Urinary concentrations of phthalate metabolites associated with changes in clinical hemostatic and hematologic parameters in pregnant women

Associations of exposure to disinfection by-products with blood coagulation parameters among women: Results from the Tongji reproductive and environmental (TREE) study

BACKGROUND

Experimental studies have shown that disinfection byproducts (DBPs) induce coagulotoxicity, but human evidence is scarce.

OBJECTIVE

This study aimed to explore the relationships of DBP exposures with blood coagulation parameters.

METHODS

Among 858 women from the Tongji Reproductive and Environmental (TREE) study, urinary dichloroacetic acid (DCAA) and trichloroacetic acid (TCAA) were detected as internal biomarkers of DBP exposures. We measured activated partial thromboplastin time (APTT), fibrinogen (Fbg), international normalized ratio (INR), prothrombin time (PT), and thrombin time (TT) as blood coagulation parameters. Multivariable linear regression models were utilized to estimate the relationships between urinary DCAA and TCAA and blood coagulation parameters. The effect modifications by demographic and lifestyle characteristics were further explored.

RESULTS

Elevated tertiles of urinary DCAA concentrations were associated with increased PT and INR (11.29%, 95% CI: 1.66%, 20.92% and 0.99%, 95% CI: 0.08%, 1.90% for the third vs. first tertile, respectively; both P for trends < 0.05). Stratification analysis showed that the positive associations were only observed among younger (< 30 years), leaner (body mass index < 24.0 kg/m2), and non-passive smoking women. Moreover, elevated tertiles of urinary TCAA concentrations in positive associations with PT and INR were observed among younger women (17.89%, 95% CI: 2.50%, 33.29% and 1.82%, 95% CI: 0.34%, 3.30% for the third vs. first tertile, respectively; both P for trends < 0.05) but not among older women (both P for interactions < 0.05).

CONCLUSION

Higher levels of urinary DCAA and TCAA are associated with prolonged clotting time among women.

Exposure to phthalates and their alternatives in relation to biomarkers of inflammation and oxidative stress in adults: evidence from NHANES 2017-2018

Phthalates and their alternatives are considered significant environmental risk factors that potentially influence inflammation and oxidative stress. However, their impact on biomarkers of inflammation and oxidative stress was inconsistent. This study aimed to explore the associations between phthalates and high-sensitivity C-reactive protein (hsCRP), gamma-glutamyl transferase (GGT), and white blood cell (WBC) counts, employing both univariate exposure and multivariate co-exposure models. For this analysis, a total of 1619 individuals aged 18 years and above, sourced from the National Health and Nutrition Examination Survey (NHANES) conducted between 2017 and 2018, were selected as subjects. We explored the associations between hsCRP, GGT, and WBC counts and eighteen different phthalate metabolites. Multiple linear regression analysis revealed significant associations between both MCNP and MEHP and hsCRP. We observed negative correlations of MCOP, MCPP, MHBP, and MONP with GGT. Conversely, MEHHP and MEHHTP exhibited positive correlations with GGT. Furthermore, MECPTP and MEHHTP showed positive correlations with WBC. Notably, we identified a non-linear relationship between phthalates and inflammation and oxidative stress markers. The Bayesian kernel machine regression (BKMR) analysis demonstrated a negative joint effect of the phthalates mixture on GGT, particularly at lower concentrations. The BKMR model also found that MEOHP and MHiBP were negatively associated with GGT. In contrast, MEHHP showed a significant positive association with GGT. Moderating effect analysis suggested that dietary inflammatory index (DII), income-to-poverty ratio (PIR), age, BMI, and physical activity influenced the association between phthalates and inflammation and oxidative stress. These findings contribute to a deeper understanding of the relationships between phthalates and inflammation and oxidative stress.

Co-Exposure of Polycyclic Aromatic Hydrocarbons and Phthalates with Blood Cell-Based Inflammation in Early Pregnant Women

