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Wang Y, Wang L, Jiang Z, Qu M, Meng Z, Sun Q, Du Y, Wang Y. Non-dietary exposure to phthalates in primary school children: Risk and correlation with anthropometric indices, cardiovascular and respiratory diseases. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 286:117203. [PMID: 39423508 DOI: 10.1016/j.ecoenv.2024.117203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 10/13/2024] [Accepted: 10/14/2024] [Indexed: 10/21/2024]
Abstract
Phthalates are endocrine disruptors of increasing concern for human health; however, previous studies have only assessed the association between internal exposure and human health. We aimed to assess the non-carcinogenic and carcinogenic risks of non-dietary exposure to phthalates in indoor environments among primary school children and their correlations with health indicators. A study involving 54 children was conducted in Jinan, Shandong Province, China. Questionnaires and health examinations were conducted, dust in hard-to-clean corners of students' classrooms and homes was collected, and airborne phthalates in the middle of classrooms and family living rooms were sampled. The gas-phase phthalate concentrations, individual exposure, and non-carcinogenic and carcinogenic risks were calculated. Associations were estimated using linear mixed models. The findings revealed that phthalates posed a non-carcinogenic risk to 7.4 % of the children and a moderate carcinogenic risk to 27.8 % of the children, with higher non-carcinogenic and carcinogenic risks to girls than to boys. Five phthalates were negatively correlated with body mass index, dimethyl phthalate and diethyl phthalate (DEP) were significantly correlated with waist circumference, and di-iso-butyl phthalate (DiBP) was negatively correlated with hip circumference. DiBP, di-n-butyl phthalate, and DEP, were significantly correlated with cardiovascular disease, DEP and di (2-n-butoxyethyl) phthalate were correlated with decreased lung function, and di-n-octyl phthalate influenced airway inflammation. The findings indicated that phthalate exposure may negatively impact children's health, thereby warranting further comprehensive research on the health effects of these chemicals.
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Affiliation(s)
- Yuchen Wang
- School of Environment and Energy Engineering, Beijing University of Civil Engineering and Architecture, Beijing 100044, China
| | - Lixin Wang
- School of Environment and Energy Engineering, Beijing University of Civil Engineering and Architecture, Beijing 100044, China.
| | - Zhiyu Jiang
- School of Environment and Energy Engineering, Beijing University of Civil Engineering and Architecture, Beijing 100044, China
| | - Meinan Qu
- School of Environment and Energy Engineering, Beijing University of Civil Engineering and Architecture, Beijing 100044, China
| | - Ziyan Meng
- School of Environment and Energy Engineering, Beijing University of Civil Engineering and Architecture, Beijing 100044, China
| | - Qinghua Sun
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yanjun Du
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yanwen Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
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Ashley-Martin J, Fisher M, Belanger P, Cirtiu CM, Arbuckle TE. Biomonitoring of inorganic arsenic species in pregnancy. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2023; 33:921-932. [PMID: 35948664 PMCID: PMC10733137 DOI: 10.1038/s41370-022-00457-2] [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: 02/05/2022] [Revised: 06/22/2022] [Accepted: 07/01/2022] [Indexed: 06/15/2023]
Abstract
Exposure assessment of inorganic arsenic is challenging due to the existence of multiple species, complexity of arsenic metabolism, and variety of exposure sources. Exposure assessment of arsenic during pregnancy is further complicated by the physiological changes that occur to support fetal growth. Given the well-established toxicity of inorganic arsenic at high concentrations, continued research into the potential health effects of low-level exposure on maternal and fetal health is necessary. Our objectives were to review the value of and challenges inherent in measuring inorganic arsenic species in pregnancy and highlight related research priorities. We discussed how the physiological changes of pregnancy influence arsenic metabolism and necessitate the need for pregnancy-specific data. We reviewed the biomonitoring challenges according to common and novel biological matrices and discussed how each matrix differs according to half-life, bioavailability, availability of laboratory methods, and interpretation within pregnancy. Exposure assessment in both established and novel matrices that accounts for the physiological changes of pregnancy and complexity of speciation is a research priority. Standardization of laboratory method for novel matrices will help address these data gaps. Research is particularly lacking in contemporary populations of pregnant women without naturally elevated arsenic drinking water concentrations (i.e. <10 µg/l).
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Affiliation(s)
- Jillian Ashley-Martin
- Environmental Health, Science and Research Bureau, Health Canada, Ottawa, ON, Canada.
| | - Mandy Fisher
- Environmental Health, Science and Research Bureau, Health Canada, Ottawa, ON, Canada
| | - Patrick Belanger
- INSPQ, Centre de toxicologie du Québec, Direction de la santé environnementale, au travail et de la toxicology, Quebec, QC, Canada
| | - Ciprian Mihai Cirtiu
- INSPQ, Centre de toxicologie du Québec, Direction de la santé environnementale, au travail et de la toxicology, Quebec, QC, Canada
| | - Tye E Arbuckle
- Environmental Health, Science and Research Bureau, Health Canada, Ottawa, ON, Canada
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3
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King L, Huang Y, Li T, Wang Q, Li W, Shan Z, Yin J, Chen L, Wang P, Dun C, Zhuang L, Peng X, Liu L. Associations of urinary perchlorate, nitrate and thiocyanate with central sensitivity to thyroid hormones: A US population-based cross-sectional study. ENVIRONMENT INTERNATIONAL 2022; 164:107249. [PMID: 35468408 DOI: 10.1016/j.envint.2022.107249] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 03/10/2022] [Accepted: 04/13/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Perchlorate, nitrate, and thiocyanate are three well-known sodium iodine symporter inhibitors, however, associations of their individual and concurrent exposure with central thyroid hormones sensitivity remain unclear. OBJECTIVES To investigate the associations of urinary perchlorate, nitrate, thiocyanate, and their co-occurrence with central thyroid hormones sensitivity among US general adults. METHODS A total of 7598 non-pregnant adults (weighted mean age 45.9 years and 52.9% men) from National Health and Nutritional Examination Survey 2007-2012 were included in this cross-sectional study. Central sensitivity to thyroid hormones was estimated with the Parametric Thyroid Feedback Quantile-based Index (PTFQI). Ordinary least-squares regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) models were performed to examine the associations of three anions and their co-occurrence with PTFQI. RESULTS The weighted mean values of urinary perchlorate, nitrate, thiocyanate, and perchlorate equivalent concentration (PEC) were 5.48 μg/L, 57.59 mg/L, 2.65 mg/L, and 539.8 μg/L, respectively. Compared with the lowest quartile, the least-square means difference (LSMD) of PTFQI was -0.0516 (LSMD ± SE: -0.0516 ± 0.0185, P < 0.01) in the highest perchlorate quartile. On average, PTFQI decreased by 0.0793 (LSMD ± SE: -0.0793 ± 0.0205, P < 0.001) between the highest and lowest thiocyanate quartile. Compared with those in the lowest quartile, participants in the highest PEC quartile had significantly decreased PTFQI levels (LSMD ± SE: -0.0862 ± 0.0188, P < 0.001). The WQS of three goitrogens, was inversely associated with PTFQI (β: -0.051, 95% CI: -0.068, -0.034). In BKMR model, PTFQI significantly decreased when the levels of three anions were at or above their 60th percentiles compared to the median values. CONCLUSIONS Higher levels of urinary perchlorate, thiocyanate, and co-occurrence of three goitrogens were associated with increased central thyroid hormones sensitivity among US general adults. Further studies are warranted to replicate our results and elucidate the underlying causative mechanistic links.
