = 0.96, 95% CI: 0.93, 1.00). In stratified analyses, odds of SGA were significantly different among non-white mothers compared to white mothers with exposure to chromium, cobalt, lead and nickel. This novel application of a moss-based exposure metric found that exposure to some atmospheric metals is associated with adverse birth outcomes. These findings are consistent with previous literature and suggest that moss bioindicators are a useful complement to traditional exposure-assessment methods.
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Affiliation(s)
- Saskia Comess
- Environmental Health Sciences, Yale School of Public Health, Yale University, New Haven, CT, 06510, USA
| | - Geoffrey Donovan
- USDA Forest Service, PNW Research Station, 620 SW Main, Suite 502, Portland, OR, 97205, USA.
| | - Demetrios Gatziolis
- USDA Forest Service, PNW Research Station, 620 SW Main, Suite 502, Portland, OR, 97205, USA
| | - Nicole C Deziel
- Environmental Health Sciences, Yale School of Public Health, Yale University, New Haven, CT, 06510, USA
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14
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Di Ciaula A. Bioaccumulation of Toxic Metals in Children Exposed to Urban Pollution and to Cement Plant Emissions. EXPOSURE AND HEALTH 2021; 13:681-695. [PMID: 34189342 PMCID: PMC8229267 DOI: 10.1007/s12403-021-00412-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 06/10/2021] [Accepted: 06/14/2021] [Indexed: 02/07/2023]
Abstract
Cement plants located in urban areas can increase health risk. Although children are particularly vulnerable, biomonitoring studies are lacking. Toenail concentration of 24 metals was measured in 366 children (6-10 years), who live and attend school in a city hosting a cement plant. Living addresses and schools were geocoded and attributed to exposed or control areas, according to modeled ground concentrations of PM10 generated by the cement plant. Air levels of PM10 and NO2 were monitored. PM10 levels were higher in the exposed, than in the control area. The highest mean PM10 concentration was recorded close to the cement plant. Conversely, the highest NO2 concentration was in the control area, where vehicular traffic and home heating were the prevalent sources of pollutants. Exposed children had higher concentrations of Nickel (Ni), Cadmium (Cd), Mercury (Hg), and Arsenic (As) than controls. These concentrations correlated each other, indicating a common source. Toenail Barium (Ba) concentration was higher in the control- than in the exposed area. The location of the attended school was a predictor of Cd, Hg, Ni, Ba concentrations, after adjusting for confounders. In conclusion, children living and attending school in an urban area exposed to cement plant emissions show a chronic bioaccumulation of toxic metals, and a significant exposure to PM10 pollution. Cement plants located in populous urban areas seem therefore harmful, and primary prevention policies to protect children health are needed.
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Padmanabhan V, Song W, Puttabyatappa M. Praegnatio Perturbatio-Impact of Endocrine-Disrupting Chemicals. Endocr Rev 2021; 42:295-353. [PMID: 33388776 PMCID: PMC8152448 DOI: 10.1210/endrev/bnaa035] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Indexed: 02/07/2023]
Abstract
The burden of adverse pregnancy outcomes such as preterm birth and low birth weight is considerable across the world. Several risk factors for adverse pregnancy outcomes have been identified. One risk factor for adverse pregnancy outcomes receiving considerable attention in recent years is gestational exposure to endocrine-disrupting chemicals (EDCs). Humans are exposed to a multitude of environmental chemicals with known endocrine-disrupting properties, and evidence suggests exposure to these EDCs have the potential to disrupt the maternal-fetal environment culminating in adverse pregnancy and birth outcomes. This review addresses the impact of maternal and fetal exposure to environmental EDCs of natural and man-made chemicals in disrupting the maternal-fetal milieu in human leading to adverse pregnancy and birth outcomes-a risk factor for adult-onset noncommunicable diseases, the role lifestyle and environmental factors play in mitigating or amplifying the effects of EDCs, the underlying mechanisms and mediators involved, and the research directions on which to focus future investigations to help alleviate the adverse effects of EDC exposure.