Cumulative evidence has demonstrated that exposure to polycyclic aromatic hydrocarbons (PAHs) or phthalates (PAEs) contributes to a variety of adverse health effects. However, the association of PAHs and PAEs co-exposure with blood cell-based inflammatory indicators during early pregnancy is still unclear. We aimed to investigate the single and mixed associations of exposure to PAHs and PAEs with blood cell-based inflammatory indicators among early pregnant women. A total of 318 early pregnant women were included in this study. General linear regressions were used to estimate the relationships of individual OH-PAHs and mPAEs with blood cell-based inflammatory indicators. The key pollutants were selected by an adapted least absolute shrinkage and selection operator (LASSO) penalized regression model and wasemployed to build the Bayesian kernel machine regression (BKMR) and quantile g-computation (Q-g) models, which can assess the joint association of OH-PAHs and mPAEs with blood cell-based inflammatory indicators. General linear regression indicated that each 1% increase in MOP was associated with a 4.92% (95% CI: 2.12%, 7.68%), 3.25% (95% CI: 0.50%, 6.18%), 5.87% (95% CI: 2.22%, 9.64%), and 6.50% (95% CI: 3.46%, 9.64%) increase in WBC, lymphocytes, neutrophils, and monocytes, respectively. BKMR and Q-g analysis showed that the mixture of OH-PAHs and mPAEs was linked with increased levels of white blood cells (WBC), neutrophils, monocytes, and lymphocytes, and MOP was identified as the dominant contributor. OH-PAHs and mPAEs co-exposure in early pregnancy was associated with elevated blood cell-based inflammatory indicators reactions. More attention should be paid to the inflammation induced by environmental pollution for perinatal women, especially early pregnant women.

Effects of the in-utero dicyclohexyl phthalate and di-n-hexyl phthalate administration on the oxidative stress-induced histopathological changes in the rat liver tissue correlated with serum biochemistry and hematological parameters

Phthalates are widely used as plasticizers in the industry and are found in cosmetics, food and drink packaging, drugs, toys, households, medical devices, pesticides, personal care products, and paints. Phthalates exert endocrine disrupting and peroxisome proliferator effects in humans and wildlife associated with the pathogenesis of various diseases, including diabetes, obesity, infertility, cardiovascular diseases, metabolic syndrome, and cancer. Since phthalates are metabolized in the liver, which regulates the body's energy metabolism, long or short-term exposure to the phthalates is associated with impaired glucose, lipid, and oxidative stress metabolisms contributing to liver toxicity. However, the impact of in-utero exposure to DHP and DCHP on liver metabolism has not been studied previously. Thus, in this study, we evaluated serum biochemistry parameters, hematological markers, histopathological changes, and oxidative and pentose phosphate pathway (PPP) metabolisms in the liver following in-utero DHP and DCHP administration, respectively, in male and female rats. We found increased relative and absolute liver weights and impaired triglyceride, alanine transaminase (ALT), lactate dehydrogenase (LDH), and alkaline phosphatase (ALP) levels upon dicyclohexyl phthalate (DCHP) and di-n-hexyl phthalate (DHP). Histopathological changes, including congestion, sinusoidal dilatation, inflammatory cell infiltration, cells with a pyknotic nucleus, lysis of hepatocytes, and degeneration of hepatic parenchyma have been observed in the liver samples of DHP and DCHP dose groups. Moreover, increased glutathione s-transferase (GST), glucose 6-phosphate dehydrogenase (G6PD), and glutathione reductase (GR) activities have been found in the liver samples of DHP and DCHP-treated rats associated with impaired pentose phosphate pathway (PPP) and oxidative stress metabolism. First time in the literature, we showed that in-utero exposure to DHP and DCHP causes liver damage associated with impaired oxidative stress metabolism in male and female rats. Our data may guide researchers and governments to regulate and restrict phthalates in industrial products.

Risk Assessment of Phthalate Esters in Baiyangdian Lake and Typical Rivers in China

Phthalate esters (PAEs) are frequently tracked in water environments worldwide. As a typical class of endocrine disruptor chemicals (EDCs), PAEs posed adverse effects on aquatic organisms at low concentration. Thus, they have attracted wide attention in recent years. In the present study, the concentrations of seven typical PAEs from 30 sampling sites in Baiyangdian Lake were measured, and the environmental exposure data of PAEs were gathered in typical rivers in China. Then, based on the aquatic life criteria (ALCs) derived from the reproductive toxicity data of aquatic organisms, two risk assessment methods, including hazard quotient (HQ) and probabilistic ecological risk assessment (PERA), were adopted to evaluate the ecological risks of PAEs in water. The sediment quality criteria (SQCs) of DEHP, DBP, BBP, DIBP and DEP were deduced based on the equilibrium partitioning method. Combined with the gathered environmental exposure data of seven PAEs in sediments from typical rivers in China, the ecological risk assessments of five PAEs in sediment were conducted only by the HQ method. The results of ecological risk assessment showed that in terms of water, DBP and DIBP posed low risk, while the risk of DEHP in Baiyangdian Lake cannot be ignored and should receive attention. In typical rivers in China, BBP and DEP posed no risk, while DIBP and DBP posed potential risk. Meanwhile, DEHP posed a high ecological risk. As far as sediment is concerned, DBP posed a high risk in some typical rivers in China, and the other rivers had medium risk. DEHP posed a high risk only in a few rivers and low to medium risk in others. This study provides an important reference for the protection of aquatic organisms and the risk management of PAEs in China.