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Affiliation(s)
- Lei King
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yue Huang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Li
- Institute of Statistics and Big Data, Renmin University of China, Beijing, China
| | - Qiang Wang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wanyi Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhilei Shan
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiawei Yin
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liangkai Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Pei Wang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Changchang Dun
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Litao Zhuang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaolin Peng
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China.
| | - Liegang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Andersen ME, Mallick P, Clewell HJ, Yoon M, Olsen GW, Longnecker MP. Using quantitative modeling tools to assess pharmacokinetic bias in epidemiological studies showing associations between biomarkers and health outcomes at low exposures. ENVIRONMENTAL RESEARCH 2021; 197:111183. [PMID: 33887277 DOI: 10.1016/j.envres.2021.111183] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/07/2021] [Accepted: 04/12/2021] [Indexed: 06/12/2023]
Abstract
Biomarkers of exposure can be measured at lower and lower levels due to advances in analytical chemistry. Using these sensitive methods, some epidemiology studies report associations between biomarkers and health outcomes at biomarker levels much below those associated with effects in animal studies. While some of these low exposure associations may arise from increased sensitivity of humans compared with animals or from species-specific responses, toxicology studies with drugs, commodity chemicals and consumer products have not generally indicated significantly greater sensitivity of humans compared with test animals for most health outcomes. In some cases, these associations may be indicative of pharmacokinetic (PK) bias, i.e., a situation where a confounding factor or the health outcome itself alters pharmacokinetic processes affecting biomarker levels. Quantitative assessment of PK bias combines PK modeling and statistical methods describing outcomes across large numbers of individuals in simulated populations. Here, we first provide background on the types of PK models that can be used for assessing biomarker levels in human population and then outline a process for considering PK bias in studies intended to assess associations between biomarkers and health outcomes at low levels of exposure. After providing this background, we work through published examples where these PK methods have been applied with several chemicals/chemical classes - polychlorinated biphenyls (PCBs), perfluoroalkyl substances (PFAS), polybrominated biphenyl ethers (PBDE) and phthalates - to assess the possibility of PK bias. Studies of the health effects of low levels of exposure will be improved by developing some confidence that PK bias did not play significant roles in the observed associations.
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Varshavsky JR, Morello-Frosch R, Harwani S, Snider M, Petropoulou SSE, Park JS, Petreas M, Reynolds P, Nguyen T, Quach T. A Pilot Biomonitoring Study of Cumulative Phthalates Exposure among Vietnamese American Nail Salon Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E325. [PMID: 31906553 PMCID: PMC6981895 DOI: 10.3390/ijerph17010325] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 12/27/2019] [Accepted: 12/27/2019] [Indexed: 12/28/2022]
Abstract
Many California nail salon workers are low-income Vietnamese women of reproductive age who use nail products daily that contain androgen-disrupting phthalates, which may increase risk of male reproductive tract abnormalities during pregnancy. Yet, few studies have characterized phthalate exposures among this workforce. To characterize individual metabolites and cumulative phthalates exposure among a potentially vulnerable occupational group of nail salon workers, we collected 17 post-shift urine samples from Vietnamese workers at six San Francisco Bay Area nail salons in 2011, which were analyzed for four primary phthalate metabolites: mono-n-butyl-, mono-isobutyl-, mono(2-Ethylhexyl)-, and monoethyl phthalates (MnBP, MiBP, MEHP, and MEP, respectively; μg/L). Phthalate metabolite concentrations and a potency-weighted sum of parent compound daily intake (Σandrogen-disruptor, μg/kg/day) were compared to 203 Asian Americans from the 2011-2012 National Health and Nutritional Examination Survey (NHANES) using Student's t-test and Wilcoxin signed rank test. Creatinine-corrected MnBP, MiBP, MEHP (μg/g), and cumulative phthalates exposure (Σandrogen-disruptor, μg/kg/day) levels were 2.9 (p < 0.0001), 1.6 (p = 0.015), 2.6 (p < 0.0001), and 2.0 (p < 0.0001) times higher, respectively, in our nail salon worker population compared to NHANES Asian Americans. Levels exceeded the NHANES 95th or 75th percentiles among some workers. This pilot study suggests that nail salon workers are disproportionately exposed to multiple phthalates, a finding that warrants further investigation to assess their potential health significance.