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Affiliation(s)
| | - Wenhui Song
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
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16
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Padmanabhan V, Moeller J, Puttabyatappa M. Impact of gestational exposure to endocrine disrupting chemicals on pregnancy and birth outcomes. ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 2021; 92:279-346. [PMID: 34452689 DOI: 10.1016/bs.apha.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
With the advent of industrialization, humans are exposed to a wide range of environmental chemicals, many with endocrine disrupting potential. As successful maintenance of pregnancy and fetal development are under tight hormonal control, the gestational exposure to environmental endocrine disrupting chemicals (EDC) have the potential to adversely affect the maternal milieu and support to the fetus, fetal developmental trajectory and birth outcomes. This chapter summarizes the impact of exposure to EDCs both individually and as mixtures during pregnancy, the immediate and long-term consequences of such exposures on the mother and fetus, the direct and indirect mechanisms through which they elicit their effects, factors that modify their action, and the research directions to focus future investigations.
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Affiliation(s)
| | - Jacob Moeller
- Department of Pediatrics, University of Michigan, Ann Arbor, MI, United States
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Ashrap P, Aker A, Watkins DJ, Mukherjee B, Rosario-Pabón Z, Vélez-Vega CM, Alshawabkeh A, Cordero JF, Meeker JD. Psychosocial status modifies the effect of maternal blood metal and metalloid concentrations on birth outcomes. ENVIRONMENT INTERNATIONAL 2021; 149:106418. [PMID: 33548848 PMCID: PMC7897320 DOI: 10.1016/j.envint.2021.106418] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/20/2021] [Accepted: 01/22/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND Metal exposure and psychosocial stress in pregnancy have each been associated with adverse birth outcomes, including preterm birth and low birth weight, but no study has examined the potential interaction between them. OBJECTIVES We examined the modifying effect of psychosocial stress on the association between metals and birth outcomes among pregnant women in Puerto Rico Testsite for Exploring Contamination Threats (PROTECT) birth cohort study. METHODS In our analysis of 682 women from the PROTECT study, we measured 16 essential and non-essential metals in blood samples at two time points. We administered questionnaires to collect information on depression, perceived stress, social support, and life experience during pregnancy. Using K-means clustering, we categorized pregnant women into one of two groups: "good" and "poor" psychosocial status. We then evaluated whether the effect of blood metals (geometric average) on adverse birth outcomes (gestational age, preterm birth [overall and spontaneous], birth weight z-score, small for gestation [SGA], large for gestation [LGA]) vary between two clusters of women, adjusting for maternal age, maternal education, pre-pregnancy body mass index (BMI), and second-hand smoke exposure. RESULTS Blood manganese (Mn) was associated with an increased odds ratio (OR) of overall preterm birth (OR/interquartile range [IQR] = 2.76, 95% confidence interval [CI] = 1.25, 6.12) and spontaneous preterm birth (OR/IQR: 3.68, 95% CI: 1.20, 6.57) only among women with "poor" psychosocial status. The association between copper (Cu) and SGA was also statistically significant only among women having "poor" psychosocial status (OR/IQR: 2.81, 95% CI: 1.20, 6.57). We also observed associations between nickel (Ni) and preterm birth and SGA that were modified by psychosocial status during pregnancy. CONCLUSIONS Presence of "poor" psychosocial status intensified the adverse associations between Mn and preterm birth, Cu and SGA, and protective effects of Ni on preterm. This provides evidence that prenatal psychosocial stress may modify vulnerability to metal exposure.