Association of exposure to per- and polyfluoroalkyl substances with hemoglobin and hematocrit during pregnancy

BACKGROUND

Per- and polyfluoroalkyl substances (PFASs) are common environmental contaminants and are widely detected in humans. Previous studies have linked PFASs exposure to adverse birth outcomes. However, the association between maternal exposure to PFASs and hemoglobin (Hb) and hematocrit (HCT) remains unclear.

OBJECTIVES

We aimed to explore the relationship between PFASs exposure with Hb and HCT during pregnancy.

METHODS

The present birth cohort study included 1044 pregnant women from Wuhan, China. Maternal HCT and Hb were measured in the first, second and third trimesters, and 13 PFASs were detected in the cord sera. Mixed linear models and general linear regression were applied to analyze the association between each single PFASs and Hb and HCT. Weighted quantile sum (WQS) regressions were used to investigate the association between PFASs mixture and Hb and HCT during pregnancy.

RESULTS

In single-PFAS models, 10 PFASs were positively associated with HCT and Hb across pregnancy (a 10-fold increase in PFASs was associated with 1.47-3.54 % change in HCT and 1.46-3.20 % change in Hb (All P-FDR < 0.05). In addition, Hb and HCT were more positively related to PFASs in the second and third trimesters rather than the first trimester. The association between PFASs exposure and maternal HCT and Hb was not significant in the iron supplementation group, whereas significant in the non-iron supplementation group. A significant interaction between iron supplementation and non-iron supplementation was also detected. WQS regressions showed that perfluorononanoic acid (PFNA) and perfluorohexane sulfonate (PFHxS) contributed most to the association between PFASs and HCT and Hb in the second and third trimesters, respectively.

CONCLUSION

Maternal PFASs exposure was positive with serum Hb and HCT. Moreover, maternal iron supplementation may play a modifying effect in influencing the relationship between PFASs and HCT and Hb.

Urinary phthalate metabolites and anemia: Findings from the Korean National Environmental Health Survey (2015-2017)

BACKGROUND

Several animal studies have suggested an association between phthalate exposure and decreased hemoglobin levels. To address the lack of epidemiological evidence, we evaluated the association between urinary phthalate metabolite concentrations and hematologic indices by using nationally representative data from Korea.

METHODS

Data from 3722 adults included in the third stage (2015-2017) of the Korean National Environmental Health Survey (KONEHS) were used. The association between various urinary phthalate metabolites and hematologic indices (hemoglobin, hematocrit, mean corpuscular volume [MCV], and red blood cell [RBC], white blood cell [WBC], and platelet counts) was evaluated using linear regression analysis adjusted for potential confounders. Sex-stratified analysis was performed.

RESULTS

All urinary phthalate metabolites were negatively associated with hemoglobin levels. A two-fold increase in urinary mono-(2-ethyl-5-carboxy-pentyl) phthalate (MECPP), mono-carboxyoctyl phthalate (MCOP), mono-carboxyonyl phthalate (MCNP), and mono-(3-carboxypropyl) phthalate (MCPP) levels was associated with a -0.099 g/dL (95% confidence interval (CI), -0.137 to -0.060), -0.116 g/dL (95% CI, -0.156 to -0.076), -0.111 g/dL (95% CI, -0.154 to -0.068), and -0.144 g/dL (95% CI, -0.198 to -0.089) change in hemoglobin levels, respectively. The RBC count and MCV showed negative and positive associations, respectively, with urinary phthalate metabolite concentrations. WBC counts were positively associated with MECPP, MCOP, MCNP, and MCPP levels, whereas the platelet count showed no association with urinary phthalate metabolites.

CONCLUSIONS

Urinary phthalate metabolite concentration showed a negative association with hemoglobin level. Since this was a cross-sectional study, further longitudinal and experimental studies are needed to identify a clear causal linkage and the pathological mechanism underlying phthalate exposure and anemia.