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Affiliation(s)
- Julia R. Varshavsky
- School of Public Health, University of California, Berkeley, CA 94720, USA;
- Program on Reproductive Health and the Environment, University of California, Mailstop 0132, 550 16th Street, 7th Floor, San Francisco, CA 94143, USA
| | - Rachel Morello-Frosch
- School of Public Health, University of California, Berkeley, CA 94720, USA;
- Department of Environmental Science, Policy and Management, University of California, Berkeley, CA 94720, USA
| | - Suhash Harwani
- Environmental Chemistry Laboratory, California Department of Toxic Substances Control, Berkeley, CA 94720, USA; (S.H.); (M.S.); (S.-S.E.P.); (J.-S.P.); (M.P.)
| | - Martin Snider
- Environmental Chemistry Laboratory, California Department of Toxic Substances Control, Berkeley, CA 94720, USA; (S.H.); (M.S.); (S.-S.E.P.); (J.-S.P.); (M.P.)
| | - Syrago-Styliani E. Petropoulou
- Environmental Chemistry Laboratory, California Department of Toxic Substances Control, Berkeley, CA 94720, USA; (S.H.); (M.S.); (S.-S.E.P.); (J.-S.P.); (M.P.)
| | - June-Soo Park
- Environmental Chemistry Laboratory, California Department of Toxic Substances Control, Berkeley, CA 94720, USA; (S.H.); (M.S.); (S.-S.E.P.); (J.-S.P.); (M.P.)
| | - Myrto Petreas
- Environmental Chemistry Laboratory, California Department of Toxic Substances Control, Berkeley, CA 94720, USA; (S.H.); (M.S.); (S.-S.E.P.); (J.-S.P.); (M.P.)
| | - Peggy Reynolds
- Cancer Prevention Institute of California, Berkeley, CA 94720, USA; (P.R.); (T.Q.)
- Department of Health Research and Policy, Stanford University School of Medicine, Palo Alto, CA 92705, USA
| | - Tuan Nguyen
- State Compensation Insurance Fund, Safety and Health Services, Santa Ana, CA 92705, USA;
| | - Thu Quach
- Cancer Prevention Institute of California, Berkeley, CA 94720, USA; (P.R.); (T.Q.)
- Department of Health Research and Policy, Stanford University School of Medicine, Palo Alto, CA 92705, USA
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6
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Zahoor N, Danilenko U, Vesper HW. A fully automated high-throughput liquid chromatography tandem mass spectrometry method for measuring creatinine in urine. CLINICAL MASS SPECTROMETRY (DEL MAR, CALIF.) 2019; 11:1-7. [PMID: 34414261 PMCID: PMC8372835 DOI: 10.1016/j.clinms.2018.11.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 11/16/2018] [Accepted: 11/19/2018] [Indexed: 10/27/2022]
Abstract
Reliable creatinine measurements are important to evaluate kidney function and for creatinine correction to reduce biological variability of other urinary analytes. A high-throughput, accurate liquid chromatography tandem mass spectrometry method for quantitation of human urinary creatinine has been developed and validated. Sample preparation was fully automated including cryovial decapping, sample ID scanning and two serial dilution steps. Quantitation was performed using a stable isotope-labeled internal standard. Multiplexed chromatographic separation of creatinine was achieved within a one-minute analysis and followed by tandem mass spectrometry in positive electrospray ionization mode. The precursor and product ions of creatinine and D3-creatinine were monitored in selected reaction monitoring mode. Method validation results showed reproducibility with within-run precision of 3.59, 3.49 and 2.84% and between-run precision of 4.01, 3.28 and 3.57% for low, medium and high quality control materials prepared from pooled donor urine, respectively. The method showed excellent accuracy with a bias of -1.94%, -0.78% and -1.07% for three levels of certified reference material. The calibration curve was linear throughout a 7.50-300 mg/dL (0.663-26.5 mmol/L) measurement range (R2 = 0.999), with the mean slope of 0.0115 (95%CI, 0.0108-0.0122) and intercept of 0.0027 (95%CI, 0.0003-0.0051). The limit of detection (LOD) of the method was 3.17 mg/dL (0.280 mmol/L). Analytical specificity was achieved by chromatographically separating creatinine from potentially interfering creatine within a one-minute run and monitoring the Quantitation Ion/Confirmation Ion (QI/CI) ratios in samples. A simple, accurate, high-throughput method was successfully developed for measuring creatinine in human urine samples.
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Affiliation(s)
- Neelam Zahoor
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS F25, Atlanta, GA 30341, USA
| | - Uliana Danilenko
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS F25, Atlanta, GA 30341, USA
| | - Hubert W. Vesper
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS F25, Atlanta, GA 30341, USA
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7
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Reyes JM, Price PS. Temporal Trends in Exposures to Six Phthalates from Biomonitoring Data: Implications for Cumulative Risk. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2018; 52:12475-12483. [PMID: 30272963 PMCID: PMC8862759 DOI: 10.1021/acs.est.8b03338] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Phthalates are used in a wide range of consumer goods, resulting in exposures to specific phthalates that vary over time in accordance with changes in product use and how phthalates are utilized. We investigated trends in estimates of daily intake dose and several cumulative risk metrics, including the Hazard Quotient (HQ), Hazard Index (HI), and Maximum Cumulative Ratio (MCR) for six phthalates from 2005 to 2014 using metabolite biomonitoring data collected from spot urine samples under the National Health and Nutrition Examination Survey (NHANES). Over this period, there was a 2.2-fold decrease in the mean HI (0.34 to 0.15) and a 7.2-fold decrease in the percentage of participants with an HI > 1 (5.7% to 0.8%), indicating an overall decrease in combined exposure to these phthalates. Children (aged 6-11 years) had higher mean HI values than either adolescents (aged 12-19 years) or adults (aged 20+ years) during this period. MCR values were generally low and inversely correlated with HI. This indicated that a single phthalate usually drove the hazards for highly exposed individuals. However, the average value of MCR increased 1.2-fold (1.7-2.1) over this period indicating an increasing need to consider exposures to multiple phthalates in this group.