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Affiliation(s)
- Pahriya Ashrap
- University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI, United States
| | - Amira Aker
- Department of Health and Society, University of Toronto Scarborough, Scarborough, Ontario, Canada
| | - Deborah J Watkins
- University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI, United States
| | - Bhramar Mukherjee
- University of Michigan School of Public Health, Department of Biostatistics, Ann Arbor, MI, United States
| | - Zaira Rosario-Pabón
- University of Puerto Rico Graduate School of Public Health, UPR Medical Sciences Campus, San Juan, PR, United States
| | - Carmen M Vélez-Vega
- University of Puerto Rico Graduate School of Public Health, UPR Medical Sciences Campus, San Juan, PR, United States
| | - Akram Alshawabkeh
- College of Engineering, Northeastern University, Boston, MA, United States
| | - José F Cordero
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, United States
| | - John D Meeker
- University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI, United States.
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Rivera-Núñez Z, Ashrap P, Barrett ES, Watkins DJ, Cathey AL, Vélez-Vega CM, Rosario Z, Cordero JF, Alshawabkeh A, Meeker JD. Association of biomarkers of exposure to metals and metalloids with maternal hormones in pregnant women from Puerto Rico. ENVIRONMENT INTERNATIONAL 2021; 147:106310. [PMID: 33321388 PMCID: PMC7856269 DOI: 10.1016/j.envint.2020.106310] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 10/23/2020] [Accepted: 11/26/2020] [Indexed: 05/03/2023]
Abstract
BACKGROUND Metal(loid)s have been associated to adverse birth outcomes in experimental and epidemiological studies, but the underlying mechanism(s) are not well understood. Endocrine disruption may be a mechanism by which the metal(loid)s impact birth outcomes. METHODS Pregnant women were recruited through the Puerto Rico Testsite for Exploring Contamination Threats (PROTECT). Urine, blood, demographic and pregnancy-related data were collected at recruitment and subsequent visits. Sixteen metal(loid)s were analyzed in urine and blood samples, while nine maternal hormones (corticotropin-releasing hormone (CRH), sex-hormone binding globulin (SHBG), estriol (E3), progesterone, testosterone, thyroid-stimulating hormone (TSH), total triiodothyronine (T3), total thyroxine (T4), and free thyroxine (fT4)) were measured in serum samples from 815 singleton pregnancies. Linear mixed models with random intercepts were used to examine associations between metal(loid)s in blood and urine with hormone concentrations. RESULTS Arsenic blood concentrations were significantly associated with increased levels in CRH (%Δ: 23.0, 95%CI: 8.4-39.6) and decreased levels in testosterone (%Δ: -16.3, 95%CI: -26.2--5.1). Cobalt, manganese, and lead blood concentrations were associated with small increases in SHBG (%Δ range: 3.3-4.2), E3 (%Δ range: 3.9-8.7) and progesterone (%Δ range: 4.1-6.3) levels, respectively. Nickel blood concentration was inversely associated with testosterone levels (%Δ -13.3, 95%CI: -18.7--7.6). Significant interactions were detected for the association between nickel and study visit in relation to CRH (p < 0.02) and testosterone levels (p < 0.01). CONCLUSION Our analysis suggests that metal(loid)s may act as endocrine disruptors by altering prenatal hormone levels. This disruption may depend on specific windows of exposure during pregnancy. Additionally, some essential metal(loid)s such as managense and cobalt may be contributors to adverse maternal and fetal outcomes. The study of metal(loid)s as endocrine disruptors is in the early stages of epidemiological research and future studies are needed to further investigate these associations.
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Affiliation(s)
- Zorimar Rivera-Núñez
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health and Rutgers Environmental and Occupational Sciences Institute, Rutgers University, Piscataway, NJ, USA
| | - Pahriya Ashrap
- Department of Environmental Health Sciences, School of Public Health, University of Michigan Ann Arbor, MI, USA
| | - Emily S Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health and Rutgers Environmental and Occupational Sciences Institute, Rutgers University, Piscataway, NJ, USA
| | - Deborah J Watkins
- Department of Environmental Health Sciences, School of Public Health, University of Michigan Ann Arbor, MI, USA
| | - Amber L Cathey
- Department of Environmental Health Sciences, School of Public Health, University of Michigan Ann Arbor, MI, USA
| | - Carmen M Vélez-Vega
- Graduate Program of Public Health, University of Puerto Rico, UPR Medical Sciences Campus, San Juan, PR, USA
| | - Zaira Rosario
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, USA
| | - José F Cordero
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, USA
| | | | - John D Meeker
- Department of Environmental Health Sciences, School of Public Health, University of Michigan Ann Arbor, MI, USA.