Cumulative risk assessment of dietary exposure to phthalates in pregnant women in Beijing, China

Diet is an important exposure route for phthalates, such as di-iso-butyl phthalate (DiBP), dibutyl phthalate (DBP), bis(2-ethylhexyl) phthalate (DEHP), and benzyl butyl phthalate (BBP). In this study, we aimed to estimate phthalate exposure in the diet of pregnant women and assess the health risk. A total of 517 pregnant women in the first trimester were recruited, and food frequency questionnaires were collected. A simple distribution assessment method was used to estimate daily exposure, and the hazard index (HI) method was used to assess cumulative risk. The maximum daily dietary exposure to DEHP, DBP, DiBP, and BBP was 5.25, 3.17, 2.59, and 0.58 μg/kg bw/day, respectively, and did not exceed the safety limit values. Cereals and vegetables were the main sources of the estimated daily intake (EDI) of phthalates in the diet. The cumulative risk assessment, based on the European Food Safety Authority tolerable daily intake (TDI) and the US Environmental Protection Agency reference dose (RfD), did not exceed the threshold of 1. DiBP, DBP, and DEHP had higher hazard quotient (HQ) values for cumulative health risk than BBP. In conclusion, a low health risk was posed by the cumulative dietary exposure to phthalates for pregnant women in Beijing.

Lipophilic phthalic acid esters impair human sperm acrosomal reaction through the likely inhibition of phospholipase A2-signaling pathway

Phthalic acid esters (PAEs) are recognized endocrine disruptors. Detection of PAEs in semen from idiopathic infertile males suggests possible direct mechanisms of sperm toxicity. In this study we aimed to correlate sperm function with semen levels of PAEs. Semen samples were obtained from 100 male patients attending the Unit of Andrology and Reproductive Medicine, University Hospital of Padova, (Italy), 22 of which having a recognized history of idiopathic infertility. Compared to fertile subjects, infertile patients showed reduced levels of acrosome reaction (AR), evaluated by CD46 staining upon progesterone (P4) triggering (p < 0.001). Subjects showing positive detection of PAEs in semen, evaluated by liquid chromatography-mass spectrometry (LC-MS), were significantly more represented in those reporting an history of infertility (13 out of 22), compared to fertile subjects (25 out of 78, P = 0.0266). In vitro sperm exposure to PAEs showed that lipophilic PAE representative Di-n-octyl phthalate (DNOP) had higher cell accumulation and inhibition of P4-induced AR than less lipophilic PAE representative Dibutyl phthalate (DBP). Computer-based binding analysis and fluorimetric inhibition assay, showed that both DNOP and DBP had similar Phospholipase-A2 (PLA₂) inhibitory activity (respectively: 3.98 nM and 5.52 nM). However, only DNOP showed a significant inhibition of PLA₂-mediated AR, triggered by A23187 calcium ionophore. Incubation with PLA₂-related product arachidonic acid restored AR. Our data are suggestive of a novel mechanistic model of PAEs interference on sperm function, through the inhibition of PLA₂-mediated signaling. According to this hypothesis, the inhibitory efficacy of the specific PAE is possibly linked to the corresponding cell accumulation.

E-Waste in Africa: A Serious Threat to the Health of Children

Waste electronic and electrical equipment (e-waste) consists of used and discarded electrical and electronic items ranging from refrigerators to cell phones and printed circuit boards. It is frequently moved from developed countries to developing countries where it is dismantled for valuable metals in informal settings, resulting in significant human exposure to toxic substances. E-waste is a major concern in Africa, with large sites in Ghana and Nigeria where imported e-waste is dismantled under unsafe conditions. However, as in many developing countries, used electronic and electrical devices are imported in large quantities because they are in great demand and are less expensive than new ones. Many of these used products are irreparable and are discarded with other solid waste to local landfills. These items are then often scavenged for the purpose of extracting valuable metals by heating and burning, incubating in acids and other methods. These activities pose significant health risks to workers and residents in communities near recycling sites. E-waste burning and dismantling activities are frequently undertaken at e-waste sites, often in or near homes. As a result, children and people living in the surrounding areas are exposed, even if they are not directly involved in the recycling. While toxic substances are dangerous to individuals at any age, children are more vulnerable as they are going through important developmental processes, and some adverse health impacts may have long-term impacts. We review the e-waste situation in Africa with a focus on threats to children's health.