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Affiliation(s)
- Jeanette M. Reyes
- Oak Ridge Institute for Science and Education (ORISE) Research Participation Program, hosted at U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27711, United States
| | - Paul S. Price
- Office of Research and Development, National Exposure Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27711, United States
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8
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Geller RJ, Brotman RM, O'Brien KM, Fine DM, Zota AR. Phthalate exposure and odds of bacterial vaginosis among U.S. reproductive-aged women, NHANES 2001-2004. Reprod Toxicol 2018; 82:1-9. [PMID: 30208335 DOI: 10.1016/j.reprotox.2018.09.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 07/18/2018] [Accepted: 09/06/2018] [Indexed: 12/22/2022]
Abstract
Endocrine-disrupting chemicals, such as phthalates, are an unexamined potential risk factor for bacterial vaginosis (BV) and warrant investigation because hormones affect BV. We examined the association between phthalate exposure and BV in the National Health and Nutrition Examination Survey, 2001-2004. BV outcomes were defined as intermediate (Nugent score of 4-6) and positive (7-10). Phthalate metabolites, including monoethyl phthalate (MEP), mono-n-butyl phthalate (MnBP), and di(2-ethylhexyl) phthalate (DEHP) metabolites, were measured in urine. Among 854 women with complete data, multinomial logistic regression revealed that concentrations of MnBP (Q4 vs. Q1 OR = 3.01, 95% CI 1.76-5.15, p-trend <0.001) and ΣDEHP metabolites (Q4 OR = 2.55, 95% CI 1.45-4.47, p-trend = 0.03) were associated with Nugent-score BV, although only MnBP was significant after adjustment for confounders. Associations were null after adjustment for urinary creatinine (MnBP Q4 OR = 1.11, 95% CI 0.63-1.96; ΣDEHP Q4 OR = 0.72, 95% CI 0.37-1.39). Future work should further examine these relationships using direct measurements of intravaginal phthalates exposures.
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Affiliation(s)
- Ruth J Geller
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Rebecca M Brotman
- Department of Epidemiology and Public Health, Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Katie M O'Brien
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - Derek M Fine
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ami R Zota
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
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9
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MacPherson S, Arbuckle TE, Fisher M. Adjusting urinary chemical biomarkers for hydration status during pregnancy. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2018; 28:481-493. [PMID: 29880833 PMCID: PMC8075920 DOI: 10.1038/s41370-018-0043-z] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 03/02/2018] [Accepted: 03/23/2018] [Indexed: 05/17/2023]
Abstract
One way of assessing a population's exposure to environmental chemicals is by measuring urinary biomarker concentrations, which can vary depending on the hydration status of the individual. The physiological changes that occur during pregnancy can impact the hydration adjustment approaches, such as calculating the individual's urinary flow rate (UFR), or adjusting concentrations using specific gravity (SG) or creatinine. A total of 1260 serial spot urine samples were collected from 80 women, averaging 32.4 years of age, throughout and shortly after pregnancy. The relationship between each approach was examined and time of day and across pregnancy differences were tested using linear mixed models. The correlation between the calculated excretion rate and each of the adjustment techniques was examined on a selection of seven phthalate metabolites. Based on the linear mixed model results, we found that UFR and creatinine excretion rates differed systematically across the population, with respect to body mass index (BMI) and time. SG differed with respect to BMI, but there were no systematic time trends. SG had the highest within-person reproducibility, according to the intraclass correlation coefficient (ICC). The excretion rate of each of the phthalates was most strongly correlated with the SG-standardized concentration. This analysis showed that SG showed a slightly better within-person reproducibility and the least amount of systematic variation when compared to creatinine adjustment. Therefore, SG correction appears to be a favorable approach for correcting for the hydration status of the pregnant women from this cohort.
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Affiliation(s)
- Susan MacPherson
- Population Studies Division, Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, ON, Canada.
| | - Tye E Arbuckle
- Population Studies Division, Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, ON, Canada
| | - Mandy Fisher
- Population Studies Division, Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, ON, Canada
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10
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Varshavsky JR, Morello-Frosch R, Woodruff TJ, Zota AR. Dietary sources of cumulative phthalates exposure among the U.S. general population in NHANES 2005-2014. ENVIRONMENT INTERNATIONAL 2018; 115:417-429. [PMID: 29605141 PMCID: PMC5970069 DOI: 10.1016/j.envint.2018.02.029] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 02/15/2018] [Accepted: 02/16/2018] [Indexed: 05/09/2023]
Abstract
BACKGROUND Anti-androgenic phthalates are reproductive toxicants that may have additive effects on male development. Diet is the primary exposure source for most phthalates, which contaminate the food supply through food contact materials and industrialized production. OBJECTIVE To compare dietary sources of cumulative phthalates exposure between "food at home" (e.g. food consumed from a grocery store) and "food away from home" (e.g. food consumed from fast food/restaurants and cafeterias) in the U.S. general population. METHODS We estimated cumulative phthalates exposure by calculating daily intake from metabolite concentrations in urinary spot samples for 10,253 participants (≥6 years old) using National Health and Nutrition Examination Survey (NHANES, 2005-2014) data. We constructed a biologically relevant metric of phthalates daily intake (∑androgen-disruptor, μg/kg/day) by converting phthalates into anti-androgen equivalent terms prior to their summation. Particular foods and the percent of total energy intake (TEI) consumed from multiple dining out sources were ascertained from 24-h recall surveys. Associations with ∑androgen-disruptor levels were estimated for children, adolescents, and adults using multivariable linear regression. RESULTS We observed a consistent positive association between dining out and Σandrogen-disruptor levels across the study population (p-trend <0.0001). Among adolescents, high consumers of foods outside the home had 55% (95% CI: 35%, 78%) higher Σandrogen-disruptor levels compared to those who only consumed food at home. The contribution of specific dining out sources to Σandrogen-disruptor levels varied by age group. For example, cafeteria food was associated with 15% (95% CI: 4.0%, 28%) and 64% (95% CI: 40%, 92%) higher Σandrogen-disruptor levels in children and adults, respectively. Particular foods, especially sandwiches (i.e. cheeseburgers), were associated with increased Σandrogen-disruptor levels only if they were purchased away from home (p < 0.01). CONCLUSION Dining out may be an important source of biologically relevant cumulative phthalates exposure among the U.S. POPULATION Future studies should evaluate modifiable production practices that remove phthalates from the food supply in addition to the efficacy of interventions that promote eating fresh foods prepared at home.
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Affiliation(s)
- Julia R Varshavsky
- University of California, Berkeley, School of Public Health, Berkeley, CA, USA; University of California, San Francisco, Program on Reproductive Health and the Environment, San Francisco, CA, USA.
| | - Rachel Morello-Frosch
- University of California, Berkeley, School of Public Health, Berkeley, CA, USA; University of California, Berkeley, Department of Environmental Science, Policy and Management, Berkeley, CA, USA
| | - Tracey J Woodruff
- University of California, San Francisco, Program on Reproductive Health and the Environment, San Francisco, CA, USA
| | - Ami R Zota
- Department of Environmental and Occupational Health, George Washington University Milken Institute School of Public Health, Washington, DC, USA.