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Xu C, Xu J, Zhang X, Xu S, Liu Q, Weng Z, Gu A. Serum nickel is associated with craniosynostosis risk: Evidence from humans and mice. ENVIRONMENT INTERNATIONAL 2021; 146:106289. [PMID: 33276314 DOI: 10.1016/j.envint.2020.106289] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/15/2020] [Accepted: 11/16/2020] [Indexed: 05/06/2023]
Abstract
BACKGROUND To date, few studies have explored the effects of exposure to metal mixtures on adverse developmental outcomes, and no reported studies have linked metal exposure to craniosynostosis (CS). The purpose of this study is to investigate the association between metal exposure and the risk of CS by conducting epidemiological and experimental studies. METHODS Inductively coupled plasma mass spectrometry (ICP-MS) was used to measure the concentrations of 6 metals (chromium [Cr], nickel [Ni], tin [Sn], arsenic [As], thallium [Tl], and lead [Pb]) in serum samples from 174 CS patients and 85 control individuals. Non-syndromic patients with isolated sagittal suture closure were selected as the case group, and healthy children matched by sex and age were selected as controls. Bayesian kernel machine regression (BKMR) models were used to account for joint metal effects. Multiple logistic regression analysis was used to explore the association between metal concentration and CS occurrence, with adjustment for potential confounders. During pregnancy, mice were exposed to Ni (0, 0.05, or 0.1 g/kg/day) until weaning, and the widths of the sutures and shapes of the skull were analysed by micro-CT 3D imaging and histological analysis. MC3T3-E1 cells were treated with Ni (0, 0.005, or 0.05 μg/mL) for 72 h. Alkaline phosphate (ALP) staining and Alizarin red staining were performed to observe the development of osteoblasts. The expression levels of osteoblast-related genes were also detected. RESULTS A positive association between the metal mixture and CS risk was observed based on population data; the Ni group had the highest conditional posterior inclusion probability (PIP), at 0.8416, and in the fully adjusted model, the highest Ni exposure level had a more significant association with CS (coefficient = 2.65, 95% CI: 0.29, 5.02) than the lowest Ni exposure level. The mean widths of the sagittal sutures in mice were 8.8 ± 0.6 mm in the control group, 8.0 ± 0.8 mm in the 0.05 g/kg/day group and 6.8 ± 0.4 mm in the 0.1 g/kg/day group. After Ni exposure, ALP gene expression in skull tissue was increased, and ALP activity was increased in MC3T3-E1 cells. Moreover, increased collagen content in mouse skull sections and elevated osteocalcin (OCN) expression in MC3T3-E1 cells were observed in the Ni-treated groups compared to the control group. CONCLUSIONS This study is the first to provide evidence that increased serum Ni was associated with an increased risk of CS. Early life exposure to Ni promoted osteogenesis during skull growth, which may contribute to the development of CS.
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Affiliation(s)
- Cheng Xu
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of the Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Jin Xu
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of the Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China; Department of Maternal, Child, and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xin Zhang
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of the Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Shuqin Xu
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of the Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Qian Liu
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of the Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Zhenkun Weng
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of the Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Aihua Gu
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of the Ministry of Education, Center for Global Health, Nanjing Medical University, Nanjing, China.