Occupational Exposures to Phthalates among Black and Latina U.S. Hairdressers Serving an Ethnically Diverse Clientele: A Pilot Study

Hairdressers may be differentially exposed to phthalates through hair salon services provided and products used, yet no U.S. studies have investigated these exposures in this population. We characterized concentrations and exposure determinants to nine phthalate metabolites in postshift urine samples among 23 hairdressers from three Black and three Dominican salons, as well as a comparison group of 17 female office workers from the Maryland/Washington D.C. metropolitan area. Overall, hairdressers had higher metabolite concentrations than office workers. The geometric mean (GM) for monoethyl phthalate (MEP) was 10 times higher in hairdressers (161.4 ng/mL) than office workers (15.3 ng/mL). Hairdressers providing select services and using certain products had higher GM MEP concentrations than those who did not: permanent waves/texturizing (200.2 vs 115.4 ng/mL), chemical straightening/relaxing (181.6 vs 92.1 ng/mL), bleaching (182.3 vs 71.6 ng/mL), permanent hair color (171.9 vs 83.2 ng/mL), and Brazilian blowout/keratin treatments (181.4 vs 134.6 ng/mL). Interestingly, hairdressers providing natural services had lower GM MEP concentrations than those who did not: twists (129.1 vs 215.8 ng/mL), sister locs/locs (86.0 vs 241.9 ng/mL), and afros (94.7 vs 203.9 ng/mL). Larger studies are warranted to confirm our findings and identify disparities in occupational phthalate exposures.

Phthalate levels in urine of pregnant women and their associated missed abortion risk

Phthalates are one of the most common environmental endocrine disrupting chemicals (EDCs) in human contact. Prenatal phthalates exposure may adversely affect intrauterine growth, however, little is known about their association. This study aimed to explore the impact of phthalates on the risk of missed abortion. A total of 123 women with missed abortion (cases) and 148 normal pregnant women (controls) were simultaneously collected from Taiyuan, China. Four urinary phthalate metabolites were determined by high-performance liquid chromatography (HPLC). Logistic regression model was used to estimate odds ratios (ORs) and 95 % confidence intervals (95 % CI) of missed abortion associated with phthalate metabolite levels. Four phthalate metabolites, including monomethyl phthalate (MMP), monoethyl phthalate (MEP), monobutyl phthalate (MBP), monobenzyl phthalate (MBzP), were detected in at least 78.97 % of all participants, with the highest geometric mean concentration of 147.19 ng/mL for MEP of the urine samples. Both MMP (Z = -3.898, P < 0.001) and MBP (Z = -2.198, P = 0.028) concentrations were higher in cases than in controls. There were no significant differences for MEP (Z = -0.285, P = 0.076) and MBzP (Z = -0.878, P = 0.380) concentrations between cases and controls. Furthermore, Logistic analysis revealed that each one-unit increase in log-transformed MMP (OR = 1.49, 95 % CI = 1.14-1.95) was positively associated with missed abortion. Increasing risks of missed abortion were observed the third quartile (Q3) and the highest quartile (Q4) of MMP(OR = 2.21, 95 % CI = 1.06-4.60; OR = 2.85, 95 % CI = 1.34-6.05) compared to the lowest quartile (Q1) of MMP concentrations. We concluded that prenatal phthalates exposure may contribute to an increased risk of missed abortion.

Pollution characteristics, spatial variation, and potential risks of phthalate esters in the water-sediment system of the Yangtze River estuary and its adjacent East China Sea

Spatiotemporal variability in seawater, spatial variation in sediment, pollution characteristics, and risks related to 16 phthalate esters (PAEs) were investigated in the Yangtze River estuary and its adjacent East China Sea. The total concentrations of ΣPAEs in surface water were 0.588-17.7 μg L^-1 in summer, 2.63-22.9 μg L^-1 in winter, and 1.93-20.7 μg L^-1 in spring, with average values of 2.05, 10.2, and 4.89 μg L^-1, respectively. PAE concentrations exhibited notable seasonal variations with the highest value in winter and the lowest value in summer. The seasonal variation in PAE concentrations may be influenced by runoff and diluted water from the Yangtze River. The chemical composition of PAEs showed that di-n-butyl phthalate (DnBP), diisobutyl phthalate (DiBP), and di(2-ethylhexyl) phthalate (DEHP) had significantly higher (p < 0.05) concentrations than the other congeners and were the most abundant PAE species in sediment and seawater in all three seasons. In addition, DnBP and DiBP were the two main congeners in seawater, and DEHP concentrations were higher in sediment than in seawater. DEHP had higher potential risks to sensitive organisms in water environment than DnBP and DiBP, and DiBP and DnBP which presented high levels of risk in sedimentary environment. DMP and DEP in watery and sedimentary environments and DEHP in sedimentary environment showed no or low risks to sensitive organisms.