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Campbell JL, Yoon M, Ward PL, Fromme H, Kessler W, Phillips MB, Anderson WA, Clewell HJ, Longnecker MP. Excretion of Di-2-ethylhexyl phthalate (DEHP) metabolites in urine is related to body mass index because of higher energy intake in the overweight and obese. ENVIRONMENT INTERNATIONAL 2018; 113:91-99. [PMID: 29421411 DOI: 10.1016/j.envint.2018.01.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 01/12/2018] [Accepted: 01/22/2018] [Indexed: 05/20/2023]
Abstract
A higher body mass index (BMI) has been positively associated with the rate of excretion of di-2-ethylhexyl phthalate (DEHP) metabolites in urine in data from the National Health and Nutrition Examination Survey (NHANES), suggesting an association between DEHP exposure and BMI. The association, however, may be due to the association between body mass maintenance and higher energy intake, with higher energy intake being accompanied by a higher intake of DEHP. To examine this hypothesis, we ran a Monte Carlo simulation with a DEHP physiologically-based pharmacokinetic (PBPK) model for adult humans. A realistic exposure sub-model was used, which included the relation of body weight to energy intake and of energy intake to DEHP intake. The model simulation output, when compared with urinary metabolite data from NHANES, supported good model validity. The distribution of BMI in the simulated population closely resembled that in the NHANES population. This indicated that the simulated subjects and DEHP exposure model were closely aligned with the NHANES population of interest. In the simulated population, the ordinary least squares regression coefficient for log(BMI) as a function of log(DEHP nmol/min) was 0.048 (SE 0.001), as compared with the reported value of 0.019 (SE 0.005). In other words, given our model structure, the higher energy intake in the overweight and obese, and the concomitant higher DEHP exposure, describes the reported relationship between BMI and DEHP.
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Affiliation(s)
| | - Miyoung Yoon
- ScitoVation, LLC, Research Triangle Park, NC 27709, USA
| | - Peyton L Ward
- Ramboll Environ, Research Triangle Park, NC 27709, USA
| | - Hermann Fromme
- Bavarian Health and Food Safety Authority, Munich, Germany
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12
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O'Brien KM, Upson K, Buckley JP. Lipid and Creatinine Adjustment to Evaluate Health Effects of Environmental Exposures. Curr Environ Health Rep 2018; 4:44-50. [PMID: 28097619 DOI: 10.1007/s40572-017-0122-7] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW Urine- and serum-based biomarkers are useful for assessing individuals' exposure to environmental factors. However, variations in urinary creatinine (a measure of dilution) or serum lipid levels, if not adequately corrected for, can directly impact biomarker concentrations and bias exposure-disease association measures. RECENT FINDINGS Recent methodological literature has considered the complex relationships between creatinine or serum lipid levels, exposure biomarkers, outcomes, and other potentially relevant factors using directed acyclic graphs and simulation studies. The optimal measures of urinary dilution and serum lipids have also been investigated. Existing evidence supports the use of covariate-adjusted standardization plus creatinine adjustment for urinary biomarkers and standardization plus serum lipid adjustment for lipophilic, serum-based biomarkers. It is unclear which urinary dilution measure is best, but all serum lipid measures performed similarly. Future research should assess methods for pooled biomarkers and for studying diseases and exposures that affect creatinine or serum lipids directly.
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Affiliation(s)
- Katie M O'Brien
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, 111 TW Alexander Dr, Research Triangle Park, Durham, NC, 27709, USA.
| | - Kristen Upson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 TW Alexander Dr, Research Triangle Park, Durham, NC, 27709, USA
| | - Jessie P Buckley
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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13
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Bulka CM, Mabila SL, Lash JP, Turyk ME, Argos M. Arsenic and Obesity: A Comparison of Urine Dilution Adjustment Methods. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:087020. [PMID: 28858828 PMCID: PMC5783631 DOI: 10.1289/ehp1202] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 03/21/2017] [Accepted: 03/30/2017] [Indexed: 05/18/2023]
Abstract
INTRODUCTION A commonly used approach to adjust for urine dilution in analyses of biomarkers is to adjust for urinary creatinine. However, creatinine is a product of muscle mass and is therefore associated with body mass. In studies of urinary analytes and obesity or obesity-related outcomes, controlling for creatinine could induce collider stratification bias. We illustrate this phenomenon with an analysis of urinary arsenic. OBJECTIVE We aimed to evaluate various approaches of adjustment for urinary dilution on the associations between urinary arsenic concentration and measures of obesity. METHODS Using data from the National Health and Nutrition Examination Survey, we regressed body mass index (BMI) and waist-to-height ratios on urinary arsenic concentrations. We compared eight approaches to account for urine dilution, including standardization by urinary creatinine, osmolality, and flow rates, and inclusion of these metrics as independent covariates. We also used a recently proposed method known as covariate-adjusted standardization. RESULTS Inverse associations between urinary arsenic concentration with BMI and waist-to-height ratio were observed when either creatinine or osmolality were used to standardize or as covariates. Not adjusting for dilution, standardizing or adjusting for urinary flow rate, and using covariate-adjusted standardization resulted in null associations observed between arsenic concentration in relation to BMI and waist-to-height ratio. CONCLUSIONS Our findings suggest that arsenic exposure is not associated with obesity, and that urinary creatinine and osmolality may be colliders on the causal pathway from arsenic exposure to obesity, as common descendants of hydration and body composition. In studies of urinary biomarkers and obesity or obesity-related outcomes, alternative metrics such as urinary flow rate or analytic strategies such as covariate-adjusted standardization should be considered. https://doi.org/10.1289/EHP1202.