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Jing S, Chen C, Gan Y, Vogel J, Zhang J. Incidence and trend of preterm birth in China, 1990-2016: a systematic review and meta-analysis. BMJ Open 2020; 10:e039303. [PMID: 33310797 PMCID: PMC7735132 DOI: 10.1136/bmjopen-2020-039303] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 10/19/2020] [Accepted: 11/24/2020] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES To update the WHO estimate of preterm birth rate in China in 1990-2016 and to further explore variations by geographic regions and years of occurrence. DESIGN Systematic review and meta-analysis. DATA SOURCES Pubmed, Embase, Cochrane Library and Sinomed databases were searched from 1990 to 2018. ELIGIBILITY CRITERIA Studies were included if they provided preterm birth data with at least 500 total births. Reviews, case-control studies, intervention studies and studies with insufficient information or published before 1990 were excluded. We estimated pooled incidence of preterm birth by a random effects model, and preterm birth rate in different year, region and by livebirths or all births in subgroup analyses. RESULTS Our search identified 3945 records. After the removal of duplicates and screening of titles and abstracts, we reviewed 254 studies in full text and excluded 182, leaving 72 new studies. They were combined with the 82 studies included in the WHO report (154 studies, 187 data sets in total for the meta-analysis), including 24 039 084 births from 1990 to 2016. The pooled incidence of preterm birth in China was 6.09% (95% CI 5.86% to 6.31%) but has been steadily increasing from 5.36% (95% CI 4.89% to 5.84%) in 1990-1994 to 7.04% (95% CI 6.09% to 7.99%) in 2015-2016. The annual rate of increase was about 1.05% (95% CI 0.85% to 1.21%). Northwest China appeared to have the highest preterm birth rate (7.3%, 95% CI 4.92% to 9.68% from 1990 to 2016). CONCLUSIONS The incidence of preterm birth in China has been rising gradually in the past three decades. It was 7% in 2016. Preterm birth rate varied by region with the West having the highest occurrence.
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Affiliation(s)
- Shiwen Jing
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chang Chen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuexin Gan
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Joshua Vogel
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Jun Zhang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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21
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Dietary exposure of the Italian population to nickel: The national Total Diet Study. Food Chem Toxicol 2020; 146:111813. [DOI: 10.1016/j.fct.2020.111813] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/07/2020] [Accepted: 10/12/2020] [Indexed: 01/08/2023]
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Schrenk D, Bignami M, Bodin L, Chipman JK, del Mazo J, Grasl‐Kraupp B, Hogstrand C, Hoogenboom L(R, Leblanc J, Nebbia CS, Ntzani E, Petersen A, Sand S, Schwerdtle T, Vleminckx C, Wallace H, Guérin T, Massanyi P, Van Loveren H, Baert K, Gergelova P, Nielsen E. Update of the risk assessment of nickel in food and drinking water. EFSA J 2020; 18:e06268. [PMID: 33193868 PMCID: PMC7643711 DOI: 10.2903/j.efsa.2020.6268] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The European Commission asked EFSA to update its previous Opinion on nickel in food and drinking water, taking into account new occurrence data, the updated benchmark dose (BMD) Guidance and newly available scientific information. More than 47,000 analytical results on the occurrence of nickel were used for calculating chronic and acute dietary exposure. An increased incidence of post-implantation loss in rats was identified as the critical effect for the risk characterisation of chronic oral exposure and a BMDL 10 of 1.3 mg Ni/kg body weight (bw) per day was selected as the reference point for the establishment of a tolerable daily intake (TDI) of 13 μg/kg bw. Eczematous flare-up reactions in the skin elicited in nickel-sensitised humans, a condition known as systemic contact dermatitis, was identified as the critical effect for the risk characterisation of acute oral exposure. A BMDL could not be derived, and therefore, the lowest-observed-adverse-effect-level of 4.3 μg Ni/kg bw was selected as the reference point. The margin of exposure (MOE) approach was applied and an MOE of 30 or higher was considered as being indicative of a low health concern. The mean lower bound (LB)/upper bound (UB) chronic dietary exposure was below or at the level of the TDI. The 95th percentile LB/UB chronic dietary exposure was below the TDI in adolescents and in all adult age groups, but generally exceeded the TDI in toddlers and in other children, as well as in infants in some surveys. This may raise a health concern in these young age groups. The MOE values for the mean UB acute dietary exposure and for the 95th percentile UB raises a health concern for nickel-sensitised individuals. The MOE values for an acute scenario regarding consumption of a glass of water on an empty stomach do not raise a health concern.