Short and medium-chain chlorinated paraffins in serum from residents aged from 50 to 84 in Jinan, China: Occurrence, composition and association with hematologic parameters

Human exposure to chlorinated paraffins (CPs) has been expected and assessed by external pathways considering their pervasive environmental occurrence. However, the deficiency of external exposure assessment in characterizing human burden is unavoidable. In addition, the associations between health outcomes and CP contents in human biospecimen are rarely assessed. In this study, we reported the occurrence and homologue profiles of short-chain chlorinated paraffins (SCCPs) and medium-chain chlorinated paraffins (MCCPs) in serum samples from 145 residents aged from 50 to 84 in Jinan, Shandong Province of China using quadrupole time-of-flight high-resolution mass spectrometry coupled with atmospheric pressure chemical ionization source operated in negative ion mode (APCI-qTOF-HRMS). The associations between serum CP concentrations and hematologic parameters were further analyzed by linear regression. We identified high level of ∑SCCPs (median = 107 ng/g wet weight, ww; 13,800 ng/g lipid, lw), ∑MCCPs (median = 134 ng/g ww; 15,200 ng/g lw) and elevated ∑MCCPs/∑SCCPs (median = 1.12) in serum of the studied population. C₁₃-CPs and C₁₄-CPs were the most abundant SCCP and MCCP groups, respectively. While the predominant chlorine homologues among SCCPs and MCCPs were Cl_7-8-CPs. ∑SCCPs, ∑MCCPs, ∑MCCPs/∑SCCPs and the homologue patterns presented no significant variance among age, sex and BMI groups. Further explorations suggested that perturbation of hematologic homeostasis could be induced by CP exposure in a sex-specific way, reflected by significant negative associations of serum SCCP and MCCP concentrations in lipid weight basis with sex-specific hematologic parameters. This study suffered from some limitations and should be interpreted with caution. However, the CP burdens of residents in China and the subsequent health risks must be underscored.

Multiple metal exposure and platelet counts during pregnancy: A repeated measure study

BACKGROUND

Evidence from animal and in vitro studies suggest that some metals interfere with normal platelet counts (PLT). However, limited human studies have investigated the association of metals and PLT, a marker of hematologic and hemostatic, particularly in susceptible populations such as pregnant women.

OBJECTIVES

Our purpose was to investigate the associations of repeated measures of 13 urinary metals with PLT during pregnancy.

METHODS

The present study involved 3911 pregnant women participating in a prospective cohort study in Wuhan, China, from 2013 to 2016. We measured 13 metals in urine and PLT in blood samples collected in the first, second, and third trimester (median = 13, 24, and 35 weeks of gestation, respectively). Mixed linear models and general linear models were applied to analyze the associations between multiple metals and PLT during pregnancy. The odds ratio (OR) for gestational thrombocytopenia was examined using generalized estimating equations.

RESULTS

After adjusting for other metals and covariates, the repeated measure analyses showed that decreased levels of PLT were associated with a 10-fold increase in urinary concentration of cadmium (Cd) [percent difference (%Δ) = -5.02, 95%CI = -9.53, -0.29], manganese (Mn) [percent difference (%Δ) = -4.63, 95%CI = -7.50, -1.67], and arsenic (As) [percent difference (%Δ) = -4.56, 95%CI = -8.11, -0.86]. Cross-sectional analyses by trimesters revealed that Cd was inversely associated with PLT through the three trimesters. In addition, Cd was associated with an increased OR of 1.80 (95%CI: 1.26, 2.56), 1.65 (95%CI: 1.05, 2.59), 1.54 (95%CI: 1.02, 2.33) for gestational thrombocytopenia in the first, second, and third trimester, respectively.

CONCLUSIONS

Our study suggested an association of Cd, Mn, and As with decreased PLT during pregnancy. Particularly, Cd may increase the risk of gestational thrombocytopenia.