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Affiliation(s)
- Catherine M Bulka
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago , Chicago, Illinois, USA
- Institute for Minority Health Research, Section of General Internal Medicine, Department of Medicine, University of Illinois at Chicago , Chicago, Illinois, USA
| | - Sithembile L Mabila
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois at Chicago , Chicago, Illinois, USA
| | - James P Lash
- Division of Nephrology, Department of Medicine, University of Illinois at Chicago , Chicago, Illinois, USA
| | - Mary E Turyk
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago , Chicago, Illinois, USA
| | - Maria Argos
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago , Chicago, Illinois, USA
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14
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Chang WH, Wu MH, Pan HA, Guo PL, Lee CC. Semen quality and insulin-like factor 3: Associations with urinary and seminal levels of phthalate metabolites in adult males. CHEMOSPHERE 2017; 173:594-602. [PMID: 28152410 DOI: 10.1016/j.chemosphere.2017.01.056] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 12/15/2016] [Accepted: 01/11/2017] [Indexed: 05/24/2023]
Abstract
Certain phthalates have adverse effects on male reproductive functions in animals, and potentially affect human testicular function and spermatogenesis, but little is known about the active mechanisms. We measured the urinary and seminal phthalate metabolites and explored their associations on insulin-like factor 3 (INSL3) and semen quality. Urine, blood, and semen samples were collected from the male partners of subfertile (n = 253) and fertile (n = 37) couples in a reproductive center in southern Taiwan. INSL3, reproductive hormones, semen-quality, and 11 phthalate metabolites in urine and semen were measured. There were significant correlations in the distribution pattern of metabolites, such as the relative contribution of low or high molecular weight phthalate metabolites. The significantly monotonic trends in semen volume, sperm concentration and motility were associated with increasing quartiles of INSL3 (all p-trend < 0.001). In adjusted regression models, increases in urinary phthalate metabolites levels were adversely associated with sperm concentration (monobenzyl phthalate [MBzP], mono-2-ethylhexyl phthalate [MEHP] and MEHP%), motility (MBzP and MEHP) and INSL3 (MBzP, MEHP and MEHP%) (all p < 0.01). Higher seminal phthalate metabolite levels were associated with decreases in sperm concentration (MEHP and mono-2-ethyl-5-hydroxyhexyl phthalate), motility (mono-ethyl phthalate [MEP] and di-(2-ethylhexyl) phthalate [DEHP] metabolites), normal morphology (MEP), and INSL3 (monomethyl phthalate and MEP) (all p < 0.05). Our data suggest that INSL3 secretion, reproductive hormone balance, and sperm production and quality might be simultaneously adversely affected for individuals excreting increasing levels of phthalates metabolites (especially di-ethyl phthalate, butylbenzyl phthalate, and DEHP) in urine and semen samples.
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Affiliation(s)
- Wei-Hsiang Chang
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan 70403, Taiwan.
| | - Meng-Hsing Wu
- Department of Obstetrics and Gynecology, Hospital of National Cheng Kung University, 138 Sheng-Li Road, Tainan 70403, Taiwan.
| | - Hsien-An Pan
- An-An Women and Children Clinic, 286 Kaiyuan Road, Tainan 70403, Taiwan.
| | - Pao-Lin Guo
- Department of Obstetrics and Gynecology, Hospital of National Cheng Kung University, 138 Sheng-Li Road, Tainan 70403, Taiwan.
| | - Ching-Chang Lee
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan 70403, Taiwan; Research Center of Environmental Trace Toxic Substance, National Cheng Kung University, 138 Sheng-Li Road, Tainan 70403, Taiwan.
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15
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Within-subject Pooling of Biological Samples to Reduce Exposure Misclassification in Biomarker-based Studies. Epidemiology 2017; 27:378-88. [PMID: 27035688 PMCID: PMC4820663 DOI: 10.1097/ede.0000000000000460] [Citation(s) in RCA: 178] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Supplemental Digital Content is available in the text. For chemicals with high within-subject temporal variability, assessing exposure biomarkers in a spot biospecimen poorly estimates average levels over long periods. The objective is to characterize the ability of within-subject pooling of biospecimens to reduce bias due to exposure misclassification when within-subject variability in biomarker concentrations is high.
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16
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Varshavsky JR, Zota AR, Woodruff TJ. A Novel Method for Calculating Potency-Weighted Cumulative Phthalates Exposure with Implications for Identifying Racial/Ethnic Disparities among U.S. Reproductive-Aged Women in NHANES 2001-2012. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2016; 50:10616-10624. [PMID: 27579903 PMCID: PMC5748889 DOI: 10.1021/acs.est.6b00522] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Phthalates are ubiquitous chemicals linked to hormonal disruptions that affect reproduction and development. Multiple antiandrogenic phthalates exposure during fetal development can have greater impacts than individual exposure; thus, the National Academy of Sciences (NAS) recommends them for cumulative assessment. Using National Health and Nutrition Examination Survey data (NHANES, 2001-2012), we developed a potency-weighted sum of daily intake (∑androgen-disruptor; μg/kg/day) of di-n-butyl phthalate (DnBP), diisobutyl phthalate (DiBP), butyl benzyl phthalate (BBzP), and di(2-ethylhexyl) phthalate (DEHP) based on NAS recommendations, and included diethyl phthalate (DEP) and diisononyl phthalate (DiNP) in additional metrics (2005-2012). We compared racial/ethnic differences in ∑androgen-disruptor among 2842 reproductive-aged women. In sensitivity analyses, we assessed the influence of potency assumptions, alternate urine dilution adjustment methods, and weighting phthalate metabolites directly rather than daily intake estimates of parent compounds. We found that DEHP contributed most to ∑androgen-disruptor (48-64%), and that ∑androgen-disruptor decreased over time. Black women generally had higher cumulative exposures than white women, although the magnitude and precision of the difference varied by model specification. Our approach provides a blueprint for combining chemical exposures linked to common adverse outcomes, and should be considered in future exposure, risk, and epidemiological studies.