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Ashrap P, Watkins DJ, Mukherjee B, Boss J, Richards MJ, Rosario Z, Vélez-Vega CM, Alshawabkeh A, Cordero JF, Meeker JD. Maternal blood metal and metalloid concentrations in association with birth outcomes in Northern Puerto Rico. ENVIRONMENT INTERNATIONAL 2020; 138:105606. [PMID: 32179314 PMCID: PMC7198231 DOI: 10.1016/j.envint.2020.105606] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 02/18/2020] [Accepted: 02/22/2020] [Indexed: 05/19/2023]
Abstract
BACKGROUND In previous studies, exposures to heavy metals such as Pb and Cd have been associated with adverse birth outcomes; however, knowledge on effects at low levels of exposure and of other elements remain limited. METHOD We examined individual and mixture effects of metals and metalloids on birth outcomes among 812 pregnant women in the Puerto Rico Testsite for Exploring Contamination Threats (PROTECT) cohort. We measured 16 essential and non-essential metal(loid)s in maternal blood collected at 16-20 and 24-28 weeks gestation. We used linear and logistic regression to independently examine associations between geometric mean (GM) concentrations of each metal across visits and gestational age, birthweight z-scores, preterm birth, small for gestational age (SGA), and large for gestational age (LGA). We evaluated effect modification with infant sex*metal interaction terms. To identify critical windows of susceptibility, birth outcomes were regressed on visit-specific metal concentrations. Furthermore, average metal concentrations were divided into tertiles to examine the potential for non-linear relationships. We used elastic net (ENET) regularization to construct Environmental Risk Score (ERS) as a metal risk score and Bayesian Kernel Machine Regression (BKMR) to identify individual metals most critical to each outcome, accounting for correlated exposures. RESULTS In adjusted models, an interquartile range (IQR) increase in GM lead (Pb) was associated with 1.63 higher odds of preterm birth (95%CI = 1.17, 2.28) and 2 days shorter gestational age (95% CI = -3.1, -0.5). Manganese (Mn) and zinc (Zn) were also associated with higher odds of preterm birth and shorter gestational age; the associations were strongest among the highest tertile for Mn and among females for Zn. Mercury (Hg) was associated with higher risk of preterm birth at the later window of pregnancy. Ni measured later in pregnancy was associated with lower odds of SGA. ENET and BKMR models selected similar metals as "important" predictors of birth outcomes. The association between ERS and preterm birth was assessed and the third tertile of ERS was significantly associated with an elevated odds ratio of 2.13 (95% CI = 1.12, 5.49) for preterm birth compared to the first tertile. CONCLUSION As the PROTECT cohort has lower Pb concentrations (GM = 0.33 μg/dL) compared to the mainland US, our findings suggest that low-level prenatal lead exposure, as well as elevated Mn and Zn exposure, may adversely affect birth outcomes. Improved understanding on environmental factors contributing to preterm birth, together with sustainable technologies to remove contamination, will have a direct impact in Puerto Rico and elsewhere.
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Affiliation(s)
- Pahriya Ashrap
- University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI, United States
| | - Deborah J Watkins
- University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI, United States
| | - Bhramar Mukherjee
- University of Michigan School of Public Health, Department of Biostatistics, Ann Arbor, MI, United States
| | - Jonathan Boss
- University of Michigan School of Public Health, Department of Biostatistics, Ann Arbor, MI, United States
| | | | - Zaira Rosario
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, United States
| | - Carmen M Vélez-Vega
- University of Puerto Rico Graduate School of Public Health, UPR Medical Sciences Campus, San Juan, Puerto Rico, United States
| | - Akram Alshawabkeh
- College of Engineering, Northeastern University, Boston, MA, United States
| | - José F Cordero
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, United States
| | - John D Meeker
- University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI, United States.