Urinary levels of phthalate metabolites in women associated with risk of premature ovarian failure and reproductive hormones

Phthalates, a class of high production-volume chemicals widely used as plasticizers, have been shown to impair ovarian functions in female animals, but epidemiological evidence is very limited. In this case-control study, the associations between phthalate exposure and premature ovarian failure (POF) in women were assessed. A total of 173 POF cases and 246 control women were recruited in Zhejiang, China. The urinary concentrations of 8 phthalate metabolites and the serum levels of ovary-related hormones were determined. Mono-isobutyl phthalate (MiBP) was the metabolite with the highest median concentration of 27.23 μg/g of creatinine in the whole group. Compared with the lowest quartile, higher urinary concentrations of MiBP were significantly associated with increased odds of POF (OR = 1.38, 95% CI: 0.73-2.61 for the fourth quartile; p for trend = 0.01). The estradiol/FSH ratio, a marker of ovarian function, in control women was significantly negatively associated with the urinary concentrations of most tested phthalate metabolites. Our results suggest that exposure to some phthalates may impair ovarian function and increase the odds of POF in women.

Distribution and Dietary Predictors of Urinary Phthalate Metabolites among Pregnant Women in Shanghai, China

The exposure of pregnant women to phthalates is a major concern due to their adverse effect on developmental outcomes. Diet is an important pathway for exposure to phthalate compounds. Nevertheless, studies on dietary exposure of pregnant women to phthalates in China are limited. We aimed to assess the distribution and dietary predictors of phthalate exposure among pregnant women in China. We measured the levels of 10 urinary phthalate metabolites using high-performance liquid chromatography coupled with tandem mass spectrometry in 210 pregnant women as part of the 2015 China National Chronic Disease and Nutrition Survey in Shanghai. We assessed the urinary specific gravity-adjusted phthalate metabolite levels along with potential demographic and dietary predictors. Multivariable linear regression analysis was used to examine the relationship between each potential demographic variable and dietary predictor and urinary phthalate metabolites. Seven urinary phthalate metabolites were detected in >95% of pregnant women. The geometric mean (GM) of urinary phthalate biomarker values were highest for monobutyl phthalate (GM: 25.29 ng/mL) and monoisobutyl phthalate (GM:11.18 ng/mL). Multivariate regression analysis indicated that a lower educational level was associated with elevated urinary phthalate metabolite levels. Edible seaweed consumption had a positive correlation with urinary monoethyl phthalate and monoisobutyl phthalate levels, and the total molar sum of Di-(2-ethylhexyl) phthalate metabolites. These findings offer important data on the dietary exposure to phthalates in pregnant Chinese women and suggest interventions to improve food safety.

Human exposure to phthalate esters associated with e-waste dismantling: Exposure levels, sources, and risk assessment

Phthalate esters (PAEs) can be released into the environment during the dismantling of electronic waste (e-waste), but urinary levels of PAE metabolites (mPAEs) in humans living in e-waste sites have not been documented. In this study, 11 mPAEs were determined in urine samples collected from participants living in e-waste dismantling sites and a reference area in Southern China. The total urinary concentrations of the 11 mPAEs (∑mPAEs) in the e-waste sites (range: 11.1 ng/mL to 3380 ng/mL) were dominated by mono-(2-isobutyl) phthalate and mono-n-butyl phthalate. Participants living in the e-waste sites had significantly higher (p < 0.05) urinary concentrations of ∑mPAEs (and 5 individual mPAEs) than those in the reference area. Hence, e-waste dismantling activities contributed to human exposure to PAEs. The exposure doses of di-n-butyl phthalate, di(2-ethylhexyl)phthalate, di-iso-butyl phthalate, dimethyl phthalate, and diethyl phthalate were 3.41, 3.04, 1.37, 0.25, and 0.20 μg/kg bw/day, respectively. Furthermore, the health risk assessment in terms of hazard quotient and hazard index showed that approximately 22% of the participants living in the e-waste sites had HI values exceeding 1; importantly, 68% of them were non-adults (i.e., 0-18 years old). In the e-waste sites, 8 of the 11 mPAEs in urine samples had significantly positively associations (r = 0.185-0.358, p < 0.05) with the urinary concentration of 8-hydroxy-2'-deoxyguanosine, a marker of DNA oxidative stress. Therefore, people living in e-waste dismantling areas may have a potential health risk caused by PAE exposure. To the best of our knowledge, this study is the first to measure urinary mPAE levels in people living in e-waste dismantling areas.