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Affiliation(s)
- Julia R. Varshavsky
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California 94720, United States
| | - Ami R. Zota
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, D.C. 20052, United States
| | - Tracey J. Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California 94143, United States
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Weaver VM, Kotchmar DJ, Fadrowski JJ, Silbergeld EK. Challenges for environmental epidemiology research: are biomarker concentrations altered by kidney function or urine concentration adjustment? JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2016; 26:1-8. [PMID: 25736163 DOI: 10.1038/jes.2015.8] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Revised: 01/07/2015] [Accepted: 01/07/2015] [Indexed: 05/28/2023]
Abstract
Biomonitoring has become a standard approach for exposure assessment in occupational and environmental epidemiology. The use of biological effect markers to identify early adverse changes in target organs has also become widely adopted. However, the potential for kidney function to affect biomarker levels in the body and the optimal approach to adjustment of biomarker concentrations in spot urine samples for hydration status are two important but underappreciated challenges associated with biomarker use. Several unexpected findings, such as positive associations between urine nephrotoxicant levels and estimated glomerular filtration rate (eGFR), have been reported recently in research using biomarkers. These and other findings, discussed herein, suggest an impact of kidney glomerular filtration or tubule processing on biomarker levels. This is more commonly raised in the context of decreased kidney filtration, traditionally referred to as reverse causality; however, recent data suggest that populations with normal kidney filtration may be affected as well. Misclassification bias would result if biomarkers reflect kidney function as well as either exposures or early biological effect outcomes. Furthermore, urine biomarker associations with eGFR that differ markedly by approach used to adjust for urine concentration have been reported. Associations between urine measures commonly used for this adjustment, such as urine creatinine, and specific research outcomes could alter observed biomarker associations with outcomes. Research recommendations to address the potential impact of kidney function and hydration status adjustment on biomarkers are provided, including a range of approaches to study design, exposure and outcome assessment, and adjustment for urine concentration.
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Affiliation(s)
- Virginia M Weaver
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
| | - Dennis J Kotchmar
- National Center for Environmental Assessment, United States Environmental Protection Agency, Research Triangle Park, North Carolina, USA
| | - Jeffrey J Fadrowski
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Ellen K Silbergeld
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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18
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Johns LE, Cooper GS, Galizia A, Meeker JD. Exposure assessment issues in epidemiology studies of phthalates. ENVIRONMENT INTERNATIONAL 2015; 85:27-39. [PMID: 26313703 PMCID: PMC4648682 DOI: 10.1016/j.envint.2015.08.005] [Citation(s) in RCA: 263] [Impact Index Per Article: 29.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 08/04/2015] [Accepted: 08/07/2015] [Indexed: 05/09/2023]
Abstract
PURPOSE The purpose of this paper is to review exposure assessment issues that need to be addressed in designing and interpreting epidemiology studies of phthalates, a class of chemicals commonly used in consumer and personal care products. Specific issues include population trends in exposure, temporal reliability of a urinary metabolite measurement, and how well a single urine sample may represent longer-term exposure. The focus of this review is on seven specific phthalates: diethyl phthalate (DEP); di-n-butyl phthalate (DBP); diisobutyl phthalate (DiBP); butyl benzyl phthalate (BBzP); di(2-ethylhexyl) phthalate (DEHP); diisononyl phthalate (DiNP); and diisodecyl phthalate (DiDP). METHODS Comprehensive literature search using multiple search strategies. RESULTS Since 2001, declines in population exposure to DEP, BBzP, DBP, and DEHP have been reported in the United States and Germany, but DEHP exposure has increased in China. Although the half-lives of various phthalate metabolites are relatively short (3 to 18h), the intraclass correlation coefficients (ICCs) for phthalate metabolites, based on spot and first morning urine samples collected over a week to several months, range from weak to moderate, with a tendency toward higher ICCs (greater temporal stability) for metabolites of the shorter-chained (DEP, DBP, DiBP and BBzP, ICCs generally 0.3 to 0.6) compared with those of the longer-chained (DEHP, DiNP, DiDP, ICCs generally 0.1 to 0.3) phthalates. Additional research on optimal approaches to addressing the issue of urine dilution in studies of associations between biomarkers and different type of health effects is needed. CONCLUSIONS In conclusion, the measurement of urinary metabolite concentrations in urine could serve as a valuable approach to estimating exposure to phthalates in environmental epidemiology studies. Careful consideration of the strengths and limitations of this approach when interpreting study results is required.
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Affiliation(s)
- Lauren E Johns
- Department of Environmental Health Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48103, USA.
| | - Glinda S Cooper
- National Center for Environmental Assessment, Office of Research and Development, United States Environmental Protection Agency, 1200 Pennsylvania Avenue NW, Washington DC 20460, USA.
| | - Audrey Galizia
- National Center for Environmental Assessment, Office of Research and Development, United States Environmental Protection Agency, 2890 Woodbridge Avenue, Edison, NJ 08837, USA.
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48103, USA.
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LaKind JS, Naiman DQ. Temporal trends in bisphenol A exposure in the United States from 2003-2012 and factors associated with BPA exposure: Spot samples and urine dilution complicate data interpretation. ENVIRONMENTAL RESEARCH 2015; 142:84-95. [PMID: 26121292 DOI: 10.1016/j.envres.2015.06.013] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 05/18/2015] [Accepted: 06/09/2015] [Indexed: 05/23/2023]
Abstract
Nationally representative data on urinary levels of BPA and its metabolites in the United States from the 2003-2004 to 2011-2012 National Health and Nutrition Examination Surveys (NHANES) were used to estimate daily BPA intakes and examine temporal trends. Additionally, NHANES data on lifestyle/demographic/dietary factors previously reported to be associated with BPA exposures were examined to assess the resiliency of the reported associations (whether the association is maintained across the five surveys). Finally, various approaches for addressing issues with the use of BPA concentration data from spot urine samples were examined for their effect on trends and associations. Three approaches were assessed here: (i) use of generic literature-based 24-h urine excretion volumes, (ii) use of creatinine adjustments, and (iii) use of individual urine flow rate data from NHANES. Based on 2011-2012 NHANES urinary BPA data and assumptions described in this paper, the median daily intake for the overall population is approximately 25 ng/kg day; median intake estimates were approximately two to three orders of magnitude below current health-based guidance values. Estimates of daily BPA intake have decreased significantly compared to those from the 2003-2004 NHANES. Estimates of associations between lifestyle/demographic/dietary factors and BPA exposure revealed inconsistencies related to both NHANES survey year and the three approaches listed above; these results demonstrate the difficulties in interpreting urinary BPA data, despite efforts to account for urine dilution and translation of spot sample data to 24-h data. The results further underscore the importance of continued research on how to best utilize urinary measures of environmental chemicals in exposure research. Until a consensus is achieved regarding the best biomonitoring approaches for assessing exposures to short-lived chemicals using urine samples, research on factors associated with BPA exposures should include - and report results from - assessments using both volume-based urinary BPA and creatinine-adjusted urinary BPA data.