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Wang X, Gao D, Zhang G, Zhang X, Li Q, Gao Q, Chen R, Xu S, Huang L, Zhang Y, Lin L, Zhong C, Chen X, Sun G, Song Y, Yang X, Hao L, Yang H, Yang L, Yang N. Exposure to multiple metals in early pregnancy and gestational diabetes mellitus: A prospective cohort study. ENVIRONMENT INTERNATIONAL 2020; 135:105370. [PMID: 31864020 DOI: 10.1016/j.envint.2019.105370] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 11/24/2019] [Accepted: 11/27/2019] [Indexed: 05/12/2023]
Abstract
BACKGROUND A growing number of epidemiologic studies have estimated associations between type 2 diabetes mellitus and exposure to metals. However, studies on the associations of internal assessments of metal exposure and gestational diabetes mellitus (GDM) are limited in scope and have inconsistent outcomes. OBJECTIVES This investigation aimed to explore the associations between urinary nickel (Ni), arsenic (As), cadmium (Cd), antimony (Sb), cobalt (Co), or vanadium (V) in early pregnancy and the subsequent risk of GDM in Chinese pregnant women. METHODS The study population included 2090 women with singleton pregnancy from the Tongji Maternal and Child Health Cohort (TMCHC). Urine samples were collected before 20 gestational weeks, and an oral glucose tolerance test (OGTT) was conducted at 24-28 gestational weeks to diagnose GDM. The concentrations of urinary metals were measured using inductively coupled plasma mass spectrometry (ICP-MS) and were corrected for urinary creatinine. The associations between the risk of GDM and urinary metals were assessed using Poisson regression with a robust error variance with generalized estimating equations (GEE) models and Bayesian kernel machine regression (BKMR). RESULTS A total of 241 participants (11.53%) were diagnosed with GDM. Five metals (Ni, As, Sb, Co, and V) were found significantly and positively associated with GDM based on single-metal models. In multiple-metal models, for each unit increase of ln-transformed urinary Ni or Sb, the risk of GDM increased 18% [relative risk (RR):1.18, 95%confidence interval (CI): 1.00, 1.38 or RR: 1.18, 95%CI: 1.00, 1.39, respectively]. The BKMR analysis revealed a statistically significant and positive joint effect of the six metals on the risk of GDM, when the urinary levels of the six metals were all above the 55th percentile, compared to the median levels. The effect of metal Ni was significant when the concentrations of the other metals were all fixed at their 25th percentile, and metal Sb displayed a significant and positive effect when all the other metals were fixed at 25th, 50th, and 75th percentiles. CONCLUSIONS To the best of our knowledge, this study is the first to demonstrate that increased concentrations of urinary Ni in early pregnancy are associated with an elevated risk of GDM, either evaluated individually or as a metal mixture. All six metals mixed exposure was positively associated with the risk of GDM, while Sb and Ni were demonstrated more important effects than the other four metals in the mixture.
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Affiliation(s)
- Xiaoyi Wang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Duan Gao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Guofu Zhang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China; School of Public Health, Xinxiang Medical University, Xinxiang 453003, Henan, China
| | - Xu Zhang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Qian Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Qin Gao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Renjuan Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Shangzhi Xu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Li Huang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Yu Zhang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Lixia Lin
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Chunrong Zhong
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Xi Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Guoqiang Sun
- Obstetrics Department, Maternal and Child Health Care Hospital of Hubei Province, Wuhan 430070, Hubei, China
| | - Yang Song
- Medical College, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China
| | - Xuefeng Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Liping Hao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Hongying Yang
- Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, Hubei, China
| | - Lei Yang
- Medical College, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China
| | - Nianhong Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
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Magrone T, Russo MA, Jirillo E. Impact of Heavy Metals on Host Cells: Special Focus on Nickel-Mediated Pathologies and Novel Interventional Approaches. Endocr Metab Immune Disord Drug Targets 2019; 20:1041-1058. [PMID: 31782370 DOI: 10.2174/1871530319666191129120253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 05/13/2019] [Accepted: 05/28/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Heavy metals [arsenic, aluminium, cadmium, chromium, cobalt, lead, nickel (Ni), palladium and titanium] are environmental contaminants able to impact with host human cells, thus, leading to severe damage. OBJECTIVE In this review, the detrimental effects of several heavy metals on human organs will be discussed and special emphasis will be placed on Ni. In particular, Ni is able to interact with Toll-like receptor-4 on immune and non-immune cells, thus, triggering the cascade of pro-inflammatory cytokines. Then, inflammatory and allergic reactions mediated by Ni will be illustrated within different organs, even including the central nervous system, airways and the gastrointestinal system. DISCUSSION Different therapeutic strategies have been adopted to mitigate Ni-induced inflammatoryallergic reactions. In this context, the ability of polyphenols to counteract the inflammatory pathway induced by Ni on peripheral blood leukocytes from Ni-sensitized patients will be outlined. In particular, polyphenols are able to decrease serum levels of interleukin (IL)-17, while increasing levels of IL- 10. These data suggest that the equilibrium between T regulatory cells and T helper 17 cells is recovered with IL-10 acting as an anti-inflammatory cytokine. In the same context, polyphenols reduced elevated serum levels of nitric oxide, thus, expressing their anti-oxidant potential. Finally, the carcinogenic potential of heavy metals, even including Ni, will be highlighted. CONCLUSION Heavy metals, particularly Ni, are spread in the environment. Nutritional approaches seem to represent a novel option in the treatment of Ni-induced damage and, among them, polyphenols should be taken into consideration for their anti-oxidant and anti-inflammatory activities.
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Affiliation(s)
- Thea Magrone
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, School of Medicine, University of Bari, Bari, Italy
| | - Matteo A Russo
- MEBIC Consortium, San Raffaele Open University of Rome and IRCCS San Raffaele Pisana of Rome, Rome, Italy
| | - Emilio Jirillo
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, School of Medicine, University of Bari, Bari, Italy
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Manduca P, Al Baraquni N, Al Baraquni L, Abu Abadi D, Abdallah H, Hamad GA, Mosa TA, Balousha S, Miqdad H, Mohammed W, Salah M, El Shawwa R. Hospital centered surveillance of births in Gaza, Palestine, 2011-2017 and heavy metal contamination of the mothers reveals long-term impact of wars. Reprod Toxicol 2019; 86:23-32. [PMID: 30844493 DOI: 10.1016/j.reprotox.2019.02.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 01/29/2019] [Accepted: 02/06/2019] [Indexed: 11/26/2022]
Abstract
Prevalence of preterm, low birth weight and birth defects increased significantly since 2011 in Gaza, Palestine. No change in known co-factors of reproductive health justified this rise. Two military attacks in 2012 and 2014 introduced novel risk factors for outcomes at birth: contamination by teratogenic and carcinogenic heavy metals weapon-remnants, ongoing impoverishment, and impaired rehabilitation of waste management. It was previously shown that mothers exposed to military attacks had higher metal load than those unexposed and mother's heavy metals trans-pass placenta. We investigated association in time of heavy metal contamination and reproductive health using hospital-based surveillance (2011-2016-2017) of births, accompanied by assessment in 2016 of metal load in mother and newborn hair. Mother's housing proximal to unmanaged waste predicted preterm birth and birth defects, and these women had highest load of heavy metals. Poor diet predicted low birth weight. Circumstances prevent investigation of heavy metals molecular impact(s) during fetal development.
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Affiliation(s)
| | | | | | | | | | | | | | - Suha Balousha
- Al Shifa Hospital, Gaza, Palestine; Department of Reproductive Health, Nursing and Midwifery School, International Campus, University of Medical Science, Tehran, Iran.
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