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Affiliation(s)
- Judy S LaKind
- LaKind Associates, LLC, 106 Oakdale Avenue, Catonsville, MD 21228, USA; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD 21201, USA; Department of Pediatrics, Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA 17033, USA.
| | - Daniel Q Naiman
- Department of Applied Mathematics and Statistics, The Johns Hopkins University, 3200 N. Charles Street, Baltimore, MD 21228, USA.
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Sobus JR, DeWoskin RS, Tan YM, Pleil JD, Phillips MB, George BJ, Christensen K, Schreinemachers DM, Williams MA, Hubal EAC, Edwards SW. Uses of NHANES Biomarker Data for Chemical Risk Assessment: Trends, Challenges, and Opportunities. ENVIRONMENTAL HEALTH PERSPECTIVES 2015; 123:919-27. [PMID: 25859901 PMCID: PMC4590763 DOI: 10.1289/ehp.1409177] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 04/01/2015] [Indexed: 05/18/2023]
Abstract
BACKGROUND Each year, the U.S. NHANES measures hundreds of chemical biomarkers in samples from thousands of study participants. These biomarker measurements are used to establish population reference ranges, track exposure trends, identify population subsets with elevated exposures, and prioritize research needs. There is now interest in further utilizing the NHANES data to inform chemical risk assessments. OBJECTIVES This article highlights a) the extent to which U.S. NHANES chemical biomarker data have been evaluated, b) groups of chemicals that have been studied, c) data analysis approaches and challenges, and d) opportunities for using these data to inform risk assessments. METHODS A literature search (1999-2013) was performed to identify publications in which U.S. NHANES data were reported. Manual curation identified only the subset of publications that clearly utilized chemical biomarker data. This subset was evaluated for chemical groupings, data analysis approaches, and overall trends. RESULTS A small percentage of the sampled NHANES-related publications reported on chemical biomarkers (8% yearly average). Of 11 chemical groups, metals/metalloids were most frequently evaluated (49%), followed by pesticides (9%) and environmental phenols (7%). Studies of multiple chemical groups were also common (8%). Publications linking chemical biomarkers to health metrics have increased dramatically in recent years. New studies are addressing challenges related to NHANES data interpretation in health risk contexts. CONCLUSIONS This article demonstrates growing use of NHANES chemical biomarker data in studies that can impact risk assessments. Best practices for analysis and interpretation must be defined and adopted to allow the full potential of NHANES to be realized.
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Affiliation(s)
- Jon R Sobus
- National Exposure Research Laboratory, U.S. Environmental Protection Agency (EPA), Research Triangle Park, North Carolina, USA
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Weidemann D, Kuo CC, Navas-Acien A, Abraham AG, Weaver V, Fadrowski J. Association of arsenic with kidney function in adolescents and young adults: Results from the National Health and Nutrition Examination Survey 2009-2012. ENVIRONMENTAL RESEARCH 2015; 140:317-24. [PMID: 25909687 PMCID: PMC4492804 DOI: 10.1016/j.envres.2015.03.030] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 03/25/2015] [Accepted: 03/26/2015] [Indexed: 05/25/2023]
Abstract
BACKGROUND Long-term exposure to arsenic is a major public health concern. Emerging evidence suggests adverse health effects even at low levels of exposure. This study examined the association of arsenic exposure with estimated glomerular filtration rate (eGFR) and compared methods of adjustment for urinary dilution in a representative sample of U.S. adolescents and young adults. METHODS We performed a cross-sectional study of 1253 participants ages 12-30 years in the 2009-2012 National Health and Nutrition Examination Survey (NHANES) with available urinary arsenic and eGFR measures. Multivariable linear regression was used to model the association of urinary total arsenic and dimethylarsinate (DMA) with eGFR. RESULTS The median urinary total arsenic and DMA concentrations were 6.3 μg/L (IQR 3.3-12.7 μg/L) and 3.3 μg/L (IQR 1.7-5.7 μg/L), respectively. Median eGFR was 109 mL/min/1.73 m(2). Adjusting arsenic for urine concentration with urinary creatinine, eGFR was 4.0 mL/min/1.73 m(2) higher (95% confidence interval [CI] 1.0-7.1 mL/min/1.73 m(2)) and 4.3mL/min/1.73 m(2) higher (95% CI 0.5-8.0 mL/min/1.73 m(2)) per log-unit increase in total arsenic and DMA, respectively. When using urine osmolality to adjust for urine concentration, a log-unit increase in total arsenic and DMA was associated with a 0.4 mL/min/1.73 m(2) (95% CI -1.8 to 1.1 mL/min/1.73 m(2)) and 0.01 (95% CI -1.9 to 1.9 mL/min/1.73 m(2)) lower eGFR, respectively. CONCLUSIONS Discordant associations were observed between arsenic and eGFR levels depending on whether urinary creatinine or osmolality was used to adjust for urine concentration. Further study should be dedicated to validating the best approach to account for urinary dilution in research in toxicants, and this may have implications for all studies which examine urinary biomarkers.
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Affiliation(s)
- Darcy Weidemann
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Division of Nephrology, Department of Pediatrics, Johns Hopkins Medical Institutions, Baltimore, MD, USA; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
| | - Chin-Chi Kuo
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA; Division of Nephrology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Ana Navas-Acien
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Alison G Abraham
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Virginia Weaver
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Jeffrey Fadrowski
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Division of Nephrology, Department of Pediatrics, Johns Hopkins Medical Institutions, Baltimore, MD, USA; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA
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Barrett JR. Urinary biomarkers as exposure surrogates: controlling for possible bias. ENVIRONMENTAL HEALTH PERSPECTIVES 2015; 123:A97. [PMID: 25830894 PMCID: PMC4384196 DOI: 10.1289/ehp.123-a97] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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